Reproducibility of patient setup by surface image registration system in conformal radiotherapy of prostate cancer

<p>Abstract</p> <p>Background</p> <p>The reproducibility of patient setup for radiotherapy is based on various methods including external markers, X-rays with planar or computerized image acquisition, and, more recently, surface matching imaging. We analyzed the setup reproducibility of 16 patients affected by prostate cancer who underwent conformal radiotherapy with curative intent by using a surface image registration system.</p> <p>Methods</p> <p>We analyzed the setup reproducibility of 16 patients affected by prostate cancer candidates for conformal radiotherapy by using a surface image registration system. At the initial setup, EPID images were compared with DRRs and a reference 3D surface image was obtained by the AlignRT system (Vision RT, London, UK). Surface images were acquired prior to every subsequent setup procedure. EPID acquisition was repeated when errors > 5 mm were reported.</p> <p>Results</p> <p>The mean random and systematic errors were 1.2 ± 2.3 mm and 0.3 ± 3.0 mm along the X axis, 0.0 ± 1.4 mm and 0.5 ± 2.0 mm along the Y axis, and 2.0 ± 1.8 mm and -0.7 ± 2.4 mm along the Z axis respectively. The positioning error detected by AlignRT along the 3 axes X, Y, and Z exceeded the value of 5 mm in 14.1%, 2.0%, and 5.1% measurements and the value of 3 mm in 36.9%, 13.6% and 27.8% measurements, respectively. Correlation factors calculated by linear regression between the errors measured by AlignRT and EPID ranged from 0.77 to 0.92 with a mean of 0.85 and SD of 0.13. The setup measurements by surface imaging are highly reproducible and correlate with the setup errors detected by EPID.</p> <p>Conclusion</p> <p>Surface image registration system appears to be a simple, fast, non-invasive, and reproducible method to analyze the set-up alignment in 3DCRT of prostate cancer patients.</p

Report of AAPM Task Group 235 Radiochromic Film Dosimetry: An update to TG-55

The use of radiochromic film (RCF) dosimetry in radiation therapy is extensive due to its high level of achievable accuracy for a wide range of dose values and its suitability under a variety of measurement conditions. However, since the publication of the 1998 AAPM Task Group 55, Report No. 63 on RCF dosimetry, the chemistry, composition, and readout systems for RCFs have evolved steadily. There are several challenges in using the new RCFs, readout systems and validation of the results depending on their applications. Accurate RCF dosimetry requires understanding of RCF selection, handling and calibration methods, calibration curves, dose conversion methods, correction methodologies as well as selection, operation and quality assurance (QA) programs of the readout systems. Acquiring this level of knowledge is not straight forward, even for some experienced users. This Task Group report addresses these issues and provides a basic understanding of available RCF models, dosimetric characteristics and properties, advantages and limitations, configurations, and overall elemental compositions of the RCFs that have changed over the past 20 yr. In addition, this report provides specific guidelines for data processing and analysis schemes and correction methodologies for clinical applications in radiation therapy

Enhanced strength and ductility in a friction stir processing engineered dual phase high entropy alloy

Abstract The potential of high-entropy alloys (HEAs) to exhibit an extraordinary combination of properties by shifting the compositional regime from the corners towards the centers of phase diagrams has led to worldwide attention by material scientists. Here we present a strong and ductile non-equiatomic HEA obtained after friction stir processing (FSP). A transformation-induced plasticity (TRIP) assisted HEA with composition Fe50Mn30Co10Cr10 (at.%) was severely deformed by FSP and evaluated for its microstructure-mechanical property relationship. The FSP-engineered microstructure of the TRIP HEA exhibited a substantially smaller grain size, and optimized fractions of face-centered cubic (f.c.c., γ) and hexagonal close-packed (h.c.p., ε) phases, as compared to the as-homogenized reference material. This results in synergistic strengthening via TRIP, grain boundary strengthening, and effective strain partitioning between the γ and ε phases during deformation, thus leading to enhanced strength and ductility of the TRIP-assisted dual-phase HEA engineered via FSP

A comparison of radiographic techniques and electromagnetic transponders for localization of the prostate

<p>Abstract</p> <p>Background</p> <p>The aim of this study is to compare three methodologies of prostate localization and to determine if there are significant differences in the techniques.</p> <p>Methods</p> <p>Daily prostate localization using cone beam CT or orthogonal kV imaging has been performed at UT Southwestern Medical Center since 2006. Prostate patients are implanted with gold seeds, which are matched with the planning CT or DRR before treatment. More recently, a technology using electromagnetic transponders implanted within the prostate was introduced into our clinic (Calypso®). With each technology, patients are localized initially using skin marks and the room lasers. In this study, patients were localized with Calypso and either CBCT or kV orthogonal images in the same treatment session, allowing a direct comparison of the technologies. Localization difference distributions were determined from the difference in the offsets determined by CBCT/kV imaging and Calypso. CBCT-Calypso and kV imaging-Calypso localization data were summarized from over 900 and 250 fractions each, respectively. The Wilcoxon signed rank test is used to determine if the localization differences are statistically significant. We also calculated Pearson’s product–moment correlation coefficient (R²) to determine if there is a linear relationship between the shifts determined by Calypso and the radiographic techniques.</p> <p>Results</p> <p>The differences between CBCT-Calypso and kV imaging-Calypso localizations are −0.18 ± 2.90 mm, -0.79 ± 2.18 mm, -0.01 ± 1.20 mm and −0.09 ± 1.40 mm, 0.48 ± 1.50 mm, 0.08 ± 1.04 mm, respectively, in the AP, SI, and RL directions. The Pearson product–moment correlation coefficients for the CBCT-Calypso shifts were 0.71, 0.92 and 0.88 and for the OBI-Calypso comparison were 0.95, 0.89 and 0.85. The percentage of localization differences that were less than 3 mm were 86.1%, 84.5% and 96.0% for the CBCT-Calypso comparison and 95.8%, 94.3% and 97% for the kV OBI-Calypso comparison. No trends were observed in the Bland-Altman analysis.</p> <p>Conclusions</p> <p>Localization of the prostate using electromagnetic transponders agrees well with radiographic techniques and each technology is suitable for high precision radiotherapy. This study finds that there is more uncertainty in CBCT localization of the prostate than in 2D orthogonal imaging, but the difference is not clinically significant.</p