Total Body Irradiation (TBI) is one main component in the interdisciplinary treatment of widely disseminated malignancies predominantly of haematopoietic diseases. Combined with intensive chemotherapy, TBI enables myeloablative high dose therapy and immuno­ablative conditioning treatment prior to subsequent transplantation of haematopoietic stem cells: bone marrow stem cells or peripheral blood progenitor stem cells. Jointly prepared by DEGRO and DGMP, the German Society of Radio-Oncology, and the German Association of Medical Physicists, this DEGRO/DGMP-Leitlinie Ganzkoerper-Strahlenbehandlung - DEGRO/DGMP Guideline Whole Body Radiotherapy, summarises the concepts, principles, facts and common methods of Total Body Irradiation and poses a set of recommendations for reliable and successful application of high dose large-field radiotherapy as essential part of this interdisciplinary, multi­modality treatment concept. The guideline is geared towards radio-oncologists, medical physicists, haematooncolo­gists, and all contributing to Whole Body Radiotherapy. To guide centres intending to start or actualise TBI criteria are included. The relevant treatment parameters are defined and a sample of a form is given for reporting TBI to international registries.

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The rate of glucose utilization in tumor cells is significantly enhanced as compared to normal cells and this biochemical characteristic is utilized in PET imaging using FDG as a major workhorse. The PET systems as well as cyclotrons producing positron emitting radiopharmaceuticals have undergone continuous technological refinements. While PET (CT) systems enable fusion images as well as precise attenuation correction, the self-shielded cyclotrons developed provide dedicated systems for in-house production of a large number of PET radiopharmaceuticals. The application of PET images in oncology includes those of pulmonary, colorectal, breast, lymphoma, head & neck, bone, ovarian and GI cancers. The PET has been recognized as promising diagnostic tool to predict biological and physiological changes at the molecular level and hence offer a potential area for future applications including Stem Cell research.

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To evaluate the utility of Dynalog file information for planar dose verification in IMRT QA, a program is developed to convert Dynalog file data to DMLC field files. For this study, five predefined fluencies are planned and delivered using Varian, Eclipse 3D planning system and 6MV photon beam of Varian, Clinac DMX linear accelerator. To measure planar dose distribution, Kodak, EDR2 films are exposed in similar setup as planning setup. Dynalog files are recorded for each delivery and converted into DMLC field files using in-house program. Delivered dose distributions are calculated using DMLC field files from Dynalog files. Planned, Measured and Delivered dose distributions are compared using gamma evaluation in Scanditronix, Omni Pro IMRT software. The Planned and Delivered planar dose distributions agree within 2% dose difference and 2 mm DTA. Measured dose distributions agree within 4% dose difference and 4 mm DTA with Planned dose distribution. Our results show Dynalog file as a promising tool for dynamic IMRT QA.

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Comprehensive tests on single slice CT scanner was carried out using in-house fabricated phantoms/test tools following AAPM recommended methods to independently validate the auto-performance test (APT) results. Test results of all the electromechanical parameters were found within the specified limits. Radiation and sensitivity profile widths were within ± 0.05 cm of the set slice thickness. Effective energy corresponding to nominal kVp of 80, 110 and 130 were 49.99, 55.08 and 59.48 keV, respectively. Percentage noise obtained by APT was 1.32% while the independently measured value was 0.38%. Observed contrast resolutions by independent method at 0.78% and 12% contrast difference were 4 mm and 1.25 mm (= 4 lp/cm) respectively. However, high contrast resolution (limiting spatial resolution) by APT at 50, 10 and 2% MTF levels were 9, 12.5 and 14.1 lp/cm respectively. Difference in calculated and measured CT numbers of water, air, teflon, acrylic, polystyrene and polypropylene were in the range of 0 to 24 HU, while this difference was 46 and 94 HU in case of nylon and bakelite respectively. The contrast scale determined using CT linearity phantom was 1.998×10-4 cm-1/CT number. CT dose index (CTDI) and weighted CTDI (CTDIw) measured at different kVp for standard head and body phantoms were smaller than manufacturer-specified and system-calculated values and were found within the manufacturer-specified limit of ± 20%. Measured CTDIs on surface (head: 3.6 cGy and body: 2.6 cGy) and at the center (3.3 cGy, head; and 1.2 cGy, body) were comparable to reported values of other similar CT scanners and were also within the industry-quoted CTDI range. Comprehensive QA and independent validation of APT results are necessary to obtain baseline data for CT virtual simulation.

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Optical scanning is one of the emerging evaluation tools used for obtaining dose distributions in gel dosimetry. A radiation field analyzer adapted into an optical CT scanner to evaluate an irradiated Fricke gel has been already reported by others. This prototype optical CT scanner functions like a first generation x-ray CT scanner in the translate-rotate fashion. A similar scanner was constructed in our department for optical scanning of irradiated FX gel. At first, an aquarium was constructed and fitted into the water phantom of the RFA with provision to place the gel phantom to be scanned along with a light source and detector. The movements of the RFA were utilized to scan the gel phantom. A scan of a cuvette filled with colored solution was carried out and the resulting images were reconstructed and profiles obtained to evaluate the working of the optical scanner. A scan of the gel phantom was then obtained to evaluate the performance of the scanner. Thus a radiation field analyzer (DYNASCAN) was successfully adapted to an optical scanner to evaluate Fricke gels in our department.

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