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In Vivo Dosimetry for Superficial High Dose Rate Brachytherapy with Optically Stimulated Luminescence Dosimeters: A Comparison Study with Metal-Oxide-Semiconductor Field-Effect Transistors. RADIATION 2022. [DOI: 10.3390/radiation2040026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
The purpose of the study was to calibrate and commission optically-stimulated luminescence dosimeters (OSLDs) for in vivo measurements in contact-based 192Ir treatments for superficial high dose rate (HDR) brachytherapy in place of metal-oxide-semiconductor field-effect transistors (MOSFETs). Dose linearity and dose rate dependence were tested by varying source-to-OSLD distance and dwell time. Angular dependence was measured using a solid water phantom setup for OSLD rotation. A group of OSLDs were readout 34 consecutive times to test readout depletion while OSLDs were optically annealed using a mercury lamp for 34.7 h. End-to-end tests were performed using a Freiburg flap and Valencia applicator. OSLD measurements were compared to MOSFETs and treatment planning system (TPS) doses. OSLD response was supralinear for doses above 275 cGy. They were found to be independent of dose rate and dependent on the incident angle in edge-on scenarios. OSLDs exhibited minimal readout depletion and were successfully annealed after 24 h of illumination. Freiburg flap measurements agreed well with the TPS. For the Valencia, OSLDs showed to be the more accurate system over MOSFETs, with a maximum disagreement with the TPS being 0.09%. As such, OSLDs can successfully be used in place of MOSFETs for in vivo dosimetry for superficial HDR brachytherapy.
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A publicly available dataset of out-of-field dose profiles of a 6 MV linear accelerator. Phys Eng Sci Med 2022; 45:613-621. [PMID: 35553016 DOI: 10.1007/s13246-022-01131-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 04/19/2022] [Indexed: 10/18/2022]
Abstract
An increase in radiotherapy-induced secondary malignancies has led to recent developments in analytical modelling of out-of-field dose. These models must be validated against measurements, but currently available datasets are outdated or limited in scope. This study aimed to address these shortcomings by producing a large dataset of out-of-field dose profiles measured with modern equipment. A novel method was developed with the intention of allowing physicists in all clinics to perform these measurements themselves using commonly available dosimetry equipment. A standard 3D scanning water tank was used to collect 36 extended profiles. Each profile was measured in two sections, with the inner section measured with the beam directly incident on the tank, and the outer section with the beam incident on a water-equivalent phantom abutted next to the tank. The two sections were then stitched using a novel feature-matching approach. The profiles were compared against linac commissioning data and manually inspected for discontinuities in the overlap region. The dataset is presented as a publicly accessible comma separated variable file containing off-axis ratios at a range of off-axis distances. This dataset may be applied to the development and validation of analytical models of out-of-field dose. Additionally, it may be used to inform dose estimates to radiosensitive implants and anatomy. Physicists are encouraged to perform these out-of-field measurements in their own clinics and share their results with the community.
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Daniela Falco M, Andreoli S, Delana A, Barbareschi A, De Filippo P, Leidi C, Marini M, Appignani M, Genovesi D, Di Girolamo E. In-vitro investigation of cardiac implantable electronic device malfunction during and after direct photon exposure: A three-centres experience. Phys Med 2022; 94:94-101. [PMID: 35007940 DOI: 10.1016/j.ejmp.2021.12.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 11/26/2021] [Accepted: 12/28/2021] [Indexed: 10/19/2022] Open
Abstract
PURPOSE Radiotherapy may cause malfunction of implantable cardioverter-defibrillators (ICDs) and pacemakers (PMs). We carried-out a multicentre randomized in-vitro study on 65 ICDs and 145 PMs to evaluate malfunctions during and after direct irradiation to doses up to 10 Gy. METHODS Three centres equipped with different linear accelerator and treatment-planning systems participated in the study. Computed Tomography (CT) acquisitions were performed to build the treatment plans. All devices were exposed to dose of 2, 5, or 10 Gy (6 MV). All devices underwent a baseline examination and 64 wireless real-time telemetry-transmissions (47 ICDs and 17 PMs) were monitored during photon exposures. All devices were interrogated after exposure and once monthly for six subsequent months. RESULTS Fifty-four of the 64 wireless-enabled CIEDs (84.4%) recorded noise-related interferences during exposure. In detail, 40/47 ICDs (85.1%) reported interference, of which 16 ICDs (34%) reported potentially clinically relevant pacing inhibition and inappropriate detections. Following exposure, a soft reset occurred in 1/145 PM (0.7%) while 7/145 PMs (4.8%) reported battery issues. During the six-month follow-up, 1/145 PM (0.7%) reported a soft reset, while 12/145 more PMs (8.3%) and 1/64 ICD (1.5%) showed abnormal battery depletion. All reported issues occurred independently of exposure dose. Finally, irreversible effects on software and battery life occurred in only non-MRI-compatible devices. CONCLUSION ICDs mostly featured real-time transient sensing issues, while PMs mostly experienced long-term battery or software issues that were observed immediately following radiation exposure and during follow-up. Irreversible effects on battery life and software occurred in only non-MRI-compatible devices.
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Affiliation(s)
- Maria Daniela Falco
- Department of Radiation Oncology, "G. D'Annunzio" University, "SS. Annunziata" Hospital, Chieti, Italy.
| | - Stefano Andreoli
- Medical Physics Unit, ASST "Papa Giovanni XXIII", Bergamo, Italy
| | - Anna Delana
- Medical Physics Unit, "S. Chiara" Hospital, Trento, Italy
| | | | - Paolo De Filippo
- Electrophysiology Unit, ASST "Papa Giovanni XXIII", Bergamo, Italy
| | - Cristina Leidi
- Electrophysiology Unit, ASST "Papa Giovanni XXIII", Bergamo, Italy
| | | | | | - Domenico Genovesi
- Department of Radiation Oncology, "G. D'Annunzio" University, "SS. Annunziata" Hospital, Chieti, Italy
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Peet SC, Kairn T, Lancaster CM, Trapp JV, Sylvander SR, Crowe SB. Measuring foetal dose from tomotherapy treatments. Med Dosim 2021; 46:342-346. [PMID: 33934977 DOI: 10.1016/j.meddos.2021.03.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 02/26/2021] [Accepted: 03/20/2021] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Treating pregnant women in the radiotherapy clinic is a rare occurrence. When it does occur, it is vital that the dose received by the developing embryo or foetus is understood as fully as possible. This study presents the first investigation of foetal doses delivered during helical tomotherapy treatments. Six treatment plans were delivered to an anthropomorphic phantom using a tomotherapy machine. These included treatments of the brain, unilateral and bilateral head-and-neck, chest wall, and upper lung. Measurements of foetal dose were made with an ionisation chamber positioned at various locations longitudinally within the phantom to simulate a variety of patient anatomies. All measurements were below the established limit of 100 mGy for a high risk of damage during the first trimester. The largest dose encountered was 75 mGy (0.125% of prescription dose). The majority of treatments with measurement positions less than 30 cm fell into the range of uncertain risk (50 - 100 mGy). All treatments with measurement positions beyond 30 cm fell into the low risk category (< 50 mGy). For the cases in this study, tomotherapy resulted in foetal doses that are at least on par with, if not significantly lower than, similar 3D conformal or intensity-modulated treatments delivered with other devices. Recommendations were also provided for estimating foetal doses from tomotherapy plans.
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Affiliation(s)
- Samuel C Peet
- Cancer Care Services, Royal Brisbane and Women's Hospital, Butterfield Street, Herston, Queensland 4029, Australia; School of Chemistry, Physics and Mechanical Engineering, Queensland University of Technology, GPO Box 2434, Brisbane, Queensland 4001, Australia.
| | - Tanya Kairn
- Cancer Care Services, Royal Brisbane and Women's Hospital, Butterfield Street, Herston, Queensland 4029, Australia; School of Chemistry, Physics and Mechanical Engineering, Queensland University of Technology, GPO Box 2434, Brisbane, Queensland 4001, Australia
| | - Craig M Lancaster
- Cancer Care Services, Royal Brisbane and Women's Hospital, Butterfield Street, Herston, Queensland 4029, Australia
| | - Jamie V Trapp
- School of Chemistry, Physics and Mechanical Engineering, Queensland University of Technology, GPO Box 2434, Brisbane, Queensland 4001, Australia
| | - Steven R Sylvander
- Cancer Care Services, Royal Brisbane and Women's Hospital, Butterfield Street, Herston, Queensland 4029, Australia
| | - Scott B Crowe
- Cancer Care Services, Royal Brisbane and Women's Hospital, Butterfield Street, Herston, Queensland 4029, Australia; School of Chemistry, Physics and Mechanical Engineering, Queensland University of Technology, GPO Box 2434, Brisbane, Queensland 4001, Australia
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Delana A, Barbareschi A, Consorti R, Daniela Falco M. Dose calculation accuracy in proximity of a pacemaker: A multicenter study with threecommercial treatment planning systems. Phys Med 2020; 80:201-208. [DOI: 10.1016/j.ejmp.2020.10.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 10/02/2020] [Accepted: 10/22/2020] [Indexed: 11/16/2022] Open
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Aslian H, Kron T, Watts T, Akalanli C, Hardcastle N, Lonski P, Montaseri A, Hay B, Korte J, Berk K, Longo F, Severgnini M. The effect of stereotactic body radiotherapy (SBRT) using flattening filter-free beams on cardiac implantable electronic devices (CIEDs) in clinical situations. J Appl Clin Med Phys 2020; 21:121-131. [PMID: 32277741 PMCID: PMC7324704 DOI: 10.1002/acm2.12873] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Revised: 03/05/2020] [Accepted: 03/12/2020] [Indexed: 11/23/2022] Open
Abstract
PURPOSE This study focused on determining risks from stereotactic radiotherapy using flattening filter-free (FFF) beams for patients with cardiac implantable electronic device (CIEDs). Two strategies were employed: a) a retrospective analysis of patients with CIEDs who underwent stereotactic radiosurgery (SRS)/SBRT at the Peter MacCallum Cancer Centre between 2014 and 2018 and b) an experimental study on the impact of FFF beams on CIEDs. METHODS A retrospective review was performed. Subsequently, a phantom study was performed using 30 fully functional explanted CIEDs from two different manufacturers. Irradiation was carried out in a slab phantom with 6-MV and 10-MV FFF beams. First, a repetition-rate test (RRT) with a range of beam pulse frequencies was conducted. Then, multifraction SBRT (48 Gy/4 Fx) and single-fraction SBRT (28 Gy/1 Fx) treatment plans were used for lung tumors delivered to the phantom. RESULTS Between 2014 and 2018, 13 cases were treated with an FFF beam (6 MV, 1400 MU/min or 10 MV, 2400 MU/min), and 15 cases were treated with a flattening filter (FF) beam (6 MV, 600 MU/min). All the devices were positioned outside the treatment field at a distance of more than 5 cm, except for one case, and no failures were reported due to SBRT/SRS. In the phantom rep-rate tests, inappropriate sensing occurred, starting at a rep-rate of 1200 MU/min. Cardiac implantable electronic device anomalies during and after delivering VMAT-SBRT with a 10-MV FFF beam were observed. CONCLUSIONS The study showed that caution should be paid to managing CIED patients when they undergo SBRT using FFF beams, as it is recommended by AAPM TG-203. Correspondingly, it was found that for FFF beams although there is small risk from dose-rate effects, delivering high dose of radiation with beam energy greater than 6 MV and high-dose rate to CIEDs positioned in close vicinity of the PTV may present issues.
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Affiliation(s)
| | - Tomas Kron
- Physical SciencesPeter MacCallum Cancer CentreMelbourneAustralia
| | - Troy Watts
- Department of CardiologyRoyal Melbourne HospitalMelbourneAustralia
| | - Cagla Akalanli
- Physical SciencesPeter MacCallum Cancer CentreMelbourneAustralia
| | | | - Peta Lonski
- Physical SciencesPeter MacCallum Cancer CentreMelbourneAustralia
| | - Atousa Montaseri
- Physical SciencesPeter MacCallum Cancer CentreMelbourneAustralia
| | - Barry Hay
- Physical SciencesPeter MacCallum Cancer CentreMelbourneAustralia
| | - James Korte
- Physical SciencesPeter MacCallum Cancer CentreMelbourneAustralia
| | - Kemal Berk
- Physical SciencesPeter MacCallum Cancer CentreMelbourneAustralia
| | - Francesco Longo
- Department of PhysicsUniversity of TriesteTriesteItaly
- Italian National Institute of Nuclear Physics (INFN)sezione di TriesteTriesteItaly
| | - Mara Severgnini
- Department of Medical PhysicsAzienda Sanitaria Universitaria Integrata di TriesteTriesteItaly
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Alitto AR, Chiesa S, Franco P, Fiore M, Marino L, Borghetti P, Desideri I, Greto D, Fiorentino A. PAIDEIA: pacemaker and implanted cardioverter defibrillator management in radiation therapy-a survey by the Young Group of the Italian Association of Radiotherapy and Clinical Oncology (AIRO). LA RADIOLOGIA MEDICA 2019; 125:329-335. [PMID: 31832987 DOI: 10.1007/s11547-019-01099-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 10/16/2019] [Indexed: 11/25/2022]
Abstract
INTRODUCTION The management of patients bearing a cardiac implantable electronic device and needing a radiotherapy treatment is an important clinical scenario. The aim of this survey was to evaluate the level of awareness within the Italian Radiation Oncologist community on this topic. MATERIALS AND METHODS A survey was promoted by the Young Group of Italian Association of Radiotherapy and Clinical Oncology (AIRO) with a questionnaire made up of 22 questions allowing for multiple answers, which was administered, both online and on paper version. It was addressed to Radiation Oncologists, AIRO members, participating in the National Congress held in 2015. RESULTS A total of 113 questionnaires were collected back and analyzed (survey online: 50 respondents; paper version: 63). The answers showed a good level of awareness on the issue, but with a nonhomogeneous adherence to the different published guidelines (GL). There is a general low rate of referral for a preliminary cardiological evaluation in patients bearing PM/ICDs, in line with some published surveys; nevertheless, a focused attention to certain specific treatment factors and patient-centered point of view emerged. CONCLUSIONS A generally good awareness of this topic was shown but homogeneous application of GL was not observed, possibly due to the multiplicity of available GL. A prospective data collection could help to better clarify the shadows on this topics.
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Affiliation(s)
- Anna Rita Alitto
- UOC di Radioterapia Oncologica, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Silvia Chiesa
- UOC di Radioterapia Oncologica, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
| | - Pierfrancesco Franco
- Dipartimento di Oncologia - Radioterapia Oncologica, Università di Torino - AOU Citta' della Salute e della Scienza, Turin, Italy
| | - Michele Fiore
- Radioterapia Oncologica, Policlinico Universitario Campus Biomedico, Rome, Italy
| | | | - Paolo Borghetti
- Dipartimento di Radioterapia Oncologica, Università e ASST Spedali Civili di Brescia, Brescia, Italy
| | - Isacco Desideri
- Dipartimento di Scienze Biomediche Sperimentali e Cliniche Mario Serio, Radioterapia Oncologica, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Daniela Greto
- Dipartimento di Scienze Biomediche Sperimentali e Cliniche Mario Serio, Radioterapia Oncologica, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Alba Fiorentino
- Dipartimento di Radioterapia Oncologica, Ospedale Generale Regionale "F. Miulli", Acquaviva Delle Fonti, Bari, Italy
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Characterisation of out-of-field dose at shallow depths for external beam radiotherapy: implications for eye lens dose. AUSTRALASIAN PHYSICAL & ENGINEERING SCIENCES IN MEDICINE 2019; 42:671-676. [PMID: 31183738 DOI: 10.1007/s13246-019-00764-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Accepted: 05/16/2019] [Indexed: 10/26/2022]
Abstract
Re-evaluation of the eye lens radio-sensitivity by the ICRP in 2011 resulted in a significant reduction of the threshold for lens opacities from 8 Gy to 0.5 Gy. This has led to an increase in concern for eye lens doses from treatment sites further from the eye than previously considered. The aim of this study was to examine the out-of-field dose far from the field edge and develop an effective method to accurately characterise the constituent components of this dose at varying depths. Dose profile scans using a 0.6 cm3 cylindrical ionisation chamber in a motorised water tank were compared with previous studies and displayed good agreement. At points more than 20 cm from the field edge patient scatter becomes insignificant, and the dose is dominated by head leakage and collimator scatter. Point depth-dose measurements made with a Roos parallel plate chamber in solid water at distances of 52 cm and 76 cm from central axis showed that the highest dose is at the surface. Since the sensitive region of the eye can be as shallow as 3 mm, in vivo measurements carried out with a detector with buildup more than 3 mm water equivalent thickness may be underestimating the dose to the lens. It is therefore recommended that for in vivo measurements for the eye lens further than 20 cm from the field edge the detector should have only 3 mm build-up material over the effective point of measurement.
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Radiotherapy for patients with cardiovascular implantable electronic devices: an 11-year experience. J Interv Card Electrophysiol 2019; 55:333-341. [PMID: 30603854 DOI: 10.1007/s10840-018-0506-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 12/17/2018] [Indexed: 10/27/2022]
Abstract
PURPOSE As cardiovascular implantable electronic devices (CIEDs) are increasingly indicated in older patients, and the burden of cancer is rising with the aging population, the management of patients with CIEDs who require radiotherapy (RT) is a timely concern. The objective of the study was to evaluate the management of, and malfunctions in, patients with CIEDs undergoing RT. METHODS A retrospective study of patients with CIEDs receiving RT at Kingston Health Sciences Center from March 2007-April 2018 was conducted. Data on demographics, RT, devices, and management were compared for the primary outcome of device malfunction. RESULTS Of the 189 patients with CIEDs receiving a total of 297 courses of RT, 4 patients (2.1%) experienced device malfunctions. Higher beam energy was associated with a malfunction (p < 0.05). Patients with malfunctions received a lower dose of radiation per fraction (267 ± 93 cGy vs. 477 ± 282 cGy; p < 0.05) and were significantly younger (71.4 ± 2.2 years vs. 77.8 ± 9.8 years; p < 0.01) compared to patients without malfunctions. CONCLUSION RT-induced device malfunctions are rare, but given the potential complications, a better understanding of the potential predictors of malfunction and the development of evidence-based guidelines will help optimize patient safety.
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Aslian H, Delana A, Kaiser SR, Moretti E, Foti C, Bregant P, de Denaro M, Longo F, Severgnini M. A multicenter dosimetry study to evaluate the imaging dose from Elekta XVI and Varian OBI kV-CBCT systems to cardiovascular implantable electronic devices (CIEDs). Phys Med 2018; 55:40-46. [PMID: 30471818 DOI: 10.1016/j.ejmp.2018.10.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 10/02/2018] [Accepted: 10/15/2018] [Indexed: 11/19/2022] Open
Abstract
The increasing use of daily CBCT in radiotherapy has raised concerns about the additional dose delivered to the patient, and it can also become a concern issue for those patients with cardiovascular implantable electronic devices (CIEDs) (Pacemaker [PM] and Implantable Cardioverter Defibrillator [ICD]). Although guidelines highly recommend that the cumulative dose received by CIEDs should be kept as low as possible, and a safe threshold based on patient risk classification needs to be respected, this additional imaging dose is not usually considered. Four centers with different dosimetry systems and different CBCT imaging protocols participated in this multicenter study to investigate the imaging dose to the CIEDs from Elekta XVI and Varian OBI kV-CBCT systems. It was found that although imaging doses received by CIEDs outside the CBCT field are negligible, special attention should be paid to this value when CIEDs are inside the field because the daily use of CBCT can sometimes contribute considerably to the total dose received by a CIED.
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Affiliation(s)
- Hossein Aslian
- Department of Physics, University of Trieste, Trieste, Italy.
| | - Anna Delana
- Department of Medical Physics, S. Chiara Hospital, APSS Trento, Italy.
| | - Stefano Ren Kaiser
- Department of Medical Physics, Fondazione Poliambulanza, Istituto Ospedaliero, Brescia, Italy.
| | - Eugenia Moretti
- Department of Medical Physics, Azienda Sanitaria Universitaria Integrata di Udine, Italy.
| | - Claudio Foti
- Department of Medical Physics, Azienda Sanitaria Universitaria Integrata di Udine, Italy.
| | - Paola Bregant
- Department of Medical Physics, Azienda Sanitaria Universitaria Integrata di Trieste, Trieste, Italy.
| | - Mario de Denaro
- Department of Medical Physics, Azienda Sanitaria Universitaria Integrata di Trieste, Trieste, Italy.
| | - Francesco Longo
- Department of Physics, University of Trieste, Trieste, Italy; National Institute for Nuclear Physics (INFN), Sezione di Trieste, Trieste, Italy.
| | - Mara Severgnini
- Department of Medical Physics, Azienda Sanitaria Universitaria Integrata di Trieste, Trieste, Italy.
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Kairn T, Peet S, Yu L, Crowe S. Long-Term Reliability of Optically Stimulated Luminescence Dosimeters. ACTA ACUST UNITED AC 2018. [DOI: 10.1007/978-981-10-9023-3_103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
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Yeung C, Chacko S, Glover B, Campbell D, Crystal E, Ben-Dov N, Baranchuk A. Radiotherapy for Patients with Cardiovascular Implantable Electronic Devices: A Review. Can J Cardiol 2017; 34:244-251. [PMID: 29395701 DOI: 10.1016/j.cjca.2017.11.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2017] [Revised: 11/28/2017] [Accepted: 11/29/2017] [Indexed: 11/16/2022] Open
Abstract
Because cardiovascular implantable electronic devices are increasingly indicated in older patients, and the burden of cancer is rising with the growth and aging of the world population, the management of patients with cardiac devices who require radiotherapy for cancer treatment is a timely concern. Device malfunctions might occur in as high as 3% of radiotherapy courses, posing a substantial issue in clinical practice. A nonsystematic comprehensive review was undertaken. We searched PubMed and the MEDLINE database for randomized controlled trials, meta-analyses, systematic reviews, observational studies, in vitro/in vivo studies, and case reports. Articles were selected by 2 independent reviewers, and emphasis was given to information of interest to a general medical readership. The pathophysiology and predictors of cardiovascular implantable electronic device malfunction due to radiotherapy are reviewed, recommendations for the management of patients with such devices undergoing radiotherapy are summarized, and the clinical significance and future directions of this field are discussed. Radiotherapy-induced device malfunctions are rare, but because of the potential complications, the development of evidence-based guidelines for the management of patients with cardiovascular implantable electronic devices undergoing radiotherapy is a timely concern.
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Affiliation(s)
- Cynthia Yeung
- Heart Rhythm Service, Kingston General Hospital, Queen's University, Kingston, Ontario, Canada
| | - Sanoj Chacko
- Heart Rhythm Service, Kingston General Hospital, Queen's University, Kingston, Ontario, Canada
| | - Benedict Glover
- Heart Rhythm Service, Kingston General Hospital, Queen's University, Kingston, Ontario, Canada
| | - Debra Campbell
- Heart Rhythm Service, Kingston General Hospital, Queen's University, Kingston, Ontario, Canada
| | - Eugene Crystal
- Arrhythmia Services, Schulich Heart Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Nissan Ben-Dov
- Arrhythmia Services, Schulich Heart Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Adrian Baranchuk
- Heart Rhythm Service, Kingston General Hospital, Queen's University, Kingston, Ontario, Canada.
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Aland T, Jhala E, Kairn T, Trapp J. Film dosimetry using a smart device camera: a feasibility study for point dose measurements. ACTA ACUST UNITED AC 2017; 62:N506-N515. [DOI: 10.1088/1361-6560/aa8b36] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Zolfaghari S, Francis KE, Kairn T, Crowe SB. Commissioning a hobby cutting device for radiochromic film preparation. AUSTRALASIAN PHYSICAL & ENGINEERING SCIENCES IN MEDICINE 2017; 40:449-453. [DOI: 10.1007/s13246-017-0545-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Accepted: 03/21/2017] [Indexed: 11/29/2022]
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