J Appl Clin Med Phys
-
J Appl Clin Med Phys · Mar 2015
Efficacy and workload analysis of a fixed vertical couch position technique and a fixed-action-level protocol in whole-breast radiotherapy.
Quantification of the setup errors is vital to define appropriate setup margins preventing geographical misses. The no-action-level (NAL) correction protocol reduces the systematic setup errors and, hence, the setup margins. The manual entry of the setup corrections in the record-and-verify software, however, increases the susceptibility of the NAL protocol to human errors. ⋯ Compared to the NAL protocol, a correction threshold of 2.5mm reduced the frequency of mediolateral and superior-inferior setup corrections with 40% and 63%, respectively. The implementation of the correction threshold did not deteriorate the accuracy of the off-line setup correction compared to the NAL protocol. The combination of the fixed vertical couch position protocol, for correction of the anteroposterior setup error, and the fixed-action-level protocol with 2.5 mm correction threshold, for correction of the mediolateral and the superior-inferior setup errors, was proved to provide adequate and comparable patient setup accuracy in WBRT and WBRT with additional LN irradiation.
-
J Appl Clin Med Phys · Mar 2015
Clinical experience using a video-guided spirometry system for deep inhalation breath-hold radiotherapy of left-sided breast cancer.
The purpose was to report clinical experience of a video-guided spirometry system in applying deep inhalation breath-hold (DIBH) radiotherapy for left-sided breast cancer, and to study the systematic and random uncertainties, intra- and interfraction motion and impact on cardiac dose associated with DIBH. The data from 28 left-sided breast cancer patients treated with spirometer-guided DIBH radiation were studied. Dosimetric comparisons between free-breathing (FB) and DIBH plans were performed. ⋯ The interfraction chest wall motions were 3.6 mm in "AP" and 3.4 mm in SI. Utilization of DIBH with this spirometry system led to a statistically significant reduction of cardiac dose relative to FB treatment. The DIBH using video-guided spirometry provided reproducible cardiac sparing with minimal intra- and interfraction chest wall motion, and thus is a valuable adjunct to modern breast treatment techniques.
-
This issue's editorial is an invited commentary authored by Per H. Halvorsen.* It discusses an essential question for clinically practicing medical physicists: How are external factors likely to change the way we practice our profession in the next decade? The topic is both timely and essential, as the AAPM is actively engaged in developing guidance on many related aspects. This editorial sets the framework and provides the personal observations of an individual who has led the AAPM's Professional Council for the past six years.
-
J Appl Clin Med Phys · Nov 2014
Optimization of the rounded leaf offset table in modeling the multileaf collimator leaf edge in a commercial treatment planning system.
An editable rounded leaf offset (RLO) table is provided in the Pinnacle3 treatment planning software. Default tables are provided for major linear accelerator manu- facturers, but it is not clear how the default table values should be adjusted by the user to optimize agreement between the calculated leaf tip value and the actual measured value. Since we wish for the calculated MLC-defined field edge to closely match the actual delivered field edge, optimal RLO table values are crucial. ⋯ Modified RLO tables were developed and evaluated for both dosimetric and light field-based MLC leaf calibrations. It was shown, using a Picket Fence type test, that the optimized RLO table better modeled the calculated leaf tip than the Pinnacle3 default table. This was demonstrated for both an Elekta Synergy 80-leaf and a Varian 120-leaf MLC.
-
J Appl Clin Med Phys · May 2014
Comparative StudyDosimetric study of uniform scanning proton therapy planning for prostate cancer patients with a metal hip prosthesis, and comparison with volumetric-modulated arc therapy.
The main purposes of this study were to 1) investigate the dosimetric quality of uniform scanning proton therapy planning (USPT) for prostate cancer patients with a metal hip prosthesis, and 2) compare the dosimetric results of USPT with that of volumetric-modulated arc therapy (VMAT). Proton plans for prostate cancer (four cases) were generated in XiO treatment planning system (TPS). The beam arrangement in each proton plan consisted of three fields (two oblique fields and one lateral or slightly angled field), and the proton beams passing through a metal hip prosthesis was avoided. ⋯ The average mean dose to the rectum and bladder was lower in the proton plans by 45.1% and 22.0%, respectively, whereas the mean dose to femoral head was lower in VMAT plans by an average difference of 79.6%. In comparison to the VMAT, the proton planning produced lower equivalent uniform dose (EUD) for the rectum (43.7 CGE vs. 51.4 Gy) and higher EUD for the femoral head (16.7 CGE vs. 9.5 Gy), whereas both the VMAT and proton planning produced comparable EUDs for the prostate tumor (76.2 CGE vs. 76.8 Gy) and bladder (50.3 CGE vs. 51.1 Gy). The results presented in this study show that the combination of lateral and oblique fields in USPT planning could potentially provide dosimetric advantage over the VMAT for prostate cancer involving a metallic hip prosthesis.