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Derikvand AM, Bagherzadeh S, MohammadSharifi A, Khoshgard K, AllahMoradi F. Estimation of cancer risks due to chest radiotherapy treatment planning computed tomography (CT) simulations. RADIATION AND ENVIRONMENTAL BIOPHYSICS 2023; 62:269-277. [PMID: 37129707 DOI: 10.1007/s00411-023-01025-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 03/28/2023] [Indexed: 05/03/2023]
Abstract
The objective of our study was to determine organ doses to estimate the lifetime attributable risk (LAR) of cancer incidence related to chest tomography simulations for Radiotherapy Treatment Planning (RTTP) using patient-specific information. Patient data were used to calculate organ doses and effective dose. The effective dose (E) was calculated by two methods. First, to calculate effective dose in a standard phantom, the collected dosimetric parameters were used with the ImPACT CT Patient Dosimetry Calculator and E was calculated by applying related correction factors. Second, using the scanner-derived Dose Length Product, LARs were computed using the US National Academy of Sciences (BEIR VII) model for age- and sex-specific risks at each exposure. DLP, CTDIvol, and scan length were 507 ± 143 mGy.cm, 11 ± 4 mGy, and 47 ± 7 cm, respectively. The effective dose was 10 ± 3 mSv using ImPACT patient dosimetry calculator software and 9 ± 2 mSv using the scanner-derived Dose Length Product. The LAR of cancer incidence for all cancers, all solid cancers and leukemia were 65 ± 29, 62 ± 27, 7 ± 2 cases per 100,000 individuals, respectively. Radiation exposure from the usage of CT for radiotherapy treatment planning (RTTP) causes non-negligible increases in lifetime attributable risk. The results of this study can be used as a guide by physicians to implement strategies based on the As Low As Reasonably Achievable (ALARA) principle that lead to a reduction dose without sacrificing diagnostic information.
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Affiliation(s)
- Afsaneh Mir Derikvand
- Department of Medical Physics, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Saeed Bagherzadeh
- Department of Medical Physics, Faculty of Medicine, Tarbiat Modares University, Tehran, Iran
| | - Ali MohammadSharifi
- Clinical Research Development Center, Shahid Modarres Educational Hospital, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Karim Khoshgard
- Department of Medical Physics, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Fariba AllahMoradi
- Department of Medical Physics, Kermanshah University of Medical Sciences (KUMS), Building No. 1Shahid Beheshti Boulevard, Kermanshah, 6715847141, Iran.
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Altergot A, Schürmann M, Jungert T, Auerbach H, Nüsken F, Palm J, Rübe C, Rübe CE, Dzierma Y. Imaging doses for different CBCT protocols on the Halcyon 3.0 linear accelerator - TLD measurements in an anthropomorphic phantom. Z Med Phys 2023:S0939-3889(23)00039-9. [PMID: 37088675 DOI: 10.1016/j.zemedi.2023.03.002] [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: 07/08/2022] [Revised: 02/28/2023] [Accepted: 03/07/2023] [Indexed: 04/25/2023]
Abstract
INTRODUCTION Image guided radiotherapy allows for particularly conformal tumour irradiation through precise patient positioning. Becoming the standard for radiotherapy, this increases imaging doses to the patient. The Halcyon 3.0 linear accelerator (Varian Medical Systems, Palo Alto, CA) requires daily imaging due to its geometry. For this reason, the accelerator is equipped with on-line kV and MV imaging. However, daily CBCT images required for irradiation apply additional radiation, which increases the dose to normal tissue and therefore can affect the patient's secondary cancer risk. In this study, actual organ doses were measured for the kV system, and a comparison of normal tissue doses for all available kV CBCT protocols was presented to demonstrate differences in imaging doses across entities and protocols. In addition, effective dose and secondary cancer risk from imaging are evaluated. MATERIAL AND METHODS Measurements were performed with thermoluminescent dosimeters in an anthropomorphic phantom positioned according to each entity (brain, head and neck, breast, lung, pelvis). CBCT images were obtained, using all available pre-set protocols without further adjustment of the parameters. Measured doses for each position and each protocol were then compared and secondary cancer risk of relevant and specifically radiosensitive organs was calculated. RESULTS It was found that imaging doses for protocols such as Pelvis and Head could be reduced by up to half using the corresponding Fast and Low Dose modes, respectively. On the other hand, larger field sizes or the Large mode yielded higher doses than their initial protocols. Image Gently was found to spare normal tissue best, however it is not suitable for certain entities due to low image quality or insufficient projection data. DISCUSSION By using appropriate kV-CBCT protocols, it is possible to reduce imaging doses to a significant extent and therefore spare healthy tissue. Combined with studies of image quality, the results of this study could lead to adjustments in workflow regarding the choice of protocols used in daily routine. This could prevent unnecessary radiation exposure and reduce secondary cancer risk.
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Affiliation(s)
- Angelika Altergot
- Department of Radiotherapy and Radiation Oncology, Saarland University Medical Centre, Homburg/Saar, Germany.
| | - Michaela Schürmann
- Department of Radiotherapy and Radiation Oncology, Saarland University Medical Centre, Homburg/Saar, Germany
| | - Tanja Jungert
- Department of Radiotherapy and Radiation Oncology, Saarland University Medical Centre, Homburg/Saar, Germany
| | - Hendrik Auerbach
- Department of Radiotherapy and Radiation Oncology, Saarland University Medical Centre, Homburg/Saar, Germany
| | - Frank Nüsken
- Department of Radiotherapy and Radiation Oncology, Saarland University Medical Centre, Homburg/Saar, Germany
| | - Jan Palm
- Department of Radiotherapy and Radiation Oncology, Saarland University Medical Centre, Homburg/Saar, Germany
| | - Christian Rübe
- Department of Radiotherapy and Radiation Oncology, Saarland University Medical Centre, Homburg/Saar, Germany
| | - Claudia E Rübe
- Department of Radiotherapy and Radiation Oncology, Saarland University Medical Centre, Homburg/Saar, Germany
| | - Yvonne Dzierma
- Department of Radiotherapy and Radiation Oncology, Saarland University Medical Centre, Homburg/Saar, Germany
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Sun Y, Pan R, Chen Y, Wang Y, Sun L, Wang N, Ma X, Wang GP. Efficient Preparation of a Magnetic Helical Carbon Nanomotor for Targeted Anticancer Drug Delivery. ACS NANOSCIENCE AU 2023; 3:94-102. [PMID: 37101464 PMCID: PMC10125355 DOI: 10.1021/acsnanoscienceau.2c00042] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 11/04/2022] [Accepted: 11/08/2022] [Indexed: 04/28/2023]
Abstract
The applications of nanomotors in the biomedical field have been attracting extensive attention. However, it remains a challenge to fabricate nanomotors in a facile way and effectively load drugs for active targeted therapy. In this work, we combine the microwave heating method and chemical vapor deposition (CVD) to fabricate magnetic helical nanomotors efficiently. The microwave heating method can accelerate intermolecular movement, which converts kinetic energy into heat energy and shortens the preparation time of the catalyst used for carbon nanocoil (CNC) synthesis by 15 times. Fe3O4 nanoparticles are in situ nucleated on the CNC surface by the microwave heating method to fabricate magnetically driven CNC/Fe3O4 nanomotors. In addition, we achieved precise control of the magnetically driven CNC/Fe3O4 nanomotors through remote manipulation of magnetic fields. Anticancer drug doxorubicin (DOX) is then efficiently loaded onto the nanomotors via π-π stacking interactions. Finally, the drug-loaded CNC/Fe3O4@DOX nanomotor can accurately accomplish cell targeting under external magnetic field control. Under short-time irradiation of near-infrared light, DOX can be quickly released onto target cells to effectively kill the cells. More importantly, CNC/Fe3O4@DOX nanomotors allow for single-cell or cell-cluster-targeted anticancer drug delivery, providing a dexterous platform to potentially perform many medically relevant tasks in vivo. The efficient preparation method and application in drug delivery are beneficial for future industrial production and provide inspiration for advanced micro/nanorobotic systems using the CNC as a carrier for a wide range of biomedical applications.
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Affiliation(s)
- Yanming Sun
- College
of Electronics and Information Engineering, Shenzhen University, 3688 Nanhai Boulevard, Shenzhen 518060, China
| | - Renjie Pan
- College
of Electronics and Information Engineering, Shenzhen University, 3688 Nanhai Boulevard, Shenzhen 518060, China
| | - Yuduo Chen
- School
of Materials Science and Engineering, Harbin
Institute of Technology (Shenzhen), Shenzhen 518055, Guangdong, China
- Sauvage
Laboratory for Smart Materials, Harbin Institute
of Technology (Shenzhen), Shenzhen 518055, Guangdong, China
| | - Yong Wang
- School
of Materials Science and Engineering, Harbin
Institute of Technology (Shenzhen), Shenzhen 518055, Guangdong, China
- Sauvage
Laboratory for Smart Materials, Harbin Institute
of Technology (Shenzhen), Shenzhen 518055, Guangdong, China
| | - Lei Sun
- College
of Electronics and Information Engineering, Shenzhen University, 3688 Nanhai Boulevard, Shenzhen 518060, China
| | - Neng Wang
- College
of Electronics and Information Engineering, Shenzhen University, 3688 Nanhai Boulevard, Shenzhen 518060, China
| | - Xing Ma
- School
of Materials Science and Engineering, Harbin
Institute of Technology (Shenzhen), Shenzhen 518055, Guangdong, China
- Sauvage
Laboratory for Smart Materials, Harbin Institute
of Technology (Shenzhen), Shenzhen 518055, Guangdong, China
| | - Guo Ping Wang
- College
of Electronics and Information Engineering, Shenzhen University, 3688 Nanhai Boulevard, Shenzhen 518060, China
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Wang S, Tang W, Luo H, Jin F, Wang Y. The Role of Image-guided Radiotherapy in Prostate Cancer: A Systematic Review and Meta-Analysis. Clin Transl Radiat Oncol 2022; 38:81-89. [DOI: 10.1016/j.ctro.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 10/12/2022] [Accepted: 11/04/2022] [Indexed: 11/09/2022] Open
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Effective dose for kidney-ureter-bladder plain radiography, intravenous urography, and abdominal computed tomography scan: A phantom study. Appl Radiat Isot 2022; 187:110339. [DOI: 10.1016/j.apradiso.2022.110339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 05/07/2022] [Accepted: 06/17/2022] [Indexed: 11/21/2022]
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Duan YH, Gu HL, Yang XH, Chen H, Wang H, Shao Y, Li XY, Feng AH, Ying YC, Fu XL, Ma K, Zhou T, Xu ZY. Evaluation of IGRT-Induced Imaging Doses and Secondary Cancer Risk for SBRT Early Lung Cancer Patients In Silico Study. Technol Cancer Res Treat 2021; 20:15330338211016472. [PMID: 34184567 PMCID: PMC8251513 DOI: 10.1177/15330338211016472] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Objectives: This study performed dosimetry studies and secondary cancer risk assessments on using electronic portal imaging device (EPID) and cone beam computed tomography (CBCT) as image guided tools for the early lung cancer patients treated with SBRT. Methods: The imaging doses from MV-EPID and kV-CBCT of the Edge accelerator were retrospectively added to sixty-one SBRT treatment plans of early lung cancer patients. The MV-EPID imaging dose (6MV Photon beam) was calculated in Pinnacle TPS, and the kV-CBCT imaging dose was simulated and calculated by modeling of the kV energy beam in TPS using Pinnacle automatic modeling program. Three types of plans, namely PlanEPID, PlanCBCT and Planorigin, were generated with incorporating doses of EPID, CBCT and no imaging, respectively, for analysis. The effects of imaging doses on dose-volume-histogram (DVH) and plan quality were analyzed, and the excess absolute risk (EAR) of secondary cancer for ipsilateral lung was evaluated. Results: The regions that received less than 50 cGy were significantly impacted by the imaging doses, while the isodose lines greater than 1000 cGy were barely changed. The DVH values of ipsilateral lung increased the most in PlanEPID, followed by PlanCBCT. Compared to Planorigin on the average, the estimated EAR of ipsilateral lung in PlanEPID increased by 3.43%, while the corresponding EAR increase in PlanCBCT was much smaller (about 0.4%). Considering only the contribution of the imaging dose, the EAR values for the ipsilateral lung due to the MV-EPID dose in 5 years,10 years and 15 years were 1.49 cases, 2.09 cases and 2.88 cases per 104PY respectively, and those due to the kV-CBCT dose were about 9 times lower, correspondingly. Conclusions: The imaging doses produced by MV-EPID and kV-CBCT had little effects on the target dose coverage. The secondary cancer risk caused by MV-EPID dose is more than 8.5 times that of kV-CBCT.
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Affiliation(s)
- Yan-Hua Duan
- Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Heng-Le Gu
- Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Xiao-Hui Yang
- Department of Engineering, Beijing Jingfang Technologies Co. Ltd, Beijing, China
| | - Hua Chen
- Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Hao Wang
- Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Yan Shao
- Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Xiao-Yang Li
- Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Ai-Hui Feng
- Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Yan-Chen Ying
- Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Xiao-Long Fu
- Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Kui Ma
- Clinical helpdesk, Varian Medical Systems, China
| | - Tao Zhou
- Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Shandong, China
| | - Zhi-Yong Xu
- Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
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Roser P, Birkhold A, Preuhs A, Ochs P, Stepina E, Strobel N, Kowarschik M, Fahrig R, Maier A. XDose: toward online cross-validation of experimental and computational X-ray dose estimation. Int J Comput Assist Radiol Surg 2021; 16:1-10. [PMID: 33274400 PMCID: PMC7822800 DOI: 10.1007/s11548-020-02298-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 11/19/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE As the spectrum of X-ray procedures has increased both for diagnostic and for interventional cases, more attention is paid to X-ray dose management. While the medical benefit to the patient outweighs the risk of radiation injuries in almost all cases, reproducible studies on organ dose values help to plan preventive measures helping both patient as well as staff. Dose studies are either carried out retrospectively, experimentally using anthropomorphic phantoms, or computationally. When performed experimentally, it is helpful to combine them with simulations validating the measurements. In this paper, we show how such a dose simulation method, carried out together with actual X-ray experiments, can be realized to obtain reliable organ dose values efficiently. METHODS A Monte Carlo simulation technique was developed combining down-sampling and super-resolution techniques for accelerated processing accompanying X-ray dose measurements. The target volume is down-sampled using the statistical mode first. The estimated dose distribution is then up-sampled using guided filtering and the high-resolution target volume as guidance image. Second, we present a comparison of dose estimates calculated with our Monte Carlo code experimentally obtained values for an anthropomorphic phantom using metal oxide semiconductor field effect transistor dosimeters. RESULTS We reconstructed high-resolution dose distributions from coarse ones (down-sampling factor 2 to 16) with error rates ranging from 1.62 % to 4.91 %. Using down-sampled target volumes further reduced the computation time by 30 % to 60 %. Comparison of measured results to simulated dose values demonstrated high agreement with an average percentage error of under [Formula: see text] for all measurement points. CONCLUSIONS Our results indicate that Monte Carlo methods can be accelerated hardware-independently and still yield reliable results. This facilitates empirical dose studies that make use of online Monte Carlo simulations to easily cross-validate dose estimates on-site.
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Affiliation(s)
- Philipp Roser
- Pattern Recognition Lab, Friedrich-Alexander Universität Erlangen-Nürnberg, 91058, Erlangen, Germany.
- Erlangen Graduate School in Advanced Optical Technologies (SAOT), Friedrich-Alexander Universität Erlangen-Nürnberg, 91052, Erlangen, Germany.
| | - Annette Birkhold
- Innovation, Advanced Therapies, Siemens Healthcare GmbH, 91301, Forchheim, Germany
| | - Alexander Preuhs
- Pattern Recognition Lab, Friedrich-Alexander Universität Erlangen-Nürnberg, 91058, Erlangen, Germany
| | - Philipp Ochs
- Innovation, Advanced Therapies, Siemens Healthcare GmbH, 91301, Forchheim, Germany
| | - Elizaveta Stepina
- Innovation, Advanced Therapies, Siemens Healthcare GmbH, 91301, Forchheim, Germany
| | - Norbert Strobel
- Institute of Medical Engineering Schweinfurt, University of Applied Sciences Würzburg-Schweinfurt, 97421, Schweinfurt, Germany
| | - Markus Kowarschik
- Innovation, Advanced Therapies, Siemens Healthcare GmbH, 91301, Forchheim, Germany
| | - Rebecca Fahrig
- Innovation, Advanced Therapies, Siemens Healthcare GmbH, 91301, Forchheim, Germany
| | - Andreas Maier
- Pattern Recognition Lab, Friedrich-Alexander Universität Erlangen-Nürnberg, 91058, Erlangen, Germany
- Erlangen Graduate School in Advanced Optical Technologies (SAOT), Friedrich-Alexander Universität Erlangen-Nürnberg, 91052, Erlangen, Germany
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García-Hernández T, Romero-Expósito M, Sánchez-Nieto B. Low dose radiation therapy for COVID-19: Effective dose and estimation of cancer risk. Radiother Oncol 2020; 153:289-295. [PMID: 33065184 PMCID: PMC7553901 DOI: 10.1016/j.radonc.2020.09.051] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 09/16/2020] [Accepted: 09/27/2020] [Indexed: 01/11/2023]
Abstract
BACKGROUND AND PURPOSE The objective of this work is to evaluate the risk of carcinogenesis of low dose ionizing radiation therapy (LDRT), for treatment of immune-related pneumonia following COVID-19 infection, through the estimation of effective dose and the lifetime attributable risk of cancer (LAR). MATERIAL AND METHODS LDRT treatment was planned in male and female computational phantoms. Equivalent doses in organs were estimated using both treatment planning system calculations and a peripheral dose model (based on ionization chamber measurements). Skin dose was estimated using radiochromic films. Later, effective dose and LAR were calculated following radiation protection procedures. RESULTS Equivalent doses to organs per unit of prescription dose range from 10 mSv/cGy to 0.0051 mSv/cGy. Effective doses range from 204 mSv to 426 mSv, for prescription doses ranging from 50 cGy to 100 cGy. Total LAR for a prescription dose of 50 cGy ranges from 1.7 to 0.29% for male and from 4.9 to 0.54% for female, for ages ranging from 20 to 80 years old. CONCLUSIONS The organs that mainly contribute to risk are lung and breast. Risk for out-of-field organs is low, less than 0.06 cases per 10000. Female LAR is on average 2.2 times that of a male of the same age. Effective doses are of the same order of magnitude as the higher-dose interventional radiology techniques. For a 60 year-old male, LAR is 8 times that from a cardiac CT, when prescription dose is 50 cGy.
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Affiliation(s)
| | - Maite Romero-Expósito
- Área de Ciencias Básicas y Ambientales, Instituto Tecnológico de Santo Domingo (INTEC), P.O. Box 342-9/249-2, Santo Domingo, Dominican Republic
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Yuasa Y, Shiinoki T, Onizuka R, Fujimoto K. Estimation of effective imaging dose and excess absolute risk of secondary cancer incidence for four-dimensional cone-beam computed tomography acquisition. J Appl Clin Med Phys 2019; 20:57-68. [PMID: 31593377 PMCID: PMC6839364 DOI: 10.1002/acm2.12741] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Revised: 09/02/2019] [Accepted: 09/15/2019] [Indexed: 12/25/2022] Open
Abstract
This study was conducted to estimate the organ equivalent dose and effective imaging dose for four-dimensional cone-beam computed tomography (4D-CBCT) using a Monte Carlo simulation, and to evaluate the excess absolute risk (EAR) of secondary cancer incidence. The EGSnrc/BEAMnrc were used to simulate the on-board imager (OBI) from the TrueBeam linear accelerator. Specifically, the OBI was modeled based on the percent depth dose and the off-center ratio was measured using a three-dimensional (3D) water phantom. For clinical cases, 15 lung and liver cancer patients were simulated using the EGSnrc/DOSXYZnrc. The mean absorbed doses to the lung, stomach, bone marrow, esophagus, liver, thyroid, bone surface, skin, adrenal glands, gallbladder, heart, intestine, kidney, pancreas and spleen, were quantified using a treatment planning system, and the equivalent doses to each organ were calculated. Subsequently, the effective dose was calculated as the weighted sum of the equivalent dose, and the EAR of the secondary cancer incidence was determined for each organ with the use of the biologic effects of ionizing radiation (BEIR) VII model. The effective doses were 3.9 ± 0.5, 15.7 ± 2.0, and 7.3 ± 0.9 mSv, for the lung, and 4.2 ± 0.6, 16.7 ± 2.4, and 7.8 ± 1.1 mSv, for the liver in the respective cases of the 3D-CBCT (thorax, pelvis) and 4D-CBCT modes. The lung EARs for males and females were 7.3 and 10.7 cases per million person-years, whereas the liver EARs were 9.9 and 4.5 cases per million person-years. The EAR increased with increasing time since radiation exposure. In clinical studies, we should use 4D-CBCT based on consideration of the effective dose and EAR of secondary cancer incidence.
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Affiliation(s)
- Yuki Yuasa
- Department of Radiation OncologyGraduate School of MedicineYamaguchi UniversityUbeYamaguchiJapan
| | - Takehiro Shiinoki
- Department of Radiation OncologyGraduate School of MedicineYamaguchi UniversityUbeYamaguchiJapan
| | - Ryota Onizuka
- Department of Radiological TechnologyYamaguchi University HospitalUbeYamaguchiJapan
| | - Koya Fujimoto
- Department of Radiation OncologyGraduate School of MedicineYamaguchi UniversityUbeYamaguchiJapan
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Dose calculation deviations induced by fractional image-guided-couch-shifts for Varian Halcyon MV cone beam CT. Phys Med 2019; 58:66-71. [PMID: 30824152 DOI: 10.1016/j.ejmp.2019.01.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2018] [Revised: 01/23/2019] [Accepted: 01/24/2019] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To assess the criticality of calculation deviations induced by fractional image-guided-couch-shifts for Halcyon MV cone beam CT (CBCT) dose, which is incorporated as part of total treatment dose. METHODS Eclipse-calculated imaging dose was first validated in 'Cheese Phantom' by measurement. Then, the actual imaging dose (Dact) for 18 historical patients of various sites were recalculated based on 513 MV CBCT-guided-couch-shift data, and compared with reference computations based on treatment isocentre (Dref). Patient- and plan-specific dose from treatment fields was integrated with Dact and Dref respectively for comparison. RESULTS The average absolute relative disagreements between the measured and calculated dose were less than 1.23%. The mean ± 1SD of gamma passing rates of the accumulated imaging dose and total dose were 80.71 ± 6.22% and 99.81 ± 0.32% respectively based on 3 mm/3%/local/10% threshold criteria. The accumulated errors of minimum imaging dose to PTV were no larger than -14.38 cGy, which were reduced to -0.82 cGy after the heterogeneous treatment dose was overlaid. The mean relative discrepancies of PTV minimum dose were -0.61 cGy (-0.71%) and -0.00 (0.00%), before and after incorporating the treatment dose respectively. CONCLUSIONS The Eclipse-calculated Halcyon MV CBCT dose was validated. Although the isocentre displacement-induced imaging dose calculation errors for Halcyon MV CBCT were partially cancelled out by couch shifts of various directions and distances, especially after the incorporation of heterogeneous treatment dose, it was still advisable to monitor the accumulated deviations and replan when unacceptable target under-dose or organ over-dose were observed.
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Dzierma Y, Mikulla K, Richter P, Bell K, Melchior P, Nuesken F, Rübe C. Imaging dose and secondary cancer risk in image-guided radiotherapy of pediatric patients. Radiat Oncol 2018; 13:168. [PMID: 30185206 PMCID: PMC6125956 DOI: 10.1186/s13014-018-1109-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 08/21/2018] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Daily image-guided radiotherapy (IGRT) can contribute to cover extended body volumes with low radiation dose. The effect of additional imaging dose on secondary cancer development is modelled for a collective of children with Morbus Hodgkin. METHODS Eleven radiotherapy treatment plans from pediatric patients with Hodgkin's lymphoma were retrospectively analyzed, including imaging dose from scenarios using different energies (kV/MV) and planar/cone-beam computed tomography (CBCT) techniques. In addition to assessing the effect of imaging dose on organs at risk, the excess average risk (EAR) for developing a secondary carcinoma of the lung or breast was modelled. RESULTS Although the variability between the patients is relatively large due to the different target volumes, the additional EAR due to imaging can be consistently determined. For daily 6MV CBCT, the EAR for developing a secondary cancer at age 50 is over 3 cases per 104 PY (patient-years) for the female breast and 0.7-0.8 per 104 PY for the lungs. This can be decreased by using only planar images (< 1 per 104 PY for the breast and 0.1 for the lungs). Similar values are achieved by daily 360° kV CBCT (0.44-0.57 per 104 PY for the breast and 0.08 per 104 PY for the lungs), which is again reduced for daily 200° kV CBCT (0.02 per 104 PY for the lungs and 0.07-0.08 per 104 PY for the breast). These values increase if an older attained age is considered (e.g., for 70 years, by a factor of four for the lungs). CONCLUSIONS Daily imaging can be performed with an additional secondary cancer risk of less than 1 per 104 PY if kV CBCT is applied. If MV modalities must be chosen, a similar EAR can be achieved with planar images. A further reduction in risk is possible if the imaging geometry allows for sparing of the breast by a partial rotation underneath the patient.
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Affiliation(s)
- Yvonne Dzierma
- Department of Radiotherapy and Radiation Oncology, Saarland University Medical Centre, Kirrberger Str. Geb. 6.5, 66421 Homburg, Saar Germany
| | - Katharina Mikulla
- Department of Radiotherapy and Radiation Oncology, Saarland University Medical Centre, Kirrberger Str. Geb. 6.5, 66421 Homburg, Saar Germany
| | - Patrick Richter
- Department of Radiotherapy and Radiation Oncology, Saarland University Medical Centre, Kirrberger Str. Geb. 6.5, 66421 Homburg, Saar Germany
| | - Katharina Bell
- Department of Radiotherapy and Radiation Oncology, Saarland University Medical Centre, Kirrberger Str. Geb. 6.5, 66421 Homburg, Saar Germany
| | - Patrick Melchior
- Department of Radiotherapy and Radiation Oncology, Saarland University Medical Centre, Kirrberger Str. Geb. 6.5, 66421 Homburg, Saar Germany
| | - Frank Nuesken
- Department of Radiotherapy and Radiation Oncology, Saarland University Medical Centre, Kirrberger Str. Geb. 6.5, 66421 Homburg, Saar Germany
| | - Christian Rübe
- Department of Radiotherapy and Radiation Oncology, Saarland University Medical Centre, Kirrberger Str. Geb. 6.5, 66421 Homburg, Saar Germany
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Jang JS, Yang HJ, Koo HJ, Kim SH, Park CR, Yoon SH, Shin SY, Do KH. Image quality assessment with dose reduction using high kVp and additional filtration for abdominal digital radiography. Phys Med 2018; 50:46-51. [PMID: 29891093 DOI: 10.1016/j.ejmp.2018.05.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 05/04/2018] [Accepted: 05/06/2018] [Indexed: 11/25/2022] Open
Abstract
PURPOSE Dose reduction using additional filters with high kilovoltage peak (kVp) for abdominal digital radiography has received much attention recently. We evaluated image quality with dose reduction in abdominal digital radiography by using high kVp and additional copper filters at a tertiary hospital. METHODS Between June 2016 and July 2016, 82 patients underwent abdominal digital radiography using 80 kVp in X-ray room 1 and 82 were imaged using 92 kVp with 0.1-mm copper filtration in X-ray room 2. The effective dose was calculated using a PC-based Monte Carlo program. Image quality of the abdominal radiography acquired in the two rooms was evaluated using a five-point ordinal scale, as well as the signal-to-noise and contrast-to-noise ratios. RESULTS The mean effective dose decreased by 25.8% and 25.7% for the supine and standing positions, respectively, when abdominal digital radiography using 92 kVp with 0.1-mm copper filtration was performed. In the 20 patients who performed abdominal digital radiography twice in each room, visual grading scores for visualisation of psoas outlines and kidney outlines are higher in room 1. However, there was no statistical significant difference of visual grading scores among the 124 patients who underwent only one abdominal radiography in the room 1 or 2 (P > 0.05). CONCLUSIONS Dose reduction for abdominal digital radiography can be achieved with comparable image quality by performing abdominal digital radiography using 92 kVp with 0.1-mm copper filtration, despite the higher AEC dose.
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Affiliation(s)
- Ji Sung Jang
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, South Korea; Department of Medical Physics, Korea University, South Korea
| | - Hyung Jin Yang
- Department of Medical Physics, Korea University, South Korea
| | - Hyun Jung Koo
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, South Korea
| | - Sung Ho Kim
- Department of Medical Physics, Korea University, South Korea
| | - Chan Rok Park
- Department of Medical Physics, Korea University, South Korea
| | - Suk Hwan Yoon
- Department of Medical Physics, Korea University, South Korea
| | - So Youn Shin
- Department of Radiology, Kyung Hee University Hospital, College of Medicine, Kyung Hee University, Seoul, South Korea
| | - Kyung-Hyun Do
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, South Korea.
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