Radiation dose delivery verification in the treatment of carcinoma-cervix

Energy Technology Data Exchange (ETDEWEB)

Shrotriya, D., E-mail: shrotriya2007@gmail.com; Srivastava, R. N. L. [Department of Radiotherapy, J.K. Cancer Institute Kanpur-208019 (India); Kumar, S. [Department of Physics, Christ Church College, Kanpur-208001 (India)

2015-06-24

The accurate dose delivery to the clinical target volume in radiotherapy can be affected by various pelvic tissues heterogeneities. An in-house heterogeneous woman pelvic phantom was designed and used to verify the consistency and computational capability of treatment planning system of radiation dose delivery in the treatment of cancer cervix. Oncentra 3D-TPS with collapsed cone convolution (CCC) dose calculation algorithm was used to generate AP/PA and box field technique plan. the radiation dose was delivered by Primus Linac (Siemens make) employing high energy 15 MV photon beam by isocenter technique. A PTW make, 0.125cc ionization chamber was used for direct measurements at various reference points in cervix, bladder and rectum. The study revealed that maximum variation between computed and measured dose at cervix reference point was 1% in both the techniques and 3% and 4% variation in AP/PA field and 5% and 4.5% in box technique at bladder and rectum points respectively.

Evaluation of DVH-based treatment plan verification in addition to gamma passing rates for head and neck IMRT

International Nuclear Information System (INIS)

Visser, Ruurd; Wauben, David J.L.; Groot, Martijn de; Steenbakkers, Roel J.H.M.; Bijl, Henk P.; Godart, Jeremy; Veld, Aart A. van’t; Langendijk, Johannes A.; Korevaar, Erik W.

2014-01-01

Background and purpose: Treatment plan verification of intensity modulated radiotherapy (IMRT) is generally performed with the gamma index (GI) evaluation method, which is difficult to extrapolate to clinical implications. Incorporating Dose Volume Histogram (DVH) information can compensate for this. The aim of this study was to evaluate DVH-based treatment plan verification in addition to the GI evaluation method for head and neck IMRT. Materials and methods: Dose verifications of 700 subsequent head and neck cancer IMRT treatment plans were categorised according to gamma and DVH-based action levels. Fractionation dependent absolute dose limits were chosen. The results of the gamma- and DVH-based evaluations were compared to the decision of the medical physicist and/or radiation oncologist for plan acceptance. Results: Nearly all treatment plans (99.7%) were accepted for treatment according to the GI evaluation combined with DVH-based verification. Two treatment plans were re-planned according to DVH-based verification, which would have been accepted using the evaluation alone. DVH-based verification increased insight into dose delivery to patient specific structures increasing confidence that the treatment plans were clinically acceptable. Moreover, DVH-based action levels clearly distinguished the role of the medical physicist and radiation oncologist within the Quality Assurance (QA) procedure. Conclusions: DVH-based treatment plan verification complements the GI evaluation method improving head and neck IMRT-QA

SU-E-T-375: Evaluation of a MapCHECK2(tm) Planar 2-D Diode Array for High-Dose-Rate Brachytherapy Treatment Delivery Verifications

Energy Technology Data Exchange (ETDEWEB)

Macey, N; Siebert, M; Shvydka, D; Parsai, E [University of Toledo Medical Center, Toledo, OH (United States)

2015-06-15

Purpose: Despite improvements of HDR brachytherapy delivery systems, verification of source position is still typically based on the length of the wire reeled out relative to the parked position. Yet, the majority of errors leading to medical events in HDR treatments continue to be classified as missed targets or wrong treatment sites. We investigate the feasibility of using dose maps acquired with a two-dimensional diode array to independently verify the source locations, dwell times, and dose during an HDR treatment. Methods: Custom correction factors were integrated into frame-by-frame raw counts recorded for a Varian VariSource™ HDR afterloader Ir-192 source located at various distances in air and in solid water from a MapCHECK2™ diode array. The resultant corrected counts were analyzed to determine the dwell position locations and doses delivered. The local maxima of polynomial equations fitted to the extracted dwell dose profiles provided the X and Y coordinates while the distance to the source was determined from evaluation of the full width at half maximum (FWHM). To verify the approach, the experiment was repeated as the source was moved through dwell positions at various distances along an inclined plane, mimicking a vaginal cylinder treatment. Results: Dose map analysis was utilized to provide the coordinates of the source and dose delivered over each dwell position. The accuracy in determining source dwell positions was found to be +/−1.0 mm of the preset values, and doses within +/−3% of those calculated by the BrachyVision™ treatment planning system for all measured distances. Conclusion: Frame-by-frame data furnished by a 2 -D diode array can be used to verify the dwell positions and doses delivered by the HDR source over the course of treatment. Our studies have verified that measurements provided by the MapCHECK2™ can be used as a routine QA tool for HDR treatment delivery verification.

First Experience With Real-Time EPID-Based Delivery Verification During IMRT and VMAT Sessions

International Nuclear Information System (INIS)

Woodruff, Henry C.; Fuangrod, Todsaporn; Van Uytven, Eric; McCurdy, Boyd M.C.; Beek, Timothy van; Bhatia, Shashank; Greer, Peter B.

2015-01-01

Purpose: Gantry-mounted megavoltage electronic portal imaging devices (EPIDs) have become ubiquitous on linear accelerators. WatchDog is a novel application of EPIDs, in which the image frames acquired during treatment are used to monitor treatment delivery in real time. We report on the preliminary use of WatchDog in a prospective study of cancer patients undergoing intensity modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT) and identify the challenges of clinical adoption. Methods and Materials: At the time of submission, 28 cancer patients (head and neck, pelvis, and prostate) undergoing fractionated external beam radiation therapy (24 IMRT, 4 VMAT) had ≥1 treatment fraction verified in real time (131 fractions or 881 fields). EPID images acquired continuously during treatment were synchronized and compared with model-generated transit EPID images within a frame time (∼0.1 s). A χ comparison was performed to cumulative frames to gauge the overall delivery quality, and the resulting pass rates were reported graphically during treatment delivery. Every frame acquired (500-1500 per fraction) was saved for postprocessing and analysis. Results: The system reported the mean ± standard deviation in real time χ 91.1% ± 11.5% (83.6% ± 13.2%) for cumulative frame χ analysis with 4%, 4 mm (3%, 3 mm) criteria, global over the integrated image. Conclusions: A real-time EPID-based radiation delivery verification system for IMRT and VMAT has been demonstrated that aims to prevent major mistreatments in radiation therapy.

First Experience With Real-Time EPID-Based Delivery Verification During IMRT and VMAT Sessions

Energy Technology Data Exchange (ETDEWEB)

Woodruff, Henry C., E-mail: henry.woodruff@newcastle.edu.au [Faculty of Science and Information Technology, School of Mathematical and Physical Sciences, University of Newcastle, New South Wales (Australia); Fuangrod, Todsaporn [Faculty of Engineering and Built Environment, School of Electrical Engineering and Computer Science, University of Newcastle, New South Wales (Australia); Van Uytven, Eric; McCurdy, Boyd M.C.; Beek, Timothy van [Division of Medical Physics, CancerCare Manitoba, Winnipeg, Manitoba (Canada); Department of Physics and Astronomy, University of Manitoba, Winnipeg, Manitoba (Canada); Department of Radiology, University of Manitoba, Winnipeg, Manitoba (Canada); Bhatia, Shashank [Department of Radiation Oncology, Calvary Mater Newcastle Hospital, Newcastle, New South Wales (Australia); Greer, Peter B. [Faculty of Science and Information Technology, School of Mathematical and Physical Sciences, University of Newcastle, New South Wales (Australia); Department of Radiation Oncology, Calvary Mater Newcastle Hospital, Newcastle, New South Wales (Australia)

2015-11-01

Purpose: Gantry-mounted megavoltage electronic portal imaging devices (EPIDs) have become ubiquitous on linear accelerators. WatchDog is a novel application of EPIDs, in which the image frames acquired during treatment are used to monitor treatment delivery in real time. We report on the preliminary use of WatchDog in a prospective study of cancer patients undergoing intensity modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT) and identify the challenges of clinical adoption. Methods and Materials: At the time of submission, 28 cancer patients (head and neck, pelvis, and prostate) undergoing fractionated external beam radiation therapy (24 IMRT, 4 VMAT) had ≥1 treatment fraction verified in real time (131 fractions or 881 fields). EPID images acquired continuously during treatment were synchronized and compared with model-generated transit EPID images within a frame time (∼0.1 s). A χ comparison was performed to cumulative frames to gauge the overall delivery quality, and the resulting pass rates were reported graphically during treatment delivery. Every frame acquired (500-1500 per fraction) was saved for postprocessing and analysis. Results: The system reported the mean ± standard deviation in real time χ 91.1% ± 11.5% (83.6% ± 13.2%) for cumulative frame χ analysis with 4%, 4 mm (3%, 3 mm) criteria, global over the integrated image. Conclusions: A real-time EPID-based radiation delivery verification system for IMRT and VMAT has been demonstrated that aims to prevent major mistreatments in radiation therapy.

Computer-controlled 3-D treatment delivery

International Nuclear Information System (INIS)

Fraass, Benedick A.

1995-01-01

-controlled scanned beam treatments will also be discussed. CCRT-related approaches to treatment plan generation and transfer, accelerator control systems, treatment delivery, verification, documentation and charting will also be discussed, including the importance of real-time portal imaging for conformal therapy. The potential benefits of 3-D computer-controlled conformal treatment delivery will be illustrated with results from on-going clinical dose escalation and normal tissue complication studies. Conclusion: A large amount of interest in computer-controlled conformal treatment delivery techniques has developed in recent years. This presentation will attempt to summarize the current status of clinical and research work in 3-D computer-controlled conformal therapy treatment techniques. Particular attention is paid to issues related to implementation and clinical use of this developing treatment modality

An in vivo dose verification method for SBRT–VMAT delivery using the EPID

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McCowan, P. M., E-mail: peter.mccowan@cancercare.mb.ca [Department of Physics and Astronomy, University of Manitoba, Winnipeg, Manitoba R3T 2N2 (Canada); Medical Physics Department, CancerCare Manitoba, 675 McDermot Avenue, Winnipeg, Manitoba R3E 0V9 (Canada); Van Uytven, E.; Van Beek, T.; Asuni, G. [Medical Physics Department, CancerCare Manitoba, 675 McDermot Avenue, Winnipeg, Manitoba R3E 0V9 (Canada); McCurdy, B. M. C. [Department of Physics and Astronomy, University of Manitoba, Winnipeg, Manitoba R3T 2N2 (Canada); Medical Physics Department, CancerCare Manitoba, 675 McDermot Avenue, Winnipeg, Manitoba R3E 0V9 (Canada); Department of Radiology, University of Manitoba, 820 Sherbrook Street, Winnipeg, Manitoba R3A 1R9 (Canada)

2015-12-15

Purpose: Radiation treatments have become increasingly more complex with the development of volumetric modulated arc therapy (VMAT) and the use of stereotactic body radiation therapy (SBRT). SBRT involves the delivery of substantially larger doses over fewer fractions than conventional therapy. SBRT–VMAT treatments will strongly benefit from in vivo patient dose verification, as any errors in delivery can be more detrimental to the radiobiology of the patient as compared to conventional therapy. Electronic portal imaging devices (EPIDs) are available on most commercial linear accelerators (Linacs) and their documented use for dosimetry makes them valuable tools for patient dose verification. In this work, the authors customize and validate a physics-based model which utilizes on-treatment EPID images to reconstruct the 3D dose delivered to the patient during SBRT–VMAT delivery. Methods: The SBRT Linac head, including jaws, multileaf collimators, and flattening filter, were modeled using Monte Carlo methods and verified with measured data. The simulation provides energy spectrum data that are used by their “forward” model to then accurately predict fluence generated by a SBRT beam at a plane above the patient. This fluence is then transported through the patient and then the dose to the phosphor layer in the EPID is calculated. Their “inverse” model back-projects the EPID measured focal fluence to a plane upstream of the patient and recombines it with the extra-focal fluence predicted by the forward model. This estimate of total delivered fluence is then forward projected onto the patient’s density matrix and a collapsed cone convolution algorithm calculates the dose delivered to the patient. The model was tested by reconstructing the dose for two prostate, three lung, and two spine SBRT–VMAT treatment fractions delivered to an anthropomorphic phantom. It was further validated against actual patient data for a lung and spine SBRT–VMAT plan. The

Clinical Experience and Evaluation of Patient Treatment Verification With a Transit Dosimeter

Energy Technology Data Exchange (ETDEWEB)

Ricketts, Kate, E-mail: k.ricketts@ucl.ac.uk [Division of Surgery and Interventional Sciences, University College London, London (United Kingdom); Department of Radiotherapy Physics, Royal Berkshire NHS Foundation Trust, Reading (United Kingdom); Navarro, Clara; Lane, Katherine; Blowfield, Claire; Cotten, Gary; Tomala, Dee; Lord, Christine; Jones, Joanne; Adeyemi, Abiodun [Department of Radiotherapy Physics, Royal Berkshire NHS Foundation Trust, Reading (United Kingdom)

2016-08-01

Purpose: To prospectively evaluate a protocol for transit dosimetry on a patient population undergoing intensity modulated radiation therapy (IMRT) and to assess the issues in clinical implementation of electronic portal imaging devices (EPIDs) for treatment verification. Methods and Materials: Fifty-eight patients were enrolled in the study. Amorphous silicon EPIDs were calibrated for dose and used to acquire images of delivered fields. Measured EPID dose maps were back-projected using the planning computed tomographic (CT) images to calculate dose at prespecified points within the patient and compared with treatment planning system dose offline using point dose difference and point γ analysis. The deviation of the results was used to inform future action levels. Results: Two hundred twenty-five transit images were analyzed, composed of breast, prostate, and head and neck IMRT fields. Patient measurements demonstrated the potential of the dose verification protocol to model dose well under complex conditions: 83.8% of all delivered beams achieved the initial set tolerance level of Δ{sub D} of 0 ± 5 cGy or %Δ{sub D} of 0% ± 5%. Importantly, the protocol was also sensitive to anatomic changes and spotted that 3 patients from 20 measured prostate patients had undergone anatomic change in comparison with the planning CT. Patient data suggested an EPID-reconstructed versus treatment planning system dose difference action level of 0% ± 7% for breast fields. Asymmetric action levels were more appropriate for inversed IMRT fields, using absolute dose difference (−2 ± 5 cGy) or summed field percentage dose difference (−6% ± 7%). Conclusions: The in vivo dose verification method was easy to use and simple to implement, and it could detect patient anatomic changes that impacted dose delivery. The system required no extra dose to the patient or treatment time delay and so could be used throughout the course of treatment to identify and limit

Clinical application of in vivo treatment delivery verification based on PET/CT imaging of positron activity induced at high energy photon therapy

Science.gov (United States)

Janek Strååt, Sara; Andreassen, Björn; Jonsson, Cathrine; Noz, Marilyn E.; Maguire, Gerald Q., Jr.; Näfstadius, Peder; Näslund, Ingemar; Schoenahl, Frederic; Brahme, Anders

2013-08-01

The purpose of this study was to investigate in vivo verification of radiation treatment with high energy photon beams using PET/CT to image the induced positron activity. The measurements of the positron activation induced in a preoperative rectal cancer patient and a prostate cancer patient following 50 MV photon treatments are presented. A total dose of 5 and 8 Gy, respectively, were delivered to the tumors. Imaging was performed with a 64-slice PET/CT scanner for 30 min, starting 7 min after the end of the treatment. The CT volume from the PET/CT and the treatment planning CT were coregistered by matching anatomical reference points in the patient. The treatment delivery was imaged in vivo based on the distribution of the induced positron emitters produced by photonuclear reactions in tissue mapped on to the associated dose distribution of the treatment plan. The results showed that spatial distribution of induced activity in both patients agreed well with the delivered beam portals of the treatment plans in the entrance subcutaneous fat regions but less so in blood and oxygen rich soft tissues. For the preoperative rectal cancer patient however, a 2 ± (0.5) cm misalignment was observed in the cranial-caudal direction of the patient between the induced activity distribution and treatment plan, indicating a beam patient setup error. No misalignment of this kind was seen in the prostate cancer patient. However, due to a fast patient setup error in the PET/CT scanner a slight mis-position of the patient in the PET/CT was observed in all three planes, resulting in a deformed activity distribution compared to the treatment plan. The present study indicates that the induced positron emitters by high energy photon beams can be measured quite accurately using PET imaging of subcutaneous fat to allow portal verification of the delivered treatment beams. Measurement of the induced activity in the patient 7 min after receiving 5 Gy involved count rates which were about

Online 3D EPID-based dose verification: Proof of concept

Energy Technology Data Exchange (ETDEWEB)

Spreeuw, Hanno; Rozendaal, Roel, E-mail: r.rozendaal@nki.nl; Olaciregui-Ruiz, Igor; González, Patrick; Mans, Anton; Mijnheer, Ben [Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam 1066 CX (Netherlands); Herk, Marcel van [University of Manchester, Manchester Academic Health Science Centre, The Christie NHS Foundation Trust, Manchester M20 4BX (United Kingdom)

2016-07-15

Purpose: Delivery errors during radiotherapy may lead to medical harm and reduced life expectancy for patients. Such serious incidents can be avoided by performing dose verification online, i.e., while the patient is being irradiated, creating the possibility of halting the linac in case of a large overdosage or underdosage. The offline EPID-based 3D in vivo dosimetry system clinically employed at our institute is in principle suited for online treatment verification, provided the system is able to complete 3D dose reconstruction and verification within 420 ms, the present acquisition time of a single EPID frame. It is the aim of this study to show that our EPID-based dosimetry system can be made fast enough to achieve online 3D in vivo dose verification. Methods: The current dose verification system was sped up in two ways. First, a new software package was developed to perform all computations that are not dependent on portal image acquisition separately, thus removing the need for doing these calculations in real time. Second, the 3D dose reconstruction algorithm was sped up via a new, multithreaded implementation. Dose verification was implemented by comparing planned with reconstructed 3D dose distributions delivered to two regions in a patient: the target volume and the nontarget volume receiving at least 10 cGy. In both volumes, the mean dose is compared, while in the nontarget volume, the near-maximum dose (D2) is compared as well. The real-time dosimetry system was tested by irradiating an anthropomorphic phantom with three VMAT plans: a 6 MV head-and-neck treatment plan, a 10 MV rectum treatment plan, and a 10 MV prostate treatment plan. In all plans, two types of serious delivery errors were introduced. The functionality of automatically halting the linac was also implemented and tested. Results: The precomputation time per treatment was ∼180 s/treatment arc, depending on gantry angle resolution. The complete processing of a single portal frame

Online 3D EPID-based dose verification: Proof of concept

International Nuclear Information System (INIS)

Spreeuw, Hanno; Rozendaal, Roel; Olaciregui-Ruiz, Igor; González, Patrick; Mans, Anton; Mijnheer, Ben; Herk, Marcel van

2016-01-01

Purpose: Delivery errors during radiotherapy may lead to medical harm and reduced life expectancy for patients. Such serious incidents can be avoided by performing dose verification online, i.e., while the patient is being irradiated, creating the possibility of halting the linac in case of a large overdosage or underdosage. The offline EPID-based 3D in vivo dosimetry system clinically employed at our institute is in principle suited for online treatment verification, provided the system is able to complete 3D dose reconstruction and verification within 420 ms, the present acquisition time of a single EPID frame. It is the aim of this study to show that our EPID-based dosimetry system can be made fast enough to achieve online 3D in vivo dose verification. Methods: The current dose verification system was sped up in two ways. First, a new software package was developed to perform all computations that are not dependent on portal image acquisition separately, thus removing the need for doing these calculations in real time. Second, the 3D dose reconstruction algorithm was sped up via a new, multithreaded implementation. Dose verification was implemented by comparing planned with reconstructed 3D dose distributions delivered to two regions in a patient: the target volume and the nontarget volume receiving at least 10 cGy. In both volumes, the mean dose is compared, while in the nontarget volume, the near-maximum dose (D2) is compared as well. The real-time dosimetry system was tested by irradiating an anthropomorphic phantom with three VMAT plans: a 6 MV head-and-neck treatment plan, a 10 MV rectum treatment plan, and a 10 MV prostate treatment plan. In all plans, two types of serious delivery errors were introduced. The functionality of automatically halting the linac was also implemented and tested. Results: The precomputation time per treatment was ∼180 s/treatment arc, depending on gantry angle resolution. The complete processing of a single portal frame

Online 3D EPID-based dose verification: Proof of concept.

Science.gov (United States)

Spreeuw, Hanno; Rozendaal, Roel; Olaciregui-Ruiz, Igor; González, Patrick; Mans, Anton; Mijnheer, Ben; van Herk, Marcel

2016-07-01

Delivery errors during radiotherapy may lead to medical harm and reduced life expectancy for patients. Such serious incidents can be avoided by performing dose verification online, i.e., while the patient is being irradiated, creating the possibility of halting the linac in case of a large overdosage or underdosage. The offline EPID-based 3D in vivo dosimetry system clinically employed at our institute is in principle suited for online treatment verification, provided the system is able to complete 3D dose reconstruction and verification within 420 ms, the present acquisition time of a single EPID frame. It is the aim of this study to show that our EPID-based dosimetry system can be made fast enough to achieve online 3D in vivo dose verification. The current dose verification system was sped up in two ways. First, a new software package was developed to perform all computations that are not dependent on portal image acquisition separately, thus removing the need for doing these calculations in real time. Second, the 3D dose reconstruction algorithm was sped up via a new, multithreaded implementation. Dose verification was implemented by comparing planned with reconstructed 3D dose distributions delivered to two regions in a patient: the target volume and the nontarget volume receiving at least 10 cGy. In both volumes, the mean dose is compared, while in the nontarget volume, the near-maximum dose (D2) is compared as well. The real-time dosimetry system was tested by irradiating an anthropomorphic phantom with three VMAT plans: a 6 MV head-and-neck treatment plan, a 10 MV rectum treatment plan, and a 10 MV prostate treatment plan. In all plans, two types of serious delivery errors were introduced. The functionality of automatically halting the linac was also implemented and tested. The precomputation time per treatment was ∼180 s/treatment arc, depending on gantry angle resolution. The complete processing of a single portal frame, including dose verification, took

Quantitative analysis of patient-specific dosimetric IMRT verification

International Nuclear Information System (INIS)

Budgell, G J; Perrin, B A; Mott, J H L; Fairfoul, J; Mackay, R I

2005-01-01

Patient-specific dosimetric verification methods for IMRT treatments are variable, time-consuming and frequently qualitative, preventing evidence-based reduction in the amount of verification performed. This paper addresses some of these issues by applying a quantitative analysis parameter to the dosimetric verification procedure. Film measurements in different planes were acquired for a series of ten IMRT prostate patients, analysed using the quantitative parameter, and compared to determine the most suitable verification plane. Film and ion chamber verification results for 61 patients were analysed to determine long-term accuracy, reproducibility and stability of the planning and delivery system. The reproducibility of the measurement and analysis system was also studied. The results show that verification results are strongly dependent on the plane chosen, with the coronal plane particularly insensitive to delivery error. Unexpectedly, no correlation could be found between the levels of error in different verification planes. Longer term verification results showed consistent patterns which suggest that the amount of patient-specific verification can be safely reduced, provided proper caution is exercised: an evidence-based model for such reduction is proposed. It is concluded that dose/distance to agreement (e.g., 3%/3 mm) should be used as a criterion of acceptability. Quantitative parameters calculated for a given criterion of acceptability should be adopted in conjunction with displays that show where discrepancies occur. Planning and delivery systems which cannot meet the required standards of accuracy, reproducibility and stability to reduce verification will not be accepted by the radiotherapy community

Independent verification of monitor unit calculation for radiation treatment planning system.

Science.gov (United States)

Chen, Li; Chen, Li-Xin; Huang, Shao-Min; Sun, Wen-Zhao; Sun, Hong-Qiang; Deng, Xiao-Wu

2010-02-01

To ensure the accuracy of dose calculation for radiation treatment plans is an important part of quality assurance (QA) procedures for radiotherapy. This study evaluated the Monitor Units (MU) calculation accuracy of a third-party QA software and a 3-dimensional treatment planning system (3D TPS), to investigate the feasibility and reliability of independent verification for radiation treatment planning. Test plans in a homogenous phantom were designed with 3-D TPS, according to the International Atomic Energy Agency (IAEA) Technical Report No. 430, including open, blocked, wedge, and multileaf collimator (MLC) fields. Test plans were delivered and measured in the phantom. The delivered doses were input to the QA software and the independent calculated MUs were compared with delivery. All test plans were verified with independent calculation and phantom measurements separately, and the differences of the two kinds of verification were then compared. The deviation of the independent calculation to the measurements was (0.1 +/- 0.9)%, the biggest difference fell onto the plans that used block and wedge fields (2.0%). The mean MU difference between the TPS and the QA software was (0.6 +/- 1.0)%, ranging from -0.8% to 2.8%. The deviation in dose of the TPS calculation compared to the measurements was (-0.2 +/- 1.7)%, ranging from -3.9% to 2.9%. MU accuracy of the third-party QA software is clinically acceptable. Similar results were achieved with the independent calculations and the phantom measurements for all test plans. The tested independent calculation software can be used as an efficient tool for TPS plan verification.

Verification of Gamma Knife extend system based fractionated treatment planning using EBT2 film

Energy Technology Data Exchange (ETDEWEB)

Natanasabapathi, Gopishankar; Bisht, Raj Kishor [Gamma Knife Unit, Department of Neurosurgery, Neurosciences Centre, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029 (India)

2013-12-15

Purpose: This paper presents EBT2 film verification of fractionated treatment planning with the Gamma Knife (GK) extend system, a relocatable frame system for multiple-fraction or serial multiple-session radiosurgery.Methods: A human head shaped phantom simulated the verification process for fractionated Gamma Knife treatment. Phantom preparation for Extend Frame based treatment planning involved creating a dental impression, fitting the phantom to the frame system, and acquiring a stereotactic computed tomography (CT) scan. A CT scan (Siemens, Emotion 6) of the phantom was obtained with following parameters: Tube voltage—110 kV, tube current—280 mA, pixel size—0.5 × 0.5 and 1 mm slice thickness. A treatment plan with two 8 mm collimator shots and three sectors blocking in each shot was made. Dose prescription of 4 Gy at 100% was delivered for the first fraction out of the two fractions planned. Gafchromic EBT2 film (ISP Wayne, NJ) was used as 2D verification dosimeter in this process. Films were cut and placed inside the film insert of the phantom for treatment dose delivery. Meanwhile a set of films from the same batch were exposed from 0 to 12 Gy doses for calibration purposes. An EPSON (Expression 10000 XL) scanner was used for scanning the exposed films in transparency mode. Scanned films were analyzed with inhouse written MATLAB codes.Results: Gamma index analysis of film measurement in comparison with TPS calculated dose resulted in high pass rates >90% for tolerance criteria of 1%/1 mm. The isodose overlay and linear dose profiles of film measured and computed dose distribution on sagittal and coronal plane were in close agreement.Conclusions: Through this study, the authors propose treatment verification QA method for Extend frame based fractionated Gamma Knife radiosurgery using EBT2 film.

Verification of Gamma Knife extend system based fractionated treatment planning using EBT2 film

International Nuclear Information System (INIS)

Natanasabapathi, Gopishankar; Bisht, Raj Kishor

2013-01-01

Purpose: This paper presents EBT2 film verification of fractionated treatment planning with the Gamma Knife (GK) extend system, a relocatable frame system for multiple-fraction or serial multiple-session radiosurgery.Methods: A human head shaped phantom simulated the verification process for fractionated Gamma Knife treatment. Phantom preparation for Extend Frame based treatment planning involved creating a dental impression, fitting the phantom to the frame system, and acquiring a stereotactic computed tomography (CT) scan. A CT scan (Siemens, Emotion 6) of the phantom was obtained with following parameters: Tube voltage—110 kV, tube current—280 mA, pixel size—0.5 × 0.5 and 1 mm slice thickness. A treatment plan with two 8 mm collimator shots and three sectors blocking in each shot was made. Dose prescription of 4 Gy at 100% was delivered for the first fraction out of the two fractions planned. Gafchromic EBT2 film (ISP Wayne, NJ) was used as 2D verification dosimeter in this process. Films were cut and placed inside the film insert of the phantom for treatment dose delivery. Meanwhile a set of films from the same batch were exposed from 0 to 12 Gy doses for calibration purposes. An EPSON (Expression 10000 XL) scanner was used for scanning the exposed films in transparency mode. Scanned films were analyzed with inhouse written MATLAB codes.Results: Gamma index analysis of film measurement in comparison with TPS calculated dose resulted in high pass rates >90% for tolerance criteria of 1%/1 mm. The isodose overlay and linear dose profiles of film measured and computed dose distribution on sagittal and coronal plane were in close agreement.Conclusions: Through this study, the authors propose treatment verification QA method for Extend frame based fractionated Gamma Knife radiosurgery using EBT2 film

A multi-professional software tool for radiation therapy treatment verification

International Nuclear Information System (INIS)

Fox, Tim; Brooks, Ken; Davis, Larry

1996-01-01

Purpose: Verification of patient setup is important in conformal therapy because it provides a means of quality assurance for treatment delivery. Electronic portal imaging systems have led to software tools for performing digital comparison and verification of patient setup. However, these software tools are typically designed from a radiation oncologist's perspective even though treatment verification is a team effort involving oncologists, physicists, and therapists. A new software tool, Treatment Verification Tool (TVT), has been developed as an interactive, multi-professional application for reviewing and verifying treatment plan setup using conventional personal computers. This study will describe our approach to electronic treatment verification and demonstrate the features of TVT. Methods and Materials: TVT is an object-oriented software tool written in C++ using the PC-based Windows NT environment. The software utilizes the selection of a patient's images from a database. The software is also developed as a single window interface to reduce the amount of windows presented to the user. However, the user can select from four different possible views of the patient data. One of the views is side-by-side comparison of portal images (on-line portal images or digitized port film) with a prescription image (digitized simulator film or digitally reconstructed radiograph), and another view is a textual summary of the grades of each portal image. The grades of a portal image are assigned by a radiation oncologist using an evaluation method, and the physicists and therapists may only review these results. All users of TVT can perform image enhancement processes, measure distances, and perform semi-automated registration methods. An electronic dialogue can be established through a set of annotations and notes among the radiation oncologists and the technical staff. Results: Features of TVT include: 1) side-by-side comparison of portal images and a prescription image; 2

SU-G-TeP4-08: Automating the Verification of Patient Treatment Parameters

Energy Technology Data Exchange (ETDEWEB)

DiCostanzo, D; Ayan, A; Woollard, J; Gupta, N [The Ohio State University, Columbus, OH (United States)

2016-06-15

Purpose: To automate the daily verification of each patient’s treatment by utilizing the trajectory log files (TLs) written by the Varian TrueBeam linear accelerator while reducing the number of false positives including jaw and gantry positioning errors, that are displayed in the Treatment History tab of Varian’s Chart QA module. Methods: Small deviations in treatment parameters are difficult to detect in weekly chart checks, but may be significant in reducing delivery errors, and would be critical if detected daily. Software was developed in house to read TLs. Multiple functions were implemented within the software that allow it to operate via a GUI to analyze TLs, or as a script to run on a regular basis. In order to determine tolerance levels for the scripted analysis, 15,241 TLs from seven TrueBeams were analyzed. The maximum error of each axis for each TL was written to a CSV file and statistically analyzed to determine the tolerance for each axis accessible in the TLs to flag for manual review. The software/scripts developed were tested by varying the tolerance values to ensure veracity. After tolerances were determined, multiple weeks of manual chart checks were performed simultaneously with the automated analysis to ensure validity. Results: The tolerance values for the major axis were determined to be, 0.025 degrees for the collimator, 1.0 degree for the gantry, 0.002cm for the y-jaws, 0.01cm for the x-jaws, and 0.5MU for the MU. The automated verification of treatment parameters has been in clinical use for 4 months. During that time, no errors in machine delivery of the patient treatments were found. Conclusion: The process detailed here is a viable and effective alternative to manually checking treatment parameters during weekly chart checks.

Reduction of treatment delivery variances with a computer-controlled treatment delivery system

International Nuclear Information System (INIS)

Fraass, B.A.; Lash, K.L.; Matrone, G.M.; Lichter, A.S.

1997-01-01

Purpose: To analyze treatment delivery variances for 3-D conformal therapy performed at various levels of treatment delivery automation, ranging from manual field setup to virtually complete computer-controlled treatment delivery using a computer-controlled conformal radiotherapy system. Materials and Methods: All external beam treatments performed in our department during six months of 1996 were analyzed to study treatment delivery variances versus treatment complexity. Treatments for 505 patients (40,641 individual treatment ports) on four treatment machines were studied. All treatment variances noted by treatment therapists or quality assurance reviews (39 in all) were analyzed. Machines 'M1' (CLinac (6(100))) and 'M2' (CLinac 1800) were operated in a standard manual setup mode, with no record and verify system (R/V). Machines 'M3' (CLinac 2100CD/MLC) and ''M4'' (MM50 racetrack microtron system with MLC) treated patients under the control of a computer-controlled conformal radiotherapy system (CCRS) which 1) downloads the treatment delivery plan from the planning system, 2) performs some (or all) of the machine set-up and treatment delivery for each field, 3) monitors treatment delivery, 4) records all treatment parameters, and 5) notes exceptions to the electronically-prescribed plan. Complete external computer control is not available on M3, so it uses as many CCRS features as possible, while M4 operates completely under CCRS control and performs semi-automated and automated multi-segment intensity modulated treatments. Analysis of treatment complexity was based on numbers of fields, individual segments (ports), non-axial and non-coplanar plans, multi-segment intensity modulation, and pseudo-isocentric treatments (and other plans with computer-controlled table motions). Treatment delivery time was obtained from the computerized scheduling system (for manual treatments) or from CCRS system logs. Treatment therapists rotate among the machines, so this analysis

TH-AB-202-02: Real-Time Verification and Error Detection for MLC Tracking Deliveries Using An Electronic Portal Imaging Device

International Nuclear Information System (INIS)

J Zwan, B; Colvill, E; Booth, J; J O’Connor, D; Keall, P; B Greer, P

2016-01-01

Purpose: The added complexity of the real-time adaptive multi-leaf collimator (MLC) tracking increases the likelihood of undetected MLC delivery errors. In this work we develop and test a system for real-time delivery verification and error detection for MLC tracking radiotherapy using an electronic portal imaging device (EPID). Methods: The delivery verification system relies on acquisition and real-time analysis of transit EPID image frames acquired at 8.41 fps. In-house software was developed to extract the MLC positions from each image frame. Three comparison metrics were used to verify the MLC positions in real-time: (1) field size, (2) field location and, (3) field shape. The delivery verification system was tested for 8 VMAT MLC tracking deliveries (4 prostate and 4 lung) where real patient target motion was reproduced using a Hexamotion motion stage and a Calypso system. Sensitivity and detection delay was quantified for various types of MLC and system errors. Results: For both the prostate and lung test deliveries the MLC-defined field size was measured with an accuracy of 1.25 cm 2 (1 SD). The field location was measured with an accuracy of 0.6 mm and 0.8 mm (1 SD) for lung and prostate respectively. Field location errors (i.e. tracking in wrong direction) with a magnitude of 3 mm were detected within 0.4 s of occurrence in the X direction and 0.8 s in the Y direction. Systematic MLC gap errors were detected as small as 3 mm. The method was not found to be sensitive to random MLC errors and individual MLC calibration errors up to 5 mm. Conclusion: EPID imaging may be used for independent real-time verification of MLC trajectories during MLC tracking deliveries. Thresholds have been determined for error detection and the system has been shown to be sensitive to a range of delivery errors.

MO-FG-202-01: A Fast Yet Sensitive EPID-Based Real-Time Treatment Verification System

International Nuclear Information System (INIS)

Ahmad, M; Nourzadeh, H; Neal, B; Siebers, J; Watkins, W

2016-01-01

Purpose: To create a real-time EPID-based treatment verification system which robustly detects treatment delivery and patient attenuation variations. Methods: Treatment plan DICOM files sent to the record-and-verify system are captured and utilized to predict EPID images for each planned control point using a modified GPU-based digitally reconstructed radiograph algorithm which accounts for the patient attenuation, source energy fluence, source size effects, and MLC attenuation. The DICOM and predicted images are utilized by our C++ treatment verification software which compares EPID acquired 1024×768 resolution frames acquired at ∼8.5hz from Varian Truebeam™ system. To maximize detection sensitivity, image comparisons determine (1) if radiation exists outside of the desired treatment field; (2) if radiation is lacking inside the treatment field; (3) if translations, rotations, and magnifications of the image are within tolerance. Acquisition was tested with known test fields and prior patient fields. Error detection was tested in real-time and utilizing images acquired during treatment with another system. Results: The computational time of the prediction algorithms, for a patient plan with 350 control points and 60×60×42cm^3 CT volume, is 2–3minutes on CPU and <27 seconds on GPU for 1024×768 images. The verification software requires a maximum of ∼9ms and ∼19ms for 512×384 and 1024×768 resolution images, respectively, to perform image analysis and dosimetric validations. Typical variations in geometric parameters between reference and the measured images are 0.32°for gantry rotation, 1.006 for scaling factor, and 0.67mm for translation. For excess out-of-field/missing in-field fluence, with masks extending 1mm (at isocenter) from the detected aperture edge, the average total in-field area missing EPID fluence was 1.5mm2 the out-of-field excess EPID fluence was 8mm^2, both below error tolerances. Conclusion: A real-time verification software, with

MO-FG-202-01: A Fast Yet Sensitive EPID-Based Real-Time Treatment Verification System

Energy Technology Data Exchange (ETDEWEB)

Ahmad, M; Nourzadeh, H; Neal, B; Siebers, J [University of Virginia Health System, Charlottesville, VA (United States); Watkins, W

2016-06-15

Purpose: To create a real-time EPID-based treatment verification system which robustly detects treatment delivery and patient attenuation variations. Methods: Treatment plan DICOM files sent to the record-and-verify system are captured and utilized to predict EPID images for each planned control point using a modified GPU-based digitally reconstructed radiograph algorithm which accounts for the patient attenuation, source energy fluence, source size effects, and MLC attenuation. The DICOM and predicted images are utilized by our C++ treatment verification software which compares EPID acquired 1024×768 resolution frames acquired at ∼8.5hz from Varian Truebeam™ system. To maximize detection sensitivity, image comparisons determine (1) if radiation exists outside of the desired treatment field; (2) if radiation is lacking inside the treatment field; (3) if translations, rotations, and magnifications of the image are within tolerance. Acquisition was tested with known test fields and prior patient fields. Error detection was tested in real-time and utilizing images acquired during treatment with another system. Results: The computational time of the prediction algorithms, for a patient plan with 350 control points and 60×60×42cm^3 CT volume, is 2–3minutes on CPU and <27 seconds on GPU for 1024×768 images. The verification software requires a maximum of ∼9ms and ∼19ms for 512×384 and 1024×768 resolution images, respectively, to perform image analysis and dosimetric validations. Typical variations in geometric parameters between reference and the measured images are 0.32°for gantry rotation, 1.006 for scaling factor, and 0.67mm for translation. For excess out-of-field/missing in-field fluence, with masks extending 1mm (at isocenter) from the detected aperture edge, the average total in-field area missing EPID fluence was 1.5mm2 the out-of-field excess EPID fluence was 8mm^2, both below error tolerances. Conclusion: A real-time verification software, with

The impact of treatment complexity and computer-control delivery technology on treatment delivery errors

International Nuclear Information System (INIS)

Fraass, Benedick A.; Lash, Kathy L.; Matrone, Gwynne M.; Volkman, Susan K.; McShan, Daniel L.; Kessler, Marc L.; Lichter, Allen S.

1998-01-01

Purpose: To analyze treatment delivery errors for three-dimensional (3D) conformal therapy performed at various levels of treatment delivery automation and complexity, ranging from manual field setup to virtually complete computer-controlled treatment delivery using a computer-controlled conformal radiotherapy system (CCRS). Methods and Materials: All treatment delivery errors which occurred in our department during a 15-month period were analyzed. Approximately 34,000 treatment sessions (114,000 individual treatment segments [ports]) on four treatment machines were studied. All treatment delivery errors logged by treatment therapists or quality assurance reviews (152 in all) were analyzed. Machines 'M1' and 'M2' were operated in a standard manual setup mode, with no record and verify system (R/V). MLC machines 'M3' and 'M4' treated patients under the control of the CCRS system, which (1) downloads the treatment delivery plan from the planning system; (2) performs some (or all) of the machine set up and treatment delivery for each field; (3) monitors treatment delivery; (4) records all treatment parameters; and (5) notes exceptions to the electronically-prescribed plan. Complete external computer control is not available on M3; therefore, it uses as many CCRS features as possible, while M4 operates completely under CCRS control and performs semi-automated and automated multi-segment intensity modulated treatments. Analysis of treatment complexity was based on numbers of fields, individual segments, nonaxial and noncoplanar plans, multisegment intensity modulation, and pseudoisocentric treatments studied for a 6-month period (505 patients) concurrent with the period in which the delivery errors were obtained. Treatment delivery time was obtained from the computerized scheduling system (for manual treatments) or from CCRS system logs. Treatment therapists rotate among the machines; therefore, this analysis does not depend on fixed therapist staff on particular

Quality assurance for online adapted treatment plans: Benchmarking and delivery monitoring simulation

International Nuclear Information System (INIS)

Li, Taoran; Wu, Qiuwen; Yang, Yun; Rodrigues, Anna; Yin, Fang-Fang; Jackie Wu, Q.

2015-01-01

Purpose: An important challenge facing online adaptive radiation therapy is the development of feasible and efficient quality assurance (QA). This project aimed to validate the deliverability of online adapted plans and develop a proof-of-concept online delivery monitoring system for online adaptive radiation therapy QA. Methods: The first part of this project benchmarked automatically online adapted prostate treatment plans using traditional portal dosimetry IMRT QA. The portal dosimetry QA results of online adapted plans were compared to original (unadapted) plans as well as randomly selected prostate IMRT plans from our clinic. In the second part, an online delivery monitoring system was designed and validated via a simulated treatment with intentional multileaf collimator (MLC) errors. This system was based on inputs from the dynamic machine information (DMI), which continuously reports actual MLC positions and machine monitor units (MUs) at intervals of 50 ms or less during delivery. Based on the DMI, the system performed two levels of monitoring/verification during the delivery: (1) dynamic monitoring of cumulative fluence errors resulting from leaf position deviations and visualization using fluence error maps (FEMs); and (2) verification of MLC positions against the treatment plan for potential errors in MLC motion and data transfer at each control point. Validation of the online delivery monitoring system was performed by introducing intentional systematic MLC errors (ranging from 0.5 to 2 mm) to the DMI files for both leaf banks. These DMI files were analyzed by the proposed system to evaluate the system’s performance in quantifying errors and revealing the source of errors, as well as to understand patterns in the FEMs. In addition, FEMs from 210 actual prostate IMRT beams were analyzed using the proposed system to further validate its ability to catch and identify errors, as well as establish error magnitude baselines for prostate IMRT delivery

Quality assurance for online adapted treatment plans: Benchmarking and delivery monitoring simulation

Energy Technology Data Exchange (ETDEWEB)

Li, Taoran, E-mail: taoran.li.duke@gmail.com; Wu, Qiuwen; Yang, Yun; Rodrigues, Anna; Yin, Fang-Fang; Jackie Wu, Q. [Department of Radiation Oncology, Duke University Medical Center Durham, North Carolina 27710 (United States)

2015-01-15

Purpose: An important challenge facing online adaptive radiation therapy is the development of feasible and efficient quality assurance (QA). This project aimed to validate the deliverability of online adapted plans and develop a proof-of-concept online delivery monitoring system for online adaptive radiation therapy QA. Methods: The first part of this project benchmarked automatically online adapted prostate treatment plans using traditional portal dosimetry IMRT QA. The portal dosimetry QA results of online adapted plans were compared to original (unadapted) plans as well as randomly selected prostate IMRT plans from our clinic. In the second part, an online delivery monitoring system was designed and validated via a simulated treatment with intentional multileaf collimator (MLC) errors. This system was based on inputs from the dynamic machine information (DMI), which continuously reports actual MLC positions and machine monitor units (MUs) at intervals of 50 ms or less during delivery. Based on the DMI, the system performed two levels of monitoring/verification during the delivery: (1) dynamic monitoring of cumulative fluence errors resulting from leaf position deviations and visualization using fluence error maps (FEMs); and (2) verification of MLC positions against the treatment plan for potential errors in MLC motion and data transfer at each control point. Validation of the online delivery monitoring system was performed by introducing intentional systematic MLC errors (ranging from 0.5 to 2 mm) to the DMI files for both leaf banks. These DMI files were analyzed by the proposed system to evaluate the system’s performance in quantifying errors and revealing the source of errors, as well as to understand patterns in the FEMs. In addition, FEMs from 210 actual prostate IMRT beams were analyzed using the proposed system to further validate its ability to catch and identify errors, as well as establish error magnitude baselines for prostate IMRT delivery

Quality assurance for online adapted treatment plans: benchmarking and delivery monitoring simulation.

Science.gov (United States)

Li, Taoran; Wu, Qiuwen; Yang, Yun; Rodrigues, Anna; Yin, Fang-Fang; Jackie Wu, Q

2015-01-01

An important challenge facing online adaptive radiation therapy is the development of feasible and efficient quality assurance (QA). This project aimed to validate the deliverability of online adapted plans and develop a proof-of-concept online delivery monitoring system for online adaptive radiation therapy QA. The first part of this project benchmarked automatically online adapted prostate treatment plans using traditional portal dosimetry IMRT QA. The portal dosimetry QA results of online adapted plans were compared to original (unadapted) plans as well as randomly selected prostate IMRT plans from our clinic. In the second part, an online delivery monitoring system was designed and validated via a simulated treatment with intentional multileaf collimator (MLC) errors. This system was based on inputs from the dynamic machine information (DMI), which continuously reports actual MLC positions and machine monitor units (MUs) at intervals of 50 ms or less during delivery. Based on the DMI, the system performed two levels of monitoring/verification during the delivery: (1) dynamic monitoring of cumulative fluence errors resulting from leaf position deviations and visualization using fluence error maps (FEMs); and (2) verification of MLC positions against the treatment plan for potential errors in MLC motion and data transfer at each control point. Validation of the online delivery monitoring system was performed by introducing intentional systematic MLC errors (ranging from 0.5 to 2 mm) to the DMI files for both leaf banks. These DMI files were analyzed by the proposed system to evaluate the system's performance in quantifying errors and revealing the source of errors, as well as to understand patterns in the FEMs. In addition, FEMs from 210 actual prostate IMRT beams were analyzed using the proposed system to further validate its ability to catch and identify errors, as well as establish error magnitude baselines for prostate IMRT delivery. Online adapted plans were

A novel method for sub-arc VMAT dose delivery verification based on portal dosimetry with an EPID.

Science.gov (United States)

Cools, Ruud A M; Dirkx, Maarten L P; Heijmen, Ben J M

2017-11-01

The EPID-based sub-arc verification of VMAT dose delivery requires synchronization of the acquired electronic portal images (EPIs) with the VMAT delivery, that is, establishment of the start- and stop-MU of the acquired images. To realize this, published synchronization methods propose the use of logging features of the linac or dedicated hardware solutions. In this study, we developed a novel, software-based synchronization method that only uses information inherently available in the acquired images. The EPIs are continuously acquired during pretreatment VMAT delivery and converted into Portal Dose Images (PDIs). Sub-arcs of approximately 10 MU are then defined by combining groups of sequentially acquired PDIs. The start- and stop-MUs of measured sub-arcs are established in a synchronization procedure, using only dosimetric information in measured and predicted PDIs. Sub-arc verification of a VMAT dose delivery is based on comparison of measured sub-arc PDIs with synchronized, predicted sub-arc PDIs, using γ-analyses. To assess the accuracy of this new method, measured and predicted PDIs were compared for 20 clinically applied VMAT prostate cancer plans. The sensitivity of the method for detection of delivery errors was investigated using VMAT deliveries with intentionally inserted, small perturbations (25 error scenarios; leaf gap deviations ≤ 1.5 mm, leaf motion stops during ≤ 15 MU, linac output error ≤ 2%). For the 20 plans, the average failed pixel rates (FPR) for full-arc and sub-arc dose QA were 0.36% ± 0.26% (1 SD) and 0.64% ± 0.88%, based on 2%/2 mm and 3%/3 mm γ-analyses, respectively. Small systematic perturbations of up to 1% output error and 1 mm leaf offset were detected using full-arc QA. Sub-arc QA was able to detect positioning errors in three leaves only during approximately 20 MU and small dose delivery errors during approximately 40 MU. In an ROC analysis, the area under the curve (AUC) for the combined full-arc/sub-arc approach was

MO-AB-BRA-03: Development of Novel Real Time in Vivo EPID Treatment Verification for Brachytherapy

Energy Technology Data Exchange (ETDEWEB)

Fonseca, G; Podesta, M [Department of Radiation Oncology (MAASTRO), GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht 6201 BN (Netherlands); Reniers, B [Department of Radiation Oncology (MAASTRO), GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht 6201 BN (Netherlands); Research Group NuTeC, CMK, Hasselt University, Agoralaan Gebouw H, Diepenbeek B-3590 (Belgium); Verhaegen, F [Department of Radiation Oncology (MAASTRO), GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht 6201 BN (Netherlands); Medical Physics Unit, Department of Oncology, McGill University, Montreal, Quebec H3G 1A4 (Canada)

2016-06-15

Purpose: High Dose Rate (HDR) brachytherapy treatments are employed worldwide to treat a wide variety of cancers. However, in vivo dose verification remains a challenge with no commercial dosimetry system available to verify the treatment dose delivered to the patient. We propose a novel dosimetry system that couples an independent Monte Carlo (MC) simulation platform and an amorphous silicon Electronic Portal Imaging Device (EPID) to provide real time treatment verification. Methods: MC calculations predict the EPID response to the photon fluence emitted by the HDR source by simulating the patient, the source dwell positions and times, and treatment complexities such as tissue compositions/densities and different applicators. Simulated results are then compared against EPID measurements acquired with ∼0.14s time resolution which allows dose measurements for each dwell position. The EPID has been calibrated using an Ir-192 HDR source and experiments were performed using different phantoms, including tissue equivalent materials (PMMA, lung and bone). A source positioning accuracy of 0.2 mm, without including the afterloader uncertainty, was ensured using a robotic arm moving the source. Results: An EPID can acquire 3D Cartesian source positions and its response varies significantly due to differences in the material composition/density of the irradiated object, allowing detection of changes in patient geometry. The panel time resolution allows dose rate and dwell time measurements. Moreover, predicted EPID images obtained from clinical treatment plans provide anatomical information that can be related to the patient anatomy, mostly bone and air cavities, localizing the source inside of the patient using its anatomy as reference. Conclusion: Results obtained show the feasibility of the proposed dose verification system that is capable to verify all the brachytherapy treatment steps in real time providing data about treatment delivery quality and also applicator

Comparison of 3D anatomical dose verification and 2D phantom dose verification of IMRT/VMAT treatments for nasopharyngeal carcinoma

International Nuclear Information System (INIS)

Lin, Hailei; Huang, Shaomin; Deng, Xiaowu; Zhu, Jinhan; Chen, Lixin

2014-01-01

The two-dimensional phantom dose verification (2D-PDV) using hybrid plan and planar dose measurement has been widely used for IMRT treatment QA. Due to the lack of information about the correlations between the verification results and the anatomical structure of patients, it is inadequate in clinical evaluation. A three-dimensional anatomical dose verification (3D-ADV) method was used in this study to evaluate the IMRT/VMAT treatment delivery for nasopharyngeal carcinoma and comparison with 2D-PDV was analyzed. Twenty nasopharyngeal carcinoma (NPC) patients treated with IMRT/VMAT were recruited in the study. A 2D ion-chamber array was used for the 2D-PDV in both single-gantry-angle composite (SGAC) and multi-gantry-angle composite (MGAC) verifications. Differences in the gamma pass rate between the 2 verification methods were assessed. Based on measurement of irradiation dose fluence, the 3D dose distribution was reconstructed for 3D-ADV in the above cases. The reconstructed dose homogeneity index (HI), conformity index (CI) of the planning target volume (PTV) were calculated. Gamma pass rate and deviations in the dose-volume histogram (DVH) of each PTV and organ at risk (OAR) were analyzed. In 2D-PDV, the gamma pass rate (3%, 3 mm) of SGAC (99.55% ± 0.83%) was significantly higher than that of MGAC (92.41% ± 7.19%). In 3D-ADV, the gamma pass rates (3%, 3 mm) were 99.75% ± 0.21% in global, 83.82% ± 16.98% to 93.71% ± 6.22% in the PTVs and 45.12% ± 32.78% to 98.08% ± 2.29% in the OARs. The maximum HI increment in PTVnx was 19.34%, while the maximum CI decrement in PTV1 and PTV2 were -32.45% and -6.93%, respectively. Deviations in dose volume of PTVs were all within ±5%. D2% of the brainstem, spinal cord, left/right optic nerves, and the mean doses to the left/right parotid glands maximally increased by 3.5%, 6.03%, 31.13%/26.90% and 4.78%/4.54%, respectively. The 2D-PDV and global gamma pass rate might be insufficient to provide an accurate assessment for

Tomotherapy: IMRT and tomographic verification

International Nuclear Information System (INIS)

Mackie, T.R.

2000-01-01

include MLC's and many clinics use them to replace 90% or more of the field-shaping requirements of conventional radiotherapy. Now, several academic centers are treating patients with IMRT using conventional MLC's to modulate the field. IMRT using conventional MLC's have the advantage that the patient is stationary during the treatment and the MLC's can be used in conventional practice. Nevertheless, tomotherapy using the Peacock system delivers the most conformal dose distributions of any commercial system to date. The biggest limitation with the both the NOMOS Peacock tomotherapy system and conventional MLC's for IMRT delivery is the lack of treatment verification. In conventional few-field radiotherapy one relied on portal images to determine if the patient was setup correctly and the beams were correctly positioned. With IMRT the image contrast is superimposed on the beam intensity variation. Conventional practice allowed for monitor unit calculation checks and point dosimeters placed on the patient's surface to verify that the treatment was properly delivered. With IMRT it is impossible to perform hand calculations of monitor units and dosimeters placed on the patient's surface are prone to error due to high gradients in the beam intensity. NOMOS has developed a verification phantom that allows multiple sheets of film to be placed in a light-tight box that is irradiated with the same beam pattern that is used to treat the patient. The optical density of the films are adjusted, normalized, and calibrated and then quantitatively compared with the dose calculated for the phantom delivery. However, this process is too laborious to be used for patient-specific QA. If IMRT becomes ubiquitous and it can be shown that IMRT is useful on most treatment sites then there is a need to design treatment units dedicated to IMRT delivery and verification. Helical tomotherapy is such a redesign. Helical tomotherapy is the delivery of a rotational fan beam while the patient is

SU-F-T-440: The Feasibility Research of Checking Cervical Cancer IMRT Pre- Treatment Dose Verification by Automated Treatment Planning Verification System

Energy Technology Data Exchange (ETDEWEB)

Liu, X; Yin, Y; Lin, X [Shandong Cancer Hospital and Institute, China, Jinan, Shandong (China)

2016-06-15

Purpose: To assess the preliminary feasibility of automated treatment planning verification system in cervical cancer IMRT pre-treatment dose verification. Methods: The study selected randomly clinical IMRT treatment planning data for twenty patients with cervical cancer, all IMRT plans were divided into 7 fields to meet the dosimetric goals using a commercial treatment planning system(PianncleVersion 9.2and the EclipseVersion 13.5). The plans were exported to the Mobius 3D (M3D)server percentage differences of volume of a region of interest (ROI) and dose calculation of target region and organ at risk were evaluated, in order to validate the accuracy automated treatment planning verification system. Results: The difference of volume for Pinnacle to M3D was less than results for Eclipse to M3D in ROI, the biggest difference was 0.22± 0.69%, 3.5±1.89% for Pinnacle and Eclipse respectively. M3D showed slightly better agreement in dose of target and organ at risk compared with TPS. But after recalculating plans by M3D, dose difference for Pinnacle was less than Eclipse on average, results were within 3%. Conclusion: The method of utilizing the automated treatment planning system to validate the accuracy of plans is convenientbut the scope of differences still need more clinical patient cases to determine. At present, it should be used as a secondary check tool to improve safety in the clinical treatment planning.

3-D conformal radiation therapy - Part II: Computer-controlled 3-D treatment delivery

International Nuclear Information System (INIS)

Benedick, A.

1997-01-01

-controlled scanned beam treatments will also be discussed. CCRT-related approaches to treatment plan generation and transfer, accelerator control systems, treatment delivery, verification, documentation and charting will also be discussed, including the importance of real-time portal imaging for conformal therapy. The potential benefits of 3-D computer-controlled conformal treatment delivery will be illustrated with results from on-going clinical dose escalation and normal tissue complication studies. Conclusion: A large amount of interest in computer-controlled conformal treatment delivery techniques has developed in recent years. This presentation will attempt to summarize the current status of clinical and research work in 3-D computer-controlled conformal therapy treatment techniques. Particular attention is paid to issues related to implementation and clinical use of this developing treatment modality

Feasibility study on the verification of actual beam delivery in a treatment room using EPID transit dosimetry

International Nuclear Information System (INIS)

Baek, Tae Seong; Chung, Eun Ji; Son, Jaeman; Yoon, Myonggeun

2014-01-01

The aim of this study is to evaluate the ability of transit dosimetry using commercial treatment planning system (TPS) and an electronic portal imaging device (EPID) with simple calibration method to verify the beam delivery based on detection of large errors in treatment room. Twenty four fields of intensity modulated radiotherapy (IMRT) plans were selected from four lung cancer patients and used in the irradiation of an anthropomorphic phantom. The proposed method was evaluated by comparing the calculated dose map from TPS and EPID measurement on the same plane using a gamma index method with a 3% dose and 3 mm distance-to-dose agreement tolerance limit. In a simulation using a homogeneous plastic water phantom, performed to verify the effectiveness of the proposed method, the average passing rate of the transit dose based on gamma index was high enough, averaging 94.2% when there was no error during beam delivery. The passing rate of the transit dose for 24 IMRT fields was lower with the anthropomorphic phantom, averaging 86.8% ± 3.8%, a reduction partially due to the inaccuracy of TPS calculations for inhomogeneity. Compared with the TPS, the absolute value of the transit dose at the beam center differed by −0.38% ± 2.1%. The simulation study indicated that the passing rate of the gamma index was significantly reduced, to less than 40%, when a wrong field was erroneously irradiated to patient in the treatment room. This feasibility study suggested that transit dosimetry based on the calculation with commercial TPS and EPID measurement with simple calibration can provide information about large errors for treatment beam delivery

WE-F-16A-06: Using 3D Printers to Create Complex Phantoms for Dose Verification, Quality Assurance, and Treatment Planning System Commissioning in Radiotherapy

International Nuclear Information System (INIS)

Kassaee, A; Ding, X; McDonough, J; Reiche, M; Witztum, A; Teo, B

2014-01-01

Purpose: To use 3D printers to design and construct complex geometrical phantoms for commissioning treatment planning systems, dose calculation algorithms, quality assurance (QA), dose delivery, and patient dose verifications. Methods: In radiotherapy, complex geometrical phantoms are often required for dose verification, dose delivery and calculation algorithm validation. Presently, fabrication of customized phantoms is limited due to time, expense and challenges in machining of complex shapes. In this work, we designed and utilized 3D printers to fabricate two phantoms for QA purposes. One phantom includes hills and valleys (HV) for verification of intensity modulated radiotherapy for photons, and protons (IMRT and IMPT). The other phantom includes cylindrical cavities (CC) of various sizes for dose verification of inhomogeneities. We evaluated the HV phantoms for an IMPT beam, and the CC phantom to study various inhomogeneity configurations using photon, electron, and proton beams. Gafcromic ™ films were used to quantify the dose distributions delivered to the phantoms. Results: The HV phantom has dimensions of 12 cm × 12 cm and consists of one row and one column of five peaks with heights ranging from 2 to 5 cm. The CC phantom has a size 10 cm × 14 cm and includes 6 cylindrical cavities with length of 7.2 cm and diameters ranging from 0.6 to 1.2 cm. The IMPT evaluation using the HV phantom shows good agreement as compared to the dose distribution calculated with treatment planning system. The CC phantom also shows reasonable agreements for using different algorithms for each beam modalities. Conclusion: 3D printers with submillimiter resolutions are capable of printing complex phantoms for dose verification and QA in radiotherapy. As printing costs decrease and the technology becomes widely available, phantom design and construction will be readily available to any clinic for testing geometries that were not previously feasible

EDITORIAL: International Workshop on Monte Carlo Techniques in Radiotherapy Delivery and Verification

Science.gov (United States)

Verhaegen, Frank; Seuntjens, Jan

2008-03-01

Monte Carlo particle transport techniques offer exciting tools for radiotherapy research, where they play an increasingly important role. Topics of research related to clinical applications range from treatment planning, motion and registration studies, brachytherapy, verification imaging and dosimetry. The International Workshop on Monte Carlo Techniques in Radiotherapy Delivery and Verification took place in a hotel in Montreal in French Canada, from 29 May-1 June 2007, and was the third workshop to be held on a related topic, which now seems to have become a tri-annual event. About one hundred workers from many different countries participated in the four-day meeting. Seventeen experts in the field were invited to review topics and present their latest work. About half of the audience was made up by young graduate students. In a very full program, 57 papers were presented and 10 posters were on display during most of the meeting. On the evening of the third day a boat trip around the island of Montreal allowed participants to enjoy the city views, and to sample the local cuisine. The topics covered at the workshop included the latest developments in the most popular Monte Carlo transport algorithms, fast Monte Carlo, statistical issues, source modeling, MC treatment planning, modeling of imaging devices for treatment verification, registration and deformation of images and a sizeable number of contributions on brachytherapy. In this volume you will find 27 short papers resulting from the workshop on a variety of topics, some of them on very new stuff such as graphics processing units for fast computing, PET modeling, dual-energy CT, calculations in dynamic phantoms, tomotherapy devices, . . . . We acknowledge the financial support of the National Cancer Institute of Canada, the Institute of Cancer Research of the Canadian Institutes of Health Research, the Association Québécoise des Physicien(ne)s Médicaux Clinique, the Institute of Physics, and Medical

SU-G-JeP3-06: Lower KV Image Dose Are Expected From a Limited-Angle Intra-Fractional Verification (LIVE) System for SBRT Treatments

Energy Technology Data Exchange (ETDEWEB)

Ding, G [Vanderbilt University Nashville, TN (United States); Yin, F; Ren, L [Duke University Medical Center, Durham, NC (United States)

2016-06-15

Purpose: In order to track the tumor movement for patient positioning verification during arc treatment delivery or in between 3D/IMRT beams for stereotactic body radiation therapy (SBRT), the limited-angle kV projections acquisition simultaneously during arc treatment delivery or in-between static treatment beams as the gantry moves to the next beam angle was proposed. The purpose of this study is to estimate additional imaging dose resulting from multiple tomosynthesis acquisitions in-between static treatment beams and to compare with that of a conventional kV-CBCT acquisition. Methods: kV imaging system integrated into Varian TrueBeam accelerators was modeled using EGSnrc Monte Carlo user code, BEAMnrc and DOSXYZnrc code was used in dose calculations. The simulated realistic kV beams from the Varian TrueBeam OBI 1.5 system were used to calculate dose to patient based on CT images. Organ doses were analyzed using DVHs. The imaging dose to patient resulting from realistic multiple tomosynthesis acquisitions with each 25–30 degree kV source rotation between 6 treatment beam gantry angles was studied. Results: For a typical lung SBRT treatment delivery much lower (20–50%) kV imaging doses from the sum of realistic six tomosynthesis acquisitions with each 25–30 degree x-ray source rotation between six treatment beam gantry angles were observed compared to that from a single CBCT image acquisition. Conclusion: This work indicates that the kV imaging in this proposed Limited-angle Intra-fractional Verification (LIVE) System for SBRT Treatments has a negligible imaging dose increase. It is worth to note that the MV imaging dose caused by MV projection acquisition in-between static beams in LIVE can be minimized by restricting the imaging to the target region and reducing the number of projections acquired. For arc treatments, MV imaging acquisition in LIVE does not add additional imaging dose as the MV images are acquired from treatment beams directly during the

MR image-guided portal verification for brain treatment field

International Nuclear Information System (INIS)

Yin Fangfang; Gao Qinghuai; Xie Huchen; Nelson, Diana F.; Yu Yan; Kwok, W. Edmund; Totterman, Saara; Schell, Michael C.; Rubin, Philip

1998-01-01

Purpose: To investigate a method for the generation of digitally reconstructed radiographs directly from MR images (DRR-MRI) to guide a computerized portal verification procedure. Methods and Materials: Several major steps were developed to perform an MR image-guided portal verification procedure. Initially, a wavelet-based multiresolution adaptive thresholding method was used to segment the skin slice-by-slice in MR brain axial images. Some selected anatomical structures, such as target volume and critical organs, were then manually identified and were reassigned to relatively higher intensities. Interslice information was interpolated with a directional method to achieve comparable display resolution in three dimensions. Next, a ray-tracing method was used to generate a DRR-MRI image at the planned treatment position, and the ray tracing was simply performed on summation of voxels along the ray. The skin and its relative positions were also projected to the DRR-MRI and were used to guide the search of similar features in the portal image. A Canny edge detector was used to enhance the brain contour in both portal and simulation images. The skin in the brain portal image was then extracted using a knowledge-based searching technique. Finally, a Chamfer matching technique was used to correlate features between DRR-MRI and portal image. Results: The MR image-guided portal verification method was evaluated using a brain phantom case and a clinical patient case. Both DRR-CT and DRR-MRI were generated using CT and MR phantom images with the same beam orientation and then compared. The matching result indicated that the maximum deviation of internal structures was less than 1 mm. The segmented results for brain MR slice images indicated that a wavelet-based image segmentation technique provided a reasonable estimation for the brain skin. For the clinical patient case with a given portal field, the MR image-guided verification method provided an excellent match between

Content analysis of age verification, purchase and delivery methods of internet e-cigarette vendors, 2013 and 2014.

Science.gov (United States)

Williams, Rebecca S; Derrick, Jason; Liebman, Aliza Kate; LaFleur, Kevin; Ribisl, Kurt M

2018-05-01

Identify the population of internet e-cigarette vendors (IEVs) and conduct content analyses of their age verification, purchase and delivery methods in 2013 and 2014. We used multiple sources to identify IEV websites, primarily complex search algorithms scanning more than 180 million websites. In 2013, we manually screened 32 446 websites, identifying 980 IEVs, selecting the 281 most popular for content analysis. This methodology yielded 31 239 websites for screening in 2014, identifying 3096 IEVs, with 283 selected for content analysis. The proportion of vendors that sold online-only, with no retail store, dropped significantly from 2013 (74.7%) to 2014 (64.3%) (ponline age verification services (7.1% in 2013 and 8.5% in 2014), driving licences (1.8% in 2013 and 7.4% in 2014, ponline e-cigarette sales are needed, including strict age and identity verification requirements. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

MR image-guided portal verification for brain treatment field

International Nuclear Information System (INIS)

Yin, F.-F.; Gao, Q.H.; Xie, H.; Nelson, D.F.; Yu, Y.; Kwok, W.E.; Totterman, S.; Schell, M.C.; Rubin, P.

1996-01-01

Purpose/Objective: Although MR images have been extensively used for the treatment planning of radiation therapy of cancers, especially for brain cancers, they are not effectively used for the portal verification due to lack of bone/air information in MR images and geometric distortions. Typically, MR images are utilized through correlation with CT images, and this procedure is usually very labor and time consuming. For many brain cancer patients to be treated using conventional external beam radiation, MR images with proper distortion correction provide sufficient information for treatment planning and dose calculation, and a projection images may be generated for each specific treatment port and to be used as a reference image for treatment verification. The question is how to transfer anatomical features in MR images to the projection image as landmarks which could be correlated automatically to those in the portal image. The goal of this study is to generate digitally reconstructed projection images from MR brain images with some important anatomical features (brain contour, skull and gross tumor) as well as their relative locations to be used as references for the development of computerized portal verification scheme. Materials/Methods: Compared to conventional digital reconstructed radiograph from CT images, generation of digitally reconstructed projection images from MR images is heavily involved with pixel manipulation of MR images to correlate information from two types of images (MR, portal x-ray images) which are produced based on totally different imaging principles. Initially a wavelet based multi-resolution adaptive thresholding method is used to segment the skull slice-by-slice in MR brain axial images, and identified skull pixels are re-assigned to relatively higher intensities so that projection images will have comparable grey-level information as that in typical brain portal images. Both T1- and T2-weighted images are utilized to eliminate fat

A fully electronic intensity-modulated radiation therapy quality assurance (IMRT QA) process implemented in a network comprised of independent treatment planning, record and verify, and delivery systems

International Nuclear Information System (INIS)

Bailey, Daniel W; Kumaraswamy, Lalith; Podgorsak, Matthew B

2010-01-01

The purpose of this study is to implement an electronic method to perform and analyze intensity-modulated radiation therapy quality assurance (IMRT QA) using an aSi megavoltage electronic portal imaging device in a network comprised of independent treatment planning, record and verify (R&V), and delivery systems. A verification plan was generated in the treatment planning system using the actual treatment plan of a patient. After exporting the treatment fields to the R&V system, the fields were delivered in QA mode with the aSi imager deployed. The resulting dosimetric images are automatically stored in a DICOM-RT format in the delivery system treatment console computer. The relative dose density images are subsequently pushed to the R&V system. The absolute dose images are then transferred electronically from the treatment console computer to the treatment planning system and imported into the verification plan in the dosimetry work space for further analysis. Screen shots of the gamma evaluation and isodose comparison are imported into the R&V system as an electronic file (e.g. PDF) to be reviewed prior to initiation of patient treatment. A relative dose image predicted by the treatment planning system can also be sent to the R&V system to be compared with the relative dose density image measured with the aSi imager. Our department does not have integrated planning, R&V, and delivery systems. In spite of this, we are able to fully implement a paperless and filmless IMRT QA process, allowing subsequent analysis and approval to be more efficient, while the QA document is directly attached to its specific patient chart in the R&V system in electronic form. The calculated and measured relative dose images can be compared electronically within the R&V system to analyze the density differences and ensure proper dose delivery to patients. In the absence of an integrated planning, verifying, and delivery system, we have shown that it is nevertheless possible to develop a

Review of deep inspiration breath-hold techniques for the treatment of breast cancer

Energy Technology Data Exchange (ETDEWEB)

Latty, Drew, E-mail: drew.latty@health.nsw.gov.au [Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, New South Wales (Australia); Stuart, Kirsty E [Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, New South Wales (Australia); Westmead Breast Cancer Institute, Sydney, New South Wales (Australia); Wang, Wei [Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, New South Wales (Australia); Westmead Breast Cancer Institute, Sydney, New South Wales (Australia); Nepean Cancer Care Centre, Sydney, New South Wales (Australia); Ahern, Verity [Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, New South Wales (Australia)

2015-03-15

Radiation treatment to the left breast is associated with increased cardiac morbidity and mortality. The deep inspiration breath-hold technique (DIBH) can decrease radiation dose delivered to the heart and this may facilitate the treatment of the internal mammary chain nodes. The aim of this review is to critically analyse the literature available in relation to breath-hold methods, implementation, utilisation, patient compliance, planning methods and treatment verification of the DIBH technique. Despite variation in the literature regarding the DIBH delivery method, patient coaching, visual feedback mechanisms and treatment verification, all methods of DIBH delivery reduce radiation dose to the heart. Further research is required to determine optimum protocols for patient training and treatment verification to ensure the technique is delivered successfully.

Initial Clinical Experience Performing Patient Treatment Verification With an Electronic Portal Imaging Device Transit Dosimeter

Energy Technology Data Exchange (ETDEWEB)

Berry, Sean L., E-mail: BerryS@MSKCC.org [Department of Applied Physics and Applied Mathematics, Columbia University, New York, New York (United States); Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Polvorosa, Cynthia; Cheng, Simon; Deutsch, Israel; Chao, K. S. Clifford; Wuu, Cheng-Shie [Department of Radiation Oncology, Columbia University, New York, New York (United States)

2014-01-01

Purpose: To prospectively evaluate a 2-dimensional transit dosimetry algorithm's performance on a patient population and to analyze the issues that would arise in a widespread clinical adoption of transit electronic portal imaging device (EPID) dosimetry. Methods and Materials: Eleven patients were enrolled on the protocol; 9 completed and were analyzed. Pretreatment intensity modulated radiation therapy (IMRT) patient-specific quality assurance was performed using a stringent local 3%, 3-mm γ criterion to verify that the planned fluence had been appropriately transferred to and delivered by the linear accelerator. Transit dosimetric EPID images were then acquired during treatment and compared offline with predicted transit images using a global 5%, 3-mm γ criterion. Results: There were 288 transit images analyzed. The overall γ pass rate was 89.1% ± 9.8% (average ± 1 SD). For the subset of images for which the linear accelerator couch did not interfere with the measurement, the γ pass rate was 95.7% ± 2.4%. A case study is presented in which the transit dosimetry algorithm was able to identify that a lung patient's bilateral pleural effusion had resolved in the time between the planning CT scan and the treatment. Conclusions: The EPID transit dosimetry algorithm under consideration, previously described and verified in a phantom study, is feasible for use in treatment delivery verification for real patients. Two-dimensional EPID transit dosimetry can play an important role in indicating when a treatment delivery is inconsistent with the original plan.

Television system for verification and documentation of treatment fields during intraoperative radiation therapy

International Nuclear Information System (INIS)

Fraass, B.A.; Harrington, F.S.; Kinsella, T.J.; Sindelar, W.F.

1983-01-01

Intraoperative radiation therapy (IORT) involves direct treatment of tumors or tumor beds with large single doses of radiation. The verification of the area to be treated before irradiation and the documentation of the treated area are critical for IORT, just as for other types of radiation therapy. A television system which allows the target area to be directly imaged immediately before irradiation has been developed. Verification and documentation of treatment fields has made the IORT television system indispensable

Verification of hyperthermia treatment planning in cervix carcinoma patients using invasive thermometry

International Nuclear Information System (INIS)

Haaren Van, P.M.A.; Kok, H.P.; Zum Voerde Sive Voerding, P.J.; Oldenborg, S.; Stalpers, L.J.A.; Crezee, J.; Berg Van den, C.A.T; Leeuw De, A.A.C.

2005-01-01

Full text: Hyperthermia treatment planning (HTP) is a useful tool for improvement of clinical hyperthermia treatments. Aim of this study was to determine the correlation between HTP and measurements during hyperthermia treatments. We compared the calculated specific absorption rate (SAR) with clinically measured SAR-values, from ΔT-measurements, in cervix carcinoma patients. General difficulties for such clinical verifications are changes in the anatomy during the different steps and possible movement of the catheters. We used one fixed invasive catheter in the tumor additional to the usual non-invasive catheters in the vagina, bladder and rectum, for insertion of multisensor thermocouple probes. A special CT-scan with the patient in treatment position and the catheters in situ was made for the HTP. We performed these verifications in a total of 11 treatments in 7 patients. The main difficulties for accurate verification were of clinical nature: difficulties arising from the use of gynaecological tampon and the limited number of measurements in tissue. Remaining air in the vagina and sub-optimal tissue contact of the catheters resulted in bad thermal contact between thermocouples and tissue, causing measurement artefacts that are difficult to correlate with calculations. These artefacts are probably not specific for thermocouple measurements, but more general for intraluminal temperature and SAR measurements. (author)

Nuclear disarmament verification

International Nuclear Information System (INIS)

DeVolpi, A.

1993-01-01

Arms control treaties, unilateral actions, and cooperative activities -- reflecting the defusing of East-West tensions -- are causing nuclear weapons to be disarmed and dismantled worldwide. In order to provide for future reductions and to build confidence in the permanency of this disarmament, verification procedures and technologies would play an important role. This paper outlines arms-control objectives, treaty organization, and actions that could be undertaken. For the purposes of this Workshop on Verification, nuclear disarmament has been divided into five topical subareas: Converting nuclear-weapons production complexes, Eliminating and monitoring nuclear-weapons delivery systems, Disabling and destroying nuclear warheads, Demilitarizing or non-military utilization of special nuclear materials, and Inhibiting nuclear arms in non-nuclear-weapons states. This paper concludes with an overview of potential methods for verification

SU-F-T-218: Validation of An In-Vivo Proton Range Verification Method for Reducing the Risk of Permanent Alopecia in the Treatment of Pediatric Medulloblastoma

Energy Technology Data Exchange (ETDEWEB)

Lucconi, G [Department of Medical Physics, S. Orsola-Malpighi University Hospital, Bologna (Italy); Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA (United States); Bentefour, E; Janssens, G [Advanced Technology Group, Ion Beam Applications (IBA), Louvain la Neuve (Belgium); Deepak, S [Department of Physics, Central University of Karnataka, Karnataka 585367 (India); Weaver, K; Moteabbed, M; Lu, H-M [Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA (United States)

2016-06-15

Purpose: The clinical commissioning of a workflow for pre-treatment range verification/adjustment for the head treatment of pediatric medulloblastoma patients, including dose monitoring during treatment. Methods: An array of Si-diodes (DIODES Incorporated) is placed on the patient skin on the opposite side to the beam entrance. A “scout” SOBP beam, with a longer beam range to cover the diodes in its plateau, is delivered; the measured signal is analyzed and the extracted water equivalent path lengths (WEPL) are compared to the expected values, revealing if a range correction is needed. Diodes stay in place during treatment to measure dose. The workflow was tested in solid water and head phantoms and validated against independent WEPL measurements. Both measured WEPL and skin doses were compared to computed values from the TPS (XiO); a Markus chamber was used for reference dose measurements. Results: The WEPL accuracy of the method was verified by comparing it with the dose extinction method. It resulted, for both solid water and head phantom, in the sub-millimeter range, with a deviation less than 1% to the value extracted from the TPS. The accuracy of dose measurements in the fall-off part of the dose profile was validated against the Markus chamber. The entire range verification workflow was successfully tested for the mock-treatment of head phantom with the standard delivery of 90 cGy per field per fraction. The WEPL measurement revealed no need for range correction. The dose measurements agreed to better than 4% with the prescription dose. The robustness of the method and workflow, including detector array, hardware set and software functions, was successfully stress-tested with multiple repetitions. Conclusion: The performance of the in-vivo range verification system and related workflow meet the clinical requirements in terms of the needed WEPL accuracy for pretreatment range verification with acceptable dose to the patient.

WE-D-BRA-04: Online 3D EPID-Based Dose Verification for Optimum Patient Safety

International Nuclear Information System (INIS)

Spreeuw, H; Rozendaal, R; Olaciregui-Ruiz, I; Mans, A; Mijnheer, B; Herk, M van; Gonzalez, P

2015-01-01

Purpose: To develop an online 3D dose verification tool based on EPID transit dosimetry to ensure optimum patient safety in radiotherapy treatments. Methods: A new software package was developed which processes EPID portal images online using a back-projection algorithm for the 3D dose reconstruction. The package processes portal images faster than the acquisition rate of the portal imager (∼ 2.5 fps). After a portal image is acquired, the software seeks for “hot spots” in the reconstructed 3D dose distribution. A hot spot is in this study defined as a 4 cm 3 cube where the average cumulative reconstructed dose exceeds the average total planned dose by at least 20% and 50 cGy. If a hot spot is detected, an alert is generated resulting in a linac halt. The software has been tested by irradiating an Alderson phantom after introducing various types of serious delivery errors. Results: In our first experiment the Alderson phantom was irradiated with two arcs from a 6 MV VMAT H&N treatment having a large leaf position error or a large monitor unit error. For both arcs and both errors the linac was halted before dose delivery was completed. When no error was introduced, the linac was not halted. The complete processing of a single portal frame, including hot spot detection, takes about 220 ms on a dual hexacore Intel Xeon 25 X5650 CPU at 2.66 GHz. Conclusion: A prototype online 3D dose verification tool using portal imaging has been developed and successfully tested for various kinds of gross delivery errors. The detection of hot spots was proven to be effective for the timely detection of these errors. Current work is focused on hot spot detection criteria for various treatment sites and the introduction of a clinical pilot program with online verification of hypo-fractionated (lung) treatments

TomoTherapy MLC verification using exit detector data

Energy Technology Data Exchange (ETDEWEB)

Chen Quan; Westerly, David; Fang Zhenyu; Sheng, Ke; Chen Yu [TomoTherapy Inc., 1240 Deming Way, Madison, Wisconsin 53717 (United States); Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, Colorado 80045 (United States); Xinghua Cancer Hospital, Xinghua, Jiangsu 225700 (China); Department of Radiation Oncology, University of California-Los Angeles, Los Angeles, California 90095 (United States); TomoTherapy Inc., 1240 Deming Way, Madison, Wisconsin 53717 (United States)

2012-01-15

Purpose: Treatment delivery verification (DV) is important in the field of intensity modulated radiation therapy (IMRT). While IMRT and image guided radiation therapy (IGRT), allow us to create more conformal plans and enables the use of tighter margins, an erroneously executed plan can have detrimental effects on the treatment outcome. The purpose of this study is to develop a DV technique to verify TomoTherapy's multileaf collimator (MLC) using the onboard mega-voltage CT detectors. Methods: The proposed DV method uses temporal changes in the MVCT detector signal to predict actual leaf open times delivered on the treatment machine. Penumbra and scattered radiation effects may produce confounding results when determining leaf open times from the raw detector data. To reduce the impact of the effects, an iterative, Richardson-Lucy (R-L) deconvolution algorithm is applied. Optical sensors installed on each MLC leaf are used to verify the accuracy of the DV technique. The robustness of the DV technique is examined by introducing different attenuation materials in the beam. Additionally, the DV technique has been used to investigate several clinical plans which failed to pass delivery quality assurance (DQA) and was successful in identifying MLC timing discrepancies as the root cause. Results: The leaf open time extracted from the exit detector showed good agreement with the optical sensors under a variety of conditions. Detector-measured leaf open times agreed with optical sensor data to within 0.2 ms, and 99% of the results agreed within 8.5 ms. These results changed little when attenuation was added in the beam. For the clinical plans failing DQA, the dose calculated from reconstructed leaf open times played an instrumental role in discovering the root-cause of the problem. Throughout the retrospective study, it is found that the reconstructed dose always agrees with measured doses to within 1%. Conclusions: The exit detectors in the TomoTherapy treatment

TomoTherapy MLC verification using exit detector data

International Nuclear Information System (INIS)

Chen Quan; Westerly, David; Fang Zhenyu; Sheng, Ke; Chen Yu

2012-01-01

Purpose: Treatment delivery verification (DV) is important in the field of intensity modulated radiation therapy (IMRT). While IMRT and image guided radiation therapy (IGRT), allow us to create more conformal plans and enables the use of tighter margins, an erroneously executed plan can have detrimental effects on the treatment outcome. The purpose of this study is to develop a DV technique to verify TomoTherapy's multileaf collimator (MLC) using the onboard mega-voltage CT detectors. Methods: The proposed DV method uses temporal changes in the MVCT detector signal to predict actual leaf open times delivered on the treatment machine. Penumbra and scattered radiation effects may produce confounding results when determining leaf open times from the raw detector data. To reduce the impact of the effects, an iterative, Richardson-Lucy (R-L) deconvolution algorithm is applied. Optical sensors installed on each MLC leaf are used to verify the accuracy of the DV technique. The robustness of the DV technique is examined by introducing different attenuation materials in the beam. Additionally, the DV technique has been used to investigate several clinical plans which failed to pass delivery quality assurance (DQA) and was successful in identifying MLC timing discrepancies as the root cause. Results: The leaf open time extracted from the exit detector showed good agreement with the optical sensors under a variety of conditions. Detector-measured leaf open times agreed with optical sensor data to within 0.2 ms, and 99% of the results agreed within 8.5 ms. These results changed little when attenuation was added in the beam. For the clinical plans failing DQA, the dose calculated from reconstructed leaf open times played an instrumental role in discovering the root-cause of the problem. Throughout the retrospective study, it is found that the reconstructed dose always agrees with measured doses to within 1%. Conclusions: The exit detectors in the TomoTherapy treatment systems

Source position verification and dosimetry in HDR brachytherapy using an EPID

International Nuclear Information System (INIS)

Smith, R. L.; Taylor, M. L.; McDermott, L. N.; Franich, R. D.; Haworth, A.; Millar, J. L.

2013-01-01

Purpose: Accurate treatment delivery in high dose rate (HDR) brachytherapy requires correct source dwell positions and dwell times to be administered relative to each other and to the surrounding anatomy. Treatment delivery inaccuracies predominantly occur for two reasons: (i) anatomical movement or (ii) as a result of human errors that are usually related to incorrect implementation of the planned treatment. Electronic portal imaging devices (EPIDs) were originally developed for patient position verification in external beam radiotherapy and their application has been extended to provide dosimetric information. The authors have characterized the response of an EPID for use with an 192 Ir brachytherapy source to demonstrate its use as a verification device, providing both source position and dosimetric information.Methods: Characterization of the EPID response using an 192 Ir brachytherapy source included investigations of reproducibility, linearity with dose rate, photon energy dependence, and charge build-up effects associated with exposure time and image acquisition time. Source position resolution in three dimensions was determined. To illustrate treatment verification, a simple treatment plan was delivered to a phantom and the measured EPID dose distribution compared with the planned dose.Results: The mean absolute source position error in the plane parallel to the EPID, for dwells measured at 50, 100, and 150 mm source to detector distances (SDD), was determined to be 0.26 mm. The resolution of the z coordinate (perpendicular distance from detector plane) is SDD dependent with 95% confidence intervals of ±0.1, ±0.5, and ±2.0 mm at SDDs of 50, 100, and 150 mm, respectively. The response of the EPID is highly linear to dose rate. The EPID exhibits an over-response to low energy incident photons and this nonlinearity is incorporated into the dose calibration procedure. A distance (spectral) dependent dose rate calibration procedure has been developed. The

Poster — Thur Eve — 33: The Influence of a Modeled Treatment Couch on Dose Distributions During IMRT and RapidArc Treatment Delivery

International Nuclear Information System (INIS)

Aldosary, Ghada; Nobah, Ahmad; Al-Zorkani, Faisal; Moftah, Belal; Devic, Slobodan

2014-01-01

Treatment couches have been known to perturb dose delivery in patients. This effect is most pronounced in techniques such as IMRT and RapidArc. Although modern treatment planning systems (TPS) include data for a “default” treatment couch, actual couches are not manufactured identically. Thus, variations in their Hounsfield Unit (HU) values may exist. This study demonstrates a practical and simple method of acquiring reliable HU data for any treatment couch. We also investigate the effects of both the default and modeled treatment couches on absorbed dose. Experimental verifications show that by neglecting to incorporate the treatment couch in the TPS, dose differences of up to 9.5% and 7.3% were present for 4 MV and 10 MV photon beams, respectively. Furthermore, a clinical study based on a cohort of 20 RapidArc and IMRT (brain, pelvis and abdominal) cases is performed. 2D dose distributions show that without the couch in the planning phase, differences ≤ 4.6% and 5.9% for RapidArc and IMRT cases are present for the same cases that the default couch was added to. Additionally, in comparison to the default couch, employing the modeled couch in the calculation process influences dose distributions by ≤ 2.7% and 8% for RapidArc and IMRT cases, respectively. This result was found to be site specific; where an accurate couch proves to be preferable for IMRT brain plans. As such, adding the couch during dose calculation decreases dose calculation errors, and a precisely modeled treatment couch offers higher dose delivery accuracy for brain treatment using IMRT

Poster — Thur Eve — 33: The Influence of a Modeled Treatment Couch on Dose Distributions During IMRT and RapidArc Treatment Delivery

Energy Technology Data Exchange (ETDEWEB)

Aldosary, Ghada [Medical Physics Unit, Montreal General Hospital, McGill University, Montreal, Quebec (Canada); Nobah, Ahmad; Al-Zorkani, Faisal; Moftah, Belal [Biomedical Physics Department, King Faisal Specialist Hospital and Research Center, Riyadh (Saudi Arabia); Devic, Slobodan [Department of Radiation Oncology, Jewish General Hospital, McGill University, Montreal, Quebec (Canada)

2014-08-15

Treatment couches have been known to perturb dose delivery in patients. This effect is most pronounced in techniques such as IMRT and RapidArc. Although modern treatment planning systems (TPS) include data for a “default” treatment couch, actual couches are not manufactured identically. Thus, variations in their Hounsfield Unit (HU) values may exist. This study demonstrates a practical and simple method of acquiring reliable HU data for any treatment couch. We also investigate the effects of both the default and modeled treatment couches on absorbed dose. Experimental verifications show that by neglecting to incorporate the treatment couch in the TPS, dose differences of up to 9.5% and 7.3% were present for 4 MV and 10 MV photon beams, respectively. Furthermore, a clinical study based on a cohort of 20 RapidArc and IMRT (brain, pelvis and abdominal) cases is performed. 2D dose distributions show that without the couch in the planning phase, differences ≤ 4.6% and 5.9% for RapidArc and IMRT cases are present for the same cases that the default couch was added to. Additionally, in comparison to the default couch, employing the modeled couch in the calculation process influences dose distributions by ≤ 2.7% and 8% for RapidArc and IMRT cases, respectively. This result was found to be site specific; where an accurate couch proves to be preferable for IMRT brain plans. As such, adding the couch during dose calculation decreases dose calculation errors, and a precisely modeled treatment couch offers higher dose delivery accuracy for brain treatment using IMRT.

Verification of helical tomotherapy delivery using autoassociative kernel regression

International Nuclear Information System (INIS)

Seibert, Rebecca M.; Ramsey, Chester R.; Garvey, Dustin R.; Wesley Hines, J.; Robison, Ben H.; Outten, Samuel S.

2007-01-01

Quality assurance (QA) is a topic of major concern in the field of intensity modulated radiation therapy (IMRT). The standard of practice for IMRT is to perform QA testing for individual patients to verify that the dose distribution will be delivered to the patient. The purpose of this study was to develop a new technique that could eventually be used to automatically evaluate helical tomotherapy treatments during delivery using exit detector data. This technique uses an autoassociative kernel regression (AAKR) model to detect errors in tomotherapy delivery. AAKR is a novel nonparametric model that is known to predict a group of correct sensor values when supplied a group of sensor values that is usually corrupted or contains faults such as machine failure. This modeling scheme is especially suited for the problem of monitoring the fluence values found in the exit detector data because it is able to learn the complex detector data relationships. This scheme still applies when detector data are summed over many frames with a low temporal resolution and a variable beam attenuation resulting from patient movement. Delivery sequences from three archived patients (prostate, lung, and head and neck) were used in this study. Each delivery sequence was modified by reducing the opening time for random individual multileaf collimator (MLC) leaves by random amounts. The error and error-free treatments were delivered with different phantoms in the path of the beam. Multiple autoassociative kernel regression (AAKR) models were developed and tested by the investigators using combinations of the stored exit detector data sets from each delivery. The models proved robust and were able to predict the correct or error-free values for a projection, which had a single MLC leaf decrease its opening time by less than 10 msec. The model also was able to determine machine output errors. The average uncertainty value for the unfaulted projections ranged from 0.4% to 1.8% of the detector

Monte Carlo investigation of collapsed versus rotated IMRT plan verification.

Science.gov (United States)

Conneely, Elaine; Alexander, Andrew; Ruo, Russell; Chung, Eunah; Seuntjens, Jan; Foley, Mark J

2014-05-08

IMRT QA requires, among other tests, a time-consuming process of measuring the absorbed dose, at least to a point, in a high-dose, low-dose-gradient region. Some clinics use a technique of measuring this dose with all beams delivered at a single gantry angle (collapsed delivery), as opposed to the beams delivered at the planned gantry angle (rotated delivery). We examined, established, and optimized Monte Carlo simulations of the dosimetry for IMRT verification of treatment plans for these two different delivery modes (collapsed versus rotated). The results of the simulations were compared to the treatment planning system dose calculations for the two delivery modes, as well as to measurements taken. This was done in order to investigate the validity of the use of a collapsed delivery technique for IMRT QA. The BEAMnrc, DOSXYZnrc, and egs_chamber codes were utilized for the Monte Carlo simulations along with the MMCTP system. A number of different plan complexity metrics were also used in the analysis of the dose distributions in a bid to qualify why verification in a collapsed delivery may or may not be optimal for IMRT QA. Following the Alfonso et al. formalism, the kfclin,frefQclin,Q correction factor was calculated to correct the deviation of small fields from the reference conditions used for beam calibration. We report on the results obtained for a cohort of 20 patients. The plan complexity was investigated for each plan using the complexity metrics of homogeneity index, conformity index, modulation complexity score, and the fraction of beams from a particular plan that intersect the chamber when performing the QA. Rotated QA gives more consistent results than the collapsed QA technique. The kfclin,frefQclin,Qfactor deviates less from 1 for rotated QA than for collapsed QA. If the homogeneity index is less than 0.05 then the kfclin,frefQclin,Q factor does not deviate from unity by more than 1%. A value this low for the homogeneity index can only be obtained

Design, Implementation, and Verification of the Reliable Multicast Protocol. Thesis

Science.gov (United States)

Montgomery, Todd L.

1995-01-01

This document describes the Reliable Multicast Protocol (RMP) design, first implementation, and formal verification. RMP provides a totally ordered, reliable, atomic multicast service on top of an unreliable multicast datagram service. RMP is fully and symmetrically distributed so that no site bears an undue portion of the communications load. RMP provides a wide range of guarantees, from unreliable delivery to totally ordered delivery, to K-resilient, majority resilient, and totally resilient atomic delivery. These guarantees are selectable on a per message basis. RMP provides many communication options, including virtual synchrony, a publisher/subscriber model of message delivery, a client/server model of delivery, mutually exclusive handlers for messages, and mutually exclusive locks. It has been commonly believed that total ordering of messages can only be achieved at great performance expense. RMP discounts this. The first implementation of RMP has been shown to provide high throughput performance on Local Area Networks (LAN). For two or more destinations a single LAN, RMP provides higher throughput than any other protocol that does not use multicast or broadcast technology. The design, implementation, and verification activities of RMP have occurred concurrently. This has allowed the verification to maintain a high fidelity between design model, implementation model, and the verification model. The restrictions of implementation have influenced the design earlier than in normal sequential approaches. The protocol as a whole has matured smoother by the inclusion of several different perspectives into the product development.

Treatment planning and delivery of involved field radiotherapy in advanced Hodgkin's disease: results from a questionnaire-based audit for the UK Stanford V regimen vs ABVD clinical trial quality assurance programme (ISRCTN 64141244).

Science.gov (United States)

Diez, P; Hoskin, P J; Aird, E G A

2007-10-01

This questionnaire forms the basis of the quality assurance (QA) programme for the UK randomized Phase III study of the Stanford V regimen versus ABVD for treatment of advanced Hodgkin's disease to assess differences between participating centres in treatment planning and delivery of involved-field radiotherapy for Hodgkin's lymphoma The questionnaire, which was circulated amongst 42 participating centres, consisted of seven sections: target volume definition and dose prescription; critical structures; patient positioning and irradiation techniques; planning; dose calculation; verification; and future developments The results are based on 25 responses. One-third plan using CT alone, one-third use solely the simulator and the rest individualize, depending on disease site. Eleven centres determine a dose distribution for each patient. Technique depends on disease site and whether CT or simulator planning is employed. Most departments apply isocentric techniques and use immobilization and customized shielding. In vivo dosimetry is performed in 7 centres and treatment verification occurs in 24 hospitals. In conclusion, the planning and delivery of treatment for lymphoma patients varies across the country. Conventional planning is still widespread but most centres are moving to CT-based planning and virtual simulation with extended use of immobilization, customized shielding and compensation.

Use of Electronic Portal Image Detectors for Quality Assurance of Advanced Treatments

Energy Technology Data Exchange (ETDEWEB)

Moran, Jean M, E-mail: jmmoran@med.umich.ed [Department of Radiation Therapy, University of Michigan, 1500 E. Medical Center Drive, Ann Arbor MI 48109-0010 (United States)

2010-11-01

As the complexity of radiation therapy has increased, the need for quantitative dosimetric evaluation of treatment delivery has also increased. A growing number of investigations have expanded the use of EPIDs from anatomic applications to dosimetric verification. This work focuses on the applications of EPIDs for pre-treatment dosimetric verification of IMRT and intensity modulated arc therapy techniques. The advantages and disadvantages of these techniques are discussed along with methods to extrapolate to 3D dose verification applications.

ETV REPORT AND VERIFICATION STATEMENT - KASELCO POSI-FLO ELECTROCOAGULATION TREATMENT SYSTEM

Science.gov (United States)

The Kaselco Electrocoagulation Treatment System (Kaselco system) in combination with an ion exchange polishing system was tested, under actual production conditions, processing metal finishing wastewater at Gull Industries in Houston, Texas. The verification test evaluated the a...

SU-G-IeP4-06: Feasibility of External Beam Treatment Field Verification Using Cherenkov Imaging

Energy Technology Data Exchange (ETDEWEB)

Black, P; Na, Y; Wuu, C [Columbia University, New York, NY (United States)

2016-06-15

Purpose: Cherenkov light emission has been shown to correlate with ionizing radiation (IR) dose delivery in solid tissue. In order to properly correlate Cherenkov light images with real time dose delivery in a patient, we must account for geometric and intensity distortions arising from observation angle, as well as the effect of monitor units (MU) and field size on Cherenkov light emission. To test the feasibility of treatment field verification, we first focused on Cherenkov light emission efficiency based on MU and known field size (FS). Methods: Cherenkov light emission was captured using a PI-MAX4 intensified charge coupled device(ICCD) system (Princeton Instruments), positioned at a fixed angle of 40° relative to the beam central axis. A Varian TrueBeam linear accelerator (linac) was operated at 6MV and 600MU/min to deliver an Anterior-Posterior beam to a 5cm thick block phantom positioned at 100cm Source-to-Surface-Distance(SSD). FS of 10×10, 5×5, and 2×2cm{sup 2} were used. Before beam delivery projected light field images were acquired, ensuring that geometric distortions were consistent when measuring Cherenkov field discrepancies. Cherenkov image acquisition was triggered by linac target current. 500 frames were acquired for each FS. Composite images were created through summation of frames and background subtraction. MU per image was calculated based on linac pulse delay of 2.8ms. Cherenkov and projected light FS were evaluated using ImageJ software. Results: Mean Cherenkov FS discrepancies compared to light field were <0.5cm for 5.6, 2.8, and 8.6 MU for 10×10, 5×5, and 2×2cm{sup 2} FS, respectably. Discrepancies were reduced with increasing field size and MU. We predict a minimum of 100 frames is needed for reliable confirmation of delivered FS. Conclusion: Current discrepancies in Cherenkov field sizes are within a usable range to confirm treatment delivery in standard and respiratory gated clinical scenarios at MU levels appropriate to

Towards real-time VMAT verification using a prototype, high-speed CMOS active pixel sensor.

Science.gov (United States)

Zin, Hafiz M; Harris, Emma J; Osmond, John P F; Allinson, Nigel M; Evans, Philip M

2013-05-21

This work investigates the feasibility of using a prototype complementary metal oxide semiconductor active pixel sensor (CMOS APS) for real-time verification of volumetric modulated arc therapy (VMAT) treatment. The prototype CMOS APS used region of interest read out on the chip to allow fast imaging of up to 403.6 frames per second (f/s). The sensor was made larger (5.4 cm × 5.4 cm) using recent advances in photolithographic technique but retains fast imaging speed with the sensor's regional read out. There is a paradigm shift in radiotherapy treatment verification with the advent of advanced treatment techniques such as VMAT. This work has demonstrated that the APS can track multi leaf collimator (MLC) leaves moving at 18 mm s(-1) with an automatic edge tracking algorithm at accuracy better than 1.0 mm even at the fastest imaging speed. Evaluation of the measured fluence distribution for an example VMAT delivery sampled at 50.4 f/s was shown to agree well with the planned fluence distribution, with an average gamma pass rate of 96% at 3%/3 mm. The MLC leaves motion and linac pulse rate variation delivered throughout the VMAT treatment can also be measured. The results demonstrate the potential of CMOS APS technology as a real-time radiotherapy dosimeter for delivery of complex treatments such as VMAT.

Sci—Thur PM: Planning and Delivery — 03: Automated delivery and quality assurance of a modulated electron radiation therapy plan

International Nuclear Information System (INIS)

Connell, T; Papaconstadopoulos, P; Alexander, A; Serban, M; Devic, S; Seuntjens, J

2014-01-01

Modulated electron radiation therapy (MERT) offers the potential to improve healthy tissue sparing through increased dose conformity. Challenges remain, however, in accurate beamlet dose calculation, plan optimization, collimation method and delivery accuracy. In this work, we investigate the accuracy and efficiency of an end-to-end MERT plan and automated-delivery workflow for the electron boost portion of a previously treated whole breast irradiation case. Dose calculations were performed using Monte Carlo methods and beam weights were determined using a research-based treatment planning system capable of inverse optimization. The plan was delivered to radiochromic film placed in a water equivalent phantom for verification, using an automated motorized tertiary collimator. The automated delivery, which covered 4 electron energies, 196 subfields and 6183 total MU was completed in 25.8 minutes, including 6.2 minutes of beam-on time with the remainder of the delivery time spent on collimator leaf motion and the automated interfacing with the accelerator in service mode. The delivery time could be reduced by 5.3 minutes with minor electron collimator modifications and the beam-on time could be reduced by and estimated factor of 2–3 through redesign of the scattering foils. Comparison of the planned and delivered film dose gave 3%/3 mm gamma pass rates of 62.1, 99.8, 97.8, 98.3, and 98.7 percent for the 9, 12, 16, 20 MeV, and combined energy deliveries respectively. Good results were also seen in the delivery verification performed with a MapCHECK 2 device. The results showed that accurate and efficient MERT delivery is possible with current technologies

X-ray volume imaging in bladder radiotherapy verification

International Nuclear Information System (INIS)

Henry, Ann M.; Stratford, Julia; McCarthy, Claire; Davies, Julie; Sykes, Jonathan R.; Amer, Ali; Marchant, Tom; Cowan, Richard; Wylie, James; Logue, John; Livsey, Jacqueline; Khoo, Vincent S.; Moore, Chris; Price, Pat

2006-01-01

Purpose: To assess the clinical utility of X-ray volume imaging (XVI) for verification of bladder radiotherapy and to quantify geometric error in bladder radiotherapy delivery. Methods and Materials: Twenty subjects undergoing conformal bladder radiotherapy were recruited. X-ray volume images and electronic portal images (EPIs) were acquired for the first 5 fractions and then once weekly. X-ray volume images were co-registered with the planning computed tomography scan and clinical target volume coverage assessed in three dimensions (3D). Interfraction bladder volume change was described by quantifying changes in bladder volume with time. Bony setup errors were compared from both XVI and EPI. Results: The bladder boundary was clearly visible on coronal XVI views in nearly all images, allowing accurate 3D treatment verification. In 93.5% of imaged fractions, the clinical target volume was within the planning target volume. Most subjects displayed consistent bladder volumes, but 25% displayed changes that could be predicted from the first three XVIs. Bony setup errors were similar whether calculated from XVI or EPI. Conclusions: Coronal XVI can be used to verify 3D bladder radiotherapy delivery. Image-guided interventions to reduce geographic miss and normal tissue toxicity are feasible with this technology

TU-CD-304-03: Dosimetric Verification and Preliminary Comparison of Dynamic Wave Arc for SBRT Treatments

Energy Technology Data Exchange (ETDEWEB)

Burghelea, M [UZ BRUSSEL, Brussels (Belgium); BRAINLAB AG, Munich (Germany); Babes Bolyai University, Cluj-Napoca (Romania); Poels, K; Gevaert, T; Tournel, K; Dhont, J; De Ridder, M; Verellen, D [UZ BRUSSEL, Brussels (Belgium); Hung, C [BRAINLAB AG, Munich (Germany); Eriksson, K [RAYSEARCH LABORATORIES AB, Stockholm (Sweden); Simon, V [Babes Bolyai University, Cluj-Napoca (Romania)

2015-06-15

Purpose: To evaluate the potential dosimetric benefits and verify the delivery accuracy of Dynamic Wave Arc, a novel treatment delivery approach for the Vero SBRT system. Methods: Dynamic Wave Arc (DWA) combines simultaneous movement of gantry/ring with inverse planning optimization, resulting in an uninterrupted non-coplanar arc delivery technique. Thirteen SBRT complex cases previously treated with 8–10 conformal static beams (CRT) were evaluated in this study. Eight primary centrally-located NSCLC (prescription dose 4×12Gy or 8×7.5Gy) and five oligometastatic cases (2×2 lesions, 10×5Gy) were selected. DWA and coplanar VMAT plans, partially with dual arcs, were generated for each patient using identical objective functions for target volumes and OARs on the same TPS (RayStation, RaySearch Laboratories). Dosimetric differences and delivery time among these three planning schemes were evaluated. The DWA delivery accuracy was assessed using the Delta4 diode array phantom (ScandiDos AB). The gamma analysis was performed with the 3%/3mm dose and distance-to-agreement criteria. Results: The target conformity for CRT, VMAT and DWA were 0.95±0.07, 0.96±0.04 and 0.97±0.04, while the low dose spillage gradient were 5.52±1.36, 5.44±1.11, and 5.09±0.98 respectively. Overall, the bronchus, esophagus and spinal cord maximum doses were similar between VMAT and DWA, but highly reduced compared with CRT. For the lung cases, the mean dose and V20Gy were lower for the arc techniques compares with CRT, while for the liver cases, the mean dose and the V30Gy presented slightly higher values. The average delivery time of VMAT and DWA were 2.46±1.10 min and 4.25±1.67 min, VMAT presenting shorter treatment time in all cases. The DWA dosimetric verification presented an average gamma index passing rate of 95.73±1.54% (range 94.2%–99.8%). Conclusion: Our preliminary data indicated that the DWA is deliverable with clinically acceptable accuracy and has the potential to

TU-CD-304-03: Dosimetric Verification and Preliminary Comparison of Dynamic Wave Arc for SBRT Treatments

International Nuclear Information System (INIS)

Burghelea, M; Poels, K; Gevaert, T; Tournel, K; Dhont, J; De Ridder, M; Verellen, D; Hung, C; Eriksson, K; Simon, V

2015-01-01

Purpose: To evaluate the potential dosimetric benefits and verify the delivery accuracy of Dynamic Wave Arc, a novel treatment delivery approach for the Vero SBRT system. Methods: Dynamic Wave Arc (DWA) combines simultaneous movement of gantry/ring with inverse planning optimization, resulting in an uninterrupted non-coplanar arc delivery technique. Thirteen SBRT complex cases previously treated with 8–10 conformal static beams (CRT) were evaluated in this study. Eight primary centrally-located NSCLC (prescription dose 4×12Gy or 8×7.5Gy) and five oligometastatic cases (2×2 lesions, 10×5Gy) were selected. DWA and coplanar VMAT plans, partially with dual arcs, were generated for each patient using identical objective functions for target volumes and OARs on the same TPS (RayStation, RaySearch Laboratories). Dosimetric differences and delivery time among these three planning schemes were evaluated. The DWA delivery accuracy was assessed using the Delta4 diode array phantom (ScandiDos AB). The gamma analysis was performed with the 3%/3mm dose and distance-to-agreement criteria. Results: The target conformity for CRT, VMAT and DWA were 0.95±0.07, 0.96±0.04 and 0.97±0.04, while the low dose spillage gradient were 5.52±1.36, 5.44±1.11, and 5.09±0.98 respectively. Overall, the bronchus, esophagus and spinal cord maximum doses were similar between VMAT and DWA, but highly reduced compared with CRT. For the lung cases, the mean dose and V20Gy were lower for the arc techniques compares with CRT, while for the liver cases, the mean dose and the V30Gy presented slightly higher values. The average delivery time of VMAT and DWA were 2.46±1.10 min and 4.25±1.67 min, VMAT presenting shorter treatment time in all cases. The DWA dosimetric verification presented an average gamma index passing rate of 95.73±1.54% (range 94.2%–99.8%). Conclusion: Our preliminary data indicated that the DWA is deliverable with clinically acceptable accuracy and has the potential to

MO-E-BRB-04: Real-Time Exit-Fluence Delivery Validation

Energy Technology Data Exchange (ETDEWEB)

Siebers, J. [University of Virginia Health System (United States)

2015-06-15

Recent high profile reports of technical failures and human errors causing severe radiation- induced injuries and deaths come in support of the sustained efforts to ensure patient safety in the delivery of radiation treatments. In addition, highly conformal radiation therapies and escalated fraction doses mandate increased and sustained accuracy of the entire radiotherapy process. Consequently, and as a Result of AAPM and ASTRO led efforts patient specific quality assurance for specialized radiation treatments such as IMRT, SRS/SBRT and Arc Therapy had become a three-tier process: Pre-treatment, during treatment, and post treatment patient specific QA. Traditional patient QA consists of pre-treatment data transfer integrity dosimetric verifications and during-treatment geometric verifications. However, as treatment adaptation becomes closer to deployment in the clinics, during treatment validation via exit detectors had become a realistic QA option, permitting plan assessment in near real time. Post-treatment, machine logs allow comparisons of a range of mechanical parameters. A combination of these techniques could be used in evaluating inter-fraction, and intra-fraction delivery over a long time period such as an year, to evaluate the significant errors per site, per treatment technique. This type of data mining over longer periods of time provides the potential to recognize suboptimal radiation treatments, while allowing to identify systematic, possibly significant errors. This would allow creation of a data base of realized errors, small and large in dosimetry that could be for process or equipment improvement. This educational symposium will describe and review patient QA techniques, results, and strategies for patient specific quality assurance. Learning Objectives: review the goals of pre-treatment QA for various specialized procedures review methods and means for pre-treatment QA, limitations and tolerances review the scenarios where Varian/Tomo Log files

MO-E-BRB-04: Real-Time Exit-Fluence Delivery Validation

International Nuclear Information System (INIS)

Siebers, J.

2015-01-01

Recent high profile reports of technical failures and human errors causing severe radiation- induced injuries and deaths come in support of the sustained efforts to ensure patient safety in the delivery of radiation treatments. In addition, highly conformal radiation therapies and escalated fraction doses mandate increased and sustained accuracy of the entire radiotherapy process. Consequently, and as a Result of AAPM and ASTRO led efforts patient specific quality assurance for specialized radiation treatments such as IMRT, SRS/SBRT and Arc Therapy had become a three-tier process: Pre-treatment, during treatment, and post treatment patient specific QA. Traditional patient QA consists of pre-treatment data transfer integrity dosimetric verifications and during-treatment geometric verifications. However, as treatment adaptation becomes closer to deployment in the clinics, during treatment validation via exit detectors had become a realistic QA option, permitting plan assessment in near real time. Post-treatment, machine logs allow comparisons of a range of mechanical parameters. A combination of these techniques could be used in evaluating inter-fraction, and intra-fraction delivery over a long time period such as an year, to evaluate the significant errors per site, per treatment technique. This type of data mining over longer periods of time provides the potential to recognize suboptimal radiation treatments, while allowing to identify systematic, possibly significant errors. This would allow creation of a data base of realized errors, small and large in dosimetry that could be for process or equipment improvement. This educational symposium will describe and review patient QA techniques, results, and strategies for patient specific quality assurance. Learning Objectives: review the goals of pre-treatment QA for various specialized procedures review methods and means for pre-treatment QA, limitations and tolerances review the scenarios where Varian/Tomo Log files

Regional MLEM reconstruction strategy for PET-based treatment verification in ion beam radiotherapy

International Nuclear Information System (INIS)

Gianoli, Chiara; Riboldi, Marco; Fattori, Giovanni; Baselli, Giuseppe; Baroni, Guido; Bauer, Julia; Debus, Jürgen; Parodi, Katia; De Bernardi, Elisabetta

2014-01-01

In ion beam radiotherapy, PET-based treatment verification provides a consistency check of the delivered treatment with respect to a simulation based on the treatment planning. In this work the region-based MLEM reconstruction algorithm is proposed as a new evaluation strategy in PET-based treatment verification. The comparative evaluation is based on reconstructed PET images in selected regions, which are automatically identified on the expected PET images according to homogeneity in activity values. The strategy was tested on numerical and physical phantoms, simulating mismatches between the planned and measured β + activity distributions. The region-based MLEM reconstruction was demonstrated to be robust against noise and the sensitivity of the strategy results were comparable to three voxel units, corresponding to 6 mm in numerical phantoms. The robustness of the region-based MLEM evaluation outperformed the voxel-based strategies. The potential of the proposed strategy was also retrospectively assessed on patient data and further clinical validation is envisioned. (paper)

Clinical implications of the anisotropic analytical algorithm for IMRT treatment planning and verification

International Nuclear Information System (INIS)

Bragg, Christopher M.; Wingate, Katrina; Conway, John

2008-01-01

Purpose: To determine the implications of the use of the Anisotropic Analytical Algorithm (AAA) for the production and dosimetric verification of IMRT plans for treatments of the prostate, parotid, nasopharynx and lung. Methods: 72 IMRT treatment plans produced using the Pencil Beam Convolution (PBC) algorithm were recalculated using the AAA and the dose distributions compared. Twenty-four of the plans were delivered to inhomogeneous phantoms and verification measurements made using a pinpoint ionisation chamber. The agreement between the AAA and measurement was determined. Results: Small differences were seen in the prostate plans, with the AAA predicting slightly lower minimum PTV doses. In the parotid plans, there were small increases in the lens and contralateral parotid doses while the nasopharyngeal plans revealed a reduction in the volume of the PTV covered by the 95% isodose (the V 95% ) when the AAA was used. Large changes were seen in the lung plans, the AAA predicting reductions in the minimum PTV dose and large reductions in the V 95% . The AAA also predicted small increases in the mean dose to the normal lung and the V 20 . In the verification measurements, all AAA calculations were within 3% or 3.5 mm distance to agreement of the measured doses. Conclusions: The AAA should be used in preference to the PBC algorithm for treatments involving low density tissue but this may necessitate re-evaluation of plan acceptability criteria. Improvements to the Multi-Resolution Dose Calculation algorithm used in the inverse planning are required to reduce the convergence error in the presence of lung tissue. There was excellent agreement between the AAA and verification measurements for all sites

Treatment accuracy of fractionated stereotactic radiotherapy

International Nuclear Information System (INIS)

Kumar, Shaleen; Burke, Kevin; Nalder, Colin; Jarrett, Paula; Mubata, Cephas; A'Hern, Roger; Humphreys, Mandy; Bidmead, Margaret; Brada, Michael

2005-01-01

Background and purpose: To assess the geometric accuracy of the delivery of fractionated stereotactic radiotherapy (FSRT) for brain tumours using the Gill-Thomas-Cosman (GTC) relocatable frame. Accuracy of treatment delivery was measured via portal images acquired with an amorphous silicon based electronic portal imager (EPI). Results were used to assess the existing verification process and to review the current margins used for the expansion of clinical target volume (CTV) to planning target volume (PTV). Patients and methods: Patients were immobilized in a GTC frame. Target volume definition was performed on localization CT and MRI scans and a CTV to PTV margin of 5 mm (based on initial experience) was introduced in 3D. A Brown-Roberts-Wells (BRW) fiducial system was used for stereotactic coordinate definition. The existing verification process consisted of an intercomparison of the coordinates of the isocentres and anatomy between the localization and verification CT scans. Treatment was delivered with 6 MV photons using four fixed non-coplanar conformal fields using a multi-leaf collimator. Portal imaging verification consisted of the acquisition of orthogonal images centred through the treatment isocentre. Digitally reconstructed radiographs (DRRs) created from the CT localization scans were used as reference images. Semi-automated matching software was used to quantify set up deviations (displacements and rotations) between reference and portal images. Results: One hundred and twenty six anterior and 123 lateral portal images were available for analysis for set up deviations. For displacements, the total errors in the cranial/caudal direction were shown to have the largest SD's of 1.2 mm, while systematic and random errors reached SD's of 1.0 and 0.7 mm, respectively, in the cranial/caudal direction. The corresponding data for rotational errors (the largest deviation was found in the sagittal plane) was 0.7 deg. SD (total error), 0.5 deg. (systematic) and 0

SU-E-P-27: Efficient Process for AccuBoost Planning and Treatment Delivery to Minimize Patient Compression Time

Energy Technology Data Exchange (ETDEWEB)

Iftimia, I; Talmadge, M; Halvorsen, P [Lahey Clinic, Burlington, MA (United States)

2015-06-15

Purpose: To implement an efficient and robust process for AccuBoost planning and treatment delivery that can be safely performed by a single Physicist while minimizing patient’s total session time. Methods: Following a thorough commissioning and validation process, templates were created in the brachytherapy planning system for each AccuBoost applicator. Tables of individual and total nominal dwell times for each applicator as a function of separation were generated to streamline planning while an Excel-based nomogram provided by the vendor functions as a secondary verification of the treatment parameters. Tables of surface dose as a function of separation and applicator, along with concise guidance documents for applicator selection, are readily available during the planning process. The entire process is described in a set of detailed Standard Operating Procedures which, in addition to the items described above, include a verbal time-out between the primary planner and the individual performing the secondary verification as well as direct visual confirmation of applicator placement using an articulated mirror. Prior to treatment initiation, a final time-out is conducted with the Radiation Oncologist. Chart documentation is finalized after the patient is released from compression following completion of the treatment. Results: With the aforementioned procedures, it has been possible to consistently limit the time required to prepare each treatment such that the patient is typically under compression for less than 10 minutes per orientation prior to the initiation of the treatment, which is particularly important for APBI cases. This process can be overseen by a single physicist assisted by a dosimetrist and has been optimized during the past 16 months, with 180 treatment sessions safely completed to date. Conclusion: This work demonstrates the implementation of an efficient and robust process for real-time-planned AccuBoost treatments that effectively minimizes

TH-B-204-03: TG-199: Implanted Markers for Radiation Treatment Verification

International Nuclear Information System (INIS)

Wang, Z.

2016-01-01

Implanted markers as target surrogates have been widely used for treatment verification, as they provide safe and reliable monitoring of the inter- and intra-fractional target motion. The rapid advancement of technology requires a critical review and recommendation for the usage of implanted surrogates in current field. The symposium, also reporting an update of AAPM TG 199 - Implanted Target Surrogates for Radiation Treatment Verification, will be focusing on all clinical aspects of using the implanted target surrogates for treatment verification and related issues. A wide variety of markers available in the market will be first reviewed, including radiopaque markers, MRI compatible makers, non-migrating coils, surgical clips and electromagnetic transponders etc. The pros and cons of each kind will be discussed. The clinical applications of implanted surrogates will be presented based on different anatomical sites. For the lung, we will discuss gated treatments and 2D or 3D real-time fiducial tracking techniques. For the prostate, we will be focusing on 2D-3D, 3D-3D matching and electromagnetic transponder based localization techniques. For the liver, we will review techniques when patients are under gating, shallow or free breathing condition. We will review techniques when treating challenging breast cancer as deformation may occur. Finally, we will summarize potential issues related to the usage of implanted target surrogates with TG 199 recommendations. A review of fiducial migration and fiducial derived target rotation in different disease sites will be provided. The issue of target deformation, especially near the diaphragm, and related suggestions will be also presented and discussed. Learning Objectives: Knowledge of a wide variety of markers Knowledge of their application for different disease sites Understand of issues related to these applications Z. Wang: Research funding support from Brainlab AG Q. Xu: Consultant for Accuray; Q. Xu, I am a consultant

TH-B-204-03: TG-199: Implanted Markers for Radiation Treatment Verification

Energy Technology Data Exchange (ETDEWEB)

Wang, Z. [Duke University Medical Center (United States)

2016-06-15

Implanted markers as target surrogates have been widely used for treatment verification, as they provide safe and reliable monitoring of the inter- and intra-fractional target motion. The rapid advancement of technology requires a critical review and recommendation for the usage of implanted surrogates in current field. The symposium, also reporting an update of AAPM TG 199 - Implanted Target Surrogates for Radiation Treatment Verification, will be focusing on all clinical aspects of using the implanted target surrogates for treatment verification and related issues. A wide variety of markers available in the market will be first reviewed, including radiopaque markers, MRI compatible makers, non-migrating coils, surgical clips and electromagnetic transponders etc. The pros and cons of each kind will be discussed. The clinical applications of implanted surrogates will be presented based on different anatomical sites. For the lung, we will discuss gated treatments and 2D or 3D real-time fiducial tracking techniques. For the prostate, we will be focusing on 2D-3D, 3D-3D matching and electromagnetic transponder based localization techniques. For the liver, we will review techniques when patients are under gating, shallow or free breathing condition. We will review techniques when treating challenging breast cancer as deformation may occur. Finally, we will summarize potential issues related to the usage of implanted target surrogates with TG 199 recommendations. A review of fiducial migration and fiducial derived target rotation in different disease sites will be provided. The issue of target deformation, especially near the diaphragm, and related suggestions will be also presented and discussed. Learning Objectives: Knowledge of a wide variety of markers Knowledge of their application for different disease sites Understand of issues related to these applications Z. Wang: Research funding support from Brainlab AG Q. Xu: Consultant for Accuray; Q. Xu, I am a consultant

Update on Nanotechnology-based Drug Delivery Systems in Cancer Treatment.

Science.gov (United States)

Ho, Benjamin N; Pfeffer, Claire M; Singh, Amareshwar T K

2017-11-01

The emerging field of nanotechnology meets the demands for innovative approaches in the diagnosis and treatment of cancer. The nanoparticles are biocompatible and biodegradable and are made of a core, a particle that acts as a carrier, and one or more functional groups on the core which target specific sites. Nanotech in drug delivery includes nanodisks, High Density Lipoprotein nanostructures, liposomes, and gold nanoparticles. The fundamental advantages of nanoparticles are: improved delivery of water-insoluble drugs, targeted delivery, co-delivery of two or more drugs for combination therapy, and visualization of the drug delivery site by combining imaging system and a therapeutic drug. One of the potential applications of nanotechnology is in the treatment of cancer. Conventional methods for cancer treatments have included chemotherapy, surgery, or radiation. Early recognition and treatment of cancer with these approaches is still challenging. Innovative technologies are needed to overcome multidrug resistance, and increase drug localization and efficacy. Application of nanotechnology to cancer biology has brought in a new hope for developing treatment strategies on cancer. In this study, we present a review on the recent advances in nanotechnology-based approaches in cancer treatment. Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

SU-E-T-602: Patient-Specific Online Dose Verification Based On Transmission Detector Measurements

Energy Technology Data Exchange (ETDEWEB)

Thoelking, J; Yuvaraj, S; Jens, F; Lohr, F; Wenz, F; Wertz, H; Wertz, H [University Medical Center Mannheim, University of Heidelberg, Mannheim, Baden-Wuerttemberg (Germany)

2015-06-15

Purpose: Intensity modulated radiotherapy requires a comprehensive quality assurance program in general and ideally independent verification of dose delivery. Since conventional 2D detector arrays allow only pre-treatment verification, there is a debate concerning the need of online dose verification. This study presents the clinical performance, including dosimetric plan verification in 2D as well as in 3D and the error detection abilities of a new transmission detector (TD) for online dose verification of 6MV photon beam. Methods: To validate the dosimetric performance of the new device, dose reconstruction based on TD measurements were compared to a conventional pre-treatment verification method (reference) and treatment planning system (TPS) for 18 IMRT and VMAT treatment plans. Furthermore, dose reconstruction inside the patient based on TD read-out was evaluated by comparing various dose volume indices and 3D gamma evaluations against independent dose computation and TPS. To investigate the sensitivity of the new device, different types of systematic and random errors for leaf positions and linac output were introduced in IMRT treatment sequences. Results: The 2D gamma index evaluation of transmission detector based dose reconstruction showed an excellent agreement for all IMRT and VMAT plans compared to reference measurements (99.3±1.2)% and TPS (99.1±0.7)%. Good agreement was also obtained for 3D dose reconstruction based on TD read-out compared to dose computation (mean gamma value of PTV = 0.27±0.04). Only a minimal dose underestimation within the target volume was observed when analyzing DVH indices (<1%). Positional errors in leaf banks larger than 1mm and errors in linac output larger than 2% could clearly identified with the TD. Conclusion: Since 2D and 3D evaluations for all IMRT and VMAT treatment plans were in excellent agreement with reference measurements and dose computation, the new TD is suitable to qualify for routine treatment plan

SU-E-T-602: Patient-Specific Online Dose Verification Based On Transmission Detector Measurements

International Nuclear Information System (INIS)

Thoelking, J; Yuvaraj, S; Jens, F; Lohr, F; Wenz, F; Wertz, H; Wertz, H

2015-01-01

Purpose: Intensity modulated radiotherapy requires a comprehensive quality assurance program in general and ideally independent verification of dose delivery. Since conventional 2D detector arrays allow only pre-treatment verification, there is a debate concerning the need of online dose verification. This study presents the clinical performance, including dosimetric plan verification in 2D as well as in 3D and the error detection abilities of a new transmission detector (TD) for online dose verification of 6MV photon beam. Methods: To validate the dosimetric performance of the new device, dose reconstruction based on TD measurements were compared to a conventional pre-treatment verification method (reference) and treatment planning system (TPS) for 18 IMRT and VMAT treatment plans. Furthermore, dose reconstruction inside the patient based on TD read-out was evaluated by comparing various dose volume indices and 3D gamma evaluations against independent dose computation and TPS. To investigate the sensitivity of the new device, different types of systematic and random errors for leaf positions and linac output were introduced in IMRT treatment sequences. Results: The 2D gamma index evaluation of transmission detector based dose reconstruction showed an excellent agreement for all IMRT and VMAT plans compared to reference measurements (99.3±1.2)% and TPS (99.1±0.7)%. Good agreement was also obtained for 3D dose reconstruction based on TD read-out compared to dose computation (mean gamma value of PTV = 0.27±0.04). Only a minimal dose underestimation within the target volume was observed when analyzing DVH indices (<1%). Positional errors in leaf banks larger than 1mm and errors in linac output larger than 2% could clearly identified with the TD. Conclusion: Since 2D and 3D evaluations for all IMRT and VMAT treatment plans were in excellent agreement with reference measurements and dose computation, the new TD is suitable to qualify for routine treatment plan

Enhanced skin delivery of vismodegib by microneedle treatment.

Science.gov (United States)

Nguyen, Hiep X; Banga, Ajay K

2015-08-01

The present study investigated the effects of microneedle treatment (maltose microneedles, Admin Pen™ 1200, and Admin Pen™ 1500) on in vitro transdermal delivery of vismodegib with different needle lengths, skin equilibration times, and microneedle insertion durations. The influence of microneedle treatment on the dimensions of microchannels (dye binding, calcein imaging, histology, and confocal microscopy studies), transepidermal water loss, and skin permeability of vismodegib was also evaluated. Skin viscoelasticity was assessed using a rheometer, and microneedle geometry was characterized by scanning electron microscopy. Permeation studies of vismodegib through dermatomed porcine ear skin were conducted using vertical Franz diffusion cells. Skin irritation potential of vismodegib formulation was assessed using an in vitro reconstructed human epidermis model. Results of the in vitro permeation studies revealed significant enhancement in permeation of vismodegib through microneedle-treated skin. As the needle length increased from 500 to 1100 and 1400 μm, drug delivery increased from 14.50 ± 2.35 to 32.38 ± 3.33 and 74.40 ± 15.86 μg/cm(2), respectively. Positive correlation between drug permeability and microneedle treatment duration was observed. The equilibration time was also found to affect the delivery of vismodegib. Thus, changes in microneedle length, equilibration time, and duration of treatment altered transdermal delivery of vismodegib.

A computer-controlled conformal radiotherapy system. III: graphical simulation and monitoring of treatment delivery

International Nuclear Information System (INIS)

Kessler, Marc L.; McShan, Daniel L.; Fraass, Benedick A.

1995-01-01

Purpose: Safe and efficient delivery of radiotherapy using computer-controlled machines requires new procedures to design and verify the actual delivery of these treatments. Graphical simulation and monitoring techniques for treatment delivery have been developed for this purpose. Methods and Materials: A graphics-based simulator of the treatment machine and a set of procedures for creating and manipulating treatment delivery scripts are used to simulate machine motions, detect collisions, and monitor machine positions during treatment. The treatment delivery simulator is composed of four components: a three-dimensional dynamic model of the treatment machine; a motion simulation and collision detection algorithm, user-interface widgets that mimic the treatment machine's control and readout devices; and an icon-based interface for creating and manipulating treatment delivery scripts. These components are used in a stand-alone fashion for interactive treatment delivery planning and integrated with a machine control system for treatment implementation and monitoring. Results: A graphics-based treatment delivery simulator and a set of procedures for planning and monitoring computer-controlled treatment delivery have been developed and implemented as part of a comprehensive computer-controlled conformal radiotherapy system. To date, these techniques have been used to design and help monitor computer-controlled treatments on a radiotherapy machine for more than 200 patients. Examples using these techniques for treatment delivery planning and on-line monitoring of machine motions during therapy are described. Conclusion: A system that provides interactive graphics-based tools for defining the sequence of machine motions, simulating treatment delivery including collision detection, and presenting the therapists with continual visual feedback from the treatment machine has been successfully implemented for routine clinical use as part of an overall system for computer

Dosimetric verification of radiotherapy treatment planning systems in Serbia: national audit

OpenAIRE

Rutonjski Laza; Petrović Borislava; Baucal Milutin; Teodorović Milan; Čudić Ozren; Gershkevitsh Eduard; Izewska Joanna

2012-01-01

Abstract Background Independent external audits play an important role in quality assurance programme in radiation oncology. The audit supported by the IAEA in Serbia was designed to review the whole chain of activities in 3D conformal radiotherapy (3D-CRT) workflow, from patient data acquisition to treatment planning and dose delivery. The audit was based on the IAEA recommendations and focused on dosimetry part of the treatment planning and delivery processes. Methods The audit was conducte...

Prostate HDR brachytherapy catheter displacement between planning and treatment delivery

International Nuclear Information System (INIS)

Whitaker, May; Hruby, George; Lovett, Aimee; Patanjali, Nitya

2011-01-01

Background and purpose: HDR brachytherapy is used as a conformal boost for treating prostate cancer. Given the large doses delivered, it is critical that the volume treated matches that planned. Our outpatient protocol comprises two 9 Gy fractions, two weeks apart. We prospectively assessed catheter displacement between CT planning and treatment delivery. Materials and methods: Three fiducial markers and the catheters were implanted under transrectal ultrasound guidance. Metal marker wires were inserted into 4 reference catheters before CT; marker positions relative to each other and to the marker wires were measured from the CT scout. Measurements were repeated immediately prior to treatment delivery using pelvic X-ray with marker wires in the same reference catheters. Measurements from CT scout and film were compared. For displacements of 5 mm or more, indexer positions were adjusted prior to treatment delivery. Results: Results are based on 48 implants, in 25 patients. Median time from planning CT to treatment delivery was 254 min (range 81–367 min). Median catheter displacement was 7.5 mm (range −2.9–23.9 mm), 67% of implants had displacement of 5 mm or greater. Displacements were predominantly caudal. Conclusions: Catheter displacement can occur in the 1–3 h between the planning CT scan and treatment. It is recommended that departments performing HDR prostate brachytherapy verify catheter positions immediately prior to treatment delivery.

Treatment verification and in vivo dosimetry for total body irradiation using thermoluminescent and semiconductor detectors

International Nuclear Information System (INIS)

Oliveira, F.F.; Amaral, L.L.; Costa, A.M.; Netto, T.G.

2014-01-01

The objective of this work is the characterization of thermoluminescent and semiconductor detectors and their applications in treatment verification and in vivo dosimetry for total body irradiation (TBI) technique. Dose measurements of TBI treatment simulation performed with thermoluminescent detectors inserted in the holes of a “Rando anthropomorphic phantom” showed agreement with the prescribed dose. For regions of the upper and lower chest where thermoluminescent detectors received higher doses it was recommended the use of compensating dose in clinic. The results of in vivo entrance dose measurements for three patients are presented. The maximum percentual deviation between the measurements and the prescribed dose was 3.6%, which is consistent with the action level recommended by the International Commission on Radiation Units and Measurements (ICRU), i.e., ±5%. The present work to test the applicability of a thermoluminescent dosimetric system and of a semiconductor dosimetric system for performing treatment verification and in vivo dose measurements in TBI techniques demonstrated the value of these methods and the applicability as a part of a quality assurance program in TBI treatments. - Highlights: • Characterization of a semiconductor dosimetric system. • Characterization of a thermoluminescent dosimetric system. • Application of the TLDs for treatment verification in total body irradiation treatments. • Application of semiconductor detectors for in vivo dosimetry in total body irradiation treatments. • Implementation of in vivo dosimetry as a part of a quality assurance program in radiotherapy

Methods to model and predict the ViewRay treatment deliveries to aid patient scheduling and treatment planning.

Science.gov (United States)

Liu, Shi; Wu, Yu; Wooten, H Omar; Green, Olga; Archer, Brent; Li, Harold; Yang, Deshan

2016-03-08

A software tool is developed, given a new treatment plan, to predict treatment delivery time for radiation therapy (RT) treatments of patients on ViewRay magnetic resonance image-guided radiation therapy (MR-IGRT) delivery system. This tool is necessary for managing patient treatment scheduling in our clinic. The predicted treatment delivery time and the assessment of plan complexities could also be useful to aid treatment planning. A patient's total treatment delivery time, not including time required for localization, is modeled as the sum of four components: 1) the treatment initialization time; 2) the total beam-on time; 3) the gantry rotation time; and 4) the multileaf collimator (MLC) motion time. Each of the four components is predicted separately. The total beam-on time can be calculated using both the planned beam-on time and the decay-corrected dose rate. To predict the remain-ing components, we retrospectively analyzed the patient treatment delivery record files. The initialization time is demonstrated to be random since it depends on the final gantry angle of the previous treatment. Based on modeling the relationships between the gantry rotation angles and the corresponding rotation time, linear regression is applied to predict the gantry rotation time. The MLC motion time is calculated using the leaves delay modeling method and the leaf motion speed. A quantitative analysis was performed to understand the correlation between the total treatment time and the plan complexity. The proposed algorithm is able to predict the ViewRay treatment delivery time with the average prediction error 0.22min or 1.82%, and the maximal prediction error 0.89 min or 7.88%. The analysis has shown the correlation between the plan modulation (PM) factor and the total treatment delivery time, as well as the treatment delivery duty cycle. A possibility has been identified to significantly reduce MLC motion time by optimizing the positions of closed MLC pairs. The accuracy of

Multicentre validation of IMRT pre-treatment verification: Comparison of in-house and external audit

International Nuclear Information System (INIS)

Jornet, Núria; Carrasco, Pablo; Beltrán, Mercè; Calvo, Juan Francisco; Escudé, Lluís; Hernández, Victor; Quera, Jaume; Sáez, Jordi

2014-01-01

Background and purpose: We performed a multicentre intercomparison of IMRT optimisation and dose planning and IMRT pre-treatment verification methods and results. The aims were to check consistency between dose plans and to validate whether in-house pre-treatment verification results agreed with those of an external audit. Materials and methods: Participating centres used two mock cases (prostate and head and neck) for the intercomparison and audit. Compliance to dosimetric goals and total number of MU per plan were collected. A simple quality index to compare the different plans was proposed. We compared gamma index pass rates using the centre’s equipment and methodology to those of an external audit. Results: While for the prostate case, all centres fulfilled the dosimetric goals and plan quality was homogeneous, that was not the case for the head and neck case. The number of MU did not correlate with the plan quality index. Pre-treatment verifications results of the external audit did not agree with those of the in-house measurements for two centres: being within tolerance for in-house measurements and unacceptable for the audit or the other way round. Conclusions: Although all plans fulfilled dosimetric constraints, plan quality is highly dependent on the planner expertise. External audits are an excellent tool to detect errors in IMRT implementation and cannot be replaced by intercomparison using results obtained by centres

SU-D-201-03: During-Treatment Delivery Monitoring System for TomoTherapy

Energy Technology Data Exchange (ETDEWEB)

Chen, Q; Read, P [University of Virginia, Charlottesville, VA (United States)

2016-06-15

Purpose: Multiple error pathways can lead to delivery errors during the treatment course that cannot be caught with pre-treatment QA. While in vivo solutions are being developed for linacs, no such solution exists for tomotherapy. The purpose of this study is to develop a near real-time system for tomotherapy that can monitor the delivery and dose accumulation process during the treatment-delivery, which enable the user to assess the impact of delivery variations and/or errors and to interrupt the treatment if necessary. Methods: A program running on a tomotherapy planning station fetches the raw DAS data during treatment. Exit detector data is extracted as well as output, gantry angle, and other machine parameters. For each sample, the MLC open-close state is determined. The delivered plan is compared with the original plan via a Monte Carlo dose engine which transports fluence deviations from a pre-treatment Monte Carlo run. A report containing the difference in fluence, dose and DVH statistics is created in html format. This process is repeated until the treatment is completed. Results: Since we only need to compute the dose for the difference in fluence for a few projections each time, dose with 2% statistical uncertainty can be computed in less than 1 second on a 4-core cpu. However, the current bottleneck in this near real-time system is the repeated fetching and processing the growing DAS data file throughout the delivery. The frame rate drops from 10Hz at the beginning of treatment to 5Hz after 3 minutes and to 2Hz after 10 minutes. Conclusion: A during-treatment delivery monitor system has been built to monitor tomotherapy treatments. The system improves patient safety by allowing operators to assess the delivery variations and errors during treatment delivery and adopt appropriate actions.

SU-D-201-03: During-Treatment Delivery Monitoring System for TomoTherapy

International Nuclear Information System (INIS)

Chen, Q; Read, P

2016-01-01

Purpose: Multiple error pathways can lead to delivery errors during the treatment course that cannot be caught with pre-treatment QA. While in vivo solutions are being developed for linacs, no such solution exists for tomotherapy. The purpose of this study is to develop a near real-time system for tomotherapy that can monitor the delivery and dose accumulation process during the treatment-delivery, which enable the user to assess the impact of delivery variations and/or errors and to interrupt the treatment if necessary. Methods: A program running on a tomotherapy planning station fetches the raw DAS data during treatment. Exit detector data is extracted as well as output, gantry angle, and other machine parameters. For each sample, the MLC open-close state is determined. The delivered plan is compared with the original plan via a Monte Carlo dose engine which transports fluence deviations from a pre-treatment Monte Carlo run. A report containing the difference in fluence, dose and DVH statistics is created in html format. This process is repeated until the treatment is completed. Results: Since we only need to compute the dose for the difference in fluence for a few projections each time, dose with 2% statistical uncertainty can be computed in less than 1 second on a 4-core cpu. However, the current bottleneck in this near real-time system is the repeated fetching and processing the growing DAS data file throughout the delivery. The frame rate drops from 10Hz at the beginning of treatment to 5Hz after 3 minutes and to 2Hz after 10 minutes. Conclusion: A during-treatment delivery monitor system has been built to monitor tomotherapy treatments. The system improves patient safety by allowing operators to assess the delivery variations and errors during treatment delivery and adopt appropriate actions.

Development of a computerized portal verification scheme for pelvic treatment fields

International Nuclear Information System (INIS)

Nie, K.; Yin, F.-F.; Gao, Q.; Brasacchio, R.

1996-01-01

Purpose/Objective: At present, treatment verification between portal and reference images is performed based on manually-identified features by radiation oncologist, which is both time-consuming and potentially error-prone. There is a demand for the computerized verification procedure in clinical application. The purpose of this study is to develop a computerized portal verification scheme for pelvic treatment fields. Materials/Methods: The automated verification system involves image acquisition, image feature extraction, feature matching between reference and portal images and quantitative evaluation of patient setup. Electronic portal images with a matrix size of 256 x 256 and 12 bit gray levels were acquired using a liquid matrix electronic portal imaging device. Simulation images were acquired by digitizing simulation films using a TV camera into images with 256 x 256 matrix and 8 bit gray levels. Initially a Canny edge detector is applied to identify the field edges and an elliptic Fourier transformation is used to correlate the size and shape information between the reference and portal field edges. Several measures can be calculated using the transformation coefficients to describe the field shape, size and orientation. The quantitative information regarding to the relative shifts, rotation and magnification factor between portal and reference field edges can then be determined based on these measures. Next the pelvic brim, which is typically used as the landmark for radiation treatment verification, is identified by a pyramid searching process with double snakes defined from initial global area to final local area. A snake is an active model and energy-minimizing spline guided by external constraint forces and influenced by image forces that pull it toward features such as lines and edges. The search range is limited to the region between two snakes. Sobel edge detector and wavelet transformation approach are used to generate a serial image forces at

SU-E-T-442: Sensitivity of Quality Assurance Tools to Delivery Errors On a Magnetic Resonance-Imaging Guided Radiation Therapy (MR-IGRT) System

International Nuclear Information System (INIS)

Rodriguez, V; Li, H; Yang, D; Kashani, R; Wooten, H; Mutic, S; Green, O; Dempsey, J

2014-01-01

Purpose: To test the sensitivity of the quality assurance (QA) tools actively used on a clinical MR-IGRT system for potential delivery errors. Methods: Patient-specific QA procedures have been implemented for a commercially available Cobalt-60 MR-IGRT system. The QA tools utilized were a MR-compatible cylindrical diode-array detector (ArcCHECK) with a custom insert which positions an ionization chamber (Exradin A18) in the middle of the device, as well as an in-house treatment delivery verification program. These tools were tested to investigate their sensitivity to delivery errors. For the ArcCHECK and ion chamber, a baseline was established with a static field irradiation to a known dose. Variations of the baseline were investigated which included rotated gantry, altered field size, directional shifts, and different delivery time. In addition, similar variations were tested with the automated delivery verification program that compared the treatment parameters in the machine delivery logs to the ones in the plan. To test the software, a 3-field conformal plan was generated as the baseline. Results: ArcCHECK noted at least a 13% decrease in passing rate from baseline in the following scenarios: gantry rotation of 1 degree from plan, 5mm change in field size, 2mm lateral shift, and delivery time decrease. Ion chamber measurements remained consistent for these variations except for the 5 second decrease in delivery time scenario which resulted in an 8% difference from baseline. The delivery verification software was able to detect and report the simulated errors such as when the gantry was rotated by 0.6 degrees, the beam weighting was changed by a percent, a single multileaf collimator was moved by 1cm, and the dose was changed from 2 to 1.8Gy. Conclusion: The results show that the current tools used for patient specific QA are capable of detecting small errors in RT delivery with presence of magnetic field

Field test for treatment verification of an in-situ enhanced bioremediation study

International Nuclear Information System (INIS)

Taur, C.K.; Chang, S.C.

1995-01-01

Due to a leakage from a 12-inch pressurized diesel steel pipe four years ago, an area of approximately 30,000 square meters was contaminated. A pilot study applying the technology of in-situ enhanced bioremediation was conducted. In the study, a field test kit and on-site monitoring equipment were applied for site characterization and treatment verification. Physically, the enhanced bioremediation study consisted of an air extraction and air supply system, and a nutrition supply network. Certain consistent sampling methodology was employed. Progress was verified by daily monitoring and monthly verification. The objective of this study was to evaluate the capabilities of indigenous microorganisms to biodegrade the petroleum hydrocarbons with provision of oxygen and nutrients. Nine extraction wells and eight air sparging wells were installed. The air sparging wells injected the air into geoformation and the extraction wells provided the underground air circulation. The soil samples were obtained monthly for treatment verification by a Minuteman drilling machine with 2.5-foot-long hollow-stem augers. The samples were analyzed on site for TPH-diesel concentration by a field test kit manufactured by HNU-Hanby, Houston, Texas. The analytical results from the field test kit were compared with the results from an environmental laboratory. The TVPH concentrations of the air extracted from the vadose zone by a vacuum blower and the extraction wells were routinely monitored by a Foxboro FID and Cosmos XP-311A combustible air detector. The daily monitoring of TVPH concentrations provided the reliable data for assessing the remedial progress

Enhanced dynamic wedge and independent monitor unit verification

International Nuclear Information System (INIS)

Howlett, SJ.

2005-01-01

Some serious radiation accidents have occurred around the world during the delivery of radiotherapy treatment. The regrettable incident in Panama clearly indicated the need for independent monitor unit (MU) verification. Indeed the International Atomic Energy Agency (IAEA), after investigating the incident, made specific recommendations for radiotherapy centres which included an independent monitor unit check for all treatments. Independent monitor unit verification is practiced in many radiotherapy centres in developed countries around the world. It is mandatory in USA but not yet in Australia. This paper describes development of an independent MU program, concentrating on the implementation of the Enhanced Dynamic Wedge (EDW) component. The difficult case of non centre of field (COF) calculation points under the EDW was studied in some detail. Results of a survey of Australasian centres regarding the use of independent MU check systems is also presented. The system was developed with reference to MU calculations made by Pinnacle 3 D Radiotherapy Treatment Planning (RTP) system (ADAC - Philips) for 4MV, 6MV and 18MV X-ray beams used at the Newcastle Mater Misericordiae Hospital (NMMH) in the clinical environment. A small systematic error was detected in the equation used for the EDW calculations. Results indicate that COF equations may be used in the non COF situation with similar accuracy to that achieved with profile corrected methods. Further collaborative work with other centres is planned to extend these findings

SU-E-T-127: Application of TG-119 for Evaluation of Proton Spot Scanning Based Planning and Treatment Delivery

Energy Technology Data Exchange (ETDEWEB)

Saini, J; Cao, N; Wong, T [SCCA Proton Therapy, A Procure Center, Seattle, WA (United States); Bowen, S; Bloch, C [University of Washington, School of Medicine, Seattle, WA (United States)

2015-06-15

Purpose: The clinical test cases presented in AAPM TG-119 are used to evaluate the accuracy of treatment planning and delivery through spot scanning proton beams. Methods: An IBA spot scanning delivery system has been commissioned to be used with the RayStation treatment planning system. Various test cases provided in TG-119 were used for planning and delivery verification. The CT dataset and structures as provided by TG-119 were imported into a mock patient. The plans were optimized using the multi field optimization (MFO) to achieve the desired goals. The planner was given the flexibility to achieve the given dose-volume goals by creating appropriate objectives and constraints. Beams were delivered to a phantom and measurements were performed at multiple depths using the MatrixxPT detector array. The analyses were performed on beam by beam basis and quantified using the gamma index. A tolerance of 3%/3 mm in 2D was used for gamma index analysis along with dose threshold of 10%. Results: The clinical goals for targets and critical structures were met or improved for all cases except the C-Shape target with difficult constraints. The minimum gamma index using the 3%/3mm as a criterion is 93.3% for one of the planes measured for C-Shape target. Using 2%/2mm as a criterion, the minimum gamma index drops to 70%. Only Prostate target has all the planes above >90% pass using the 2%/2mm criterion. Conclusion: The overall accuracy of the treatment planning and delivery is deemed clinically acceptable. The test cases with highly modulated beams can have steep gradients in the dose profiles that can reduce the gamma index pass rate. Gamma analysis based on 3D data may be needed for routine use of 2%/2mm criterion. In addition, improvements in modelling of spot profiles in dose engine may be required for further improving the gamma index pass rate.

Verification and validation of the decision analysis model for assessment of TWRS waste treatment strategies

International Nuclear Information System (INIS)

Awadalla, N.G.; Eaton, S.C.F.

1996-01-01

This document is the verification and validation final report for the Decision Analysis Model for Assessment of Tank Waste Remediation System Waste Treatment Strategies. This model is also known as the INSIGHT Model

A microcomputer system for prescription, calculation, verification and recording of radiotherapy treatments

International Nuclear Information System (INIS)

Morrey, D.; Smith, C.W.; Belcher, R.A.; Harding, T.; Sutherland, W.H.

1982-01-01

The design of a microcomputer system for the reduction of mistakes in radiotherapy is described. The system covers prescription entry, prescription and treatment calculations, and verification and recording of the treatment set-up. A telecobalt unit was interfaced to the system and in the first 12 months 400 patients have been prescribed and 5000 treatment fields verified. The prescription is entered by the medical officer using an interactive program and this prescription provides the reference for verifying the treatment set-up. The program allows amendments to the prescription to be made easily during the treatment course. The treatment parameters verified are field size, wedge and treatment time. The system uses bar-codes for patient and field identification. A reduction in the number of mistakes has been achieved and future developments are discussed. (author)

Dosimetric pre-treatment verification of IMRT using an EPID; clinical experience

International Nuclear Information System (INIS)

Zijtveld, Mathilda van; Dirkx, Maarten L.P.; Boer, Hans C.J. de; Heijmen, Ben J.M.

2006-01-01

Background and purpose: In our clinic a QA program for IMRT verification, fully based on dosimetric measurements with electronic portal imaging devices (EPID), has been running for over 3 years. The program includes a pre-treatment dosimetric check of all IMRT fields. During a complete treatment simulation at the linac, a portal dose image (PDI) is acquired with the EPID for each patient field and compared with a predicted PDI. In this paper, the results of this pre-treatment procedure are analysed, and intercepted errors are reported. An automated image analysis procedure is proposed to limit the number of fields that need human intervention in PDI comparison. Materials and methods: Most of our analyses are performed using the γ index with 3% local dose difference and 3 mm distance to agreement as reference values. Scalar parameters are derived from the γ values to summarize the agreement between measured and predicted 2D PDIs. Areas with all pixels having γ values larger than one are evaluated, making decisions based on clinically relevant criteria more straightforward. Results: In 270 patients, the pre-treatment checks revealed four clinically relevant errors. Calculation of statistics for a group of 75 patients showed that the patient-averaged mean γ value inside the field was 0.43 ± 0.13 (1 SD) and only 6.1 ± 6.8% of pixels had a γ value larger than one. With the proposed automated image analysis scheme, visual inspection of images can be avoided in 2/3 of the cases. Conclusion: EPIDs may be used for high accuracy and high resolution routine verification of IMRT fields to intercept clinically relevant dosimetric errors prior to the start of treatment. For the majority of fields, PDI comparison can fully rely on an automated procedure, avoiding excessive workload

Verification of absorbed dose calculation with XIO Radiotherapy Treatment Planning System

International Nuclear Information System (INIS)

Bokulic, T.; Budanec, M.; Frobe, A.; Gregov, M.; Kusic, Z.; Mlinaric, M.; Mrcela, I.

2013-01-01

Modern radiotherapy relies on computerized treatment planning systems (TPS) for absorbed dose calculation. Most TPS require a detailed model of a given machine and therapy beams. International Atomic Energy Agency (IAEA) recommends acceptance testing for the TPS (IAEA-TECDOC-1540). In this study we present customization of those tests for measurements with the purpose of verification of beam models intended for clinical use in our department. Elekta Synergy S linear accelerator installation and data acquisition for Elekta CMS XiO 4.62 TPS was finished in 2011. After the completion of beam modelling in TPS, tests were conducted in accordance with the IAEA protocol for TPS dose calculation verification. The deviations between the measured and calculated dose were recorded for 854 points and 11 groups of tests in a homogenous phantom. Most of the deviations were within tolerance. Similar to previously published results, results for irregular L shaped field and asymmetric wedged fields were out of tolerance for certain groups of points.(author)

Automated radiotherapy treatment plan integrity verification

Energy Technology Data Exchange (ETDEWEB)

Yang Deshan; Moore, Kevin L. [Department of Radiation Oncology, School of Medicine, Washington University in Saint Louis, St. Louis, Missouri 63110 (United States)

2012-03-15

Purpose: In our clinic, physicists spend from 15 to 60 min to verify the physical and dosimetric integrity of radiotherapy plans before presentation to radiation oncology physicians for approval. The purpose of this study was to design and implement a framework to automate as many elements of this quality control (QC) step as possible. Methods: A comprehensive computer application was developed to carry out a majority of these verification tasks in the Philips PINNACLE treatment planning system (TPS). This QC tool functions based on both PINNACLE scripting elements and PERL sub-routines. The core of this technique is the method of dynamic scripting, which involves a PERL programming module that is flexible and powerful for treatment plan data handling. Run-time plan data are collected, saved into temporary files, and analyzed against standard values and predefined logical rules. The results were summarized in a hypertext markup language (HTML) report that is displayed to the user. Results: This tool has been in clinical use for over a year. The occurrence frequency of technical problems, which would cause delays and suboptimal plans, has been reduced since clinical implementation. Conclusions: In addition to drastically reducing the set of human-driven logical comparisons, this QC tool also accomplished some tasks that are otherwise either quite laborious or impractical for humans to verify, e.g., identifying conflicts amongst IMRT optimization objectives.

Automated radiotherapy treatment plan integrity verification

International Nuclear Information System (INIS)

Yang Deshan; Moore, Kevin L.

2012-01-01

Purpose: In our clinic, physicists spend from 15 to 60 min to verify the physical and dosimetric integrity of radiotherapy plans before presentation to radiation oncology physicians for approval. The purpose of this study was to design and implement a framework to automate as many elements of this quality control (QC) step as possible. Methods: A comprehensive computer application was developed to carry out a majority of these verification tasks in the Philips PINNACLE treatment planning system (TPS). This QC tool functions based on both PINNACLE scripting elements and PERL sub-routines. The core of this technique is the method of dynamic scripting, which involves a PERL programming module that is flexible and powerful for treatment plan data handling. Run-time plan data are collected, saved into temporary files, and analyzed against standard values and predefined logical rules. The results were summarized in a hypertext markup language (HTML) report that is displayed to the user. Results: This tool has been in clinical use for over a year. The occurrence frequency of technical problems, which would cause delays and suboptimal plans, has been reduced since clinical implementation. Conclusions: In addition to drastically reducing the set of human-driven logical comparisons, this QC tool also accomplished some tasks that are otherwise either quite laborious or impractical for humans to verify, e.g., identifying conflicts amongst IMRT optimization objectives.

Carrier-Based Drug Delivery System for Treatment of Acne

Science.gov (United States)

Vyas, Amber; Kumar Sonker, Avinesh

2014-01-01

Approximately 95% of the population suffers at some point in their lifetime from acne vulgaris. Acne is a multifactorial disease of the pilosebaceous unit. This inflammatory skin disorder is most common in adolescents but also affects neonates, prepubescent children, and adults. Topical conventional systems are associated with various side effects. Novel drug delivery systems have been used to reduce the side effect of drugs commonly used in the topical treatment of acne. Topical treatment of acne with active pharmaceutical ingredients (API) makes direct contact with the target site before entering the systemic circulation which reduces the systemic side effect of the parenteral or oral administration of drug. The objective of the present review is to discuss the conventional delivery systems available for acne, their drawbacks, and limitations. The advantages, disadvantages, and outcome of using various carrier-based delivery systems like liposomes, niosomes, solid lipid nanoparticles, and so forth, are explained. This paper emphasizes approaches to overcome the drawbacks and limitations associated with the conventional system and the advances and application that are poised to further enhance the efficacy of topical acne formulations, offering the possibility of simplified dosing regimen that may improve treatment outcomes using novel delivery system. PMID:24688376

The development and verification of a highly accurate collision prediction model for automated noncoplanar plan delivery

International Nuclear Information System (INIS)

Yu, Victoria Y.; Tran, Angelia; Nguyen, Dan; Cao, Minsong; Ruan, Dan; Low, Daniel A.; Sheng, Ke

2015-01-01

Purpose: Significant dosimetric benefits had been previously demonstrated in highly noncoplanar treatment plans. In this study, the authors developed and verified an individualized collision model for the purpose of delivering highly noncoplanar radiotherapy and tested the feasibility of total delivery automation with Varian TrueBeam developer mode. Methods: A hand-held 3D scanner was used to capture the surfaces of an anthropomorphic phantom and a human subject, which were positioned with a computer-aided design model of a TrueBeam machine to create a detailed virtual geometrical collision model. The collision model included gantry, collimator, and couch motion degrees of freedom. The accuracy of the 3D scanner was validated by scanning a rigid cubical phantom with known dimensions. The collision model was then validated by generating 300 linear accelerator orientations corresponding to 300 gantry-to-couch and gantry-to-phantom distances, and comparing the corresponding distance measurements to their corresponding models. The linear accelerator orientations reflected uniformly sampled noncoplanar beam angles to the head, lung, and prostate. The distance discrepancies between measurements on the physical and virtual systems were used to estimate treatment-site-specific safety buffer distances with 0.1%, 0.01%, and 0.001% probability of collision between the gantry and couch or phantom. Plans containing 20 noncoplanar beams to the brain, lung, and prostate optimized via an in-house noncoplanar radiotherapy platform were converted into XML script for automated delivery and the entire delivery was recorded and timed to demonstrate the feasibility of automated delivery. Results: The 3D scanner measured the dimension of the 14 cm cubic phantom within 0.5 mm. The maximal absolute discrepancy between machine and model measurements for gantry-to-couch and gantry-to-phantom was 0.95 and 2.97 cm, respectively. The reduced accuracy of gantry-to-phantom measurements was

The development and verification of a highly accurate collision prediction model for automated noncoplanar plan delivery

Energy Technology Data Exchange (ETDEWEB)

Yu, Victoria Y.; Tran, Angelia; Nguyen, Dan; Cao, Minsong; Ruan, Dan; Low, Daniel A.; Sheng, Ke, E-mail: ksheng@mednet.ucla.edu [Department of Radiation Oncology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California 90024 (United States)

2015-11-15

Purpose: Significant dosimetric benefits had been previously demonstrated in highly noncoplanar treatment plans. In this study, the authors developed and verified an individualized collision model for the purpose of delivering highly noncoplanar radiotherapy and tested the feasibility of total delivery automation with Varian TrueBeam developer mode. Methods: A hand-held 3D scanner was used to capture the surfaces of an anthropomorphic phantom and a human subject, which were positioned with a computer-aided design model of a TrueBeam machine to create a detailed virtual geometrical collision model. The collision model included gantry, collimator, and couch motion degrees of freedom. The accuracy of the 3D scanner was validated by scanning a rigid cubical phantom with known dimensions. The collision model was then validated by generating 300 linear accelerator orientations corresponding to 300 gantry-to-couch and gantry-to-phantom distances, and comparing the corresponding distance measurements to their corresponding models. The linear accelerator orientations reflected uniformly sampled noncoplanar beam angles to the head, lung, and prostate. The distance discrepancies between measurements on the physical and virtual systems were used to estimate treatment-site-specific safety buffer distances with 0.1%, 0.01%, and 0.001% probability of collision between the gantry and couch or phantom. Plans containing 20 noncoplanar beams to the brain, lung, and prostate optimized via an in-house noncoplanar radiotherapy platform were converted into XML script for automated delivery and the entire delivery was recorded and timed to demonstrate the feasibility of automated delivery. Results: The 3D scanner measured the dimension of the 14 cm cubic phantom within 0.5 mm. The maximal absolute discrepancy between machine and model measurements for gantry-to-couch and gantry-to-phantom was 0.95 and 2.97 cm, respectively. The reduced accuracy of gantry-to-phantom measurements was

The development and verification of a highly accurate collision prediction model for automated noncoplanar plan delivery.

Science.gov (United States)

Yu, Victoria Y; Tran, Angelia; Nguyen, Dan; Cao, Minsong; Ruan, Dan; Low, Daniel A; Sheng, Ke

2015-11-01

Significant dosimetric benefits had been previously demonstrated in highly noncoplanar treatment plans. In this study, the authors developed and verified an individualized collision model for the purpose of delivering highly noncoplanar radiotherapy and tested the feasibility of total delivery automation with Varian TrueBeam developer mode. A hand-held 3D scanner was used to capture the surfaces of an anthropomorphic phantom and a human subject, which were positioned with a computer-aided design model of a TrueBeam machine to create a detailed virtual geometrical collision model. The collision model included gantry, collimator, and couch motion degrees of freedom. The accuracy of the 3D scanner was validated by scanning a rigid cubical phantom with known dimensions. The collision model was then validated by generating 300 linear accelerator orientations corresponding to 300 gantry-to-couch and gantry-to-phantom distances, and comparing the corresponding distance measurements to their corresponding models. The linear accelerator orientations reflected uniformly sampled noncoplanar beam angles to the head, lung, and prostate. The distance discrepancies between measurements on the physical and virtual systems were used to estimate treatment-site-specific safety buffer distances with 0.1%, 0.01%, and 0.001% probability of collision between the gantry and couch or phantom. Plans containing 20 noncoplanar beams to the brain, lung, and prostate optimized via an in-house noncoplanar radiotherapy platform were converted into XML script for automated delivery and the entire delivery was recorded and timed to demonstrate the feasibility of automated delivery. The 3D scanner measured the dimension of the 14 cm cubic phantom within 0.5 mm. The maximal absolute discrepancy between machine and model measurements for gantry-to-couch and gantry-to-phantom was 0.95 and 2.97 cm, respectively. The reduced accuracy of gantry-to-phantom measurements was attributed to phantom setup

Clinical commissioning of an in vivo range verification system for prostate cancer treatment with anterior and anterior oblique proton beams

Science.gov (United States)

Hoesl, M.; Deepak, S.; Moteabbed, M.; Jassens, G.; Orban, J.; Park, Y. K.; Parodi, K.; Bentefour, E. H.; Lu, H. M.

2016-04-01

The purpose of this work is the clinical commissioning of a recently developed in vivo range verification system (IRVS) for treatment of prostate cancer by anterior and anterior oblique proton beams. The IRVS is designed to perform a complete workflow for pre-treatment range verification and adjustment. It contains specifically designed dosimetry and electronic hardware and a specific software for workflow control with database connection to the treatment and imaging systems. An essential part of the IRVS system is an array of Si-diode detectors, designed to be mounted to the endorectal water balloon routinely used for prostate immobilization. The diodes can measure dose rate as function of time from which the water equivalent path length (WEPL) and the dose received are extracted. The former is used for pre-treatment beam range verification and correction, if necessary, while the latter is to monitor the dose delivered to patient rectum during the treatment and serves as an additional verification. The entire IRVS workflow was tested for anterior and 30 degree inclined proton beam in both solid water and anthropomorphic pelvic phantoms, with the measured WEPL and rectal doses compared to the treatment plan. Gafchromic films were also used for measurement of the rectal dose and compared to IRVS results. The WEPL measurement accuracy was in the order of 1 mm and after beam range correction, the dose received by the rectal wall were 1.6% and 0.4% from treatment planning, respectively, for the anterior and anterior oblique field. We believe the implementation of IRVS would make the treatment of prostate with anterior proton beams more accurate and reliable.

Liposome-based drug delivery in breast cancer treatment

International Nuclear Information System (INIS)

Park, John W

2002-01-01

Drug delivery systems can in principle provide enhanced efficacy and/or reduced toxicity for anticancer agents. Long circulating macromolecular carriers such as liposomes can exploit the 'enhanced permeability and retention' effect for preferential extravasation from tumor vessels. Liposomal anthracyclines have achieved highly efficient drug encapsulation, resulting in significant anticancer activity with reduced cardiotoxicity, and include versions with greatly prolonged circulation such as liposomal daunorubicin and pegylated liposomal doxorubicin. Pegylated liposomal doxorubucin has shown substantial efficacy in breast cancer treatment both as monotherapy and in combination with other chemotherapeutics. Additional liposome constructs are being developed for the delivery of other drugs. The next generation of delivery systems will include true molecular targeting; immunoliposomes and other ligand-directed constructs represent an integration of biological components capable of tumor recognition with delivery technologies

Development of dose delivery verification by PET imaging of photonuclear reactions following high energy photon therapy

International Nuclear Information System (INIS)

Janek, S; Svensson, R; Jonsson, C; Brahme, A

2006-01-01

A method for dose delivery monitoring after high energy photon therapy has been investigated based on positron emission tomography (PET). The technique is based on the activation of body tissues by high energy bremsstrahlung beams, preferably with energies well above 20 MeV, resulting primarily in 11 C and 15 O but also 13 N, all positron-emitting radionuclides produced by photoneutron reactions in the nuclei of 12 C, 16 O and 14 N. A PMMA phantom and animal tissue, a frozen hind leg of a pig, were irradiated to 10 Gy and the induced positron activity distributions were measured off-line in a PET camera a couple of minutes after irradiation. The accelerator used was a Racetrack Microtron at the Karolinska University Hospital using 50 MV scanned photon beams. From photonuclear cross-section data integrated over the 50 MV photon fluence spectrum the predicted PET signal was calculated and compared with experimental measurements. Since measured PET images change with time post irradiation, as a result of the different decay times of the radionuclides, the signals from activated 12 C, 16 O and 14 N within the irradiated volume could be separated from each other. Most information is obtained from the carbon and oxygen radionuclides which are the most abundant elements in soft tissue. The predicted and measured overall positron activities are almost equal (-3%) while the predicted activity originating from nitrogen is overestimated by almost a factor of two, possibly due to experimental noise. Based on the results obtained in this first feasibility study the great value of a combined radiotherapy-PET-CT unit is indicated in order to fully exploit the high activity signal from oxygen immediately after treatment and to avoid patient repositioning. With an RT-PET-CT unit a high signal could be collected even at a dose level of 2 Gy and the acquisition time for the PET could be reduced considerably. Real patient dose delivery verification by means of PET imaging seems to be

A quality assurance index for brachytherapy treatment plan verification

International Nuclear Information System (INIS)

Simpson, J.B.; Clarke, J.P.

2000-01-01

A method is described which provides an independent verification of a brachytherapy treatment plan. The method is applicable to any common geometric configuration and utilises a simple equation derived from a common form of nonlinear regression. The basis for the index value is the relationship between the treatment time, prescribed dose, source strength and plan geometry. This relationship may be described mathematically as: Total Treatment Time ∝ Prescribed Dose/Source Strength x (a geometric term) with the geometric term incorporating three geometric components, namely the distance from source positions to points of dose normalisation (d), the total length of the dwell positions (L), and the number of source trains or catheters (N). A general equation of the form GF = k (d) -α (L) -β (N) -y is used to describe the plan geometry, where GF is what we have termed the geometric factor, k is a constant of proportionality and the exponents are derived from the non-linear regression process. The resulting index is simple to calculate prior to patient treatment and sensitive enough to identify significant error whilst being robust enough to allow for a normal degree of geometric distortion

Comparison of monitor units calculated by radiotherapy treatment planning system and an independent monitor unit verification software.

Science.gov (United States)

Sellakumar, P; Arun, C; Sanjay, S S; Ramesh, S B

2011-01-01

In radiation therapy, the monitor units (MU) needed to deliver a treatment plan are calculated by treatment planning systems (TPS). The essential part of quality assurance is to verify the MU with independent monitor unit calculation to correct any potential errors prior to the start of treatment. In this study, we have compared the MU calculated by TPS and by independent MU verification software. The MU verification software was commissioned and tested for the data integrity to ensure that the correct beam data was considered for MU calculations. The accuracy of the calculations was tested by creating a series of test plans and comparing them with ion chamber measurements. The results show that there is good agreement between the two. The MU difference (MUdiff) between the monitor unit calculations of TPS and independent MU verification system was calculated for 623 fields from 245 patients and was analyzed by treatment site for head & neck, thorax, breast, abdomen and pelvis. The mean MUdiff of -0.838% with a standard deviation of 3.04% was observed for all 623 fields. The site specific standard deviation of MUdiff was as follows: abdomen and pelvis (<1.75%), head & neck (2.5%), thorax (2.32%) and breast (6.01%). The disparities were analyzed and different correction methods were used to reduce the disparity. © 2010 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Treatment planning for SBRT using automated field delivery: A case study

International Nuclear Information System (INIS)

Ritter, Timothy A.; Owen, Dawn; Brooks, Cassandra M.; Stenmark, Matthew H.

2015-01-01

Stereotactic body radiation therapy (SBRT) treatment planning and delivery can be accomplished using a variety of techniques that achieve highly conformal dose distributions. Herein, we describe a template-based automated treatment field approach that enables rapid delivery of more than 20 coplanar fields. A case study is presented to demonstrate how modest adaptations to traditional SBRT planning can be implemented to take clinical advantage of this technology. Treatment was planned for a left-sided lung lesion adjacent to the chest wall using 25 coplanar treatment fields spaced at 11° intervals. The plan spares the contralateral lung and is in compliance with the conformality standards set forth in Radiation Therapy and Oncology Group protocol 0915, and the dose tolerances found in the report of the American Association of Physicists in Medicine Task Group 101. Using a standard template, treatment planning was accomplished in less than 20 minutes, and each 10 Gy fraction was delivered in approximately 5.4 minutes. For those centers equipped with linear accelerators capable of automated treatment field delivery, the use of more than 20 coplanar fields is a viable SBRT planning approach and yields excellent conformality and quality combined with rapid planning and treatment delivery. Although the case study discusses a laterally located lung lesion, this technique can be applied to centrally located tumors with similar results

Impact of gantry rotation time on plan quality and dosimetric verification. Volumetric modulated arc therapy (VMAT) vs. intensity modulated radiotherapy (IMRT)

Energy Technology Data Exchange (ETDEWEB)

Pasler, Marlies; Wirtz, Holger; Lutterbach, Johannes [Gemeinschaftspraxis fuer Strahlentherapie Singen-Friedrichshafen, Singen (Germany)

2011-12-15

To compare plan quality criteria and dosimetric accuracy of step-and-shoot intensity-modulated radiotherapy (ss-IMRT) and volumetric modulated arc radiotherapy (VMAT) using two different gantry rotation times. This retrospective planning study based on 20 patients was comprised of 10 prostate cancer (PC) and 10 head and neck (HN) cancer cases. Each plan contained two target volumes: a primary planning target volume (PTV) and a boost volume. For each patient, one ss-IMRT plan and two VMAT plans at 90 s (VMAT90) and 120 s (VMAT120) per arc were generated with the Pinnacle {sup copyright} planning system. Two arcs were provided for the PTV plans and a single arc for boost volumes. Dosimetric verification of the plans was performed using a 2D ionization chamber array placed in a full scatter phantom. VMAT reduced delivery time and monitor units for both treatment sites compared to IMRT. VMAT120 vs. VMAT90 increased delivery time and monitor units in PC plans without improving plan quality. For HN cases, VMAT120 provided comparable organs at risk sparing and better target coverage and conformity than VMAT90. In the VMAT plan verification, an average of 97.1% of the detector points passed the 3 mm, 3% {gamma} criterion, while in IMRT verification it was 98.8%. VMAT90, VMAT120, and IMRT achieved comparable treatment plans. Slower gantry movement in VMAT120 plans only improves dosimetric quality for highly complex targets.

Impact of gantry rotation time on plan quality and dosimetric verification. Volumetric modulated arc therapy (VMAT) vs. intensity modulated radiotherapy (IMRT)

International Nuclear Information System (INIS)

Pasler, Marlies; Wirtz, Holger; Lutterbach, Johannes

2011-01-01

To compare plan quality criteria and dosimetric accuracy of step-and-shoot intensity-modulated radiotherapy (ss-IMRT) and volumetric modulated arc radiotherapy (VMAT) using two different gantry rotation times. This retrospective planning study based on 20 patients was comprised of 10 prostate cancer (PC) and 10 head and neck (HN) cancer cases. Each plan contained two target volumes: a primary planning target volume (PTV) and a boost volume. For each patient, one ss-IMRT plan and two VMAT plans at 90 s (VMAT90) and 120 s (VMAT120) per arc were generated with the Pinnacle copyright planning system. Two arcs were provided for the PTV plans and a single arc for boost volumes. Dosimetric verification of the plans was performed using a 2D ionization chamber array placed in a full scatter phantom. VMAT reduced delivery time and monitor units for both treatment sites compared to IMRT. VMAT120 vs. VMAT90 increased delivery time and monitor units in PC plans without improving plan quality. For HN cases, VMAT120 provided comparable organs at risk sparing and better target coverage and conformity than VMAT90. In the VMAT plan verification, an average of 97.1% of the detector points passed the 3 mm, 3% γ criterion, while in IMRT verification it was 98.8%. VMAT90, VMAT120, and IMRT achieved comparable treatment plans. Slower gantry movement in VMAT120 plans only improves dosimetric quality for highly complex targets.

Monte Carlo Treatment Planning for Advanced Radiotherapy

DEFF Research Database (Denmark)

Cronholm, Rickard

This Ph.d. project describes the development of a workflow for Monte Carlo Treatment Planning for clinical radiotherapy plans. The workflow may be utilized to perform an independent dose verification of treatment plans. Modern radiotherapy treatment delivery is often conducted by dynamically...... modulating the intensity of the field during the irradiation. The workflow described has the potential to fully model the dynamic delivery, including gantry rotation during irradiation, of modern radiotherapy. Three corner stones of Monte Carlo Treatment Planning are identified: Building, commissioning...... and validation of a Monte Carlo model of a medical linear accelerator (i), converting a CT scan of a patient to a Monte Carlo compliant phantom (ii) and translating the treatment plan parameters (including beam energy, angles of incidence, collimator settings etc) to a Monte Carlo input file (iii). A protocol...

TU-FG-BRB-05: A 3 Dimensional Prompt Gamma Imaging System for Range Verification in Proton Radiotherapy

Energy Technology Data Exchange (ETDEWEB)

Draeger, E; Chen, H; Polf, J [University of Maryland School of Medicine, Baltimore, MD (United States); Mackin, D; Beddar, S [MD Anderson Cancer Center, Houston, TX (United States); Avery, S [University of Cape Town, Rondebosch (South Africa); Peterson, S

2016-06-15

Purpose: To report on the initial developments of a clinical 3-dimensional (3D) prompt gamma (PG) imaging system for proton radiotherapy range verification. Methods: The new imaging system under development consists of a prototype Compton camera to measure PG emission during proton beam irradiation and software to reconstruct, display, and analyze 3D images of the PG emission. For initial test of the system, PGs were measured with a prototype CC during a 200 cGy dose delivery with clinical proton pencil beams (ranging from 100 MeV – 200 MeV) to a water phantom. Measurements were also carried out with the CC placed 15 cm from the phantom for a full range 150 MeV pencil beam and with its range shifted by 2 mm. Reconstructed images of the PG emission were displayed by the clinical PG imaging software and compared to the dose distributions of the proton beams calculated by a commercial treatment planning system. Results: Measurements made with the new PG imaging system showed that a 3D image could be reconstructed from PGs measured during the delivery of 200 cGy of dose, and that shifts in the Bragg peak range of as little as 2 mm could be detected. Conclusion: Initial tests of a new PG imaging system show its potential to provide 3D imaging and range verification for proton radiotherapy. Based on these results, we have begun work to improve the system with the goal that images can be produced from delivery of as little as 20 cGy so that the system could be used for in-vivo proton beam range verification on a daily basis.

SIFT: A method to verify the IMRT fluence delivered during patient treatment using an electronic portal imaging device

International Nuclear Information System (INIS)

Vieira, Sandra C.; Dirkx, Maarten L.P.; Heijmen, Ben J.M.; Boer, Hans C.J. de

2004-01-01

Purpose: Radiotherapy patients are increasingly treated with intensity-modulated radiotherapy (IMRT) and high tumor doses. As part of our quality control program to ensure accurate dose delivery, a new method was investigated that enables the verification of the IMRT fluence delivered during patient treatment using an electronic portal imaging device (EPID), irrespective of changes in patient geometry. Methods and materials: Each IMRT treatment field is split into a static field and a modulated field, which are delivered in sequence. Images are acquired for both fields using an EPID. The portal dose image obtained for the static field is used to determine changes in patient geometry between the planning CT scan and the time of treatment delivery. With knowledge of these changes, the delivered IMRT fluence can be verified using the portal dose image of the modulated field. This method, called split IMRT field technique (SIFT), was validated first for several phantom geometries, followed by clinical implementation for a number of patients treated with IMRT. Results: The split IMRT field technique allows for an accurate verification of the delivered IMRT fluence (generally within 1% [standard deviation]), even if large interfraction changes in patient geometry occur. For interfraction radiological path length changes of 10 cm, deliberately introduced errors in the delivered fluence could still be detected to within 1% accuracy. Application of SIFT requires only a minor increase in treatment time relative to the standard IMRT delivery. Conclusions: A new technique to verify the delivered IMRT fluence from EPID images, which is independent of changes in the patient geometry, has been developed. SIFT has been clinically implemented for daily verification of IMRT treatment delivery

Recent advances in delivery of drug-nucleic acid combinations for cancer treatment.

Science.gov (United States)

Li, Jing; Wang, Yan; Zhu, Yu; Oupický, David

2013-12-10

Cancer treatment that uses a combination of approaches with the ability to affect multiple disease pathways has been proven highly effective in the treatment of many cancers. Combination therapy can include multiple chemotherapeutics or combinations of chemotherapeutics with other treatment modalities like surgery or radiation. However, despite the widespread clinical use of combination therapies, relatively little attention has been given to the potential of modern nanocarrier delivery methods, like liposomes, micelles, and nanoparticles, to enhance the efficacy of combination treatments. This lack of knowledge is particularly notable in the limited success of vectors for the delivery of combinations of nucleic acids with traditional small molecule drugs. The delivery of drug-nucleic acid combinations is particularly challenging due to differences in the physicochemical properties of the two types of agents. This review discusses recent advances in the development of delivery methods using combinations of small molecule drugs and nucleic acid therapeutics to treat cancer. This review primarily focuses on the rationale used for selecting appropriate drug-nucleic acid combinations as well as progress in the development of nanocarriers suitable for simultaneous delivery of drug-nucleic acid combinations. Copyright © 2013 Elsevier B.V. All rights reserved.

Passive breath gating equipment for cone beam CT-guided RapidArc gastric cancer treatments

International Nuclear Information System (INIS)

Hu, Weigang; Li, Guichao; Ye, Jinsong; Wang, Jiazhou; Peng, Jiayuan; Gong, Min; Yu, Xiaoli; Studentski, Matthew T.; Xiao, Ying; Zhang, Zhen

2015-01-01

Background and purpose: To report preliminary results of passive breath gating (PBG) equipment for cone-beam CT image-guided gated RapidArc gastric cancer treatments. Material and methods: Home-developed PBG equipment integrated with the real-time position management system (RPM) for passive patient breath hold was used in CT simulation, online partial breath hold (PBH) CBCT acquisition, and breath-hold gating (BHG) RapidArc delivery. The treatment was discontinuously delivered with beam on during BH and beam off for free breathing (FB). Pretreatment verification PBH CBCT was obtained with the PBG-RPM system. Additionally, the reproducibility of the gating accuracy was evaluated. Results: A total of 375 fractions of breath-hold gating RapidArc treatments were successfully delivered and 233 PBH CBCTs were available for analysis. The PBH CBCT images were acquired with 2–3 breath holds and 1–2 FB breaks. The imaging time was the same for PBH CBCT and conventional FB CBCT (60 s). Compared to FB CBCT, the motion artifacts seen in PBH CBCT images were remarkably reduced. The average BHG RapidArc delivery time was 103 s for one 270-degree arc and 269 s for two full arcs. Conclusions: The PBG-RPM based PBH CBCT verification and BHG RapidArc delivery was successfully implemented clinically. The BHG RapidArc treatment was accomplished using a conventional RapidArc machine with high delivery efficiency

Targeted nanodrug delivery systems for the treatment of Tuberculosis

CSIR Research Space (South Africa)

Lemmer, Yolandy

2010-06-01

Full Text Available patient treatment compliance and drug resistance pose a great challenge to TB treatment programs worldwide. To improve the current inadequate therapeutic management of TB, a polymeric anti-TB nanodrug delivery system for anti-TB drugs was developed...

Dry Eye Treatment Based on Contact Lens Drug Delivery: A Review.

Science.gov (United States)

Guzman-Aranguez, Ana; Fonseca, Begoña; Carracedo, Gonzalo; Martin-Gil, Alba; Martinez-Aguila, Alejandro; Pintor, Jesús

2016-09-01

Dry eye disease affects a substantial segment of the word population with increasing frequency. It is a multifactorial disease of the ocular surface and tear film, which causes ocular discomfort, visual disturbances, and tear instability with potential damage to the cornea and conjunctiva. Because of its multifactorial etiology, the use of different pharmacological treatment for dry eye treatment has been proposed, which include anti-inflammatory molecules, lubricants or comfort agents, and secretagogues. However, in some cases these pharmacological approaches only relieve symptoms temporarily, and consequently, eye care professionals continue to have difficulties managing dry eye. To improve pharmacological therapy that allows a more efficient and long-term action, effective ocular drug delivery of the currently available drugs for dry eye treatment is required. Contact lenses are emerging as alternative ophthalmic drugs delivery systems that provide an increased residence time of the drug at the eye, thus leading to enhanced bioavailability and more convenient and efficacious therapy. In this article, we reviewed the different techniques used to prepare contact lens-based drug delivery systems and focused on articles that describe the delivery of compounds for dry eye treatment through contact lenses.

Evaluation of Gafchromic EBT-XD film, with comparison to EBT3 film, and application in high dose radiotherapy verification

Science.gov (United States)

Palmer, Antony L.; Dimitriadis, Alexis; Nisbet, Andrew; Clark, Catharine H.

2015-11-01

There is renewed interest in film dosimetry for the verification of dose delivery of complex treatments, particularly small fields, compared to treatment planning system calculations. A new radiochromic film, Gafchromic EBT-XD, is available for high-dose treatment verification and we present the first published evaluation of its use. We evaluate the new film for MV photon dosimetry, including calibration curves, performance with single- and triple-channel dosimetry, and comparison to existing EBT3 film. In the verification of a typical 25 Gy stereotactic radiotherapy (SRS) treatment, compared to TPS planned dose distribution, excellent agreement was seen with EBT-XD using triple-channel dosimetry, in isodose overlay, maximum 1.0 mm difference over 200-2400 cGy, and gamma evaluation, mean passing rate 97% at 3% locally-normalised, 1.5 mm criteria. In comparison to EBT3, EBT-XD gave improved evaluation results for the SRS-plan, had improved calibration curve gradients at high doses, and had reduced lateral scanner effect. The dimensions of the two films are identical. The optical density of EBT-XD is lower than EBT3 for the same dose. The effective atomic number for both may be considered water-equivalent in MV radiotherapy. We have validated the use of EBT-XD for high-dose, small-field radiotherapy, for routine QC and a forthcoming multi-centre SRS dosimetry intercomparison.

Evaluation of Gafchromic EBT-XD film, with comparison to EBT3 film, and application in high dose radiotherapy verification

International Nuclear Information System (INIS)

Palmer, Antony L; Dimitriadis, Alexis; Nisbet, Andrew; Clark, Catharine H

2015-01-01

There is renewed interest in film dosimetry for the verification of dose delivery of complex treatments, particularly small fields, compared to treatment planning system calculations. A new radiochromic film, Gafchromic EBT-XD, is available for high-dose treatment verification and we present the first published evaluation of its use. We evaluate the new film for MV photon dosimetry, including calibration curves, performance with single- and triple-channel dosimetry, and comparison to existing EBT3 film. In the verification of a typical 25 Gy stereotactic radiotherapy (SRS) treatment, compared to TPS planned dose distribution, excellent agreement was seen with EBT-XD using triple-channel dosimetry, in isodose overlay, maximum 1.0 mm difference over 200–2400 cGy, and gamma evaluation, mean passing rate 97% at 3% locally-normalised, 1.5 mm criteria. In comparison to EBT3, EBT-XD gave improved evaluation results for the SRS-plan, had improved calibration curve gradients at high doses, and had reduced lateral scanner effect. The dimensions of the two films are identical. The optical density of EBT-XD is lower than EBT3 for the same dose. The effective atomic number for both may be considered water-equivalent in MV radiotherapy. We have validated the use of EBT-XD for high-dose, small-field radiotherapy, for routine QC and a forthcoming multi-centre SRS dosimetry intercomparison. (paper)

Monitoring and verification R and D

International Nuclear Information System (INIS)

Pilat, Joseph F.; Budlong-Sylvester, Kory W.; Fearey, Bryan L.

2011-01-01

The 2010 Nuclear Posture Review (NPR) report outlined the Administration's approach to promoting the agenda put forward by President Obama in Prague on April 5, 2009. The NPR calls for a national monitoring and verification R and D program to meet future challenges arising from the Administration's nonproliferation, arms control and disarmament agenda. Verification of a follow-on to New START could have to address warheads and possibly components along with delivery capabilities. Deeper cuts and disarmament would need to address all of these elements along with nuclear weapon testing, nuclear material and weapon production facilities, virtual capabilities from old weapon and existing energy programs and undeclared capabilities. We only know how to address some elements of these challenges today, and the requirements may be more rigorous in the context of deeper cuts as well as disarmament. Moreover, there is a critical need for multiple options to sensitive problems and to address other challenges. There will be other verification challenges in a world of deeper cuts and disarmament, some of which we are already facing. At some point, if the reductions process is progressing, uncertainties about past nuclear materials and weapons production will have to be addressed. IAEA safeguards will need to continue to evolve to meet current and future challenges, and to take advantage of new technologies and approaches. Transparency/verification of nuclear and dual-use exports will also have to be addressed, and there will be a need to make nonproliferation measures more watertight and transparent. In this context, and recognizing we will face all of these challenges even if disarmament is not achieved, this paper will explore possible agreements and arrangements; verification challenges; gaps in monitoring and verification technologies and approaches; and the R and D required to address these gaps and other monitoring and verification challenges.

QA Issues for Computer-Controlled Treatment Delivery: This Is Not Your Old R/V System Any More!

International Nuclear Information System (INIS)

Fraass, Benedick A.

2008-01-01

State-of-the-art radiotherapy treatment delivery has changed dramatically during the past decade, moving from manual individual field setup and treatment to automated computer-controlled delivery of complex treatments, including intensity-modulated radiotherapy and other similarly complex delivery strategies. However, the quality assurance methods typically used to ensure treatment is performed precisely and correctly have not evolved in a similarly dramatic way. This paper reviews the old manual treatment process and use of record-and-verify systems, and describes differences with modern computer-controlled treatment delivery. The process and technology used for computer-controlled treatment delivery are analyzed in terms of potential (and actual) problems, as well as relevant published guidance on quality assurance. The potential for improved quality assurance for computer-controlled delivery is discussed

PET/CT imaging for treatment verification after proton therapy: a study with plastic phantoms and metallic implants.

Science.gov (United States)

Parodi, Katia; Paganetti, Harald; Cascio, Ethan; Flanz, Jacob B; Bonab, Ali A; Alpert, Nathaniel M; Lohmann, Kevin; Bortfeld, Thomas

2007-02-01

The feasibility of off-line positron emission tomography/computed tomography (PET/CT) for routine three dimensional in-vivo treatment verification of proton radiation therapy is currently under investigation at Massachusetts General Hospital in Boston. In preparation for clinical trials, phantom experiments were carried out to investigate the sensitivity and accuracy of the method depending on irradiation and imaging parameters. Furthermore, they addressed the feasibility of PET/CT as a robust verification tool in the presence of metallic implants. These produce x-ray CT artifacts and fluence perturbations which may compromise the accuracy of treatment planning algorithms. Spread-out Bragg peak proton fields were delivered to different phantoms consisting of polymethylmethacrylate (PMMA), PMMA stacked with lung and bone equivalent materials, and PMMA with titanium rods to mimic implants in patients. PET data were acquired in list mode starting within 20 min after irradiation at a commercial luthetium-oxyorthosilicate (LSO)-based PET/CT scanner. The amount and spatial distribution of the measured activity could be well reproduced by calculations based on the GEANT4 and FLUKA Monte Carlo codes. This phantom study supports the potential of millimeter accuracy for range monitoring and lateral field position verification even after low therapeutic dose exposures of 2 Gy, despite the delay between irradiation and imaging. It also indicates the value of PET for treatment verification in the presence of metallic implants, demonstrating a higher sensitivity to fluence perturbations in comparison to a commercial analytical treatment planning system. Finally, it addresses the suitability of LSO-based PET detectors for hadron therapy monitoring. This unconventional application of PET involves countrates which are orders of magnitude lower than in diagnostic tracer imaging, i.e., the signal of interest is comparable to the noise originating from the intrinsic radioactivity of

Quantitative analysis of beam delivery parameters and treatment process time for proton beam therapy

International Nuclear Information System (INIS)

Suzuki, Kazumichi; Gillin, Michael T.; Sahoo, Narayan; Zhu, X. Ronald; Lee, Andrew K.; Lippy, Denise

2011-01-01

Purpose: To evaluate patient census, equipment clinical availability, maximum daily treatment capacity, use factor for major beam delivery parameters, and treatment process time for actual treatments delivered by proton therapy systems. Methods: The authors have been recording all beam delivery parameters, including delivered dose, energy, range, spread-out Bragg peak widths, gantry angles, and couch angles for every treatment field in an electronic medical record system. We analyzed delivery system downtimes that had been recorded for every equipment failure and associated incidents. These data were used to evaluate the use factor of beam delivery parameters, the size of the patient census, and the equipment clinical availability of the facility. The duration of each treatment session from patient walk-in and to patient walk-out of the treatment room was measured for 82 patients with cancers at various sites. Results: The yearly average equipment clinical availability in the last 3 yrs (June 2007-August 2010) was 97%, which exceeded the target of 95%. Approximately 2200 patients had been treated as of August 2010. The major disease sites were genitourinary (49%), thoracic (25%), central nervous system (22%), and gastrointestinal (2%). Beams have been delivered in approximately 8300 treatment fields. The use factor for six beam delivery parameters was also evaluated. Analysis of the treatment process times indicated that approximately 80% of this time was spent for patient and equipment setup. The other 20% was spent waiting for beam delivery and beam on. The total treatment process time can be expressed by a quadratic polynomial of the number of fields per session. The maximum daily treatment capacity of our facility using the current treatment processes was estimated to be 133 ± 35 patients. Conclusions: This analysis shows that the facility has operated at a high performance level and has treated a large number of patients with a variety of diseases. The use

Methodology, results and experience of independent brachytherapy plan verifications based on DICOM standard; Implementacion, resultados y experiencia de una verificacion independiente de tratamientos de braquiterapia basada en el estandar DICOM

Energy Technology Data Exchange (ETDEWEB)

Ferrando Sanchez, A.; Pardo Perez, E.; Castro Novals, J.; Casa de Julian, M. A. de la; Cabello Murillo, E.; Diaz Fuentes, R.; Molina Lopez, M. Y.

2013-09-01

The use of a high dose rate source together with an afterloading treatment delivery in brachytherapy plans allows for dose modulation minimizing dose to staff. An independent verification of the exported data to the treatment station is required by local regulations (being also a widely accepted recommendation on the international literature). We have developed a methodology under home brew code to import DICOM treatment data onto an Excel spreadsheet that is able to calculate dose on given reference points using the TG-43 formalism of the AAPM3-5. It employs analytic fits of anisotropy factor and radial dose function for different sources. The end point implementations we present here allow merging in one step an independent verification and a treatment printout. The use of DICOM standard makes our code versatile and provides greater compatibility with respect to current treatment planning systems. (Author)

Characterization of a dose verification system dedicated to radiotherapy treatments based on a silicon detector multi-strips

International Nuclear Information System (INIS)

Bocca, A.; Cortes Giraldo, M. A.; Gallardo, M. I.; Espino, J. M.; Aranas, R.; Abou Haidar, Z.; Alvarez, M. A. G.; Quesada, J. M.; Vega-Leal, A. P.; Perez Neto, F. J.

2011-01-01

In this paper, we present the characterization of a silicon detector multi-strips (SSSSD: Single Sided Silicon Strip Detector), developed by the company Micron Semiconductors Ltd. for use as a verification system for radiotherapy treatments.

Verification of Treatment Planning System (TPS) on Beam Axis of Co-60 Teletherapy

International Nuclear Information System (INIS)

Nunung-Nuraeni; Budhy-Kurniawan; Purwanto; Sugiyantari; Heru-Prasetio; Nasukha

2001-01-01

Cancer diseases up to now can be able to be treated by using surgery, chemotherapy and radiotherapy. The need of high level precision and accuracy on radiation dose are very important task. One of task is verification of Treatment Planning System (Tps) to the treatment of patients. The research has been done to verify Tps on beam exis of teletherapy Co-60. Result found that the different between Tps and measurements are about -2.682 % to 1.918% for simple geometry and homogeneous material, 5.278 % to 4.990 % for complex geometry, and -3.202 % to -2.090 % for more complex geometry. (author)

A virtual linear accelerator for verification of treatment planning systems

International Nuclear Information System (INIS)

Wieslander, Elinore

2000-01-01

A virtual linear accelerator is implemented into a commercial pencil-beam-based treatment planning system (TPS) with the purpose of investigating the possibility of verifying the system using a Monte Carlo method. The characterization set for the TPS includes depth doses, profiles and output factors, which is generated by Monte Carlo simulations. The advantage of this method over conventional measurements is that variations in accelerator output are eliminated and more complicated geometries can be used to study the performance of a TPS. The difference between Monte Carlo simulated and TPS calculated profiles and depth doses in the characterization geometry is less than ±2% except for the build-up region. This is of the same order as previously reported results based on measurements. In an inhomogeneous, mediastinum-like case, the deviations between TPS and simulations are small in the unit-density regions. In low-density regions, the TPS overestimates the dose, and the overestimation increases with increasing energy from 3.5% for 6 MV to 9.5% for 18 MV. This result points out the widely known fact that the pencil beam concept does not handle changes in lateral electron transport, nor changes in scatter due to lateral inhomogeneities. It is concluded that verification of a pencil-beam-based TPS with a Monte Carlo based virtual accelerator is possible, which facilitates the verification procedure. (author)

SU-F-T-573: Evaluation of EBT-XD Radiochromic Films for Verification of SBRT and SRS Treatment Delivery

Energy Technology Data Exchange (ETDEWEB)

Aubry, J; Zerouali, K [Centre hospitalier de l’Universite de Montreal, Montreal, Quebec (Canada)

2016-06-15

Purpose: To evaluate the accuracy and precision of radiochromic films EBT-XD for quality control of stereotaxic body radiation therapy (SBRT) and stereotactic radiosurgery (SRS) plan delivery. Methods: A film cut in 3×10 cm2 strips was irradiated from 0 to 20 Gy in increments of 1 to 1.5 Gy using a 15 MeV electron beam. Triple-channel film calibration was completed 24 hours later by scanning the film strips on an Epson 10000XL scanner using a well-defined protocol. Several dose measurements of increasing complexity were subsequently performed with Varian iX accelerators. Pieces of films were first irradiated in a solid water phantom with 6 MV photon beams and a static gantry to doses spanning the calibration range, either in a single field or multiple fields setup. High dose (>15 Gy per fraction) IMRT plans were then measured. Finally films were irradiated with volumetric modulated arc therapy (VMAT) plans of lung and spinal lesions with prescribed doses per fraction between 8 and 20 Gy. The dose measured with the films was compared to the calculated dose from the Eclipse planning system using the Anisotropic Analytical Algorithm (AAA). Results: 77 dose measurements were compared to either ion chamber measurements or dose calculations (reference). The average dose difference between film measurements and reference was 0.7 % and the standard deviation was 1.3%. The maximum and minimum dose differences were +3.5% and −2% in the 4 Gy to 20 Gy range. Measured dose profiles of lung and vertebra treatment plans agreed very well with the calculations. Conclusion: EBT-XD films are a useful dosimeter for quality control of SBRT and SRS plan delivery. The measurement of a full 2D dose plane with high spatial resolution and acceptable dose accuracy make it an advantageous choice compared to other detectors such as ion chambers or diodes.

A study into the review and verification of breast images treated with isocentric technique

International Nuclear Information System (INIS)

Mitchell, Fiona

2007-01-01

In radiation therapy practice, portal imaging is a common occurrence. Radiation Oncologists want to be able to view the actual treatment port and compare it to the simulated view for quality assurance. Historically, this has been the domain of oncologists only but with the changes in imaging technology, this area of practice is now more commonly shared with the radiation therapists. Purpose: The primary aim of this study was to compare the Radiation Therapists' result versus the Radiation Oncologists' practice of review and verification of electronic portal imaging in the treatment of breast cancer. A secondary result was enhancement of electronic portal imaging use. Methods: The study was divided into two parts. Part 1 reviewed imaging of tangential breast treatment and part 2 reviewed mono-isocentric four-field breast technique. The review and verification of the images were conducted by the Radiation Therapists and Radiation Oncologists and their subsequent results were compared. Results: Overall the Radiation Oncologist agreed with 96.9% of the images approved by the Radiation Therapists. This makes for a rejection rate of 3.1%. In general, Radiation Therapists adhered to the guidelines more closely than the Radiation Oncologist hence the rejection rate of Radiation Therapists was greater than the Radiation Oncologist by 7.0%. Conclusions: The practice of electronic portal imaging review and verification in the treatment of breast cancer can be streamlined and achieved more efficiently. The Radiation Therapists consistently demonstrated their ability to review and verify the portal images, as equivalent to the Radiation Oncologist. Given the high standard of accuracy demonstrated the process of portal image review should be transferred to the Radiation Therapist. This transfer leads to reduction in duplicity of task, an increase in the use of technology, an improvement in efficiencies, and an increase in the quality of care, which will potentially lead to more

Patient study of in vivo verification of beam delivery and range, using positron emission tomography and computed tomography imaging after proton therapy

NARCIS (Netherlands)

Parodi, Katia; Paganetti, Harald; Shih, Helen A; Michaud, Susan; Loeffler, Jay S; DeLaney, Thomas F; Liebsch, Norbert J; Munzenrider, John E; Fischman, Alan J; Knopf, Antje; Bortfeld, Thomas

2007-01-01

PURPOSE: To investigate the feasibility and value of positron emission tomography and computed tomography (PET/CT) for treatment verification after proton radiotherapy. METHODS AND MATERIALS: This study included 9 patients with tumors in the cranial base, spine, orbit, and eye. Total doses of 1.8-3

Patient Perceptions of Treatment Delivery Platforms for Cognitive Behavioral Therapy for Insomnia.

Science.gov (United States)

Cheung, Janet M Y; Bartlett, Delwyn J; Armour, Carol L; Laba, Tracey-Lea; Saini, Bandana

2017-03-21

Stepped care has given rise to the proliferation of abbreviated CBT-I programs and delivery formats. This includes interventions delivered by allied health professionals and those delivered electronically through the Internet. This article aims to explore patient perceptions between electronic and face-to-face (FTF) delivery platforms for (abbreviated) CBT-I. Patients with insomnia from specialist sleep or psychology clinics and those from the general community in Sydney, Australia. Semistructured interviews were conducted with patients with insomnia, guided by a schedule of questions and a choice task to explore patient perceptions of the different CBT-I treatment delivery platforms (e.g., perceived advantages and disadvantages or willingness to engage with either platform). Interviews were transcribed verbatim and analyzed using Framework Analysis. Participants also completed a battery of clinical mood and insomnia measures. Fifty-one interviews were conducted with patients with insomnia from specialist sleep or psychology clinics (n = 22) and the general community (n = 29). Synthesis of the qualitative data set revealed three themes pertinent to the patients' perspective toward electronic and FTF CBT-I delivery: Concepts of Efficacy, Concerns About Treatment, and Treatment on My Terms. Participants' choice to engage with either platform was also informed by diverse factors including perceived efficacy of treatment, personal commitments, lifestyle, and beliefs about sleep and insomnia. Clarifying patient treatment priorities and allaying potential concerns about engaging with an electronic treatment platform represent important steps for disseminating eCBT-I into mainstream practice.

Process evaluation of treatment times in a large radiotherapy department

International Nuclear Information System (INIS)

Beech, R.; Burgess, K.; Stratford, J.

2016-01-01

Purpose/objective: The Department of Health (DH) recognises access to appropriate and timely radiotherapy (RT) services as crucial in improving cancer patient outcomes, especially when facing a predicted increase in cancer diagnosis. There is a lack of ‘real-time’ data regarding daily demand of a linear accelerator, the impact of increasingly complex techniques on treatment times, and whether current scheduling reflects time needed for RT delivery, which would be valuable in highlighting current RT provision. Material/methods: A systematic quantitative process evaluation was undertaken in a large regional cancer centre, including a satellite centre, between January and April 2014. Data collected included treatment room-occupancy time, RT site, RT and verification technique and patient mobility status. Data was analysed descriptively; average room-occupancy times were calculated for RT techniques and compared to historical standardised treatment times within the department. Results: Room-occupancy was recorded for over 1300 fractions, over 50% of which overran their allotted treatment time. In a focused sample of 16 common techniques, 10 overran their allocated timeslots. Verification increased room-occupancy by six minutes (50%) over non-imaging. Treatments for patients requiring mobility assistance took four minutes (29%) longer. Conclusion: The majority of treatments overran their standardised timeslots. Although technique advancement has reduced RT delivery time, room-occupancy has not necessarily decreased. Verification increases room-occupancy and needs to be considered when moving towards adaptive techniques. Mobility affects room-occupancy and will become increasingly significant in an ageing population. This evaluation assesses validity of current treatment times in this department, and can be modified and repeated as necessary. - Highlights: • A process evaluation examined room-occupancy for various radiotherapy techniques. • Appointment lengths

IMRT, IGRT, SBRT - Advances in the Treatment Planning and Delivery of Radiotherapy

CERN Document Server

Meyer, JL

2011-01-01

Over the last 4 years, IMRT, IGRT, SBRT: Advances in the Treatment Planning and Delivery of Radiotherapy has become a standard reference in the field. During this time, however, significant progress in high-precision technologies for the planning and delivery of radiotherapy in cancer treatment has called for a second edition to include these new developments. Thoroughly updated and extended, this new edition offers a comprehensive guide and overview of these new technologies and the many clinical treatment programs that bring them into practical use. Advances in intensity-modulated radiothera

Expert system verification and validation survey. Delivery 3: Recommendations

Science.gov (United States)

1990-01-01

The purpose is to determine the state-of-the-practice in Verification and Validation (V and V) of Expert Systems (ESs) on current NASA and Industry applications. This is the first task of a series which has the ultimate purpose of ensuring that adequate ES V and V tools and techniques are available for Space Station Knowledge Based Systems development. The strategy for determining the state-of-the-practice is to check how well each of the known ES V and V issues are being addressed and to what extent they have impacted the development of ESs.

Reassessing the Role of Intra-Arterial Drug Delivery for Glioblastoma Multiforme Treatment

Directory of Open Access Journals (Sweden)

Jason A. Ellis

2015-01-01

Full Text Available Effective treatment for glioblastoma (GBM will likely require targeted delivery of several specific pharmacological agents simultaneously. Intra-arterial (IA delivery is one technique for targeting the tumor site with multiple agents. Although IA chemotherapy for glioblastoma (GBM has been attempted since the 1950s, the predicted benefits remain unproven in clinical practice. This review focuses on innovative approaches to IA drug delivery in treating GBM. Guided by novel in vitro and in vivo optical measurements, newer pharmacokinetic models promise to better define the complex relationship between background cerebral blood flow and drug injection parameters. Advanced optical technologies and tracers, unique nanoparticles designs, new cellular targets, and rational drug formulations are continuously modifying the therapeutic landscape for GBM. Personalized treatment approaches are emerging; however, such tailored approaches will largely depend on effective drug delivery techniques and on the ability to simultaneously deliver multidrug regimens. These new paradigms for tumor-selective drug delivery herald dramatic improvements in the effectiveness of IA chemotherapy for GBM. Therefore, within this context of so-called “precision medicine,” the role of IA delivery for GBM is thoroughly reassessed.

Performance characteristics of an independent dose verification program for helical tomotherapy

Directory of Open Access Journals (Sweden)

Isaac C. F. Chang

2017-01-01

Full Text Available Helical tomotherapy with its advanced method of intensity-modulated radiation therapy delivery has been used clinically for over 20 years. The standard delivery quality assurance procedure to measure the accuracy of delivered radiation dose from each treatment plan to a phantom is time-consuming. RadCalc®, a radiotherapy dose verification software, has released specifically for beta testing a module for tomotherapy plan dose calculations. RadCalc®'s accuracy for tomotherapy dose calculations was evaluated through examination of point doses in ten lung and ten prostate clinical plans. Doses calculated by the TomoHDA™ tomotherapy treatment planning system were used as the baseline. For lung cases, RadCalc® overestimated point doses in the lung by an average of 13%. Doses within the spinal cord and esophagus were overestimated by 10%. Prostate plans showed better agreement, with overestimations of 6% in the prostate, bladder, and rectum. The systematic overestimation likely resulted from limitations of the pencil beam dose calculation algorithm implemented by RadCalc®. Limitations were more severe in areas of greater inhomogeneity and less prominent in regions of homogeneity with densities closer to 1 g/cm3. Recommendations for RadCalc® dose calculation algorithms and anatomical representation were provided based on the results of the study.

Leaf trajectory verification during dynamic intensity modulated radiotherapy using an amorphous silicon flat panel imager

International Nuclear Information System (INIS)

Sonke, Jan-Jakob; Ploeger, Lennert S.; Brand, Bob; Smitsmans, Monique H.P.; Herk, Marcel van

2004-01-01

An independent verification of the leaf trajectories during each treatment fraction improves the safety of IMRT delivery. In order to verify dynamic IMRT with an electronic portal imaging device (EPID), the EPID response should be accurate and fast such that the effect of motion blurring on the detected moving field edge position is limited. In the past, it was shown that the errors in the detected position of a moving field edge determined by a scanning liquid-filled ionization chamber (SLIC) EPID are negligible in clinical practice. Furthermore, a method for leaf trajectory verification during dynamic IMRT was successfully applied using such an EPID. EPIDs based on amorphous silicon (a-Si) arrays are now widely available. Such a-Si flat panel imagers (FPIs) produce portal images with superior image quality compared to other portal imaging systems, but they have not yet been used for leaf trajectory verification during dynamic IMRT. The aim of this study is to quantify the effect of motion distortion and motion blurring on the detection accuracy of a moving field edge for an Elekta iViewGT a-Si FPI and to investigate its applicability for the leaf trajectory verification during dynamic IMRT. We found that the detection error for a moving field edge to be smaller than 0.025 cm at a speed of 0.8 cm/s. Hence, the effect of motion blurring on the detection accuracy of a moving field edge is negligible in clinical practice. Furthermore, the a-Si FPI was successfully applied for the verification of dynamic IMRT. The verification method revealed a delay in the control system of the experimental DMLC that was also found using a SLIC EPID, resulting in leaf positional errors of 0.7 cm at a leaf speed of 0.8 cm/s

Need of patient-specific quality assurance and pre-treatment verification program for special plans in radiotherapy

International Nuclear Information System (INIS)

Ravichandran, Ramamoorthy; Bhasi, Saju; Binukumar, J.P.; Davis, C.A.

2011-01-01

Accuracy in planned radiation dose delivery in cancer treatments becomes necessary in the advent of complex treatment delivery options with newer technology using medical linear accelerators, which makes patient management very crucial. Treatment outcome in an individual patient therefore depends on the professional involvement of staff and execution accuracy of planned procedure. Therefore, this article has addressed an important problem. International Atomic Energy Agency (IAEA) and International Commission on Radiological Protection (ICRP) reported mis-administrations of radiation dose, the nature of their occurrence and complexity of situations. Lack of adequate quality assurance (QA) program or failure in their routine applications, complacency in attention, lack of knowledge, overconfidence, pressures of time, lack of resources and failures in communication are some of the general human causes of errors. A recent report enumerated misadministration of radiation doses under the heading 'harming instead of healing' delivery of wrong doses in small field treatment plans with stereotactic equipment' was mostly highlighted

Fast film dosimetry calibration method for IMRT treatment plan verification

International Nuclear Information System (INIS)

Schwob, N.; Wygoda, A.

2004-01-01

Intensity-Modulated Radiation Therapy (IMRT) treatments are delivered dynamically and as so, require routinely performed verification measurements [1]. Radiographic film dosimetry is a well-adapted method for integral measurements of dynamic treatments fields, with some drawbacks related to the known problems of dose calibration of films. Classically, several films are exposed to increasing doses, and a Net Optical Density (N.O.D) vs. dose sensitometric curve (S.C.) is generated. In order to speed up the process, some authors have developed a method based on the irradiation of a single film with a non-uniform pattern of O.D., delivered with a dynamic MLC. However, this curve still needs to be calibrated to dose by the means of measurements in a water phantom. It is recommended to make a new calibration for every series of measurements, in order to avoid the processing quality dependence of the film response. These frequent measurements are very time consuming. We developed a simple method for quick dose calibration of films, including a check of the accuracy of the calibration curve obtained

An investigation of PRESAGE® 3D dosimetry for IMRT and VMAT radiation therapy treatment verification

International Nuclear Information System (INIS)

Jackson, Jake; Juang, Titania; Oldham, Mark; Adamovics, John

2015-01-01

The purpose of this work was to characterize three formulations of PRESAGE ® dosimeters (DEA-1, DEA-2, and DX) and to identify optimal readout timing and procedures for accurate in-house 3D dosimetry. The optimal formulation and procedure was then applied for the verification of an intensity modulated radiation therapy (IMRT) and a volumetric modulated arc therapy (VMAT) treatment technique. PRESAGE ® formulations were studied for their temporal stability post-irradiation, sensitivity, and linearity of dose response. Dosimeters were read out using a high-resolution optical-CT scanner. Small volumes of PRESAGE ® were irradiated to investigate possible differences in sensitivity for large and small volumes (‘volume effect’). The optimal formulation and read-out technique was applied to the verification of two patient treatments: an IMRT plan and a VMAT plan. A gradual decrease in post-irradiation optical-density was observed in all formulations with DEA-1 exhibiting the best temporal stability with less than 4% variation between 2–22 h post-irradiation. A linear dose response at the 4 h time point was observed for all formulations with an R 2 value >0.99. A large volume effect was observed for DEA-1 with sensitivity of the large dosimeter being ∼63% less than the sensitivity of the cuvettes. For the IMRT and VMAT treatments, the 3D gamma passing rates for 3%/3 mm criteria using absolute measured dose were 99.6 and 94.5% for the IMRT and VMAT treatments, respectively. In summary, this work shows that accurate 3D dosimetry is possible with all three PRESAGE ® formulations. The optimal imaging windows post-irradiation were 3–24 h, 2–6 h, and immediately for the DEA-1, DEA-2, and DX formulations, respectively. Because of the large volume effect, small volume cuvettes are not yet a reliable method for calibration of larger dosimeters to absolute dose. Finally, PRESAGE ® is observed to be a useful method of 3D verification when careful

3D VMAT Verification Based on Monte Carlo Log File Simulation with Experimental Feedback from Film Dosimetry.

Science.gov (United States)

Barbeiro, A R; Ureba, A; Baeza, J A; Linares, R; Perucha, M; Jiménez-Ortega, E; Velázquez, S; Mateos, J C; Leal, A

2016-01-01

A model based on a specific phantom, called QuAArC, has been designed for the evaluation of planning and verification systems of complex radiotherapy treatments, such as volumetric modulated arc therapy (VMAT). This model uses the high accuracy provided by the Monte Carlo (MC) simulation of log files and allows the experimental feedback from the high spatial resolution of films hosted in QuAArC. This cylindrical phantom was specifically designed to host films rolled at different radial distances able to take into account the entrance fluence and the 3D dose distribution. Ionization chamber measurements are also included in the feedback process for absolute dose considerations. In this way, automated MC simulation of treatment log files is implemented to calculate the actual delivery geometries, while the monitor units are experimentally adjusted to reconstruct the dose-volume histogram (DVH) on the patient CT. Prostate and head and neck clinical cases, previously planned with Monaco and Pinnacle treatment planning systems and verified with two different commercial systems (Delta4 and COMPASS), were selected in order to test operational feasibility of the proposed model. The proper operation of the feedback procedure was proved through the achieved high agreement between reconstructed dose distributions and the film measurements (global gamma passing rates > 90% for the 2%/2 mm criteria). The necessary discretization level of the log file for dose calculation and the potential mismatching between calculated control points and detection grid in the verification process were discussed. Besides the effect of dose calculation accuracy of the analytic algorithm implemented in treatment planning systems for a dynamic technique, it was discussed the importance of the detection density level and its location in VMAT specific phantom to obtain a more reliable DVH in the patient CT. The proposed model also showed enough robustness and efficiency to be considered as a pre-treatment

Ultrasound-Mediated Drug/Gene Delivery in Solid Tumor Treatment

Directory of Open Access Journals (Sweden)

Yufeng Zhou

2013-01-01

Full Text Available Ultrasound is an emerging modality for drug delivery in chemotherapy. This paper reviews this novel technology by first introducing the designs and characteristics of three classes of drug/gene vehicles, microbubble (including nanoemulsion, liposomes, and micelles. In comparison to conventional free drug, the targeted drug-release and delivery through vessel wall and interstitial space to cancerous cells can be activated and enhanced under certain sonication conditions. In the acoustic field, there are several reactions of these drug vehicles, including hyperthermia, bubble cavitation, sonoporation, and sonodynamics, whose physical properties are illustrated for better understanding of this approach. In vitro and in vivo results are summarized, and future directions are discussed. Altogether, ultrasound-mediated drug/gene delivery under imaging guidance provides a promising option in cancer treatment with enhanced agent release and site specificity and reduced toxicity.

Experience Using DosimetryCheck software for IMRT and RapidArc Patient Pre-treatment QA and a New Feature for QA during Treatment

International Nuclear Information System (INIS)

Pinkerton, Arthur; Hannon, Michael; Kwag, Jae; Renner, Wendel Dean

2010-01-01

We have used the DosimetryCheck program with the EPID's on our Varian 2100EX's to perform pre-treatment QA on more than 350 patients, between the last quarter of 2006 and the present. The software uses the EPID measured fluences of the treatment fields to reconstruct the dose distribution in the CT planning model of the patient. Since the dose calculation algorithm, is different from that used by our Eclipse planning system, this provides an independent check of planning accuracy as well as treatment delivery. 2D and 3D dose distributions, point doses, Gamma distributions, DVH statistics and MU calculations can be compared. Absolute differences of Reference Point doses between Dosimetry Check and Eclipse average 1.20%, which is similar to the ionization chamber dose differences of 1.29% for the same patient verification plans. Examples of cases for various treatment sites and delivery modes will be presented. A Special Report in Medical Physics Vol. 37 Number 6 Pg. 2638-2644 from Mans et al at The Netherlands Cancer Institute demonstrated the ability of in vivo EPID dosimetry to detect treatment errors, that escaped other QA checks. A new version of DosimetryCheck awaiting FDA approval, is capable of successfully reconstructing the dose distribution in the patient from the EPID measured exit fluences. This can also be applied to CBCT images providing actual patient dose verification for a treatment session. This should be particularly useful for monitoring hypo-fractionated treatment regimens. Examples of this method will also be presented.

A Monte Carlo tool for evaluating VMAT and DIMRT treatment deliveries including planar detectors

International Nuclear Information System (INIS)

Asuni, G; Van Beek, T A; Venkataraman, S; McCurdy, B M C; Popescu, I A

2013-01-01

The aim of this work is to describe and validate a new general research tool that performs Monte Carlo (MC) simulations for volumetric modulated arc therapy (VMAT) and dynamic intensity modulated radiation therapy (DIMRT), simultaneously tracking dose deposition in both the patient CT geometry and an arbitrary planar detector system. The tool is generalized to handle either entrance or exit detectors and provides the simulated dose for the individual control-points of the time-dependent VMAT and DIMRT deliveries. The MC simulation tool was developed with the EGSnrc radiation transport. For the individual control point simulation, we rotate the patient/phantom volume only (i.e. independent of the gantry and planar detector geometries) using the gantry angle in the treatment planning system (TPS) DICOM RP file such that each control point has its own unique phantom file. After MC simulation, we obtained the total dose to the phantom by summing dose contributions for all control points. Scored dose to the sensitive layer of the planar detector is available for each control point. To validate the tool, three clinical treatment plans were used including VMAT plans for a prostate case and a head-and-neck case, and a DIMRT plan for a head-and-neck case. An electronic portal imaging device operated in ‘movie’ mode was used with the VMAT plans delivered to cylindrical and anthropomorphic phantoms to validate the code using an exit detector. The DIMRT plan was delivered to a novel transmission detector, to validate the code using an entrance detector. The total MC 3D absolute doses in patient/phantom were compared with the TPS doses, while 2D MC doses were compared with planar detector doses for all individual control points, using the gamma evaluation test with 3%/3 mm criteria. The MC 3D absolute doses demonstrated excellent agreement with the TPS doses for all the tested plans, with about 95% of voxels having γ 90% of percentage pixels with γ <1. We found that over

Assessing the quality of proton PBS treatment delivery using machine log files: comprehensive analysis of clinical treatments delivered at PSI Gantry 2

International Nuclear Information System (INIS)

Scandurra, D; Albertini, F; Van der Meer, R; Meier, G; Weber, D C; Bolsi, A; Lomax, A

2016-01-01

Pencil beam scanning (PBS) proton therapy requires the delivery of many thousand proton beams, each modulated for position, energy and monitor units, to provide a highly conformal patient treatment. The quality of the treatment is dependent on the delivery accuracy of each beam and at each fraction. In this work we describe the use of treatment log files, which are a record of the machine parameters for a given field delivery on a given fraction, to investigate the integrity of treatment delivery compared to the nominal planned dose. The dosimetry-relevant log file parameters are used to reconstruct the 3D dose distribution on the patient anatomy, using a TPS-independent dose calculation system. The analysis was performed for patients treated at Paul Scherrer Institute on Gantry 2, both for individual fields and per series (or plan), and delivery quality was assessed by determining the percentage of voxels in the log file dose distribution within  +/−  1% of the nominal dose. It was seen that, for all series delivered, the mean pass rate is 96.4%. Furthermore, this work establishes a correlation between the delivery quality of a field and the beam position accuracy. This correlation is evident for all delivered fields regardless of individual patient or plan characteristics. We have also detailed further usefulness of log file analysis within our clinical workflow. In summary, we have highlighted that the integrity of PBS treatment delivery is dependent on daily machine performance and is specifically highly correlated with the accuracy of beam position. We believe this information will be useful for driving machine performance improvements in the PBS field. (paper)

Iontophoresis-targeted, follicular delivery of minoxidil sulfate for the treatment of alopecia.

Science.gov (United States)

Gelfuso, Guilherme Martins; Gratieri, Tais; Delgado-Charro, M Begoña; Guy, Richard H; Vianna Lopez, Renata Fonseca

2013-05-01

Although minoxidil (MX) is a drug known to stimulate hair growth, the treatment of androgenic alopecia could be improved by delivery strategies that would favor drug accumulation into the hair follicles. This work investigated in vitro the potential of iontophoresis to achieve this objective using MX sulfate (MXS), a more water-soluble derivative of MX. Passive delivery of MXS was first determined from an ethanol-water solution and from a thermosensitive gel. The latter formulation resulted in greater accumulation of MXS in the stratum corneum (skin's outermost layer) and hair follicles and an overall decrease in absorption through the skin. Anodal iontophoresis of MXS from the same gel formulation was then investigated at pH 3.5 and pH 5.5. Compared with passive delivery, iontophoresis increased the amount of drug reaching the follicular infundibula from 120 to 600 ng per follicle. In addition, drug recovery from follicular casts was threefold higher following iontophoresis at pH 5.5 compared with that at pH 3.5. Preliminary in vivo experiments in rats confirmed that iontophoretic delivery of MXS facilitated drug accumulation in hair follicles. Overall, therefore, iontophoresis successfully and significantly enhanced follicular delivery of MX suggesting a useful opportunity for the improved treatment of alopecia. Copyright © 2013 Wiley Periodicals, Inc.

Treatment planning, optimization, and beam delivery technqiues for intensity modulated proton therapy

Science.gov (United States)

Sengbusch, Evan R.

Physical properties of proton interactions in matter give them a theoretical advantage over photons in radiation therapy for cancer treatment, but they are seldom used relative to photons. The primary barriers to wider acceptance of proton therapy are the technical feasibility, size, and price of proton therapy systems. Several aspects of the proton therapy landscape are investigated, and new techniques for treatment planning, optimization, and beam delivery are presented. The results of these investigations suggest a means by which proton therapy can be delivered more efficiently, effectively, and to a much larger proportion of eligible patients. An analysis of the existing proton therapy market was performed. Personal interviews with over 30 radiation oncology leaders were conducted with regard to the current and future use of proton therapy. In addition, global proton therapy market projections are presented. The results of these investigations serve as motivation and guidance for the subsequent development of treatment system designs and treatment planning, optimization, and beam delivery methods. A major factor impacting the size and cost of proton treatment systems is the maximum energy of the accelerator. Historically, 250 MeV has been the accepted value, but there is minimal quantitative evidence in the literature that supports this standard. A retrospective study of 100 patients is presented that quantifies the maximum proton kinetic energy requirements for cancer treatment, and the impact of those results with regard to treatment system size, cost, and neutron production is discussed. This study is subsequently expanded to include 100 cranial stereotactic radiosurgery (SRS) patients, and the results are discussed in the context of a proposed dedicated proton SRS treatment system. Finally, novel proton therapy optimization and delivery techniques are presented. Algorithms are developed that optimize treatment plans over beam angle, spot size, spot spacing

Patient Study of In Vivo Verification of Beam Delivery and Range, Using Positron Emission Tomography and Computed Tomography Imaging After Proton Therapy

International Nuclear Information System (INIS)

Parodi, Katia; Paganetti, Harald; Shih, Helen A.; Michaud, Susan; Loeffler, Jay S.; DeLaney, Thomas F.; Liebsch, Norbert J.; Munzenrider, John E.; Fischman, Alan J.; Knopf, Antje; Bortfeld, Thomas

2007-01-01

Purpose: To investigate the feasibility and value of positron emission tomography and computed tomography (PET/CT) for treatment verification after proton radiotherapy. Methods and Materials: This study included 9 patients with tumors in the cranial base, spine, orbit, and eye. Total doses of 1.8-3 GyE and 10 GyE (for an ocular melanoma) per fraction were delivered in 1 or 2 fields. Imaging was performed with a commercial PET/CT scanner for 30 min, starting within 20 min after treatment. The same treatment immobilization device was used during imaging for all but 2 patients. Measured PET/CT images were coregistered to the planning CT and compared with the corresponding PET expectation, obtained from CT-based Monte Carlo calculations complemented by functional information. For the ocular case, treatment position was approximately replicated, and spatial correlation was deduced from reference clips visible in both the planning radiographs and imaging CT. Here, the expected PET image was obtained from an analytical model. Results: Good spatial correlation and quantitative agreement within 30% were found between the measured and expected activity. For head-and-neck patients, the beam range could be verified with an accuracy of 1-2 mm in well-coregistered bony structures. Low spine and eye sites indicated the need for better fixation and coregistration methods. An analysis of activity decay revealed as tissue-effective half-lives of 800-1,150 s. Conclusions: This study demonstrates the feasibility of postradiation PET/CT for in vivo treatment verification. It also indicates some technological and methodological improvements needed for optimal clinical application

Commissioning and first clinical application of mARC treatment

International Nuclear Information System (INIS)

Dzierma, Yvonne; Nuesken, Frank G.; Kremp, Stephanie; Palm, Jan; Licht, Norbert P.; Ruebe, Christian

2014-01-01

The modulated arc (mARC) technique has recently been introduced for Siemens ARTISTE linear accelerators. We present the first experiences with the commissioning of the system and first patient treatments. Treatment planning and delivery are presented for the Prowess Panther treatment planning system or, alternatively, an in-house code. Dosimetric verification is performed both by point dose measurements and in 3D dose distribution. Depending on the target volume, one or two arcs can be used to create highly conformal plans. Dosimetric verification of the converted mARC plans with step-and-shoot plans shows deviations below 1 % in absolute point dose; in the 3D dose distribution, over 95 % of the points pass the 3D gamma criteria (3 % deviation in local dose and 3 mm distance to agreement for doses > 20 % of the maximum). Patient specific verification of the mARC dose distribution with the calculations has a similar pass rate. Treatment times range between 2 and 5 min for a single arc. To our knowledge, this is the first report of clinical application of the mARC technique. The mARC offers the possibility to save significant amounts of time, with single-arc treatments of only a few minutes achieving comparable dose distribution to IMRT plans taking up to twice as long. (orig.) [de

4D offline PET-based treatment verification in ion beam therapy. Experimental and clinical evaluation

Energy Technology Data Exchange (ETDEWEB)

Kurz, Christopher

2014-06-12

Due to the accessible sharp dose gradients, external beam radiotherapy with protons and heavier ions enables a highly conformal adaptation of the delivered dose to arbitrarily shaped tumour volumes. However, this high conformity is accompanied by an increased sensitivity to potential uncertainties, e.g., due to changes in the patient anatomy. Additional challenges are imposed by respiratory motion which does not only lead to rapid changes of the patient anatomy, but, in the cased of actively scanned ions beams, also to the formation of dose inhomogeneities. Therefore, it is highly desirable to verify the actual application of the treatment and to detect possible deviations with respect to the planned irradiation. At present, the only clinically implemented approach for a close-in-time verification of single treatment fractions is based on detecting the distribution of β{sup +}-emitter formed in nuclear fragmentation reactions during the irradiation by means of positron emission tomography (PET). For this purpose, a commercial PET/CT (computed tomography) scanner has been installed directly next to the treatment rooms at the Heidelberg Ion-Beam Therapy Center (HIT). Up to present, the application of this treatment verification technique is, however, still limited to static target volumes. This thesis aimed at investigating the feasibility and performance of PET-based treatment verification under consideration of organ motion. In experimental irradiation studies with moving phantoms, not only the practicability of PET-based treatment monitoring for moving targets, using a commercial PET/CT device, could be shown for the first time, but also the potential of this technique to detect motion-related deviations from the planned treatment with sub-millimetre accuracy. The first application to four exemplary hepato-cellular carcinoma patient cases under substantially more challenging clinical conditions indicated potential for improvement by taking organ motion into

4D offline PET-based treatment verification in ion beam therapy. Experimental and clinical evaluation

International Nuclear Information System (INIS)

Kurz, Christopher

2014-01-01

Due to the accessible sharp dose gradients, external beam radiotherapy with protons and heavier ions enables a highly conformal adaptation of the delivered dose to arbitrarily shaped tumour volumes. However, this high conformity is accompanied by an increased sensitivity to potential uncertainties, e.g., due to changes in the patient anatomy. Additional challenges are imposed by respiratory motion which does not only lead to rapid changes of the patient anatomy, but, in the cased of actively scanned ions beams, also to the formation of dose inhomogeneities. Therefore, it is highly desirable to verify the actual application of the treatment and to detect possible deviations with respect to the planned irradiation. At present, the only clinically implemented approach for a close-in-time verification of single treatment fractions is based on detecting the distribution of β + -emitter formed in nuclear fragmentation reactions during the irradiation by means of positron emission tomography (PET). For this purpose, a commercial PET/CT (computed tomography) scanner has been installed directly next to the treatment rooms at the Heidelberg Ion-Beam Therapy Center (HIT). Up to present, the application of this treatment verification technique is, however, still limited to static target volumes. This thesis aimed at investigating the feasibility and performance of PET-based treatment verification under consideration of organ motion. In experimental irradiation studies with moving phantoms, not only the practicability of PET-based treatment monitoring for moving targets, using a commercial PET/CT device, could be shown for the first time, but also the potential of this technique to detect motion-related deviations from the planned treatment with sub-millimetre accuracy. The first application to four exemplary hepato-cellular carcinoma patient cases under substantially more challenging clinical conditions indicated potential for improvement by taking organ motion into

SU-E-T-784: Using MLC Log Files for Daily IMRT Delivery Verification

Energy Technology Data Exchange (ETDEWEB)

Stathakis, S; Defoor, D; Linden, P; Kirby, N; Papanikolaou, N [University of Texas HSC SA, San Antonio, TX (United States)

2015-06-15

Purpose: To verify daily intensity modulated radiation therapy (IMRT) treatments using multi-leaf collimator (MLC) log files. Methods: The MLC log files from a NovalisTX Varian linear accelerator were used in this study. The MLC files were recorded daily for all patients undergoing IMRT or volumetric modulated arc therapy (VMAT). The first record of each patient was used as reference and all records for subsequent days were compared against the reference. An in house MATLAB software code was used for the comparisons. Each MLC log file was converted to a fluence map (FM) and a gamma index (γ) analysis was used for the evaluation of each daily delivery for every patient. The tolerance for the gamma index was set to 2% dose difference and 2mm distance to agreement while points with signal of 10% or lower of the maximum value were excluded from the comparisons. Results: The γ between each of the reference FMs and the consecutive daily fraction FMs had an average value of 99.1% (ranged from 98.2 to 100.0%). The FM images were reconstructed at various resolutions in order to study the effect of the resolution on the γ and at the same time reduce the time for processing the images. We found that the comparison of images with the highest resolution (768×1024) yielded on average a lower γ (99.1%) than the ones with low resolution (192×256) (γ 99.5%). Conclusion: We developed an in-house software that allows us to monitor the quality of daily IMRT and VMAT treatment deliveries using information from the MLC log files of the linear accelerator. The information can be analyzed and evaluated as early as after the completion of each daily treatment. Such tool can be valuable to assess the effect of MLC positioning on plan quality, especially in the context of adaptive radiotherapy.

Validation of a cylindrical phantom for verification of radiotherapy treatments in head and neck with special techniques

International Nuclear Information System (INIS)

Vargas, Nicolas M.; Garcia, Marcia; Piriz, Gustavo; Perez, Niurka

2011-01-01

Verification of radiotherapy treatments in head and neck requires, among other things, small volume chambers and a phantom to reproduce the geometry and density of the anatomical structure. New documents from the ICRU (International Commission on Radiation Units and Measurements), Report 83, established the need for quality control in radiotherapy with special techniques such as IMRT (intensity-modulated radiation therapy). In this study, we built a cylindrical acrylic phantom with standing water, containing seven measuring points in the transverse plane and free location (0-20 cm) in the longitudinal plane. These points of measurement are constituted by cavities for the accommodation of the ionization chamber of 7 mm of mayor diameter (semi flex, pinpoint with build cup). The results of the phantom validation yielded percentage differences less than 1% in fixed beams and less than 2.5% in arc therapy for TPS Eclipse calculation. The preparation of this phantom, particularly made to verify the head and neck treatments, was simple and reliable for checking the dose in radiotherapy with fixed beams and/or special techniques such as arc therapy or IMRT, so that will be sent to various radiotherapy centers in the country for dosimetric verification in such treatments. (author)

Validation of a cylindrical phantom for verification of radiotherapy treatments in head and neck with special techniques

Energy Technology Data Exchange (ETDEWEB)

Vargas, Nicolas M.; Garcia, Marcia, E-mail: nimoralesv@gmail.com [Universidad de La Frontera, Temuco (Chile). Dept. de Ciencias Fisicas; Piriz, Gustavo [Instituto Nacional del Cancer, Santiago (Chile). Fisica Medica; Perez, Niurka [Instituto de Salud Publica, Santiago (Chile). QA Radioterapia. Inst. de Salud Publica

2011-07-01

Verification of radiotherapy treatments in head and neck requires, among other things, small volume chambers and a phantom to reproduce the geometry and density of the anatomical structure. New documents from the ICRU (International Commission on Radiation Units and Measurements), Report 83, established the need for quality control in radiotherapy with special techniques such as IMRT (intensity-modulated radiation therapy). In this study, we built a cylindrical acrylic phantom with standing water, containing seven measuring points in the transverse plane and free location (0-20 cm) in the longitudinal plane. These points of measurement are constituted by cavities for the accommodation of the ionization chamber of 7 mm of mayor diameter (semi flex, pinpoint with build cup). The results of the phantom validation yielded percentage differences less than 1% in fixed beams and less than 2.5% in arc therapy for TPS Eclipse calculation. The preparation of this phantom, particularly made to verify the head and neck treatments, was simple and reliable for checking the dose in radiotherapy with fixed beams and/or special techniques such as arc therapy or IMRT, so that will be sent to various radiotherapy centers in the country for dosimetric verification in such treatments. (author)

Verification of patient position and delivery of IMRT by electronic portal imaging

International Nuclear Information System (INIS)

Fielding, Andrew L.; Evans, Philip M.; Clark, Catharine H.

2004-01-01

Background and purpose: The purpose of the work presented in this paper was to determine whether patient positioning and delivery errors could be detected using electronic portal images of intensity modulated radiotherapy (IMRT). Patients and methods: We carried out a series of controlled experiments delivering an IMRT beam to a humanoid phantom using both the dynamic and multiple static field method of delivery. The beams were imaged, the images calibrated to remove the IMRT fluence variation and then compared with calibrated images of the reference beams without any delivery or position errors. The first set of experiments involved translating the position of the phantom both laterally and in a superior/inferior direction a distance of 1, 2, 5 and 10 mm. The phantom was also rotated 1 and 2 deg. For the second set of measurements the phantom position was kept fixed and delivery errors were introduced to the beam. The delivery errors took the form of leaf position and segment intensity errors. Results: The method was able to detect shifts in the phantom position of 1 mm, leaf position errors of 2 mm, and dosimetry errors of 10% on a single segment of a 15 segment IMRT step and shoot delivery (significantly less than 1% of the total dose). Conclusions: The results of this work have shown that the method of imaging the IMRT beam and calibrating the images to remove the intensity modulations could be a useful tool in verifying both the patient position and the delivery of the beam

Dosimetric accuracy of Kodak EDR2 film for IMRT verifications.

Science.gov (United States)

Childress, Nathan L; Salehpour, Mohammad; Dong, Lei; Bloch, Charles; White, R Allen; Rosen, Isaac I

2005-02-01

Patient-specific intensity-modulated radiotherapy (IMRT) verifications require an accurate two-dimensional dosimeter that is not labor-intensive. We assessed the precision and reproducibility of film calibrations over time, measured the elemental composition of the film, measured the intermittency effect, and measured the dosimetric accuracy and reproducibility of calibrated Kodak EDR2 film for single-beam verifications in a solid water phantom and for full-plan verifications in a Rexolite phantom. Repeated measurements of the film sensitometric curve in a single experiment yielded overall uncertainties in dose of 2.1% local and 0.8% relative to 300 cGy. 547 film calibrations over an 18-month period, exposed to a range of doses from 0 to a maximum of 240 MU or 360 MU and using 6 MV or 18 MV energies, had optical density (OD) standard deviations that were 7%-15% of their average values. This indicates that daily film calibrations are essential when EDR2 film is used to obtain absolute dose results. An elemental analysis of EDR2 film revealed that it contains 60% as much silver and 20% as much bromine as Kodak XV2 film. EDR2 film also has an unusual 1.69:1 silver:halide molar ratio, compared with the XV2 film's 1.02:1 ratio, which may affect its chemical reactions. To test EDR2's intermittency effect, the OD generated by a single 300 MU exposure was compared to the ODs generated by exposing the film 1 MU, 2 MU, and 4 MU at a time to a total of 300 MU. An ion chamber recorded the relative dose of all intermittency measurements to account for machine output variations. Using small MU bursts to expose the film resulted in delivery times of 4 to 14 minutes and lowered the film's OD by approximately 2% for both 6 and 18 MV beams. This effect may result in EDR2 film underestimating absolute doses for patient verifications that require long delivery times. After using a calibration to convert EDR2 film's OD to dose values, film measurements agreed within 2% relative

The impacts of dental filling materials on RapidArc treatment planning and dose delivery: Challenges and solution

Energy Technology Data Exchange (ETDEWEB)

Mail, Noor; Al-Ghamdi, S.; Saoudi, A. [Princess Norah Oncology Center, National Guard Health Affairs, Jeddah 21423, Saudi Arabia and King Abdullah International Medical Research Center, Jeddah 21423 (Saudi Arabia); Albarakati, Y.; Ahmad Khan, M.; Saeedi, F.; Safadi, N. [Princess Norah Oncology Center, National Guard Health Affairs, Jeddah 21423 (Saudi Arabia)

2013-08-15

Purpose: The presence of high-density material in the oral cavity creates dose perturbation in both downstream and upstream directions at the surfaces of dental filling materials (DFM). In this study, the authors have investigated the effect of DFM on head and neck RapidArc treatment plans and delivery. Solutions are proposed to address (1) the issue of downstream dose perturbation, which might cause target under dosage, and (2) to reduce the upstream dose from DFM which may be the primary source of mucositis. In addition, an investigation of the clinical role of a custom-made plastic dental mold/gutter (PDM) in sparing the oral mucosa and tongue reaction is outlined.Methods: The influence of the dental filling artifacts on dose distribution was investigated using a geometrically well-defined head and neck intensity modulated radiation therapy (IMRT) verification phantom (PTW, Freiberg, Germany) with DFM inserts called amalgam, which contained 50% mercury, 25% silver, 14% tin, 8% copper, and 3% other trace metals. Three RapidArc plans were generated in the Varian Eclipse System to treat the oral cavity using the same computer tomography (CT) dataset, including (1) a raw CT image, (2) a streaking artifacts region, which was replaced with a mask of 10 HU, and (3) a 2 cm-thick 6000 HU virtual filter [a volume created in treatment planning system to compensate for beam attenuation, where the thickness of this virtual filter is based on the measured percent depth dose (PDD) data and Eclipse calculation]. The dose delivery for the three plans was verified using Gafchromic-EBT2 film measurements. The custom-made PDM technique to reduce backscatter dose was clinically tested on four head and neck cancer patients (T3, N1, M0) with DFM, two patients with PDM and the other two patients without PDM. The thickness calculation of the PDM toward the mucosa and tongue was purely based on the measured upstream dose. Patients’ with oral mucosal reaction was clinically examined

The impacts of dental filling materials on RapidArc treatment planning and dose delivery: Challenges and solution

International Nuclear Information System (INIS)

Mail, Noor; Al-Ghamdi, S.; Saoudi, A.; Albarakati, Y.; Ahmad Khan, M.; Saeedi, F.; Safadi, N.

2013-01-01

Purpose: The presence of high-density material in the oral cavity creates dose perturbation in both downstream and upstream directions at the surfaces of dental filling materials (DFM). In this study, the authors have investigated the effect of DFM on head and neck RapidArc treatment plans and delivery. Solutions are proposed to address (1) the issue of downstream dose perturbation, which might cause target under dosage, and (2) to reduce the upstream dose from DFM which may be the primary source of mucositis. In addition, an investigation of the clinical role of a custom-made plastic dental mold/gutter (PDM) in sparing the oral mucosa and tongue reaction is outlined.Methods: The influence of the dental filling artifacts on dose distribution was investigated using a geometrically well-defined head and neck intensity modulated radiation therapy (IMRT) verification phantom (PTW, Freiberg, Germany) with DFM inserts called amalgam, which contained 50% mercury, 25% silver, 14% tin, 8% copper, and 3% other trace metals. Three RapidArc plans were generated in the Varian Eclipse System to treat the oral cavity using the same computer tomography (CT) dataset, including (1) a raw CT image, (2) a streaking artifacts region, which was replaced with a mask of 10 HU, and (3) a 2 cm-thick 6000 HU virtual filter [a volume created in treatment planning system to compensate for beam attenuation, where the thickness of this virtual filter is based on the measured percent depth dose (PDD) data and Eclipse calculation]. The dose delivery for the three plans was verified using Gafchromic-EBT2 film measurements. The custom-made PDM technique to reduce backscatter dose was clinically tested on four head and neck cancer patients (T3, N1, M0) with DFM, two patients with PDM and the other two patients without PDM. The thickness calculation of the PDM toward the mucosa and tongue was purely based on the measured upstream dose. Patients’ with oral mucosal reaction was clinically examined

Development of a software of VMAT delivery using EPID

International Nuclear Information System (INIS)

Arumugam, Sankar; Xing, Aitang; Jameson, Michael; Holloway, Lois; Goozee, Gary

2011-01-01

Full text: Volumetric Modulated Arc Therapy (VMAT) is more complex than standard IMRT, requiring new methodology to evaluate delivery accuracy. Here, we present the development of methodology and a software tool to perform control point based verification of VMAT delivery using an EPID. Individual segment dose comparison allows the verification of VMAT deli very accuracy for individual control-points. An in-house software tool was developed to predict the individual segment dose as measured by EPID for Pinnacle (Philips) generated VMAT plans. The VMAT plans were delivered using an Elekta-synergy accelerator and the segment doses were measured using EPID. A normalised dose comparison of measured and predicted doses was performed using gamma analysis with 3% dose tolerance and 3 mm DTA. The sensitivity of the proposed methodology in detecting delivery errors was studied by delivering a standard intensity pattern with a preset dose error of 4 and 5% in two of its eight control-points. Four clinical plans were also tested using this methodology. The developed software accurately predicts the EPID dose by considering all possible leaf trajectories in VMAT delivery. The mean gamma value and percentage of pixels exceeding the gamma tolerance for a segment with and without delivery errors are shown in Table. From the tabulated values it is evident that the proposed methodology is sensitive in detecting delivery errors above 3% tolerance level. The clinical plans were successfully validated showing a maximum 2.5% of pixels exceeding gamma tolerance. Methodology and a software were successfully developed to perform control-point validation of VMAT delivery using an EPID. Set error in Delivery (%) Mean gamma value% of pixels exceeding Gamma tolerance 0 0.40 1.240.5417.050.6221.8.

Transepidermal drug delivery: a new treatment option for areata alopecia?

Science.gov (United States)

Issa, Maria Claudia Almeida; Pires, Marianna; Silveira, Priscilla; Xavier de Brito, Esther; Sasajima, Cristiane

2015-02-01

Transepidermal drug delivery (TED) is a new potential method in dermatology. Permeability alterations induced by ablative fractional resurfacing have been described with the aim to increasing the delivery of different substances into the skin. To evaluate clinical response and side effects of TED in areata alopecia (AA) treatment using ablative fractional methods associated with acoustic pressure ultrasound (US) to deliver triamcinolone solution into the skin. Five cases of AA underwent treatment which comprised of 3 steps: 1) Ablative fractioned RF or CO2 laser 2) topical application of triamcinolone 3) acoustic pressure wave US. The number of sessions varied according to the clinical response, ranging from one to six sessions. All patients had complete recovery of the area treated. Two of them treated with ablative fractional RF + triamcinolone + US had complete response after three and six sessions. The other two treated with ablative fractional CO2 + triamcinolone + US had complete response after one session. Fractioned ablative resurfacing associated with acoustic pressure wave US is a new option to areata alopecia treatment with good clinical result and low incidence of side effects.

The electronic view box: a software tool for radiation therapy treatment verification

International Nuclear Information System (INIS)

Bosch, Walter R.; Low, Daniel A.; Gerber, Russell L.; Michalski, Jeff M.; Graham, Mary V.; Perez, Carlos A.; Harms, William B.; Purdy, James A.

1995-01-01

Purpose: We have developed a software tool for interactively verifying treatment plan implementation. The Electronic View Box (EVB) tool copies the paradigm of current practice but does so electronically. A portal image (online portal image or digitized port film) is displayed side by side with a prescription image (digitized simulator film or digitally reconstructed radiograph). The user can measure distances between features in prescription and portal images and 'write' on the display, either to approve the image or to indicate required corrective actions. The EVB tool also provides several features not available in conventional verification practice using a light box. Methods and Materials: The EVB tool has been written in ANSI C using the X window system. The tool makes use of the Virtual Machine Platform and Foundation Library specifications of the NCI-sponsored Radiation Therapy Planning Tools Collaborative Working Group for portability into an arbitrary treatment planning system that conforms to these specifications. The present EVB tool is based on an earlier Verification Image Review tool, but with a substantial redesign of the user interface. A graphical user interface prototyping system was used in iteratively refining the tool layout to allow rapid modifications of the interface in response to user comments. Results: Features of the EVB tool include 1) hierarchical selection of digital portal images based on physician name, patient name, and field identifier; 2) side-by-side presentation of prescription and portal images at equal magnification and orientation, and with independent grayscale controls; 3) 'trace' facility for outlining anatomical structures; 4) 'ruler' facility for measuring distances; 5) zoomed display of corresponding regions in both images; 6) image contrast enhancement; and 7) communication of portal image evaluation results (approval, block modification, repeat image acquisition, etc.). Conclusion: The EVB tool facilitates the rapid

Robotic path-finding in inverse treatment planning for stereotactic radiosurgery with continuous dose delivery

Energy Technology Data Exchange (ETDEWEB)

Vandewouw, Marlee M., E-mail: marleev@mie.utoronto.ca; Aleman, Dionne M. [Department of Mechanical and Industrial Engineering, University of Toronto, Toronto, Ontario M5S 3G8 (Canada); Jaffray, David A. [Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Ontario M5G 2M9 (Canada)

2016-08-15

Purpose: Continuous dose delivery in radiation therapy treatments has been shown to decrease total treatment time while improving the dose conformity and distribution homogeneity over the conventional step-and-shoot approach. The authors develop an inverse treatment planning method for Gamma Knife® Perfexion™ that continuously delivers dose along a path in the target. Methods: The authors’ method is comprised of two steps: find a path within the target, then solve a mixed integer optimization model to find the optimal collimator configurations and durations along the selected path. Robotic path-finding techniques, specifically, simultaneous localization and mapping (SLAM) using an extended Kalman filter, are used to obtain a path that travels sufficiently close to selected isocentre locations. SLAM is novelly extended to explore a 3D, discrete environment, which is the target discretized into voxels. Further novel extensions are incorporated into the steering mechanism to account for target geometry. Results: The SLAM method was tested on seven clinical cases and compared to clinical, Hamiltonian path continuous delivery, and inverse step-and-shoot treatment plans. The SLAM approach improved dose metrics compared to the clinical plans and Hamiltonian path continuous delivery plans. Beam-on times improved over clinical plans, and had mixed performance compared to Hamiltonian path continuous plans. The SLAM method is also shown to be robust to path selection inaccuracies, isocentre selection, and dose distribution. Conclusions: The SLAM method for continuous delivery provides decreased total treatment time and increased treatment quality compared to both clinical and inverse step-and-shoot plans, and outperforms existing path methods in treatment quality. It also accounts for uncertainty in treatment planning by accommodating inaccuracies.

Robotic path-finding in inverse treatment planning for stereotactic radiosurgery with continuous dose delivery

International Nuclear Information System (INIS)

Vandewouw, Marlee M.; Aleman, Dionne M.; Jaffray, David A.

2016-01-01

Purpose: Continuous dose delivery in radiation therapy treatments has been shown to decrease total treatment time while improving the dose conformity and distribution homogeneity over the conventional step-and-shoot approach. The authors develop an inverse treatment planning method for Gamma Knife® Perfexion™ that continuously delivers dose along a path in the target. Methods: The authors’ method is comprised of two steps: find a path within the target, then solve a mixed integer optimization model to find the optimal collimator configurations and durations along the selected path. Robotic path-finding techniques, specifically, simultaneous localization and mapping (SLAM) using an extended Kalman filter, are used to obtain a path that travels sufficiently close to selected isocentre locations. SLAM is novelly extended to explore a 3D, discrete environment, which is the target discretized into voxels. Further novel extensions are incorporated into the steering mechanism to account for target geometry. Results: The SLAM method was tested on seven clinical cases and compared to clinical, Hamiltonian path continuous delivery, and inverse step-and-shoot treatment plans. The SLAM approach improved dose metrics compared to the clinical plans and Hamiltonian path continuous delivery plans. Beam-on times improved over clinical plans, and had mixed performance compared to Hamiltonian path continuous plans. The SLAM method is also shown to be robust to path selection inaccuracies, isocentre selection, and dose distribution. Conclusions: The SLAM method for continuous delivery provides decreased total treatment time and increased treatment quality compared to both clinical and inverse step-and-shoot plans, and outperforms existing path methods in treatment quality. It also accounts for uncertainty in treatment planning by accommodating inaccuracies.

Delivery of Intraocular Triamcinolone Acetonide in the Treatment of Macular Edema

Directory of Open Access Journals (Sweden)

Brent Siesky

2012-03-01

Full Text Available Macular edema (ME is one of the eventual outcomes of various intraocular and systemic pathologies. The pathogenesis for ME is not yet entirely understood; however, some of the common risk factors for its development have been identified. While this investigation will not discuss the numerous etiologies of ME in detail, it appraises the two most widely studied delivery modalities of intraocular corticosteroids in the treatment of ME—intravitreal injection (IVI and sub-Tenon’s infusion (STI. A thorough review of the medical literature was conducted to identify the efficacy and safety of IVI and STI, specifically for the administration of triamcinolone acetonide (TA, in the setting of ME in an attempt to elucidate a preferred steroid delivery modality for treatment of ME.

Current challenges and emerging drug delivery strategies for the treatment of psoriasis.

Science.gov (United States)

Hoffman, Melissa B; Hill, Dane; Feldman, Steven R

2016-10-01

Psoriasis is a common skin disorder associated with physical, social, psychological and financial burden. Over the past two decades, advances in our understanding of pathogenesis and increased appreciation for the multifaceted burden of psoriasis has led to new treatment development and better patient outcomes. Yet, surveys demonstrate that many psoriasis patients are either undertreated or are dissatisfied with treatment. There are many barriers that need be overcome to optimize patient outcomes and satisfaction. This review covers the current challenges associated with each major psoriasis treatment strategy (topical, phototherapy, oral medications and biologics). It also reviews the challenges associated with the psychosocial aspects of the disease and how they affect treatment outcomes. Patient adherence, inconvenience, high costs, and drug toxicities are all discussed. Then, we review the emerging drug delivery strategies in topical, oral, and biologic therapy. By outlining current treatment challenges and emerging drug delivery strategies, we hope to highlight the deficits in psoriasis treatment and strategies for how to overcome them. Regardless of disease severity, clinicians should use a patient-centered approach. In all cases, we need to balance patients' psychosocial needs, treatment costs, convenience, and effectiveness with patients' preferences in order to optimize treatment outcomes.

Dosimetric verification of radiotherapy treatment planning systems in Serbia: national audit

International Nuclear Information System (INIS)

Rutonjski, Laza; Petrović, Borislava; Baucal, Milutin; Teodorović, Milan; Čudić, Ozren; Gershkevitsh, Eduard; Izewska, Joanna

2012-01-01

Independent external audits play an important role in quality assurance programme in radiation oncology. The audit supported by the IAEA in Serbia was designed to review the whole chain of activities in 3D conformal radiotherapy (3D-CRT) workflow, from patient data acquisition to treatment planning and dose delivery. The audit was based on the IAEA recommendations and focused on dosimetry part of the treatment planning and delivery processes. The audit was conducted in three radiotherapy departments of Serbia. An anthropomorphic phantom was scanned with a computed tomography unit (CT) and treatment plans for eight different test cases involving various beam configurations suggested by the IAEA were prepared on local treatment planning systems (TPSs). The phantom was irradiated following the treatment plans for these test cases and doses in specific points were measured with an ionization chamber. The differences between the measured and calculated doses were reported. The measurements were conducted for different photon beam energies and TPS calculation algorithms. The deviation between the measured and calculated values for all test cases made with advanced algorithms were within the agreement criteria, while the larger deviations were observed for simpler algorithms. The number of measurements with results outside the agreement criteria increased with the increase of the beam energy and decreased with TPS calculation algorithm sophistication. Also, a few errors in the basic dosimetry data in TPS were detected and corrected. The audit helped the users to better understand the operational features and limitations of their TPSs and resulted in increased confidence in dose calculation accuracy using TPSs. The audit results indicated the shortcomings of simpler algorithms for the test cases performed and, therefore the transition to more advanced algorithms is highly desirable

Dosimetric verification of radiotherapy treatment planning systems in Serbia: national audit

Directory of Open Access Journals (Sweden)

Rutonjski Laza

2012-09-01

Full Text Available Abstract Background Independent external audits play an important role in quality assurance programme in radiation oncology. The audit supported by the IAEA in Serbia was designed to review the whole chain of activities in 3D conformal radiotherapy (3D-CRT workflow, from patient data acquisition to treatment planning and dose delivery. The audit was based on the IAEA recommendations and focused on dosimetry part of the treatment planning and delivery processes. Methods The audit was conducted in three radiotherapy departments of Serbia. An anthropomorphic phantom was scanned with a computed tomography unit (CT and treatment plans for eight different test cases involving various beam configurations suggested by the IAEA were prepared on local treatment planning systems (TPSs. The phantom was irradiated following the treatment plans for these test cases and doses in specific points were measured with an ionization chamber. The differences between the measured and calculated doses were reported. Results The measurements were conducted for different photon beam energies and TPS calculation algorithms. The deviation between the measured and calculated values for all test cases made with advanced algorithms were within the agreement criteria, while the larger deviations were observed for simpler algorithms. The number of measurements with results outside the agreement criteria increased with the increase of the beam energy and decreased with TPS calculation algorithm sophistication. Also, a few errors in the basic dosimetry data in TPS were detected and corrected. Conclusions The audit helped the users to better understand the operational features and limitations of their TPSs and resulted in increased confidence in dose calculation accuracy using TPSs. The audit results indicated the shortcomings of simpler algorithms for the test cases performed and, therefore the transition to more advanced algorithms is highly desirable.

Dosimetric verification of radiotherapy treatment planning systems in Serbia: national audit.

Science.gov (United States)

Rutonjski, Laza; Petrović, Borislava; Baucal, Milutin; Teodorović, Milan; Cudić, Ozren; Gershkevitsh, Eduard; Izewska, Joanna

2012-09-12

Independent external audits play an important role in quality assurance programme in radiation oncology. The audit supported by the IAEA in Serbia was designed to review the whole chain of activities in 3D conformal radiotherapy (3D-CRT) workflow, from patient data acquisition to treatment planning and dose delivery. The audit was based on the IAEA recommendations and focused on dosimetry part of the treatment planning and delivery processes. The audit was conducted in three radiotherapy departments of Serbia. An anthropomorphic phantom was scanned with a computed tomography unit (CT) and treatment plans for eight different test cases involving various beam configurations suggested by the IAEA were prepared on local treatment planning systems (TPSs). The phantom was irradiated following the treatment plans for these test cases and doses in specific points were measured with an ionization chamber. The differences between the measured and calculated doses were reported. The measurements were conducted for different photon beam energies and TPS calculation algorithms. The deviation between the measured and calculated values for all test cases made with advanced algorithms were within the agreement criteria, while the larger deviations were observed for simpler algorithms. The number of measurements with results outside the agreement criteria increased with the increase of the beam energy and decreased with TPS calculation algorithm sophistication. Also, a few errors in the basic dosimetry data in TPS were detected and corrected. The audit helped the users to better understand the operational features and limitations of their TPSs and resulted in increased confidence in dose calculation accuracy using TPSs. The audit results indicated the shortcomings of simpler algorithms for the test cases performed and, therefore the transition to more advanced algorithms is highly desirable.

Verification of the linac isocenter for stereotactic radiosurgery using cine-EPID imaging and arc delivery

International Nuclear Information System (INIS)

Rowshanfarzad, Pejman; Sabet, Mahsheed; O' Connor, Daryl J.; Greer, Peter B.

2011-01-01

Purpose:Verification of the mechanical isocenter position is required as part of comprehensive quality assurance programs for stereotactic radiosurgery/radiotherapy (SRS/SRT) treatments. Several techniques have been proposed for this purpose but each of them has certain drawbacks. In this paper, a new efficient and more comprehensive method using cine-EPID images has been introduced for automatic verification of the isocenter with sufficient accuracy for stereotactic applications. Methods: Using a circular collimator fixed to the gantry head to define the field, EPID images of a Winston-Lutz phantom were acquired in cine-imaging mode during 360 deg. gantry rotations. A robust matlab code was developed to analyze the data by finding the center of the field and the center of the ball bearing shadow in each image with sub-pixel accuracy. The distance between these two centers was determined for every image. The method was evaluated by comparison to results of a mechanical pointer and also by detection of a manual shift applied to the phantom position. The repeatability and reproducibility of the method were tested and it was also applied to detect couch and collimator wobble during rotation. Results:The accuracy of the algorithm was 0.03 ± 0.02 mm. The repeatability was less than 3 μm and the reproducibility was less than 86 μm. The time elapsed for the analysis of more than 100 cine images of Varian aS1000 and aS500 EPIDs were ∼65 and 20 s, respectively. Processing of images taken in integrated mode took 0.1 s. The output of the analysis software is printable and shows the isocenter shifts as a function of angle in both in-plane and cross-plane directions. It gives warning messages where the shifts exceed the criteria for SRS/SRT and provides useful data for the necessary adjustments in the system including bearing system and/or room lasers. Conclusions: The comprehensive method introduced in this study uses cine-images, is highly accurate, fast, and independent

Verification of the linac isocenter for stereotactic radiosurgery using cine-EPID imaging and arc delivery

Energy Technology Data Exchange (ETDEWEB)

Rowshanfarzad, Pejman; Sabet, Mahsheed; O' Connor, Daryl J.; Greer, Peter B. [School of Mathematical and Physical Sciences, University of Newcastle, Newcastle, New South Wales 2308 (Australia); Department of Radiation Oncology, Calvary Mater Newcastle Hospital, Newcastle, New South Wales 2310, Australia and School of Mathematical and Physical Sciences, University of Newcastle, Newcastle, New South Wales 2308 (Australia)

2011-07-15

Purpose:Verification of the mechanical isocenter position is required as part of comprehensive quality assurance programs for stereotactic radiosurgery/radiotherapy (SRS/SRT) treatments. Several techniques have been proposed for this purpose but each of them has certain drawbacks. In this paper, a new efficient and more comprehensive method using cine-EPID images has been introduced for automatic verification of the isocenter with sufficient accuracy for stereotactic applications. Methods: Using a circular collimator fixed to the gantry head to define the field, EPID images of a Winston-Lutz phantom were acquired in cine-imaging mode during 360 deg. gantry rotations. A robust matlab code was developed to analyze the data by finding the center of the field and the center of the ball bearing shadow in each image with sub-pixel accuracy. The distance between these two centers was determined for every image. The method was evaluated by comparison to results of a mechanical pointer and also by detection of a manual shift applied to the phantom position. The repeatability and reproducibility of the method were tested and it was also applied to detect couch and collimator wobble during rotation. Results:The accuracy of the algorithm was 0.03 {+-} 0.02 mm. The repeatability was less than 3 {mu}m and the reproducibility was less than 86 {mu}m. The time elapsed for the analysis of more than 100 cine images of Varian aS1000 and aS500 EPIDs were {approx}65 and 20 s, respectively. Processing of images taken in integrated mode took 0.1 s. The output of the analysis software is printable and shows the isocenter shifts as a function of angle in both in-plane and cross-plane directions. It gives warning messages where the shifts exceed the criteria for SRS/SRT and provides useful data for the necessary adjustments in the system including bearing system and/or room lasers. Conclusions: The comprehensive method introduced in this study uses cine-images, is highly accurate, fast, and

Micelles As Delivery System for Cancer Treatment.

Science.gov (United States)

Keskin, Dilek; Tezcaner, Aysen

2017-01-01

Micelles are nanoparticles formed by the self-assembly of amphiphilic block copolymers in certain solvents above concentrations called critical micelle concentration (CMC). Micelles are used in different fields like food, cosmetics, medicine, etc. These nanosized delivery systems are under spotlight in the recent years with new achievements in terms of their in vivo stability, ability to protect entrapped drug, release kinetics, ease of cellular penetration and thereby increased therapeutic efficacy. Drug loaded micelles can be prepared by dialysis, oil-in-water method, solid dispersion, freezing, spray drying, etc. The aim of this review is to give an overview of the research on micelles (in vitro, in vivo and clinical) as delivery system for cancer treatment. Passive targeting is one route for accumulation of nanosized micellar drug formulations. Many research groups from both academia and industry focus on developing new strategies for improving the therapeutic efficacy of micellar systems (active targeting to the tumor site, designing multidrug delivery systems for overcoming multidrug resistance or micelles formed by prodrug conjugates, etc). There is only one micellar drug formulation in South Korea that has reached clinical practice. However, there are many untargeted anticancer drug loaded micellar formulations in clinical trials, which have potential for use in clinics. Many more products are expected to be on the market in the near future. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

The Effect of Mystery Shopper Reports on Age Verification for Tobacco Purchases

Science.gov (United States)

KREVOR, BRAD S.; PONICKI, WILLIAM R.; GRUBE, JOEL W.; DeJONG, WILLIAM

2011-01-01

Mystery shops (MS) involving attempted tobacco purchases by young buyers have been employed to monitor retail stores’ performance in refusing underage sales. Anecdotal evidence suggests that MS visits with immediate feedback to store personnel can improve age verification. This study investigated the impact of monthly and twice-monthly MS reports on age verification. Forty-five Walgreens stores were each visited 20 times by mystery shoppers. The stores were randomly assigned to one of three conditions. Control group stores received no feedback, whereas two treatment groups received feedback communications every visit (twice monthly) or every second visit (monthly) after baseline. Logit regression models tested whether each treatment group improved verification rates relative to the control group. Post-baseline verification rates were higher in both treatment groups than in the control group, but only the stores receiving monthly communications had a significantly greater improvement than control group stores. Verification rates increased significantly during the study period for all three groups, with delayed improvement among control group stores. Communication between managers regarding the MS program may account for the delayed age-verification improvements observed in the control group stores. Encouraging inter-store communication might extend the benefits of MS programs beyond those stores that receive this intervention. PMID:21541874

Planning, delivery, and quality assurance of treatment with dynamic multileaf collimator for prostate: a strategy for large scale implementation

International Nuclear Information System (INIS)

Burman, Chandra; Chen, Chui; Kutcher, Gerald; Leibel, Steven; Zelefsky, Michael; LoSasso, Thomas; Spirou, Spiridon; Wu Qiuwen; Stein, Jorge; Mohan, Radhe; Ling, C. Clifton; Fuks, Zvi

1996-01-01

Purpose: In an attempt to improve tumor control of patients treated for the adenocarcinoma of the prostate, we have implemented a technique to deliver a prescribed dose of 81 Gy. At such high doses, the surrounding normal organs such as the rectum, bladder, and femur impose challenging constraints. We present a method to plan and deliver intensity modulated fields with dynamic multileaf collimators (DMLCs) in an effort to meet the difficult constraints. While the planning technique which uses inverse planning has been described in the literature, safe delivery with DMLC is a new and challenging problem. We will describe in detail our procedures with the emphasis on the delivery problems and chosen solutions. Procedures for the quality assurance of DMLC will be described. Methods and Materials: Using a recently developed and modified inverse planning algorithm, we have developed a 5-field intensity modulated plan that is delivered using DMLC. The planner specifies the target, normal organs, and the desired doses for these tissues and for the overlap regions. The planning system designs the desired intensity profiles to meet the specified criteria. To deliver the dose DMLCs provide a practical and convenient method. A procedure has been developed for the dose delivery. A scheme has been designed to determine the leaf motion to produce the required intensity pattern based on the prescribed dose and the dose rate. In order to ensure that the dose is delivered as planned, we have instituted the following procedures: (1) verification of the aperture shape on a localization port film, (2) an additional dose calculation, which uses the delivered leaf motion, and compares the difference between the planned and delivered doses, (3) comparison of the machine log files, generated during the actual dose delivery, with the planned leaf motions, (4) comparison of the measured dose profile in a flat phantom with the calculated dose distribution using the prescribed treatment

Mapping {sup 15}O Production Rate for Proton Therapy Verification

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Grogg, Kira; Alpert, Nathaniel M.; Zhu, Xuping [Center for Advanced Radiological Sciences, Nuclear Medicine and Molecular Imaging, Radiology Department, Massachusetts General Hospital, Boston, Massachusetts (United States); Min, Chul Hee [Department of Radiological Science, College of Health Science, Yonsei University, Wonju, Kangwon (Korea, Republic of); Testa, Mauro; Winey, Brian [Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts (United States); Normandin, Marc D. [Center for Advanced Radiological Sciences, Nuclear Medicine and Molecular Imaging, Radiology Department, Massachusetts General Hospital, Boston, Massachusetts (United States); Shih, Helen A.; Paganetti, Harald; Bortfeld, Thomas [Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts (United States); El Fakhri, Georges, E-mail: elfakhri@pet.mgh.harvard.edu [Center for Advanced Radiological Sciences, Nuclear Medicine and Molecular Imaging, Radiology Department, Massachusetts General Hospital, Boston, Massachusetts (United States)

2015-06-01

Purpose: This work was a proof-of-principle study for the evaluation of oxygen-15 ({sup 15}O) production as an imaging target through the use of positron emission tomography (PET), to improve verification of proton treatment plans and to study the effects of perfusion. Methods and Materials: Dynamic PET measurements of irradiation-produced isotopes were made for a phantom and rabbit thigh muscles. The rabbit muscle was irradiated and imaged under both live and dead conditions. A differential equation was fitted to phantom and in vivo data, yielding estimates of {sup 15}O production and clearance rates, which were compared to live versus dead rates for the rabbit and to Monte Carlo predictions. Results: PET clearance rates agreed with decay constants of the dominant radionuclide species in 3 different phantom materials. In 2 oxygen-rich materials, the ratio of {sup 15}O production rates agreed with the expected ratio. In the dead rabbit thighs, the dynamic PET concentration histories were accurately described using {sup 15}O decay constant, whereas the live thigh activity decayed faster. Most importantly, the {sup 15}O production rates agreed within 2% (P>.5) between conditions. Conclusions: We developed a new method for quantitative measurement of {sup 15}O production and clearance rates in the period immediately following proton therapy. Measurements in the phantom and rabbits were well described in terms of {sup 15}O production and clearance rates, plus a correction for other isotopes. These proof-of-principle results support the feasibility of detailed verification of proton therapy treatment delivery. In addition, {sup 15}O clearance rates may be useful in monitoring permeability changes due to therapy.

WE-F-16A-04: Micro-Irradiator Treatment Verification with High-Resolution 3D-Printed Rodent-Morphic Dosimeters

International Nuclear Information System (INIS)

Bache, S; Belley, M; Benning, R; Adamovics, J; Stanton, I; Therien, M; Yoshizumi, T; Oldham, M

2014-01-01

Purpose: Pre-clinical micro-radiation therapy studies often utilize very small beams (∼0.5-5mm), and require accurate dose delivery in order to effectively investigate treatment efficacy. Here we present a novel high-resolution absolute 3D dosimetry procedure, capable of ∼100-micron isotopic dosimetry in anatomically accurate rodent-morphic phantoms Methods: Anatomically accurate rat-shaped 3D dosimeters were made using 3D printing techniques from outer body contours and spinal contours outlined on CT. The dosimeters were made from a radiochromic plastic material PRESAGE, and incorporated high-Z PRESASGE inserts mimicking the spine. A simulated 180-degree spinal arc treatment was delivered through a 2 step process: (i) cone-beam-CT image-guided positioning was performed to precisely position the rat-dosimeter for treatment on the XRad225 small animal irradiator, then (ii) treatment was delivered with a simulated spine-treatment with a 180-degree arc with 20mm x 10mm cone at 225 kVp. Dose distribution was determined from the optical density change using a high-resolution in-house optical-CT system. Absolute dosimetry was enabled through calibration against a novel nano-particle scintillation detector positioned in a channel in the center of the distribution. Results: Sufficient contrast between regular PRESAGE (tissue equivalent) and high-Z PRESAGE (spinal insert) was observed to enable highly accurate image-guided alignment and targeting. The PRESAGE was found to have linear optical density (OD) change sensitivity with respect to dose (R 2 = 0.9993). Absolute dose for 360-second irradiation at isocenter was found to be 9.21Gy when measured with OD change, and 9.4Gy with nano-particle detector- an agreement within 2%. The 3D dose distribution was measured at 500-micron resolution Conclusion: This work demonstrates for the first time, the feasibility of accurate absolute 3D dose measurement in anatomically accurate rat phantoms containing variable density PRESAGE

Beam intensity scanner system for three dimensional dose verification of IMRT

International Nuclear Information System (INIS)

Vahc, Young W.; Kwon, Ohyun; Park, Kwangyl; Park, Kyung R.; Yi, Byung Y.; Kim, Keun M.

2003-01-01

Patient dose verification is clinically one of the most important parts in the treatment delivery of radiation therapy. The three dimensional (3D) reconstruction of dose distribution delivered to target volume helps to verify patient dose and determine the physical characteristics of beams used in IMRT. Here we present beam intensity scanner (BInS) system for the pre-treatment dosimetric verification of two dimensional photon intensity. The BInS is a radiation detector with a custom-made software for dose conversion of fluorescence signals from scintillator. The scintillator is used to produce fluorescence from the irradiation of 6 MV photons on a Varian Clinac 21EX. The digitized fluoroscopic signals obtained by digital video camera-based scintillator (DVCS) will be processed by our custom made software to reproduce 3D- relative dose distribution. For the intensity modulated beam (IMB), the BInS calculates absorbed dose in absolute beam fluence which is used for the patient dose distribution. Using BInS, we performed various measurements related to IMRT and found the following: (1) The 3D-dose profiles of the IMBs measured by the BInS demonstrate good agreement with radiographic film, pin type ionization chamber and Monte Carlo simulation. (2) The delivered beam intensity is altered by the mechanical and dosimetric properties of the collimation of dynamic and/or step MLC system. This is mostly due to leaf transmission, leaf penumbra scattered photons from the round edges of leaves, and geometry of leaf. (3) The delivered dose depends on the operational detail of how to make multi leaf opening. These phenomena result in a fluence distribution that can be substantially different from the initial and calculated intensity modulation and therefore, should be taken into account by the treatment planning for accurate dose calculations delivered to the target volume in IMRT. (author)

Dosimetric verification of a dedicated 3D treatment planning system for episcleral plaque therapy

International Nuclear Information System (INIS)

Knutsen, Stig; Hafslund, Rune; Monge, Odd R.; Valen, Harald; Muren, Ludvig Paul; Rekstad, Bernt Louni; Krohn, Joergen; Dahl, Olav

2001-01-01

Purpose: Episcleral plaque therapy (EPT) is applied in the management of some malignant ocular tumors. A customized configuration of typically 4 to 20 radioactive seeds is fixed in a gold plaque, and the plaque is sutured to the scleral surface corresponding to the basis of the intraocular tumor, allowing for a localized radiation dose delivery to the tumor. Minimum target doses as high as 100 Gy are directed at malignant tumor sites close to critical normal tissues (e.g., optic disc and macula). Precise dosimetry is therefore fundamental for judging both the risk for normal tissue toxicity and tumor dose prescription. This paper describes the dosimetric verification of a commercially available dedicated treatment planning system (TPS) for EPT when realistic multiple-seed configurations are applied. Materials and Methods: The TPS Bebig Plaque Simulator is used to plan EPT at our institution. Relative dose distributions in a water phantom, including central axis depth dose and off-axis dose profiles for three different plaques, the University of Southern California (USC) No. 9 and the Collaborative Ocular Melanoma Study (COMS) 12-mm and 20-mm plaques, were measured with a diode detector. Each plaque was arranged with realistic multiple 125 I seed configurations. The measured dose distributions were compared to the corresponding dose profiles calculated with the TPS. All measurements were corrected for the angular sensitivity variation of the diode. Results: Single-seed dose distributions measured with our dosimetry setup agreed with previously published data within 3%. For the three multiple-seed plaque configurations, the measured and calculated dose distributions were in good agreement. For the central axis depth doses, the agreement was within 4%, whereas deviations up to 11% were observed in single points far off-axis. Conclusions: The Bebig Plaque Simulator is a reliable TPS for calculating relative dose distributions around realistic multiple 125 I seed

A DICOM-RT-based toolbox for the evaluation and verification of radiotherapy plans

International Nuclear Information System (INIS)

Spezi, E; Lewis, D G; Smith, C W

2002-01-01

The verification of radiotherapy plans is an essential step in the treatment planning process. This is especially important for highly conformal and IMRT plans which produce non-intuitive fluence maps and complex 3D dose distributions. In this work we present a DICOM (Digital Imaging and Communication in Medicine) based toolbox, developed for the evaluation and the verification of radiotherapy treatment plans. The toolbox offers the possibility of importing treatment plans generated with different calculation algorithms and/or different optimization engines and evaluating dose distributions on an independent platform. Furthermore the radiotherapy set-up can be exported to the BEAM Monte Carlo code system for dose verification. This can be done by simulating the irradiation of the patient CT dataset or the irradiation of a software-generated water phantom. We show the application of some of the functions implemented in this toolbox for the evaluation and verification of an IMRT treatment of the head and neck region

The use of gold markers and electronic portal imaging for radiotherapy verification in prostate cancer patients: Sweden Ghana Medical Centre experience

Directory of Open Access Journals (Sweden)

George Felix Acquah

2014-02-01

Full Text Available The success of radiotherapy cancer treatment delivery depends on the accuracy of patient setup for each fraction. A significant problem arises from reproducing the same patient position and prostate location during treatment planning for every fraction of the treatment process. To analyze the daily movements of the prostate, gold markers are implanted in the prostate and portal images taken and manually matched with reference images to locate the prostate. Geometrical and fiducial markers are annotated onto a highly quality generated digitally reconstructed radiographs, that are compared with portal images acquired right before treatment dose delivery. A 0 and 270 degree treatment fields are used to calculate prostate shifts for all prostate cancer patients undergoing treatment at the Sweden Ghana Medical Centre, using an iViewGT portal imaging device. After aligning of the marker positions onto the reference images, the set-up deviations corrections are displayed and an on-line correction procedure applied. The measured migrations of the prostate markers are below the threshold of 3 mm for the main plans and 2 mm for the boost plans. With daily electronic portal imaging combined with gold markers, provides an objective method for verifying and correcting the position of the prostate immediately prior to radiation delivery.--------------------------------------------Cite this article as: Acquah GF. The use of gold markers and electronic portal imaging for radiotherapy verification in prostate cancer patients: Sweden Ghana Medical Centre experience. Int J Cancer Ther Oncol 2014; 2(1:020112.DOI: http://dx.doi.org/10.14319/ijcto.0201.12

A framework for the organization and delivery of systemic treatment.

Science.gov (United States)

Vandenberg, T; Coakley, N; Nayler, J; Degrasse, C; Green, E; Mackay, J A; McLennan, C; Smith, A; Wilcock, L; Trudeau, M E

2009-01-01

Increasing systemic treatment and shortages of oncology professionals in Canada require innovative approaches to the safe and effective delivery of intravenous (IV) cancer treatment. We conducted a systematic review of the clinical and scientific literature, and an environmental scan of models in Canada, the United Kingdom, Australia, and New Zealand. We then developed a framework for the organization and delivery of IV systemic treatment. The systematic review covered the medline, embase, cinahl, and HealthStar databases. The environmental scan retrieved published and unpublished sources, coupled with a free key word search using the Google search engine. The Systemic Treatment Working Group reviewed the evidence and developed a draft framework using evidence-based analysis, existing recommendations from various jurisdictions, and expert opinion based on experience and consensus. The draft was assessed by Ontario stakeholders and reviewed and approved by Cancer Care Ontario. The poor quantity and quality of the evidence necessitated a consensus-derived model. That model comprises four levels of care determined by a regional systemic treatment program and three integrated structures (integrated cancer programs, affiliate institutions, and satellite institutions), each with a defined scope of practice and a specific organizational framework. New models of care are urgently required beyond large centres, particularly in geographically remote or rural areas. Despite limited applicable evidence, the development and successful implementation of this framework is intended to create sustainable, accessible, quality care and to measurably improve patient outcomes.

Technical Note: Using experimentally determined proton spot scanning timing parameters to accurately model beam delivery time.

Science.gov (United States)

Shen, Jiajian; Tryggestad, Erik; Younkin, James E; Keole, Sameer R; Furutani, Keith M; Kang, Yixiu; Herman, Michael G; Bues, Martin

2017-10-01

To accurately model the beam delivery time (BDT) for a synchrotron-based proton spot scanning system using experimentally determined beam parameters. A model to simulate the proton spot delivery sequences was constructed, and BDT was calculated by summing times for layer switch, spot switch, and spot delivery. Test plans were designed to isolate and quantify the relevant beam parameters in the operation cycle of the proton beam therapy delivery system. These parameters included the layer switch time, magnet preparation and verification time, average beam scanning speeds in x- and y-directions, proton spill rate, and maximum charge and maximum extraction time for each spill. The experimentally determined parameters, as well as the nominal values initially provided by the vendor, served as inputs to the model to predict BDTs for 602 clinical proton beam deliveries. The calculated BDTs (T BDT ) were compared with the BDTs recorded in the treatment delivery log files (T Log ): ∆t = T Log -T BDT . The experimentally determined average layer switch time for all 97 energies was 1.91 s (ranging from 1.9 to 2.0 s for beam energies from 71.3 to 228.8 MeV), average magnet preparation and verification time was 1.93 ms, the average scanning speeds were 5.9 m/s in x-direction and 19.3 m/s in y-direction, the proton spill rate was 8.7 MU/s, and the maximum proton charge available for one acceleration is 2.0 ± 0.4 nC. Some of the measured parameters differed from the nominal values provided by the vendor. The calculated BDTs using experimentally determined parameters matched the recorded BDTs of 602 beam deliveries (∆t = -0.49 ± 1.44 s), which were significantly more accurate than BDTs calculated using nominal timing parameters (∆t = -7.48 ± 6.97 s). An accurate model for BDT prediction was achieved by using the experimentally determined proton beam therapy delivery parameters, which may be useful in modeling the interplay effect and patient throughput. The model may

Treatment verification with megavoltage electronic portal imaging applied to the tomotherapy concept

International Nuclear Information System (INIS)

Hesse, B.-M.; Spies, L.; Groh, B.; Doll, J.; Haering, P.; Hoever, K. H.

1997-01-01

Purpose: A new treatment strategy called Tomotherapy, introduced by T. R. Mackie et al. in 1993, was designed to perform a dynamic conformal treatment technique in precision radiotherapy. This technique delivers sliced intensity-modulated radiation fields to achieve best tumor control while sparing neighbouring sensitive normal tissue and organs at risk. The beam continuously revolves around the patient similarly to a spiral-CT while the patient is moved through the bore of the gantry. As a first step towards the realization of such a concept with a linear accelerator (Siemens Mevatron Experimental) used in clinical routine, we focused on treatment setup and dose verification. In tomotherapy, an actual CT data set is needed for patient positioning and for the verification of the absorbed dose, also, the dose transmitted through the patient must be known. This makes possible both routine tomographic treatment setup verification and tomographic dose reconstruction of the actual delivered dose. Materials and Methods: All measurements were performed with a megavoltage electronic portal imaging device of Wellhoefer TM (BIS-710). The BIS-710 detector is based on a scintillation foil and contains a camera for 10-bit digital data output. The dimension of the detector plane is 512 x 512 pixels with a pixel size of 0.6 mm in each direction. The BIS-710 was developed especially for quantitative dose measuring, whereas most of the existing Portal Imaging Systems are used for image display only. To examine the properties of the BIS-710 concerning tomographical reconstruction with a therapeutic 6 MV X-ray beam, a tissue-equivalent Alderson head phantom was rotated stepwise across a stationary beam between the collimator and the detector plane. The influence of scattering can be estimated by comparing measurements which were taken with a homogeneous phantom which is invariant under rotation with a calculated exit dose distribution using a simple exponential law for the

Megavoltage conebeam CT cine as final verification of treatment plan in lung stereotactic body radiotherapy

International Nuclear Information System (INIS)

Kudithipudi, Vijay; Gayou, Olivier; Colonias, Athanasios

2016-01-01

To analyse the clinical impact of megavoltage conebeam computed tomography (MV-CBCT) cine on internal target volume (ITV) coverage in lung stereotactic body radiotherapy (SBRT). One hundred and six patients received lung SBRT. All underwent 4D computed tomography simulation followed by treatment via image guided 3D conformal or intensity modulated radiation. Prior to SBRT, all patients underwent MV-CBCT cine, in which raw projections are displayed as beam's-eye-view fluoroscopic series with the planning target volume (PTV) projected onto each image, enabling verification of tumour motion relative to the PTV and assessment of adequacy of treatment margin. Megavoltage conebeam computed tomography cine was completed 1–2 days prior to SBRT. Four patients (3.8%) had insufficient ITV coverage inferiorly at cine review. All four plans were changed by adding 5 mm on the PTV margin inferiorly. The mean change in PTV volumes was 3.9 cubic centimetres (cc) (range 1.85–6.32 cc). Repeat cine was performed after plan modification to ensure adequate PTV coverage in the modified plans. PTV margin was adequate in the majority of patients with this technique. MV-CBCT cine did show insufficient coverage in a small subset of patients. Insufficient PTV margins may be a function of 4D CT simulation inadequacies or deficiencies in visualizing the ITV inferior border in the full-inhale phase. MV-CBCT cine is a valuable tool for final verification of PTV margins.

Dosimetric verification of radiation therapy including intensity modulated treatments, using an amorphous-silicon electronic portal imaging device

Science.gov (United States)

Chytyk-Praznik, Krista Joy

Radiation therapy is continuously increasing in complexity due to technological innovation in delivery techniques, necessitating thorough dosimetric verification. Comparing accurately predicted portal dose images to measured images obtained during patient treatment can determine if a particular treatment was delivered correctly. The goal of this thesis was to create a method to predict portal dose images that was versatile and accurate enough to use in a clinical setting. All measured images in this work were obtained with an amorphous silicon electronic portal imaging device (a-Si EPID), but the technique is applicable to any planar imager. A detailed, physics-motivated fluence model was developed to characterize fluence exiting the linear accelerator head. The model was further refined using results from Monte Carlo simulations and schematics of the linear accelerator. The fluence incident on the EPID was converted to a portal dose image through a superposition of Monte Carlo-generated, monoenergetic dose kernels specific to the a-Si EPID. Predictions of clinical IMRT fields with no patient present agreed with measured portal dose images within 3% and 3 mm. The dose kernels were applied ignoring the geometrically divergent nature of incident fluence on the EPID. A computational investigation into this parallel dose kernel assumption determined its validity under clinically relevant situations. Introducing a patient or phantom into the beam required the portal image prediction algorithm to account for patient scatter and attenuation. Primary fluence was calculated by attenuating raylines cast through the patient CT dataset, while scatter fluence was determined through the superposition of pre-calculated scatter fluence kernels. Total dose in the EPID was calculated by convolving the total predicted incident fluence with the EPID-specific dose kernels. The algorithm was tested on water slabs with square fields, agreeing with measurement within 3% and 3 mm. The

Dosimetric verification of the dynamic intensity modulated radiotherapy (IMR) of 21 patients

International Nuclear Information System (INIS)

Tsai, J.-S.; Engler, Mark J.; Ling, Marilyn N.; Wu, Julian; Kramer, Bradley; Fagundes, Marcio; Dipetrillo, Thomas; Wazer, David E.

1996-01-01

Purpose: To verify the accuracy of conformal isodose distributions and absolute doses delivered with a dynamic IMR system. Methods and materials: 21 patients treated with advanced or recurrent disease with a dynamic IMR system, of which 13 were immobilized with head screws, and 8, with non-invasive plastic masks. The system included immobilization techniques, computerized tomography (CT), a dynamic pencil beam multileaf collimator (MLC), a collimator controller computer, collimator safety interlocks, a simulated annealing optimization implemented on a dedicated quad processing computer system, phantoms embedded with dosemeters, patient setup and dose delivery techniques, in vivo dose verification, and a comprehensive quality assurance program. The collimator consisted of a 2 x 20 array of Tungsten leaves, each programmable to be either fully open or shut, thus offering 2 40 beam patterns with cross sectional areas of up to 4 x 20 cm at the linear accelerator (linac) gantry rotational axis. Any of these patterns were dynamically changeable per degree sign of gantry rotation. An anthropomorphic phantom composed of transverse anatomic slabs helped simulate patient geometry relative to immobilization devices, fiducial markers, CT and treatment room lasers, and linac rotational axis. Before each treatment regimen, the compliance of measured to planned doses was tested in phantom irradiations using each patient's fiducial markers, immobilization system, anatomic positioning, and collimator sequencing. Films and thermoluminescent dosemeters (TLD) were embedded in the phantom to measure absolute doses and dose distributions. Because the planner didn't account for variable electron density distributions in head and neck targets, the air cavities of the anthropomorphic phantom were filled with tissue equivalent bolus. Optical density distributions of films exposed to the dynamic IMR of each patient were obtained with a Hurter-Driffield calibration curved based on films

Dosimetric verification of the intensity-modulated radiation therapy

International Nuclear Information System (INIS)

Zou Huawei; Jia Mingxuan; Wu Rong; Xiao Fuda; Dong Xiaoqi

2004-01-01

Objective: To discuss the methods of the dosimetric verification in the intensity-modulated radiation therapy (IMRT) and insure correct execution of the IMRT planning in the clinical practice. Methods: The CMSFOCUS9200 inverse planning system was used to provide optimized 5-field IMRT treatment plans for the patients. A phantom was made from true water-equivalent material. The doses of the interesting points and isodose distributions of the interesting planes in the phantom were calculated using patients' treatment plan. The phantom was placed on the couch of the accelerator and was irradiated using the phantom's treatment planning data. The doses of interesting points were measured using a 0.23 cc chamber and the isodose distributions of interesting planes were measured using RIT 113 film dosimetry system in the phantom. The results were compared with those from calculation in planning system for verification. Results: The doses and isodose distributions measured by the chamber and the film were consistent with those predicted by the planning. The error between the measured dose and calculated dose in the interesting points was less than 3%. Conclusion: The dosimetric verification of IMRT is a reliable measure in the course of its implementation. (authors)

Microprocessor Based Temperature Control of Liquid Delivery with Flow Disturbances.

Science.gov (United States)

Kaya, Azmi

1982-01-01

Discusses analytical design and experimental verification of a PID control value for a temperature controlled liquid delivery system, demonstrating that the analytical design techniques can be experimentally verified by using digital controls as a tool. Digital control instrumentation and implementation are also demonstrated and documented for…

Feasibility of a unified approach to intensity-modulated radiation therapy and volume-modulated arc therapy optimization and delivery

International Nuclear Information System (INIS)

Hoover, Douglas A.; Chen, Jeff Z.; MacFarlane, Michael; Wong, Eugene; Battista, Jerry J.

2015-01-01

Purpose: To study the feasibility of unified intensity-modulated arc therapy (UIMAT) which combines intensity-modulated radiotherapy (IMRT) and volumetric-modulated arc therapy (VMAT) optimization and delivery to produce superior radiation treatment plans, both in terms of dose distribution and efficiency of beam delivery when compared with either VMAT or IMRT alone. Methods: An inverse planning algorithm for UIMAT was prototyped within the PINNACLE treatment planning system (Philips Healthcare). The IMRT and VMAT deliveries are unified within the same arc, with IMRT being delivered at specific gantry angles within the arc. Optimized gantry angles for the IMRT and VMAT phases are assigned automatically by the inverse optimization algorithm. Optimization of the IMRT and VMAT phases is done simultaneously using a direct aperture optimization algorithm. Five treatment plans each for prostate, head and neck, and lung were generated using a unified optimization technique and compared with clinical IMRT or VMAT plans. Delivery verification was performed with an ArcCheck phantom (Sun Nuclear) on a Varian TrueBeam linear accelerator (Varian Medical Systems). Results: In this prototype implementation, the UIMAT plans offered the same target dose coverage while reducing mean doses to organs at risk by 8.4% for head-and-neck cases, 5.7% for lung cases, and 3.5% for prostate cases, compared with the VMAT or IMRT plans. In addition, UIMAT can be delivered with similar efficiency as VMAT. Conclusions: In this proof-of-concept work, a novel radiation therapy optimization and delivery technique that interlaces VMAT or IMRT delivery within the same arc has been demonstrated. Initial results show that unified VMAT/IMRT has the potential to be superior to either standard IMRT or VMAT

Dosimetric Verification and Evaluation of the 3-D Conformal Parotid Gland-Sparing Irradiation Technique for Bilateral Neck Treatment at University Hospital Centre Zagreb

International Nuclear Information System (INIS)

Kovacevic, N; Hrsak, H.; Bibic, J.

2011-01-01

3-D Conformal Parotid Gland-Sparing Irradiation Technique for Bilateral Neck (ConPas) is an alternative to Intensity-modulated radiotherapy (IMRT), and is in routine use at University Hospital Centre Rebro (KBC-Rebro), Zagreb. This technique includes highly asymmetric wedged conformal multi-leaf fields and demands very precise application. The aim of this paper is to present the dosimetric verification method of ConPas (and evaluation of ConPas applicability) as performed at KBC, taking into account the precision of the Treatment Planning System (TPS), possibilities of linear accelerator and patient set-up error. Results for two patients are shown in some details.ConPas is a rather sophisticated method and demands high precision in the whole radiotherapy process. Verification of ConPas using IMRT Verification Matrix Phantom shows good agreement between measured and predicted doses inside and outside PTV regions of the head and neck. Furthermore, a careful track of the positioning during the treatment shows that the overall set-up error is very small (practically negligible). When possible, one parotid gland may be partially spared, and therefore its function preserved at least to some extent. (author)

Advanced verification topics

CERN Document Server

Bhattacharya, Bishnupriya; Hall, Gary; Heaton, Nick; Kashai, Yaron; Khan Neyaz; Kirshenbaum, Zeev; Shneydor, Efrat

2011-01-01

The Accellera Universal Verification Methodology (UVM) standard is architected to scale, but verification is growing and in more than just the digital design dimension. It is growing in the SoC dimension to include low-power and mixed-signal and the system integration dimension to include multi-language support and acceleration. These items and others all contribute to the quality of the SOC so the Metric-Driven Verification (MDV) methodology is needed to unify it all into a coherent verification plan. This book is for verification engineers and managers familiar with the UVM and the benefits it brings to digital verification but who also need to tackle specialized tasks. It is also written for the SoC project manager that is tasked with building an efficient worldwide team. While the task continues to become more complex, Advanced Verification Topics describes methodologies outside of the Accellera UVM standard, but that build on it, to provide a way for SoC teams to stay productive and profitable.

Dosimetric parameters of enhanced dynamic wedge for treatment planning and verification

International Nuclear Information System (INIS)

Leavitt, Dennis D.; Lee, Wing Lok; Gaffney, David K.

1996-01-01

Purpose/Objective: Enhanced Dynamic Wedge (EDW) is an intensity-modulated radiotherapy technique in which one collimating jaw sweeps across the field to define a desired wedge dose distribution while dose rate is modified according to jaw position. This tool enables discrete or continuous wedge angles from zero to sixty degrees for field widths from three cm to 30 cm in the direction of the wedge, and up to 40 cm perpendicular to the wedge direction. Additionally, asymmetric wedge fields not centered on the line through isocenter can be created for applications such as tangential breast irradiation. The unique range of field shapes and wedge angles introduce a new set of dosimetric challenges to be resolved before routine clinical use of EDW, and especially require that a simple set of independent dose calculation and verification techniques be developed to check computerized treatment planning results. Using terminology in common use in treatment planning, this work defines the effective wedge factor vs. field width and wedge angle, evaluates the depth dose vs. open field values, defines primary intensity functions from which specific dynamic wedges can be calculated in treatment planning systems, and describes the technique for independent calculation of Monitor Units for EDW fields. Materials and Methods: Using 6- and 18-MV beams from a CI2100C, EDW beam profiles were measured in water phantom for depths from near-surface to 30 cm for the full range of field widths and wedge angles using a linear detector array of 25 energy-compensated diodes. Asymmetric wedge field profiles were likewise measured. Depth doses were measured in water phantom using an ionization chamber sequentially positioned to depths of 30 cm. Effective wedge factors for the full range of field widths and wedge angles were measured using an ionization chamber in water-equivalent plastic at a depth of 10 cm on central axis. Dose profiles were calculated by computer as the summation of a series

Chitosan and glyceryl monooleate nanostructures containing gemcitabine: potential delivery system for pancreatic cancer treatment.

Science.gov (United States)

Trickler, William J; Khurana, Jatin; Nagvekar, Ankita A; Dash, Alekha K

2010-03-01

The objectives of this study are to enhance cellular accumulation of gemcitabine with chitosan/glyceryl monooleate (GMO) nanostructures, and to provide significant increase in cell death of human pancreatic cancer cells in vitro. The delivery system was prepared by a multiple emulsion solvent evaporation method. The nanostructure topography, size, and surface charge were determined by atomic force microscopy (AFM), and a zetameter. The cellular accumulation, cellular internalization and cytotoxicity of the nanostructures were evaluated by HPLC, confocal microscopy, or MTT assay in Mia PaCa-2 and BxPC-3 cells. The average particle diameter for 2% and 4% (w/w) drug loaded delivery system were 382.3 +/- 28.6 nm, and 385.2 +/- 16.1 nm, respectively with a surface charge of +21.94 +/- 4.37 and +21.23 +/- 1.46 mV. The MTT cytotoxicity dose-response studies revealed the placebo at/or below 1 mg/ml has no effect on MIA PaCa-2 or BxPC-3 cells. The delivery system demonstrated a significant decrease in the IC50 (3 to 4 log unit shift) in cell survival for gemcitabine nanostructures at 72 and 96 h post-treatment when compared with a solution of gemcitabine alone. The nanostructure reported here can be resuspended in an aqueous medium that demonstrate increased effective treatment compared with gemcitabine treatment alone in an in vitro model of human pancreatic cancer. The drug delivery system demonstrates capability to entrap both hydrophilic and hydrophobic compounds to potentially provide an effective treatment option in human pancreatic cancer.

The impact of treatment density and molecular weight for fractional laser-assisted drug delivery

DEFF Research Database (Denmark)

Haak, Christina S; Bhayana, Brijesh; Farinelli, William A

2012-01-01

Ablative fractional lasers (AFXL) facilitate uptake of topically applied drugs by creating narrow open micro-channels into the skin, but there is limited information on optimal laser settings for delivery of specific molecules. The objective of this study was to investigate the impact of laser...... treatment density (% of skin occupied by channels) and molecular weight (MW) for fractional CO(2) laser-assisted drug delivery. AFXL substantially increased intra- and transcutaneous delivery of polyethylene glycols (PEGs) in a MW range from 240 to 4300 Da (Nuclear Magnetic Resonance, p...

Medical capsule robots: A renaissance for diagnostics, drug delivery and surgical treatment.

Science.gov (United States)

Mapara, Sanyat S; Patravale, Vandana B

2017-09-10

The advancements in electronics and the progress in nanotechnology have resulted in path breaking development that will transform the way diagnosis and treatment are carried out currently. This development is Medical Capsule Robots, which has emerged from the science fiction idea of robots travelling inside the body to diagnose and cure disorders. The first marketed capsule robot was a capsule endoscope developed to capture images of the gastrointestinal tract. Today, varieties of capsule endoscopes are available in the market. They are slightly larger than regular oral capsules, made up of a biocompatible case and have electronic circuitry and mechanisms to capture and transmit images. In addition, robots with diagnostic features such as in vivo body temperature detection and pH monitoring have also been launched in the market. However, a multi-functional unit that will diagnose and cure diseases inside the body has not yet been realized. A remote controlled capsule that will undertake drug delivery and surgical treatment has not been successfully launched in the market. High cost, inadequate power supply, lack of control over drug release, limited space for drug storage on the capsule, inadequate safety and no mechanisms for active locomotion and anchoring have prevented their entry in the market. The capsule robots can revolutionize the current way of diagnosis and treatment. This paper discusses in detail the applications of medical capsule robots in diagnostics, drug delivery and surgical treatment. In diagnostics, detailed analysis has been presented on wireless capsule endoscopes, issues associated with the marketed versions and their corresponding solutions in literature. Moreover, an assessment has been made of the existing state of remote controlled capsules for targeted drug delivery and surgical treatment and their future impact is predicted. Besides the need for multi-functional capsule robots and the areas for further research have also been

Megavoltage conebeam CT cine as final verification of treatment plan in lung stereotactic body radiotherapy.

Science.gov (United States)

Kudithipudi, Vijay; Gayou, Olivier; Colonias, Athanasios

2016-06-01

To analyse the clinical impact of megavoltage conebeam computed tomography (MV-CBCT) cine on internal target volume (ITV) coverage in lung stereotactic body radiotherapy (SBRT). One hundred and six patients received lung SBRT. All underwent 4D computed tomography simulation followed by treatment via image guided 3D conformal or intensity modulated radiation. Prior to SBRT, all patients underwent MV-CBCT cine, in which raw projections are displayed as beam's-eye-view fluoroscopic series with the planning target volume (PTV) projected onto each image, enabling verification of tumour motion relative to the PTV and assessment of adequacy of treatment margin. Megavoltage conebeam computed tomography cine was completed 1-2 days prior to SBRT. Four patients (3.8%) had insufficient ITV coverage inferiorly at cine review. All four plans were changed by adding 5 mm on the PTV margin inferiorly. The mean change in PTV volumes was 3.9 cubic centimetres (cc) (range 1.85-6.32 cc). Repeat cine was performed after plan modification to ensure adequate PTV coverage in the modified plans. PTV margin was adequate in the majority of patients with this technique. MV-CBCT cine did show insufficient coverage in a small subset of patients. Insufficient PTV margins may be a function of 4D CT simulation inadequacies or deficiencies in visualizing the ITV inferior border in the full-inhale phase. MV-CBCT cine is a valuable tool for final verification of PTV margins. © 2016 The Royal Australian and New Zealand College of Radiologists.

Three dimensional dose verification for clinical treatments of small intracranial tumours

International Nuclear Information System (INIS)

Taylor, M.L.; Dunn, L.; Kairn, L.; Jenny, J.; Knight, R.; Trapp, J.; Smith, R.; Ackerly, T.

2010-01-01

Full text: Cancers of the brain and central nervous system account for 1.6% of new cancers and 1.8% of cancer deaths globally. The highest rates of all developed nations are observed in Australia and New Zealand. There are known complexities associated with dose measurement of very small radiation fields. Here, 3D dosimetric verification of treatments for small intracranial tumours using gel dosimetry was investigated. An anthropomorphic head phantom with a 43 mm diameter and 63 mm long gel container was filled with PAGAT normoxic radiosensitive gel. In this work, we show results for a 12-field stereotactic radiotherapy treatment delivered using a Varian 21EX with BrainLAB mini-multi leaf collimator. The gel was read out using an Octopus-1Q laser optical CT scanner. Generally good agreement was observed between the measured doses and those calculated with the iPlan treatment planning system (pencil beam convolution); see Fig. I. For gamma criteria of 5%/5 mm the percentage of gamma values less than unity was 95% above the 80% isodose line, indicating good PTV coverage. For lower isodose regions approaching the boundaries of the container poorer agreement was observed. The feasibility of three-dimensional measurement of small field dose distributions in clinical contexts has been demonstrated. Development of this methodology has the potential to overcome many shortcomings of other dosimetric methods, such as limitations of spatial information (typically one- and two-dimensions), volume-averaging effects and perturbation due to poor mediamatching. (author)

ENVIRONMENTAL TECHNOLOGY VERIFICATION REPORT, REMOVAL OF ARSENIC IN DRINKING WATER: WATTS PREMIER M-SERIES M-15,000 REVERSE OSMOSIS TREATMENT SYSTEM

Science.gov (United States)

Verification testing of the Watts Premier M-Series M-15,000 RO Treatment System was conducted over a 31-day period from April 26, 2004, through May 26, 2004. This test was conducted at the Coachella Valley Water District (CVWD) Well 7802 in Thermal, California. The source water...

Needle displacement during HDR brachytherapy in the treatment of prostate cancer

International Nuclear Information System (INIS)

Damore, Steven J.; Syed, A.M. Nisar; Puthawala, Ajmel A.; Sharma, Anil

2000-01-01

Purpose: We used clinical patient data to examine implant displacement between high dose rate (HDR) brachytherapy fractions for prostate cancer to determine its impact on treatment delivery. Materials and Methods: We analyzed the verification films taken prior to each fraction for 96 consecutive patients treated with HDR brachytherapy boosts as part of their radiation therapy for definitive treatment of organ-confined prostate cancer at our institution. Patients were treated with 18-24 Gy in 4 fractions of HDR delivered in 40 hours followed by 36-39.6 Gy external beam radiation to the prostate. We determined the mean and maximum displacement distances of marker seeds placed in the prostate and of the implanted needles between HDR fractions. Results: Mean and maximum displacement distances between fractions were documented up to 7.6 mm and 28.5 mm, respectively, for the implant needles and 3.6 mm and 11.4 mm, respectively, for the gold marker seeds. All displacement of implant needles occurred in the caudal direction. At least 1 cm caudal displacement of needles occurred prior to 15.5% all fractions. Manual adjustment of needles was required prior to 15% of fractions, and adjustment of the CLP only was required in 24%. Most of the displacement for both the marker seeds and needles occurred between the first and second fractions. Conclusions: There is significant caudal displacement of interstitial implant needles between HDR fractions in our prostate cancer patients. Obtaining verification films and making adjustments in the treatment volume prior to each fraction is necessary to avoid significant inaccuracies in treatment delivery

MO-D-BRB-02: SBRT Treatment Planning and Delivery

International Nuclear Information System (INIS)

Yang, Y.

2016-01-01

Increased use of SBRT and hypofractionation in radiation oncology practice has posted a number of challenges to medical physicist, ranging from planning, image-guided patient setup and on-treatment monitoring, to quality assurance (QA) and dose delivery. This symposium is designed to provide current knowledge necessary for the safe and efficient implementation of SBRT in various linac platforms, including the emerging digital linacs equipped with high dose rate FFF beams. Issues related to 4D CT, PET and MRI simulations, 3D/4D CBCT guided patient setup, real-time image guidance during SBRT dose delivery using gated/un-gated VMAT/IMRT, and technical advancements in QA of SBRT (in particular, strategies dealing with high dose rate FFF beams) will be addressed. The symposium will help the attendees to gain a comprehensive understanding of the SBRT workflow and facilitate their clinical implementation of the state-of-art imaging and planning techniques. Learning Objectives: Present background knowledge of SBRT, describe essential requirements for safe implementation of SBRT, and discuss issues specific to SBRT treatment planning and QA. Update on the use of multi-dimensional and multi-modality imaging for reliable guidance of SBRT. Discuss treatment planning and QA issues specific to SBRT. Provide a comprehensive overview of emerging digital linacs and summarize the key geometric and dosimetric features of the new generation of linacs for substantially improved SBRT. NIH/NCI; Varian Medical Systems; F. Yin, Duke University has a research agreement with Varian Medical Systems. In addition to research grant, I had a technology license agreement with Varian Medical Systems

MO-D-BRB-02: SBRT Treatment Planning and Delivery

Energy Technology Data Exchange (ETDEWEB)

Yang, Y. [Stanford University Cancer Center (United States)

2016-06-15

Increased use of SBRT and hypofractionation in radiation oncology practice has posted a number of challenges to medical physicist, ranging from planning, image-guided patient setup and on-treatment monitoring, to quality assurance (QA) and dose delivery. This symposium is designed to provide current knowledge necessary for the safe and efficient implementation of SBRT in various linac platforms, including the emerging digital linacs equipped with high dose rate FFF beams. Issues related to 4D CT, PET and MRI simulations, 3D/4D CBCT guided patient setup, real-time image guidance during SBRT dose delivery using gated/un-gated VMAT/IMRT, and technical advancements in QA of SBRT (in particular, strategies dealing with high dose rate FFF beams) will be addressed. The symposium will help the attendees to gain a comprehensive understanding of the SBRT workflow and facilitate their clinical implementation of the state-of-art imaging and planning techniques. Learning Objectives: Present background knowledge of SBRT, describe essential requirements for safe implementation of SBRT, and discuss issues specific to SBRT treatment planning and QA. Update on the use of multi-dimensional and multi-modality imaging for reliable guidance of SBRT. Discuss treatment planning and QA issues specific to SBRT. Provide a comprehensive overview of emerging digital linacs and summarize the key geometric and dosimetric features of the new generation of linacs for substantially improved SBRT. NIH/NCI; Varian Medical Systems; F. Yin, Duke University has a research agreement with Varian Medical Systems. In addition to research grant, I had a technology license agreement with Varian Medical Systems.

Independent verification of the delivered dose in High-Dose Rate (HDR) brachytherapy

International Nuclear Information System (INIS)

Portillo, P.; Feld, D.; Kessler, J.

2009-01-01

An important aspect of a Quality Assurance program in Clinical Dosimetry is an independent verification of the dosimetric calculation done by the Treatment Planning System for each radiation treatment. The present paper is aimed at creating a spreadsheet for the verification of the dose recorded at a point of an implant with radioactive sources and HDR in gynecological injuries. An 192 Ir source automatic differed loading equipment, GammaMedplus model, Varian Medical System with HDR installed at the Angel H. Roffo Oncology Institute has been used. The planning system implemented for getting the dose distribution is the BraquiVision. The sources coordinates as well as those of the calculation point (Rectum) are entered into the Excel-devised verification program by assuming the existence of a point source in each one of the applicators' positions. Such calculation point has been selected as the rectum is an organ at risk, therefore determining the treatment planning. The dose verification is performed at points standing at a sources distance having at least twice the active length of such sources, so they may be regarded as point sources. Most of the sources used in HDR brachytherapy with 192 Ir have a 5 mm active length for all equipment brands. Consequently, the dose verification distance must be at least of 10 mm. (author)

Preclinical evaluation of gene delivery methods for the treatment of loco-regional disease in breast cancer.

LENUS (Irish Health Repository)

Rajendran, Simon

2011-04-01

Preclinical results with various gene therapy strategies indicate significant potential for new cancer treatments. However, many therapeutics fail at clinical trial, often due to differences in tissue physiology between animal models and humans, and tumor phenotype variation. Clinical data relevant to treatment strategies may be generated prior to clinical trial through experimentation using intact patient tissue ex vivo. We developed a novel tumor slice model culture system that is universally applicable to gene delivery methods, using a realtime luminescence detection method to assess gene delivery. Methods investigated include viruses (adenovirus [Ad] and adeno-associated virus), lipofection, ultrasound (US), electroporation and naked DNA. Viability and tumor populations within the slices were well maintained for seven days, and gene delivery was qualitatively and quantitatively examinable for all vectors. Ad was the most efficient gene delivery vector with transduction efficiency >50%. US proved the optimal non-viral gene delivery method in human tumor slices. The nature of the ex vivo culture system permitted examination of specific elements. Parameters shown to diminish Ad gene delivery included blood, regions of low viability and secondary disease. US gene delivery was significantly reduced by blood and skin, while tissue hyperthermia improved gene delivery. US achieved improved efficacy for secondary disease. The ex vivo model was also suitable for examination of tissue-specific effects on vector expression, with Ad expression mediated by the CXCR4 promoter shown to provide a tumor selective advantage over the ubiquitously active cytomegalovirus promoter. In conclusion, this is the first study incorporating patient tissue models in comparing gene delivery from various vectors, providing knowledge on cell-type specificity and examining the crucial biological factors determining successful gene delivery. The results highlight the importance of in

Preclinical evaluation of gene delivery methods for the treatment of loco-regional disease in breast cancer.

LENUS (Irish Health Repository)

Rajendran, Simon

2012-01-31

Preclinical results with various gene therapy strategies indicate significant potential for new cancer treatments. However, many therapeutics fail at clinical trial, often due to differences in tissue physiology between animal models and humans, and tumor phenotype variation. Clinical data relevant to treatment strategies may be generated prior to clinical trial through experimentation using intact patient tissue ex vivo. We developed a novel tumor slice model culture system that is universally applicable to gene delivery methods, using a realtime luminescence detection method to assess gene delivery. Methods investigated include viruses (adenovirus [Ad] and adeno-associated virus), lipofection, ultrasound (US), electroporation and naked DNA. Viability and tumor populations within the slices were well maintained for seven days, and gene delivery was qualitatively and quantitatively examinable for all vectors. Ad was the most efficient gene delivery vector with transduction efficiency >50%. US proved the optimal non-viral gene delivery method in human tumor slices. The nature of the ex vivo culture system permitted examination of specific elements. Parameters shown to diminish Ad gene delivery included blood, regions of low viability and secondary disease. US gene delivery was significantly reduced by blood and skin, while tissue hyperthermia improved gene delivery. US achieved improved efficacy for secondary disease. The ex vivo model was also suitable for examination of tissue-specific effects on vector expression, with Ad expression mediated by the CXCR4 promoter shown to provide a tumor selective advantage over the ubiquitously active cytomegalovirus promoter. In conclusion, this is the first study incorporating patient tissue models in comparing gene delivery from various vectors, providing knowledge on cell-type specificity and examining the crucial biological factors determining successful gene delivery. The results highlight the importance of in

Dosimetric and qualitative analysis of kinetic properties of millennium 80 multileaf collimator system for dynamic intensity modulated radiotherapy treatments

Directory of Open Access Journals (Sweden)

Bhardwaj Anup

2007-01-01

Full Text Available The aim of this paper is to analyze the positional accuracy, kinetic properties of the dynamic multileaf collimator (MLC and dosimetric evaluation of fractional dose delivery for the intensity modulated radiotherapy (IMRT for step and shoot and sliding window (dynamic techniques of Varian multileaf collimator millennium 80. Various quality assurance tests such as accuracy in leaf positioning and speed, stability of dynamic MLC output, inter and intra leaf transmission, dosimetric leaf separation and multiple carriage field verification were performed. Evaluation of standard field patterns as pyramid, peaks, wedge, chair, garden fence test, picket fence test and sweeping gap output was done. Patient dose quality assurance procedure consists of an absolute dose measurement for all fields at 5 cm depth on solid water phantom using 0.6cc water proof ion chamber and relative dose verification using Kodak EDR-2 films for all treatment fields along transverse and coronal direction using IMRT phantom. The relative dose verification was performed using Omni Pro IMRT film verification software. The tests performed showed acceptable results for commissioning the millennium 80 MLC and Clinac DHX for dynamic and step and shoot IMRT treatments.

In vivo verification of proton beam path by using post-treatment PET/CT imaging

Energy Technology Data Exchange (ETDEWEB)

Hsi, Wen C.; Indelicato, Daniel J.; Vargas, Carlos; Duvvuri, Srividya; Li Zuofeng; Palta, Jatinder [Proton Therapy Institute, University of Florida, Jacksonville, Florida 32206 (United States); Boca Radiation Oncology Associates, Boca Raton, Florida 33431 (United States); Proton Therapy Institute, University of Florida, Jacksonville, Florida 32206 (United States); Department of Radiation Oncology, University of Florida, Gainesville, Florida 32610 (United States)

2009-09-15

Purpose: The purpose of this study is to establish the in vivo verification of proton beam path by using proton-activated positron emission distributions. Methods: A total of 50 PET/CT imaging studies were performed on ten prostate cancer patients immediately after daily proton therapy treatment through a single lateral portal. The PET/CT and planning CT were registered by matching the pelvic bones, and the beam path of delivered protons was defined in vivo by the positron emission distribution seen only within the pelvic bones, referred to as the PET-defined beam path. Because of the patient position correction at each fraction, the marker-defined beam path, determined by the centroid of implanted markers seen in the post-treatment (post-Tx) CT, is used for the planned beam path. The angular variation and discordance between the PET- and marker-defined paths were derived to investigate the intrafraction prostate motion. For studies with large discordance, the relative location between the centroid and pelvic bones seen in the post-Tx CT was examined. The PET/CT studies are categorized for distinguishing the prostate motion that occurred before or after beam delivery. The post-PET CT was acquired after PET imaging to investigate prostate motion due to physiological changes during the extended PET acquisition. Results: The less than 2 deg. of angular variation indicates that the patient roll was minimal within the immobilization device. Thirty of the 50 studies with small discordance, referred as good cases, show a consistent alignment between the field edges and the positron emission distributions from the entrance to the distal edge. For those good cases, average displacements are 0.6 and 1.3 mm along the anterior-posterior (D{sub AP}) and superior-inferior (D{sub SI}) directions, respectively, with 1.6 mm standard deviations in both directions. For the remaining 20 studies demonstrating a large discordance (more than 6 mm in either D{sub AP} or D{sub SI}), 13

Postoperative Irradiation of Gynecologic Malignancies: Improving Treatment Delivery Using Aperture-Based Intensity-Modulated Radiotherapy

International Nuclear Information System (INIS)

Nadeau, Sylvain; Bouchard, Myriam; Germain, Isabelle; Raymond, Paul-Emile; Beaulieu, Frederic; Beaulieu, Luc; Roy, Rene; Gingras, Luc

2007-01-01

Purpose: To evaluate dosimetric and treatment delivery advantages of aperture-based intensity-modulated radiotherapy (AB-IMRT) for the treatment of patients receiving whole pelvic radiotherapy for gynecologic malignancies. Methods and Materials: Nineteen patients undergoing pelvic radiotherapy after resection of endometrial cancers were selected. A 45-Gy dose was prescribed to the target volume delineated on a planning CT scan. An in-house inverse planning system, Ballista, was used to develop a treatment plan using aperture-based multileaf collimator segments. This approach was compared with conventional four-field, enlarged four-field, and static beamlet-based IMRT (BB-IMRT) techniques in terms of target coverage, dose-volume histogram statistics for surrounding normal tissues, and numbers of segments and monitor units (MU). Results: Three quarters (76.4%) of the planning target volume received the prescription dose with conventional four-field plans. With adequate target coverage, the Ballista plans significantly reduced the volume of bowel and bladder irradiated at the prescribed dose (p < 0.001), whereas the two approaches provided equivalent results for the rectum (p 0.5). On the other hand, AB-IMRT and BB-IMRT plans showed only small differences in dose-volume histogram statistics of unknown clinical impact, whereas Ballista plan delivery required on average 73% and 59% fewer segments and MU, respectively. Conclusion: With respect to conventional techniques, AB-IMRT for the treatment of gynecologic malignancies provides dosimetric advantages similar to those with BB-IMRT but with clear treatment delivery improvements

Implementation of a gel dosimeter for dosimetric verification of treatments with RapidArcTM

International Nuclear Information System (INIS)

Cortes, H.; Vasquez, J.; Plazas, M.

2014-08-01

The gel dosimetry represents advantages on other dosimetric systems for its potential of analyzing information in third dimension (3D). This work seeks to find another alternative for the verification of treatments of high complexity like the RapidArc TM . A gel type Magic was prepared and characterized, which was irradiated with base in a plan of RapidArc TM calculated in the Treatment Planning System (Tps) Eclipse, using the Anisotropic Analytic Algorithm (Aaa) for a beam with an acceleration potential of 6 MV. The dosimeter was characterized using Magnetic Resonance Images starting from the correlation between the T2 and the dose. The dose distribution curves were analyzed in second dimension (2D) using the program Omni Pro-I mrT and were compared with the curves obtained for the Tps under the approach gamma 2D. The comparison showed that the Gel represents a valid option inside the acceptable ranges for Quality Assurance in radiotherapy. (Author)

Role of IGRT in patient positioning and verification

International Nuclear Information System (INIS)

Mijnheer, Ben

2008-01-01

Image-guided radiation therapy is 'Frequent imaging in the treatment room during a course of radiotherapy to guide the treatment process'. Instrumentation related to IGRT is highlighted. Focus of the lecture was on clinical experience gained by NKI-AVL, such as the use of EPID (electronic portal imaging devices) and CBCT (cone beam computed tomography) and their comparison: good results for head and neck and prostate/bladder patients: portal imaging was replaced by CBCT. After further investigation convincing results for lung patients were obtained: portal imaging was replaced by CBCT. Scan protocols were developed for these patient groups. Since February 2004 CBCT-based decision rules have been developed for: Head and Neck (Bony anatomy); Prostate (Bony anatomy; Soft tissue registration); Lung (Bony anatomy, Soft tissue registration); Brain (Bony anatomy); and Breast, bladder and liver (in progress). Final remarks are as follows: The introduction of various IGRT techniques allowed 3D verification of the position of target volumes and organs at risk just before or during treatment. Because the information is in 3D, or sometimes even in 4D, in principle these IGRT approaches provide more information compared to the use of 2D verification methods (e.g. EPIDs). Clinical data are becoming available to assess quantitatively for which treatment techniques IGRT approaches are advantageous compared to the use of conventional verification methods taking the additional resources (time, money, manpower) into account. (P.A.)

Pre-clinical evaluation of an inverse planning module for segmental MLC based IMRT delivery

International Nuclear Information System (INIS)

Georg, Dietmar; Kroupa, Bernhard

2002-01-01

Phantom tests are performed for pre-clinical evaluation of a commercial inverse planning system (HELAX TMS, V 6.0) for segmented multileaf collimator (MLC) intensity modulated radiotherapy (IMRT) delivery. The optimization module has available two optimization algorithms: the target primary feasibility and the weighted feasibility algorithm, only the latter allows the user to specify weights for structures. In the first series, single beam tests are performed to evaluate the outcome of inverse planning in terms of plausibility for the following situations: oblique incidence, presence of inhomogeneities, multiple targets at different depths and multiple targets with different desired doses. Additionally, for these tests a manual plan is made for comparison. In the absence of organs at risk, both the optimization algorithms are found to assign the highest priority to low dose constraints for targets. In the second series, tests resembling clinical relevant configurations (simultaneous boost and concave target with critical organ) are performed with multiple beam arrangements in order to determine the impact of the system's configuration on inverse planning. It is found that the definition of certain segment number and segment size limitations does not largely compromise treatment plans when using multiple beams. On the other hand, these limitations are important for delivery efficiency and dosimetry. For the number of iterations and voxels per volume of interest, standard values in the system's configuration are considered to be sufficient. Additionally, it is demonstrated that precautions must be taken to precisely define treatment goals when using computerized treatment optimization. Similar phantom tests could be used for a direct dosimetric verification of all steps from inverse treatment planning to IMRT delivery. (note)

Virosome, a hybrid vehicle for efficient and safe drug delivery and its emerging application in cancer treatment.

Science.gov (United States)

Liu, Hanqing; Tu, Zhigang; Feng, Fan; Shi, Haifeng; Chen, Keping; Xu, Ximing

2015-06-01

A virosome is an innovative hybrid drug delivery system with advantages of both viral and non-viral vectors. Studies have shown that a virosome can carry various biologically active molecules, such as nucleic acids, peptides, proteins and small organic molecules. Targeted drug delivery using virosome-based systems can be achieved through surface modifications of virosomes. A number of virosome-based prophylactic and therapeutic products with high safety profiles are currently available in the market. Cancer treatment is a big battlefield for virosome-based drug delivery systems. This review provides an overview of the general concept, preparation procedures, working mechanisms, preclinical studies and clinical applications of virosomes in cancer treatment.

Nanotechnology-Based Drug Delivery Systems for Treatment of Tuberculosis--A Review.

Science.gov (United States)

da Silva, Patricia Bento; de Freitas, Eduardo Sinésio; Bernegossi, Jessica; Gonçalez, Maíra Lima; Sato, Mariana Rillo; Leite, Clarice Queico Fujimura; Pavan, Fernando Rogério; Chorilli, Marlus

2016-02-01

Tuberculosis (TB) is an infectious and transmissible disease that is caused by Mycobacterium tuberculosis and primarily affects the lungs, although it can affect other organs and systems. The pulmonary presentation of TB, in addition to being more frequent, is also the most relevant to public health because it is primarily responsible for the transmission of the disease. The to their low World Health Organization (WHO) recommends a combined therapeutic regimen of several drugs, such as rifampicin (RIF), isoniazid (INH), pyrazinamide (PZA) and ethambutol (ETB). These drugs have low plasma levels after oral administration, due to their low water solubility, poor permeability and ability to be rapidly metabolized by the liver and at high concentrations. Furthermore, they have short t₁/₂ (only 1-4 hours) indicating a short residence in the plasma and the need for multiple high doses, which can result in neurotoxicity and hepatotoxicity. Nanotechnology drug delivery systems have considerable potential for the treatment of TB. The systems can also be designed to allow for the sustained release of drugs from the matrix and drug delivery to a specific target. These properties of the systems enable the improvement of the bioavailability of drugs, can reduce the dosage and frequency of administration, and may solve the problem of non-adherence to prescribed therapy, which is a major obstacle to the control of TB. The purpose of this study was to systematically review nanotechnology-based drug delivery systems for the treatment of TB.

Motion management during IMAT treatment of mobile lung tumors-A comparison of MLC tracking and gated delivery

DEFF Research Database (Denmark)

Falk, Marianne; Pommer, Tobias; Keall, Paul

2014-01-01

Purpose:To compare real-time dynamic multileaf collimator (MLC) tracking, respiratory amplitude and phase gating, and no compensation for intrafraction motion management during intensity modulated arc therapy (IMAT). Methods: Motion management with MLC tracking and gating was evaluated for four...... tracking reduced the effects of the target movements, although the gated delivery showed a better dosimetric accuracy and enabled a larger reduction of the margins in some cases. MLC tracking did not prolong the treatment time compared to delivery with no motion compensation while gating had a considerably...... of the dosimetric error contributions showed that the gated delivery mainly had errors in target localization, while MLC tracking also had contributions from MLC leaf fitting and leaf adjustment. The average treatment time was about three times longer with gating compared to delivery with MLC tracking (that did...

Multilateral disarmament verification

International Nuclear Information System (INIS)

Persbo, A.

2013-01-01

Non-governmental organisations, such as VERTIC (Verification Research, Training and Information Centre), can play an important role in the promotion of multilateral verification. Parties involved in negotiating nuclear arms accords are for the most part keen that such agreements include suitable and robust provisions for monitoring and verification. Generally progress in multilateral arms control verification is often painstakingly slow, but from time to time 'windows of opportunity' - that is, moments where ideas, technical feasibility and political interests are aligned at both domestic and international levels - may occur and we have to be ready, so the preparatory work is very important. In the context of nuclear disarmament, verification (whether bilateral or multilateral) entails an array of challenges, hurdles and potential pitfalls relating to national security, health, safety and even non-proliferation, so preparatory work is complex and time-greedy. A UK-Norway Initiative was established in order to investigate the role that a non-nuclear-weapon state such as Norway could potentially play in the field of nuclear arms control verification. (A.C.)

The cumulative verification image analysis tool for offline evaluation of portal images

International Nuclear Information System (INIS)

Wong, John; Yan Di; Michalski, Jeff; Graham, Mary; Halverson, Karen; Harms, William; Purdy, James

1995-01-01

treatment plan recalculation and to test various decision strategies for treatment adjustment. Conclusions: The CVIA tool provides comprehensive analysis of daily images acquired with electronic portal imaging devices. Its offline approach allows characterization of the nature of setup variation for the individual patient that would have been difficult to deduce using only a few daily or weekly portal images. Distribution of the tool will help establish an important database of setup variation from many clinics. The information derived from CVIA can also serve as the foundation to integrate treatment verification, treatment planning, and treatment delivery

High-intensity focused ultrasound treatment of placenta accreta after vaginal delivery: a preliminary study.

Science.gov (United States)

Bai, Y; Luo, X; Li, Q; Yin, N; Fu, X; Zhang, H; Qi, H

2016-04-01

To evaluate the safety and efficiency of high-intensity focused ultrasound (HIFU) in the treatment of placenta accreta after vaginal delivery. Enrolled into this study between September 2011 and September 2013 were 12 patients who had been diagnosed with placenta accreta following vaginal delivery and who had stable vital signs. All patients were treated using an ultrasound-guided HIFU treatment system. As indication of the effectiveness of the treatment we considered decreased vascular index on color Doppler imaging, decrease in size of residual placenta compared with pretreatment size on assessment by three-dimensional ultrasound with Virtual Organ Computer-aided Analysis, reduced signal intensity and degree of enhancement on magnetic resonance imaging and avoidance of hysterectomy following treatment. To assess the safety of HIFU treatment, we recorded side effects, hemorrhage, infection, sex steroid levels, return of menses and subsequent pregnancy. Patients were followed up in this preliminary study until December 2013. The 12 patients receiving HIFU treatment had an average postpartum hospital stay of 6.8 days and an average period of residual placental involution of 36.9 days. HIFU treatment did not apparently increase the risk of infection or hemorrhage and no patient required hysterectomy. In all patients menstruation recommenced after an average of 80.2 days, and sex steroid levels during the middle luteal phase of the second menstrual cycle were normal. Two patients became pregnant again during the follow-up period. This preliminary study suggests that ultrasound-guided HIFU is a safe and effective non-invasive method to treat placenta accreta patients after vaginal delivery who have stable vital signs and desire to preserve fertility. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.

The Impact of Advanced Technologies on Treatment Deviations in Radiation Treatment Delivery

International Nuclear Information System (INIS)

Marks, Lawrence B.; Light, Kim L.; Hubbs, Jessica L.; Georgas, Debra L.; Jones, Ellen L.; Wright, Melanie C.; Willett, Christopher G.; Yin Fangfang

2007-01-01

Purpose: To assess the impact of new technologies on deviation rates in radiation therapy (RT). Methods and Materials: Treatment delivery deviations in RT were prospectively monitored during a time of technology upgrade. In January 2003, our department had three accelerators, none with 'modern' technologies (e.g., without multileaf collimators [MLC]). In 2003 to 2004, we upgraded to five new accelerators, four with MLC, and associated advanced capabilities. The deviation rates among patients treated on 'high-technology' versus 'low-technology' machines (defined as those with vs. without MLC) were compared over time using the two-tailed Fisher's exact test. Results: In 2003, there was no significant difference between the deviation rate in the 'high-technology' versus 'low-technology' groups (0.16% vs. 0.11%, p = 0.45). In 2005 to 2006, the deviation rate for the 'high-technology' groups was lower than the 'low-technology' (0.083% vs. 0.21%, p = 0.009). This difference was caused by a decline in deviations on the 'high-technology' machines over time (p = 0.053), as well as an unexpected trend toward an increase in deviations over time on the 'low-technology' machines (p = 0.15). Conclusions: Advances in RT delivery systems appear to reduce the rate of treatment deviations. Deviation rates on 'high-technology' machines with MLC decline over time, suggesting a learning curve after the introduction of new technologies. Associated with the adoption of 'high-technology' was an unexpected increase in the deviation rate with 'low-technology' approaches, which may reflect an over-reliance on tools inherent to 'high-technology' machines. With the introduction of new technologies, continued diligence is needed to ensure that staff remain proficient with 'low-technology' approaches

An inter-centre quality assurance network for IMRT verification: Results of the ESTRO QUASIMODO project

International Nuclear Information System (INIS)

Gillis, Sofie; Wagter, Carlos de; Bohsung, Joerg; Perrin, Bruce; Williams, Peter; Mijnheer, Ben J.

2005-01-01

Background and purpose: IMRT necessitates extension of existing inter-centre quality assurance programs due to its increased complexity. We assessed the feasibility of an inter-centre verification method for different IMRT techniques. Materials and methods: Eight European radiotherapy institutions of the QUASIMODO network, have designed an IMRT plan for a horseshoe-shaped PTV surrounding a cylindrical OAR in a simplified pelvic phantom. All centres applied common plan objectives but used their own equipment for planning and delivery. They verified the delivery of this plan according to a common protocol with radiographic film and ionisation chamber measurements. The irradiated films, the results of the ionisation chamber measurements and the computed dose distributions were sent to one analysis centre that compared the measured and computed dose distributions with the gamma method and composite dose-area histograms. Results: 4% (relative to the prescribed dose) and 3 mm (distance-to-agreement) were decided feasible gamma criteria. The composite dose-area histograms showed a maximum local deviation of 3.5% in the mean dose of the PTV and 5% in the OAR. Systematic differences could be identified, and in some cases explained. Conclusions: This multi-centre dosimetric verification study demonstrated both the feasibility of a multi-centre quality assurance network to evaluate any IMRT planning and delivery system combination, as well as the validity of the methodology involved

In Vivo Diode Dosimetry for Imrt Treatments Generated by Pinnacle Treatment Planning System

International Nuclear Information System (INIS)

Alaei, Parham; Higgins, Patrick D.; Gerbi, Bruce J.

2009-01-01

Dose verification using diodes has been proposed and used for intensity modulated radiation therapy (IMRT) treatments. We have previously evaluated diode response for IMRT deliveries planned with the Eclipse/Helios treatment planning system. The Pinnacle treatment planning system generates plans that are delivered in a different fashion than Eclipse. Whereas the Eclipse-generated segments are delivered in organized progression from one side of each field to the other, Pinnacle-generated segments are delivered in a much more randomized fashion to different areas within the field. This makes diode measurements at a point more challenging because the diode may be exposed fully or partially to multiple small segments during one single field's treatment as opposed to being exposed to very few segments scanning across the diode during an Eclipse-generated delivery. We have evaluated in vivo dosimetry for Pinnacle-generated IMRT plans and characterized the response of the diode to various size segments on phantom. We present results of patient measurements on approximately 300 fields, which show that 76% of measurements agree to within 10% of the treatment-plan generated calculated doses. Of the other 24%, about 11% are within 15% of the calculated dose. Comparison of these with phantom measurements indicates that many of the discrepancies are due to diode positioning on patients and increased diode response at short source-to-surface distances (SSDs), with the remainder attributable to other factors such as segment size and partial irradiation of the diode

Embedded software verification and debugging

CERN Document Server

Winterholer, Markus

2017-01-01

This book provides comprehensive coverage of verification and debugging techniques for embedded software, which is frequently used in safety critical applications (e.g., automotive), where failures are unacceptable. Since the verification of complex systems needs to encompass the verification of both hardware and embedded software modules, this book focuses on verification and debugging approaches for embedded software with hardware dependencies. Coverage includes the entire flow of design, verification and debugging of embedded software and all key approaches to debugging, dynamic, static, and hybrid verification. This book discusses the current, industrial embedded software verification flow, as well as emerging trends with focus on formal and hybrid verification and debugging approaches. Includes in a single source the entire flow of design, verification and debugging of embedded software; Addresses the main techniques that are currently being used in the industry for assuring the quality of embedded softw...

Investigating output and energy variations and their relationship to delivery QA results using Statistical Process Control for helical tomotherapy.

Science.gov (United States)

Binny, Diana; Mezzenga, Emilio; Lancaster, Craig M; Trapp, Jamie V; Kairn, Tanya; Crowe, Scott B

2017-06-01

The aims of this study were to investigate machine beam parameters using the TomoTherapy quality assurance (TQA) tool, establish a correlation to patient delivery quality assurance results and to evaluate the relationship between energy variations detected using different TQA modules. TQA daily measurement results from two treatment machines for periods of up to 4years were acquired. Analyses of beam quality, helical and static output variations were made. Variations from planned dose were also analysed using Statistical Process Control (SPC) technique and their relationship to output trends were studied. Energy variations appeared to be one of the contributing factors to delivery output dose seen in the analysis. Ion chamber measurements were reliable indicators of energy and output variations and were linear with patient dose verifications. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

Prospective longitudinal cohort study on cumulative 5-year delivery and adoption rates among 1338 couples initiating infertility treatment

DEFF Research Database (Denmark)

Pinborg, A; Hougaard, C O; Andersen, A Nyboe

2009-01-01

occurred for 5.9% (48/817) of the women. Positive prognostic factors for delivery were male infertility, female age infertility and less than three previous treatment cycles. CONCLUSIONS A crude delivery rate of 69.4% in the total population 5 years after referral to tertiary......BACKGROUND The objective was to assess crude 5-year delivery rates after assisted reproductive technology (ART) treatment, intrauterine inseminations (IUI), spontaneous conceptions (SC) and adoptions in a large infertile cohort. METHODS A prospective longitudinal survey comprised 1338 infertile...... couples starting public infertility programmes offering IUIs and three free ART cycles during 2000-2001. The cohort was cross-linked with the National Medical Birth Register to obtain delivery rates for all 1338 couples. More detailed data were available from 817 women responding to a 5-year follow...

Software verification for nuclear industry

International Nuclear Information System (INIS)

Wilburn, N.P.

1985-08-01

Why verification of software products throughout the software life cycle is necessary is considered. Concepts of verification, software verification planning, and some verification methodologies for products generated throughout the software life cycle are then discussed

The design of verification regimes

International Nuclear Information System (INIS)

Gallagher, N.W.

1991-01-01

Verification of a nuclear agreement requires more than knowledge of relevant technologies and institutional arrangements. It also demands thorough understanding of the nature of verification and the politics of verification design. Arms control efforts have been stymied in the past because key players agreed to verification in principle, only to disagree radically over verification in practice. In this chapter, it is shown that the success and stability of arms control endeavors can be undermined by verification designs which promote unilateral rather than cooperative approaches to security, and which may reduce, rather than enhance, the security of both sides. Drawing on logical analysis and practical lessons from previous superpower verification experience, this chapter summarizes the logic and politics of verification and suggests implications for South Asia. The discussion begins by determining what properties all forms of verification have in common, regardless of the participants or the substance and form of their agreement. Viewing verification as the political process of making decisions regarding the occurrence of cooperation points to four critical components: (1) determination of principles, (2) information gathering, (3) analysis and (4) projection. It is shown that verification arrangements differ primarily in regards to how effectively and by whom these four stages are carried out

Pregnancy and delivery while receiving vagus nerve stimulation for the treatment of major depression: a case report

Directory of Open Access Journals (Sweden)

Stegman Diane

2005-09-01

Full Text Available Abstract Background Depression during pregnancy can have significant health consequences for the mother and her infant. Antidepressant medications, which pass through the placenta, may increase the risk of low birth weight and preterm delivery. The use of selective serotonin reuptake inhibitors (SSRIs during pregnancy may induce serotonergic symptoms in the infant after delivery. Antidepressant medications in breast milk may also be passed to an infant. Vagus nerve stimulation (VNS therapy is an effective non-pharmacologic treatment for treatment-resistant depression (TRD, but little information exists regarding the use of VNS therapy during pregnancy. Case presentation The patient began receiving VNS therapy for TRD in March 1999. The therapy was effective, producing substantial reductions in depressive symptoms and improvement of function. In 2002, the patient reported that she was pregnant. She continued receiving VNS therapy throughout her pregnancy, labor, and delivery, which enabled the sustained remission of her depression. The pregnancy was uneventful; a healthy daughter was delivered at full term. Conclusion In this case, VNS therapy provided effective treatment for TRD during pregnancy and delivery. VNS was safe for the patient and her child.

Improved verification methods for safeguards verifications at enrichment plants

International Nuclear Information System (INIS)

Lebrun, A.; Kane, S. C.; Bourva, L.; Poirier, S.; Loghin, N. E.; Langlands, D.

2009-01-01

The International Atomic Energy Agency (IAEA) has initiated a coordinated research and development programme to improve its verification methods and equipment applicable to enrichment plants. The programme entails several individual projects to meet the objectives of the IAEA Safeguards Model Approach for Gas Centrifuge Enrichment Plants updated in 2006. Upgrades of verification methods to confirm the absence of HEU (highly enriched uranium) production have been initiated and, in particular, the Cascade Header Enrichment Monitor (CHEM) has been redesigned to reduce its weight and incorporate an electrically cooled germanium detector. Such detectors are also introduced to improve the attended verification of UF 6 cylinders for the verification of the material balance. Data sharing of authenticated operator weighing systems such as accountancy scales and process load cells is also investigated as a cost efficient and an effective safeguards measure combined with unannounced inspections, surveillance and non-destructive assay (NDA) measurement. (authors)

Improved verification methods for safeguards verifications at enrichment plants

Energy Technology Data Exchange (ETDEWEB)

Lebrun, A.; Kane, S. C.; Bourva, L.; Poirier, S.; Loghin, N. E.; Langlands, D. [Department of Safeguards, International Atomic Energy Agency, Wagramer Strasse 5, A1400 Vienna (Austria)

2009-07-01

The International Atomic Energy Agency (IAEA) has initiated a coordinated research and development programme to improve its verification methods and equipment applicable to enrichment plants. The programme entails several individual projects to meet the objectives of the IAEA Safeguards Model Approach for Gas Centrifuge Enrichment Plants updated in 2006. Upgrades of verification methods to confirm the absence of HEU (highly enriched uranium) production have been initiated and, in particular, the Cascade Header Enrichment Monitor (CHEM) has been redesigned to reduce its weight and incorporate an electrically cooled germanium detector. Such detectors are also introduced to improve the attended verification of UF{sub 6} cylinders for the verification of the material balance. Data sharing of authenticated operator weighing systems such as accountancy scales and process load cells is also investigated as a cost efficient and an effective safeguards measure combined with unannounced inspections, surveillance and non-destructive assay (NDA) measurement. (authors)

19 CFR 10.784 - Verification and justification of claim for preferential treatment.

Science.gov (United States)

2010-04-01

... accounting principles. When conducting a verification of origin to which Generally Accepted Accounting Principles may be relevant, CBP will apply and accept the Generally Accepted Accounting Principles applicable...

19 CFR 10.824 - Verification and justification of claim for preferential treatment.

Science.gov (United States)

2010-04-01

... accounting principles. When conducting a verification of origin to which Generally Accepted Accounting Principles may be relevant, CBP will apply and accept the Generally Accepted Accounting Principles applicable...

Investigating the impact of treatment delivery uncertainties on treatment effectiveness for lung SABR

DEFF Research Database (Denmark)

Blake, Samuel J.; Arumugam, Sankar; Holloway, Lois

2017-01-01

To quantify the impact of treatment delivery uncertainties on lung stereotactic ablative body radiotherapy (SABR) plans for step-and-shoot intensity-modulated radiotherapy (ssIMRT) and volumetric modulated arc therapy (VMAT). Baseline ssIMRT and VMAT treatment plans were generated for a cohort...... of 18 lung SABR patients. Modified plans were generated for each baseline plan by systematically varying gantry and collimator angles between − 5 and + 5 degrees, as well as multi-leaf collimator (MLC) leaf position errors of magnitude between 1 and 5 mm in both directions (i.e. leaf banks shifted...... either in the same (Type 1) or opposite (Type 2) directions). Planning target volume (PTV), spinal cord and healthy lung dose-volume histogram (DVH) metrics were compared between the modified and baseline plans. Collimator and gantry angle uncertainties did not significantly impact any of the PTV DVH...

The role of treatment delivery factors in exposure-based cognitive behavioral therapy for panic disorder with agoraphobia.

Science.gov (United States)

Weck, Florian; Grikscheit, Florian; Höfling, Volkmar; Kordt, Anne; Hamm, Alfons O; Gerlach, Alexander L; Alpers, Georg W; Arolt, Volker; Kircher, Tilo; Pauli, Paul; Rief, Winfried; Lang, Thomas

2016-08-01

Treatment delivery factors (i.e., therapist adherence, therapist competence, and therapeutic alliance) are considered to be important for cognitive behavioral therapy (CBT) for panic disorder and agoraphobia (PD/AG). In the current study, four independent raters conducted process evaluations based on 168 two-hour videotapes of 84 patients with PD/AG treated with exposure-based CBT. Two raters evaluated patients' interpersonal behavior in Session 1. Two raters evaluated treatment delivery factors in Session 6, in which therapists provided the rationale for conducting exposure exercises. At the 6-month follow-up, therapists' adherence (r=0.54) and therapeutic alliance (r=0.31) were significant predictors of changes in agoraphobic avoidance behavior; therapist competence was not associated with treatment outcomes. Patients' interpersonal behavior in Session 1 was a significant predictor of the therapeutic alliance in Session 6 (r=0.17). The findings demonstrate that treatment delivery factors, particularly therapist adherence, are relevant to the long-term success of CBT for PD/AG. Copyright © 2016 Elsevier Ltd. All rights reserved.

First online real-time evaluation of motion-induced 4D dose errors during radiotherapy delivery

DEFF Research Database (Denmark)

Ravkilde, Thomas; Skouboe, Simon; Hansen, Rune

2018-01-01

PURPOSE: In radiotherapy, dose deficits caused by tumor motion often far outweigh the discrepancies typically allowed in plan-specific quality assurance (QA). Yet, tumor motion is not usually included in present QA. We here present a novel method for online treatment verification by real......-time motion-including 4D dose reconstruction and dose evaluation and demonstrate its use during stereotactic body radiotherapy (SBRT) delivery with and without MLC tracking. METHODS: Five volumetric modulated arc therapy (VMAT) plans were delivered with and without MLC tracking to a motion stage carrying...... a Delta4 dosimeter. The VMAT plans have previously been used for (non-tracking) liver SBRT with intra-treatment tumor motion recorded by kilovoltage intrafraction monitoring (KIM). The motion stage reproduced the KIM-measured tumor motions in 3D while optical monitoring guided the MLC tracking. Linac...

Physics Verification Overview

Energy Technology Data Exchange (ETDEWEB)

Doebling, Scott William [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

2017-09-12

The purpose of the verification project is to establish, through rigorous convergence analysis, that each ASC computational physics code correctly implements a set of physics models and algorithms (code verification); Evaluate and analyze the uncertainties of code outputs associated with the choice of temporal and spatial discretization (solution or calculation verification); and Develop and maintain the capability to expand and update these analyses on demand. This presentation describes project milestones.

TU-A-304-02: Treatment Simulation, Planning and Delivery for SBRT

Energy Technology Data Exchange (ETDEWEB)

Yang, Y.

2015-06-15

Increased use of SBRT and hypo fractionation in radiation oncology practice has posted a number of challenges to medical physicist, ranging from planning, image-guided patient setup and on-treatment monitoring, to quality assurance (QA) and dose delivery. This symposium is designed to provide updated knowledge necessary for the safe and efficient implementation of SBRT in various linac platforms, including the emerging digital linacs equipped with high dose rate FFF beams. Issues related to 4D CT, PET and MRI simulations, 3D/4D CBCT guided patient setup, real-time image guidance during SBRT dose delivery using gated/un-gated VMAT or IMRT, and technical advancements in QA of SBRT (in particular, strategies dealing with high dose rate FFF beams) will be addressed. The symposium will help the attendees to gain a comprehensive understanding of the SBRT workflow and facilitate their clinical implementation of the state-of-art imaging and planning techniques. Learning Objectives: Present background knowledge of SBRT, describe essential requirements for safe implementation of SBRT, and discuss issues specific to SBRT treatment planning and QA. Update on the use of multi-dimensional (3D and 4D) and multi-modality (CT, beam-level X-ray imaging, pre- and on-treatment 3D/4D MRI, PET, robotic ultrasound, etc.) for reliable guidance of SBRT. Provide a comprehensive overview of emerging digital linacs and summarize the key geometric and dosimetric features of the new generation of linacs for substantially improved SBRT. Discuss treatment planning and quality assurance issues specific to SBRT. Research grant from Varian Medical Systems.

Reinforcing of QA/QC programs in radiotherapy departments in Croatia: Results of treatment planning system verification

Energy Technology Data Exchange (ETDEWEB)

Jurković, Slaven; Švabić, Manda; Diklić, Ana; Smilović Radojčić, Đeni; Dundara, Dea [Clinic for Radiotherapy and Oncology, Physics Division, University Hospital Rijeka, Rijeka (Croatia); Kasabašić, Mladen; Ivković, Ana [Department for Radiotherapy and Oncology, University Hospital Osijek, Osijek (Croatia); Faj, Dario, E-mail: dariofaj@mefos.hr [Department of Physics, School of Medicine, University of Osijek, Osijek (Croatia)

2013-04-01

Implementation of advanced techniques in clinical practice can greatly improve the outcome of radiation therapy, but it also makes the process much more complex with a lot of room for errors. An important part of the quality assurance program is verification of treatment planning system (TPS). Dosimetric verifications in anthropomorphic phantom were performed in 4 centers where new systems were installed. A total of 14 tests for 2 photon energies and multigrid superposition algorithms were conducted using the CMS XiO TPS. Evaluation criteria as specified in the International Atomic Energy Agency Technical Reports Series (IAEA TRS) 430 were employed. Results of measurements are grouped according to the placement of the measuring point and the beam energy. The majority of differences between calculated and measured doses in the water-equivalent part of the phantom were in tolerance. Significantly more out-of-tolerance values were observed in “nonwater-equivalent” parts of the phantom, especially for higher-energy photon beams. This survey was done as a part of continuous effort to build up awareness of quality assurance/quality control (QA/QC) importance in the Croatian radiotherapy community. Understanding the limitations of different parts of the various systems used in radiation therapy can systematically improve quality as well.

SU-E-J-115: Graticule for Verification of Treatment Position in Neutron Therapy.

Science.gov (United States)

Halford, R; Snyder, M

2012-06-01

Until recently the treatment verification for patients undergoing fast neutron therapy at our facility was accomplished through a combination of neutron beam portal films aligned with a graticule mounted on an orthronormal x-ray tube. To eliminate uncertainty with respect to the relative positions of the x-ray graticule and the therapy beam, we have developed a graticule which is placed in the neutron beam itself. For a graticule to be visible on the portal film, the attenuation of the neutron beam by the graticule landmarks must be significantly greater than that of the material in which the landmarks are mounted. Various materials, thicknesses, and mounting points were tried to gain the largest contrast between the graticule landmarks and the mounting material. The final design involved 2 inch steel pins of 0.125 inch diameter captured between two parallel plates of 0.25 inch thick clear acrylic plastic. The distance between the two acrylic plates was 1.625 inches, held together at the perimeter with acrylic sidewall spacers. This allowed the majority of length of the steel pins to be surrounded by air. The pins were set 1 cm apart and mounted at angles parallel to the divergence of the beam dependent on their position within the array. The entire steel pin and acrylic plate assembly was mounted on an acrylic accessory tray to allow for graticule alignment. Despite the inherent difficulties in attenuating fast neutrons, our simple graticule design produces the required difference of attenuation between the arrays of landmarks and the mounting material. The graticule successfully provides an in-beam frame of reference for patient portal verification. © 2012 American Association of Physicists in Medicine.

Enhanced dynamic wedge and independent monitor unit verification

International Nuclear Information System (INIS)

Howlett, S.J.; University of Newcastle, NSW

2004-01-01

Full text: Some serious radiation accidents have occurred around the world during the delivery of radiotherapy treatment. The regrettable incident in Panama clearly indicated the need for independent monitor unit (MU) verification. Indeed the International Atomic Energy Agency (IAEA), after investigating the incident, made specific recommendations for radiotherapy centres which included an independent monitor unit check for all treatments. Independent monitor unit verification is practiced in many radiotherapy centres in developed countries around the world. It is mandatory in USA but not yet in Australia. The enhanced dynamic wedge factor (EDWF) presents some significant problems in accurate MU calculation, particularly in the case of non centre of field position (COF). This paper describes development of an independent MU program, concentrating on the implementation of the EDW component. The difficult case of non COF points under the EDW was studied in detail. A survey of Australasian centres regarding the use of independent MU check systems was conducted. The MUCalculator was developed with reference to MU calculations made by Pinnacle 3D RTP system (Philips) for 4MV, 6MV and 18MV X-ray beams from Varian machines used at the Newcastle Mater Misericordiae Hospital (NMMH) in the clinical environment. Ionisation chamber measurements in solid water TM and liquid water were performed based on a published test data set. Published algorithms combined with a depth dependent profile correction were applied in an attempt to match measured data with maximum accuracy. The survey results are presented. Substantial data is presented in tabular form and extensive comparison with published data. Several different methods for calculating EDWF are examined. A small systematic error was detected in the Gibbon equation used for the EDW calculations. Generally, calculations were within +2% of measured values, although some setups exceeded this variation. Results indicate that COF

Treatment of acute massive pulmonary embolism by streptokinase during labour and delivery.

Science.gov (United States)

Hall, R J; Young, C; Sutton, G C; Cambell, S

1972-12-16

A 29-year-old woman sustained an acute massive pulmonary embolism in the 32nd week of pregnancy. Rapid clinical improvement followed the use of streptokinase. Treatment was continued for 41 hours, including labour and the first three hours after delivery. There was slow but severe postpartum haemorrhage. Partial uterine atony occurred, and may have been due, at least in part, to fibrin degradation products arising from thrombolysis. No adverse effects were noted in the baby.Our experience suggests that streptokinase may be given during labour but that an oxytocic agent may be needed; and that reversal of fibrinolysis before delivery is best achieved by the use of aprotinin (Trasylol) rather than aminocaproic acid.

Micro- and Nano-Carrier Mediated Intra-Articular Drug Delivery Systems for the Treatment of Osteoarthritis

Directory of Open Access Journals (Sweden)

Zhiyue Zhang

2012-01-01

Full Text Available The objective of this paper is to provide readers with current developments of intra-articular drug delivery systems. In recent years, although the search for a clinically successful ideal carrier is ongoing, sustained-release systems, such as polymeric micro- and nanoparticles, liposomes, and hydrogels, are being extensively studied for intra-articular drug delivery purposes. The advantages associated with long-acting preparations include a longer effect of the drug in the action site and a reduced risk of infection due to numerous injections consequently. This paper discusses the recent developments in the field of intra-articular sustained-release delivery systems for the treatment of osteoarthritis.

Micro- and Nano-Carrier Mediated Intra-Articular Drug Delivery Systems for the Treatment of Osteoarthritis

International Nuclear Information System (INIS)

Zhang, Z.; Huang, G.

2012-01-01

The objective of this paper is to provide readers with current developments of intra-articular drug delivery systems. In recent years, although the search for a clinically successful ideal carrier is ongoing, sustained-release systems, such as polymeric micro- and nanoparticles, liposomes, and hydrogels, are being extensively studied for intra-articular drug delivery purposes. The advantages associated with long-acting preparations include a longer effect of the drug in the action site and a reduced risk of infection due to numerous injections consequently. This paper discusses the recent developments in the field of intra-articular sustained-release delivery systems for the treatment of osteoarthritis

PMO Delivery System Using Bubble Liposomes and Ultrasound Exposure for Duchenne Muscular Dystrophy Treatment.

Science.gov (United States)

Negishi, Yoichi; Ishii, Yuko; Nirasawa, Kei; Sasaki, Eri; Endo-Takahashi, Yoko; Suzuki, Ryo; Maruyama, Kazuo

2018-01-01

Duchenne muscular dystrophy (DMD) is a genetic disorder characterized by progressive muscle degeneration, caused by nonsense or frameshift mutations in the dystrophin (DMD) gene. Antisense oligonucleotides can be used to induce specific exon skipping; recently, a phosphorodiamidate morpholino oligomer (PMO) has been approved for clinical use in DMD. However, an efficient PMO delivery strategy is required to improve the therapeutic efficacy in DMD patients. We previously developed polyethylene glycol (PEG)-modified liposomes containing ultrasound contrast gas, "Bubble liposomes" (BLs), and found that the combination of BLs with ultrasound exposure is a useful gene delivery tool. Here, we describe an efficient PMO delivery strategy using the combination of BLs and ultrasound exposure to treat muscles in a DMD mouse model (mdx). This ultrasound-mediated BL technique can increase the PMO-mediated exon-skipping efficiency, leading to significantly increased dystrophin expression. Thus, the combination of BLs and ultrasound exposure may be a feasible PMO delivery method to improve therapeutic efficacy and reduce the PMO dosage for DMD treatment.

Polymeric Gene Delivery for Diabetic Treatment

Directory of Open Access Journals (Sweden)

Sung Wan Kim

2011-08-01

Full Text Available Several polymers were used to delivery genes to diabetic animals. Polyaminobutyl glycolic acid was utilized to deliver IL-10 plasmid DNA to prevent autoimmune insulitis of non-obese diabetic (NOD mouse. Polyethylene glycol grafted polylysine was combined with antisense glutamic acid decarboxylase (GAD MRNA to represent GAD autoantigene expression. GLP1 and TSTA (SP-EX4 were delivered by bioreducible polymer to stop diabetic progression. Fas siRNA delivery was carried out to treat diabetic NOD mice animal.

Film techniques in radiotherapy for treatment verification, determination of patient exit dose, and detection of localization error

International Nuclear Information System (INIS)

Haus, A.G.; Marks, J.E.

1974-01-01

In patient radiation therapy, it is important to know that the diseased area is included in the treatment field and that normal anatomy is properly shielded or excluded. Since 1969, a film technique developed for imaging of the complete patient radiation exposure has been applied for treatment verification and for the detection and evaluation of localization errors that may occur during treatment. The technique basically consists of placing a film under the patient during the entire radiation exposure. This film should have proper sensitivity and contrast in the exit dose exposure range encountered in radiotherapy. In this communication, we describe how various exit doses fit the characteristic curve of the film; examples of films exposed to various exit doses; the technique for using the film to determine the spatial distribution of the absorbed exit dose; and types of errors commonly detected. Results are presented illustrating that, as the frequency of use of this film technique is increased, localization error is reduced significantly

Treatment delivery software for a new clinical grade ultrasound system for thermoradiotherapy.

Science.gov (United States)

Novák, Petr; Moros, Eduardo G; Straube, William L; Myerson, Robert J

2005-11-01

A detailed description of a clinical grade Scanning Ultrasound Reflector Linear Array System (SURLAS) applicator was given in a previous paper [Med. Phys. 32, 230-240 (2005)]. In this paper we concentrate on the design, development, and testing of the personal computer (PC) based treatment delivery software that runs the therapy system. The SURLAS requires the coordinated interaction between the therapy applicator and several peripheral devices for its proper and safe operation. One of the most important tasks was the coordination of the input power sequences for the elements of two parallel opposed ultrasound arrays (eight 1.5 cm x 2 cm elements/array, array 1 and 2 operate at 1.9 and 4.9 MHz, respectively) in coordination with the position of a dual-face scanning acoustic reflector. To achieve this, the treatment delivery software can divide the applicator's treatment window in up to 64 sectors (minimum size of 2 cm x 2 cm), and control the power to each sector independently by adjusting the power output levels from the channels of a 16-channel radio-frequency generator. The software coordinates the generator outputs with the position of the reflector as it scans back and forth between the arrays. Individual sector control and dual frequency operation allows the SURLAS to adjust power deposition in three dimensions to superficial targets coupled to its treatment window. The treatment delivery software also monitors and logs several parameters such as temperatures acquired using a 16-channel thermocouple thermometry unit. Safety (in particular to patients) was the paramount concern and design criterion. Failure mode and effects analysis (FMEA) was applied to the applicator as well as to the entire therapy system in order to identify safety issues and rank their relative importance. This analysis led to the implementation of several safety mechanisms and a software structure where each device communicates with the controlling PC independently of the others. In case

FMCT verification: Case studies

International Nuclear Information System (INIS)

Hui Zhang

2001-01-01

Full text: How to manage the trade-off between the need for transparency and the concern about the disclosure of sensitive information would be a key issue during the negotiations of FMCT verification provision. This paper will explore the general concerns on FMCT verification; and demonstrate what verification measures might be applied to those reprocessing and enrichment plants. A primary goal of an FMCT will be to have the five declared nuclear weapon states and the three that operate unsafeguarded nuclear facilities become parties. One focus in negotiating the FMCT will be verification. Appropriate verification measures should be applied in each case. Most importantly, FMCT verification would focus, in the first instance, on these states' fissile material production facilities. After the FMCT enters into force, all these facilities should be declared. Some would continue operating to produce civil nuclear power or to produce fissile material for non- explosive military uses. The verification measures necessary for these operating facilities would be essentially IAEA safeguards, as currently being applied to non-nuclear weapon states under the NPT. However, some production facilities would be declared and shut down. Thus, one important task of the FMCT verifications will be to confirm the status of these closed facilities. As case studies, this paper will focus on the verification of those shutdown facilities. The FMCT verification system for former military facilities would have to differ in some ways from traditional IAEA safeguards. For example, there could be concerns about the potential loss of sensitive information at these facilities or at collocated facilities. Eventually, some safeguards measures such as environmental sampling might be seen as too intrusive. Thus, effective but less intrusive verification measures may be needed. Some sensitive nuclear facilities would be subject for the first time to international inspections, which could raise concerns

Inspector measurement verification activities

International Nuclear Information System (INIS)

George, R.S.; Crouch, R.

e most difficult and complex activity facing a safeguards inspector involves the verification of measurements and the performance of the measurement system. Remeasurement is the key to measurement verification activities. Remeasurerements using the facility's measurement system provide the bulk of the data needed for determining the performance of the measurement system. Remeasurements by reference laboratories are also important for evaluation of the measurement system and determination of systematic errors. The use of these measurement verification activities in conjunction with accepted inventory verification practices provides a better basis for accepting or rejecting an inventory. (U.S.)

Verification and disarmament

Energy Technology Data Exchange (ETDEWEB)

Blix, H. [IAEA, Vienna (Austria)

1998-07-01

The main features are described of the IAEA safeguards verification system that non-nuclear weapon states parties of the NPT are obliged to accept. Verification activities/problems in Iraq and North Korea are discussed.

Verification and disarmament

International Nuclear Information System (INIS)

Blix, H.

1998-01-01

The main features are described of the IAEA safeguards verification system that non-nuclear weapon states parties of the NPT are obliged to accept. Verification activities/problems in Iraq and North Korea are discussed

Intracranial microcapsule chemotherapy delivery for the localized treatment of rodent metastatic breast adenocarcinoma in the brain.

Science.gov (United States)

Upadhyay, Urvashi M; Tyler, Betty; Patta, Yoda; Wicks, Robert; Spencer, Kevin; Scott, Alexander; Masi, Byron; Hwang, Lee; Grossman, Rachel; Cima, Michael; Brem, Henry; Langer, Robert

2014-11-11

Metastases represent the most common brain tumors in adults. Surgical resection alone results in 45% recurrence and is usually accompanied by radiation and chemotherapy. Adequate chemotherapy delivery to the CNS is hindered by the blood-brain barrier. Efforts at delivering chemotherapy locally to gliomas have shown modest increases in survival, likely limited by the infiltrative nature of the tumor. Temozolomide (TMZ) is first-line treatment for gliomas and recurrent brain metastases. Doxorubicin (DOX) is used in treating many types of breast cancer, although its use is limited by severe cardiac toxicity. Intracranially implanted DOX and TMZ microcapsules are compared with systemic administration of the same treatments in a rodent model of breast adenocarcinoma brain metastases. Outcomes were animal survival, quantified drug exposure, and distribution of cleaved caspase 3. Intracranial delivery of TMZ and systemic DOX administration prolong survival more than intracranial DOX or systemic TMZ. Intracranial TMZ generates the more robust induction of apoptotic pathways. We postulate that these differences may be explained by distribution profiles of each drug when administered intracranially: TMZ displays a broader distribution profile than DOX. These microcapsule devices provide a safe, reliable vehicle for intracranial chemotherapy delivery and have the capacity to be efficacious and superior to systemic delivery of chemotherapy. Future work should include strategies to improve the distribution profile. These findings also have broader implications in localized drug delivery to all tissue, because the efficacy of a drug will always be limited by its ability to diffuse into surrounding tissue past its delivery source.

In vivo verification of proton beam path by using post-treatment PET/CT imaging.

Science.gov (United States)

Hsi, Wen C; Indelicato, Daniel J; Vargas, Carlos; Duvvuri, Srividya; Li, Zuofeng; Palta, Jatinder

2009-09-01

The purpose of this study is to establish the in vivo verification of proton beam path by using proton-activated positron emission distributions. A total of 50 PET/CT imaging studies were performed on ten prostate cancer patients immediately after daily proton therapy treatment through a single lateral portal. The PET/CT and planning CT were registered by matching the pelvic bones, and the beam path of delivered protons was defined in vivo by the positron emission distribution seen only within the pelvic bones, referred to as the PET-defined beam path. Because of the patient position correction at each fraction, the marker-defined beam path, determined by the centroid of implanted markers seen in the posttreatment (post-Tx) CT, is used for the planned beam path. The angular variation and discordance between the PET- and marker-defined paths were derived to investigate the intrafraction prostate motion. For studies with large discordance, the relative location between the centroid and pelvic bones seen in the post-Tx CT was examined. The PET/CT studies are categorized for distinguishing the prostate motion that occurred before or after beam delivery. The post-PET CT was acquired after PET imaging to investigate prostate motion due to physiological changes during the extended PET acquisition. The less than 2 degrees of angular variation indicates that the patient roll was minimal within the immobilization device. Thirty of the 50 studies with small discordance, referred as good cases, show a consistent alignment between the field edges and the positron emission distributions from the entrance to the distal edge. For those good cases, average displacements are 0.6 and 1.3 mm along the anterior-posterior (D(AP)) and superior-inferior (D(SI)) directions, respectively, with 1.6 mm standard deviations in both directions. For the remaining 20 studies demonstrating a large discordance (more than 6 mm in either D(AP) or D(SI)), 13 studies, referred as motion-after-Tx cases

The Challenge for Arms Control Verification in the Post-New START World

Energy Technology Data Exchange (ETDEWEB)

Wuest, C R

2012-05-24

Nuclear weapon arms control treaty verification is a key aspect of any agreement between signatories to establish that the terms and conditions spelled out in the treaty are being met. Historically, arms control negotiations have focused more on the rules and protocols for reducing the numbers of warheads and delivery systems - sometimes resorting to complex and arcane procedures for counting forces - in an attempt to address perceived or real imbalances in a nation's strategic posture that could lead to instability. Verification procedures are generally defined in arms control treaties and supporting documents and tend to focus on technical means and measures designed to ensure that a country is following the terms of the treaty and that it is not liable to engage in deception or outright cheating in an attempt to circumvent the spirit and the letter of the agreement. As the Obama Administration implements the articles, terms, and conditions of the recently ratified and entered-into-force New START treaty, there are already efforts within and outside of government to move well below the specified New START levels of 1550 warheads, 700 deployed strategic delivery vehicles, and 800 deployed and nondeployed strategic launchers (Inter-Continental Ballistic Missile (ICBM) silos, Submarine-Launched Ballistic Missile (SLBM) tubes on submarines, and bombers). A number of articles and opinion pieces have appeared that advocate for significantly deeper cuts in the U.S. nuclear stockpile, with some suggesting that unilateral reductions on the part of the U.S. would help coax Russia and others to follow our lead. Papers and studies prepared for the U.S. Department of Defense and at the U.S. Air War College have also been published, suggesting that nuclear forces totaling no more than about 300 warheads would be sufficient to meet U.S. national security and deterrence needs. (Davis 2011, Schaub and Forsyth 2010) Recent articles by James M. Acton and others suggest that

Vision 20/20: Positron emission tomography in radiation therapy planning, delivery, and monitoring

Energy Technology Data Exchange (ETDEWEB)

Parodi, Katia, E-mail: Katia.parodi@physik.uni-muenchen.de [Faculty of Physics, Department of Medical Physics, Ludwig Maximilians University Munich, Munich 85748 (Germany)

2015-12-15

Positron emission tomography (PET) is increasingly considered as an effective imaging method to support several stages of radiation therapy. The combined usage of functional and morphological imaging in state-of-the-art PET/CT scanners is rapidly emerging to support the treatment planning process in terms of improved tumor delineation, and to assess the tumor response in follow-up investigations after or even during the course of fractionated therapy. Moreover, active research is being pursued on new tracers capable of providing different insights into tumor function, in order to identify areas of the planning volume which may require additional dosage for improved probability of tumor control. In this respect, major progresses in the next years will likely concern the development and clinical investigation of novel tracers and image processing techniques for reliable thresholding and segmentation, of treatment planning and beam delivery approaches integrating the PET imaging information, as well as improved multimodal clinical instrumentation such as PET/MR. But especially in the rapidly emerging case of ion beam therapy, the usage of PET is not only limited to the imaging of external tracers injected to the patient. In fact, a minor amount of positron emitters is formed in nuclear fragmentation reactions between the impinging ions and the tissue, bearing useful information for confirmation of the delivered treatment during or after therapeutic irradiation. Different implementations of unconventional PET imaging for therapy monitoring are currently being investigated clinically, and major ongoing research aims at new dedicated detector technologies and at challenging applications such as real-time imaging and time-resolved in vivo verification of motion compensated beam delivery. This paper provides an overview of the different areas of application of PET in radiation oncology and discusses the most promising perspectives in the years to come for radiation therapy

Vision 20/20: Positron emission tomography in radiation therapy planning, delivery, and monitoring

International Nuclear Information System (INIS)

Parodi, Katia

2015-01-01

Positron emission tomography (PET) is increasingly considered as an effective imaging method to support several stages of radiation therapy. The combined usage of functional and morphological imaging in state-of-the-art PET/CT scanners is rapidly emerging to support the treatment planning process in terms of improved tumor delineation, and to assess the tumor response in follow-up investigations after or even during the course of fractionated therapy. Moreover, active research is being pursued on new tracers capable of providing different insights into tumor function, in order to identify areas of the planning volume which may require additional dosage for improved probability of tumor control. In this respect, major progresses in the next years will likely concern the development and clinical investigation of novel tracers and image processing techniques for reliable thresholding and segmentation, of treatment planning and beam delivery approaches integrating the PET imaging information, as well as improved multimodal clinical instrumentation such as PET/MR. But especially in the rapidly emerging case of ion beam therapy, the usage of PET is not only limited to the imaging of external tracers injected to the patient. In fact, a minor amount of positron emitters is formed in nuclear fragmentation reactions between the impinging ions and the tissue, bearing useful information for confirmation of the delivered treatment during or after therapeutic irradiation. Different implementations of unconventional PET imaging for therapy monitoring are currently being investigated clinically, and major ongoing research aims at new dedicated detector technologies and at challenging applications such as real-time imaging and time-resolved in vivo verification of motion compensated beam delivery. This paper provides an overview of the different areas of application of PET in radiation oncology and discusses the most promising perspectives in the years to come for radiation therapy

19 CFR 10.550 - Verification and justification of claim for preferential treatment.

Science.gov (United States)

2010-04-01

... may agree. (b) Applicable accounting principles. When conducting a verification of origin to which Generally Accepted Accounting Principles may be relevant, CBP will apply and accept the Generally Accepted Accounting Principles applicable in the country of production. ...

Tolerance limits and methodologies for IMRT measurement-based verification QA: Recommendations of AAPM Task Group No. 218.

Science.gov (United States)

Miften, Moyed; Olch, Arthur; Mihailidis, Dimitris; Moran, Jean; Pawlicki, Todd; Molineu, Andrea; Li, Harold; Wijesooriya, Krishni; Shi, Jie; Xia, Ping; Papanikolaou, Nikos; Low, Daniel A

2018-04-01

Patient-specific IMRT QA measurements are important components of processes designed to identify discrepancies between calculated and delivered radiation doses. Discrepancy tolerance limits are neither well defined nor consistently applied across centers. The AAPM TG-218 report provides a comprehensive review aimed at improving the understanding and consistency of these processes as well as recommendations for methodologies and tolerance limits in patient-specific IMRT QA. The performance of the dose difference/distance-to-agreement (DTA) and γ dose distribution comparison metrics are investigated. Measurement methods are reviewed and followed by a discussion of the pros and cons of each. Methodologies for absolute dose verification are discussed and new IMRT QA verification tools are presented. Literature on the expected or achievable agreement between measurements and calculations for different types of planning and delivery systems are reviewed and analyzed. Tests of vendor implementations of the γ verification algorithm employing benchmark cases are presented. Operational shortcomings that can reduce the γ tool accuracy and subsequent effectiveness for IMRT QA are described. Practical considerations including spatial resolution, normalization, dose threshold, and data interpretation are discussed. Published data on IMRT QA and the clinical experience of the group members are used to develop guidelines and recommendations on tolerance and action limits for IMRT QA. Steps to check failed IMRT QA plans are outlined. Recommendations on delivery methods, data interpretation, dose normalization, the use of γ analysis routines and choice of tolerance limits for IMRT QA are made with focus on detecting differences between calculated and measured doses via the use of robust analysis methods and an in-depth understanding of IMRT verification metrics. The recommendations are intended to improve the IMRT QA process and establish consistent, and comparable IMRT QA

Verification techniques and dose distribution for computed tomographic planned supine craniospinal radiation therapy

International Nuclear Information System (INIS)

Chang, Eric L.; Wong Peifong; Forster, Kenneth M.; Petru, Mark D.; Kowalski, Alexander V.; Maor, Moshe H.

2003-01-01

A modified 3-field technique was designed with opposed cranial fields and a single spinal field encompassing the entire spinal axis. Two methods of plan verifications were performed before the first treatment. First, a system of orthogonal rulers plus the thermoplastic head holder was used to visualize the light fields at the craniospinal junction. Second, film phantom measurements were taken to visualize the gap between the fields at the level of the spinal cord. Treatment verification entailed use of a posterior-anterior (PA) portal film and placement of radiopaque wire on the inferior border of the cranial field. More rigorous verification required a custom-fabricated orthogonal film holder. The isocenter positions of both fields when they matched were recorded using a record-and-verify system. A single extended distance spinal field collimated at 42 degree sign encompassed the entire spinal neuraxis. Data were collected from 40 fractions of craniospinal irradiation (CSI). The systematic error observed for the actual daily treatments was -0.5 mm (underlap), while the stochastic error was represented by a standard deviation of 5.39 mm. Measured data across the gapped craniospinal junction with junction shifts included revealed a dose ranging from 89.3% to 108%. CSI can be performed without direct visualization of the craniospinal junction by using the verification methods described. While the use of rigorous film verification for supine technique may have reduced the systematic error, the inability to visualize the supine craniospinal junction on skin appears to have increased the stochastic error compared to published data on such errors associated with prone craniospinal irradiation

The feasibility of using Pareto fronts for comparison of treatment planning systems and delivery techniques

International Nuclear Information System (INIS)

Ottosson, Rickard O.; Sjoestroem, David; Behrens, Claus F.; Karlsson, Anna; Engstroem, Per E.; Knoeoes, Tommy; Ceberg, Crister

2009-01-01

Pareto optimality is a concept that formalises the trade-off between a given set of mutually contradicting objectives. A solution is said to be Pareto optimal when it is not possible to improve one objective without deteriorating at least one of the other. A set of Pareto optimal solutions constitute the Pareto front. The Pareto concept applies well to the inverse planning process, which involves inherently contradictory objectives, high and uniform target dose on one hand, and sparing of surrounding tissue and nearby organs at risk (OAR) on the other. Due to the specific characteristics of a treatment planning system (TPS), treatment strategy or delivery technique, Pareto fronts for a given case are likely to differ. The aim of this study was to investigate the feasibility of using Pareto fronts as a comparative tool for TPSs, treatment strategies and delivery techniques. In order to sample Pareto fronts, multiple treatment plans with varying target conformity and dose sparing of OAR were created for a number of prostate and head and neck IMRT cases. The DVHs of each plan were evaluated with respect to target coverage and dose to relevant OAR. Pareto fronts were successfully created for all studied cases. The results did indeed follow the definition of the Pareto concept, i.e. dose sparing of the OAR could not be improved without target coverage being impaired or vice versa. Furthermore, various treatment techniques resulted in distinguished and well separated Pareto fronts. Pareto fronts may be used to evaluate a number of parameters within radiotherapy. Examples are TPS optimization algorithms, the variation between accelerators or delivery techniques and the degradation of a plan during the treatment planning process. The issue of designing a model for unbiased comparison of parameters with such large inherent discrepancies, e.g. different TPSs, is problematic and should be carefully considered

The feasibility of using Pareto fronts for comparison of treatment planning systems and delivery techniques.

Science.gov (United States)

Ottosson, Rickard O; Engstrom, Per E; Sjöström, David; Behrens, Claus F; Karlsson, Anna; Knöös, Tommy; Ceberg, Crister

2009-01-01

Pareto optimality is a concept that formalises the trade-off between a given set of mutually contradicting objectives. A solution is said to be Pareto optimal when it is not possible to improve one objective without deteriorating at least one of the other. A set of Pareto optimal solutions constitute the Pareto front. The Pareto concept applies well to the inverse planning process, which involves inherently contradictory objectives, high and uniform target dose on one hand, and sparing of surrounding tissue and nearby organs at risk (OAR) on the other. Due to the specific characteristics of a treatment planning system (TPS), treatment strategy or delivery technique, Pareto fronts for a given case are likely to differ. The aim of this study was to investigate the feasibility of using Pareto fronts as a comparative tool for TPSs, treatment strategies and delivery techniques. In order to sample Pareto fronts, multiple treatment plans with varying target conformity and dose sparing of OAR were created for a number of prostate and head & neck IMRT cases. The DVHs of each plan were evaluated with respect to target coverage and dose to relevant OAR. Pareto fronts were successfully created for all studied cases. The results did indeed follow the definition of the Pareto concept, i.e. dose sparing of the OAR could not be improved without target coverage being impaired or vice versa. Furthermore, various treatment techniques resulted in distinguished and well separated Pareto fronts. Pareto fronts may be used to evaluate a number of parameters within radiotherapy. Examples are TPS optimization algorithms, the variation between accelerators or delivery techniques and the degradation of a plan during the treatment planning process. The issue of designing a model for unbiased comparison of parameters with such large inherent discrepancies, e.g. different TPSs, is problematic and should be carefully considered.

HDL to verification logic translator

Science.gov (United States)

Gambles, J. W.; Windley, P. J.

1992-01-01

The increasingly higher number of transistors possible in VLSI circuits compounds the difficulty in insuring correct designs. As the number of possible test cases required to exhaustively simulate a circuit design explodes, a better method is required to confirm the absence of design faults. Formal verification methods provide a way to prove, using logic, that a circuit structure correctly implements its specification. Before verification is accepted by VLSI design engineers, the stand alone verification tools that are in use in the research community must be integrated with the CAD tools used by the designers. One problem facing the acceptance of formal verification into circuit design methodology is that the structural circuit descriptions used by the designers are not appropriate for verification work and those required for verification lack some of the features needed for design. We offer a solution to this dilemma: an automatic translation from the designers' HDL models into definitions for the higher-ordered logic (HOL) verification system. The translated definitions become the low level basis of circuit verification which in turn increases the designer's confidence in the correctness of higher level behavioral models.

Z-2 Architecture Description and Requirements Verification Results

Science.gov (United States)

Graziosi, Dave; Jones, Bobby; Ferl, Jinny; Scarborough, Steve; Hewes, Linda; Ross, Amy; Rhodes, Richard

2016-01-01

, partial pressure relief valve, purge valve, donning stand and ISS Body Restraint Tether (BRT). Examples of manned requirements include verification of anthropometric range, suit self-don/doff, secondary suit exit method, donning stand self-ingress/egress and manned mobility covering eight functional tasks. The eight functional tasks include kneeling with object pick-up, standing toe touch, cross-body reach, walking, reach to the SIP and helmet visor. This paper will provide an overview of the Z-2 design. Z-2 requirements verification testing was performed with NASA at the ILC Houston test facility. This paper will also discuss pre-delivery manned and unmanned test results as well as analysis performed in support of requirements verification.

SNF verification requirements imposed through 10 CFR Part 961: Interrelationship with MC ampersand A requirements for the OCRWM safeguards system

International Nuclear Information System (INIS)

Slater, N.; Vance, S.

1994-01-01

Article VI.B.2 of the Standard Contract for Disposal of Spent Nuclear Fuel and/or High-Level Radioactive Waste (10 CFR Part 961, Standard Contract) provides that spent nuclear fuel shall be subject to verification prior to acceptance by the Department of Energy. As part of the overall process for scheduling deliveries of spent nuclear fuel, the Standard Contract requires contract holders to submit detailed descriptions of the spent nuclear fuel they intend to deliver. Thus, the provision for verification in the Standard contract allows the Department the opportunity to ensure that the spent nuclear fuel intended for deliver is consistent with the description provided, and that the material is properly loaded, packaged, marked, and labeled. The Department is currently evaluating the verification requirements for spent nuclear fuel that it will establish pursuant to Article VI.B.2 of the Standard Contract. The Department recognizes that there may be significant overlap between these verification requirements and the requirements established for material control and accountability (MC ampersand A). Therefore, the Department may recommend modifications to the process established in the Standard Contract to ensure that the verification and MC ampersand A functions and activities are fully integrated

Formulating adaptive radiation therapy (ART) treatment planning into a closed-loop control framework

International Nuclear Information System (INIS)

Zerda, Adam de la; Armbruster, Benjamin; Xing Lei

2007-01-01

While ART has been studied for years, the specific quantitative implementation details have not. In order for this new scheme of radiation therapy (RT) to reach its potential, an effective ART treatment planning strategy capable of taking into account the dose delivery history and the patient's on-treatment geometric model must be in place. This paper performs a theoretical study of dynamic closed-loop control algorithms for ART and compares their utility with data from phantom and clinical cases. We developed two classes of algorithms: those Adapting to Changing Geometry and those Adapting to Geometry and Delivered Dose. The former class takes into account organ deformations found just before treatment. The latter class optimizes the dose distribution accumulated over the entire course of treatment by adapting at each fraction, not only to the information just before treatment about organ deformations but also to the dose delivery history. We showcase two algorithms in the class of those Adapting to Geometry and Delivered Dose. A comparison of the approaches indicates that certain closed-loop ART algorithms may significantly improve the current practice. We anticipate that improvements in imaging, dose verification and reporting will further increase the importance of adaptive algorithms

Verification and implications of the multiple pin treatment in the SASSYS-1 LMR systems analysis code

International Nuclear Information System (INIS)

Dunn, F.E.

1994-01-01

As part of a program to obtain realistic, as opposed to excessively conservative, analysis of reactor transients, a multiple pin treatment for the analysis of intra-subassembly thermal hydraulics has been included in the SASSYS-1 liquid metal reactor systems analysis code. This new treatment has made possible a whole new level of verification for the code. The code can now predict the steady-state and transient responses of individual thermocouples within instrumented subassemlies in a reactor, rather than just predicting average temperatures for a subassembly. Very good agreement has been achieved between code predictions and the experimental measurements of steady-state and transient temperatures and flow rates in the Shutdown Heat Removal Tests in the EBR-II Reactor. Detailed multiple pin calculations for blanket subassemblies in the EBR-II reactor demonstrate that the actual steady-state and transient peak temperatures in these subassemblies are significantly lower than those that would be calculated by simpler models

A Blockchain Ecosystem for Digital Identity: Improving Service Delivery in Canada’s Public and Private Sectors

Directory of Open Access Journals (Sweden)

Greg Wolfond

2017-10-01

Full Text Available Blockchain-based solutions have the potential to make government operations more efficient and improve the delivery of services in the public and private sectors. Identity verification and authentication technologies, as one of the applications of blockchain-based solutions – and the focus of our own efforts at SecureKey Technologies – have been critical components in service delivery in both sectors due to their power to increase trust between citizens and the services they access. To convert trust into solid value added, identities must be validated through highly-reliable technologies, such as blockchain, that have the capacity to reduce cost and fraud and to simplify the experience for customers while also keeping out the bad actors. With identities migrating to digital platforms, organizations and citizens need to be able to transact with reduced friction even as more counter-bound services move to online delivery. In this article, drawing on our own experiences with an ecosystem approach to digital identity, we describe the potential value of using blockchain technology to address the present and future challenges of identity verification and authentication within a Canadian context.

19 CFR 10.470 - Verification and justification of claim for preferential treatment.

Science.gov (United States)

2010-04-01

... accounting and financial records, information relating to the place of production, the number and...) Applicable accounting principles. When conducting a verification of origin to which Generally Accepted Accounting Principles may be relevant, CBP will apply and accept the Generally Accepted Accounting Principles...

PLGA-Chitosan nanoparticle-mediated gene delivery for oral cancer treatment: A brief review

Science.gov (United States)

Bakar, L. M.; Abdullah, M. Z.; Doolaanea, A. A.; Ichwan, S. J. A.

2017-08-01

Cancer becomes a serious issue on society with increasing of their growth and proliferation, either in well economic developed countries or not. Recent years, oral cancer is one of the most threatening diseases impairing the quality of life of the patient. Scientists have emphasised on application of gene therapy for oral cancer by using nanoparticle as transportation vectors as a new alternative platform in order to overcome the limitations of conventional approaches. In modern medicine, nanotechnologies’ application, such as nanoparticles-mediated gene delivery, is one of promising tool for therapeutic devices. The objective of this article is to present a brief review summarizes on the current progress of nanotechnology-based gene delivery treatment system targeted for oral cancer.

Automation and uncertainty analysis of a method for in-vivo range verification in particle therapy.

Science.gov (United States)

Frey, K; Unholtz, D; Bauer, J; Debus, J; Min, C H; Bortfeld, T; Paganetti, H; Parodi, K

2014-10-07

We introduce the automation of the range difference calculation deduced from particle-irradiation induced β(+)-activity distributions with the so-called most-likely-shift approach, and evaluate its reliability via the monitoring of algorithm- and patient-specific uncertainty factors. The calculation of the range deviation is based on the minimization of the absolute profile differences in the distal part of two activity depth profiles shifted against each other. Depending on the workflow of positron emission tomography (PET)-based range verification, the two profiles under evaluation can correspond to measured and simulated distributions, or only measured data from different treatment sessions. In comparison to previous work, the proposed approach includes an automated identification of the distal region of interest for each pair of PET depth profiles and under consideration of the planned dose distribution, resulting in the optimal shift distance. Moreover, it introduces an estimate of uncertainty associated to the identified shift, which is then used as weighting factor to 'red flag' problematic large range differences. Furthermore, additional patient-specific uncertainty factors are calculated using available computed tomography (CT) data to support the range analysis. The performance of the new method for in-vivo treatment verification in the clinical routine is investigated with in-room PET images for proton therapy as well as with offline PET images for proton and carbon ion therapy. The comparison between measured PET activity distributions and predictions obtained by Monte Carlo simulations or measurements from previous treatment fractions is performed. For this purpose, a total of 15 patient datasets were analyzed, which were acquired at Massachusetts General Hospital and Heidelberg Ion-Beam Therapy Center with in-room PET and offline PET/CT scanners, respectively. Calculated range differences between the compared activity distributions are reported in a

Nanomedicine and drug delivery strategies for treatment of inflammatory bowel disease.

Science.gov (United States)

Takedatsu, Hidetoshi; Mitsuyama, Keiichi; Torimura, Takuji

2015-10-28

Crohn's disease and ulcerative colitis are two important categories of human inflammatory bowel disease (IBD). Because the precise mechanisms of the inflammation and immune responses in IBD have not been fully elucidated, the treatment of IBD primarily aims to inhibit the pathogenic factors of the inflammatory cascade. Inconsistencies exist regarding the response and side effects of the drugs that are currently used to treat IBD. Recent studies have suggested that the use of nanomedicine might be advantageous for the treatment of intestinal inflammation because nano-sized molecules can effectively penetrate epithelial and inflammatory cells. We reviewed nanomedicine treatments, such as the use of small interfering RNAs, antisense oligonucleotides, and anti-inflammatory molecules with delivery systems in experimental colitis models and clinical trials for IBD based on a systematic search. The efficacy and usefulness of the treatments reviewed in this manuscript have been demonstrated in experimental colitis models and clinical trials using various types of nanomedicine. Nanomedicine is expected to become a new therapeutic approach to the treatment of IBD.

Verification of setup errors in external beam radiation therapy using electronic portal imaging

International Nuclear Information System (INIS)

Krishna Murthy, K.; Al-Rahbi, Zakiya; Sivakumar, S.S.; Davis, C.A.; Ravichandran, R.

2008-01-01

The objective of this study was to conduct an audit on QA aspects of treatment delivery by the verification of the treatment fields position on different days to document the efficiency of immobilization methods and reproducibility of treatment. A retrospective study was carried out on 60 patients, each 20 treated for head and neck, breast, and pelvic sites; and a total of 506 images obtained by electronic portal imaging device (EPID) were analyzed. The portal images acquired using the EPID systems attached to the Varian linear accelerators were superimposed on the reference images. The anatomy matching software (Varian portal Vision. 6.0) was used, and the displacements in two dimensions and rotation were noted for each treated field to study the patient setup errors. The percentages of mean deviations more than 3 mm in lateral (X) and longitudinal (Y) directions were 17.5%, 11.25%, and 7.5% for breast, pelvis, and head and neck cases respectively. In all cases, the percentage of mean deviation with more than 5 mm error was 0.83%. The maximum average mean deviation in all the cases was 1.87. The average mean SD along X and Y directions in all the cases was less than 2.65. The results revealed that the ranges of setup errors are site specific and immobilization methods improve reproducibility. The observed variations were well within the limits. The study confirmed the accuracy and quality of treatments delivered to the patients. (author)

Likelihood-ratio-based biometric verification

NARCIS (Netherlands)

Bazen, A.M.; Veldhuis, Raymond N.J.

2002-01-01

This paper presents results on optimal similarity measures for biometric verification based on fixed-length feature vectors. First, we show that the verification of a single user is equivalent to the detection problem, which implies that for single-user verification the likelihood ratio is optimal.

Likelihood Ratio-Based Biometric Verification

NARCIS (Netherlands)

Bazen, A.M.; Veldhuis, Raymond N.J.

The paper presents results on optimal similarity measures for biometric verification based on fixed-length feature vectors. First, we show that the verification of a single user is equivalent to the detection problem, which implies that, for single-user verification, the likelihood ratio is optimal.

Radiation dose verification using real tissue phantom in modern radiotherapy techniques

International Nuclear Information System (INIS)

Gurjar, Om Prakash; Mishra, S.P.; Bhandari, Virendra; Pathak, Pankaj; Patel, Prapti; Shrivastav, Garima

2014-01-01

In vitro dosimetric verification prior to patient treatment has a key role in accurate and precision radiotherapy treatment delivery. Most of commercially available dosimetric phantoms have almost homogeneous density throughout their volume, while real interior of patient body has variable and varying densities inside. In this study an attempt has been made to verify the physical dosimetry in actual human body scenario by using goat head as 'head phantom' and goat meat as 'tissue phantom'. The mean percentage variation between planned and measured doses was found to be 2.48 (standard deviation (SD): 0.74), 2.36 (SD: 0.77), 3.62 (SD: 1.05), and 3.31 (SD: 0.78) for three-dimensional conformal radiotherapy (3DCRT) (head phantom), intensity modulated radiotherapy (IMRT; head phantom), 3DCRT (tissue phantom), and IMRT (tissue phantom), respectively. Although percentage variations in case of head phantom were within tolerance limit (< ± 3%), but still it is higher than the results obtained by using commercially available phantoms. And the percentage variations in most of cases of tissue phantom were out of tolerance limit. On the basis of these preliminary results it is logical and rational to develop radiation dosimetry methods based on real human body and also to develop an artificial phantom which should truly represent the interior of human body. (author)

Radiation dose verification using real tissue phantom in modern radiotherapy techniques

Directory of Open Access Journals (Sweden)

Om Prakash Gurjar

2014-01-01

Full Text Available In vitro dosimetric verification prior to patient treatment has a key role in accurate and precision radiotherapy treatment delivery. Most of commercially available dosimetric phantoms have almost homogeneous density throughout their volume, while real interior of patient body has variable and varying densities inside. In this study an attempt has been made to verify the physical dosimetry in actual human body scenario by using goat head as "head phantom" and goat meat as "tissue phantom". The mean percentage variation between planned and measured doses was found to be 2.48 (standard deviation (SD: 0.74, 2.36 (SD: 0.77, 3.62 (SD: 1.05, and 3.31 (SD: 0.78 for three-dimensional conformal radiotherapy (3DCRT (head phantom, intensity modulated radiotherapy (IMRT; head phantom, 3DCRT (tissue phantom, and IMRT (tissue phantom, respectively. Although percentage variations in case of head phantom were within tolerance limit (< ± 3%, but still it is higher than the results obtained by using commercially available phantoms. And the percentage variations in most of cases of tissue phantom were out of tolerance limit. On the basis of these preliminary results it is logical and rational to develop radiation dosimetry methods based on real human body and also to develop an artificial phantom which should truly represent the interior of human body.

Cell based-gene delivery approaches for the treatment of spinal cord injury and neurodegenerative disorders.

Science.gov (United States)

Taha, Masoumeh Fakhr

2010-03-01

Cell based-gene delivery has provided an important therapeutic strategy for different disorders in the recent years. This strategy is based on the transplantation of genetically modified cells to express specific genes and to target the delivery of therapeutic factors, especially for the treatment of cancers and neurological, immunological, cardiovascular and heamatopoietic disorders. Although, preliminary reports are encouraging, and experimental studies indicate functionally and structurally improvements in the animal models of different disorders, universal application of this strategy for human diseases requires more evidence. There are a number of parameters that need to be evaluated, including the optimal cell source, the most effective gene/genes to be delivered, the optimal vector and method of gene delivery into the cells and the most efficient route for the delivery of genetically modified cells into the patient. Also, some obstacles have to be overcome, including the safety and usefulness of the approaches and the stability of the improvements. Here, recent studies concerning with the cell-based gene delivery for spinal cord injury and some neurodegenerative disorders such as amyotrophic lateral sclerosis, Parkinson's disease and Alzheimer's disease are briefly reviewed, and their exciting consequences are discussed.

Cell mediated therapeutics for cancer treatment: Tumor homing cells as therapeutic delivery vehicles

Science.gov (United States)

Balivada, Sivasai

Many cell types were known to have migratory properties towards tumors and different research groups have shown reliable results regarding cells as delivery vehicles of therapeutics for targeted cancer treatment. Present report discusses proof of concept for 1. Cell mediated delivery of Magnetic nanoparticles (MNPs) and targeted Magnetic hyperthermia (MHT) as a cancer treatment by using in vivo mouse cancer models, 2. Cells surface engineering with chimeric proteins for targeted cancer treatment by using in vitro models. 1. Tumor homing cells can carry MNPs specifically to the tumor site and tumor burden will decrease after alternating magnetic field (AMF) exposure. To test this hypothesis, first we loaded Fe/Fe3O4 bi-magnetic NPs into neural progenitor cells (NPCs), which were previously shown to migrate towards melanoma tumors. We observed that NPCs loaded with MNPs travel to subcutaneous melanoma tumors. After alternating magnetic field (AMF) exposure, the targeted delivery of MNPs by the NPCs resulted in a mild decrease in tumor size (Chapter-2). Monocytes/macrophages (Mo/Ma) are known to infiltrate tumor sites, and also have phagocytic activity which can increase their uptake of MNPs. To test Mo/Ma-mediated MHT we transplanted Mo/Ma loaded with MNPs into a mouse model of pancreatic peritoneal carcinomatosis. We observed that MNP-loaded Mo/Ma infiltrated pancreatic tumors and, after AMF treatment, significantly prolonged the lives of mice bearing disseminated intraperitoneal pancreatic tumors (Chapter-3). 2. Targeted cancer treatment could be achieved by engineering tumor homing cell surfaces with tumor proteases cleavable, cancer cell specific recombinant therapeutic proteins. To test this, Urokinase and Calpain (tumor specific proteases) cleavable; prostate cancer cell (CaP) specific (CaP1 targeting peptide); apoptosis inducible (Caspase3 V266ED3)- rCasp3V266ED3 chimeric protein was designed in silico. Hypothesized membrane anchored chimeric protein (rCasp3V

Scalable Techniques for Formal Verification

CERN Document Server

Ray, Sandip

2010-01-01

This book presents state-of-the-art approaches to formal verification techniques to seamlessly integrate different formal verification methods within a single logical foundation. It should benefit researchers and practitioners looking to get a broad overview of the spectrum of formal verification techniques, as well as approaches to combining such techniques within a single framework. Coverage includes a range of case studies showing how such combination is fruitful in developing a scalable verification methodology for industrial designs. This book outlines both theoretical and practical issue

Pre-treatment verification of RapidArc® using Electronic Portal Imaging Device; Verificacao pre-tratamento de RapidArc® utilizando Dispositivo Eletronico de Imagem Porta

Energy Technology Data Exchange (ETDEWEB)

Lima, Marilia B.; Ferreira, Anne Caroline M.; Bittencourt, Guilherme R.; Pirani, Luis F.; Silveira, Thiago B., E-mail: mbeckerlima@gmail.com [Instituto Nacional do Cancer (INCA), Rio de Janeiro, RJ (Brazil)

2012-12-15

The RapidArc® is a novel but widespread technique to achieve intensity modulated beams. One of the major challenges concerning this technique is the pretreatment verification process. The aim of this paper was to analyze the viability of the Electronic Portal Imaging Device (EPID) used to perform the verification of RapidArc® using the Sun Nuclear SNC Patient software enable to EPID dose conversion (EPIDose license) and compare its results with punctual dose measurements against a low volume ion chamber. There were analyze five RapidArc® planning, evaluating, separately, planar and punctual doses for each arc. For punctual measurements was used a 0,15 cm³ volume ion chamber and the planar distributions, in Calibration Units (CU), were acquired using the EPID and then converted to absolute dose in centigray through EPIDose. The predicted doses were calculated using the AAA algorithm in Eclipse treatment planning system, version 8.6. The planar comparisons, performed in SNC Patient, employed the Gamma Index tool with a 4% dose difference, 4 mm distance to agreement and 20% threshold. The evaluation of punctual dose was defined by calculating deviations between predicted and measured doses. The mean approval percentage in planar distributions was 94.8% and the average deviation in punctual dose was -1.2%. The use of EPID for RapidArc® pre-treatment verification proved to be feasible and showed good sensibility, because of its high spatial resolution. However one must consider the uncertainty of the method. (author)

19 CFR 10.616 - Verification and justification of claim for preferential tariff treatment.

Science.gov (United States)

2010-04-01

.... (b) Applicable accounting principles. When conducting a verification of origin to which Generally Accepted Accounting Principles may be relevant, CBP will apply and accept the Generally Accepted Accounting Principles applicable in the country of production. ...

Self-verification and social anxiety: preference for negative social feedback and low social self-esteem.

Science.gov (United States)

Valentiner, David P; Skowronski, John J; McGrath, Patrick B; Smith, Sarah A; Renner, Kerry A

2011-10-01

A self-verification model of social anxiety views negative social self-esteem as a core feature of social anxiety. This core feature is proposed to be maintained through self-verification processes, such as by leading individuals with negative social self-esteem to prefer negative social feedback. This model is tested in two studies. In Study 1, questionnaires were administered to a college sample (N = 317). In Study 2, questionnaires were administered to anxiety disordered patients (N = 62) before and after treatment. Study 1 developed measures of preference for negative social feedback and social self-esteem, and provided evidence of their incremental validity in a college sample. Study 2 found that these two variables are not strongly related to fears of evaluation, are relatively unaffected by a treatment that targets such fears, and predict residual social anxiety following treatment. Overall, these studies provide preliminary evidence for a self-verification model of social anxiety.

SU-E-T-183: Clinical Quality Assurance Workflow for Dynamic Tumor Tracking Radiation Dose Delivery

International Nuclear Information System (INIS)

Mamalui-Hunter, M; Su, Z; Li, Z

2015-01-01

Purpose: One of the most important aspects of implementation of new treatment modalities is an ‘end-to-end’ verification of the treatment process. Radiation treatment based on dynamic tracking of a tumor is highly patient-specific, therefore, special attention should be paid to quality assurance of the treatment delivery. Our goal was to design the clinical workflow that ensures accurate delivery of the planned dose using the Dynamic Target Tracking option of VeroTM (BrainLab,MHI) linac. Methods: A patient simulation is designed to include a pre-treatment session to verify whether the system can reliably track the motion of the implanted marker and build the 4D model of the target motion. The external surrogate and target motion patterns are recorded in the ExactracTM log files. In this work, a spectrum of custom marker and external surrogate motion trajectories closely resembling the patient specific motion patterns was used. 1mm thick/11mm long VisicoilTM marker was placed 15 and 20mm from the center of the spherical tissue equivalent target (centroid to centroid distance) in the 4D motion phantom (CIRSTM). 3D conformal (3 mm block margin) SBRT plans were delivered to 2 moving targets in the phantom: 1) 20mm diameter target that allows ion chamber dose measurement and 2) 25mm target that allows using film to measure CAX dose (GafchromicTM EBT3 used). The measured dose was compared to the iPlanTM TPS results using MonteCarlo algorithm (1% variance, Dose-to-water). Results: On average, film shows 98.9% pass using gamma criterion for 2% and 2mm DTA, 94.3% match for 2% and 1 mm DTA, 98% pass for 1% and 2 mm DTA however only 88% points passing for 1% and 1 mm DTA. Ion chamber measurements agreed with the calculation within 1.5%. Conclusion: The clinical QA workflow was designed for SBRT delivery using real-time tumor tracking on VeroTM linac

Exploring implementation practices in results-based financing: the case of the verification in Benin.

Science.gov (United States)

Antony, Matthieu; Bertone, Maria Paola; Barthes, Olivier

2017-03-14

Results-based financing (RBF) has been introduced in many countries across Africa and a growing literature is building around the assessment of their impact. These studies are usually quantitative and often silent on the paths and processes through which results are achieved and on the wider health system effects of RBF. To address this gap, our study aims at exploring the implementation of an RBF pilot in Benin, focusing on the verification of results. The study is based on action research carried out by authors involved in the pilot as part of the agency supporting the RBF implementation in Benin. While our participant observation and operational collaboration with project's stakeholders informed the study, the analysis is mostly based on quantitative and qualitative secondary data, collected throughout the project's implementation and documentation processes. Data include project documents, reports and budgets, RBF data on service outputs and on the outcome of the verification, daily activity timesheets of the technical assistants in the districts, as well as focus groups with Community-based Organizations and informal interviews with technical assistants and district medical officers. Our analysis focuses on the actual practices of quantitative, qualitative and community verification. Results show that the verification processes are complex, costly and time-consuming, and in practice they end up differing from what designed originally. We explore the consequences of this on the operation of the scheme, on its potential to generate the envisaged change. We find, for example, that the time taken up by verification procedures limits the time available for data analysis and feedback to facility staff, thus limiting the potential to improve service delivery. Verification challenges also result in delays in bonus payment, which delink effort and reward. Additionally, the limited integration of the verification activities of district teams with their routine tasks

Floating Microparticulate Oral Diltiazem Hydrochloride Delivery ...

African Journals Online (AJOL)

Delivery System for Improved Delivery to Heart ... Conclusion: Microparticulate floating (gastroretentive) oral drug delivery system of diltiazem prepared ..... treatment of cardiac disease. ... hydrochloride-loaded mucoadhesive microspheres.

SU-E-T-370: Evaluating Plan Quality and Dose Delivery Accuracy of Tomotherapy SBRT Treatments for Lung Cancer

Energy Technology Data Exchange (ETDEWEB)

Blake, S; Thwaites, D [University of Sydney, Sydney, NSW (Australia); Hansen, C [Odense University Hospital, Odense C (Denmark); Deshpande, S; Phan, P; Franji, I [Liverpool & Macarthur Cancer Therapy Centres, Liverpool, NSW (United Kingdom); Holloway, L [Ingham Institute, Sydney, NSW (Australia)

2015-06-15

Purpose: This study evaluated the plan quality and dose delivery accuracy of stereotactic body radiotherapy (SBRT) helical Tomotherapy (HT) treatments for lung cancer. Results were compared with those previously reported by our group for flattening filter (FF) and flattening filter free (FFF) VMAT treatments. This work forms part of an ongoing multicentre and multisystem planning and dosimetry audit on FFF beams for lung SBRT. Methods: CT datasets and DICOM RT structures delineating the target volume and organs at risk for 6 lung cancer patients were selected. Treatment plans were generated using the HT treatment planning system. Tumour locations were classified as near rib, near bronchial tree or in free lung with prescribed doses of 48Gy/4fr, 50Gy/5fr and 54Gy/3fr respectively. Dose constraints were specified by a modified RTOG0915 protocol used for an Australian SBRT phase II trial. Plan quality was evaluated using mean PTV dose, PTV volume receiving 100% of the prescribed dose (V100%), target conformity (CI=VD100%/VPTV) and low dose spillage (LDS=VD50%/VPTV). Planned dose distributions were compared to those measured using an ArcCheck phantom. Delivery accuracy was evaluated using a gamma-index pass rate of 95% with 3% (of max dose) and 3mm criteria. Results: Treatment plans for all patients were clinically acceptable in terms of quality and accuracy of dose delivery. The following DVH metrics are reported as averages (SD) of all plans investigated: mean PTV dose was 115.3(2.4)% of prescription, V100% was 98.8(0.9)%, CI was 1.14(0.03) and LDS was 5.02(0.37). The plans had an average gamma-index passing rate of 99.3(1.3)%. Conclusion: The results reported in this study for HT agree within 1 SD to those previously published by our group for VMAT FF and FFF lung SBRT treatments. This suggests that HT delivers lung SBRT treatments of comparable quality and delivery accuracy as VMAT using both FF and FFF beams.

STRATEGIES AND PROSPECTS OF NASAL DRUG DELIVERY SYSTEMS

OpenAIRE

Gannu Praveen Kumar

2012-01-01

The recent advancement of nasal drug delivery systems has increased enormously and is gaining significant importance. Intranasal therapy has been an accepted form of treatment in the Ayurvedic system of Indian Medicine. The non-invasive delivery of nasal drug delivery systems made to exploit for the development of successful treatment. The advantages, disadvantages, mechanism of action and application of nasal drug delivery system in local delivery, systematic delivery, nasal vaccines and CNS...

Frame average optimization of cine-mode EPID images used for routine clinical in vivo patient dose verification of VMAT deliveries

Energy Technology Data Exchange (ETDEWEB)

McCowan, P. M., E-mail: pmccowan@cancercare.mb.ca [Department of Physics and Astronomy, University of Manitoba, Winnipeg, Manitoba R3T 2N2, Canada and Medical Physics Department, CancerCare Manitoba, 675 McDermot Avenue, Winnipeg, Manitoba R3E 0V9 (Canada); McCurdy, B. M. C. [Department of Physics and Astronomy, University of Manitoba, Winnipeg, Manitoba R3T 2N2 (Canada); Medical Physics Department, CancerCare Manitoba, 675 McDermot Avenue, Winnipeg, Manitoba R3E 0V9 (Canada); Department of Radiology, University of Manitoba, 820 Sherbrook Street, Winnipeg, Manitoba R3A 1R9 (Canada)

2016-01-15

Purpose: The in vivo 3D dose delivered to a patient during volumetric modulated arc therapy (VMAT) delivery can be calculated using electronic portal imaging device (EPID) images. These images must be acquired in cine-mode (i.e., “movie” mode) in order to capture the time-dependent delivery information. The angle subtended by each cine-mode EPID image during an arc can be changed via the frame averaging number selected within the image acquisition software. A large frame average number will decrease the EPID’s angular resolution and will result in a decrease in the accuracy of the dose information contained within each image. Alternatively, less EPID images acquired per delivery will decrease the overall 3D patient dose calculation time, which is appealing for large-scale clinical implementation. Therefore, the purpose of this study was to determine the optimal frame average value per EPID image, defined as the highest frame averaging that can be used without an appreciable loss in 3D dose reconstruction accuracy for VMAT treatments. Methods: Six different VMAT plans and six different SBRT-VMAT plans were delivered to an anthropomorphic phantom. Delivery was carried out on a Varian 2300ix model linear accelerator (Linac) equipped with an aS1000 EPID running at a frame acquisition rate of 7.5 Hz. An additional PC was set up at the Linac console area, equipped with specialized frame-grabber hardware and software packages allowing continuous acquisition of all EPID frames during delivery. Frames were averaged into “frame-averaged” EPID images using MATLAB. Each frame-averaged data set was used to calculate the in vivo dose to the patient and then compared to the single EPID frame in vivo dose calculation (the single frame calculation represents the highest possible angular resolution per EPID image). A mean percentage dose difference of low dose (<20% prescription dose) and high dose regions (>80% prescription dose) was calculated for each frame averaged

Frame average optimization of cine-mode EPID images used for routine clinical in vivo patient dose verification of VMAT deliveries

International Nuclear Information System (INIS)

McCowan, P. M.; McCurdy, B. M. C.

2016-01-01

Purpose: The in vivo 3D dose delivered to a patient during volumetric modulated arc therapy (VMAT) delivery can be calculated using electronic portal imaging device (EPID) images. These images must be acquired in cine-mode (i.e., “movie” mode) in order to capture the time-dependent delivery information. The angle subtended by each cine-mode EPID image during an arc can be changed via the frame averaging number selected within the image acquisition software. A large frame average number will decrease the EPID’s angular resolution and will result in a decrease in the accuracy of the dose information contained within each image. Alternatively, less EPID images acquired per delivery will decrease the overall 3D patient dose calculation time, which is appealing for large-scale clinical implementation. Therefore, the purpose of this study was to determine the optimal frame average value per EPID image, defined as the highest frame averaging that can be used without an appreciable loss in 3D dose reconstruction accuracy for VMAT treatments. Methods: Six different VMAT plans and six different SBRT-VMAT plans were delivered to an anthropomorphic phantom. Delivery was carried out on a Varian 2300ix model linear accelerator (Linac) equipped with an aS1000 EPID running at a frame acquisition rate of 7.5 Hz. An additional PC was set up at the Linac console area, equipped with specialized frame-grabber hardware and software packages allowing continuous acquisition of all EPID frames during delivery. Frames were averaged into “frame-averaged” EPID images using MATLAB. Each frame-averaged data set was used to calculate the in vivo dose to the patient and then compared to the single EPID frame in vivo dose calculation (the single frame calculation represents the highest possible angular resolution per EPID image). A mean percentage dose difference of low dose ( 80% prescription dose) was calculated for each frame averaged scenario for each plan. The authors defined their

Online pretreatment verification of high-dose rate brachytherapy using an imaging panel

Science.gov (United States)

Fonseca, Gabriel P.; Podesta, Mark; Bellezzo, Murillo; Van den Bosch, Michiel R.; Lutgens, Ludy; Vanneste, Ben G. L.; Voncken, Robert; Van Limbergen, Evert J.; Reniers, Brigitte; Verhaegen, Frank

2017-07-01

Brachytherapy is employed to treat a wide variety of cancers. However, an accurate treatment verification method is currently not available. This study describes a pre-treatment verification system that uses an imaging panel (IP) to verify important aspects of the treatment plan. A detailed modelling of the IP was only possible with an extensive calibration performed using a robotic arm. Irradiations were performed with a high dose rate (HDR) 192Ir source within a water phantom. An empirical fit was applied to measure the distance between the source and the detector so 3D Cartesian coordinates of the dwell positions can be obtained using a single panel. The IP acquires 7.14 fps to verify the dwell times, dwell positions and air kerma strength (Sk). A gynecological applicator was used to create a treatment plan that was registered with a CT image of the water phantom used during the experiments for verification purposes. Errors (shifts, exchanged connections and wrong dwell times) were simulated to verify the proposed verification system. Cartesian source positions (panel measurement plane) have a standard deviation of about 0.02 cm. The measured distance between the source and the panel (z-coordinate) have a standard deviation up to 0.16 cm and maximum absolute error of  ≈0.6 cm if the signal is close to sensitive limit of the panel. The average response of the panel is very linear with Sk. Therefore, Sk measurements can be performed with relatively small errors. The measured dwell times show a maximum error of 0.2 s which is consistent with the acquisition rate of the panel. All simulated errors were clearly identified by the proposed system. The use of IPs is not common in brachytherapy, however, it provides considerable advantages. It was demonstrated that the IP can accurately measure Sk, dwell times and dwell positions.

Noninvasive ocular drug delivery: potential transcorneal and other alternative delivery routes for therapeutic molecules in glaucoma.

Science.gov (United States)

Foldvari, Marianna

2014-01-01

Drug delivery to the eye is made difficult by multiple barriers (such as the tear film, cornea, and vitreous) between the surface of the eye and the treatment site. These barriers are difficult to surmount for the purposes of drug delivery without causing toxicity. Using nanotechnology tools to control, manipulate, and study delivery systems, new approaches to delivering drugs, genes, and antigens that are effective and safe can be developed. Topical administration to the ocular surface would be the safest method for delivery, as it is noninvasive and painless compared with other delivery methods. However, there is only limited success using topical delivery methods, especially for gene therapy. Current thinking on treatments of the future enabled by nanodelivery systems and the identification of target specificity parameters that require deeper understanding to develop successful topical delivery systems for glaucoma is highlighted.

Microspheres and Nanotechnology for Drug Delivery.

Science.gov (United States)

Jóhannesson, Gauti; Stefánsson, Einar; Loftsson, Thorsteinn

2016-01-01

Ocular drug delivery to the posterior segment of the eye can be accomplished by invasive drug injections into different tissues of the eye and noninvasive topical treatment. Invasive treatment involves the risks of surgical trauma and infection, and conventional topical treatments are ineffective in delivering drugs to the posterior segment of the eye. In recent years, nanotechnology has become an ever-increasing part of ocular drug delivery. In the following, we briefly review microspheres and nanotechnology for drug delivery to the eye, including different forms of nanotechnology such as nanoparticles, microparticles, liposomes, microemulsions and micromachines. The permeation barriers and anatomical considerations linked to ocular drug delivery are discussed and a theoretical overview on drug delivery through biological membranes is given. Finally, in vitro, in vivo and human studies of x03B3;-cyclodextrin nanoparticle eyedrop suspensions are discussed as an example of nanotechnology used for drug delivery to the eye. © 2016 S. Karger AG, Basel.

Can self-verification strivings fully transcend the self-other barrier? Seeking verification of ingroup identities.

Science.gov (United States)

Gómez, Angel; Seyle, D Conor; Huici, Carmen; Swann, William B

2009-12-01

Recent research has demonstrated self-verification strivings in groups, such that people strive to verify collective identities, which are personal self-views (e.g., "sensitive") associated with group membership (e.g., "women"). Such demonstrations stop short of showing that the desire for self-verification can fully transcend the self-other barrier, as in people working to verify ingroup identities (e.g., "Americans are loud") even when such identities are not self-descriptive ("I am quiet and unassuming"). Five studies focus on such ingroup verification strivings. Results indicate that people prefer to interact with individuals who verify their ingroup identities over those who enhance these identities (Experiments 1-5). Strivings for ingroup identity verification were independent of the extent to which the identities were self-descriptive but were stronger among participants who were highly invested in their ingroup identities, as reflected in high certainty of these identities (Experiments 1-4) and high identification with the group (Experiments 1-5). In addition, whereas past demonstrations of self-verification strivings have been limited to efforts to verify the content of identities (Experiments 1 to 3), the findings also show that they strive to verify the valence of their identities (i.e., the extent to which the identities are valued; Experiments 4 and 5). Self-verification strivings, rather than self-enhancement strivings, appeared to motivate participants' strivings for ingroup identity verification. Links to collective self-verification strivings and social identity theory are discussed.

Risk Factors for Uterine Atony/Postpartum Hemorrhage Requiring Treatment after Vaginal Delivery

Science.gov (United States)

Wetta, Luisa A; Szychowski, Jeff M; Seals, Ms. Samantha; Mancuso, Melissa S; Biggio, Joseph R; Tita, Alan TN

2013-01-01

Objective To identify risk factors for uterine atony or hemorrhage. Study Design Secondary analysis of a 3-arm double-blind randomized trial of different dose-regimens of oxytocin to prevent uterine atony after vaginal delivery. The primary outcome was uterine atony or hemorrhage requiring treatment. Twenty-one potential risk factors were evaluated. Logistic regression was used to identify independent risk factors using 2 complementary pre-defined model selection strategies. Results Among 1798 women randomized to 10, 40 or 80U prophylactic oxytocin after vaginal delivery, treated uterine atony occurred in 7%. Hispanic (OR 2.1; 95% CI 1.3–3.4) and non-Hispanic whites (OR 1.6; 95% CI 1.0–2.5), preeclampsia (OR 3.2; 95% CI 2.0–4.9) and chorioamnionitis (OR 2.8; 95% CI 1.6–5.0) were consistent independent risk factors. Other risk factors based on the specified selection strategies were obesity, induction/augmentation of labor, twins, hydramnios, anemia, and arrest of descent. Amnioinfusion appeared to be protective against uterine atony (OR 0.53; 95% CI 0.29–0.98). Conclusion Independent risk factors for uterine atony requiring treatment include Hispanic and non-Hispanic white ethnicity, preeclampsia and chorioamnionitis. PMID:23507549

Peptide and protein delivery using new drug delivery systems.

Science.gov (United States)

Jain, Ashish; Jain, Aviral; Gulbake, Arvind; Shilpi, Satish; Hurkat, Pooja; Jain, Sanjay K

2013-01-01

Pharmaceutical and biotechnological research sorts protein drug delivery systems by importance based on their various therapeutic applications. The effective and potent action of the proteins/peptides makes them the drugs of choice for the treatment of numerous diseases. Major research issues in protein delivery include the stabilization of proteins in delivery devices and the design of appropriate target-specific protein carriers. Many efforts have been made for effective delivery of proteins/peptidal drugs through various routes of administrations for successful therapeutic effects. Nanoparticles made of biodegradable polymers such as poly lactic acid, polycaprolactone, poly(lactic-co-glycolic acid), the poly(fumaric-co-sebacic) anhydride chitosan, and modified chitosan, as well as solid lipids, have shown great potential in the delivery of proteins/peptidal drugs. Moreover, scientists also have used liposomes, PEGylated liposomes, niosomes, and aquasomes, among others, for peptidal drug delivery. They also have developed hydrogels and transdermal drug delivery systems for peptidal drug delivery. A receptor-mediated delivery system is another attractive strategy to overcome the limitation in drug absorption that enables the transcytosis of the protein across the epithelial barrier. Modification such as PEGnology is applied to various proteins and peptides of the desired protein and peptides also increases the circulating life, solubility and stability, pharmacokinetic properties, and antigenicity of protein. This review focuses on various approaches for effective protein/peptidal drug delivery, with special emphasis on insulin delivery.

EPID-based verification of the MLC performance for dynamic IMRT and VMAT

International Nuclear Information System (INIS)

Rowshanfarzad, Pejman; Sabet, Mahsheed; Barnes, Michael P.; O’Connor, Daryl J.; Greer, Peter B.

2012-01-01

Purpose: In advanced radiotherapy treatments such as intensity modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT), verification of the performance of the multileaf collimator (MLC) is an essential part of the linac QA program. The purpose of this study is to use the existing measurement methods for geometric QA of the MLCs and extend them to more comprehensive evaluation techniques, and to develop dedicated robust algorithms to quantitatively investigate the MLC performance in a fast, accurate, and efficient manner. Methods: The behavior of leaves was investigated in the step-and-shoot mode by the analysis of integrated electronic portal imaging device (EPID) images acquired during picket fence tests at fixed gantry angles and arc delivery. The MLC was also studied in dynamic mode by the analysis of cine EPID images of a sliding gap pattern delivered in a variety of conditions including different leaf speeds, deliveries at fixed gantry angles or in arc mode, and changing the direction of leaf motion. The accuracy of the method was tested by detection of the intentionally inserted errors in the delivery patterns. Results: The algorithm developed for the picket fence analysis was able to find each individual leaf position, gap width, and leaf bank skewness in addition to the deviations from expected leaf positions with respect to the beam central axis with sub-pixel accuracy. For the three tested linacs over a period of 5 months, the maximum change in the gap width was 0.5 mm, the maximum deviation from the expected leaf positions was 0.1 mm and the MLC skewness was up to 0.2°. The algorithm developed for the sliding gap analysis could determine the velocity and acceleration/deceleration of each individual leaf as well as the gap width. There was a slight decrease in the accuracy of leaf performance with increasing leaf speeds. The analysis results were presented through several graphs. The accuracy of the method was assessed as 0.01 mm

RISKIND verification and benchmark comparisons

Energy Technology Data Exchange (ETDEWEB)

Biwer, B.M.; Arnish, J.J.; Chen, S.Y.; Kamboj, S.

1997-08-01

This report presents verification calculations and benchmark comparisons for RISKIND, a computer code designed to estimate potential radiological consequences and health risks to individuals and the population from exposures associated with the transportation of spent nuclear fuel and other radioactive materials. Spreadsheet calculations were performed to verify the proper operation of the major options and calculational steps in RISKIND. The program is unique in that it combines a variety of well-established models into a comprehensive treatment for assessing risks from the transportation of radioactive materials. Benchmark comparisons with other validated codes that incorporate similar models were also performed. For instance, the external gamma and neutron dose rate curves for a shipping package estimated by RISKIND were compared with those estimated by using the RADTRAN 4 code and NUREG-0170 methodology. Atmospheric dispersion of released material and dose estimates from the GENII and CAP88-PC codes. Verification results have shown the program to be performing its intended function correctly. The benchmark results indicate that the predictions made by RISKIND are within acceptable limits when compared with predictions from similar existing models.

RISKIND verification and benchmark comparisons

International Nuclear Information System (INIS)

Biwer, B.M.; Arnish, J.J.; Chen, S.Y.; Kamboj, S.

1997-08-01

This report presents verification calculations and benchmark comparisons for RISKIND, a computer code designed to estimate potential radiological consequences and health risks to individuals and the population from exposures associated with the transportation of spent nuclear fuel and other radioactive materials. Spreadsheet calculations were performed to verify the proper operation of the major options and calculational steps in RISKIND. The program is unique in that it combines a variety of well-established models into a comprehensive treatment for assessing risks from the transportation of radioactive materials. Benchmark comparisons with other validated codes that incorporate similar models were also performed. For instance, the external gamma and neutron dose rate curves for a shipping package estimated by RISKIND were compared with those estimated by using the RADTRAN 4 code and NUREG-0170 methodology. Atmospheric dispersion of released material and dose estimates from the GENII and CAP88-PC codes. Verification results have shown the program to be performing its intended function correctly. The benchmark results indicate that the predictions made by RISKIND are within acceptable limits when compared with predictions from similar existing models

Co-delivery of resveratrol and docetaxel via polymeric micelles to improve the treatment of drug-resistant tumors

DEFF Research Database (Denmark)

Guo, Xiong; Zhao, Zhiyue; Chen, Dawei

2018-01-01

Co-delivery of anti-cancer drugs is promising to improve the efficacy of cancer treatment. This study was aiming to investigate the potential of concurrent delivery of resveratrol (RES) and docetaxel (DTX) via polymeric nanocarriers to treat breast cancer. To this end, methoxyl poly(ethylene glycol...... profiles, and enhanced cytotoxicity in vitro against MCF-7 cells. The AUC(0→t) of DTX and RES in mPEG-PDLA micelles after i.v. administration to rats were 3.0-fold and 1.6-fold higher than that of i.v. injections of the individual drugs. These findings indicated that the co-delivery of RES and DTX using m...

Targeted drug delivery nanosystems based on copolymer poly(lactide)-tocopheryl polyethylene glycol succinate for cancer treatment

International Nuclear Information System (INIS)

Ha, Phuong Thu; Nguyen, Hoai Nam; Do, Hai Doan; Phan, Quoc Thong; Thi, Minh Nguyet Tran; Nguyen, Xuan Phuc; Thi, My Nhung Hoang; Le, Mai Huong; Nguyen, Linh Toan; Bui, Thuc Quang; Phan, Van Hieu

2016-01-01

Along with the development of nanotechnology, drug delivery nanosystems (DDNSs) have attracted a great deal of concern among scientists over the world, especially in cancer treatment. DDNSs not only improve water solubility of anticancer drugs but also increase therapeutic efficacy and minimize the side effects of treatment methods through targeting mechanisms including passive and active targeting. Passive targeting is based on the nano-size of drug delivery systems while active targeting is based on the specific bindings between targeting ligands attached on the drug delivery systems and the unique receptors on the cancer cell surface. In this article we present some of our results in the synthesis and testing of DDNSs prepared from copolymer poly(lactide)-tocopheryl polyethylene glycol succinate (PLA-TPGS), which carry anticancer drugs including curcumin, paclitaxel and doxorubicin. In order to increase the targeting effect to cancer cells, active targeting ligand folate was attached to the DDNSs. The results showed copolymer PLA-TPGS to be an excellent carrier for loading hydrophobic drugs (curcumin and paclitaxel). The fabricated DDNSs had a very small size (50–100 nm) and enhanced the cellular uptake and cytotoxicity of drugs. Most notably, folate-decorated paclitaxel-loaded copolymer PLA-TPGS nanoparticles (Fol/PTX/PLA-TPGS NPs) were tested on tumor-bearing nude mice. During the treatment time, Fol/PTX/PLA-TPGS NPs always exhibited the best tumor growth inhibition compared to free paclitaxel and paclitaxel-loaded copolymer PLA-TPGS nanoparticles. All results evidenced the promising potential of copolymer PLA-TPGS in fabricating targeted DDNSs for cancer treatment. (paper)

Targeted drug delivery nanosystems based on copolymer poly(lactide)-tocopheryl polyethylene glycol succinate for cancer treatment

Science.gov (United States)

Thu Ha, Phuong; Nguyen, Hoai Nam; Doan Do, Hai; Thong Phan, Quoc; Nguyet Tran Thi, Minh; Phuc Nguyen, Xuan; Nhung Hoang Thi, My; Huong Le, Mai; Nguyen, Linh Toan; Quang Bui, Thuc; Hieu Phan, Van

2016-03-01

Along with the development of nanotechnology, drug delivery nanosystems (DDNSs) have attracted a great deal of concern among scientists over the world, especially in cancer treatment. DDNSs not only improve water solubility of anticancer drugs but also increase therapeutic efficacy and minimize the side effects of treatment methods through targeting mechanisms including passive and active targeting. Passive targeting is based on the nano-size of drug delivery systems while active targeting is based on the specific bindings between targeting ligands attached on the drug delivery systems and the unique receptors on the cancer cell surface. In this article we present some of our results in the synthesis and testing of DDNSs prepared from copolymer poly(lactide)-tocopheryl polyethylene glycol succinate (PLA-TPGS), which carry anticancer drugs including curcumin, paclitaxel and doxorubicin. In order to increase the targeting effect to cancer cells, active targeting ligand folate was attached to the DDNSs. The results showed copolymer PLA-TPGS to be an excellent carrier for loading hydrophobic drugs (curcumin and paclitaxel). The fabricated DDNSs had a very small size (50-100 nm) and enhanced the cellular uptake and cytotoxicity of drugs. Most notably, folate-decorated paclitaxel-loaded copolymer PLA-TPGS nanoparticles (Fol/PTX/PLA-TPGS NPs) were tested on tumor-bearing nude mice. During the treatment time, Fol/PTX/PLA-TPGS NPs always exhibited the best tumor growth inhibition compared to free paclitaxel and paclitaxel-loaded copolymer PLA-TPGS nanoparticles. All results evidenced the promising potential of copolymer PLA-TPGS in fabricating targeted DDNSs for cancer treatment.

A new method for verification of IMRT treatments on patient geometry files using DYNALOG; Un metodo para la verficacion de tratamientos de IMRT sobre la geometria del paciente utilizando los archivos Dynalog

Energy Technology Data Exchange (ETDEWEB)

Infante Utrilla, M. A.; Calama Santiago, J. A.; Lavado Rodriguez, M. E.

2011-07-01

The aim of this work is to implement a novel method of verification of IMRT treatments, using this information to reconstruct the flow in the scheduler and calculate the dose, comparing dose distributions in 2D and 3D histograms obtained with the initials. This procedure lacks the limitations and uncertainties of the dosimetric detectors used in the verification of model (ionization chamber, film, etc..) Or ILD, also allowing to quantify the differences on the patient.

SU-E-T-335: Transit Dosimetry for Verification of Dose Delivery Using Electronic Portal Imaging Device (EPID)

Energy Technology Data Exchange (ETDEWEB)

Baek, T [Korea University, Seoul (Korea, Republic of); National Health Insurance Co.Ilsan Hospital, Ilsan (Korea, Republic of); Chung, E [National Health Insurance Co.Ilsan Hospital, Ilsan (Korea, Republic of); Lee, S [Cheil General Hospital and Women Healthcare Center, Kwandong University, Seoul (Korea, Republic of); Yoon, M [Korea University, Seoul (Korea, Republic of)

2014-06-01

Purpose: To evaluate the effectiveness of transit dose, measured with an electronic portal imaging device (EPID), in verifying actual dose delivery to patients. Methods: Plans of 5 patients with lung cancer, who received IMRT treatment, were examined using homogeneous solid water phantom and inhomogeneous anthropomorphic phantom. To simulate error in patient positioning, the anthropomorphic phantom was displaced from 5 mm to 10 mm in the inferior to superior (IS), superior to inferior (SI), left to right (LR), and right to left (RL) directions. The transit dose distribution was measured with EPID and was compared to the planed dose using gamma index. Results: Although the average passing rate based on gamma index (GI) with a 3% dose and a 3 mm distance-to-dose agreement tolerance limit was 94.34 % for the transit dose with homogeneous phantom, it was reduced to 84.63 % for the transit dose with inhomogeneous anthropomorphic phantom. The Result also shows that the setup error of 5mm (10mm) in IS, SI, LR and SI direction can Result in the decrease in values of GI passing rates by 1.3% (3.0%), 2.2% (4.3%), 5.9% (10.9%), and 8.9% (16.3%), respectively. Conclusion: Our feasibility study suggests that the transit dose-based quality assurance may provide information regarding accuracy of dose delivery as well as patient positioning.

Reduced prevalence of early preterm delivery in women with Type 1 diabetes and microalbuminuria--possible effect of early antihypertensive treatment during pregnancy

DEFF Research Database (Denmark)

Nielsen, L R; Kragh-Müller, Claus; Damm, P

2006-01-01

In normotensive women with Type 1 diabetes and microalbuminuria we previously found preterm delivery (treatment was initiated in late pregnancy when preeclampsia was diagnosed and diastolic blood pressure > 90 mmHg. From April 2000 our routine...... treatment in the prevalence of preterm delivery....... was changed and early antihypertensive treatment with methyldopa was initiated if antihypertensive treatment was given prior to pregnancy, if urinary albumin excretion (UAE) was > 2 g/24 h, or blood pressure > 140/90 mmHg. The present study describes the impact of this more aggressive antiypertensive...

Utterance Verification for Text-Dependent Speaker Recognition

DEFF Research Database (Denmark)

Kinnunen, Tomi; Sahidullah, Md; Kukanov, Ivan

2016-01-01

Text-dependent automatic speaker verification naturally calls for the simultaneous verification of speaker identity and spoken content. These two tasks can be achieved with automatic speaker verification (ASV) and utterance verification (UV) technologies. While both have been addressed previously...

Dosimetric properties of an amorphous silicon electronic portal imaging device for verification of dynamic intensity modulated radiation therapy

International Nuclear Information System (INIS)

Greer, Peter B.; Popescu, Carmen C.

2003-01-01

Dosimetric properties of an amorphous silicon electronic portal imaging device (EPID) for verification of dynamic intensity modulated radiation therapy (IMRT) delivery were investigated. The EPID was utilized with continuous frame-averaging during the beam delivery. Properties studied included effect of buildup, dose linearity, field size response, sampling of rapid multileaf collimator (MLC) leaf speeds, response to dose-rate fluctuations, memory effect, and reproducibility. The dependence of response on EPID calibration and a dead time in image frame acquisition occurring every 64 frames were measured. EPID measurements were also compared to ion chamber and film for open and wedged static fields and IMRT fields. The EPID was linear with dose and dose rate, and response to MLC leaf speeds up to 2.5 cm s-1 was found to be linear. A field size dependent response of up to 5% relative to d max ion-chamber measurement was found. Reproducibility was within 0.8% (1 standard deviation) for an IMRT delivery recorded at intervals over a period of one month. The dead time in frame acquisition resulted in errors in the EPID that increased with leaf speed and were over 20% for a 1 cm leaf gap moving at 1.0 cm s-1. The EPID measurements were also found to depend on the input beam profile utilized for EPID flood-field calibration. The EPID shows promise as a device for verification of IMRT, the major limitation currently being due to dead-time in frame acquisition

Total skin electron therapy treatment verification: Monte Carlo simulation and beam characteristics of large non-standard electron fields

International Nuclear Information System (INIS)

Pavon, Ester Carrasco; Sanchez-Doblado, Francisco; Leal, Antonio; Capote, Roberto; Lagares, Juan Ignacio; Perucha, Maria; Arrans, Rafael

2003-01-01

Total skin electron therapy (TSET) is a complex technique which requires non-standard measurements and dosimetric procedures. This paper investigates an essential first step towards TSET Monte Carlo (MC) verification. The non-standard 6 MeV 40 x 40 cm 2 electron beam at a source to surface distance (SSD) of 100 cm as well as its horizontal projection behind a polymethylmethacrylate (PMMA) screen to SSD = 380 cm were evaluated. The EGS4 OMEGA-BEAM code package running on a Linux home made 47 PCs cluster was used for the MC simulations. Percentage depth-dose curves and profiles were calculated and measured experimentally for the 40 x 40 cm 2 field at both SSD = 100 cm and patient surface SSD = 380 cm. The output factor (OF) between the reference 40 x 40 cm 2 open field and its horizontal projection as TSET beam at SSD = 380 cm was also measured for comparison with MC results. The accuracy of the simulated beam was validated by the good agreement to within 2% between measured relative dose distributions, including the beam characteristic parameters (R 50 , R 80 , R 100 , R p , E 0 ) and the MC calculated results. The energy spectrum, fluence and angular distribution at different stages of the beam (at SSD = 100 cm, at SSD = 364.2 cm, behind the PMMA beam spoiler screen and at treatment surface SSD = 380 cm) were derived from MC simulations. Results showed a final decrease in mean energy of almost 56% from the exit window to the treatment surface. A broader angular distribution (FWHM of the angular distribution increased from 13deg at SSD 100 cm to more than 30deg at the treatment surface) was fully attributable to the PMMA beam spoiler screen. OF calculations and measurements agreed to less than 1%. The effect of changing the electron energy cut-off from 0.7 MeV to 0.521 MeV and air density fluctuations in the bunker which could affect the MC results were shown to have a negligible impact on the beam fluence distributions. Results proved the applicability of using MC

Portal verification for breast cancer radiotherapy

International Nuclear Information System (INIS)

Petkovska, Sonja; Pejkovikj, Sasho; Apostolovski, Nebojsha

2013-01-01

At the University Clinic in Skopje, breast cancer irradiation is being planned and performed by using a mono-iso centrical method, which means that a unique isocenter (I C) for all irradiation fields is used. The goal of this paper is to present the patient’s position in all coordinates before the first treatment session, relative to the position determined during the CT simulation. Deviation of up to 5 mm is allowed. The analysis was made by using a portal verification. Sixty female patients at random selection are reviewed. The matching results show that for each patient deviation exists at least on one axis. The largest deviations are in the longitudinal direction (head-feet) up to 4 mm, mean 1.8 mm. In 60 out of 85 analysed fields, the deviation is towards the head. In lateral direction, median deviation is 1.1 mm and in 65% of the analysed portals those deviations are in medial direction – contralateral breast which can increases the dose in the lung and in the contralateral breast. This deviation for supraclavicular field can increase the dose in the spinal cord. Although these doses are well below the limit, this fact should be taken into account in setting the treatment fields. The final conclusion from the research is that despite of the fact we are dealing with small deviations, in conditions when accuracy in positioning is done with portal, the portal verification needs to be done in the coming weeks of the treatment, not only before the first treatment. This provides information for an intra fractional set-up deviation. (Author)

ENVIRONMENTAL TECHNOLOGY VERIFICATION REPORT: IN-DRAIN TREATMENT DEVICE. HYDRO INTERNATIONAL UP-FLO™ FILTER

Science.gov (United States)

Verification testing of the Hydro International Up-Flo™ Filter with one filter module and CPZ Mix™ filter media was conducted at the Penn State Harrisburg Environmental Engineering Laboratory in Middletown, Pennsylvania. The Up-Flo™ Filter is designed as a passive, modular filtr...

Implementation of a method for patient-specific IMRT treatment verification using dynalog files; Aplicacion de un metodo para la verificacion de tratamientos de imrt sobre la anatomia del paciente utilizando archivos dynalog

Energy Technology Data Exchange (ETDEWEB)

Calama Santiago, J. A.; Infante Utrilla, M. A.; Lavado Rodriguez, M. E.

2011-07-01

The aim of this work is to implement a simple method of intensity modulated radiation therapy (IMRT) verification on the patient anatomy using dynalog files. Monitor units (MU) fraction and leaf positions, both planned and actually positioned during treatment, are sampled every 55 ms and stored in these files. This information was used in the treatment planning system to reconstruct the given fluence and to recalculate the absorbed dose in the patients CT, comparing absorbed dose distributions and histograms with those initially planned. Differences mainly appeared in areas with high absorbed dose gradients at the beginning and at the end of the radiation fields. These differences were lower than 3% in absorbed dose for most cases. No significant differences were found on dose-volume histograms. With proper linac and multileaf collimator commissioning, and a more stringent linac, treatment planning and record and verify system quality assurance program, this procedure allows patient-specific IMRT treatment verification, unlike conventional methods. (Author) 15 refs.

A Practitioners Perspective on Verification

Science.gov (United States)

Steenburgh, R. A.

2017-12-01

NOAAs Space Weather Prediction Center offers a wide range of products and services to meet the needs of an equally wide range of customers. A robust verification program is essential to the informed use of model guidance and other tools by both forecasters and end users alike. In this talk, we present current SWPC practices and results, and examine emerging requirements and potential approaches to satisfy them. We explore the varying verification needs of forecasters and end users, as well as the role of subjective and objective verification. Finally, we describe a vehicle used in the meteorological community to unify approaches to model verification and facilitate intercomparison.

Clinical evaluation and verification of the hyperthermia treatment planning system hyperplan

International Nuclear Information System (INIS)

Gellermann, Johanna; Wust, Peter; Stalling, Dether; Seebass, Martin; Nadobny, Jacek; Beck, Rudolf; Hege, Hans-Christian; Deuflhard, Peter; Felix, Roland

2000-01-01

Purpose: A prototype of the hyperthermia treatment planning system (HTPS) HyperPlan for the SIGMA-60 applicator (BSD Medical Corp., Salt Lake City, Utah, USA) has been evaluated with respect to clinical practicability and correctness. Materials and Methods: HyperPlan modules extract tissue boundaries from computed tomography (CT) images to generate regular and tetrahedral grids as patient models, to calculate electric field (E-field) distributions, and to visualize three-dimensional data sets. The finite difference time-domain (FDTD) method is applied to calculate the specific absorption rate (SAR) inside the patient. Temperature distributions are calculated by a finite-element code and can be optimized. HyperPlan was tested on 6 patients with pelvic tumors. For verification, measured SAR values were compared with calculated SAR values. Furthermore, intracorporeal E-field scans were performed and compared with calculated profiles. Results: The HTPS can be applied under clinical conditions. Measured absolute SAR (in W/kg), as well as relative E-field scans, correlated well with calculated values (±20%) using the contour-based FDTD method. Values calculated by applying the FDTD method directly on the voxel (CT) grid, were less well correlated with measured data. Conclusion: The HyperPlan system proved to be clinically feasible, and the results were quantitatively and qualitatively verified for the contour-based FDTD method

A potential non-invasive glioblastoma treatment: Nose-to-brain delivery of farnesylthiosalicylic acid incorporated hybrid nanoparticles.

Science.gov (United States)

Sekerdag, Emine; Lüle, Sevda; Bozdağ Pehlivan, Sibel; Öztürk, Naile; Kara, Aslı; Kaffashi, Abbas; Vural, Imran; Işıkay, Ilkay; Yavuz, Burҫin; Oguz, Kader Karlı; Söylemezoğlu, Figen; Gürsoy-Özdemir, Yasemin; Mut, Melike

2017-09-10

New drug delivery systems are highly needed in research and clinical area to effectively treat gliomas by reaching a high antineoplastic drug concentration at the target site without damaging healthy tissues. Intranasal (IN) administration, an alternative route for non-invasive drug delivery to the brain, bypasses the blood-brain-barrier (BBB) and eliminates systemic side effects. This study evaluated the antitumor efficacy of farnesylthiosalicylic acid (FTA) loaded (lipid-cationic) lipid-PEG-PLGA hybrid nanoparticles (HNPs) after IN application in rats. FTA loaded HNPs were prepared, characterized and evaluated for cytotoxicity. Rat glioma 2 (RG2) cells were implanted unilaterally into the right striatum of female Wistar rats. 10days later, glioma bearing rats received either no treatment, or 5 repeated doses of 500μM freshly prepared FTA loaded HNPs via IN or intravenous (IV) application. Pre-treatment and post-treatment tumor sizes were determined with MRI. After a treatment period of 5days, IN applied FTA loaded HNPs achieved a significant decrease of 55.7% in tumor area, equal to IV applied FTA loaded HNPs. Herewith, we showed the potential utility of IN application of FTA loaded HNPs as a non-invasive approach in glioblastoma treatment. Copyright © 2017 Elsevier B.V. All rights reserved.

TH-AB-201-01: A Feasibility Study of Independent Dose Verification for CyberKnife

International Nuclear Information System (INIS)

Sato, A; Noda, T; Keduka, Y; Kawajiri, T; Itano, M; Yamazaki, T; Tachibana, H

2016-01-01

Purpose: CyberKnife irradiation is composed of tiny-size, multiple and intensity-modulated beams compared to conventional linacs. Few of the publications for Independent dose calculation verification for CyberKnife have been reported. In this study, we evaluated the feasibility of independent dose verification for CyberKnife treatment as Secondary check. Methods: The followings were measured: test plans using some static and single beams, clinical plans in a phantom and using patient’s CT. 75 patient plans were collected from several treatment sites of brain, lung, liver and bone. In the test plans and the phantom plans, a pinpoint ion-chamber measurement was performed to assess dose deviation for a treatment planning system (TPS) and an independent verification program of Simple MU Analysis (SMU). In the clinical plans, dose deviation between the SMU and the TPS was performed. Results: In test plan, the dose deviations were 3.3±4.5%, and 4.1±4.4% for the TPS and the SMU, respectively. In the phantom measurements for the clinical plans, the dose deviations were −0.2±3.6% for the TPS and −2.3±4.8% for the SMU. In the clinical plans using the patient’s CT, the dose deviations were −3.0±2.1% (Mean±1SD). The systematic difference was partially derived from inverse square law and penumbra calculation. Conclusion: The independent dose calculation for CyberKnife shows −3.0±4.2% (Mean±2SD) and our study, the confidence limit was achieved within 5% of the tolerance level from AAPM task group 114 for non-IMRT treatment. Thus, it may be feasible to use independent dose calculation verification for CyberKnife treatment as the secondary check. This research is partially supported by Japan Agency for Medical Research and Development (AMED)

Rectal cancer delivery of radiotherapy in adequate time and with adequate dose is influenced by treatment center, treatment schedule, and gender and is prognostic parameter for local control: Results of study CAO/ARO/AIO-94

International Nuclear Information System (INIS)

Fietkau, Rainer; Roedel, Claus; Hohenberger, Werner; Raab, Rudolf; Hess, Clemens; Liersch, Torsten; Becker, Heinz; Wittekind, Christian; Hutter, Matthias; Hager, Eva; Karstens, Johann; Ewald, Hermann; Christen, Norbert; Jagoditsch, Michael; Martus, Peter; Sauer, Rolf

2007-01-01

Purpose: The impact of the delivery of radiotherapy (RT) on treatment results in rectal cancer patients is unknown. Methods and Materials: The data from 788 patients with rectal cancer treated within the German CAO/AIO/ARO-94 phase III trial were analyzed concerning the impact of the delivery of RT (adequate RT: minimal radiation RT dose delivered, 4300 cGy for neoadjuvant RT or 4700 cGy for adjuvant RT; completion of RT in <44 days for neoadjuvant RT or <49 days for adjuvant RT) in different centers on the locoregional recurrence rate (LRR) and disease-free survival (DFS) at 5 years. The LRR, DFS, and delivery of RT were analyzed as endpoints in multivariate analysis. Results: A significant difference was found between the centers and the delivery of RT. The overall delivery of RT was a prognostic factor for the LRR (no RT, 29.6% ± 7.8%; inadequate RT, 21.2% ± 5.6%; adequate RT, 6.8% ± 1.4%; p = 0.0001) and DFS (no RT, 55.1% ± 9.1%; inadequate RT, 57.4% ± 6.3%; adequate RT, 69.1% ± 2.3%; p = 0.02). Postoperatively, delivery of RT was a prognostic factor for LRR on multivariate analysis (together with pathologic stage) but not for DFS (independent parameters, pathologic stage and age). Preoperatively, on multivariate analysis, pathologic stage, but not delivery of RT, was an independent prognostic parameter for LRR and DFS (together with adequate chemotherapy). On multivariate analysis, the treatment center, treatment schedule (neoadjuvant vs. adjuvant RT), and gender were prognostic parameters for adequate RT. Conclusion: Delivery of RT should be regarded as a prognostic factor for LRR in rectal cancer and is influenced by the treatment center, treatment schedule, and patient gender

Verification Account Management System (VAMS)

Data.gov (United States)

Social Security Administration — The Verification Account Management System (VAMS) is the centralized location for maintaining SSA's verification and data exchange accounts. VAMS account management...

Monte Carlo systems used for treatment planning and dose verification

Energy Technology Data Exchange (ETDEWEB)

Brualla, Lorenzo [Universitaetsklinikum Essen, NCTeam, Strahlenklinik, Essen (Germany); Rodriguez, Miguel [Centro Medico Paitilla, Balboa (Panama); Lallena, Antonio M. [Universidad de Granada, Departamento de Fisica Atomica, Molecular y Nuclear, Granada (Spain)

2017-04-15

General-purpose radiation transport Monte Carlo codes have been used for estimation of the absorbed dose distribution in external photon and electron beam radiotherapy patients since several decades. Results obtained with these codes are usually more accurate than those provided by treatment planning systems based on non-stochastic methods. Traditionally, absorbed dose computations based on general-purpose Monte Carlo codes have been used only for research, owing to the difficulties associated with setting up a simulation and the long computation time required. To take advantage of radiation transport Monte Carlo codes applied to routine clinical practice, researchers and private companies have developed treatment planning and dose verification systems that are partly or fully based on fast Monte Carlo algorithms. This review presents a comprehensive list of the currently existing Monte Carlo systems that can be used to calculate or verify an external photon and electron beam radiotherapy treatment plan. Particular attention is given to those systems that are distributed, either freely or commercially, and that do not require programming tasks from the end user. These systems are compared in terms of features and the simulation time required to compute a set of benchmark calculations. (orig.) [German] Seit mehreren Jahrzehnten werden allgemein anwendbare Monte-Carlo-Codes zur Simulation des Strahlungstransports benutzt, um die Verteilung der absorbierten Dosis in der perkutanen Strahlentherapie mit Photonen und Elektronen zu evaluieren. Die damit erzielten Ergebnisse sind meist akkurater als solche, die mit nichtstochastischen Methoden herkoemmlicher Bestrahlungsplanungssysteme erzielt werden koennen. Wegen des damit verbundenen Arbeitsaufwands und der langen Dauer der Berechnungen wurden Monte-Carlo-Simulationen von Dosisverteilungen in der konventionellen Strahlentherapie in der Vergangenheit im Wesentlichen in der Forschung eingesetzt. Im Bemuehen, Monte

Quantum money with classical verification

Energy Technology Data Exchange (ETDEWEB)

Gavinsky, Dmitry [NEC Laboratories America, Princeton, NJ (United States)

2014-12-04

We propose and construct a quantum money scheme that allows verification through classical communication with a bank. This is the first demonstration that a secure quantum money scheme exists that does not require quantum communication for coin verification. Our scheme is secure against adaptive adversaries - this property is not directly related to the possibility of classical verification, nevertheless none of the earlier quantum money constructions is known to possess it.

Quantum money with classical verification

International Nuclear Information System (INIS)

Gavinsky, Dmitry

2014-01-01

We propose and construct a quantum money scheme that allows verification through classical communication with a bank. This is the first demonstration that a secure quantum money scheme exists that does not require quantum communication for coin verification. Our scheme is secure against adaptive adversaries - this property is not directly related to the possibility of classical verification, nevertheless none of the earlier quantum money constructions is known to possess it

Dosimetry investigation of MOSFET for clinical IMRT dose verification.

Science.gov (United States)

Deshpande, Sudesh; Kumar, Rajesh; Ghadi, Yogesh; Neharu, R M; Kannan, V

2013-06-01

In IMRT, patient-specific dose verification is followed regularly at each centre. Simple and efficient dosimetry techniques play a very important role in routine clinical dosimetry QA. The MOSFET dosimeter offers several advantages over the conventional dosimeters such as its small detector size, immediate readout, immediate reuse, multiple point dose measurements. To use the MOSFET as routine clinical dosimetry system for pre-treatment dose verification in IMRT, a comprehensive set of experiments has been conducted, to investigate its linearity, reproducibility, dose rate effect and angular dependence for 6 MV x-ray beam. The MOSFETs shows a linear response with linearity coefficient of 0.992 for a dose range of 35 cGy to 427 cGy. The reproducibility of the MOSFET was measured by irradiating the MOSFET for ten consecutive irradiations in the dose range of 35 cGy to 427 cGy. The measured reproducibility of MOSFET was found to be within 4% up to 70 cGy and within 1.4% above 70 cGy. The dose rate effect on the MOSFET was investigated in the dose rate range 100 MU/min to 600 MU/min. The response of the MOSFET varies from -1.7% to 2.1%. The angular responses of the MOSFETs were measured at 10 degrees intervals from 90 to 270 degrees in an anticlockwise direction and normalized at gantry angle zero and it was found to be in the range of 0.98 ± 0.014 to 1.01 ± 0.014. The MOSFETs were calibrated in a phantom which was later used for IMRT verification. The measured calibration coefficients were found to be 1 mV/cGy and 2.995 mV/cGy in standard and high sensitivity mode respectively. The MOSFETs were used for pre-treatment dose verification in IMRT. Nine dosimeters were used for each patient to measure the dose in different plane. The average variation between calculated and measured dose at any location was within 3%. Dose verification using MOSFET and IMRT phantom was found to quick and efficient and well suited for a busy radiotherapy

SU-E-T-151: Breathing Synchronized Delivery (BSD) Planning for RapicArc Treatment

International Nuclear Information System (INIS)

Lu, W; Chen, M; Jiang, S

2015-01-01

Purpose: To propose a workflow for breathing synchronized delivery (BSD) planning for RapicArc treatment. Methods: The workflow includes three stages: screening/simulation, planning, and delivery. In the screening/simulation stage, a 4D CT with the corresponding breathing pattern is acquired for each of the selected patients, who are able to follow their own breathing pattern. In the planning stage, one breathing phase is chosen as the reference, and contours are delineated on the reference image. Deformation maps to other phases are performed along with contour propagation. Based on the control points of the initial 3D plan for the reference phase and the respiration trace, the correlation with respiration phases, the leaf sequence and gantry angles is determined. The beamlet matrices are calculated with the corresponding breathing phase and deformed to the reference phase. Using the 4D dose evaluation tool and the original 3D plan DVHs criteria, the leaf sequence is further optimized to meet the planning objectives and the machine constraints. In the delivery stage, the patients are instructed to follow the programmed breathing patterns of their own, and all other parts are the same as the conventional Rapid-Arc delivery. Results: Our plan analysis is based on comparison of the 3D plan with a static target (SD), 3D plan with motion delivery (MD), and the BSD plan. Cyclic motion of range 0 cm to 3 cm was simulated for phantoms and lung CT. The gain of the BSD plan over MD is significant and concordant for both simulation and lung 4DCT, indicating the benefits of 4D planning. Conclusion: Our study shows that the BSD plan can approach the SD plan quality. However, such BSD scheme relies on the patient being able to follow the same breathing curve that is used in the planning stage during radiation delivery. Funded by Varian Medical Systems

Three-dimensional pre-treatment verification for intensity modulated radiotherapy using the 3DVH™ software

International Nuclear Information System (INIS)

Martins, Lais P.; Silveira, Thiago B.; Garcia, Paulo L.; Trindade, Cassia; Santos, Maira R.; Batista, Delano V.S.

2013-01-01

The IMRT quality assurance is normally analyzed punctual or bi-dimensionally. One difficult of this procedure is to evaluate the clinical impact of the QA result on treatment. The 3DVHTM software gives a 3D measured dose distribution, providing DVH analysis for organs at risk and target volumes. The aim of this work is to validate and implement the software 3DVH™ for IMRT treatments and to verify advantages over the QA 2D. The software uses two groups of data to generate the dose distribution: one from the treatment planning system and another from the irradiation for traditional QA 2D, measured with MapCHECK (Sun Nuclear) (MC). To validate the software, a small volume ionization chamber was used to check if both calculated 3DVHTM dose and measured dose by the chamber were equivalent. For QA analysis, ten IMRT cases planned in Eclipse 8.6 (Varian) and treated in Instituto Nacional de Cancer (INCA) were selected. For all cases, verification plans were created and irradiated in MC, and the analysis were made using the gamma index. Among the cases, five DVH comparisons between planned and measured data presented a deviation lower than 4% of the prescribed dose in 95% of the PTV and GTV's coverage. Other cases showed differences larger than 4%, presented in areas where the movements of the MLC leaves were more complex, mostly in the neighborhood of organs at risk. The 3DVH™ software provides several clinical advantages to IMRT QA, generating refined analysis of the cases evaluated, in comparison to conventional QA 2D. (author)

Particularities of Verification Processes for Distributed Informatics Applications

Directory of Open Access Journals (Sweden)

Ion IVAN

2013-01-01

Full Text Available This paper presents distributed informatics applications and characteristics of their development cycle. It defines the concept of verification and there are identified the differences from software testing. Particularities of the software testing and software verification processes are described. The verification steps and necessary conditions are presented and there are established influence factors of quality verification. Software optimality verification is analyzed and some metrics are defined for the verification process.

The use of gel dosimetry for verification of electron and photon treatment plans in carcinoma of the scalp

International Nuclear Information System (INIS)

Trapp, J V; Partridge, M; Hansen, V N; Childs, P; Bedford, J; Warrington, A P; Leach, M O; Webb, S

2004-01-01

In recent years there has been a large amount of research into the potential use of radiation sensitive gels for three-dimensional verification of clinical radiotherapy doses. In this paper we report the use of a MAGIC gel dosimeter (Fong et al 2001 Phys. Med. Biol. 46 3105) for the verification of a specific patient's radiation therapy dose distribution. A 69-year-old male patient presented with a squamous cell carcinoma extending approximately 180 deg. across the top of the scalp (anterior to posterior) and from just over midline to 90 deg. left of the skull. The patient's treatment was commenced using two electron fields. For gel dosimetry, phantoms were produced in which the outer surface spatially corresponded to the outer contours of the patient's anatomy in the region of irradiation. The phantoms were treated with either electrons or intensity modulated radiation therapy (IMRT) with photons. The results identified a hot spot between the matched electron fields and confirmed the more homogeneous dose distribution produced by the IMRT planning system. The IMRT plan was then clinically implemented. The application of a clinical dose to a phantom shaped to a specific patient as well as the ability to select a slice at will during phantom imaging means that gel dosimetry can no longer be considered to simply have potential alone, but is now in fact a useful dosimetric tool

Nuclear test ban verification

International Nuclear Information System (INIS)

Chun, Kin-Yip

1991-07-01

This report describes verification and its rationale, the basic tasks of seismic verification, the physical basis for earthquake/explosion source discrimination and explosion yield determination, the technical problems pertaining to seismic monitoring of underground nuclear tests, the basic problem-solving strategy deployed by the forensic seismology resarch team at the University of Toronto, and the scientific significance of the team's research. The research carried out at the Univeristy of Toronto has two components: teleseismic verification using P wave recordings from the Yellowknife Seismic Array (YKA), and regional (close-in) verification using high-frequency L g and P n recordings from the Eastern Canada Telemetered Network. Major differences have been found in P was attenuation among the propagation paths connecting the YKA listening post with seven active nuclear explosion testing areas in the world. Significant revisions have been made to previously published P wave attenuation results, leading to more interpretable nuclear explosion source functions. (11 refs., 12 figs.)

Accuracy of field alignment in abdominal radiation therapy

International Nuclear Information System (INIS)

Kortmann, R. D.; Hess, C. F.; Meisner, C.; Schmidberger, H.; Bamberg, M.

1996-01-01

Purpose: To assess the accuracy of field alignment in a homogeneous group of patients undergoing radiotherapy of the abdomen (adjuvant treatment of the paraaortic region in Stage I testicular seminoma). To evaluate the predictive value of the first verification on field placement errors during subsequent treatment delivery. Methods and Materials: In 45 patients, linear and rotational discrepancies were measured between simulation and first check and between 10 consecutive verification films. Results: For the total group of patients, the distribution of all deviations showed mean values between 2.3 mm and -2.7 mm with standard deviations of 3.9 mm to 4.7 mm for linear discrepancies, and -0.5 deg. to 0.3 deg. with standard deviations of 1.2 deg. to 2.1 deg. for rotational discrepancies, respectively. For all patients, deviations for the transition from simulator to the treatment machine were similar to deviations during subsequent treatment delivery, with 95% of all absolute deviations < 10.0 mm and 4 deg. , respectively. When performing correlation analysis between deviations at first check and during treatment delivery, a correlation for lateral displacements and a borderline correlation for caudal displacements could be found. There was no correlation for cranial and rotational displacements. Conclusions: Although a trend of deviations for subsequent treatment delivery may be shown at first check, our analysis indicates that the first verification cannot reliably predict inaccuracies during treatment delivery. Random fluctuations of field displacements of up to 1.0 cm prevail. They must be considered when prescribing the safety margins of the planned target volume and determining cutoff points for corrective actions in abdominal radiation therapy

Evaluation of implanted gold seeds for breast radiotherapy planning and on treatment verification: A feasibility study on behalf of the IMPORT trialists

International Nuclear Information System (INIS)

Coles, Charlotte E.; Harris, Emma J.; Donovan, Ellen M.; Bliss, Peter; Evans, Philip M.; Fairfoul, Jamie; Mackenzie, Christine; Rawlings, Christine; Syndikus, Isabel; Twyman, Nicola; Vasconcelos, Joana; Vowler, Sarah L.; Wilkinson, Jenny S.; Wilks, Robin; Wishart, Gordon C.; Yarnold, John

2011-01-01

Background and purpose: We describe a feasibility study testing the use of gold seeds for the identification of post-operative tumour bed after breast conservation surgery (BCS). Materials and Methods: Fifty-three patients undergoing BCS for invasive cancer were recruited. Successful use was defined as all six seeds correctly positioned around the tumour bed during BCS, unique identification of all implanted seeds on CT planning scan and ≥3 seeds uniquely identified at verification to give couch displacement co-ordinates in 10/15 fractions. Planning target volume (PTV) margin size for four correction strategies were calculated from these data. Variability in tumour bed contouring was investigated with five radiation oncologists outlining five CT datasets. Results: Success in inserting gold seeds, identifying them at CT planning and using them for on-treatment verification was recorded in 45/51 (88%), 37/38 (97%) and 42/43 (98%) of patients, respectively. The clinicians unfamiliar with CT breast planning consistently contoured larger volumes than those already trained. Margin size ranged from 10.1 to 1.4 mm depending on correction strategy. Conclusion: It is feasible to implant tumour bed gold seeds during BCS. Whilst taking longer to insert than surgical clips, they have the advantage of visibility for outlining and verification regardless of the ionising radiation beam quality. Appropriate correction strategies enable margins of the order of 5 mm as required by the IMPORT trials however, tackling clinician variability in contouring is important.

Gating treatment delivery QA based on a surrogate motion analysis

International Nuclear Information System (INIS)

Chojnowski, J.; Simpson, E.

2011-01-01

Full text: To develop a methodology to estimate intrafractional target position error during a phase-based gated treatment. Westmead Cancer Care Centre is using respiratory correlated phase-based gated beam delivery in the treatment of lung cancer. The gating technique is managed by the Varian Real-time Position Management (RPM) system, version 1.7.5. A 6-dot block is placed on the abdomen of the patient and acts as a surrogate for the target motion. During a treatment session, the motion of the surrogate can be recorded by RPM application. Analysis of the surrogate motion file by in-house developed software allows the intrafractional error of the treatment session to be computed. To validate the computed error, a simple test that involves the introduction of deliberate errors is performed. Errors of up to 1.1 cm are introduced to a metal marker placed on a surrogate using the Varian Breathing Phantom. The moving marker was scanned in prospective mode using a GE Lightspeed 16 CT scanner. Using the CT images, a difference of the marker position with and without introduced errors is compared to the calculated errors based on the surrogate motion. The average and standard deviation of a difference between calculated target position errors and measured introduced artificial errors of the marker position is 0.02 cm and 0.07 cm respectively. Conclusion The calculated target positional error based on surrogate motion analysis provides a quantitative measure of intrafractional target positional errors during treatment. Routine QA for gated treatment using surrogate motion analysis is relatively quick and simple.

SU-F-T-522: Dosimetric Study of Junction Dose in Double Isocenter Flatten and Flatten Filter Free IMRT and VMAT Plan Delivery

Energy Technology Data Exchange (ETDEWEB)

Samuvel, K; Yadav, G; Bhushan, M; Tamilarasu, S; Kumar, L; Suhail, M [Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, Delhi (India)

2016-06-15

Purpose: To quantify the dosimetric accuracy of junction dose in double isocenter flattened and flatten filter free(FFF) intensity modulated radiation therapy(IMRT) and volumetric modulated arc therapy(VMAT) plan delivery using pelvis phantom. Methods: Five large field pelvis patients were selected for this study. Double isocenter IMRT and VMAT treatment plans were generated in Eclipse Treatment planning System (V.11.0) using 6MV FB and FFF beams. For all the plans same distance 17.0cm was kept between one isocenter to another isocenter. IMRT Plans were made with 7 coplanar fields and VMAT plans were made with full double arcs. Dose calculation was performed using AAA algorithms with dose grid size of 0.25 cm. Verification plans were calculated on Scanditronix Wellhofer pelvis slab phantom. Measurement point was selected and calculated, where two isocenter plan fields are overlapping, this measurement point was kept at distance 8.5cm from both isocenter. The plans were delivered using Varian TrueBeamTM machine on pelvis slab phantom. Point dose measurements was carried out using CC13 ion chamber volume of 0.13cm3. Results: The measured junction point dose are compared with TPS calculated dose. The mean difference observed was 4.5%, 6.0%, 4.0% and 7.0% for IMRT-FB,IMRT-FFF, VMAT-FB and VMAT-FFF respectively. The measured dose results shows closer agreement with calculated dose in Flatten beam planning in both IMRT and VMAT, whereas in FFF beam plan dose difference are more compared with flatten beam plan. Conclusion: Dosimetry accuracy of Large Field junction dose difference was found less in Flatten beam compared with FFF beam plan delivery. Even though more dosimetric studies are required to analyse junction dose for FFF beam planning using multiple point dose measurements and fluence map verification in field junction area.

Calculation of dose distribution in the patient for verification of plans of intensity modulated radiation therapy; Calculo de la distribucion de dosis en el paciente para la verificacion de planes de radioterapia de intensidad modulada

Energy Technology Data Exchange (ETDEWEB)

Perez Moreno, J. M.; Zucca Aparicio, D.; Garcia Ruiz-Zorrila, J.; Fernandez Leton, J. P.; Minambres Moro, A.

2013-07-01

The precision in the delivery of radiation therapy treatments intensity modulated depends on, among other things, of the proper administration of the sequence of radiation calculated on the planning system. In recent years the electronic devices of imaging portal have shown as a useful tool for the measurement of dose distribution with high resolution. An algorithm has been developed to calculate the distribution of dose in the patient's Anatomy, using the accelerator as measuring equipment electronic imaging of portal In this way the acceptance criteria can be changed in the dosimetry verifications pretreatment of radiation therapy treatments, from those based on evaluation of gamma index to others based on the evaluation of the distribution of dose in the patient. (Author)

SU-E-T-435: Development and Commissioning of a Complete System for In-Vivo Dosimetry and Range Verification in Proton Therapy

Energy Technology Data Exchange (ETDEWEB)

Samuel, D [Universite catholique de Louvain, Louvain-la-neuve, BW (Belgium); Testa, M; Park, Y [Massachusetts General Hospital, Boston, MA (United States); Schneider, R; Moteabbed, M [General Hospital, Boston, MA (United States); Janssens, G; Prieels, D [Ion Beam Applications, Louvain-la-neuve, Brabant Wallon (Belgium); Orban de Xivry, J [Universite catholique de Louvain, Louvain-la-neuve, BW (Belgium); Lu, H [Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Bentefour, E

2014-06-01

Purpose: In-vivo dose and beam range verification in proton therapy could play significant roles in proton treatment validation and improvements. Invivo beam range verification, in particular, could enable new treatment techniques one of which, for example, could be the use of anterior fields for prostate treatment instead of opposed lateral fields as in current practice. We have developed and commissioned an integrated system with hardware, software and workflow protocols, to provide a complete solution, simultaneously for both in-vivo dosimetry and range verification for proton therapy. Methods: The system uses a matrix of diodes, up to 12 in total, but separable into three groups for flexibility in application. A special amplifier was developed to capture extremely small signals from very low proton beam current. The software was developed within iMagX, a general platform for image processing in radiation therapy applications. The range determination exploits the inherent relationship between the internal range modulation clock of the proton therapy system and the radiological depth at the point of measurement. The commissioning of the system, for in-vivo dosimetry and for range verification was separately conducted using anthropomorphic phantom. EBT films and TLDs were used for dose comparisons and range scan of the beam distal fall-off was used as ground truth for range verification. Results: For in-vivo dose measurement, the results were in agreement with TLD and EBT films and were within 3% from treatment planning calculations. For range verification, a precision of 0.5mm is achieved in homogeneous phantoms, and a precision of 2mm for anthropomorphic pelvic phantom, except at points with significant range mixing. Conclusion: We completed the commissioning of our system for in-vivo dosimetry and range verification in proton therapy. The results suggest that the system is ready for clinical trials on patient.

SU-E-T-435: Development and Commissioning of a Complete System for In-Vivo Dosimetry and Range Verification in Proton Therapy

International Nuclear Information System (INIS)

Samuel, D; Testa, M; Park, Y; Schneider, R; Moteabbed, M; Janssens, G; Prieels, D; Orban de Xivry, J; Lu, H; Bentefour, E

2014-01-01

Purpose: In-vivo dose and beam range verification in proton therapy could play significant roles in proton treatment validation and improvements. Invivo beam range verification, in particular, could enable new treatment techniques one of which, for example, could be the use of anterior fields for prostate treatment instead of opposed lateral fields as in current practice. We have developed and commissioned an integrated system with hardware, software and workflow protocols, to provide a complete solution, simultaneously for both in-vivo dosimetry and range verification for proton therapy. Methods: The system uses a matrix of diodes, up to 12 in total, but separable into three groups for flexibility in application. A special amplifier was developed to capture extremely small signals from very low proton beam current. The software was developed within iMagX, a general platform for image processing in radiation therapy applications. The range determination exploits the inherent relationship between the internal range modulation clock of the proton therapy system and the radiological depth at the point of measurement. The commissioning of the system, for in-vivo dosimetry and for range verification was separately conducted using anthropomorphic phantom. EBT films and TLDs were used for dose comparisons and range scan of the beam distal fall-off was used as ground truth for range verification. Results: For in-vivo dose measurement, the results were in agreement with TLD and EBT films and were within 3% from treatment planning calculations. For range verification, a precision of 0.5mm is achieved in homogeneous phantoms, and a precision of 2mm for anthropomorphic pelvic phantom, except at points with significant range mixing. Conclusion: We completed the commissioning of our system for in-vivo dosimetry and range verification in proton therapy. The results suggest that the system is ready for clinical trials on patient

Java bytecode verification via static single assignment form

DEFF Research Database (Denmark)

Gal, Andreas; Probst, Christian W.; Franz, Michael

2008-01-01

Java Virtual Machines (JVMs) traditionally perform bytecode verification by way of an iterative data-flow analysis. Bytecode verification is necessary to ensure type safety because temporary variables in the JVM are not statically typed. We present an alternative verification mechanism that trans......Java Virtual Machines (JVMs) traditionally perform bytecode verification by way of an iterative data-flow analysis. Bytecode verification is necessary to ensure type safety because temporary variables in the JVM are not statically typed. We present an alternative verification mechanism...

U.S. ENVIRONMENTAL PROTECTION AGENCY (EPA) ENVIRONMENTAL TECHNOLOGY VERIFICATION (ETV) PROGRAM: ARSENIC TREATMENT TECHNOLOGIES

Science.gov (United States)

The U.S. Environmental Protection Agency (EPA) Environmental Technology Verification (ETV) program evaluates the performance of innovative air, water, pollution prevention and monitoring technologies that have the potential to improve human health and the environment. This techn...

SU-E-T-350: Verification of Gating Performance of a New Elekta Gating Solution: Response Kit and Catalyst System

Energy Technology Data Exchange (ETDEWEB)

Xie, X; Cao, D; Housley, D; Mehta, V; Shepard, D [Swedish Cancer Institute, Seattle, WA (United States)

2014-06-01

Purpose: In this work, we have tested the performance of new respiratory gating solutions for Elekta linacs. These solutions include the Response gating and the C-RAD Catalyst surface mapping system.Verification measurements have been performed for a series of clinical cases. We also examined the beam on latency of the system and its impact on delivery efficiency. Methods: To verify the benefits of tighter gating windows, a Quasar Respiratory Motion Platform was used. Its vertical-motion plate acted as a respiration surrogate and was tracked by the Catalyst system to generate gating signals. A MatriXX ion-chamber array was mounted on its longitudinal-moving platform. Clinical plans are delivered to a stationary and moving Matrix array at 100%, 50% and 30% gating windows and gamma scores were calculated comparing moving delivery results to the stationary result. It is important to note that as one moves to tighter gating windows, the delivery efficiency will be impacted by the linac's beam-on latency. Using a specialized software package, we generated beam-on signals of lengths of 1000ms, 600ms, 450ms, 400ms, 350ms and 300ms. As the gating windows get tighter, one can expect to reach a point where the dose rate will fall to nearly zero, indicating that the gating window is close to beam-on latency. A clinically useful gating window needs to be significantly longer than the latency for the linac. Results: As expected, the use of tighter gating windows improved delivery accuracy. However, a lower limit of the gating window, largely defined by linac beam-on latency, exists at around 300ms. Conclusion: The Response gating kit, combined with the C-RAD Catalyst, provides an effective solution for respiratorygated treatment delivery. Careful patient selection, gating window design, even visual/audio coaching may be necessary to ensure both delivery quality and efficiency. This research project is funded by Elekta.

New possibilities of digital luminescence radiography (DLR) and digital image processing for verification and portal imaging

International Nuclear Information System (INIS)

Zimmermann, J.S.; Blume, J.; Wendhausen, H.; Hebbinghaus, D.; Kovacs, G.; Eilf, K.; Schultze, J.; Kimmig, B.N.

1995-01-01

We developed a method, using digital luminescence radiography (DLR), not only for portal imaging of photon beams in an excellent quality, but also for verification of electron beams. Furtheron, DLR was used as basic instrument for image fusion of portal and verification film and simulation film respectively for image processing in ''beams-eye-view'' verification (BEVV) of rotating beams or conformation therapy. Digital radiographs of an excellent quality are gained for verification of photon and electron beams. In photon beams, quality improvement vs. conventional portal imaging may be dramatic, even more for high energy beams (e.g. 15-MV-photon beams) than for Co-60. In electron beams, excellent results may be easily obtained. By digital image fusion of 1 or more verification films on simulation film or MRI-planning film, more precise judgement even on small differences between simulation and verification films becomes possible. Using BEVV, it is possible to compare computer aided simulation in rotating beams or conformation therapy with the really applied treatment. The basic principle of BEVV is also suitable for dynamic multileaf collimation. (orig.) [de

Formal verification of algorithms for critical systems

Science.gov (United States)

Rushby, John M.; Von Henke, Friedrich

1993-01-01

We describe our experience with formal, machine-checked verification of algorithms for critical applications, concentrating on a Byzantine fault-tolerant algorithm for synchronizing the clocks in the replicated computers of a digital flight control system. First, we explain the problems encountered in unsynchronized systems and the necessity, and criticality, of fault-tolerant synchronization. We give an overview of one such algorithm, and of the arguments for its correctness. Next, we describe a verification of the algorithm that we performed using our EHDM system for formal specification and verification. We indicate the errors we found in the published analysis of the algorithm, and other benefits that we derived from the verification. Based on our experience, we derive some key requirements for a formal specification and verification system adequate to the task of verifying algorithms of the type considered. Finally, we summarize our conclusions regarding the benefits of formal verification in this domain, and the capabilities required of verification systems in order to realize those benefits.

Challenges for effective WMD verification

International Nuclear Information System (INIS)

Andemicael, B.

2006-01-01

Effective verification is crucial to the fulfillment of the objectives of any disarmament treaty, not least as regards the proliferation of weapons of mass destruction (WMD). The effectiveness of the verification package depends on a number of factors, some inherent in the agreed structure and others related to the type of responses demanded by emerging challenges. The verification systems of three global agencies-the IAEA, the Comprehensive Nuclear-Test-Ban Treaty Organization (CTBTO, currently the Preparatory Commission), and the Organization for the Prohibition of Chemical Weapons (OPCW)-share similarities in their broad objectives of confidence-building and deterrence by assuring members that rigorous verification would deter or otherwise detect non-compliance. Yet they are up against various constraints and other issues, both internal and external to the treaty regime. These constraints pose major challenges to the effectiveness and reliability of the verification operations. In the nuclear field, the IAEA safeguards process was the first to evolve incrementally from modest Statute beginnings to a robust verification system under the global Treaty on the Non-Proliferation of Nuclear Weapons (NPT). The nuclear non-proliferation regime is now being supplemented by a technology-intensive verification system of the nuclear test-ban treaty (CTBT), a product of over three decades of negotiation. However, there still remain fundamental gaps and loopholes in the regime as a whole, which tend to diminish the combined effectiveness of the IAEA and the CTBT verification capabilities. He three major problems are (a) the lack of universality of membership, essentially because of the absence of three nuclear weapon-capable States-India, Pakistan and Israel-from both the NPT and the CTBT, (b) the changes in US disarmament policy, especially in the nuclear field, and (c) the failure of the Conference on Disarmament to conclude a fissile material cut-off treaty. The world is

SU-F-T-293: Experimental Comparisons of Ionization Chambers with Different Volumes for CyberKnife Delivery Quality Assurance

Energy Technology Data Exchange (ETDEWEB)

Nakayama, M [Kobe Minimally invasive Cancer Center, Kobe, Hyogo (Japan); Kobe University Graduate School of Medicine, Kobe, Hyogo (Japan); Munetomo, Y; Ogata, T; Uehara, K; Tsudou, S; Nishimura, H; Mayahara, H [Kobe Minimally invasive Cancer Center, Kobe, Hyogo (Japan); Sasaki, R [Kobe University Graduate School of Medicine, Kobe, Hyogo (Japan)

2016-06-15

Purpose: To evaluate the practicality use of ionization chambers with different volumes for delivery quality assurance of CyberKnife plans, Methods: Dosimetric measurements with a spherical solid water phantom and three ionization chambers with volumes of 0.13, 0.04, and 0.01 cm3 (IBA CC13, CC04, and CC01, respectively) were performed for various CyberKnife clinical treatment plans including both isocentric and nonisocentric delivery. For each chamber, the ion recombination correction factors Ks were calculated using the Jaffe plot method and twovoltage method at a 10-cm depth for a 60-mm collimator field in a water phantom. The polarity correction factors Kpol were determined for 5–60-mm collimator fields in same experimental setup. The measured doses were compared to the doses for the detectors calculated using a treatment planning system. Results: The differences in the Ks between the Jaffe plot method and two-voltage method were −0.12, −0.02, and 0.89% for CC13, CC04, and CC01, respectively. The changes in Kpol for the different field sizes were 0.2, 0.3, and 0.8% for CC13, CC04, and CC01, respectively. The measured doses for CC04 and CC01 were within 3% of the calculated doses for the clinical treatment plans with isocentric delivery with collimator fields greater than 12.5 mm. Those for CC13 had differences of over 3% for the plans with isocentric delivery with collimator fields less than 15 mm. The differences for the isocentric plans were similar to those for the single beam plans. The measured doses for each chamber were within 3% of the calculated doses for the non-isocentric plans except for that with a PTV volume less than 1.0 cm{sup 3}. Conclusion: Although there are some limitations, the ionization chamber with a smaller volume is a better detector for verification of the CyberKnife plans owing to the high spatial resolution.

A Syntactic-Semantic Approach to Incremental Verification

OpenAIRE

Bianculli, Domenico; Filieri, Antonio; Ghezzi, Carlo; Mandrioli, Dino

2013-01-01

Software verification of evolving systems is challenging mainstream methodologies and tools. Formal verification techniques often conflict with the time constraints imposed by change management practices for evolving systems. Since changes in these systems are often local to restricted parts, an incremental verification approach could be beneficial. This paper introduces SiDECAR, a general framework for the definition of verification procedures, which are made incremental by the framework...

An Optimized Online Verification Imaging Procedure for External Beam Partial Breast Irradiation

International Nuclear Information System (INIS)

Willis, David J.; Kron, Tomas; Chua, Boon

2011-01-01

The purpose of this study was to evaluate the capabilities of a kilovoltage (kV) on-board imager (OBI)-equipped linear accelerator in the setting of on-line verification imaging for external-beam partial breast irradiation. Available imaging techniques were optimized and assessed for image quality using a modified anthropomorphic phantom. Imaging dose was also assessed. Imaging techniques were assessed for physical clearance between patient and treatment machine using a volunteer. Nonorthogonal kV image pairs were identified as optimal in terms of image quality, clearance, and dose. After institutional review board approval, this approach was used for 17 patients receiving accelerated partial breast irradiation. Imaging was performed before every fraction verification with online correction of setup deviations >5 mm (total image sessions = 170). Treatment staff rated risk of collision and visibility of tumor bed surgical clips where present. Image session duration and detected setup deviations were recorded. For all cases, both image projections (n = 34) had low collision risk. Surgical clips were rated as well as visualized in all cases where they were present (n = 5). The average imaging session time was 6 min, 16 sec, and a reduction in duration was observed as staff became familiar with the technique. Setup deviations of up to 1.3 cm were detected before treatment and subsequently confirmed offline. Nonorthogonal kV image pairs allowed effective and efficient online verification for partial breast irradiation. It has yet to be tested in a multicenter study to determine whether it is dependent on skilled treatment staff.

Nanoscale drug delivery for targeted chemotherapy.

Science.gov (United States)

Xin, Yong; Huang, Qian; Tang, Jian-Qin; Hou, Xiao-Yang; Zhang, Pei; Zhang, Long Zhen; Jiang, Guan

2016-08-28

Despite significant improvements in diagnostic methods and innovations in therapies for specific cancers, effective treatments for neoplastic diseases still represent major challenges. Nanotechnology as an emerging technology has been widely used in many fields and also provides a new opportunity for the targeted delivery of cancer drugs. Nanoscale delivery of chemotherapy drugs to the tumor site is highly desirable. Recent studies have shown that nanoscale drug delivery systems not only have the ability to destroy cancer cells but may also be carriers for chemotherapy drugs. Some studies have demonstrated that delivery of chemotherapy via nanoscale carriers has greater therapeutic benefit than either treatment modality alone. In this review, novel approaches to nanoscale delivery of chemotherapy are described and recent progress in this field is discussed. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Investigation of Plasma Treatment on Micro-Injection Moulded Microneedle for Drug Delivery

Directory of Open Access Journals (Sweden)

Karthik Nair

2015-10-01

Full Text Available Plasma technology has been widely used to increase the surface energy of the polymer surfaces for many industrial applications; in particular to increase in wettability. The present work was carried out to investigate how surface modification using plasma treatment modifies the surface energy of micro-injection moulded microneedles and its influence on drug delivery. Microneedles of polyether ether ketone and polycarbonate and have been manufactured using micro-injection moulding and samples from each production batch have been subsequently subjected to a range of plasma treatment. These samples were coated with bovine serum albumin to study the protein adsorption on these treated polymer surfaces. Sample surfaces structures, before and after treatment, were studied using atomic force microscope and surface energies have been obtained using contact angle measurement and calculated using the Owens-Wendt theory. Adsorption performance of bovine serum albumin and release kinetics for each sample set was assessed using a Franz diffusion cell. Results indicate that plasma treatment significantly increases the surface energy and roughness of the microneedles resulting in better adsorption and release of BSA.

Verification and validation benchmarks.

Energy Technology Data Exchange (ETDEWEB)

Oberkampf, William Louis; Trucano, Timothy Guy

2007-02-01

Verification and validation (V&V) are the primary means to assess the accuracy and reliability of computational simulations. V&V methods and procedures have fundamentally improved the credibility of simulations in several high-consequence fields, such as nuclear reactor safety, underground nuclear waste storage, and nuclear weapon safety. Although the terminology is not uniform across engineering disciplines, code verification deals with assessing the reliability of the software coding, and solution verification deals with assessing the numerical accuracy of the solution to a computational model. Validation addresses the physics modeling accuracy of a computational simulation by comparing the computational results with experimental data. Code verification benchmarks and validation benchmarks have been constructed for a number of years in every field of computational simulation. However, no comprehensive guidelines have been proposed for the construction and use of V&V benchmarks. For example, the field of nuclear reactor safety has not focused on code verification benchmarks, but it has placed great emphasis on developing validation benchmarks. Many of these validation benchmarks are closely related to the operations of actual reactors at near-safety-critical conditions, as opposed to being more fundamental-physics benchmarks. This paper presents recommendations for the effective design and use of code verification benchmarks based on manufactured solutions, classical analytical solutions, and highly accurate numerical solutions. In addition, this paper presents recommendations for the design and use of validation benchmarks, highlighting the careful design of building-block experiments, the estimation of experimental measurement uncertainty for both inputs and outputs to the code, validation metrics, and the role of model calibration in validation. It is argued that the understanding of predictive capability of a computational model is built on the level of

Verification of Ceramic Structures

Science.gov (United States)

Behar-Lafenetre, Stephanie; Cornillon, Laurence; Rancurel, Michael; De Graaf, Dennis; Hartmann, Peter; Coe, Graham; Laine, Benoit

2012-07-01

In the framework of the “Mechanical Design and Verification Methodologies for Ceramic Structures” contract [1] awarded by ESA, Thales Alenia Space has investigated literature and practices in affiliated industries to propose a methodological guideline for verification of ceramic spacecraft and instrument structures. It has been written in order to be applicable to most types of ceramic or glass-ceramic materials - typically Cesic®, HBCesic®, Silicon Nitride, Silicon Carbide and ZERODUR®. The proposed guideline describes the activities to be performed at material level in order to cover all the specific aspects of ceramics (Weibull distribution, brittle behaviour, sub-critical crack growth). Elementary tests and their post-processing methods are described, and recommendations for optimization of the test plan are given in order to have a consistent database. The application of this method is shown on an example in a dedicated article [7]. Then the verification activities to be performed at system level are described. This includes classical verification activities based on relevant standard (ECSS Verification [4]), plus specific analytical, testing and inspection features. The analysis methodology takes into account the specific behaviour of ceramic materials, especially the statistical distribution of failures (Weibull) and the method to transfer it from elementary data to a full-scale structure. The demonstration of the efficiency of this method is described in a dedicated article [8]. The verification is completed by classical full-scale testing activities. Indications about proof testing, case of use and implementation are given and specific inspection and protection measures are described. These additional activities are necessary to ensure the required reliability. The aim of the guideline is to describe how to reach the same reliability level as for structures made of more classical materials (metals, composites).

Image registration of BANG[reg] gel dose maps for quantitative dosimetry verification

International Nuclear Information System (INIS)

Meeks, Sanford L.; Bova, Frank J.; Maryanski, Marek J.; Kendrick, Lance A.; Ranade, Manisha K.; Buatti, John M.; Friedman, William A.

1999-01-01

the pixel resolution of the MRI dose maps is 1.56 x 1.56 mm, and the treatment-planning dose distributions were calculated on a 1-mm dose grid. All points within the dose distribution were well within the tolerances set forth for commissioning and quality assurance of stereotactic treatment-planning systems. Moreover, the quantitative evaluation presented here tests the accuracy of the entire treatment-planning and delivery process, including stereotactic frame rigidity, CT localization, CT/MR correlation, dose calculation, and radiation delivery. Conclusion: BANG[reg] polymer gel dosimetry coupled with image correlation provides quantitative verification of the accuracy of 3D dose distributions. Such quantitative evaluation is imperative to ensure the high quality of the 3D dose distributions generated and delivered by stereotactic and other conformal irradiation systems

Is flow verification necessary

International Nuclear Information System (INIS)

Beetle, T.M.

1986-01-01

Safeguards test statistics are used in an attempt to detect diversion of special nuclear material. Under assumptions concerning possible manipulation (falsification) of safeguards accounting data, the effects on the statistics due to diversion and data manipulation are described algebraically. A comprehensive set of statistics that is capable of detecting any diversion of material is defined in terms of the algebraic properties of the effects. When the assumptions exclude collusion between persons in two material balance areas, then three sets of accounting statistics are shown to be comprehensive. Two of the sets contain widely known accountancy statistics. One of them does not require physical flow verification - comparisons of operator and inspector data for receipts and shipments. The third set contains a single statistic which does not require physical flow verification. In addition to not requiring technically difficult and expensive flow verification, this single statistic has several advantages over other comprehensive sets of statistics. This algebraic approach as an alternative to flow verification for safeguards accountancy is discussed in this paper

Procedure generation and verification

International Nuclear Information System (INIS)

Sheely, W.F.

1986-01-01

The Department of Energy has used Artificial Intelligence of ''AI'' concepts to develop two powerful new computer-based techniques to enhance safety in nuclear applications. The Procedure Generation System, and the Procedure Verification System, can be adapted to other commercial applications, such as a manufacturing plant. The Procedure Generation System can create a procedure to deal with the off-normal condition. The operator can then take correct actions on the system in minimal time. The Verification System evaluates the logic of the Procedure Generator's conclusions. This evaluation uses logic techniques totally independent of the Procedure Generator. The rapid, accurate generation and verification of corrective procedures can greatly reduce the human error, possible in a complex (stressful/high stress) situation

An automated portal verification system for the tangential breast portal field

International Nuclear Information System (INIS)

Yin, F.-F.; Lai, W.; Chen, C. W.; Nelson, D. F.

1995-01-01

Purpose/Objective: In order to ensure the treatment is delivered as planned, a portal image is acquired in the accelerator and is compared to the reference image. At present, this comparison is performed by radiation oncologists based on the manually-identified features, which is both time-consuming and potentially error-prone. With the introduction of various electronic portal imaging devices, real-time patient positioning correction is becoming clinically feasible to replace time-delayed analysis using films. However, this procedure requires present of radiation oncologists during patient treatment which is not cost-effective and practically not realistic. Therefore, the efficiency and quality of radiation therapy could be substantially improved if this procedure can be automated. The purpose of this study is to develop a fully computerized verification system for the radiation therapy of breast cancer for which a similar treatment setup is generally employed. Materials/Methods: The automated verification system involves image acquisition, image feature extraction, feature correlation between reference and portal images, and quantitative evaluation of patient setup. In this study, a matrix liquid ion-chamber EPID was used to acquire digital portal images which is directly attached to Varian CL2100C accelerator. For effective use of computation memory, the 12-bit gray levels in original portal images were quantized to form a range of 8-bit gray levels. A typical breast portal image includes three important components: breast and lung tissues in the treatment field, air space within the treatment field, and non-irradiated region. A hierarchical region processing technique was developed to separate these regions sequentially. The inherent hierarchical features were formulated based on different radiation attenuation for different regions as: treatment field edge -- breast skin line -- chest wall. Initially, a combination of a Canny edge detector and a constrained

A Scalable Approach for Hardware Semiformal Verification

OpenAIRE

Grimm, Tomas; Lettnin, Djones; Hübner, Michael

2018-01-01

The current verification flow of complex systems uses different engines synergistically: virtual prototyping, formal verification, simulation, emulation and FPGA prototyping. However, none is able to verify a complete architecture. Furthermore, hybrid approaches aiming at complete verification use techniques that lower the overall complexity by increasing the abstraction level. This work focuses on the verification of complex systems at the RT level to handle the hardware peculiarities. Our r...

Genital herpes and its treatment in relation to preterm delivery.

Science.gov (United States)

Li, De-Kun; Raebel, Marsha A; Cheetham, T Craig; Hansen, Craig; Avalos, Lyndsay; Chen, Hong; Davis, Robert

2014-12-01

To examine the risks of genital herpes and antiherpes treatment during pregnancy in relation to preterm delivery (PTD), we conducted a multicenter, member-based cohort study within 4 Kaiser Permanente regions: northern and southern California, Colorado, and Georgia. The study included 662,913 mother-newborn pairs from 1997 to 2010. Pregnant women were classified into 3 groups based on genital herpes diagnosis and treatment: genital herpes without treatment, genital herpes with antiherpes treatment, and no herpes diagnosis or treatment (unexposed controls). After controlling for potential confounders, we found that compared with being unexposed, having untreated genital herpes during first or second trimester was associated with more than double the risk of PTD (odds ratio (OR) = 2.23, 95% confidence interval (CI): 1.80, 2.76). The association was stronger for PTD due to premature rupture of membrane (OR = 3.57, 95% CI: 2.53, 5.06) and for early PTD (≤35 weeks gestation) (OR = 2.87, 95% CI: 2.22, 3.71). In contrast, undergoing antiherpes treatment during pregnancy was associated with a lower risk of PTD compared with not being treated, and the PTD risk was similar to that observed in the unexposed controls (OR = 1.11, 95% CI: 0.89, 1.38). The present study revealed increased risk of PTD associated with genital herpes infection if left untreated and a potential benefit of antiherpes medications in mitigating the effect of genital herpes infection on the risk of PTD. © The Author 2014. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Survey on Offline Finger Print Verification System

NARCIS (Netherlands)

Suman, R.; Kaur, R.

2012-01-01

The fingerprint verification, means where "verification" implies a user matching a fingerprint against a single fingerprint associated with the identity that the user claims. Biometrics can be classified into two types Behavioral (signature verification, keystroke dynamics, etc.) And Physiological

Improving consistency and quality of service delivery: implications for the addiction treatment field.

Science.gov (United States)

Knott, Anne Marie; Corredoira, Rafael; Kimberly, John

2008-09-01

Addiction treatment providers face serious problems in delivering consistent, high-quality services over time. Among those providers with multiple treatment sites, there is also intersite variability. This is a serious problem in the addiction field, likely to be made worse as new technologies are introduced and/or as there is industry consolidation (Corredoira, R., Kimberly, J. (2006) Industry evolution through consolidation: Implications for addiction treatment. Journal of Substance Abuse Treatment 31, 255-265.). Although serious, these problems in managing and monitoring to assure consistent service quality have been faced by many other industries. Here, we review evidence from research in other industries regarding three different forms of management (vertical integration, franchising, and licensing) across a chain of individual service providers. We show how each management form affects the level, consistency, and improvement of service delivery over time. In addition, we discuss how such performance advantages affect customer demand as well as regulatory endorsement of the consolidated firm and its approach.

Tetracycline as local drug delivery in treatment of chronic periodontitis: A systematic review and meta-analysis

Directory of Open Access Journals (Sweden)

Prasad Shyamrajan Nadig

2016-01-01

Full Text Available Background: The aim of the present meta-analysis is to determine the efficacy of tetracycline group of antibiotics as local drug delivery agents in the treatment of chronic periodontitis. Materials and Methods: MEDLINE, EBSCO, Cochrane database, and Google Scholar were used to identify studies in English published up to January 31, 2017. An additional hand search of relevant journals and of the bibliographies of the paper identified was also performed. Articles retrieved were screened using specific inclusion criteria by two independent reviewers. Randomized control trials investigating the effect of tetracycline group of antibiotics as local drug delivery agents in chronic periodontitis were included in the study. Results: Ten relevant articles were selected for the meta-analysis, of which five articles were retrieved after electronic search, three articles were included after hand search, and two unpublished articles were included. The number of patients in studies ranged from 13 to 140 sites with mean age ranging from 20 to 75. A total of 588 sites were treated using tetracycline group of antibiotics as local drug delivery agents in the treatment of chronic periodontitis. The meta-analysis showed standard difference in mean −1.02 mm (95% confidence interval [CI] 0.28, 1.75 for clinical gain in attachment in favor of tetracycline group. Standard difference in mean for probing depth (PD was 1.20 mm (95% CI 0.57, 1.87 in tetracycline group. Conclusion: The results of this meta-analysis showed a significant improvement in periodontal parameters such as CAL, PD, and sulcular bleeding index in favor of tetracycline as local drug delivery compared to placebo.

Proton therapy treatment monitoring with the DoPET system: activity range, positron emitters evaluation and comparison with Monte Carlo predictions

Science.gov (United States)

Muraro, S.; Battistoni, G.; Belcari, N.; Bisogni, M. G.; Camarlinghi, N.; Cristoforetti, L.; Del Guerra, A.; Ferrari, A.; Fracchiolla, F.; Morrocchi, M.; Righetto, R.; Sala, P.; Schwarz, M.; Sportelli, G.; Topi, A.; Rosso, V.

2017-12-01

Ion beam irradiations can deliver conformal dose distributions minimizing damage to healthy tissues thanks to their characteristic dose profiles. Nevertheless, the location of the Bragg peak can be affected by different sources of range uncertainties: a critical issue is the treatment verification. During the treatment delivery, nuclear interactions between the ions and the irradiated tissues generate β+ emitters: the detection of this activity signal can be used to perform the treatment monitoring if an expected activity distribution is available for comparison. Monte Carlo (MC) codes are widely used in the particle therapy community to evaluate the radiation transport and interaction with matter. In this work, FLUKA MC code was used to simulate the experimental conditions of irradiations performed at the Proton Therapy Center in Trento (IT). Several mono-energetic pencil beams were delivered on phantoms mimicking human tissues. The activity signals were acquired with a PET system (DoPET) based on two planar heads, and designed to be installed along the beam line to acquire data also during the irradiation. Different acquisitions are analyzed and compared with the MC predictions, with a special focus on validating the PET detectors response for activity range verification.

In-core Instrument Subcritical Verification (INCISV) - Core Design Verification Method - 358

International Nuclear Information System (INIS)

Prible, M.C.; Heibel, M.D.; Conner, S.L.; Sebastiani, P.J.; Kistler, D.P.

2010-01-01

According to the standard on reload startup physics testing, ANSI/ANS 19.6.1, a plant must verify that the constructed core behaves sufficiently close to the designed core to confirm that the various safety analyses bound the actual behavior of the plant. A large portion of this verification must occur before the reactor operates at power. The INCISV Core Design Verification Method uses the unique characteristics of a Westinghouse Electric Company fixed in-core self powered detector design to perform core design verification after a core reload before power operation. A Vanadium self powered detector that spans the length of the active fuel region is capable of confirming the required core characteristics prior to power ascension; reactivity balance, shutdown margin, temperature coefficient and power distribution. Using a detector element that spans the length of the active fuel region inside the core provides a signal of total integrated flux. Measuring the integrated flux distributions and changes at various rodded conditions and plant temperatures, and comparing them to predicted flux levels, validates all core necessary core design characteristics. INCISV eliminates the dependence on various corrections and assumptions between the ex-core detectors and the core for traditional physics testing programs. This program also eliminates the need for special rod maneuvers which are infrequently performed by plant operators during typical core design verification testing and allows for safer startup activities. (authors)

Verification of Dosimetric Commissioning Accuracy of Intensity Modulated Radiation Therapy and Volumetric Modulated Arc Therapy Delivery using Task Group-119 Guidelines.

Science.gov (United States)

Kaviarasu, Karunakaran; Nambi Raj, N Arunai; Hamid, Misba; Giri Babu, A Ananda; Sreenivas, Lingampally; Murthy, Kammari Krishna

2017-01-01

The purpose of this study is to verify the accuracy of the commissioning of intensity-modulated radiation therapy (IMRT) and volumetric-modulated arc therapy (VMAT) based on the recommendation of the American Association of Physicists in Medicine Task Group 119 (TG-119). TG-119 proposes a set of clinical test cases to verify the accuracy of IMRT planning and delivery system. For these test cases, we generated two sets of treatment plans, the first plan using 7-9 IMRT fields and a second plan utilizing two-arc VMAT technique for both 6 MV and 15 MV photon beams. The template plans of TG-119 were optimized and calculated by Varian Eclipse Treatment Planning System (version 13.5). Dose prescription and planning objectives were set according to the TG-119 goals. The point dose (mean dose to the contoured chamber volume) at the specified positions/locations was measured using compact (CC-13) ion chamber. The composite planar dose was measured with IMatriXX Evaluation 2D array with OmniPro IMRT Software (version 1.7b). The per-field relative gamma was measured using electronic portal imaging device in a way similar to the routine pretreatment patient-specific quality assurance. Our planning results are compared with the TG-119 data. Point dose and fluence comparison data where within the acceptable confident limit. From the obtained data in this study, we conclude that the commissioning of IMRT and VMAT delivery were found within the limits of TG-119.

Shortening Delivery Times of Intensity Modulated Proton Therapy by Reducing Proton Energy Layers During Treatment Plan Optimization

Energy Technology Data Exchange (ETDEWEB)

Water, Steven van de, E-mail: s.vandewater@erasmusmc.nl [Department of Radiation Oncology, Erasmus MC Cancer Institute, Rotterdam (Netherlands); Kooy, Hanne M. [F. H. Burr Proton Therapy Center, Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts (United States); Heijmen, Ben J.M.; Hoogeman, Mischa S. [Department of Radiation Oncology, Erasmus MC Cancer Institute, Rotterdam (Netherlands)

2015-06-01

Purpose: To shorten delivery times of intensity modulated proton therapy by reducing the number of energy layers in the treatment plan. Methods and Materials: We have developed an energy layer reduction method, which was implemented into our in-house-developed multicriteria treatment planning system “Erasmus-iCycle.” The method consisted of 2 components: (1) minimizing the logarithm of the total spot weight per energy layer; and (2) iteratively excluding low-weighted energy layers. The method was benchmarked by comparing a robust “time-efficient plan” (with energy layer reduction) with a robust “standard clinical plan” (without energy layer reduction) for 5 oropharyngeal cases and 5 prostate cases. Both plans of each patient had equal robust plan quality, because the worst-case dose parameters of the standard clinical plan were used as dose constraints for the time-efficient plan. Worst-case robust optimization was performed, accounting for setup errors of 3 mm and range errors of 3% + 1 mm. We evaluated the number of energy layers and the expected delivery time per fraction, assuming 30 seconds per beam direction, 10 ms per spot, and 400 Giga-protons per minute. The energy switching time was varied from 0.1 to 5 seconds. Results: The number of energy layers was on average reduced by 45% (range, 30%-56%) for the oropharyngeal cases and by 28% (range, 25%-32%) for the prostate cases. When assuming 1, 2, or 5 seconds energy switching time, the average delivery time was shortened from 3.9 to 3.0 minutes (25%), 6.0 to 4.2 minutes (32%), or 12.3 to 7.7 minutes (38%) for the oropharyngeal cases, and from 3.4 to 2.9 minutes (16%), 5.2 to 4.2 minutes (20%), or 10.6 to 8.0 minutes (24%) for the prostate cases. Conclusions: Delivery times of intensity modulated proton therapy can be reduced substantially without compromising robust plan quality. Shorter delivery times are likely to reduce treatment uncertainties and costs.

An external dosimetry audit programme to credential static and rotational IMRT delivery for clinical trials quality assurance.

Science.gov (United States)

Eaton, David J; Tyler, Justine; Backshall, Alex; Bernstein, David; Carver, Antony; Gasnier, Anne; Henderson, Julia; Lee, Jonathan; Patel, Rushil; Tsang, Yatman; Yang, Huiqi; Zotova, Rada; Wells, Emma

2017-03-01

External dosimetry audits give confidence in the safe and accurate delivery of radiotherapy. The RTTQA group have performed an on-site audit programme for trial recruiting centres, who have recently implemented static or rotational IMRT, and those with major changes to planning or delivery systems. Measurements of reference beam output were performed by the host centre, and by the auditor using independent equipment. Verification of clinical plans was performed using the ArcCheck helical diode array. A total of 54 measurement sessions were performed between May 2014 and June 2016 at 28 UK institutions, reflecting the different combinations of planning and delivery systems used at each institution. Average ratio of measured output between auditor and host was 1.002±0.006. Average point dose agreement for clinical plans was -0.3±1.8%. Average (and 95% lower confidence intervals) of gamma pass rates at 2%/2mm, 3%/2mm and 3%/3mm respectively were: 92% (80%), 96% (90%) and 98% (94%). Moderately significant differences were seen between fixed gantry angle and rotational IMRT, and between combination of planning systems and linac manufacturer, but not between anatomical treatment site or beam energy. An external audit programme has been implemented for universal and efficient credentialing of IMRT treatments in clinical trials. Good agreement was found between measured and expected doses, with few outliers, leading to a simple table of optimal and mandatory tolerances for approval of dosimetry audit results. Feedback was given to some centres leading to improved clinical practice. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Comparison of megavoltage position verification for prostate irradiation based on bony anatomy and implanted fiducials

International Nuclear Information System (INIS)

Nederveen, Aart J.; Dehnad, Homan; Heide, Uulke A. van der; Moorselaar, R. Jeroen A. van; Hofman, Pieter; Lagendijk, Jan J.W.

2003-01-01

Purpose: The patient position during radiotherapy treatment of prostate cancer can be verified with the help of portal images acquired during treatment. In this study we quantify the clinical consequences of the use of image-based verification based on the bony anatomy and the prostate target itself. Patients and methods: We analysed 2025 portal images and 23 computed tomography (CT) scans from 23 patients with prostate cancer. In all patients gold markers were implanted prior to CT scanning. Statistical data for both random and systematic errors were calculated for displacements of bones and markers and we investigated the effectiveness of an off-line correction protocol. Results: Standard deviations for systematic marker displacement are 2.4 mm in the lateral (LR) direction, 4.4 mm in the anterior-posterior (AP) direction and 3.7 mm in the caudal-cranial direction (CC). Application of off-line position verification based on the marker positions results in a shrinkage of the systematic error to well below 1 mm. Position verification based on the bony anatomy reduces the systematic target uncertainty to 50% in the AP direction and in the LR direction. No reduction was observed in the CC direction. For six out of 23 patients we found an increase of the systematic error after application of bony anatomy-based position verification. Conclusions: We show that even if correction based on the bony anatomy is applied, considerable margins have to be set to account for organ motion. Our study highlights that for individual patients the systematic error can increase after application of bony anatomy-based position verification, whereas the population standard deviation will decrease. Off-line target-based position verification effectively reduces the systematic error to well below 1 mm, thus enabling significant margin reduction

Innovative Technology for the Assisted Delivery of Intensive Voice Treatment (LSVT[R]LOUD) for Parkinson Disease

Science.gov (United States)

Halpern, Angela E.; Ramig, Lorraine O.; Matos, Carlos E. C.; Petska-Cable, Jill A.; Spielman, Jennifer L.; Pogoda, Janice M.; Gilley, Phillip M.; Sapir, Shimon; Bennett, John K.; McFarland, David H.

2012-01-01

Purpose: To assess the feasibility and effectiveness of a newly developed assistive technology system, Lee Silverman Voice Treatment Companion (LSVT[R] Companion[TM], hereafter referred to as "Companion"), to support the delivery of LSVT[R]LOUD, an efficacious speech intervention for individuals with Parkinson disease (PD). Method: Sixteen…

Treatment planning and verification of proton therapy using spot scanning: Initial experiences

International Nuclear Information System (INIS)

Lomax, Antony J.; Boehringer, Terence; Bolsi, Alessandra; Coray, Doelf; Emert, Frank; Goitein, Gudrun; Jermann, Martin; Lin, Shixiong; Pedroni, Eros; Rutz, Hanspeter; Stadelmann, Otto; Timmermann, Beate; Verwey, Jorn; Weber, Damien C.

2004-01-01

Since the end of 1996, we have treated more than 160 patients at PSI using spot-scanned protons. The range of indications treated has been quite wide and includes, in the head region, base-of-skull sarcomas, low-grade gliomas, meningiomas, and para-nasal sinus tumors. In addition, we have treated bone sarcomas in the neck and trunk - mainly in the sacral area - as well as prostate cases and some soft tissue sarcomas. PTV volumes for our treated cases are in the range 20-4500 ml, indicating the flexibility of the spot scanning system for treating lesions of all types and sizes. The number of fields per applied plan ranges from between 1 and 4, with a mean of just under 3 beams per plan, and the number of fluence modulated Bragg peaks delivered per field has ranged from 200 to 45 000. With the current delivery rate of roughly 3000 Bragg peaks per minute, this translates into delivery times per field of between a few seconds to 20-25 min. Bragg peak weight analysis of these spots has shown that over all fields, only about 10% of delivered spots have a weight of more than 10% of the maximum in any given field, indicating that there is some scope for optimizing the number of spots delivered per field. Field specific dosimetry shows that these treatments can be delivered accurately and precisely to within ±1 mm (1 SD) orthogonal to the field direction and to within 1.5 mm in range. With our current delivery system the mean widths of delivered pencil beams at the Bragg peak is about 8 mm (σ) for all energies, indicating that this is an area where some improvements can be made. In addition, an analysis of the spot weights and energies of individual Bragg peaks shows a relatively broad spread of low and high weighted Bragg peaks over all energy steps, indicating that there is at best only a limited relationship between pencil beam weighting and depth of penetration. This latter observation may have some consequences when considering strategies for fast re-scanning on

Transdermal delivery of naltrexol and skin permeability lifetime after microneedle treatment in hairless guinea pigs.

Science.gov (United States)

Banks, Stan L; Pinninti, Raghotham R; Gill, Harvinder S; Paudel, Kalpana S; Crooks, Peter A; Brogden, Nicole K; Prausnitz, Mark R; Stinchcomb, Audra L

2010-07-01

Controlled-release delivery of 6-beta-naltrexol (NTXOL), the major active metabolite of naltrexone, via a transdermal patch is desirable for treatment of alcoholism. Unfortunately, NTXOL does not diffuse across skin at a therapeutic rate. Therefore, the focus of this study was to evaluate microneedle (MN) skin permeation enhancement of NTXOL's hydrochloride salt in hairless guinea pigs. Specifically, these studies were designed to determine the lifetime of MN-created aqueous pore pathways. MN pore lifetime was estimated by pharmacokinetic evaluation, transepidermal water loss (TEWL) and visualization of MN-treated skin pore diameters using light microscopy. A 3.6-fold enhancement in steady-state plasma concentration was observed in vivo with MN treated skin with NTXOL.HCl, as compared to NTXOL base. TEWL measurements and microscopic evaluation of stained MN-treated guinea pig skin indicated the presence of pores, suggesting a feasible nonlipid bilayer pathway for enhanced transdermal delivery. Overall, MN-assisted transdermal delivery appears viable for at least 48 h after MN-application. (c) 2010 Wiley-Liss, Inc. and the American Pharmacists Association

ESTRO ACROP guidelines for positioning, immobilisation and position verification of head and neck patients for radiation therapists

Directory of Open Access Journals (Sweden)

Michelle Leech

2017-03-01

Full Text Available Background and purpose: Over the last decade, the management of locally advanced head and neck cancers (HNCs has seen a substantial increase in the use of chemoradiation. These guidelines have been developed to assist Radiation TherapisTs (RTTs in positioning, immobilisation and position verification for head and neck cancer patients. Materials and methods: A critical review of the literature was undertaken by the writing committee.Based on the literature review, a survey was developed to ascertain the current positioning, immobilisation and position verification methods for head and neck radiation therapy across Europe. The survey was translated into Italian, German, Greek, Portuguese, Russian, Croatian, French and Spanish.Guidelines were subsequently developed by the writing committee. Results: Results from the survey indicated that a wide variety of treatment practices and treatment verification protocols are in operation for head and neck cancer patients across Europe currently.The guidelines developed are based on the experience and expertise of the writing committee, remaining cognisant of the variations in imaging and immobilisation techniques used currently in Europe. Conclusions: These guidelines have been developed to provide RTTs with guidance on positioning, immobilisation and position verification of HNC patients. The guidelines will also provide RTTs with the means to critically reflect on their own daily clinical practice with this patient group. Keywords: Head and neck, Immobilisation, Positioning, Verification

Fingerprint verification prediction model in hand dermatitis.

Science.gov (United States)

Lee, Chew K; Chang, Choong C; Johor, Asmah; Othman, Puwira; Baba, Roshidah

2015-07-01

Hand dermatitis associated fingerprint changes is a significant problem and affects fingerprint verification processes. This study was done to develop a clinically useful prediction model for fingerprint verification in patients with hand dermatitis. A case-control study involving 100 patients with hand dermatitis. All patients verified their thumbprints against their identity card. Registered fingerprints were randomized into a model derivation and model validation group. Predictive model was derived using multiple logistic regression. Validation was done using the goodness-of-fit test. The fingerprint verification prediction model consists of a major criterion (fingerprint dystrophy area of ≥ 25%) and two minor criteria (long horizontal lines and long vertical lines). The presence of the major criterion predicts it will almost always fail verification, while presence of both minor criteria and presence of one minor criterion predict high and low risk of fingerprint verification failure, respectively. When none of the criteria are met, the fingerprint almost always passes the verification. The area under the receiver operating characteristic curve was 0.937, and the goodness-of-fit test showed agreement between the observed and expected number (P = 0.26). The derived fingerprint verification failure prediction model is validated and highly discriminatory in predicting risk of fingerprint verification in patients with hand dermatitis. © 2014 The International Society of Dermatology.

Verification of gamma knife based fractionated radiosurgery with newly developed head-thorax phantom

International Nuclear Information System (INIS)

Bisht, Raj Kishor; Kale, Shashank Sharad; Natanasabapathi, Gopishankar; Singh, Manmohan Jit; Agarwal, Deepak; Garg, Ajay; Rath, Goura Kishore; Julka, Pramod Kumar; Kumar, Pratik; Thulkar, Sanjay; Sharma, Bhawani Shankar

2016-01-01

Objective: Purpose of the study is to verify the Gamma Knife Extend™ system (ES) based fractionated stereotactic radiosurgery with newly developed head-thorax phantom. Methods: Phantoms are extensively used to measure radiation dose and verify treatment plan in radiotherapy. A human upper body shaped phantom with thorax was designed to simulate fractionated stereotactic radiosurgery using Extend™ system of Gamma Knife. The central component of the phantom aids in performing radiological precision test, dosimetric evaluation and treatment verification. A hollow right circular cylindrical space of diameter 7.0 cm was created at the centre of this component to place various dosimetric devices using suitable adaptors. The phantom is made of poly methyl methacrylate (PMMA), a transparent thermoplastic material. Two sets of disk assemblies were designed to place dosimetric films in (1) horizontal (xy) and (2) vertical (xz) planes. Specific cylindrical adaptors were designed to place thimble ionization chamber inside phantom for point dose recording along xz axis. EBT3 Gafchromic films were used to analyze and map radiation field. The focal precision test was performed using 4 mm collimator shot in phantom to check radiological accuracy of treatment. The phantom head position within the Extend™ frame was estimated using encoded aperture measurement of repositioning check tool (RCT). For treatment verification, the phantom with inserts for film and ion chamber was scanned in reference treatment position using X-ray computed tomography (CT) machine and acquired stereotactic images were transferred into Leksell Gammaplan (LGP). A patient treatment plan with hypo-fractionated regimen was delivered and identical fractions were compared using EBT3 films and in-house MATLAB codes. Results: RCT measurement showed an overall positional accuracy of 0.265 mm (range 0.223 mm–0.343 mm). Gamma index analysis across fractions exhibited close agreement between LGP and film

Fractional erbium-doped yttrium aluminum garnet laser-assisted drug delivery of hydroquinone in the treatment of melasma

Science.gov (United States)

Badawi, Ashraf M; Osman, Mai Abdelraouf

2018-01-01

Background Melasma is a difficult-to-treat hyperpigmentary disorder. Ablative fractional laser (AFL)-assisted delivery of topically applied drugs to varied targets in the skin has been an area of ongoing study and research. Objective The objective of this study was to evaluate the efficacy and safety of fractional erbium-doped yttrium aluminum garnet (Er:YAG) laser as an assisted drug delivery for enhancing topical hydroquinone (HQ) permeation into the skin of melasma patients. Patients and methods Thirty female patients with bilateral melasma were randomly treated in a split-face controlled manner with a fractional Er:YAG laser followed by 4% HQ cream on one side and 4% HQ cream alone on the other side. All patients received six laser sessions with a 2-week interval. The efficacy of treatments was determined through photographs, dermoscopic photomicrographs and Melasma Area Severity Index (MASI) score, all performed at baseline and at 12 weeks of starting therapy. The patient’s level of satisfaction was also recorded. Results Er:YAG laser + HQ showed significantly better results (plaser + HQ side vs HQ side. Minor reversible side effects were observed on both sides. Conclusion AFL-assisted delivery of HQ is a safe and effective method for the treatment of melasma. PMID:29379308

Capability verification of the beam delivery system in the superficially-placed tumor therapy terminal at HIRFL

International Nuclear Information System (INIS)

Dai Zhongying; Li Qiang; Xiao Guoqing; Jin Xiaodong; Yan Zheng; Chinese Academy of Sciences, Beijing

2007-01-01

The passive beam delivery system in the superficially-placed tumor therapy terminal at Heavy Ion Research Facility in Lanzhou (HIRFL), which includes two orthogonal dipole magnets as scanning system, a motor-driven energy degrader as range-shifter, series of ridge filters as range modulator and a multileaf collimator, is introduced in detail. The capacities of its important components and the whole system have been verified experimentally. The tests of the ridge filter for extending Bragg peak and the range shifter for energy adjustment show both work well. To examine the passive beam delivery system, a beam shaping experiment were carried out, simulating a three-dimensional (3D) conformal irradiation to a tumor. The encouraging experimental result confirms that 3D layer-stacking conformal irradiation can be performed by means of the passive system. The validation of the beam delivery system establishes a substantial basis for upcoming clinical trial for superficially-placed tumors with heavy ions in the therapy terminal at HIRFL. (authors)

Verification and validation benchmarks

International Nuclear Information System (INIS)

Oberkampf, William Louis; Trucano, Timothy Guy

2007-01-01

Verification and validation (V and V) are the primary means to assess the accuracy and reliability of computational simulations. V and V methods and procedures have fundamentally improved the credibility of simulations in several high-consequence fields, such as nuclear reactor safety, underground nuclear waste storage, and nuclear weapon safety. Although the terminology is not uniform across engineering disciplines, code verification deals with assessing the reliability of the software coding, and solution verification deals with assessing the numerical accuracy of the solution to a computational model. Validation addresses the physics modeling accuracy of a computational simulation by comparing the computational results with experimental data. Code verification benchmarks and validation benchmarks have been constructed for a number of years in every field of computational simulation. However, no comprehensive guidelines have been proposed for the construction and use of V and V benchmarks. For example, the field of nuclear reactor safety has not focused on code verification benchmarks, but it has placed great emphasis on developing validation benchmarks. Many of these validation benchmarks are closely related to the operations of actual reactors at near-safety-critical conditions, as opposed to being more fundamental-physics benchmarks. This paper presents recommendations for the effective design and use of code verification benchmarks based on manufactured solutions, classical analytical solutions, and highly accurate numerical solutions. In addition, this paper presents recommendations for the design and use of validation benchmarks, highlighting the careful design of building-block experiments, the estimation of experimental measurement uncertainty for both inputs and outputs to the code, validation metrics, and the role of model calibration in validation. It is argued that the understanding of predictive capability of a computational model is built on the

Verification and validation benchmarks

International Nuclear Information System (INIS)

Oberkampf, William L.; Trucano, Timothy G.

2008-01-01

Verification and validation (V and V) are the primary means to assess the accuracy and reliability of computational simulations. V and V methods and procedures have fundamentally improved the credibility of simulations in several high-consequence fields, such as nuclear reactor safety, underground nuclear waste storage, and nuclear weapon safety. Although the terminology is not uniform across engineering disciplines, code verification deals with assessing the reliability of the software coding, and solution verification deals with assessing the numerical accuracy of the solution to a computational model. Validation addresses the physics modeling accuracy of a computational simulation by comparing the computational results with experimental data. Code verification benchmarks and validation benchmarks have been constructed for a number of years in every field of computational simulation. However, no comprehensive guidelines have been proposed for the construction and use of V and V benchmarks. For example, the field of nuclear reactor safety has not focused on code verification benchmarks, but it has placed great emphasis on developing validation benchmarks. Many of these validation benchmarks are closely related to the operations of actual reactors at near-safety-critical conditions, as opposed to being more fundamental-physics benchmarks. This paper presents recommendations for the effective design and use of code verification benchmarks based on manufactured solutions, classical analytical solutions, and highly accurate numerical solutions. In addition, this paper presents recommendations for the design and use of validation benchmarks, highlighting the careful design of building-block experiments, the estimation of experimental measurement uncertainty for both inputs and outputs to the code, validation metrics, and the role of model calibration in validation. It is argued that the understanding of predictive capability of a computational model is built on the

SU-F-T-268: A Feasibility Study of Independent Dose Verification for Vero4DRT

International Nuclear Information System (INIS)

Yamashita, M; Kokubo, M; Takahashi, R; Takayama, K; Tanabe, H; Sueoka, M; Okuuchi, N; Ishii, M; Iwamoto, Y; Tachibana, H

2016-01-01

Purpose: Vero4DRT (Mitsubishi Heavy Industries Ltd.) has been released for a few years. The treatment planning system (TPS) of Vero4DRT is dedicated, so the measurement is the only method of dose verification. There have been no reports of independent dose verification using Clarksonbased algorithm for Vero4DRT. An independent dose verification software program of the general-purpose linac using a modified Clarkson-based algorithm was modified for Vero4DRT. In this study, we evaluated the accuracy of independent dose verification program and the feasibility of the secondary check for Vero4DRT. Methods: iPlan (Brainlab AG) was used as the TPS. PencilBeam Convolution was used for dose calculation algorithm of IMRT and X-ray Voxel Monte Carlo was used for the others. Simple MU Analysis (SMU, Triangle Products, Japan) was used as the independent dose verification software program in which CT-based dose calculation was performed using a modified Clarkson-based algorithm. In this study, 120 patients’ treatment plans were collected in our institute. The treatments were performed using the conventional irradiation for lung and prostate, SBRT for lung and Step and shoot IMRT for prostate. Comparison in dose between the TPS and the SMU was done and confidence limits (CLs, Mean ± 2SD %) were compared to those from the general-purpose linac. Results: As the results of the CLs, the conventional irradiation (lung, prostate), SBRT (lung) and IMRT (prostate) show 2.2 ± 3.5% (CL of the general-purpose linac: 2.4 ± 5.3%), 1.1 ± 1.7% (−0.3 ± 2.0%), 4.8 ± 3.7% (5.4 ± 5.3%) and −0.5 ± 2.5% (−0.1 ± 3.6%), respectively. The CLs for Vero4DRT show similar results to that for the general-purpose linac. Conclusion: The independent dose verification for the new linac is clinically available as a secondary check and we performed the check with the similar tolerance level of the general-purpose linac. This research is partially supported by Japan Agency for Medical Research and

SU-F-T-268: A Feasibility Study of Independent Dose Verification for Vero4DRT

Energy Technology Data Exchange (ETDEWEB)

Yamashita, M; Kokubo, M [Kobe City Medical Center General Hospital, Kobe, Hyogo (Japan); Institute of Biomedical Research and Innovation, Kobe, Hyogo (Japan); Takahashi, R [Cancer Institute Hospital of Japanese Foundation for Cancer Research, Koto, Tokyo (Japan); Takayama, K [Institute of Biomedical Research and Innovation, Kobe, Hyogo (Japan); Kobe City Medical Center General Hospital, Kobe, Hyogo (Japan); Tanabe, H; Sueoka, M; Okuuchi, N [Institute of Biomedical Research and Innovation, Kobe, Hyogo (Japan); Ishii, M; Iwamoto, Y [Kobe City Medical Center General Hospital, Kobe, Hyogo (Japan); Tachibana, H [National Cancer Center, Kashiwa, Chiba (Japan)

2016-06-15

Purpose: Vero4DRT (Mitsubishi Heavy Industries Ltd.) has been released for a few years. The treatment planning system (TPS) of Vero4DRT is dedicated, so the measurement is the only method of dose verification. There have been no reports of independent dose verification using Clarksonbased algorithm for Vero4DRT. An independent dose verification software program of the general-purpose linac using a modified Clarkson-based algorithm was modified for Vero4DRT. In this study, we evaluated the accuracy of independent dose verification program and the feasibility of the secondary check for Vero4DRT. Methods: iPlan (Brainlab AG) was used as the TPS. PencilBeam Convolution was used for dose calculation algorithm of IMRT and X-ray Voxel Monte Carlo was used for the others. Simple MU Analysis (SMU, Triangle Products, Japan) was used as the independent dose verification software program in which CT-based dose calculation was performed using a modified Clarkson-based algorithm. In this study, 120 patients’ treatment plans were collected in our institute. The treatments were performed using the conventional irradiation for lung and prostate, SBRT for lung and Step and shoot IMRT for prostate. Comparison in dose between the TPS and the SMU was done and confidence limits (CLs, Mean ± 2SD %) were compared to those from the general-purpose linac. Results: As the results of the CLs, the conventional irradiation (lung, prostate), SBRT (lung) and IMRT (prostate) show 2.2 ± 3.5% (CL of the general-purpose linac: 2.4 ± 5.3%), 1.1 ± 1.7% (−0.3 ± 2.0%), 4.8 ± 3.7% (5.4 ± 5.3%) and −0.5 ± 2.5% (−0.1 ± 3.6%), respectively. The CLs for Vero4DRT show similar results to that for the general-purpose linac. Conclusion: The independent dose verification for the new linac is clinically available as a secondary check and we performed the check with the similar tolerance level of the general-purpose linac. This research is partially supported by Japan Agency for Medical Research and

Automated System Calibration and Verification of the Position Measurements for the Los Alamos Isotope Production Facility and the Switchyard Kicker Facilities

Science.gov (United States)

Barr, D.; Gilpatrick, J. D.; Martinez, D.; Shurter, R. B.

2004-11-01

The Los Alamos Neutron Science Center (LANSCE) facility at Los Alamos National Laboratory has constructed both an Isotope Production Facility (IPF) and a Switchyard Kicker (XDK) as additions to the H+ and H- accelerator. These additions contain eleven Beam Position Monitors (BPMs) that measure the beam's position throughout the transport. The analog electronics within each processing module determines the beam position using the log-ratio technique. For system reliability, calibrations compensate for various temperature drifts and other imperfections in the processing electronics components. Additionally, verifications are periodically implemented by a PC running a National Instruments LabVIEW virtual instrument (VI) to verify continued system and cable integrity. The VI communicates with the processor cards via a PCI/MXI-3 VXI-crate communication module. Previously, accelerator operators performed BPM system calibrations typically once per day while beam was explicitly turned off. One of this new measurement system's unique achievements is its automated calibration and verification capability. Taking advantage of the pulsed nature of the LANSCE-facility beams, the integrated electronics hardware and VI perform calibration and verification operations between beam pulses without interrupting production beam delivery. The design, construction, and performance results of the automated calibration and verification portion of this position measurement system will be the topic of this paper.

Dosimetric verification for primary focal hypermetabolism of nasopharyngeal carcinoma patients treated with dynamic intensity-modulated radiation therapy.

Science.gov (United States)

Xin, Yong; Wang, Jia-Yang; Li, Liang; Tang, Tian-You; Liu, Gui-Hong; Wang, Jian-She; Xu, Yu-Mei; Chen, Yong; Zhang, Long-Zhen

2012-01-01

To make sure the feasibility with (18F)FDG PET/CT to guided dynamic intensity-modulated radiation therapy (IMRT) for nasopharyngeal carcinoma patients, by dosimetric verification before treatment. Chose 11 patients in III~IVA nasopharyngeal carcinoma treated with functional image-guided IMRT and absolute and relative dosimetric verification by Varian 23EX LA, ionization chamber, 2DICA of I'mRT Matrixx and IBA detachable phantom. Drawing outline and making treatment plan were by different imaging techniques (CT and (18F)FDG PET/CT). The dose distributions of the various regional were realized by SMART. The absolute mean errors of interest area were 2.39%±0.66 using 0.6 cc ice chamber. Results using DTA method, the average relative dose measurements within our protocol (3%, 3 mm) were 87.64% at 300 MU/min in all filed. Dosimetric verification before IMRT is obligatory and necessary. Ionization chamber and 2DICA of I'mRT Matrixx was the effective dosimetric verification tool for primary focal hyper metabolism in functional image-guided dynamic IMRT for nasopharyngeal carcinoma. Our preliminary evidence indicates that functional image-guided dynamic IMRT is feasible.

Drug Delivery Approaches for the Treatment of Cervical Cancer

Directory of Open Access Journals (Sweden)

Farideh Ordikhani

2016-07-01

Full Text Available Cervical cancer is a highly prevalent cancer that affects women around the world. With the availability of new technologies, researchers have increased their efforts to develop new drug delivery systems in cervical cancer chemotherapy. In this review, we summarized some of the recent research in systematic and localized drug delivery systems and compared the advantages and disadvantages of these methods.

Post-silicon and runtime verification for modern processors

CERN Document Server

Wagner, Ilya

2010-01-01

The purpose of this book is to survey the state of the art and evolving directions in post-silicon and runtime verification. The authors start by giving an overview of the state of the art in verification, particularly current post-silicon methodologies in use in the industry, both for the domain of processor pipeline design and for memory subsystems. They then dive into the presentation of several new post-silicon verification solutions aimed at boosting the verification coverage of modern processors, dedicating several chapters to this topic. The presentation of runtime verification solution

Development of Microemulsion Based Nabumetone Transdermal Delivery For Treatment of Arthritis.

Science.gov (United States)

Jagdale, Swati; Deore, Gokul; Chabukswar, Anuruddha

2018-02-26

Background Nabumetone is biopharmaceutics classification system (BCS) class II drug, widely used in the treatment of osteoarthritis and rheumatoid arthritis. The most frequently reported adverse reactions for the drug involve disturbance in gastrointestinal tract , diarrhea, dyspepsia and abdominal pain. Microemulgel has advantages of microemulsion for improving solubility for hydrophobic drug. Patent literature had shown that the work for drug has been carried on spray chilling, enteric coated tablet, and topical formulation which gave idea for present research work for development of transdermal delivery. Objective Objective of the present research work was to optimize transdermal microemulgel delivery for Nabumetone for treatment of arthritis. Method Oil, surfactant and co-surfactant were selected based on solubility study for the drug. Gelling agents used were Carbopol 934 and HPMC K100M. Optimization was carried out using 32 factorial design. Characterization and evaluation were carried out for microemulsion and microemulsion based gel. Results Field emission-scanning electron microscopy (FE-SEM) study of the microemulsion revealed globules of 50-200 nm size . Zeta potential -9.50 mV indicated good stability of microemulsion. Globule size measured by dynamic light scattering (zetasizer) was 160 nm. Design expert gave optimized batch as F7 which contain 0.2% w/w drug, 4.3% w/w liquid paraffin, 0.71% w/w tween 80, 0.35% w/w propylene glycol, 0.124% w/w Carbopol 934, 0.187% w/w HPMC K100M and 11.68% w/w water. In-vitro diffusion study for F7 batch showed 99.16±2.10 % drug release through egg membrane and 99.15±2.73% drug release in ex-vivo study. Conclusion Nabumetone microemulgel exhibiting good in-vitro and ex-vivo controlled drug release was optimized. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Pectin-based colon-specific drug delivery

OpenAIRE

Shailendra Shukla; Deepak Jain; Kavita Verma; Shiddarth Verma

2011-01-01

Colon-specific drug delivery have a great importance in the delivery of drugs for the treatment of local colonic, as well as systemic diseases like Crohn′s disease, ulcerative colitis, colorectal cancer, amoebiasis, asthma, arthritis and inflammation which can be achieved by targeted delivery of drug to colon. Specific systemic absorption in the colon gave interesting possibilities for the delivery of protein and peptides. It contains relatively less proteolytic enzyme activities in the colon...

Verification and the safeguards legacy

International Nuclear Information System (INIS)

Perricos, Demetrius

2001-01-01

A number of inspection or monitoring systems throughout the world over the last decades have been structured drawing upon the IAEA experience of setting up and operating its safeguards system. The first global verification system was born with the creation of the IAEA safeguards system, about 35 years ago. With the conclusion of the NPT in 1968, inspections were to be performed under safeguards agreements, concluded directly between the IAEA and non-nuclear weapon states parties to the Treaty. The IAEA developed the safeguards system within the limitations reflected in the Blue Book (INFCIRC 153), such as limitations of routine access by the inspectors to 'strategic points', including 'key measurement points', and the focusing of verification on declared nuclear material in declared installations. The system, based as it was on nuclear material accountancy. It was expected to detect a diversion of nuclear material with a high probability and within a given time and therefore determine also that there had been no diversion of nuclear material from peaceful purposes. The most vital element of any verification system is the inspector. Technology can assist but cannot replace the inspector in the field. Their experience, knowledge, intuition and initiative are invaluable factors contributing to the success of any inspection regime. The IAEA inspectors are however not part of an international police force that will intervene to prevent a violation taking place. To be credible they should be technically qualified with substantial experience in industry or in research and development before they are recruited. An extensive training program has to make sure that the inspectors retain their professional capabilities and that it provides them with new skills. Over the years, the inspectors and through them the safeguards verification system gained experience in: organization and management of large teams; examination of records and evaluation of material balances

Verification of dosimetric commissioning accuracy of intensity modulated radiation therapy and volumetric modulated arc therapy delivery using task Group-119 guidelines

Directory of Open Access Journals (Sweden)

Karunakaran Kaviarasu

2017-01-01

Full Text Available Aim: The purpose of this study is to verify the accuracy of the commissioning of intensity-modulated radiation therapy (IMRT and volumetric-modulated arc therapy (VMAT based on the recommendation of the American Association of Physicists in Medicine Task Group 119 (TG-119. Materials and Methods: TG-119 proposes a set of clinical test cases to verify the accuracy of IMRT planning and delivery system. For these test cases, we generated two sets of treatment plans, the first plan using 7–9 IMRT fields and a second plan utilizing two-arc VMAT technique for both 6 MV and 15 MV photon beams. The template plans of TG-119 were optimized and calculated by Varian Eclipse Treatment Planning System (version 13.5. Dose prescription and planning objectives were set according to the TG-119 goals. The point dose (mean dose to the contoured chamber volume at the specified positions/locations was measured using compact (CC-13 ion chamber. The composite planar dose was measured with IMatriXX Evaluation 2D array with OmniPro IMRT Software (version 1.7b. The per-field relative gamma was measured using electronic portal imaging device in a way similar to the routine pretreatment patient-specific quality assurance. Results: Our planning results are compared with the TG-119 data. Point dose and fluence comparison data where within the acceptable confident limit. Conclusion: From the obtained data in this study, we conclude that the commissioning of IMRT and VMAT delivery were found within the limits of TG-119.

Helium ions for radiotherapy? Physical and biological verifications of a novel treatment modality

Energy Technology Data Exchange (ETDEWEB)

Krämer, Michael, E-mail: m.kraemer@gsi.de; Scifoni, Emanuele; Schuy, Christoph; Rovituso, Marta; Maier, Andreas; Kaderka, Robert; Kraft-Weyrather, Wilma [Biophysics, GSI Helmholtzzentrum für Schwerionenforschung GmbH, Planckstr. 1, 64291 Darmstadt (Germany); Tinganelli, Walter; Durante, Marco [Biophysics, GSI Helmholtzzentrum für Schwerionenforschung GmbH, Planckstr. 1, 64291 Darmstadt, Germany and Trento Institute for Fundamental Physics and Application (TIFPA-INFN), 38123, via Sommarive 14, Trento (Italy); Brons, Stephan; Tessonnier, Thomas [Heidelberger Ionenstrahl-Therapiezentrum (HIT), Im Neuenheimer Feld 450, 69120 Heidelberg, Germany and Radioonkologie und Strahlentherapie, Universitätsklinikums Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg (Germany); Parodi, Katia [Heidelberger Ionenstrahl-Therapiezentrum (HIT), Im Neuenheimer Feld 450, 69120 Heidelberg (Germany); Radioonkologie und Strahlentherapie, Universitätsklinikums Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg (Germany); Ludwig-Maximilians-Universitaet Muenchen (LMU Munich), Department of Medical Physics, Am Coulombwall 1, 85748 Munich (Germany)

2016-04-15

Purpose: Modern facilities for actively scanned ion beam radiotherapy allow in principle the use of helium beams, which could present specific advantages, especially for pediatric tumors. In order to assess the potential use of these beams for radiotherapy, i.e., to create realistic treatment plans, the authors set up a dedicated {sup 4}He beam model, providing base data for their treatment planning system TRiP98, and they have reported that in this work together with its physical and biological validations. Methods: A semiempirical beam model for the physical depth dose deposition and the production of nuclear fragments was developed and introduced in TRiP98. For the biological effect calculations the last version of the local effect model was used. The model predictions were experimentally verified at the HIT facility. The primary beam attenuation and the characteristics of secondary charged particles at various depth in water were investigated using {sup 4}He ion beams of 200 MeV/u. The nuclear charge of secondary fragments was identified using a ΔE/E telescope. 3D absorbed dose distributions were measured with pin point ionization chambers and the biological dosimetry experiments were realized irradiating a Chinese hamster ovary cells stack arranged in an extended target. Results: The few experimental data available on basic physical processes are reproduced by their beam model. The experimental verification of absorbed dose distributions in extended target volumes yields an overall agreement, with a slight underestimation of the lateral spread. Cell survival along a 4 cm extended target is reproduced with remarkable accuracy. Conclusions: The authors presented a simple simulation model for therapeutical {sup 4}He beams which they introduced in TRiP98, and which is validated experimentally by means of physical and biological dosimetries. Thus, it is now possible to perform detailed treatment planning studies with {sup 4}He beams, either exclusively or in

RESRAD-BUILD verification

International Nuclear Information System (INIS)

Kamboj, S.; Yu, C.; Biwer, B. M.; Klett, T.

2002-01-01

The results generated by the RESRAD-BUILD code (version 3.0) were verified with hand or spreadsheet calculations using equations given in the RESRAD-BUILD manual for different pathways. For verification purposes, different radionuclides--H-3, C-14, Na-22, Al-26, Cl-36, Mn-54, Co-60, Au-195, Ra-226, Ra-228, Th-228, and U-238--were chosen to test all pathways and models. Tritium, Ra-226, and Th-228 were chosen because of the special tritium and radon models in the RESRAD-BUILD code. Other radionuclides were selected to represent a spectrum of radiation types and energies. Verification of the RESRAD-BUILD code was conducted with an initial check of all the input parameters for correctness against their original source documents. Verification of the calculations was performed external to the RESRAD-BUILD code with Microsoft Excel to verify all the major portions of the code. In some cases, RESRAD-BUILD results were compared with those of external codes, such as MCNP (Monte Carlo N-particle) and RESRAD. The verification was conducted on a step-by-step basis and used different test cases as templates. The following types of calculations were investigated: (1) source injection rate, (2) air concentration in the room, (3) air particulate deposition, (4) radon pathway model, (5) tritium model for volume source, (6) external exposure model, (7) different pathway doses, and (8) time dependence of dose. Some minor errors were identified in version 3.0; these errors have been corrected in later versions of the code. Some possible improvements in the code were also identified

siRNA as a tool to improve the treatment of brain diseases: Mechanism, targets and delivery.

Science.gov (United States)

Gomes, Maria João; Martins, Susana; Sarmento, Bruno

2015-05-01

As the population ages, brain pathologies such as neurodegenerative diseases and brain cancer increase their incidence, being the need to find successful treatments of upmost importance. Drug delivery to the central nervous system (CNS) is required in order to reach diseases causes and treat them. However, biological barriers, mainly blood-brain barrier (BBB), are the key obstacles that prevent the effectiveness of possible treatments due to their ability to strongly limit the perfusion of compounds into the brain. Over the past decades, new approaches towards overcoming BBB and its efflux transporters had been proposed. One of these approaches here reviewed is through small interfering RNA (siRNA), which is capable to specifically target one gene and silence it in a post-transcriptional way. There are different possible functional proteins at the BBB, as the ones responsible for transport or just for its tightness, which could be a siRNA target. As important as the effective silence is the way to delivery siRNA to its anatomical site of action. This is where nanotechnology-based systems may help, by protecting siRNA circulation and providing cell/tissue-targeting and intracellular siRNA delivery. After an initial overview on incidence of brain diseases and basic features of the CNS, BBB and its efflux pumps, this review focuses on recent strategies to reach brain based on siRNA, and how to specifically target these approaches in order to treat brain diseases. Copyright © 2015 Elsevier B.V. All rights reserved.

A two-dimensional liquid-filled ionization chamber array prototype for small-field verification: characterization and first clinical tests

International Nuclear Information System (INIS)

Brualla-González, Luis; Vicedo, Aurora; Roselló, Joan V; Gómez, Faustino; González-Castaño, Diego M; Gago-Arias, Araceli; Pazos, Antonio; Zapata, Martín; Pardo-Montero, Juan

2012-01-01

In this work we present the design, characterization and first clinical tests of an in-house developed two-dimensional liquid-filled ionization chamber prototype for the verification of small radiotherapy fields and treatments containing such small fields as in radiosurgery, which consists of 2 mm × 2 mm pixels arranged on a 16×8 rectangular grid. The ionization medium is isooctane. The characterization of the device included the study of depth, field-size and dose-rate dependences, which are sufficiently moderate for a good operation at therapy radiation levels. However, the detector presents an important anisotropic response, up to ≃ 12% for front versus near-lateral incidence, which can impact the verification of full treatments with different incidences. In such a case, an anisotropy correction factor can be applied. Output factors of small square fields measured with the device show a small systematic over-response, less than 1%, when compared to unshielded diode measurements. An IMRT radiosurgery treatment has been acquired with the liquid-filled ionization chamber device and compared with film dosimetry by using the gamma method, showing good agreement: over 99% passing rates for 1.2% and 1.2 mm for an incidence-per-incidence analysis; 100% passing rates for tolerances 1.8% and 1.8 mm when the whole treatment is analysed and the anisotropy correction factor is applied. The point dose verification for each incidence of the treatment performed with the liquid-filled ionization chamber agrees within 1% with a CC01 ionization chamber. This prototype has shown the utility of this kind of technology for the verification of small fields/treatments. Currently, a larger device covering a 5 cm × 5 cm area is under development. (paper)

Spent fuel verification options for final repository safeguards in Finland. A study on verification methods, their feasibility and safety aspects

International Nuclear Information System (INIS)

Hautamaeki, J.; Tiitta, A.

2000-12-01

The verification possibilities of the spent fuel assemblies from the Olkiluoto and Loviisa NPPs and the fuel rods from the research reactor of VTT are contemplated in this report. The spent fuel assemblies have to be verified at the partial defect level before the final disposal into the geologic repository. The rods from the research reactor may be verified at the gross defect level. Developing a measurement system for partial defect verification is a complicated and time-consuming task. The Passive High Energy Gamma Emission Tomography and the Fork Detector combined with Gamma Spectrometry are the most potential measurement principles to be developed for this purpose. The whole verification process has to be planned to be as slick as possible. An early start in the planning of the verification and developing the measurement devices is important in order to enable a smooth integration of the verification measurements into the conditioning and disposal process. The IAEA and Euratom have not yet concluded the safeguards criteria for the final disposal. E.g. criteria connected to the selection of the best place to perform the verification. Measurements have not yet been concluded. Options for the verification places have been considered in this report. One option for a verification measurement place is the intermediate storage. The other option is the encapsulation plant. Crucial viewpoints are such as which one offers the best practical possibilities to perform the measurements effectively and which would be the better place in the safeguards point of view. Verification measurements may be needed both in the intermediate storages and in the encapsulation plant. In this report also the integrity of the fuel assemblies after wet intermediate storage period is assessed, because the assemblies have to stand the handling operations of the verification measurements. (orig.)

Patients setup verification tool for RT (PSVTs): DRR, simulation, portal and digital images

International Nuclear Information System (INIS)

Lee, Suk; Seong, Jin Sil; Chu, Sung Sil; Lee, Chang Geol; Suh, Chang Ok; Kwon, Soo Il

2003-01-01

To develop a patients' setup verification tool (PSVT) to verify the alignment of the machine and the target isocenters, and the reproducibility of patients' setup for three dimensional conformal radiotherapy (3DCRT) and intensity modulated radiotherapy (MRT). The utilization of this system is evaluated through phantom and patient case studies. We developed and clinically tested a new method for patients' setup verification, using digitally reconstructed radiography (DRR), simulation, portal and digital images. The PSVT system was networked to a Pentium PC for the transmission of the acquired images to the PC for analysis. To verify the alignment of the machine and target isocenters, orthogonal pairs of simulation images were used as verification images. Errors in the isocenter alignment were measured by comparing the verification images with DRR of CT images. Orthogonal films were taken of all the patients once a week. These verification films were compared with the DRR were used for the treatment setup. By performing this procedure every treatment, using humanoid phantom and patient cases, the errors of localization can be analyzed, with adjustments made from the translation. The reproducibility of the patients' setup was verified using portal and digital images. The PSVT system was developed to verify the alignment of the machine and the target isocenters, and the reproducibility of the patients' setup for 3DCRT and IMRT The results show that the localization errors are 0.8±0.2 mm (AP) and 1.0±0.3 mm (Lateral) in the cases relating to the brain and 1.1± 0.5 mm (AP) and 1.0±0.6 mm (Lateral) in the cases relating to the pelvis. The reproducibility of the patients' setup was verified by visualization, using real-time image acquisition, leading to the practical utilization of our software. A PSVT system was developed for the verification of the alignment between machine and the target isocenters, and the reproducibility of the patients' setup in 3DCRT and IMRT

Dosimetric inter-institutional comparison in European radiotherapy centres: Results of IAEA supported treatment planning system audit.

Science.gov (United States)

Gershkevitsh, Eduard; Pesznyak, Csilla; Petrovic, Borislava; Grezdo, Joseph; Chelminski, Krzysztof; do Carmo Lopes, Maria; Izewska, Joanna; Van Dyk, Jacob

2014-05-01

One of the newer audit modalities operated by the International Atomic Energy Agency (IAEA) involves audits of treatment planning systems (TPS) in radiotherapy. The main focus of the audit is the dosimetry verification of the delivery of a radiation treatment plan for three-dimensional (3D) conformal radiotherapy using high energy photon beams. The audit has been carried out in eight European countries - Estonia, Hungary, Latvia, Lithuania, Serbia, Slovakia, Poland and Portugal. The corresponding results are presented. The TPS audit reviews the dosimetry, treatment planning and radiotherapy delivery processes using the 'end-to-end' approach, i.e. following the pathway similar to that of the patient, through imaging, treatment planning and dose delivery. The audit is implemented at the national level with IAEA assistance. The national counterparts conduct the TPS audit at local radiotherapy centres through on-site visits. TPS calculated doses are compared with ion chamber measurements performed in an anthropomorphic phantom for eight test cases per algorithm/beam. A set of pre-defined agreement criteria is used to analyse the performance of TPSs. TPS audit was carried out in 60 radiotherapy centres. In total, 190 data sets (combination of algorithm and beam quality) have been collected and reviewed. Dosimetry problems requiring interventions were discovered in about 10% of datasets. In addition, suboptimal beam modelling in TPSs was discovered in a number of cases. The TPS audit project using the IAEA methodology has verified the treatment planning system calculations for 3D conformal radiotherapy in a group of radiotherapy centres in Europe. It contributed to achieving better understanding of the performance of TPSs and helped to resolve issues related to imaging, dosimetry and treatment planning.