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Casanova Borca V, Radici L, Petrucci E, Piva C, Cante D, Pasquino M. Preliminary evaluation of a novel secondary check tool for intensity modulated radiotherapy treatment planning. Phys Med 2023; 106:102528. [PMID: 36610176 DOI: 10.1016/j.ejmp.2023.102528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 01/02/2023] [Accepted: 01/02/2023] [Indexed: 01/07/2023] Open
Abstract
PURPOSE To evaluate the dosimetric accuracy of the Delta4 Insight (DI) secondary-check dosimetry system. METHODS Absolute dosimetry in reference conditions, output factors, percent depth doses normalized and off-axis dose profiles for different field sizes calculated by DI were compared with measurements. Dose calculations for 20 clinical IMRT/VMAT plans generated in the TPS using both AAA or AcurosXB algorithms were compared with measurements. The average difference between calculated and measured point dose in high-dose region was calculated for all cases. 3D dose measurements were performed in Delta4 Phantom+ and a comparison between calculated and measured dose distributions was performed by means of the gamma analysis with 3 %/2 mm criteria. The dose distributions calculated by DI for 20 IMRT/VMAT plans were compared with those calculated by the TPS. RESULTS The absolute dosimetry computed by DI showed dose value in agreement with the measured one within 0.3 %. The average differences between measured and calculated output factors were less than 2.5 %. The average PDD differences were less than 0.6 %. An excellent agreement between calculations and off-axis measurements is found. The point doses calculated for the 20 recalculated plan showed good agreement with measurements with average differences less than 0.5 %. The average gamma pass rate values for the Delta4 Phantom + 3D dose analysis was greater than 97.%. The comparison of DI with theTPS showed good agreement for the used metrics. CONCLUSIONS Delta4 Insight may provide a useful independent secondary dose verification system for IMRT/VMAT plans, complementing the traditional global QA protocols.
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Affiliation(s)
| | - Lorenzo Radici
- Medical Physics Department, A.S.L. TO4, 10015 Ivrea (TO), Italy
| | | | - Cristina Piva
- Radiotherapy Department, A.S.L. TO4, 10015 Ivrea (TO), Italy
| | - Domenico Cante
- Radiotherapy Department, A.S.L. TO4, 10015 Ivrea (TO), Italy
| | - Massimo Pasquino
- Medical Physics Department, A.S.L. TO4, 10015 Ivrea (TO), Italy.
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Radici L, Petrucci E, Garello A, Borca VC, La Porta MR, Pasquino M. VALIDATION OF A SECONDARY DOSE CALCULATION SYSTEM FOR VOLUMETRIC MODULATED ARC THERAPY QUALITY ASSURANCE. Phys Med 2022. [DOI: 10.1016/s1120-1797(22)02387-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
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Radici L, Petrucci E, Borca VC, La Porta M, Pasquino M. Dosimetric characterization of a new transmission detector for patient-specific in-vivo plan verification. Phys Med 2021. [DOI: 10.1016/s1120-1797(22)00169-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Piva C, Panier Suffat L, Petrucci ETF, Manuguerra G, Vittone F, Cante D, Ferrario S, Paolini M, Radici L, Vellani G, La Porta MR. Effect of delaying surgery by more than 10 weeks after neoadjuvant therapy in rectal cancer: a single institution experience. Updates Surg 2021; 74:145-151. [PMID: 34661871 DOI: 10.1007/s13304-021-01189-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 10/01/2021] [Indexed: 10/20/2022]
Abstract
The optimal timing of surgery after neoadjuvant chemoradiotherapy (CRT) in locally advanced rectal cancer is still controversial. Aim of this study was to evaluate the effect of increasing time interval between the end of CRT and surgery on pathological outcomes. This is a retrospective analysis on 114 patients treated with long-course neoadjuvant RT with or without chemotherapy between January 2005 and September 2020. 43 patients underwent surgery within 10 weeks from the end of CRT (1st group), whereas 71 patients underwent total mesorectal excision with a time interval equal or greater than 10 weeks (2nd group). Primary endpoint was pCR (pathological complete response). Secondary endpoints were near pCR (ypT0-1 N0), tumor downstaging (ypT less than cT), nodal downstaging (ypN less than cN), and overall response comparing clinical with pathological TN stage. Overall, the pCR rate was 8.8%, whereas we observed no significantly difference in primary endpoint between the two groups. Considering near pCR, a trend toward significant difference in favor of 2nd group was seen (p = 0.072). Tumor and nodal downstaging rates were 39.5%, 41.9%, 59.2%, and 56.3% in the 1st and 2nd group, respectively, with a statistically significant difference for T category (p = 0.042). Overall response rates (TN stage) showed a trend toward significant difference in favor of patients of the ≥ 10 week group (p = 0.059). Our study suggests that a prolonged time interval between the end of CRT and surgery (≥ 10 weeks) increases pathological response rates.
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Affiliation(s)
- Cristina Piva
- Department of Radiation Oncology, ASL TO4, Ivrea Community Hospital, Ivrea, Italy
| | - Luca Panier Suffat
- Department of Surgery, ASL TO4, Ivrea Community Hospital, Piazza Credenza 2, 10015, Ivrea, Italy.
| | | | | | - Federico Vittone
- Department of Pathology, ASL TO4, Ivrea Community Hospital, Ivrea, Italy
| | - Domenico Cante
- Department of Radiation Oncology, ASL TO4, Ivrea Community Hospital, Ivrea, Italy
| | - Silvia Ferrario
- Department of Radiation Oncology, ASL TO4, Ivrea Community Hospital, Ivrea, Italy
| | - Marina Paolini
- Department of Radiation Oncology, ASL TO4, Ivrea Community Hospital, Ivrea, Italy
| | - Lorenzo Radici
- Department of Medical Physics, ASL TO4, Ivrea Community Hospital, Ivrea, Italy
| | - Giorgio Vellani
- Department of Oncology, ASL TO4, Ivrea Community Hospital, Ivrea, Italy
| | - Maria R La Porta
- Department of Radiation Oncology, ASL TO4, Ivrea Community Hospital, Ivrea, Italy
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Petrucci E, Radici L, Borca VC, Ferrario S, Paolini M, Pasquino M. Delta 4 Discover transmission detector: A comprehensive characterization for in-vivo VMAT monitoring. Phys Med 2021; 85:15-23. [PMID: 33945949 DOI: 10.1016/j.ejmp.2021.04.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 04/13/2021] [Accepted: 04/18/2021] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To investigate the dosimetric behaviour, influence on photon beam fluence and error detection capability of Delta4 Discover transmission detector. METHODS The transmission detector (TRD) was characterized on a TrueBeam linear accelerator with 6 MV beams. Linearity, reproducibility and dose rate dependence were investigated. The effect on photon beam fluence was evaluated in terms of beam profiles, percentage depth dose, transmission factor and surface dose for different open field sizes. The transmission factor of the 10x10 cm2 field was entered in the TPS's configuration and its correct use in the dose calculation was verified recalculating 17 clinical IMRT/VMAT plans. Surface dose was measured for 20 IMRT fields. The capability to detect different delivery errors was investigated evaluating dose gamma index, MLC gamma index and leaf position of 15 manually modified VMAT plans. RESULTS TRD showed a linear dependence on MU. No dose rate dependence was observed. Short-term and long-term reproducibility were within 0.1% and 0.5%. The presence of the TRD did not significantly affect PDDs and profiles. The transmission factor of the 10x10 cm2 field size was 0.985 and 0.983, for FF and FFF beams respectively. The 17 recalculated plans met our clinical gamma-index passing rate, confirming the correct use of the transmission factor by the TPS. The surface dose differences for the open fields increase for shorter SSDs and greater field size. Differences in surface dose for the IMRT beams were less than 2%. Output variation ≥2%, collimator angle variations within 0.3°, gantry angle errors of 1°, jaw tracking and leaf position errors were detected. CONCLUSIONS Delta4 Discover shows good linearity and reproducibility, is not dependent on dose rate and does not affect beam quality and dose profiles. It is also capable to detect dosimetric and geometric errors and therefore it is suitable for monitoring VMAT delivery.
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Affiliation(s)
| | - Lorenzo Radici
- Medical Physics Department, A.S.L. TO4, 10015 Ivrea, TO, Italy
| | | | | | - Marina Paolini
- Radiotherapy Department, A.S.L. TO4, 10015 Ivrea, TO, Italy
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Loi G, Fusella M, Vecchi C, Menna S, Rosica F, Gino E, Maffei N, Menghi E, Savini A, Roggio A, Radici L, Cagni E, Lucio F, Strigari L, Strolin S, Garibaldi C, Romanò C, Piovesan M, Franco P, Fiandra C. Computed Tomography to Cone Beam Computed Tomography Deformable Image Registration for Contour Propagation Using Head and Neck, Patient-Based Computational Phantoms: A Multicenter Study. Pract Radiat Oncol 2019; 10:125-132. [PMID: 31786233 DOI: 10.1016/j.prro.2019.11.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 10/22/2019] [Accepted: 11/12/2019] [Indexed: 12/14/2022]
Abstract
PURPOSE To investigate the performance of various algorithms for deformable image registration (DIR) for propagating regions of interest (ROIs) using multiple commercial platforms, from computed tomography to cone beam computed tomography (CBCT) and megavoltage computed tomography. METHODS AND MATERIALS Fourteen institutions participated in the study using 5 commercial platforms: RayStation (RaySearch Laboratories, Stockholm, Sweden), MIM (Cleveland, OH), VelocityAI and SmartAdapt (Varian Medical Systems, Palo Alto, CA), and ABAS (Elekta AB, Stockholm, Sweden). Algorithms were tested on synthetic images generated with the ImSimQA (Oncology Systems Limited, Shrewsbury, UK) package by applying 2 specific deformation vector fields (DVF) to real head and neck patient datasets. On-board images from 3 systems were used: megavoltage computed tomography from Tomotherapy and 2 kinds of CBCT from a clinical linear accelerator. Image quality of the system was evaluated. The algorithms' accuracy was assessed by comparing the DIR-mapped ROIs returned by each center with those of the reference, using the Dice similarity coefficient and mean distance to conformity metrics. Statistical inference on the validation results was carried out to identify the prognostic factors of DIR performance. RESULTS Analyzing 840 DIR-mapped ROIs returned by the centers, it was demonstrated that DVF intensity and image quality were significant prognostic factors of DIR performance. The accuracy of the propagated contours was generally high, and acceptable DIR performance can be obtained with lower-dose CBCT image protocols. CONCLUSIONS The performance of the systems proved to be image quality specific, depending on the DVF type and only partially on the platforms. All systems proved to be robust against image artifacts and noise, except the demon-based software.
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Affiliation(s)
- Gianfranco Loi
- Department of Medical Physics, University Hospital "Maggiore della Carità," Novara, Italy
| | - Marco Fusella
- Medical Physics Department, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy.
| | | | - Sebastiano Menna
- Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC di Fisica Sanitaria, Dipartimento di diagnostica per immagini, radioterapia oncologica ed ematologia, Rome, Italy
| | | | - Eva Gino
- SC Fisica Sanitaria, A.O. Ordine Mauriziano di Torino, Italy
| | - Nicola Maffei
- Department of Medical Physics, A.O. U. di Modena, Modena, Italy; University of Turin, Post Graduate School in Medical Physics, Turin, Italy
| | - Enrico Menghi
- Medical Physics Department, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, FC, Italy
| | - Alessandro Savini
- Medical Physics Department, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, FC, Italy
| | - Antonella Roggio
- Medical Physics Department, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Lorenzo Radici
- Ospedale regionale "Umberto Parini" Azienda USL VDA, Fisica Sanitaria, Italy
| | - Elisabetta Cagni
- Medical Physics Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy; School of Engineering, Cardiff University, Cardiff, Wales, UK
| | | | - Lidia Strigari
- Department of Medical Physics, St. Orsola-Malpighi Hospital, Bologna, Italy
| | | | - Cristina Garibaldi
- IEO, European Institute of Oncology IRCCS, Unit of Medical Physics, Milan, Italy
| | - Chiara Romanò
- IEO, European Institute of Oncology IRCCS, Unit of Medical Physics, Milan, Italy
| | | | | | - Christian Fiandra
- University of Turin, Department of Oncology, Turin, Italy; School of Bioengineering and Medical-Surgical Sciences, Politecnico di Torino, Turin, Italy
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Fusella M, Loi G, Cagni E, Gino E, Lucio F, Menghi E, Orlandi G, Piovesan M, Radici L, Roggio A, Savini A, Strigari L, Strolin S, Fiandra C. [P200] Deformable Image Registration performances in head and neck patients: Impact of daily imaging quality. Phys Med 2018. [DOI: 10.1016/j.ejmp.2018.06.494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Pasquino M, Cutaia C, Radici L, Valzano S, Gino E, Cavedon C, Stasi M. Dosimetric characterization and behaviour in small X-ray fields of a microchamber and a plastic scintillator detector. Br J Radiol 2016; 90:20160596. [PMID: 27826990 DOI: 10.1259/bjr.20160596] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE The aim of this work was to investigate the main dosimetric characteristics and the performance of an A26 Exradin ionization microchamber (A26 IC) and a W1 Exradin plastic scintillation detector (W1 PSD) in small photon beam dosimetry for treatment planning system commissioning and quality assurance programme. METHODS Detector characterization measurements (short-term stability, dose linearity, angular dependence and energy dependence) were performed in water for field sizes up to 10 × 10 cm2. Polarity effect (Ppol) was examined for the A26 IC. The behaviour of the detectors in small field relative dosimetry [percentage depth dose, dose profiles often called the off-axis ratio and output factors (OFs)] was investigated for field sizes ranging from 1 × 1 to 3 × 3 cm2. RESULTS Results were compared with those obtained with other detectors we already use for small photon beam dosimetry. A26 IC and W1 PSD showed a linear dose response. While the A26 IC showed no energy dependence, the W1 PSD showed energy dependence within 2%; no angular dependence was registered. Ppol values for A26 IC were below 0.9% (0.5% for field size >2 × 2 cm2). A26 IC and W1 PSD depth-dose curves and lateral profiles agreed with those obtained with an EDGE diode. No differences were observed among the detectors in OF measurement for field sizes larger than 1 × 1 cm2, with average differences <1%. For field sizes <1 × 1 cm2, the effective volume of ionization chamber and non-water equivalence of EDGE diode become significant. A26 IC OF values were significantly lower than EDGE diode and W1 PSD values, with percentage differences of about -23 and -13% for the smallest field, respectively. W1 PSD OF values lay between ion chambers and diode values, with a maximum percentage difference of about -10% with respect to the EDGE diode, for a 6 × 6-mm2 field size. CONCLUSION The results of our investigation confirm that A26 IC and W1 PSD could play an important role in small field relative dosimetry. Advances in knowledge: Dosimetric characteristics of Exradin A26 ionization microchamber and W1 plastic scintillation detector for small field dosimetry.
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Affiliation(s)
- Massimo Pasquino
- 1 Medical Physics Department, AO Ordine Mauriziano di Torino, Turin, Italy
| | - Claudia Cutaia
- 1 Medical Physics Department, AO Ordine Mauriziano di Torino, Turin, Italy
| | - Lorenzo Radici
- 1 Medical Physics Department, AO Ordine Mauriziano di Torino, Turin, Italy
| | - Serena Valzano
- 1 Medical Physics Department, AO Ordine Mauriziano di Torino, Turin, Italy
| | - Eva Gino
- 1 Medical Physics Department, AO Ordine Mauriziano di Torino, Turin, Italy
| | - Carlo Cavedon
- 2 Medical Physics Department, University Hospital, Verona, Italy
| | - Michele Stasi
- 1 Medical Physics Department, AO Ordine Mauriziano di Torino, Turin, Italy
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Richetta E, Radici L, Pasquino M, Cutaia C, Valzano S, Menga M, Pellerito R, Stasi M. previsional dosimetry in 99mTc-MAA SPECT-TC images for liver radioembolization with 90Y microspheres: Influence of iterative and FBP reconstruction algorithms on dose calculation. Phys Med 2016. [DOI: 10.1016/j.ejmp.2016.07.677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Pasquino M, Cutaia C, Radici L, Gino E, Stasi M. Characterization of the Exradin A26 microchamber for small field dosimetry. Phys Med 2016. [DOI: 10.1016/j.ejmp.2016.07.682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Richetta E, Radici L, Cutaia C, Valzano S, Moro GL, Pasquino M, Pellerito R, Stasi M. Dosimetry of lesions in radioiodine therapy of metastatic throid cancer: SPECT-TC calibration, verification and preliminary patient results. Phys Med 2016. [DOI: 10.1016/j.ejmp.2016.07.678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Cerello P, Bocchini L, Gobbato A, Attili A, Cutaia C, Ferrero V, Pontremoli C, Radici L, Stasi M, Visentin S. EP-1917: Measurements of reactive oxygen species production induced by gold nanoparticles in radiotherapy. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)33168-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Loi G, Fiandra C, Lanzi E, Fusella M, Orlandini L, Lucio F, Strolin S, Radici L, Mezzenga E, Roggio A, Tana L, Cagni E, Savini A, Garibaldi C. EP-1902: Impact of image quality on DIR performances: results from a multi-institutional study. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)33153-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Bocchini L, Gobbato A, Attili A, Cutaia C, Ferrero V, Pontremoli C, Radici L, Stasi, Visentin S, Cerello P. Measurements of Reactive Oxygen Species production induced by Gold Nanoparticles in Radiotherapy protocols. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)30046-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Radici L, Cutaia C, Mazzotta B, Gino E, Stasi M. EP-1378: Exradin A26 microchamber characterization for small field dosimetry. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)41370-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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