Abstract: Radiation therapy has undergone many advancements and evloved from 2D to 3D. Recently, with rapid pace of drug discoveries, cutting edge technology, and clinical trials has made innovative advancements in computer technology and treatment planning and upgraded to intensity modulated radiotherapy (IMRT) which delivers in homogenous dose to tumor and normal tissues. The present study was a hospital-based experience comparing two different conformal radiotherapy techniques for brain tumors. This analytical study design has been conducted at Regional Cancer Centre, India from January 2014 to January 2015. Ten patients have been selected after inclusion and exclusion criteria. All the patients were treated on Artiste Siemens Linac Accelerator. The tolerance level for maximum dose was 6.0 Gyfor lenses and 54.0 Gy for brain stem, optic chiasm and optical nerves as per RTOG criteria. Mean and standard deviation values of PTV98%, PTV 95% and PTV 2% in IMRT were 93.16±2.9, 95.01±3.4 and 103.1±1.1 respectively; for 3DCRT were 91.4±4.7, 94.17±2.6 and 102.7±0.39 respectively. PTV max dose (%) in IMRT and 3D-CRT were 104.7±0.96 and 103.9±1.0 respectively. Maximum dose to the tumor can be delivered with IMRT with acceptable toxicity limits. Variables such as expertise, location of tumor, patient condition, and TPS influence the outcome of the treatment.
Abstract: Dosimetry is an indispensable and precious factor in patient treatment planning to minimize the absorbed dose in vital tissues. In this study, compartmental model was used in order to estimate the human absorbed dose of 177Lu-DOTATOC from the biodistribution data in wild type rats. For this purpose, 177Lu-DOTATOC was prepared under optimized conditions and its biodistribution was studied in male Syrian rats up to 168 h. Compartmental model was applied to mathematical description of the drug behaviour in tissue at different times. Dosimetric estimation of the complex was performed using radiation absorbed dose assessment resource (RADAR). The biodistribution data showed high accumulation in the adrenal and pancreas as the major expression sites for somatostatin receptor (SSTR). While kidneys as the major route of excretion receive 0.037 mSv/MBq, pancreas and adrenal also obtain 0.039 and 0.028 mSv/MBq. Due to the usage of this method, the points of accumulated activity data were enhanced, and further information of tissues uptake was collected that it will be followed by high (or improved) precision in dosimetric calculations.
Abstract: Mechanical index (MI) is used for quantifying acoustic cavitation and the relationship between acoustic pressure and the frequency. In this study, modeling of the MI was applied to provide treatment protocol and to understand the effective physical processes on reproducibility of stem cells. The acoustic pressure and MI equations are modeled and solved to estimate optimal MI for 28, 40, 150 kHz and 1 MHz frequencies. Radial and axial acoustic pressure distribution was extracted. To validate the results of the modeling, the acoustic pressure in the water and near field depth was measured by a piston hydrophone. Results of modeling and experiments show that the model is consistent well to experimental results with 0.91 and 0.90 correlation of coefficient (p
Abstract: Objectives: In recent years, the Faculty of Dentistry of the University of Hong Kong have extended the implementation of 3D electronic models (e-models) into problem-based learning (PBL) of the Bachelor of Dental Surgery (BDS) curriculum, aiming at mutual enhancement of PBL teaching quality and the students’ skills in using e-models. This study focuses on the effectiveness of e-models serving as a tool to enhance the students’ skills and competences in PBL. Methods: The questionnaire surveys are conducted to measure 50 fourth-year BDS students’ attitude change between beginning and end of blended PBL tutorials. The response rate of this survey is 100%. Results: The results of this study show the students’ agreement on enhancement of their learning experience after e-model implementation and their expectation to have more blended PBL courses in the future. The potential of e-models in cultivating students’ self-learning skills reduces their dependence on others, while improving their communication skills to argue about pros and cons of different treatment options. The students’ independent thinking ability and problem solving skills are promoted by e-model implementation, resulting in better decision making in treatment planning. Conclusion: It is important for future dental education curriculum planning to cope with the students’ needs, and offer support in the form of software, hardware and facilitators’ assistance for better e-model implementation.
Abstract: Purpose: This E-survey was carried out to facilitate the implementation and Education of VMAT (Volumetric Modulated Arc Therapy) in Radiotherapy-RT departments and reasons for not using IMRT (Intensity Modulated Radiotherapy). VMAT Skills in demand were also identified. Method: E-Survey was distributed to NHS hospitals across UK by email. Thirty NHS and related centres in England, 21 in Scotland, 3 in Ireland and 1 in Wales were contacted. This Survey was intended for those working in RT and Medical Physics and who were responsible for Treatment Planning and training. Results: This E-survey have indicated pathways adopted by staff to acquire VMAT skills, strategies to efficiently implement VMAT in RT departments and for obtaining VMAT Education. Conclusion: Despite poor survey response this survey has managed to highlight requirements for education and implementation of VMAT that are also applicable to IMRT. Other RT centres in world can also find these results useful.
Abstract: Radiation doses to tissues and organs were measured using the anthropomorphic phantom as an equivalent to the human body. When high-energy X-rays are externally applied to treat laryngeal cancer, the absorbed dose at the laryngeal lumen is lower than given dose because of air space, which it should pass through, before reaching the lesion. Specially, in case of high-energy X-rays, the loss of dose is considerable. Three-dimensional absorbed dose distributions have been computed for high-energy photon radiation therapy of laryngeal and hypopharyngeal cancers, using a coaxial pair of opposing lateral beams in fixed positions. Treatment plans obtained under various conditions of irradiation.
Abstract: Nowadays, in most radiotherapy departments, the commercial treatment planning systems (TPS) used to calculate dose distributions needs to be verified; therefore, quick, easy-to-use and low cost dose distribution algorithms are desirable to test and verify the performance of the TPS. In this paper, we put forth an analytical method to calculate the phantom scatter contribution and depth dose on the central axis based on the equivalent square concept. Then, this method was generalized to calculate the profiles at any depth and for several field shapes regular or irregular fields under symmetry and asymmetry photon beam conditions. Varian 2100 C/D and Siemens Primus Plus Linacs with 6 and 18 MV photon beam were used for irradiations. Percentage depth doses (PDDs) were measured for a large number of square fields for both energies, and for 45º wedges which were employed to obtain the profiles in any depth. To assess the accuracy of the calculated profiles, several profile measurements were carried out for some treatment fields. The calculated and measured profiles were compared by gamma-index calculation. All γ–index calculations were based on a 3% dose criterion and a 3 mm dose-to-agreement (DTA) acceptance criterion. The γ values were less than 1 at most points. However, the maximum γ observed was about 1.10 in the penumbra region in most fields and in the central area for the asymmetric fields. This analytical approach provides a generally quick and fairly accurate algorithm to calculate dose distribution for some treatment fields in conventional radiotherapy.
Abstract: Segmenting the lungs in medical images is a
challenging and important task for many applications. In particular,
automatic segmentation of lung cavities from multiple magnetic
resonance (MR) images is very useful for oncological applications
such as radiotherapy treatment planning. However, distinguishing of
the lung areas is not trivial due to largely changing lung shapes, low
contrast and poorly defined boundaries. In this paper, we address
lung segmentation problem from pulmonary magnetic resonance
images and propose an automated method based on a robust regionaided
geometric snake with a modified diffused region force into the
standard geometric model definition. The extra region force gives the
snake a global complementary view of the lung boundary
information within the image which along with the local gradient
flow, helps detect fuzzy boundaries. The proposed method has been
successful in segmenting the lungs in every slice of 30 magnetic
resonance images with 80 consecutive slices in each image. We
present results by comparing our automatic method to manually
segmented lung cavities provided by an expert radiologist and with
those of previous works, showing encouraging results and high
robustness of our approach.
Abstract: To investigate the applicability of the EDR-2 film for
clinical radiation dosimetry, percentage depth-doses, profiles and
distributions in open and dynamically wedged fields were measured
using film and compared with data from a Treatment Planning
system.The validity of the EDR2 film to measure dose in a plane
parallel to the beam was tested by irradiating 10 cm×10 cm and 4
cm×4 cm fields from a Siemens, primus linac with a 6MV beam and
a source-to-surface distance of 100 cm. The film was placed
Horizontally between solid water phantom blocks and marked
with pin holes at a depth of 10 cm from the incident beam surface.
The film measurement results, in absolute dose, were compared with
ion chamber measurements using a Welhoffer scanning water tank
system and Treatment Planning system. Our results indicate a
maximum underestimate of calculated dose of 8 % with Treatment
Planning system.
Abstract: This study presents a mathematical modeling approach to the planning of HIV therapies on an individual basis. The model replicates clinical data from typical-progressors to AIDS for all stages of the disease with good agreement. Clinical data from rapid-progressors and long-term non-progressors is also matched by estimation of immune system parameters only. The ability of the model to reproduce these phenomena validates the formulation, a fact which is exploited in the investigation of effective therapies. The therapy investigation suggests that, unlike continuous therapy, structured treatment interruptions (STIs) are able to control the increase in both the drug-sensitive and drug-resistant virus population and, hence, prevent the ultimate progression from HIV to AIDS. The optimization results further suggest that even patients characterised by the same progression type can respond very differently to the same treatment and that the latter should be designed on a case-by-case basis. Such a methodology is presented here.
Abstract: The overall penumbra is usually defined as the
distance, p20–80, separating the 20% and 80% of the dose on the beam axis at the depth of interest. This overall penumbra accounts
also for the fact that some photons emitted by the distal parts of the source are only partially attenuated by the collimator. Medulloblastoma is the most common type of childhood brain tumor
and often spreads to the spine. Current guidelines call for surgery to remove as much of the tumor as possible, followed by radiation of the brain and spinal cord, and finally treatment with chemotherapy.
The purpose of this paper was to present results on an Uniformity of dose distribution in radiation fields surrounding the spine using film
dosimetry and comparison with 3D treatment planning software.
Abstract: It is necessary to incorporate technological advances
achieved in the field of engineering into dentistry in order to enhance
the process of diagnosis, treatment planning and enable the doctors to
render better treatment to their patients. To achieve this ultimate goal
long distance collaborations are often necessary. This paper discusses
the various collaborative tools and their applications to solve a few
burning problems confronted by the dentists. Customization is often
the solution to most of the problems. But rapid designing,
development and cost effective manufacturing is a difficult task to
achieve. This problem can be solved using the technique of digital
manufacturing. Cases from 6 major branches of dentistry have been
discussed and possible solutions with the help of state of art
technology using rapid digital manufacturing have been proposed in
the present paper. The paper also entails the usage of existing tools in
collaborative and digital manufacturing area.
Abstract: As a part of routine oesophageal HDR Brachytherapy procedure, treatment planning takes about 45 minutes while patients are under light sedation. Some patients may suffer gagging and/or spasms before the 90-minute brachytherapy procedure complete, and the treatment may need to be aborted. A pre-prepared plan generated before patient’s sedation may reduce the brachytherapy procedure time by 40 minutes. This paper reports rationality and evidence of pre-prepared treatment plans. A retrospective study of 28 patients confirms that pre-prepared plans would be acceptable for all reviewed patients. The rationality is further confirmed by a systemic study with a wide range of applicator curvature and treatment volume. Detailed comparison between CT based treatment plans and pre-prepared plans are discussed. The argument holds for endobronchial HDR brachytherapy too. With the above evidence, pre-prepared plans have been used for all oesophageal and endobronchial HDR brachytherapy cases in our clinic.
Abstract: In intensity modulated radiation therapy (IMRT)
treatment planning, beam angles are usually preselected on the basis of
experience and intuition. Therefore, getting an appropriate beam
configuration needs a very long time. Based on the present situation,
the paper puts forward beam orientation optimization using ant colony
optimization (ACO). We use ant colony optimization to select the
beam configurations, after getting the beam configuration using
Conjugate Gradient (CG) algorithm to optimize the intensity profiles.
Combining with the information of the effect of pencil beam, we can
get the global optimal solution accelerating. In order to verify the
feasibility of the presented method, a simulated and clinical case was
tested, compared with dose-volume histogram and isodose line
between target area and organ at risk. The results showed that the
effect was improved after optimizing beam configurations. The
optimization approach could make treatment planning meet clinical
requirements more efficiently, so it had extensive application
perspective.
Abstract: Analysis of blood vessel mechanics in normal and
diseased conditions is essential for disease research, medical device
design and treatment planning. In this work, 3D finite element
models of normal vessel and atherosclerotic vessel with 50% plaque
deposition were developed. The developed models were meshed
using finite number of tetrahedral elements. The developed models
were simulated using actual blood pressure signals. Based on the
transient analysis performed on the developed models, the parameters
such as total displacement, strain energy density and entropy per unit
volume were obtained. Further, the obtained parameters were used to
develop artificial neural network models for analyzing normal and
atherosclerotic blood vessels. In this paper, the objectives of the
study, methodology and significant observations are presented.