Med Phys
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Intensity-modulated radiation therapy (IMRT) represents one of the most significant technical advances in radiation therapy since the advent of the medical linear accelerator. It allows the clinical implementation of highly conformal nonconvex dose distributions. This complex but promising treatment modality is rapidly proliferating in both academic and community practice settings. ⋯ Therefore, the purpose of this report is to guide and assist the clinical medical physicist in developing and implementing a viable and safe IMRT program. The scope of the IMRT program is quite broad, encompassing multileaf-collimator-based IMRT delivery systems, goal-based inverse treatment planning, and clinical implementation of IMRT with patient-specific quality assurance. This report, while not prescribing specific procedures, provides the framework and guidance to allow clinical radiation oncology physicists to make judicious decisions in implementing a safe and efficient IMRT program in their clinics.
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Comparative Study
Flat panel detector-based cone beam computed tomography with a circle-plus-two-arcs data acquisition orbit: preliminary phantom study.
Cone beam computed tomography (CBCT) has been investigated in the past two decades due to its potential advantages over a fan beam CT. These advantages include (a) great improvement in data acquisition efficiency, spatial resolution, and spatial resolution uniformity, (b) substantially better utilization of x-ray photons generated by the x-ray tube compared to a fan beam CT, and (c) significant advancement in clinical three-dimensional (3D) CT applications. However, most studies of CBCT in the past are focused on cone beam data acquisition theories and reconstruction algorithms. ⋯ The results obtained using the new cone beam acquisition orbit and the related reconstruction algorithm were compared to those obtained using a single-circle cone beam geometry and Feldkamp's algorithm in terms of reconstruction accuracy. The results of the study demonstrate that the circle-plus-two-arcs cone beam orbit is achievable in practice. Also, the reconstruction accuracy of cone beam reconstruction is significantly improved with the circle-plus-two-arcs orbit and its related exact CB-FPB algorithm, as compared to using a single circle cone beam orbit and Feldkamp's algorithm.
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Comparative Study
Automated lung nodule classification following automated nodule detection on CT: a serial approach.
We have evaluated the performance of an automated classifier applied to the task of differentiating malignant and benign lung nodules in low-dose helical computed tomography (CT) scans acquired as part of a lung cancer screening program. The nodules classified in this manner were initially identified by our automated lung nodule detection method, so that the output of automated lung nodule detection was used as input to automated lung nodule classification. This study begins to narrow the distinction between the "detection task" and the "classification task." Automated lung nodule detection is based on two- and three-dimensional analyses of the CT image data. ⋯ The automated classification method was applied to the computerized detection results obtained from a database of 393 low-dose thoracic CT scans containing 470 confirmed lung nodules (69 malignant and 401 benign nodules). Receiver operating characteristic (ROC) analysis was used to evaluate the ability of the classifier to differentiate between nodule candidates that correspond to malignant nodules and nodule candidates that correspond to benign lesions. The area under the ROC curve for this classification task attained a value of 0.79 during a leave-one-out evaluation.
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Comparative Study
Evaluation of the transmitted exposure through lead equivalent aprons used in a radiology department, including the contribution from backscatter.
A study was conducted to evaluate the radiation transmission through lead equivalent aprons that are used in a radiology department. A large area beam (poor geometry) was employed for the transmission measurements, and backscatter was simulated by placing 7" of Lucite behind each apron. Separate ionization chambers were used to measure the incident and transmitted x-ray beams. ⋯ The radiation transmissions at 70 kVp, through two "lead-free" 0.5 mm lead equivalent aprons, were 1.7% and 1.9% and at 100 kVp the transmissions were 6.1% and 6.8%, respectively. This study indicates that there is a need to establish methods for acceptance testing of aprons and a need to establish acceptance limits for the x-ray transmission of aprons at specific kVp values. There is also a need for the establishment of appropriate methods and frequencies of routine quality assurance testing of radiation protection aprons.
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Comparative Study
A method for the reconstruction of four-dimensional synchronized CT scans acquired during free breathing.
Breathing motion is a significant source of error in radiotherapy treatment planning for the thorax and upper abdomen. Accounting for breathing motion has a profound effect on the size of conformal radiation portals employed in these sites. Breathing motion also causes artifacts and distortions in treatment planning computed tomography (CT) scans acquired during free breathing and also causes a breakdown of the assumption of the superposition of radiation portals in intensity-modulated radiation therapy, possibly leading to significant dose delivery errors. ⋯ The actual tidal lung volumes agreed with the specified bin volumes within standard deviations ranging between 22 and 33 cm3. An analysis of sagittal and coronal images demonstrated relatively small (<1 cm) motion artifacts along the diaphragm, even for tidal volumes where the rate of breathing motion is greatest. While still under development, this technology has the potential for revolutionizing the radiotherapy treatment planning for the thorax and upper abdomen.