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Stern W, Alaei P, Berbeco R, DeWerd LA, Kamen J, MacKenzie C, Moros EG, Poirier Y, Potter CA, Schaue D, Patallo IS, Abend M, Swarts S, Trompier F. Recommendations for harmonized reporting of radiation Dosimetry by adoption of Compatibility in Irradiation Research Protocols Expert Roundtable (CIRPER). Int J Radiat Biol 2024:1-3. [PMID: 38568854 DOI: 10.1080/09553002.2024.2331130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 03/05/2024] [Indexed: 04/05/2024]
Affiliation(s)
- Warren Stern
- Nonproliferation and National Security Department, Brookhaven National Laboratory, Upton, NY, USA
| | - Parham Alaei
- Department of Radiation Oncology, University of Minnesota, Minneapolis, MN, USA
| | - Ross Berbeco
- Department of Radiation Oncology Brigham and Women's Hospital, Dana-Farber Cancer Institute, and Harvard Medical School, Boston, MA, USA
| | - Larry A DeWerd
- Medical Radiation Research Center, Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Jacob Kamen
- Department of Radiology, Mount Sinai Health System, New York, NY, USA
| | | | - Eduardo G Moros
- H. Lee Moffitt Cancer Center and Research Institute, Department of Oncological Sciences and Department of Physics, University of South Florida, Tampa, FL, USA
| | - Yannick Poirier
- Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MA, USA
| | | | - Dörthe Schaue
- Department of Radiation Oncology, David Geffen School of Medicine, University of California Los Angelos, Los Angeles, CA, USA
| | - Ileana Silvestre Patallo
- Medical Radiation Physics and Science Groups, National Physical Laboratory (NPL), Guilford, UK
- RadNet Standardization Dosimetry Group (Co-chair), Cancer Research UK (CRUK), London, UK
| | - Michael Abend
- Bundeswehr Institute of Radiobiology, Munich, Germany
| | - Steven Swarts
- Department of Radiation Oncology, University of Florida, Gainesville, FL, USA
| | - François Trompier
- Ionizing Radiation Dosimetry Laboratory (LDRI), Human Radiation Protection Unity, Institut de Radioprotection et de Sûreté Nucléaire (IRSN), Fontenay-aux-Rose, France
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Stern W, Alaei P, Berbeco R, DeWerd LA, Kamen J, MacKenzie C, Moros EG, Poirier Y, Potter CA, Schaue D, Patallo IS, Abend M, Swarts S, Trompier F. Achieving Consistent Reporting of Radiation Dosimetry by Adoption of Compatibility in Irradiation Research Protocols Expert Roundtable (CIRPER) Recommendations. Radiat Res 2024; 201:267-269. [PMID: 38205905 DOI: 10.1667/rade-23-00234.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 12/15/2023] [Indexed: 01/12/2024]
Affiliation(s)
- Warren Stern
- Nonproliferation and National Security Department, Brookhaven National Laboratory, Upton, New York
| | - Parham Alaei
- Department of Radiation Oncology, University of Minnesota, Minneapolis, Minnesota
| | - Ross Berbeco
- Department of Radiation Oncology Brigham and Women's Hospital, Dana-Farber Cancer Institute, and Harvard Medical School, Boston, Massachusetts
| | - Larry A DeWerd
- Medical Radiation Research Center, Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Jacob Kamen
- Department of Radiology, Mount Sinai Health System, New York, New York
| | | | - Eduardo G Moros
- H. Lee Moffitt Cancer Center and Research Institute, Department of Oncological Sciences and Department of Physics, University of South Florida, Tampa, Florida
| | - Yannick Poirier
- Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, Maryland
| | | | - Dörthe Schaue
- Department of Radiation Oncology, David Geffen School of Medicine, University of California Los Angeles, California
| | - Ileana Silvestre Patallo
- Medical Radiation Physics and Science Groups, National Physical Laboratory (NPL), Teddington, United Kingdom; RadNet Standardization Dosimetry Group (Co-chair), Cancer Research UK (CRUK), London, United Kingdom
| | - Michael Abend
- Bundeswehr Institute of Radiobiology, Munich, Germany
| | - Steven Swarts
- Department of Radiation Oncology, University of Florida, Gainesville, Florida
| | - François Trompier
- Ionizing Radiation Dosimetry Laboratory (LDRI), Human Radiation Protection Unity, Institut de Radioprotection et de Sûreté Nucléaire (IRSN), Fontenay-aux-Rose, France
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Becerra‐Espinosa N, Claps L, Alaei P. Comparison of visual and semi-automated kilovoltage cone beam CT image QA analysis. J Appl Clin Med Phys 2024; 25:e14190. [PMID: 37937765 PMCID: PMC10860539 DOI: 10.1002/acm2.14190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 10/08/2023] [Accepted: 10/12/2023] [Indexed: 11/09/2023] Open
Abstract
Established kilovoltage cone-beam computed tomography (kV-CBCT) image quality assurance (QA) guidelines often rely on recommendations provided by the American Association of Physicists in Medicine (AAPM) task group (TG) reports with metrics that use visual analysis. This can result in measurement variations by different users, especially in visually subjective analyzes such as low contrast resolution. Consequently, there is a growing interest in more automated means of image QA analysis that can offer increased consistency, accuracy, and convenience. This work compares visual QA to semi-automated software QA analysis to establish the performance and viability of a semi-automated method. In this study, a commercial product (RIT Radia. Radiological Imaging Technology, Colorado Springs, CO) was used to evaluate 68 months of kV-CBCT images of a Catphan® 504 phantom obtained from a Varian TrueBeam® linear accelerator. Six key metrics were examined: high contrast resolution, low contrast resolution, Hounsfield unit constancy, uniformity and noise, and spatial linearity. The results of this method were then compared to those recorded visually using Bland-Altman, and/or paired sample t-test. Comparison of all modules showed a non-random, statistically significant difference between visual and semi-automated methods except for LDPE and Teflon in the Hounsfield unit constancy analysis, which falls outside the paired sample t-test's 5% significance level. A small high contrast resolution bias indicates the two analysis methods are largely equivalent, while a large low contrast resolution bias indicates greater semi-automated target detection. Wide limits of agreement in the uniformity module suggests variability due to multiple visual observers. Spatial linearity results measured differences of less than 0.17%. Semi-automated QA analysis offered greater stability over visual analysis. Additionally, semi-automated QA results satisfied or exceeded visual QA passing criteria and allowed for fast and consistent image quality analysis.
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Affiliation(s)
- Nicholas Becerra‐Espinosa
- Department of Radiation OncologyUniversity of MinnesotaMinneapolisMinnesotaUSA
- Present address:
Northwestern Medicine Proton Center, 4455 Weaver PkwyWarrenville, IL 60555USA
| | - Lindsey Claps
- Department of Radiation OncologyUniversity of MinnesotaMinneapolisMinnesotaUSA
- Present address:
Department of Medical PhysicsMemorial Sloan Kettering Cancer Center, 1275 York AvenueNew York, NY 10065USA
| | - Parham Alaei
- Department of Radiation OncologyUniversity of MinnesotaMinneapolisMinnesotaUSA
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Fakhraei S, Ehler E, Sterling D, Chinsoo Cho L, Alaei P. A Patient-Specific correspondence model to track tumor location in thorax during radiation therapy. Phys Med 2023; 116:103167. [PMID: 37972484 DOI: 10.1016/j.ejmp.2023.103167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 10/08/2023] [Accepted: 11/05/2023] [Indexed: 11/19/2023] Open
Abstract
PURPOSE We present a patient-specific model to estimate tumor location in the thorax during radiation therapy using chest surface displacement as the surrogate signal. METHODS Two types of data are used for model construction: Four-dimensional computed tomography (4D-CT) images of the patient and the displacement of two points on the patient's skin on the thoracic area. Principal component analysis is used to fit the correspondence model. This model incorporates the recorded surrogate signals during radiation delivery as input and delivers the 3D trajectory of the tumor as output. We evaluated the accuracy of the proposed model on a respiratory phantom and five lung cancer patients. RESULTS For the respiratory phantom, the location of the center of the sphere during treatment was calculated in three directions: Left-Right (LR), Anterior-Posterior (AP) and, Superior-Inferior (SI). The error of localization was less than 1 mm in the LR and AP directions and less than 2 mm in the SI direction. The location of the tumor center for two of the patients, and the location of the apex of the diaphragm for the other three, was calculated in three directions. For all patients, the localization error in the LR and AP directions was less than 1.1 mm for two fractions and the maximum localization error in the SI direction was 6.4 mm. CONCLUSIONS This work presents a feasibility study of utilizing surface displacement data to locate the tumor in the thorax during radiation treatment. Future work will validate the model on a larger patient population.
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Affiliation(s)
- Sharareh Fakhraei
- Department of Radiation Oncology, University of Minnesota, Minneapolis, MN, 55455, USA.
| | - Eric Ehler
- Department of Radiation Oncology, University of Minnesota, Minneapolis, MN, 55455, USA
| | - David Sterling
- Department of Radiation Oncology, University of Minnesota, Minneapolis, MN, 55455, USA
| | - L Chinsoo Cho
- Department of Radiation Oncology, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Parham Alaei
- Department of Radiation Oncology, University of Minnesota, Minneapolis, MN, 55455, USA
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Zhang S, Reynolds M, Dusenbery K, Chen C, Alaei P, Alshreef A, Sterling D, Sloan L, Patel K, Ferreira C. Considerations in Treatment Planning and Dosimetric Specifications of Permanent 131Cs Brachytherapy Implantation in Treatment of Brain Tumor – An Institutional Experience. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.2217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Heidarloo N, Mahmoud Reza Aghamiri S, Saghamanesh S, Azma Z, Alaei P. A novel analytical method for computing dose from kilovoltage beams used in Image-Guided radiation therapy. Phys Med 2022; 96:54-61. [PMID: 35219962 DOI: 10.1016/j.ejmp.2022.02.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 02/12/2022] [Accepted: 02/20/2022] [Indexed: 10/19/2022] Open
Abstract
PURPOSE A modified convolution/superposition algorithm is proposed to compute dose from the kilovoltage beams used in IGRT. The algorithm uses material-specific energy deposition kernels instead of water-energy deposition kernels. METHODS Monte Carlo simulation was used to model the Elekta XVI unit and determine dose deposition characteristics of its kilovoltage beams. The dosimetric results were compared with ion chamber measurements. The dose from the kilovoltage beams was then computed using convolution/superposition along with material-specific energy deposition kernels and compared with Monte Carlo and measurements. The material-specific energy deposition kernels were previously generated using Monte Carlo. RESULTS The obtained gamma indices (using 2%/2mm criteria for 95% of points) were lower than 1 in almost all instances which indicates good agreement between simulated and measured depth doses and profiles. The comparisons of the algorithm with measurements in a homogeneous solid water slab phantom, and that with Monte Carlo in a head and neck CT dataset produced acceptable results. The calculated point doses were within 4.2% of measurements in the homogeneous phantom. Gamma analysis of the calculated vs. Monte Carlo simulations in the head and neck phantom resulted in 94% of points passing with a 2%/2mm criteria. CONCLUSIONS The proposed method offers sufficient accuracy in kilovoltage beams dose calculations and has the potential to supplement the conventional megavoltage convolution/superposition algorithms for dose calculations in low energy range.
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Affiliation(s)
- Nematollah Heidarloo
- Department of Medical Radiation Engineering, Shahid Beheshti University, Tehran, Iran
| | | | - Somayeh Saghamanesh
- Center for X-ray Analytics, Empa, Swiss Federal Laboratories for Materials Science and Technology, Dübendorf, Switzerland
| | - Zohreh Azma
- Department of Medical Radiation Engineering, Shahid Beheshti University, Tehran, Iran; Erfan Radiation Oncology Center, Erfan-Niyayesh hospital, Iran University of Medical Science, Tehran, Iran
| | - Parham Alaei
- Department of Radiation Oncology, University of Minnesota, Minneapolis, MN, USA
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Fakhraei S, Ehler E, Sterling D, Cho L, Alaei P. A Patient-Specific Correspondence Model to Track Tumor Location in Thorax During Radiation Therapy. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Heidarloo N, Aghamiri SMR, Saghamanesh S, Azma Z, Alaei P. Generation of material-specific energy deposition kernels for kilovoltage x-ray dose calculations. Med Phys 2021; 48:5423-5439. [PMID: 34173989 DOI: 10.1002/mp.15061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 06/11/2021] [Accepted: 06/14/2021] [Indexed: 11/10/2022] Open
Abstract
PURPOSE Dose calculation of kilovoltage x rays used in Image-Guided Radiotherapy has been investigated in recent years using various methods. Among these methods are model-based ones that suffer from inaccuracies in high-density materials and at interfaces when used in the kilovoltage energy range. The main reason for this is the use of water energy deposition kernels and simplifications employed such as density scaling in heterogeneous media. The purpose of this study was to produce and characterize material-specific energy deposition kernels, which could be used for dose calculations in this energy range. These kernels will also have utility in dose calculations in superficial radiation therapy and orthovoltage beams utilized in small animal irradiators. METHODS Water energy deposition kernels with various resolutions; and high-resolution, material-specific energy deposition kernels were generated in the energy range of 10-150 kVp, using the EGSnrc Monte Carlo toolkit. The generated energy deposition kernels were further characterized by calculating the effective depth of penetration, the effective radial distance, and the effective lateral distance. A simple benchmarking of the kernels against Monte Caro calculations has also been performed. RESULTS There was good agreement with previously reported water kernels, as well as between kernels with different resolution. The evaluation of effective depth of penetration, and radial and laterals distances, defines the relationship between energy, material density, and the shape of the material-specific kernels. The shape of these kernels becomes more forwardly scattered as the energy and material density are increased. The comparison of the dose calculated using the kernels with Monte Carlo provides acceptable results. CONCLUSIONS Water and material-specific energy deposition kernels in the kilovoltage energy range have been generated, characterized, and compared to previous work. These kernels will have utility in dose calculations in this energy range once algorithms capable of employing them are fully developed.
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Affiliation(s)
- Nematollah Heidarloo
- Department of Medical Radiation Engineering, Shahid Beheshti University, Tehran, Iran
| | | | - Somayeh Saghamanesh
- Center for X-ray Analytics, Empa, Swiss Federal Laboratories for Materials Science and Technology, Dübendorf, Switzerland
| | - Zohreh Azma
- Department of Medical Radiation Engineering, Shahid Beheshti University, Tehran, Iran.,Erfan Radiation Oncology Center, Erfan-Niyayesh Hospital, Iran University of Medical Science, Tehran, Iran
| | - Parham Alaei
- Department of Radiation Oncology, University of Minnesota, Minneapolis, MN, USA
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Zuro D, Madabushi SS, Brooks J, Chen BT, Goud J, Salhotra A, Song JY, Parra LE, Pierini A, Sanchez JF, Stein A, Malki MA, Kortylewski M, Wong JYC, Alaei P, Froelich J, Storme G, Hui SK. First Multimodal, Three-Dimensional, Image-Guided Total Marrow Irradiation Model for Preclinical Bone Marrow Transplantation Studies. Int J Radiat Oncol Biol Phys 2021; 111:671-683. [PMID: 34119592 DOI: 10.1016/j.ijrobp.2021.06.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 05/28/2021] [Accepted: 06/04/2021] [Indexed: 01/13/2023]
Abstract
PURPOSE Total marrow irradiation (TMI) has significantly advanced radiation conditioning for hematopoietic cell transplantation in hematologic malignancies by reducing conditioning-induced toxicities and improving survival outcomes in relapsed/refractory patients. However, the relapse rate remains high, and the lack of a preclinical TMI model has hindered scientific advancements. To accelerate TMI translation to the clinic, we developed a TMI delivery system in preclinical models. METHODS AND MATERIALS A Precision X-RAD SmART irradiator was used for TMI model development. Images acquired with whole-body contrast-enhanced computed tomography (CT) were used to reconstruct and delineate targets and vital organs for each mouse. Multiple beam and CT-guided Monte Carlo-based plans were performed to optimize doses to the targets and to vary doses to the vital organs. Long-term engraftment and reconstitution potential were evaluated by a congenic bone marrow transplantation (BMT) model and serial secondary BMT, respectively. Donor cell engraftment was measured using noninvasive bioluminescence imaging and flow cytometry. RESULTS Multimodal imaging enabled identification of targets (skeleton and spleen) and vital organs (eg, lungs, gut, liver). In contrast to total body irradiation (TBI), TMI treatment allowed variation of radiation dose exposure to organs relative to the target dose. Dose reduction mirrored that in clinical TMI studies. Similar to TBI, mice treated with different TMI regimens showed full long-term donor engraftment in primary BMT and second serial BMT. The TBI-treated mice showed acute gut damage, which was minimized in mice treated with TMI. CONCLUSIONS A novel multimodal image guided preclinical TMI model is reported here. TMI conditioning maintained long-term engraftment with reconstitution potential and reduced organ damage. Therefore, this TMI model provides a unique opportunity to study the therapeutic benefit of reduced organ damage and BM dose escalation to optimize treatment regimens in BMT and hematologic malignancies.
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Affiliation(s)
- Darren Zuro
- Department of Radiation Oncology, City of Hope Medical Center, Duarte, California
| | | | - Jamison Brooks
- Department of Radiation Oncology, City of Hope Medical Center, Duarte, California
| | - Bihong T Chen
- Department of Diagnostic Radiology, City of Hope Medical Center, Duarte, California
| | - Janagama Goud
- Department of Radiation Oncology, City of Hope Medical Center, Duarte, California
| | - Amandeep Salhotra
- Department of Hematology and HCT, City of Hope Medical Center, Duarte, California
| | - Joo Y Song
- Department of Pathology, City of Hope Medical Center, Duarte, California
| | | | - Antonio Pierini
- Division of Hematology and Clinical Immunology, Department of Medicine, University of Perugia, Perugia, Italy
| | - James F Sanchez
- Beckman Research Institute of City of Hope, Duarte, California
| | - Anthony Stein
- Department of Hematology and HCT, City of Hope Medical Center, Duarte, California
| | - Monzr Al Malki
- Department of Hematology and HCT, City of Hope Medical Center, Duarte, California
| | - Marcin Kortylewski
- Department of Immuno-Oncology, Beckman Research Institute, City of Hope, Duarte, California
| | - Jeffrey Y C Wong
- Department of Radiation Oncology, City of Hope Medical Center, Duarte, California
| | - Parham Alaei
- Department of Radiation Oncology, University of Minnesota, Minneapolis, Minnesota
| | - Jerry Froelich
- Department of Radiology, University of Minnesota, Minneapolis, Minnesota
| | - Guy Storme
- Department of Radiotherapy UZ Brussels, Brussels, Belgium
| | - Susanta K Hui
- Department of Radiation Oncology, City of Hope Medical Center, Duarte, California; Beckman Research Institute of City of Hope, Duarte, California; Department of Radiation Oncology, University of Minnesota, Minneapolis, Minnesota.
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Ferreira C, Sterling D, Reynolds M, Dusenbery K, Chen C, Alaei P. First clinical implementation of GammaTile permanent brain implants after FDA clearance. Brachytherapy 2021; 20:673-685. [PMID: 33487560 DOI: 10.1016/j.brachy.2020.12.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 11/17/2020] [Accepted: 12/10/2020] [Indexed: 01/18/2023]
Abstract
PURPOSE GammaTile cesium-131 (131Cs) permanent brain implant has received Food and Drug Administration (FDA) clearance as a promising treatment for certain brain tumors. Our center was the first institution in the United States after FDA clearance to offer the clinical use of GammaTile brachytherapy outside of a clinical trial. The purpose of this work is to aid the medical physicist and radiation oncologist in implementing this collagen carrier tile brachytherapy (CTBT) program in their practice. METHODS A total of 23 patients have been treated with GammaTile to date at our center. Treatment planning system (TPS) commissioning was performed by configuring the parameters for the 131Cs (IsoRay Model CS-1, Rev2) source, and doses were validated with the consensus data from the American Association of Physicists in Medicine TG-43U1S2. Implant procedures, dosimetry, postimplant planning, and target delineations were established based on our clinical experience. Radiation safety aspects were evaluated based on exposure rate measurements of implanted patients, as well as body and ring badge measurements. RESULTS An estimated timeframe of the GammaTile clinical responsibilities for the medical physicist, radiation oncologist, and neurosurgeon is presented. TPS doses were validated with published dose to water for 131Cs. Clinical aspects, including estimation of the number of tiles, treatment planning, dosimetry, and radiation safety considerations, are presented. CONCLUSION The implementation of the GammaTile program requires collaboration from multiple specialties, including medical physics, radiation oncology, and neurosurgery. This manuscript provides a roadmap for the implementation of this therapy.
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Affiliation(s)
- Clara Ferreira
- Department of Radiation Oncology, University of Minnesota, Minneapolis, MN.
| | - David Sterling
- Department of Radiation Oncology, University of Minnesota, Minneapolis, MN
| | - Margaret Reynolds
- Department of Radiation Oncology, University of Minnesota, Minneapolis, MN
| | - Kathryn Dusenbery
- Department of Radiation Oncology, University of Minnesota, Minneapolis, MN
| | - Clark Chen
- Department of Neurosurgery, University of Minnesota, Minneapolis, MN
| | - Parham Alaei
- Department of Radiation Oncology, University of Minnesota, Minneapolis, MN
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Abstract
Purpose Cone beam computed tomography (CBCT) is often used for patient setup based solely on bony anatomy. The goal of this work was to evaluate whether CBCT dose can be lowered to the level of kV image pair doses when used for bony anatomy‐based IGRT without compromising positioning accuracy. Methods An anthropomorphic phantom was CT scanned in the head, head and neck, chest, and pelvis regions and setup on the linear accelerator couch with the isocenter near the planned location. Cone beam computed tomographies were performed with the standard “full dose” protocol supplied by the linac vendor. With sequentially lowering the dose, three‐dimensional (3D) matching was performed for each without shifting the couch. The standard kV image pair protocol for each site was also used to image the phantoms. For all studies, six degrees of freedom was included in the 2D or 3D matching to the extent they could be employed. Imaging doses were determined in air at isocenter following the TG‐61 formalism. Results Cone beam computed tomography dose was reduced by 81–98% of the standard CBCT protocol to nearly that of the standard kV image pair dose for each site. Relative to the standard CBCT shift values, translational shifts were within 0.3 and 1.6 mm for all sites, for the reduced dose CBCT and kV image pair, respectively. Rotational shifts were within 0.2 degree and 0.7 degrees for all sites, for the reduced dose CBCTs and kV image pair, respectively. Conclusion For bony anatomy‐based image guidance, CBCT dose can be reduced to a value similar to that of a kV image pair with similar or better patient positioning accuracy than kV image pair alignment. Where rotations are important to correct, CBCT will be superior to orthogonal kV imaging without significantly increased imaging dose. This is especially important for image guidance for pediatric patient treatments.
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Affiliation(s)
- Arthur J Olch
- Radiation Oncology Program, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - Parham Alaei
- Department of Radiation Oncology, University of Minnesota, Minneapolis, MN, USA
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Rossetti-Chung A, Lawrence J, Bhela S, Alaei P, Claps L, Wilke C, Vezys V. Tumor-Targeted Low-dose Radiation and Immunotherapy in Mouse Models of Melanoma. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.1724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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13
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Hua CH, Vern-Gross TZ, Hess CB, Olch AJ, Alaei P, Sathiaseelan V, Deng J, Ulin K, Laurie F, Gopalakrishnan M, Esiashvili N, Wolden SL, Krasin MJ, Merchant TE, Donaldson SS, FitzGerald TJ, Constine LS, Hodgson DC, Haas-Kogan DA, Mahajan A, Laack N, Marcus KJ, Taylor PA, Ahern VA, Followill DS, Buchsbaum JC, Breneman JC, Kalapurakal JA. Practice patterns and recommendations for pediatric image-guided radiotherapy: A Children's Oncology Group report. Pediatr Blood Cancer 2020; 67:e28629. [PMID: 32776500 PMCID: PMC7774502 DOI: 10.1002/pbc.28629] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 06/16/2020] [Accepted: 07/19/2020] [Indexed: 12/18/2022]
Abstract
This report by the Radiation Oncology Discipline of Children's Oncology Group (COG) describes the practice patterns of pediatric image-guided radiotherapy (IGRT) based on a member survey and provides practice recommendations accordingly. The survey comprised of 11 vignettes asking clinicians about their recommended treatment modalities, IGRT preferences, and frequency of in-room verification. Technical questions asked physicists about imaging protocols, dose reduction, setup correction, and adaptive therapy. In this report, the COG Radiation Oncology Discipline provides an IGRT modality/frequency decision tree and the expert guidelines for the practice of ionizing image guidance in pediatric radiotherapy patients.
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Affiliation(s)
- Chia-ho Hua
- Department of Radiation Oncology, St. Jude Children’s Research Hospital, Memphis, Tennessee
| | | | - Clayton B. Hess
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts
- Department of Radiation Oncology, Emory University, Atlanta, Georgia
| | - Arthur J. Olch
- Department of Radiation Oncology, University of Southern California and Children’s Hospital of Los Angeles, Los Angeles, California
| | - Parham Alaei
- Department of Radiation Oncology, University of Minnesota, Minneapolis, Minnesota
| | | | - Jun Deng
- Department of Therapeutic Radiology, Yale University, New Haven, Connecticut
| | - Kenneth Ulin
- Department of Radiation Oncology, University of Massachusetts, Worcester, Massachusetts
| | - Fran Laurie
- Department of Radiation Oncology, University of Massachusetts, Worcester, Massachusetts
| | | | - Natia Esiashvili
- Department of Radiation Oncology, Emory University, Atlanta, Georgia
| | - Suzanne L. Wolden
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Matthew J. Krasin
- Department of Radiation Oncology, St. Jude Children’s Research Hospital, Memphis, Tennessee
| | - Thomas E Merchant
- Department of Radiation Oncology, St. Jude Children’s Research Hospital, Memphis, Tennessee
| | - Sarah S. Donaldson
- Department of Radiation Oncology, Stanford University, Stanford, California
| | - Thomas J. FitzGerald
- Department of Radiation Oncology, University of Massachusetts, Worcester, Massachusetts
| | - Louis S. Constine
- Department of Radiation Oncology, University of Rochester, Rochester, New York
| | - David C. Hodgson
- Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada
| | - Daphne A. Haas-Kogan
- Department of Radiation Oncology, Dana Farber Cancer Institute/Boston Children’s Hospital, Boston, Massachusetts
| | - Anita Mahajan
- Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota
| | - Nadia Laack
- Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota
| | - Karen J. Marcus
- Department of Radiation Oncology, Dana Farber Cancer Institute/Boston Children’s Hospital, Boston, Massachusetts
| | - Paige A Taylor
- Department of Radiation Physics, Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Verity A Ahern
- Department of Radiation Oncology, Children’s Hospital at Westmead, Sydney, Australia
| | - David S. Followill
- Department of Radiation Physics, Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jeffrey C. Buchsbaum
- Division of Cancer Treatment and Diagnosis, National Cancer Institute, Bethesda, Maryland
| | - John C. Breneman
- Department of Radiation Oncology, University of Cincinnati, Cincinnati, Ohio
| | - John A. Kalapurakal
- Department of Radiation Oncology, Northwestern University, Chicago, Illinois
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Sendani NG, Karimian A, Mahdavi SR, Jabbari I, Alaei P. Effect of beam configuration with inaccurate or incomplete small field output factors on the accuracy of treatment planning dose calculation. Med Phys 2019; 46:5273-5283. [DOI: 10.1002/mp.13796] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 08/16/2019] [Accepted: 08/16/2019] [Indexed: 11/11/2022] Open
Affiliation(s)
- Neda Gholizadeh Sendani
- Faculty of Advanced Sciences and Technologies University of Isfahan Isfahan 81746‐73441Iran
- Department of Radiation Oncology University of Minnesota Minneapolis MN 55455USA
| | - Alireza Karimian
- Department of Biomedical Engineering Faculty of Engineering University of Isfahan Isfahan 81746‐73441Iran
| | - S. Rabie Mahdavi
- Radiation Biology Research Center and Department of Medical Physics Iran University of Medical Sciences Tehran 14496Iran
| | - Iraj Jabbari
- Faculty of Advanced Sciences and Technologies University of Isfahan Isfahan 81746‐73441Iran
| | - Parham Alaei
- Department of Radiation Oncology University of Minnesota Minneapolis MN 55455USA
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Zuro D, Vagge S, Broggi S, Agostinelli S, Takahashi Y, Brooks J, Leszcynska P, Liu A, Zucchetti C, Saldi S, Han C, Cattaneo M, Giebel S, Mahe MA, Sanchez JF, Alaei P, Anna C, Dusenbery K, Pierini A, Storme G, Aristei C, Wong JYC, Hui S. Multi-institutional evaluation of MVCT guided patient registration and dosimetric precision in total marrow irradiation: A global health initiative by the international consortium of total marrow irradiation. Radiother Oncol 2019; 141:275-282. [PMID: 31421913 DOI: 10.1016/j.radonc.2019.07.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 06/09/2019] [Accepted: 07/08/2019] [Indexed: 11/18/2022]
Abstract
PURPOSE Total marrow irradiation (TMI) is a highly conformal treatment of the human skeleton structure requiring a high degree of precision and accuracy for treatment delivery. Although many centers worldwide initiated clinical studies using TMI, currently there is no standard for pretreatment patient setup. To this end, the accuracy of different patient setups was measured using pretreatment imaging. Their impact on dose delivery was assessed for multiple institutions. METHODS AND MATERIALS Whole body imaging (WBI) or partial body imaging (PBI) was performed using pretreatment megavoltage computed tomography (MVCT) in a helical Tomotherapy machine. Rigid registration of MVCT and planning kilovoltage computed tomography images were performed to measure setup error and its effect on dose distribution. The entire skeleton was considered the planning target volume (PTV) with five sub regions: head/neck (HN), spine, shoulder and clavicle (SC), and one avoidance structure, the lungs. Sixty-eight total patients (>300 images) across six institutions were analyzed. RESULTS Patient setup techniques differed between centers, creating variations in dose delivery. Registration accuracy varied by anatomical region and by imaging technique, with the lowest to the highest degree of pretreatment rigid shifts in the following order: spine, pelvis, HN, SC, and lungs. Mean fractional dose was affected in regions of high registration mismatch, in particular the lungs. CONCLUSIONS MVCT imaging and whole body patient immobilization was essential for assessing treatment setup, allowing for the complete analysis of 3D dose distribution in the PTV and lungs (or avoidance structures).
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Affiliation(s)
- Darren Zuro
- Department of Radiation Oncology, Beckman Research Institute, City of Hope, Duarte, USA; Department of Radiation Oncology, University of Minnesota, Minneapolis, USA
| | - Stefano Vagge
- Deparment of Medical Imaging and Radiation Sciences, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Sara Broggi
- Department of Medical Physics, San Raffaele Scientific Institute, Milan, Italy
| | - Stefano Agostinelli
- Deparment of Medical Imaging and Radiation Sciences, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Yutaka Takahashi
- Department of Radiation Oncology, Osaka University, Suita, Japan
| | - Jamison Brooks
- Department of Radiation Oncology, Beckman Research Institute, City of Hope, Duarte, USA
| | - Paulina Leszcynska
- Department of Radiotherapy Planning, Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Poland
| | - An Liu
- Department of Radiation Oncology, Beckman Research Institute, City of Hope, Duarte, USA
| | | | - Simonetta Saldi
- Department of Radiation Oncology, University of Nantes, France
| | - Chunhui Han
- Department of Radiation Oncology, Beckman Research Institute, City of Hope, Duarte, USA
| | - Mauro Cattaneo
- Department of Medical Physics, San Raffaele Scientific Institute, Milan, Italy
| | - Sebastian Giebel
- Department of Radiotherapy Planning, Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Poland
| | - Marc Andre Mahe
- Department of Radiation Oncology, University of Nantes, France
| | - James F Sanchez
- Department of Radiation Oncology, Beckman Research Institute, City of Hope, Duarte, USA
| | - Parham Alaei
- Department of Radiation Oncology, University of Minnesota, Minneapolis, USA
| | - Chiara Anna
- Department of Medical Physics, San Raffaele Scientific Institute, Milan, Italy
| | - Kathryn Dusenbery
- Department of Radiation Oncology, University of Minnesota, Minneapolis, USA
| | - Antonio Pierini
- Division of Hematology and Clinical Immunology, Department of Medicine, University of Perugia, Italy
| | - Guy Storme
- Department of Radiotherapy UZ Brussel, Belgium
| | - Cynthia Aristei
- Department of Radiation Oncology, University of Nantes, France
| | - Jeffrey Y C Wong
- Department of Radiation Oncology, Beckman Research Institute, City of Hope, Duarte, USA
| | - Susanta Hui
- Department of Radiation Oncology, Beckman Research Institute, City of Hope, Duarte, USA.
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Gholizadeh Sendani N, Karimian A, Ferreira C, Alaei P. Technical Note: Impact of region of interest size and location in Gafchromic film dosimetry. Med Phys 2018; 45:2329-2336. [DOI: 10.1002/mp.12885] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 01/05/2018] [Accepted: 02/17/2018] [Indexed: 11/06/2022] Open
Affiliation(s)
- Neda Gholizadeh Sendani
- Department of Medical Radiation Engineering; University of Isfahan; Isfahan 81746 Iran
- Department of Radiation Oncology; University of Minnesota; Minneapolis MN 55455 USA
| | - Alireza Karimian
- Department of Biomedical Engineering; University of Isfahan; Isfahan 81746 Iran
| | - Clara Ferreira
- Department of Radiation Oncology; University of Minnesota; Minneapolis MN 55455 USA
| | - Parham Alaei
- Department of Radiation Oncology; University of Minnesota; Minneapolis MN 55455 USA
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Ding GX, Alaei P, Curran B, Flynn R, Gossman M, Mackie TR, Miften M, Morin R, Xu XG, Zhu TC. Image guidance doses delivered during radiotherapy: Quantification, management, and reduction: Report of the AAPM Therapy Physics Committee Task Group 180. Med Phys 2018; 45:e84-e99. [PMID: 29468678 DOI: 10.1002/mp.12824] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 01/10/2018] [Accepted: 01/10/2018] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND With radiotherapy having entered the era of image guidance, or image-guided radiation therapy (IGRT), imaging procedures are routinely performed for patient positioning and target localization. The imaging dose delivered may result in excessive dose to sensitive organs and potentially increase the chance of secondary cancers and, therefore, needs to be managed. AIMS This task group was charged with: a) providing an overview on imaging dose, including megavoltage electronic portal imaging (MV EPI), kilovoltage digital radiography (kV DR), Tomotherapy MV-CT, megavoltage cone-beam CT (MV-CBCT) and kilovoltage cone-beam CT (kV-CBCT), and b) providing general guidelines for commissioning dose calculation methods and managing imaging dose to patients. MATERIALS & METHODS We briefly review the dose to radiotherapy (RT) patients resulting from different image guidance procedures and list typical organ doses resulting from MV and kV image acquisition procedures. RESULTS We provide recommendations for managing the imaging dose, including different methods for its calculation, and techniques for reducing it. The recommended threshold beyond which imaging dose should be considered in the treatment planning process is 5% of the therapeutic target dose. DISCUSSION Although the imaging dose resulting from current kV acquisition procedures is generally below this threshold, the ALARA principle should always be applied in practice. Medical physicists should make radiation oncologists aware of the imaging doses delivered to patients under their care. CONCLUSION Balancing ALARA with the requirement for effective target localization requires that imaging dose be managed based on the consideration of weighing risks and benefits to the patient.
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Affiliation(s)
- George X Ding
- Department of Radiation Oncology, Vanderbilt University School of Medicine, Nashville, TN, 37232, USA
| | - Parham Alaei
- University of Minnesota, Minneapolis, MN, 55455, USA
| | - Bruce Curran
- Virginia Commonwealth University, Richmond, VA, 23284, USA
| | - Ryan Flynn
- University of Iowa, Iowa City, IA, 52242, USA
| | | | | | | | | | - X George Xu
- Rensselaer Polytechnic Institute, Troy, NY, 12180, USA
| | - Timothy C Zhu
- University of Pennsylvania, Philadelphia, PA, 19104, USA
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Paulu D, Alaei P. Evaluation of dose calculation accuracy of treatment planning systems at hip prosthesis interfaces. J Appl Clin Med Phys 2017; 18:9-15. [PMID: 28317312 PMCID: PMC5689850 DOI: 10.1002/acm2.12060] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Revised: 12/15/2016] [Accepted: 01/25/2017] [Indexed: 11/09/2022] Open
Abstract
There are an increasing number of radiation therapy patients with hip prosthesis. The common method of minimizing treatment planning inaccuracies is to avoid radiation beams to transit through the prosthesis. However, the beams often exit through them, especially when the patient has a double-prosthesis. Modern treatment planning systems employ algorithms with improved dose calculation accuracies but even these algorithms may not predict the dose accurately at high atomic number interfaces. The current study evaluates the dose calculation accuracy of three common dose calculation algorithms employed in two commercial treatment planning systems. A hip prosthesis was molded inside a cylindrical phantom and the dose at several points within the phantom at the interface with prosthesis was measured using thermoluminescent dosimeters. The measured doses were then compared to the predicted ones by the planning systems. The results of the study indicate all three algorithms underestimate the dose at the prosthesis interface, albeit to varying degrees, and for both low- and high-energy x rays. The measured doses are higher than calculated ones by 5-22% for Pinnacle Collapsed Cone Convolution algorithm, 2-23% for Eclipse Acuros XB, and 6-25% for Eclipse Analytical Anisotropic Algorithm. There are generally better agreements for AXB algorithm and the worst results are for the AAA.
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Affiliation(s)
- David Paulu
- Department of Radiation Oncology, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Parham Alaei
- Department of Radiation Oncology, University of Minnesota, Minneapolis, MN, 55455, USA
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Alaei P. TU-B-201-02: Accounting for KV Imaging Dose. Med Phys 2016. [DOI: 10.1118/1.4957453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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21
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Azimi R, Kilgore A, Alaei P. SU-F-P-62: The Sensitivity of Routine IMRT QA Metrics to Monitor Unit Errors. Med Phys 2016. [DOI: 10.1118/1.4955770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Mathew D, Alaei P. SU-F-P-07: Applying Failure Modes and Effects Analysis to Treatment Planning System QA. Med Phys 2016. [DOI: 10.1118/1.4955714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Kim S, Alaei P. Implementation of full/half bowtie filter models in a commercial treatment planning system for kilovoltage cone-beam CT dose estimations. J Appl Clin Med Phys 2016; 17:153-164. [PMID: 27074480 PMCID: PMC5874958 DOI: 10.1120/jacmp.v17i2.5988] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Revised: 12/03/2015] [Accepted: 11/30/2015] [Indexed: 11/23/2022] Open
Abstract
The purpose of this study was to implement full/half bowtie filter models in a com-mercial treatment planning system (TPS) to calculate kilovoltage (kV) cone-beam CT (CBCT) doses of Varian On-Board Imager (OBI) kV X-ray imaging system. The full/half bowtie filter models were created as compensators in Pinnacle TPS using MATLAB software. The physical profiles of both bowtie filters were imported and hard-coded in the MATLAB system. Pinnacle scripts were written to import bowtie filter models into Pinnacle treatment plans. Bowtie filter-free kV X-ray beam models were commissioned and the bowtie filter models were validated by analyzing the lateral and percent-depth-dose (PDD) profiles of anterior/posterior X-ray beams in water phantoms. A CT dose index (CTDI) phantom was employed to calculate CTDI and weighted CTDI values for pelvis and pelvis-spotlight CBCT protocols. A five-year-old pediatric anthropomorphic phantom was utilized to evaluate absorbed and effective doses (ED) for standard and low-dose head CBCT protocols. The CBCT dose calculation results were compared to ion chamber (IC) and Monte Carlo (MC) data for the CTDI phantom and MOSFET and MC results for the pediatric phantom, respectively. The differences of lateral and PDD profiles between TPS calculations and IC measurements were within 6%. The CTDI and weighted CTDI values of the TPS were respectively within 0.25 cGy and 0.08 cGy compared to IC measurements. The absorbed doses ranged from 0 to 7.22 cGy for the standard dose CBCT and 0 to 1.56 cGy for the low-dose CBCT. The ED values were found to be 36-38 mSv and 7-8 mSv for the standard and low-dose CBCT protocols, respectively. This study demonstrated that the established full/half bowtie filter beam models can produce reasonable dose calculation results. Further study is to be performed to evaluate the models in clinical situations.
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Abstract
Imaging dose in radiation therapy has traditionally been ignored due to its low magnitude and frequency in comparison to therapeutic dose used to treat patients. The advent of modern, volumetric, imaging modalities, often as an integral part of linear accelerators, has facilitated the implementation of image-guided radiation therapy (IGRT), which is often accomplished by daily imaging of patients. Daily imaging results in additional dose delivered to patient that warrants new attention be given to imaging dose. This review summarizes the imaging dose delivered to patients as the result of cone beam computed tomography (CBCT) imaging performed in radiation therapy using current methods and equipment. This review also summarizes methods to calculate the imaging dose, including the use of Monte Carlo (MC) and treatment planning systems (TPS). Peripheral dose from CBCT imaging, dose reduction methods, the use of effective dose in describing imaging dose, and the measurement of CT dose index (CTDI) in CBCT systems are also reviewed.
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Affiliation(s)
| | - Emiliano Spezi
- School of Engineering, Cardiff University, Cardiff, Wales, UK; Velindre Cancer Centre, Cardiff, Wales, UK
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Kim S, Alaei P. SU-D-207-07: Implementation of Full/half Bowtie Filter Model in a Commercial Treatment Planning System for Kilovoltage X-Ray Imaging Dose Estimation. Med Phys 2015. [DOI: 10.1118/1.4923908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Reynolds T, Arentsen L, Watanabe Y, Alaei P. SU-E-P-24: Simplified EDW Profile Measurements Using Two Commonly Available Detector Arrays. Med Phys 2015. [DOI: 10.1118/1.4923958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Azimi R, Alaei P, Spezi E, Hui SK. Characterization of an orthovoltage biological irradiator used for radiobiological research. J Radiat Res 2015; 56:485-492. [PMID: 25694476 PMCID: PMC4426923 DOI: 10.1093/jrr/rru129] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Revised: 12/16/2014] [Accepted: 12/27/2014] [Indexed: 06/01/2023]
Abstract
Orthovoltage irradiators are routinely used to irradiate specimens and small animals in biological research. There are several reports on the characteristics of these units for small field irradiations. However, there is limited knowledge about use of these units for large fields, which are essential for emerging large-field irregular shape irradiations, namely total marrow irradiation used as a conditioning regimen for hematological malignancies. This work describes characterization of a self-contained Orthovoltage biological irradiator for large fields using measurements and Monte Carlo simulations that could be used to compute the dose for in vivo or in vitro studies for large-field irradiation using this or a similar unit. Percentage depth dose, profiles, scatter factors, and half-value layers were measured and analyzed. A Monte Carlo model of the unit was created and used to generate depth dose and profiles, as well as scatter factors. An ion chamber array was also used for profile measurements of flatness and symmetry. The output was determined according to AAPM Task Group 61 guidelines. The depth dose measurements compare well with published data for similar beams. The Monte Carlo-generated depth dose and profiles match our measured doses to within 2%. Scatter factor measurements indicate gradual variation of these factors with field size. Dose rate measured by placing the ion chamber atop the unit's steel plate or solid water indicate enhanced readings of 5 to 28% compared with those measured in air. The stability of output over a 5-year period is within 2% of the 5-year average.
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Affiliation(s)
- Rezvan Azimi
- Department of Radiation Oncology, University of Minnesota, 420 Delaware Street, SE MMC 494, Minneapolis, MN 55455, USA
| | - Parham Alaei
- Department of Radiation Oncology, University of Minnesota, 420 Delaware Street, SE MMC 494, Minneapolis, MN 55455, USA
| | - Emiliano Spezi
- Department of Medical Physics, Velindre Cancer Centre, Velindre Road, CF14 2TL, Cardiff, UK
| | - Susanta K Hui
- Department of Radiation Oncology, University of Minnesota, 420 Delaware Street, SE MMC 494, Minneapolis, MN 55455, USA
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Anvari A, Aghamiri SM, Mahdavi S, Alaei P. Dose response characteristics of a novel CCD camera-based electronic portal imaging device comparison with OCTAVIUS detector. J Cancer Res Ther 2015; 11:765-9. [DOI: 10.4103/0973-1482.148695] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Alaei P. SU-E-P-05: Is Routine Treatment Planning System Quality Assurance Necessary? Med Phys 2014. [DOI: 10.1118/1.4887943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Ding G, Alaei P. SU-E-J-204: Radiation Dose to Patients Resulting From Image Guidance Procedures and AAPM TG-180 Update. Med Phys 2014. [DOI: 10.1118/1.4888257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Anvari A, Aghamiri S, Mahdavi S, Alaei P. SU-E-T-65: Characterization of a 2D Array for QA and Pretreatment Plan Verification. Med Phys 2014. [DOI: 10.1118/1.4888395] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Abstract
BACKGROUND With the increasing use of cone beam computed tomography (CBCT) for patient position verification and radiotherapy treatment adaptation, there is an increasing need to develop techniques that can take into account concomitant dose using a personalized approach. MATERIAL AND METHODS A total of 20 patients (10 pelvis and 10 head and neck) who had undergone radiation therapy using intensity modulated radiation therapy (IMRT) were selected and the dose from kV CBCT was retrospectively calculated using a treatment planning system previously commissioned for this purpose. The imaging dose was added to the CT images used for treatment planning and the difference in its addition prior to and after the planning was assessed. RESULTS The additional isocenter dose as a result of daily CBCT is in the order of 3-4 cGy for 35-fraction head and neck and 23-47 cGy for 25-fraction pelvis cases using the standard head and neck and pelvis image acquisition protocols. The pelvic dose is especially dependent on patient size and body mass index (BMI), being higher for patients with lower BMI. Due to the low energy of the kV CBCT beam, the maximum energy deposition is at or near the surface with the highest dose being on the patient's left side for the head and neck (∼7 cGy) and on the posterior for the pelvic cases (∼80 cGy). Addition of imaging dose prior to plan optimization resulted in an average reduction of 4% in the plan monitor units and 5% in the number of control points. CONCLUSION Dose from daily kV CBCT has been added to patient treatment plans using previously commissioned kV CBCT beams in a treatment planning system. Addition of imaging dose can be included in IMRT treatment plan optimization and would facilitate customization of imaging protocol based on patient anatomy and location of isocenter.
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Affiliation(s)
- Parham Alaei
- Department of Radiation Oncology, University of Minnesota , Minneapolis, Minnesota , USA
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Alaei P, Spezi E, Ehler E, Dusenbery K. SU-E-J-08: Assessing and Minimizing the Dose From KV Cone Beam CT to Pediatric Patients Undergoing Radiation Therapy. Med Phys 2013. [DOI: 10.1118/1.4814220] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Azimi R, Alaei P, Takahashi Y, Spezi E, Yagi M, Arentsen L, Sharkey L, Seelig D, Schappa J, Hui S. WE-E-108-08: Dosimetric and Biological Benchmarking of a Murine Total Marrow Irradiation Platform. Med Phys 2013. [DOI: 10.1118/1.4815586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Alaei P, Spezi E. Commissioning kilovoltage cone-beam CT beams in a radiation therapy treatment planning system. J Appl Clin Med Phys 2012; 13:3971. [PMID: 23149789 PMCID: PMC5718524 DOI: 10.1120/jacmp.v13i6.3971] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2012] [Revised: 05/15/2012] [Accepted: 06/18/2012] [Indexed: 11/23/2022] Open
Abstract
The feasibility of accounting of the dose from kilovoltage cone‐beam CT in treatment planning has been discussed previously for a single cone‐beam CT (CBCT) beam from one manufacturer. Modeling the beams and computing the dose from the full set of beams produced by a kilovoltage cone‐beam CT system requires extensive beam data collection and verification, and is the purpose of this work. The beams generated by Elekta X‐ray volume imaging (XVI) kilovoltage CBCT (kV CBCT) system for various cassettes and filters have been modeled in the Philips Pinnacle treatment planning system (TPS) and used to compute dose to stack and anthropomorphic phantoms. The results were then compared to measurements made using thermoluminescent dosimeters (TLDs) and Monte Carlo (MC) simulations. The agreement between modeled and measured depth‐dose and cross profiles is within 2% at depths beyond 1 cm for depth‐dose curves, and for regions within the beam (excluding penumbra) for cross profiles. The agreements between TPS‐calculated doses, TLD measurements, and Monte Carlo simulations are generally within 5% in the stack phantom and 10% in the anthropomorphic phantom, with larger variations observed for some of the measurement/calculation points. Dose computation using modeled beams is reasonably accurate, except for regions that include bony anatomy. Inclusion of this dose in treatment plans can lead to more accurate dose prediction, especially when the doses to organs at risk are of importance. PACS numbers: 87.55.D, 87.55.K, 87.56.bd
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Affiliation(s)
- Parham Alaei
- Department of Radiation Oncology, University of Minnesota, Minneapolis, MN 55455, USA.
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Alaei P, Spezi E, Reynolds M. SU-E-J-15: Calculating the Dose from KV Cone Beam CT Within and Outside the Treatment Volume Using a Treatment Planning System. Med Phys 2012; 39:3655. [DOI: 10.1118/1.4734848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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41
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Arentsen L, Azimi R, Alaei P, Fairchild G, Kidder L, Hui S. SU-E-I-17: Characterization of Rotating Source MicroCT for Evaluating in Vivo Murine Trabecular Bone. Med Phys 2012; 39:3628. [DOI: 10.1118/1.4734731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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42
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Alaei P, Ding G. TH-B-211-01: Cone Beam CT: Dose Measurement, Calculation, and Inclusion in the Treatment Plan. Med Phys 2012. [DOI: 10.1118/1.4736285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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43
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Paulu D, Alaei P. SU-E-T-512: Evaluation of Treatment Planning Dose Calculation Accuracy at the Interface of Prosthetic Devices. Med Phys 2012; 39:3823. [DOI: 10.1118/1.4735601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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44
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Ding G, Alaei P. TH-B-211-02: Patient Organ Doses From Imaging in IGRT: KV Radiograph Vs. KV- CBCT Vs. MV Portal Image Vs. MV-CBCT. Med Phys 2012. [DOI: 10.1118/1.4736286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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45
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Alaei P, Higgins PD. The Accuracy of Inhomogeneity Corrections in Intensity Modulated Radiation Therapy Planning in Philips Pinnacle System. Med Dosim 2011; 36:240-5. [DOI: 10.1016/j.meddos.2010.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2010] [Accepted: 03/29/2010] [Indexed: 11/24/2022]
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46
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Alaei P. SU-E-J-170: Influence of Technique and Filtration on Kilovoltage Cone Beam CT Dose. Med Phys 2011. [DOI: 10.1118/1.3611938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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47
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Alaei P. MO-D-110-03: Calculating Organ Dose from Fluoroscopy. Med Phys 2011. [DOI: 10.1118/1.3612979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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48
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Qin L, Alaei P, Zhang J, Chaudhari S. SU-E-T-190: Measuring Patient Cone Beam CT Dose Using a Commercial 4D Diode Array. Med Phys 2011. [DOI: 10.1118/1.3612140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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49
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Alkhatib H, Stenbeck J, Tedeschi D, Tsang B, Oves S, Neglia W, Higgins P, Alaei P, Bzdusek K. SU-E-J-03: The Modeling of Cone Beam Computed Tomography in a Treatment Planning System. Med Phys 2011. [DOI: 10.1118/1.3611771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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50
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Grelewicz Z, Pearson E, Alaei P, Pelizzari C, Wiersma R. Investigation of a Dynamical kV Aperture together with Combined MV-kV Dose Planning for Implementing Real-time 3D MV-kV Prostate Motion Tracking. Int J Radiat Oncol Biol Phys 2010. [DOI: 10.1016/j.ijrobp.2010.07.1564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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