1
|
Demos-Davies K, Lawrence J, Ferreira C, Seelig D. The Distant Molecular Effects on the Brain by Cancer Treatment. Brain Sci 2023; 14:22. [PMID: 38248237 PMCID: PMC10813787 DOI: 10.3390/brainsci14010022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 12/16/2023] [Accepted: 12/22/2023] [Indexed: 01/23/2024] Open
Abstract
Cancer survivors experience cancer-related cognitive impairment (CRCI) secondary to treatment. Chemotherapy and radiation therapy independently contribute to cognitive dysfunction; however, the underlying mechanisms leading to dysfunction remain unclear. We characterized brain gene expression changes in a mouse model of CRCI to identify the mechanistic underpinnings. Eleven-to-twelve-week-old SKH1 mice were treated with doxorubicin (DOX), hindlimb radiation (RT), concurrent hindlimb radiation and doxorubicin (DOX-RT), or no treatment (control). Sixteen days following treatment, gene expression was measured from murine brains using the NanoString nCounter® glial profiling panel. Gene expression was normalized and compared between groups. No two groups shared the same expression pattern, and only Gnb1 and Srpr were upregulated in multiple treatment groups. Brains from DOX-treated mice had upregulated Atf2, Atp5b, Gnb1, Rad23b, and Srpr and downregulated Sirt5 expression compared to control brains. Brains from RT-treated mice demonstrated increased Abcg2 and Fgf2 and decreased C1qa and C1qb expression compared to control brains. Brains from DOX-RT-treated mice had upregulated Adar, E2f3, Erlec1, Gnb1, Srpr, Vim, and Pdgfra expression and downregulated Rock2 and Inpp5f expression compared to control brains. The gene expression changes demonstrated here highlight roles for neuronal transmission and oxidative stress in the pathogenesis of doxorubicin-related CRCI and inflammation in RT-related CRCI.
Collapse
Affiliation(s)
- Kimberly Demos-Davies
- Department of Veterinary Clinical Sciences, University of Minnesota College of Veterinary Medicine, Saint Paul, MN 55108, USA; (J.L.); (D.S.)
| | - Jessica Lawrence
- Department of Veterinary Clinical Sciences, University of Minnesota College of Veterinary Medicine, Saint Paul, MN 55108, USA; (J.L.); (D.S.)
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN 55455,USA
| | - Clara Ferreira
- Department of Radiation Oncology, University of Minnesota Medical School, Minneapolis, MN 55455, USA;
| | - Davis Seelig
- Department of Veterinary Clinical Sciences, University of Minnesota College of Veterinary Medicine, Saint Paul, MN 55108, USA; (J.L.); (D.S.)
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN 55455,USA
| |
Collapse
|
2
|
Petoukhova A, Snijder R, Vissers T, Ceha H, Struikmans H. In vivodosimetry in cancer patients undergoing intraoperative radiation therapy. Phys Med Biol 2023; 68:18TR01. [PMID: 37607566 DOI: 10.1088/1361-6560/acf2e4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Accepted: 08/22/2023] [Indexed: 08/24/2023]
Abstract
In vivodosimetry (IVD) is an important tool in external beam radiotherapy (EBRT) to detect major errors by assessing differences between expected and delivered dose and to record the received dose by individual patients. Also, in intraoperative radiation therapy (IORT), IVD is highly relevant to register the delivered dose. This is especially relevant in low-risk breast cancer patients since a high dose of IORT is delivered in a single fraction. In contrast to EBRT, online treatment planning based on intraoperative imaging is only under development for IORT. Up to date, two commercial treatment planning systems proposed intraoperative ultrasound or in-room cone-beam CT for real-time IORT planning. This makes IVD even more important because of the possibility for real-time treatment adaptation. Here, we summarize recent developments and applications of IVD methods for IORT in clinical practice, highlighting important contributions and identifying specific challenges such as a treatment planning system for IORT. HDR brachytherapy as a delivery technique was not considered. We add IVD for ultrahigh dose rate (FLASH) radiotherapy that promises to improve the treatment efficacy, when compared to conventional radiotherapy by limiting the rate of toxicity while maintaining similar tumour control probabilities. To date, FLASH IORT is not yet in clinical use.
Collapse
Affiliation(s)
- Anna Petoukhova
- Haaglanden Medical Centre , Department of Medical Physics, Leidschendam, The Netherlands
| | - Roland Snijder
- Haaglanden Medical Centre , Department of Medical Physics, Leidschendam, The Netherlands
| | - Thomas Vissers
- Haaglanden Medical Centre , Medical Library, Leidschendam, The Netherlands
| | - Heleen Ceha
- Haaglanden Medical Centre , Department of Radiation Oncology, Leidschendam, The Netherlands
| | - Henk Struikmans
- Haaglanden Medical Centre , Department of Radiation Oncology, Leidschendam, The Netherlands
| |
Collapse
|
3
|
Aghdam SRH, Aghamiri SMR, Siavashpour Z, Malekie S, Dashtipoor MR. Assessment of out-of-field radiation doses for high dose per pulse intraoperative electron beam radiotherapy using TLD-100. Radiat Phys Chem Oxf Engl 1993 2023; 204:110652. [DOI: https:/doi.org/10.1016/j.radphyschem.2022.110652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/21/2023]
|
4
|
Hosseini FS, Baghani HR, Robatjazi M, Mowlavi AA, Porouhan P. Performance evaluation of buildup bolus during external radiotherapy of mastectomy patients: treatment planning and film dosimetry. Med Biol Eng Comput 2023; 61:435-444. [PMID: 36460872 DOI: 10.1007/s11517-022-02721-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 11/19/2022] [Indexed: 12/04/2022]
Abstract
A buildup bolus is used during the post-mastectomy radiotherapy (PMRT) to overcome under-dosage issues in the chest wall. The current study is aimed at evaluating the performance of a bolus in dose enhancement through both film dosimetry and treatment planning approaches. Twenty patients were enrolled in current research. The received dose by the skin at the lateral and medial regions of the chest wall in the presence and absence bolus was evaluated. Film dosimetry results showed that the presence of the bolus can averagely increase the skin dose by about 80% (P value < 0.001) and 92% (P value < 0.001) in lateral and medial regions, respectively. No significant difference was observed between the measured and treatment planning system (TPS)-calculated dose values in the presence of bolus. The presence of the bolus can considerably increase the absorbed dose by superficial chest wall regions. The TPS shows a favorable performance in superficial dose calculations in the presence of the buildup bolus. Hosseini et al.: demonstration of implemented research in the current study.
Collapse
Affiliation(s)
| | | | - Mostafa Robatjazi
- Medical Physics and Radiological Sciences Department, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | | | - Pejman Porouhan
- Radiation Oncology Department, Sabzevar University of Medical Sciences, Sabzevar, Iran
| |
Collapse
|
5
|
Demos-Davies K, Lawrence J, Rogich A, Lind E, Seelig D. Cancer treatment induces neuroinflammation and behavioral deficits in mice. Front Behav Neurosci 2023; 16:1067298. [PMID: 36699654 PMCID: PMC9868853 DOI: 10.3389/fnbeh.2022.1067298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 12/16/2022] [Indexed: 01/12/2023] Open
Abstract
Introduction: Cancer survivors are increasingly diagnosed with a syndrome of neurocognitive dysfunction termed cancer-related cognitive impairment (CRCI). Chemotherapy and radiation therapy have been implicated in CRCI; however, its underlying pathogenesis remains unclear, hindering effective prevention or treatment. Methods: We used the hairless strain SKH1 (11-12-week-old) and treated the mice with radiation to the right hindlimb, doxorubicin (a chemotherapy agent), concurrent radiation, and doxorubicin, or no treatment (control). Neurocognition was evaluated via standardized behavioral testing following treatment. Mice were subsequently humanely euthanized, and plasma and brains were collected to identify inflammatory changes. Results: Mice treated with radiation, doxorubicin, or both radiation and doxorubicin demonstrated equivalent hippocampal dependent memory deficits and significant increases in activated microglia and astrocytes compared to control mice. Doxorubicin-treated mice had significantly increased plasma IL-6 and failed to gain weight compared to control mice over the study period. Discussion: This study demonstrates that non-brain directed radiation induces both gliosis and neurocognitive deficits. Moreover, this work presents the first characterization of SKH1 mice as a relevant and facile animal model of CRCI. This study provides a platform from which to build further studies to identify potential key targets that contribute to CRCI such that strategies can be developed to mitigate unintended neuropathologic consequences associated with anticancer treatment.
Collapse
Affiliation(s)
- Kimberly Demos-Davies
- Department of Veterinary Clinical Sciences, University of Minnesota College of Veterinary Medicine, Saint Paul, MN, United States
| | - Jessica Lawrence
- Department of Veterinary Clinical Sciences, University of Minnesota College of Veterinary Medicine, Saint Paul, MN, United States
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, United States
| | - Allison Rogich
- Department of Veterinary Clinical Sciences, University of Minnesota College of Veterinary Medicine, Saint Paul, MN, United States
| | - Erin Lind
- Department of Neuroscience, University of Minnesota, Minneapolis, MN, United States
| | - Davis Seelig
- Department of Veterinary Clinical Sciences, University of Minnesota College of Veterinary Medicine, Saint Paul, MN, United States
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, United States
| |
Collapse
|
6
|
Aghdam SRH, Aghamiri SMR, Siavashpour Z, Malekie S, Dashtipoor MR. Assessment of out-of-field radiation doses for high dose per pulse intraoperative electron beam radiotherapy using TLD-100. Radiat Phys Chem Oxf Engl 1993 2022. [DOI: 10.1016/j.radphyschem.2022.110652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
7
|
On measuring the 3D dose distribution for notched and circular Ru-106 plaque shapes through Gafchromic film dosimetry approach. Radiat Phys Chem Oxf Engl 1993 2022. [DOI: 10.1016/j.radphyschem.2021.109792] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
8
|
Hur BI, Jin SJ, Kim GR, Kwak JH, Kim YH, Lee SW, Sung SK. Validation of Gamma Knife Perfexion Dose Profile Distribution by a Modified Variable Ellipsoid Modeling Technique. J Korean Neurosurg Soc 2021; 64:13-22. [PMID: 33465847 PMCID: PMC7819799 DOI: 10.3340/jkns.2020.0186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 12/15/2020] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE High precision and accuracy are expected in gamma knife radiosurgery treatment. Because of the requirement of clinically applying complex radiation and dose gradients together with a rapid radiation decline, a dedicated quality assurance program is required to maintain the radiation dosimetry and geometric accuracy and to reduce all associated risk factors. This study investigates the validity of Leksell Gamma plan (LGP)10.1.1 system of 5th generation Gamma Knife Perfexion as modified variable ellipsoid modeling technique (VEMT) method. METHODS To verify LGP10.1.1 system, we compare the treatment plan program system of the Gamma Knife Perfexion, that is, the LGP, with the calculated value of the proposed modified VEMT program. To verify a modified VEMT method, we compare the distributions of the dose of Gamma Knife Perfexion measured by Gafchromic EBT3 and EBT-XD films. For verification, the center of an 80 mm radius solid water phantom is placed in the center of all sectors positioned at 16 mm, 4 mm and 8 mm; that is, the dose distribution is similar to the method used in the x, y, and z directions by the VEMT. The dose distribution in the axial direction is compared and analyzed based on Full-Width-of-Half-Maximum (FWHM) evaluation. RESULTS The dose profile distribution was evaluated by FWHM, and it showed an average difference of 0.104 mm for the LGP value and 0.130 mm for the EBT-XD film. CONCLUSION The modified VEMT yielded consistent results in the two processes. The use of the modified VEMT as a verification tool can enable the system to stably test and operate the Gamma Knife Perfexion treatment planning system.
Collapse
Affiliation(s)
- Beong Ik Hur
- Department of Neurosurgery, Pusan National University Hospital, Busan, Korea
| | - Seong Jin Jin
- Gamma-knife Center, Haeundae Paik Hospital, Inje University, Busan, Korea
| | - Gyeong Rip Kim
- Gamma-knife Center, Pusan National University Yangsan Hospital, Yangsan, Korea.,Department of Neurosurgery, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Jong Hyeok Kwak
- Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Young Ha Kim
- Department of Neurosurgery, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Sang Weon Lee
- Gamma-knife Center, Pusan National University Yangsan Hospital, Yangsan, Korea.,Department of Neurosurgery, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Soon Ki Sung
- Gamma-knife Center, Pusan National University Yangsan Hospital, Yangsan, Korea.,Department of Neurosurgery, Pusan National University Yangsan Hospital, Yangsan, Korea
| |
Collapse
|
9
|
Niroomand‐Rad A, Chiu‐Tsao S, Grams MP, Lewis DF, Soares CG, Van Battum LJ, Das IJ, Trichter S, Kissick MW, Massillon‐JL G, Alvarez PE, Chan MF. Report of AAPM Task Group 235 Radiochromic Film Dosimetry: An Update to TG‐55. Med Phys 2020; 47:5986-6025. [DOI: 10.1002/mp.14497] [Citation(s) in RCA: 64] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 09/15/2020] [Accepted: 09/17/2020] [Indexed: 12/12/2022] Open
Affiliation(s)
| | | | | | | | | | | | - Indra J. Das
- Radiation Oncology Northwestern University Memorial Hospital Chicago IL USA
| | - Samuel Trichter
- New York‐Presbyterian HospitalWeill Cornell Medical Center New York NY USA
| | | | - Guerda Massillon‐JL
- Instituto de Fisica Universidad Nacional Autonoma de Mexico Mexico City Mexico
| | - Paola E. Alvarez
- Imaging and Radiation Oncology Core MD Anderson Cancer Center Houston TX USA
| | - Maria F. Chan
- Memorial Sloan Kettering Cancer Center Basking Ridge NJ USA
| |
Collapse
|
10
|
Evaluating the radiation contamination dose around a high dose per pulse intraoperative radiotherapy accelerator: a Monte Carlo study. JOURNAL OF RADIOTHERAPY IN PRACTICE 2020. [DOI: 10.1017/s1460396920000084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractAim:In this study, the radiation contamination dose (RCD) for different combinations of electron energy/distance, applicator and radius around the light intraoperative accelerator (LIAC), a high dose per pulse dedicated intraoperative electron radiotherapy machine, has been estimated. Being aware about the amount of RCDs is highly recommended for linear medical electron accelerators.Methods and methods:Monte Carlo Nuclear Particles (MCNP) code was used to simulate the LIAC® head and calculate RCDs. Experimental RCDs measurements were also done by Advanced Markus chamber inside a MP3-XS water phantom. Relative differences of simulations and measurements were calculated.Result:RCD reduction by distance from the machine follows the inverse-square law, as expected. The RCD was decreased by increasing angle from applicator walls opposed to the electron beam direction. The maximum differences between the simulation and measurement results were lower than 3%.Conclusions:The RCD is strongly dependent on electron beam energy, applicator size and distance from the accelerator head. Agreement between the MCNP results and ionometric dosimetry confirms the applicability of this simulation code in modelling the intraoperative electron beam and obtaining the dosimetric parameters. The RCD is a parameter that would restrict working with LIAC in an unshielded operative room.
Collapse
|
11
|
Baghani HR, Hosseini Aghdam SR, Robatjazi M, Mahdavi SR. Monte Carlo-based determination of radiation leakage dose around a dedicated IOERT accelerator. RADIATION AND ENVIRONMENTAL BIOPHYSICS 2019; 58:263-276. [PMID: 30972494 DOI: 10.1007/s00411-019-00786-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 03/07/2019] [Indexed: 06/09/2023]
Abstract
Evaluating the stray radiation around medical electron accelerators is a mandatory issue. Surveying the radiation leakage dose is important for patients, technicians, and health physicists, due to radiation protection aspects. Consequently, radiation leakage dose around the head of a mobile-dedicated intraoperative radiotherapy accelerator (LIAC), at different electron energies and field sizes have been evaluated in this study. More specifically, the MCNPX Monte Carlo code was used to model the LIAC head, connected applicator, and employed water phantom. Radiation leakage dose around the LIAC head was calculated for different energy and field sizes through tuning the Monte Carlo results to the practically measured doses. These measurements were performed using an Advance Markus ionization chamber inside an automated MP3-XS water phantom. The good agreement between the calculated dose distributions within the water tank and corresponding dose measurements show that the simulation model of the LIAC head is appropriate for radiation leakage assessment. The obtained radiation leakage dose distribution highly depends on the electron energy and applicator diameter. With increasing the electron energy, the leakage dose decreased, while increasing the field size increased the leakage dose. It is concluded that the rate of stray radiation and leakage dose around the LIAC head in both vertical and horizontal planes were acceptable according to the recommended radiation protection criteria. To meet the recommended dose limit (100 µSv/week for controlled areas), the maximum number of patients should be kept to four patients per week inside a standard and unshielded operating room.
Collapse
Affiliation(s)
- Hamid Reza Baghani
- Physics Department, Hakim Sabzevari University, Tohid Shahr St., 617976487, P.O. Box: 397, Sabzevar, Iran.
| | | | - Mostafa Robatjazi
- Department of Medical Physics and Radiological Sciences, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Seyed Rabi Mahdavi
- Medical Physics Department, Iran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
12
|
Baghani HR, Robatjazi M, Mahdavi SR, Nafissi N, Akbari ME. Breast intraoperative electron radiotherapy: Image-based setup verification and in-vivo dosimetry. Phys Med 2019; 60:37-43. [PMID: 31000084 DOI: 10.1016/j.ejmp.2019.03.017] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 02/25/2019] [Accepted: 03/19/2019] [Indexed: 10/27/2022] Open
Abstract
INTRODUCTION Single fraction nature of intraoperative radiotherapy highly demands a quality assurance procedure to qualify both beam setup and treatment delivery. The aim of this study is to evaluate the treatment setup during breast intraoperative electron radiotherapy (IOERT) and in-vivo dose delivery verification. MATERIALS AND METHODS Twenty-five breast cancer patients were enrolled and setup verification for each case was performed using C-arm imaging. The received dose by surface and distal end of target was measured by EBT2 film. The significance level of difference between obtained dosimetry results and predicted ones was evaluated by the T statistical test. RESULTS Acquired C-arm images in two different oblique views revealed any misalignment between the applicator and shielding disk. The mean difference between the measured surface dose and expected one was 1.8% ± 1.2 (p = 0.983) while a great disagreement, 11.1% ± 1.5 (p < 0.001), was observed between the measured distal end dose and expected one. This discrepancy is mainly correlated to the backscattering effect from the shielding disk. Target depth nonuniformities can also contribute to this remarkable difference. CONCLUSION Employing the intraoperative imaging for IOERT setup verification can considerably improve the treatment quality. Therefore, it is suggested to implement this imaging procedure as a part of treatment quality assurance. Favorable agreement between the predicted and measured surface doses demonstrates the applicability of EBT2 film for dose delivery verification. The results of in-vivo dosimetry showed that the electron backscattering from employed shielding disk can affect the received dose by the distal end of tumor bed.
Collapse
Affiliation(s)
- Hamid Reza Baghani
- Physics Department, Hakim Sabzevari University, Shohada-e Hastei Blvd, P.O. 9617976487, Sabzevar, Iran.
| | - Mostafa Robatjazi
- Department of Medical Physics and Radiological Sciences, Sabzevar University of Medical Sciences, Shohada-e Hastei Blvd, Sabzevar University of Medical Sciences Campus, P.O. 9617913112, Sabzevar, Iran; Vasei Radiotherapy & Oncology Center, Vasei Hospital, P.O. 9617913113, Sabzevar, Iran.
| | - Seied Rabi Mahdavi
- Department of Medical Physics, Iran University of Medical Sciences. Hemmat Exp. Way, Faculty of Medicine, P.O. 14496141525, Tehran, Iran
| | - Nahid Nafissi
- Department of Breast Surgery, Iran University of Medical Sciences. Hemmat Exp. Way, Faculty of Medicine, P.O. 14496141525, Tehran, Iran
| | - Mohammad Esmail Akbari
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Shohadaye Tajrrish Hospital, Tajrish Sq., P.O. 19996 14414, Tehran, Iran
| |
Collapse
|
13
|
Moradi F, Ung NM, Mahdiraji GA, Khandaker MU, See MH, Taib NA, Bradley DA. Evaluation of Ge-doped silica fibre TLDs forin vivodosimetry during intraoperative radiotherapy. ACTA ACUST UNITED AC 2019; 64:08NT04. [DOI: 10.1088/1361-6560/ab0d4e] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
|
14
|
|
15
|
|
16
|
Baghani HR, Robatjazi M, Mahdavi SR, Hosseini Aghdam SR. Evaluating the performance characteristics of some ion chamber dosimeters in high dose per pulse intraoperative electron beam radiation therapy. Phys Med 2019; 58:81-89. [DOI: 10.1016/j.ejmp.2019.01.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2018] [Revised: 01/29/2019] [Accepted: 01/30/2019] [Indexed: 10/27/2022] Open
|
17
|
Rohani SA, Mahdavi SR, Mostaar A, Ueltzhöffer S, Mohammadi R, Geraily G. Physical and Dosimetric Aspect of Euromechanics Add-on Multileaf Collimator on Varian Clinac 2100 C/D. J Biomed Phys Eng 2019; 9:29-36. [PMID: 30881932 PMCID: PMC6409378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Accepted: 11/20/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Before treatment planning and dose delivery, quality assurance of multi-leaf collimator (MLC) has an important role in intensity-modulated radiation therapy (IMRT) due to the creation of multiple segments from optimization process. OBJECTIVE The purpose of this study is to assess the quality control of MLC leaves using EBT3 Gafchromic films. MATERIAL AND METHODS Leaf Position accuracy and leaf gap reproducibility were checked with Garden fence test. The garden fence test consists of 5 thin bands A) 0.2 Cm width spaced at 2 Cm intervals and B) 1 Cm width spaced at 1 Cm intervals. Each leaf accuracy was analyzed with measuring the full-width half-maximum (FWHM). Maximum and average leaf transmission were measured with gafchromic EBT3 films from Ashland for both 6 MV and 18 MV beams. RESULTS Leaf positions were found to be in a range between 1.78 - 2.53 mm, instead of nominal 2 mm for the test A and between 9.09 - 10.36 mm, instead of nominal 10 mm for the test B. The Average radiation transmission of the MLC was noted 1.79% and 1.98% of the open 10x10 Cm2 field at isocenter for 6 MV and 18 MV beams, respectively. Maximum radiation transmission was noted 4.1% and 4.4% for 6 MV and 18 MV beams, respectively. CONCLUSION In this study, application of gafchromic EBT3 films for the quality assurance of Euromechanics multileaf collimator was studied. Our results showed that the average leaf leakage and positional accuracy of this type of MLC were in the acceptance level based on the Protocols.
Collapse
Affiliation(s)
- S A Rohani
- Department of Medical Physics, Tehran University of Medical Sciences, Tehran, Iran
| | - S R Mahdavi
- Radiation biology research center & medical Physics department, faculty of medicine, Iran University of Medical Sciences, Tehran, Iran
| | - A Mostaar
- Department of Medical Physics, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - S Ueltzhöffer
- Department of Clinic for Radiotherapy and RadioOncology, Medical Faculty Mannheim of the University of Heidelberg, Heidelberg, Germany
| | - R Mohammadi
- Department of Medical Physics, Iran University of Medical Sciences, Tehran, Iran
| | - Gh Geraily
- Department of Medical Physics, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
18
|
Evaluation of dosimetric properties of shielding disk used in intraoperative electron radiotherapy: A Monte Carlo study. Appl Radiat Isot 2018; 139:107-113. [DOI: 10.1016/j.apradiso.2018.04.037] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2017] [Revised: 02/26/2018] [Accepted: 04/30/2018] [Indexed: 11/18/2022]
|
19
|
Breast intraoperative radiotherapy: a review of available modalities, dedicated machines and treatment procedure. JOURNAL OF RADIOTHERAPY IN PRACTICE 2018. [DOI: 10.1017/s146039691800033x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
AbstractBackgroundBreast intraoperative radiotherapy (IORT) is a partial irradiation technique that delivers a single fraction of radiation dose to the tumour bed during surgery. The use of this technique is increasing (especially in the Middle East), and therefore, it is essential to have a comprehensive approach to this treatment modality. The aim of this study is to conduct a literature review on available IORT modalities during breast irradiation as well as dedicated IORT machines and associated treatment procedures. The main IORT trials and corresponding clinical outcomes are also studied.Materials and MethodsA computerised search was performed through MEDLINE, PubMed, PubMed Central, ISI web of knowledge and reference list of related articles.ResultsIORT is now feasible through using two main modalities, including low-kilovolt IORT and intraoperative electron radiotherapy (IOERT). The dedicated machines employed and treatment procedure for mentioned modalities are quite different. The outcomes of implemented clinical trials showed that IORT is not inferior to external beam radiotherapy (EBRT) in specifically selected and well-informed patients and can be considered as an alternative to EBRT.ConclusionAlthough the clinical outcomes of introduced IORT methods are comparable, but based on the review results, it could be said that IOERT is the most effective technical method, in view of the treatment time and dose uniformity concepts. The popularity of IORT is mainly due to the distinguished obtained results during breast cancer treatment. Despite the presence of some technical challenges, it is expected that the IORT technique will become more widespread in the immediate future.
Collapse
|
20
|
In vivo dosimetry with MOSFETs and GAFCHROMIC films during electron IORT for Accelerated Partial Breast Irradiation. Phys Med 2017; 44:26-33. [DOI: 10.1016/j.ejmp.2017.11.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2017] [Revised: 10/19/2017] [Accepted: 11/04/2017] [Indexed: 11/22/2022] Open
|
21
|
Hosseini Daghigh SM, Baghani HR, Aghamiri SMR, Mahdavi SR. Evaluating the performance of TG-43 protocol in esophageal HDR brachytherapy viewpoint to trachea inhomogeneity. Rep Pract Oncol Radiother 2017; 22:284-289. [DOI: 10.1016/j.rpor.2017.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2016] [Revised: 02/24/2017] [Accepted: 04/18/2017] [Indexed: 11/30/2022] Open
|
22
|
Analysis of Gafchromic EBT3 film calibration irradiated with gamma rays from different systems: Gamma Knife and Cobalt-60 unit. Med Dosim 2017; 42:159-168. [PMID: 28527605 DOI: 10.1016/j.meddos.2017.01.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2015] [Revised: 11/19/2016] [Accepted: 01/29/2017] [Indexed: 11/20/2022]
Abstract
In recent years, Gafchromic films are used as an advanced instrument for dosimetry systems. The EBT3 films are a new generation of Gafchromic films. Our main interest is to compare the response of the EBT3 films exposed to gamma rays provided by the Theratron 780C as a conventional radiotherapy system and the Leksell Gamma Knife as a stereotactic radiotherapy system (SRS). Both systems use Cobalt-60 sources, thus using the same energy. However, other factors such as source-to-axis distance, number of sources, dose rate, direction of irradiation, shape of phantom, the field shape of radiation, and different scatter contribution may influence the calibration curve. Calibration curves for the 2 systems were measured and plotted for doses ranging from 0 to 40 Gy at the red and green channels. The best fitting curve was obtained with the Levenberg-Marquardt algorithm. Also, the component of dose uncertainty was obtained for any calibration curve. With the best fitting curve for the EBT3 films, we can use the calibration curve to measure the absolute dose in radiation therapy. Although there is a small deviation between the 2 curves, the p-value at any channel shows no significant difference between the 2 calibration curves. Therefore, the calibration curve for each system can be the same because of minor differences. The results show that with the best fitting curve from measured data, while considering the measurement uncertainties related to them, the EBT3 calibration curve can be used to measure the unknown dose both in SRS and in conventional radiotherapy.
Collapse
|
23
|
Heidarloo N, Baghani HR, Aghamiri SMR, Mahdavi SR, Akbari ME. Commissioning of beam shaper applicator for conformal intraoperative electron radiotherapy. Appl Radiat Isot 2017; 123:69-81. [DOI: 10.1016/j.apradiso.2017.02.039] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2016] [Revised: 02/04/2017] [Accepted: 02/23/2017] [Indexed: 11/27/2022]
|
24
|
Monte Carlo study on effective source to surface distance for electron beams from a mobile dedicated IORT accelerator. JOURNAL OF RADIOTHERAPY IN PRACTICE 2016. [DOI: 10.1017/s1460396916000455] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractPurposeThe effective source to surface distance (SSDeff) for different combinations of energy/applicator size of the electron beam produced by the light intraoperative accelerator, a mobile dedicated intraoperative radiotherapy accelerator, has been calculated in this study.MethodsBoth ionometric dosimetry and Monte Carlo (MC) simulation were followed to obtain the SSDeff for different combinations of electron energy/applicator size. Simulations were performed using Monte Carlo Nuclear Particles (MCNP) MC code. Measurements were performed by Advance Markus chamber and inside a polymethyl methacrylate slab phantom. Inverse square law method was employed to determine the SSDeff from acquired dosimetry data.ResultWith increasing the applicator diameter at a given energy, SSDeff is also increased. The same result is obtained with increasing the electron beam energy for a given applicator size. The results of MC-based SSDeff for 10 cm diameter reference applicator at different energies were in a good accordance with those obtained by ionometric dosimetry. The maximum and mean differences between the results were 1·1 and 0·6%, respectively.ConclusionsThe results of this study showed that SSDeff of intraoperative electron beam is highly dependent on the applicator size and is a mild function of electron beam energy. These facts are in accordance with those reported for conventional electron beam. The good agreement between the results of MC simulation and ionometric dosimetry confirms the application of MCNP code in modelling of intraoperative electron beam and obtaining the intended parameters.
Collapse
|
25
|
Robatjazi M, Mahdavi SR, Takavr A, Baghani HR. Application of Gafchromic EBT2 film for intraoperative radiation therapy quality assurance. Phys Med 2015; 31:314-9. [PMID: 25703011 DOI: 10.1016/j.ejmp.2015.01.020] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2014] [Revised: 01/29/2015] [Accepted: 01/31/2015] [Indexed: 10/24/2022] Open
Abstract
PURPOSE Intraoperative radiation therapy (IORT) using electron beam is commonly done by mobile dedicated linacs that have a variable range of electron energies. This paper focuses on the evaluation of the EBT2 film response in the green and red colour channels for IORT quality assurance (QA). METHODS The calibration of the EBT2 films was done in two ranges; 0-8 Gy for machine QA by red channel and 8-24 Gy for patient-specific QA by green channel analysis. Irradiation of calibration films and relative dosimetries were performed in a water phantom. To evaluate the accuracy of the film response in relative dosimetry, gamma analysis was used to compare the results of the Monte Carlo simulation and ionometric dosimetry. Ten patients with early stage breast cancer were selected for in-vivo dosimetry using the green channel of the EBT2 film. RESULTS The calibration curves were obtained by linear fitting of the green channel and a third-order polynomial function in the red channel (R2=0.99). The total dose uncertainty was up to 4.2% and 4.7% for the red and green channels, respectively. There was a good agreement between the relative dosimetries of films by the red channel, Monte Carlo simulations and ionometric values. The mean dose difference of the in-vivo dosimetry by green channel of this film and the expected values was about 1.98% ± 0.75. CONCLUSION The results of this study showed that EBT2 film can be considered as an appropriate tool for machine and patient-specific QA in IORT.
Collapse
Affiliation(s)
- Mostafa Robatjazi
- Department of Medical Physics, Tehran University of Medical Science, Poursina St, 1417614411 Tehran, Iran
| | - Seied Rabi Mahdavi
- Department of Medical Physics, Iran University of Medical Science, Hemmat Exp. Way, 14496141525 Tehran, Iran.
| | - Abbas Takavr
- Department of Medical Physics, Tehran University of Medical Science, Poursina St, 1417614411 Tehran, Iran
| | - Hamid Reza Baghani
- Department of Radiation Medicine, Shahid Beheshti University, Daneshjoo St, Velenjak, 1983963113 Tehran, Iran
| |
Collapse
|