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Tahmasbi M, Capela M, Santos T, Mateus J, Ventura T, do Carmo Lopes M. Particular issues to be considered in small field dosimetry for TrueBeam STx commissioning. Appl Radiat Isot 2023; 202:111066. [PMID: 37865066 DOI: 10.1016/j.apradiso.2023.111066] [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: 11/09/2022] [Revised: 08/28/2023] [Accepted: 10/05/2023] [Indexed: 10/23/2023]
Abstract
This study aims to report the relevant issues concerning small fields in the commissioning of a TrueBeam STx for photon energies of 6MV, 10MV, 6FFF, and 10FFF. Percent depth doses, profiles, and field output factors were measured according to the beam model configuration of the treatment planning system. Multiple detectors were used based on the IAEA TRS-483 protocol as well as EBT3 radiochromic film. Analytical Anisotropic and Acuros XB algorithms, were configured and validated through basic dosimetry comparisons and end-to-end clinical tests.
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Affiliation(s)
- Marziyeh Tahmasbi
- Radiologic Technology Department, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran; Medical Physics Department, Instituto Portugues de Oncologia Coimbra Francisco Gentil, E.P.E., Portugal.
| | - Miguel Capela
- Medical Physics Department, Instituto Portugues de Oncologia Coimbra Francisco Gentil, E.P.E., Portugal
| | - Tania Santos
- Medical Physics Department, Instituto Portugues de Oncologia Coimbra Francisco Gentil, E.P.E., Portugal
| | - Josefina Mateus
- Medical Physics Department, Instituto Portugues de Oncologia Coimbra Francisco Gentil, E.P.E., Portugal
| | - Tiago Ventura
- Medical Physics Department, Instituto Portugues de Oncologia Coimbra Francisco Gentil, E.P.E., Portugal
| | - Maria do Carmo Lopes
- Medical Physics Department, Instituto Portugues de Oncologia Coimbra Francisco Gentil, E.P.E., Portugal
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Lambri N, Hernandez V, Sáez J, Pelizzoli M, Parabicoli S, Tomatis S, Loiacono D, Scorsetti M, Mancosu P. Multicentric evaluation of a machine learning model to streamline the radiotherapy patient specific quality assurance process. Phys Med 2023; 110:102593. [PMID: 37104920 DOI: 10.1016/j.ejmp.2023.102593] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 03/02/2023] [Accepted: 04/14/2023] [Indexed: 04/29/2023] Open
Abstract
PURPOSE Patient-specific quality assurance (PSQA) is performed to ensure that modulated treatment plans can be delivered as intended, but constitutes a substantial workload that could slow down the radiotherapy process and delay the start of clinical treatments. In this study, we investigated a machine learning (ML) tree-based ensemble model to predict the gamma passing rate (GPR) for volumetric modulated arc therapy (VMAT) plans. MATERIALS AND METHODS 5622 VMAT plans from multiple treatment sites were selected from a database of Institution 1 and the ML model trained using 19 metrics. PSQA analyses were performed automatically using criteria 3%/1 mm (global normalization, absolute dose, 10% threshold) and 95% action limit. Model's performance was evaluated on an out-of-sample test set of Institution 1 and on two independent sets of measurements collected at Institution 2 and Institution 3. Mean absolute error (MAE), as well as the model's sensitivity and specificity, were computed. RESULTS The model obtained a MAE of 2.33%, 2.54% and 3.91% for the three Institutions, with a specificity of 0.90, 0.90 and 0.68, and a sensitivity of 0.61, 0.25, and 0.55, respectively. Small positive median values of the residuals (i.e., the difference between measurements and predictions) were observed for each Institution (0.95%, 1.66%, and 3.42%). Thus, the model's predictions were, on average, close to the real values and provided a conservative estimation of the GPR. CONCLUSIONS ML models can be integrated into clinical practice to streamline the radiotherapy workflow, but they should be center-specific or thoroughly verified within centers before clinical use.
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Affiliation(s)
- Nicola Lambri
- IRCCS Humanitas Research Hospital, Radiotherapy and Radiosurgery Department, via Manzoni 56, 20089 Rozzano, Milan, Italy; Department of Biomedical Sciences, Humanitas University, via Rita Levi Montalcini 4, 20072 Pieve Emanuele, Milan, Italy
| | - Victor Hernandez
- Department of Medical Physics, Hospital Universitari Sant Joan de Reus, IISPV, Tarragona, Spain
| | - Jordi Sáez
- Department of Radiation Oncology, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Marco Pelizzoli
- IRCCS Humanitas Research Hospital, Radiotherapy and Radiosurgery Department, via Manzoni 56, 20089 Rozzano, Milan, Italy; Dipartimento di Fisica "Aldo Pontremoli", Università degli Studi di Milano, Milan, Italy
| | - Sara Parabicoli
- IRCCS Humanitas Research Hospital, Radiotherapy and Radiosurgery Department, via Manzoni 56, 20089 Rozzano, Milan, Italy; Dipartimento di Fisica "Aldo Pontremoli", Università degli Studi di Milano, Milan, Italy
| | - Stefano Tomatis
- IRCCS Humanitas Research Hospital, Radiotherapy and Radiosurgery Department, via Manzoni 56, 20089 Rozzano, Milan, Italy
| | - Daniele Loiacono
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milan, Italy
| | - Marta Scorsetti
- IRCCS Humanitas Research Hospital, Radiotherapy and Radiosurgery Department, via Manzoni 56, 20089 Rozzano, Milan, Italy; Department of Biomedical Sciences, Humanitas University, via Rita Levi Montalcini 4, 20072 Pieve Emanuele, Milan, Italy
| | - Pietro Mancosu
- IRCCS Humanitas Research Hospital, Radiotherapy and Radiosurgery Department, via Manzoni 56, 20089 Rozzano, Milan, Italy.
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Mancosu P, Russo S, Antonucci AR, Stasi M. Lean Thinking to manage a national working group on physics aspects of Stereotactic Body Radiation Therapy. Med Phys 2021; 48:2050-2056. [PMID: 33598932 DOI: 10.1002/mp.14783] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 01/21/2021] [Accepted: 02/09/2021] [Indexed: 12/14/2022] Open
Abstract
PURPOSE To report how the adoption of a Lean Thinking mindset in the management of a national working group (WG) on the physics of stereotactic body radiation therapy (SBRT) contributed to achieve SBRT standardization objectives. METHODS Vision for the WG has been established as fragmentation reduction and process harmonization enhancement in SBRT for Italian centers. Two main research themes of the technical aspects of SBRT emerged as areas with major standardization improvement needs, small field dosimetry and SBRT planning comparisons, to be investigated through multi-institutional studies. The management of the WG leveraged on the Lean concept of fostering self-organization in a non-hierarchical environment. Four progressive involvement levels were defined for each study. No specific "scientific" pre-experience was required to propose and coordinate a project, just requiring a voluntary commitment. People engagement was measured in terms of number of published articles. The standardization goals have been conducted through a simplified "5S" (Sort, Set in Order, Shine, Standardize, and Sustain) methodology, first considering a phase of awareness (the first three "S"), then identifying and implementing standardization actions (the last two "S"). RESULTS Since the beginning, 157 medical physicists joined the AIFM/SBRT-WG. Twenty-four papers/reviews/letters have been published in the period 2014-2019 on major radiation oncology journals, authored by >100 physicists (>50% working in small hospitals). Six over 12 first authors worked in peripheral/small hospitals, with no prior publication as first author. These studies contributed to the awareness and standardization phases for both small-field dosimetry and planning. In particular, errors in small-field measurements in 8% of centers were detected thanks to a generalized output factor curve in function of the effective field size created by averaging data available from different Linacs. Furthermore, planner's experience in SBRT was correlated with dosimetric parameters in the awareness phase; while sharing median dose volume histograms (DVHs) reduced variability among centers while keeping the same level of plan complexity. Finally, all the dosimetric parameters statistically significant to the planner experience during the awareness phase, were no longer significantly different in the standardization phase. CONCLUSIONS The experience of our SBRT-WG has shown how a Lean Thinking mindset could foster the SBRT procedure standardization and spread the physics of SBRT knowledge, enhancing personal growth. Our expectation is to inspire other scientific societies that have to deal with fragmented contexts or pursue processes harmonization through Lean principles.
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Affiliation(s)
- Pietro Mancosu
- Medical Physics Unit, Radiotherapy Department, IRCCS Humanitas Research Hospital, Milano, Italy
| | - Serenella Russo
- Medical Physics Unit, Azienda USL Toscana Centro, Firenze, Italy
| | | | - Michele Stasi
- Medical Physics Department, A.O. Ordine Mauriziano di Torino, Turin, Italy
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Clemente S, Falco MD, Cagni E, Talamonti C, Boccia M, Gino E, Lorenzini E, Rosica F, Russo S, Alparone A, Zefiro D, Fiandra C. The influence of small field output factors simulated uncertainties on the calculated dose in VMAT plans for brain metastases: a multicentre study. Br J Radiol 2021; 94:20201354. [PMID: 33481637 DOI: 10.1259/bjr.20201354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES This multicentric study was carried out to investigate the impact of small field output factors (OFs) inaccuracies on the calculated dose in volumetric arctherapy (VMAT) radiosurgery brain plans. METHODS Nine centres, realised the same five VMAT plans with common planning rules and their specific clinical equipment Linac/treatment planning system commissioned with their OFs measured values (OFbaseline). In order to simulate OFs errors, two new OFs sets were generated for each centre by changing only the OFs values of the smallest field sizes (from 3.2 × 3.2 cm2 to 1 × 1 cm2) with well-defined amounts (positive and negative). Consequently, two virtual machines for each centre were recommissioned using the new OFs and the percentage dose differences ΔD (%) between the baseline plans and the same plans recalculated using the incremented (OFup) and decremented (OFdown) values were evaluated. The ΔD (%) were analysed in terms of planning target volume (PTV) coverage and organs at risk (OARs) sparing at selected dose/volume points. RESULTS The plans recalculated with OFdown sets resulted in higher variation of doses than baseline within 1.6 and 3.4% to PTVs and OARs respectively; while the plans with OFup sets resulted in lower variation within 1.3% to both PTVs and OARs. Our analysis highlights that OFs variations affect calculated dose depending on the algorithm and on the delivery mode (field jaw/MLC-defined). The Monte Carlo (MC) algorithm resulted significantly more sensitive to OFs variations than all of the other algorithms. CONCLUSION The aim of our study was to evaluate how small fields OFs inaccuracies can affect the dose calculation in VMAT brain radiosurgery treatments plans. It was observed that simulated OFs errors, return dosimetric calculation accuracies within the 3% between concurrent plans analysed in terms of percentage dose differences at selected dose/volume points of the PTV coverage and OARs sparing. ADVANCES IN KNOWLEDGE First multicentre study involving different Planning/Linacs about undetectable errors in commissioning output factor for small fields.
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Affiliation(s)
- Stefania Clemente
- Unit of Medical Physics and Radioprotection, Federico II University Hospital, Napoli, Italy
| | - Maria Daniela Falco
- Department of Radiation Oncology, "G. D'Annunzio" University, "SS. Annunziata" Hospital, Chieti, Italy
| | - Elisabetta Cagni
- Medical Physics Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Cinzia Talamonti
- Medical Physics Unit, University Of Florence, Azienda Ospedaliero Universitaria Careggi, Florence, Italy
| | | | - Eva Gino
- Medical PhysicDepartment, A.O. Ordine Mauriziano, Turin, Italy
| | - Elena Lorenzini
- U.O.C Fisica Sanitaria Area Nord, Azienda USL Nord Ovest Toscana, Massa Carrara, Italy
| | | | | | | | - Daniele Zefiro
- MedicaPhysics Unit, ASL5 Sistema Sanitario Regione Liguria, La Spezia, Italy
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Dufreneix S, Bellec J, Josset S, Vieillevigne L. Field output factors for small fields: A large multicentre study. Phys Med 2021; 81:191-196. [PMID: 33465756 DOI: 10.1016/j.ejmp.2021.01.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 12/30/2020] [Accepted: 01/02/2021] [Indexed: 02/06/2023] Open
Abstract
PURPOSE The determination of output factors in small field dosimetry is a crucial point, especially when implementing stereotactic radiotherapy (SRT). Herein, a working group of the French medical physicist society (SFPM) was created to collect small field output factors. The objective was to gather and disseminate information on small field output factors based on different detectors for various clinical SRT equipment and measurement configurations. METHOD Participants were surveyed for information about their SRT equipment, including the type of linear particle accelerator (linac), collimator settings, measurement conditions for the output factors and the detectors used. Participants had to report both the ratio of detector readings and the correction factors applied as described in the IAEA TRS-483 code of practice for nominal field sizes smaller or equal to 3 cm. Mean field output factors and their associated standard deviations were calculated when data from at least 3 linacs were available. RESULTS 23 centres were enrolled in the project. Standard deviations of the mean field output factors were systematically smaller than 1.5% for field sizes larger or equal to 1 cm and reached 5% for the smallest field size (0.5 cm). Deviations with published data were smaller than 2% except for the 0.5 cm circular fixed aperture collimator of the CyberKnife where it reached 3.5%. CONCLUSION These field output factor values obtained via a large multicentre study can be considered as an external cross verification for any radiotherapy centre starting a SRT program and should help minimize systematic errors when determining small field output factors.
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Affiliation(s)
- S Dufreneix
- Institut de Cancérologie de l'Ouest, Angers, Saint-Herblain, France.
| | - J Bellec
- Centre Eugène Marquis, Rennes, France
| | - S Josset
- Institut de Cancérologie de l'Ouest, Angers, Saint-Herblain, France
| | - L Vieillevigne
- Institut Claudius Régaud, Institut Universitaire du Cancer de Toulouse, France; Centre de Recherche et de Cancérologie de Toulouse, UMR1037 INSERM - Université Toulouse 3 - ERL5294 CNRS, Oncopole, Toulouse, France
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Lam S, Bradley D, Khandaker M. Small-field radiotherapy photon beam output evaluation: Detectors reviewed. Radiat Phys Chem Oxf Engl 1993 2021. [DOI: 10.1016/j.radphyschem.2020.108950] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Gul A, Fukuda S, Mizuno H, Taku N, Kakakhel MB, Mirza SM. Feasibility study of using Stereotactic Field Diode for field output factors measurement and evaluating three new detectors for small field relative dosimetry of 6 and 10 MV photon beams. J Appl Clin Med Phys 2020; 21:23-36. [PMID: 33078544 PMCID: PMC7700919 DOI: 10.1002/acm2.13007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 06/29/2020] [Accepted: 07/10/2020] [Indexed: 11/23/2022] Open
Abstract
This study assesses the feasibility of using stereotactic field diode (SFD) as an alternate to gaf chromic films for field output factor (FF) measurement and further evaluating three new detectors for small field dosimetry. Varian 21EX linear accelerator was used to generate 6 and 10 MV beams of nominal square fields ranging from 0.5 × 0.5 cm2 to 10 × 10 cm2. One passive (EBT3 films) and five active detectors including IBA RAZOR diode(RD), SFD, RAZOR nanochamber (RNC), pinpoint chamber (PTW31023), and semiflex chamber (PTW31010) were employed. FFs were measured using films and SFD while beam profiles and percentage depth dose (PDD) distribution were acquired with active detectors. Polarity (kpol) and recombination (ks) effects of ion chambers were determined and corrected for output ratio measurement. Correction factors (CF) of RD, RNC, and PTW31023 in axial and radial orientation were also measured. Stereotactic field diode measured FFs have shown good agreement with films (with difference of <1%). RD and RNC measured beam profiles were within 3% deviation from the SFD values. Variation in kpol with field size for RNC and PTW31023 was up to 4% and 0.4% (for fields ≥ 1 × 1 cm2), respectively, while variation in ks of PTW31023 was <0.2 %. The maximum values of CF have been calculated to be 5.2%, 2.0%, 13.6%, and 25.5% for RD, RNC, PTW31023‐axial, and PTW31023‐radial respectively. This study concludes that SFD with appropriate CFs as given in TRS 483 may be used for measuring FFs as an alternate to EBT3 films. Whereas RD and RNC may be used for beam profile and PDD measurement in small fields. Considering the limit of usability of 2%, RNC may be used without CF for FF measurement in the smallfields investigated in this study.
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Affiliation(s)
- Attia Gul
- QST Hospital, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan.,Department of Physics & Applied Mathematics, Pakistan Institute of Engineering and Applied Sciences (PIEAS), Islamabad, Pakistan
| | - Shigekazu Fukuda
- QST Hospital, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
| | - Hideyuki Mizuno
- QST Hospital, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
| | - Nakaji Taku
- QST Hospital, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
| | - M Basim Kakakhel
- Department of Physics & Applied Mathematics, Pakistan Institute of Engineering and Applied Sciences (PIEAS), Islamabad, Pakistan
| | - Sikander M Mirza
- Department of Physics & Applied Mathematics, Pakistan Institute of Engineering and Applied Sciences (PIEAS), Islamabad, Pakistan
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A national survey on technology and quality assurance for stereotactic body radiation therapy. Phys Med 2019; 65:6-14. [DOI: 10.1016/j.ejmp.2019.07.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 07/26/2019] [Accepted: 07/30/2019] [Indexed: 12/22/2022] Open
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Russo S, Masi L, Francescon P, Dicarolo P, De Martin E, Frassanito C, Redaelli I, Vigorito S, Stasi M, Mancosu P. Multi-site evaluation of the Razor stereotactic diode for CyberKnife small field relative dosimetry. Phys Med 2019; 65:40-45. [DOI: 10.1016/j.ejmp.2019.07.027] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 07/22/2019] [Accepted: 07/30/2019] [Indexed: 10/26/2022] Open
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Talamonti C, Russo S, Pimpinella M, Falco MD, Cagni E, Pallotta S, Stasi M, Mancosu P. Community approach for reducing small field measurement errors: Experience over 24 centres. Radiother Oncol 2018; 132:218-222. [PMID: 30385173 DOI: 10.1016/j.radonc.2018.10.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Revised: 08/20/2018] [Accepted: 10/10/2018] [Indexed: 11/18/2022]
Abstract
PURPOSE The complexity of the modern Stereotactic Body Radiation Therapy (SBRT) techniques requires comprehensive quality assurance programs, to ensure the right treatment to the patient. Dosimetry of small radiation fields is a challenge especially for radiotherapy centres starting to work on this issue. The matter to be discussed here concerns the need of detailed measurement procedures and cross checks to be paired to the usual recommendations on detectors and correction factors. MATERIALS AND METHODS The presented work involved 24 Italian radiotherapy centres, with the specific purpose to minimize systematic errors in output factor measurements over different radiotherapy centres. Using the unshielded silicon diode IBA Razor, reference curves for the relative signal ratio (RSR) as a function of beam size were created for each Linac family. RESULTS With this study we have demonstrated consistency of small field dosimetry on all the centres involved, moreover all radiotherapy centres using Razor are allowed to compare measurements amongst each other and centres with values deviating more than 5% from the reference curve are advised to repeat their measurements. With this procedure, some critical issues were detected from two centres in RSR measurements, that, if implemented into the own treatment planning system, would induce an unwanted overdosage larger than 5%. CONCLUSIONS The proposed approach could allow one to envision high-skilled therapy centres providing support to those featuring minor experience and could represent an important strategy for the clinical implementation of emerging technologies at high quality levels. The methodology adopted exploits crowd knowledge methods which could be applied in others areas of radiation dosimetry.
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Affiliation(s)
- Cinzia Talamonti
- University of Florence, Dept Biomedical Experimental and Clinical Science, "Mario Serio", Medical Physics Unit, AOU Careggi, Florence, Italy.
| | - Serenella Russo
- Medical Physics Unit, Azienda USL Toscana Centro, Florence, Italy
| | - Maria Pimpinella
- Istituto Nazionale di Metrologia delle Radiazioni Ionizzanti, ENEA-INMRI C R Casaccia, I-00123 Roma, Italy
| | - Maria Daniela Falco
- Department of Radiation Oncology "G. D'Annunzio", University of Chieti, SS. Annunziata Hospital, Chieti, Italy
| | - Elisabetta Cagni
- Medical Physics Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Stefania Pallotta
- University of Florence, Dept Biomedical Experimental and Clinical Science, "Mario Serio", Medical Physics Unit, AOU Careggi, Florence, Italy
| | - Michele Stasi
- Medical Physics Department, A.O. Ordine Mauriziano, Turin, Italy
| | - Pietro Mancosu
- Medical Physics Unit of Radiation Oncology Dept., Humanitas Clinical and Research Hospital, Milano, Italy
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Reggiori G, Stravato A, Mancosu P, Lobefalo F, Paganini L, Zucconi F, Palumbo V, Gaudino A, Scorsetti M, Tomatis S. Small field characterization of a Nanochamber prototype under flattening filter free photon beams. Phys Med 2018; 49:139-146. [DOI: 10.1016/j.ejmp.2017.08.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Revised: 08/04/2017] [Accepted: 08/16/2017] [Indexed: 11/28/2022] Open
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12
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Clemente S, Masi L, Fiandra C, Cagni E, Villaggi E, Esposito M, Giglioli FR, Marino C, Strigari L, Garibaldi C, Stasi M, Mancosu P, Russo S. A multi-center output factor intercomparison to uncover systematic inaccuracies in small field dosimetry. PHYSICS & IMAGING IN RADIATION ONCOLOGY 2018; 5:93-96. [PMID: 33458376 PMCID: PMC7807548 DOI: 10.1016/j.phro.2018.03.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Revised: 03/15/2018] [Accepted: 03/15/2018] [Indexed: 11/28/2022]
Abstract
Large uncertainties in output factor (OF) small fields dosimetry motivated multicentric studies. The focus of the study was the determination of the OFs, for different linacs and radiosurgery units, using new-generation detectors. Intercomparison studies between radiotherapy centers improved quality dosimetry practices. Results confirmed the effectiveness of the studies to uncover large systematic inaccuracies in small field dosimetry.
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Affiliation(s)
- Stefania Clemente
- Unit of Medical Physics and Radioprotection, A.O.U Federico II, Napoli, Italy
| | - Laura Masi
- Department of Medical Physics and Radiation Oncology, IFCA, I-50139 Firenze, Italy
| | - Christian Fiandra
- Department of Oncology, Radiation Oncology Unit, University of Torino, Italy
| | | | | | - Marco Esposito
- Medical Physics Unit, Azienda USL Toscana Centro, Firenze I-50012, Italy
| | | | | | - Lidia Strigari
- Laboratory of Medical Physics and Expert Systems, Regina Elena Cancer Center IFO, Roma, Italy
| | - Cristina Garibaldi
- Unit of Radiation Research, European Institute of Oncology, Milano, Italy
| | | | - Pietro Mancosu
- Medical Physics Unit of Radiation Oncology Dept., Humanitas Research Hospital, Milano, Italy
| | - Serenella Russo
- Medical Physics Unit, Azienda USL Toscana Centro, Firenze I-50012, Italy
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Dosimetric characterization of small fields using a plastic scintillator detector: A large multicenter study. Phys Med 2017; 41:33-38. [DOI: 10.1016/j.ejmp.2017.03.024] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 03/23/2017] [Accepted: 03/28/2017] [Indexed: 12/31/2022] Open
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14
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Small field output factors evaluation with a microDiamond detector over 30 Italian centers. Phys Med 2016; 32:1644-1650. [DOI: 10.1016/j.ejmp.2016.10.017] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2016] [Revised: 10/25/2016] [Accepted: 10/26/2016] [Indexed: 11/18/2022] Open
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Cagni E, Russo S, Reggiori G, Bresciani S, Fedele D, Iori M, Marino C, Nardiello B, Ruggieri R, Strigari L, Mancosu P. Technical Note: Multicenter study of TrueBeam FFF beams with a new stereotactic diode: Can a common small field signal ratio curve be defined? Med Phys 2016; 43:5570. [DOI: 10.1118/1.4961744] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
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