PANOPTES: Een nieuw hulpmiddel voor MBB'ers om kritieke organen te leren intekenen ten behoeve van radiotherapie planning

Een nauwkeurige intekening van de tumor en omliggende kritieke organen is essentieel voor radiotherapie om een zo goed mogelijk behandelresultaat te verkrijgen. Het intekenen van kritieke organen is echter gevoelig voor inter- en intra-observervariatie. Eerder onderzoek heeft uitgewezen dat de kwaliteit van intekenen van kritieke organen door MBRT studenten verbetering behoeft, maar dat hulpmiddelen hiervoor niet voorhanden zijn. In het Panoptes project is een web-based hulpmiddel voor het onderwijs ontwikkeld en getest om het intekenonderwijs te verbeteren. Het project is uitgevoerd door het Lectoraat Medische Technologie van de Hogeschool Inholland in samenwerking met de Universiteit van Manchester en het Amsterdam UMC (locatie AMC). De ontwikkelde tool is, na evaluatie, geïmplementeerd in het curriculum van de opleiding Medisch Beeldvormende en Radiotherapeutische Technieken in Haarlem

Just transition: an operational framework to make transitions more just : Lessons learned from science and practice

Just transition is currently a leading principle in discussions about transitions. But what does that mean? How do we make sure that transitions are just? We have developed an operational framework to help people in the transition process to put justice in practice, based on a review of the literature, analysis of just transition practices and dialogues between policymakers, scientists and practitioners. We have scoped our work in the context of food systems transformation and climate change. The operational framework consists out of four steps and several questions that help to raise awareness on the potential to make transitions more just. It can even be used to initiate a dialogue among people in transition process on how they jointly would put justice into the transition practices. The report concludes with a knowledge agenda that summarises pending research questions that would be useful to further complete the operational framework

Position verification for the prostate: effect on rectal wall dose.

Purpose: To evaluate the effect of gold marker (GM)-based position correction on the cumulative dose in the anorectal wall compared with traditional bony anatomy (BA)-based correction, taking into account changes in anorectal shape and position. Methods and Materials: A total of 20 consecutive prostate cancer patients, treated with curative external beam radiotherapy, were included. Four fiducial GMs were implanted in the prostate. Positioning was verified according to the shift in BA and GMs on daily electronic portal images. Position corrections were determined using on- and off-line position verification protocols according to the position of the GMs (GM-on and GM-off) and BA (BA-off). For all patients, intensity-modulated radiotherapy plans were made for the GM (8-mm planning target volume margin) and BA (10-mm planning target volume margin) protocols. The dose distribution was recomputed on 11 repeat computed tomography scans to estimate the accumulated dose to the prostate and anorectal wall while considering internal organ motion. Results: The dose that is at least received by 99% of the prostate was, on average, acceptable for all protocols. The individual patient data showed the best coverage for both GM protocols, with >95% of the prescribed dose for all patients. The anorectal wall dose was significantly lower for the GM protocols. The dose that is at least received by 30% of the rectal wall was, on average, 54.6 Gy for GM-on, 54.1 Gy for GM-off, and 58.9 Gy for BA-off (p <.001). Conclusion: Position verification with GM and reduced planning target volume margins yielded adequate treatment of the prostate and a lower rectal wall dose, even when accounting for independent movement of the prostate and anorectal wall. (C) 2011 Elsevier In