Journal of Medical Physics
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   2016| October-December  | Volume 41 | Issue 4  
    Online since December 5, 2016

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Clinical implications of Eclipse analytical anisotropic algorithm and Acuros XB algorithm for the treatment of lung cancer
Gangarapu Sri Krishna, Vuppu Srinivas, Palreddy Yadagiri Reddy
October-December 2016, 41(4):219-223
DOI:10.4103/0971-6203.195185  PMID:28144113
The aim of the present study was to investigate the dose-volume variations of planning target volume (PTV) and organs at risks (OARs) in 15 left lung cancer patients comparing analytical anisotropic algorithm (AAA) versus Acuros XB algorithm. Originally, all plans were created using AAA with a template of dose constraints and optimization parameters, and the patients were treated using intensity modulated radiotherapy. In addition, another set of plans was created by performing only dose calculations using Acuros algorithm without doing any reoptimization. Thereby, in both set of plans, the entire plan parameters, namely, beam angle, beam weight, number of beams, prescribed dose, normalization point, region of interest constraints, number of monitor units, and plan optimization were kept constant. The evaluated plan parameters were PTV coverage at dose at 95% volume (TV95) of PTV (D95), the dose at 5% of PTV (D5), maximum dose (D max ), the mean dose (D mean ), the percent volume receiving 5 Gy (V5), 20 Gy (V20), 30 Gy (V30) of normal lung at risk (left lung- gross target volume [GTV], the dose at 33% volume (D33), at 67% volume (D67), and the D mean (Gy) of the heart, the D max of the spinal cord. Furthermore, homogeneity index (HI) and conformity index were evaluated to check the quality of the plans. Significant statistical differences between the two algorithms, P < 0.05, were found in D95, D max , TV95, and HI of PTV. Furthermore, significant statistical differences were found in the dose parameters for the OARs, namely, V5, V20, and V30 of left lung-GTV, right lung (D mean ), D33, and D mean of the heart, and D max of the spine, respectively. Although statistical differences do exist, the magnitude of the differences is too small to cause any clinically observable effect.
  3,381 307 3
Dosimetric evaluation of newly developed well-type ionization chamber for use in the calibration of brachytherapy sources
Sathiyan Saminathan, Henry Finlay Godson, Retna Ponmalar, Ravikumar Manickam, James Mazarello
October-December 2016, 41(4):234-239
DOI:10.4103/0971-6203.195187  PMID:28144115
The well-type ionization chamber has been designed for convenient use in brachytherapy source strength calibration. The chamber has a volume of 240 cm 3 , weight of 2.5 kg, and is open to atmospheric conditions. The well-type ionization chamber dosimetric characteristics such as leakage current, stability, scattering effect, ion collection efficiency, and nominal response with energy were studied. The evaluated dosimetric characteristics of well-type ionization chamber were compared with two other commercially available well-type ionization chambers. The study shows that the newly developed well-type ionization chamber is reliable for air-kerma strength calibration. The results obtained confirm that this chamber can be used for the calibrations of high-dose rate brachytherapy sources.
  3,201 310 -
A Monte Carlo study on quantifying the amount of dose reduction by shielding the superficial organs of an Iranian 11-year-old boy
Parisa Akhlaghi, Elie Hoseinian-Azghadi, Hashem Miri-Hakimabad, Laleh Rafat-Motavalli
October-December 2016, 41(4):246-253
DOI:10.4103/0971-6203.195189  PMID:28144117
A method for minimizing organ dose during computed tomography examinations is the use of shielding to protect superficial organs. There are some scientific reports that usage of shielding technique reduces the surface dose to patients with no appreciable loss in diagnostic quality. Therefore, in this Monte Carlo study based on the phantom of a 11-year-old Iranian boy, the effect of using an optimized shield on dose reduction to body organs was quantified. Based on the impact of shield on image quality, lead shields with thicknesses of 0.2 and 0.4 mm were considered for organs exposed directly and indirectly in the scan range, respectively. The results showed that there is 50%-62% reduction in amounts of dose for organs located fully or partly in the scan range at different tube voltages and modeling the true location of all organs in human anatomy, especially the ones located at the border of the scan, range affects the results up to 49%.
  3,344 163 2
A partial differential equation-based general framework adapted to Rayleigh's, Rician's and Gaussian's distributed noise for restoration and enhancement of magnetic resonance image
Ram Bharos Yadav, Subodh Srivastava, Rajeev Srivastava
October-December 2016, 41(4):254-265
DOI:10.4103/0971-6203.195190  PMID:28144118
The proposed framework is obtained by casting the noise removal problem into a variational framework. This framework automatically identifies the various types of noise present in the magnetic resonance image and filters them by choosing an appropriate filter. This filter includes two terms: the first term is a data likelihood term and the second term is a prior function. The first term is obtained by minimizing the negative log likelihood of the corresponding probability density functions: Gaussian or Rayleigh or Rician. Further, due to the ill-posedness of the likelihood term, a prior function is needed. This paper examines three partial differential equation based priors which include total variation based prior, anisotropic diffusion based prior, and a complex diffusion (CD) based prior. A regularization parameter is used to balance the trade-off between data fidelity term and prior. The finite difference scheme is used for discretization of the proposed method. The performance analysis and comparative study of the proposed method with other standard methods is presented for brain web dataset at varying noise levels in terms of peak signal-to-noise ratio, mean square error, structure similarity index map, and correlation parameter. From the simulation results, it is observed that the proposed framework with CD based prior is performing better in comparison to other priors in consideration.
  3,072 169 4
Clinical implementation of an electron monitor unit dosimetry system based on task group 71 report and a commercial calculation program
Huijun Xu, Mariana Guerrero, Shifeng Chen, Xiaocheng Yang, Karl Prado, Colleen Schinkel
October-December 2016, 41(4):214-218
DOI:10.4103/0971-6203.195184  PMID:28144112
Many clinics still use monitor unit (MU) calculations for electron treatment planning and/or quality assurance (QA). This work (1) investigates the clinical implementation of a dosimetry system including a modified American Association of Physicists in Medicine-task group-71 (TG-71)-based electron MU calculation protocol (modified TG-71 electron [mTG-71E] and an independent commercial calculation program and (2) provides the practice recommendations for clinical usage. Following the recently published TG-71 guidance, an organized mTG-71E databook was developed to facilitate data access and subsequent MU computation according to our clinical need. A recently released commercial secondary calculation program - Mobius3D (version 1.5.1) Electron Quick Calc (EQC) (Mobius Medical System, LP, Houston, TX, USA), with inherent pencil beam algorithm and independent beam data, was used to corroborate the calculation results. For various setups, the calculation consistency and accuracy of mTG-71E and EQC were validated by their cross-comparison and the ion chamber measurements in a solid water phantom. Our results show good agreement between mTG-71E and EQC calculations, with average 2% difference. Both mTG-71E and EQC calculations match with measurements within 3%. In general, these differences increase with decreased cutout size, increased extended source to surface distance, and lower energy. It is feasible to use TG71 and Mobius3D clinically as primary and secondary electron MU calculations or vice versa. We recommend a practice that only requires patient-specific measurements in rare cases when mTG-71E and EQC calculations differ by 5% or more.
  2,571 588 -
Biological bases for the revision of dose limits to the eye lens
Srinivasa Badanidiyoor Rao
October-December 2016, 41(4):211-213
DOI:10.4103/0971-6203.195183  PMID:28144111
  2,292 640 -
A method to obtain correct standard uptake values in Pinnacle treatment planning system for target volume delineation
Farshid Salehzahi, Jason Tse, Jonathan Lee, Jothybasu Selvaraj
October-December 2016, 41(4):240-245
DOI:10.4103/0971-6203.195188  PMID:28144116
Standardized uptake value (SUV) is an advanced tool for quantitative tumor identification and metabolic target volume delineation (TVD) in diagnostic and therapeutic settings. It is thus important to establish a quality assured process to maintain the traceability of data correctly by positron emission tomography (PET) systems. Patient administration of 18 fluoro-deoxy-glucose is increasingly delivered by automated infusion systems (AISs). Whenever AIS is used, its accuracy and traceability measurement need verification. In addition, it was observed that the unreproducible SUV displayed in PET and the treatment planning system (TPS) may cause grave concerns for radiation oncologists for TVD. This concern may complicate the correlation of TVD on PET and TPS and their clinical reporting. The SUV traceability was established from the PET system to AIS. Its accuracy was verified by cross-referencing to the reference dose calibrator traceable to a primary standard. The SUV values were converted in TPS using the in-house "clinical tool" to be identical as in PET, to allow radiation oncologists to use SUV confidently. The outcome of this study enables the clinical groups to rely on the correct SUV values displayed on the TPS and to improve the quality of care for patients in clinical procedures.
  2,321 124 1
On-line estimations of delivered radiation doses in three-dimensional conformal radiotherapy treatments of carcinoma uterine cervix patients in linear accelerator
Suman Kumar Putha, PU Saxena, S Banerjee, Challapalli Srinivas, BM Vadhiraja, Ramamoorthy Ravichandran, Mary Joan, K Dinesh Pai
October-December 2016, 41(4):224-233
DOI:10.4103/0971-6203.195186  PMID:28144114
Transmission of radiation fluence through patient's body has a correlation to the planned target dose. A method to estimate the delivered dose to target volumes was standardized using a beam level 0.6 cc ionization chamber (IC) positioned at electronic portal imaging device (EPID) plane from the measured transit signal (S t ) in patients with cancer of uterine cervix treated with three-dimensional conformal radiotherapy (3DCRT). The IC with buildup cap was mounted on linear accelerator EPID frame with fixed source to chamber distance of 146.3 cm, using a locally fabricated mount. S t s were obtained for different water phantom thicknesses and radiation field sizes which were then used to generate a calibration table against calculated midplane doses at isocenter (D iso,TPS ), derived from the treatment planning system. A code was developed using MATLAB software which was used to estimate the in vivo dose at isocenter (D iso,Transit ) from the measured S t s. A locally fabricated pelvic phantom validated the estimations of D iso,Transit before implementing this method on actual patients. On-line dose estimations were made (3 times during treatment for each patient) in 24 patients. The D iso,Transit agreement with D iso,TPS in phantom was within 1.7% and the mean percentage deviation with standard deviation is −1.37% ±2.03% (n = 72) observed in patients. Estimated in vivo dose at isocenter with this method provides a good agreement with planned ones which can be implemented as part of quality assurance in pelvic sites treated with simple techniques, for example, 3DCRT where there is a need for documentation of planned dose delivery.
  2,203 209 -
Simplified method for creating a density-absorbed dose calibration curve for the low dose range from Gafchromic EBT3 film
Tatsuhiro Gotanda, Toshizo Katsuda, Rumi Gotanda, Tadao Kuwano, Takuya Akagawa, Nobuyoshi Tanki, Akihiko Tabuchi, Tetsunori Shimono, Yasuyuki Kawaji
October-December 2016, 41(4):266-270
DOI:10.4103/0971-6203.195192  PMID:28144120
Radiochromic film dosimeters have a disadvantage in comparison with an ionization chamber in that the dosimetry process is time-consuming for creating a density-absorbed dose calibration curve. The purpose of this study was the development of a simplified method of creating a density-absorbed dose calibration curve from radiochromic film within a short time. This simplified method was performed using Gafchromic EBT3 film with a low energy dependence and step-shaped Al filter. The simplified method was compared with the standard method. The density-absorbed dose calibration curves created using the simplified and standard methods exhibited approximately similar straight lines, and the gradients of the density-absorbed dose calibration curves were −32.336 and −33.746, respectively. The simplified method can obtain calibration curves within a much shorter time compared to the standard method. It is considered that the simplified method for EBT3 film offers a more time-efficient means of determining the density-absorbed dose calibration curve within a low absorbed dose range such as the diagnostic range.
  1,998 160 -
Measurement of eye lens dose for Varian On-Board Imaging with different cone-beam computedtomography acquisition techniques

October-December 2016, 41(4):265-265
DOI:10.4103/0971-6203.195191  PMID:28144119
  1,580 175 -
Dosimetric and radiobiological characterizations of prostate intensity modulated radiotherapy and volumetric modulated arc therapy: A single institution review of ninety cases

October-December 2016, 41(4):270-270
DOI:10.4103/0971-6203.195193  PMID:28144121
  1,518 198 -
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