Dosimetric accuracy of tomotherapy dose calculation in thorax lesions

<p>Abstract</p> <p>Background</p> <p>To analyse limits and capabilities in dose calculation of collapsed-cone-convolution (CCC) algorithm implemented in helical tomotherapy (HT) treatment planning system for thorax lesions.</p> <p>Methods</p> <p>The agreement between measured and calculated dose was verified both in homogeneous (Cheese Phantom) and in a custom-made inhomogeneous phantom. The inhomogeneous phantom was employed to mimic a patient's thorax region with lung density encountered in extreme cases and acrylic inserts of various dimensions and positions inside the lung cavity. For both phantoms, different lung treatment plans (single or multiple metastases and targets in the mediastinum) using HT technique were simulated and verified. Point and planar dose measurements, both with radiographic extended-dose-range (EDR2) and radiochromic external-beam-therapy (EBT2) films, were performed. Absolute point dose measurements, dose profile comparisons and quantitative analysis of gamma function distributions were analyzed.</p> <p>Results</p> <p>An excellent agreement between measured and calculated dose distributions was found in homogeneous media, both for point and planar dose measurements. Absolute dose deviations <3% were found for all considered measurement points, both inside the PTV and in critical structures. Very good results were also found for planar dose distribution comparisons, where at least 96% of all points satisfied the gamma acceptance criteria (3%-3 mm), both for EDR2 and for EBT2 films. Acceptable results were also reported for the inhomogeneous phantom. Similar point dose deviations were found with slightly worse agreement for the planar dose distribution comparison: 96% of all points passed the gamma analysis test with acceptable levels of 4%-4 mm and 5%-4 mm, for EDR2 and EBT2 films respectively. Lower accuracy was observed in high dose/low density regions, where CCC seems to overestimate the measured dose around 4-5%.</p> <p>Conclusions</p> <p>Very acceptable accuracy was found for complex lung treatment plans calculated with CCC algorithm implemented in the tomotherapy TPS even in the heterogeneous phantom with very low lung-density.</p

Optical imaging of Tc-99m-based tracers: in vitro and in vivo results.

It has been recently shown that optical imaging (OI) methods can be used to image the in vivo biodistribution of several radiopharmaceuticals labeled with beta or alpha emitters. In this work particular attention has been focused on investigating the weaker optical signal induced by an almost pure gamma emitter like Tc-99m. Visible light emission measurements of a water solution containing Tc-99m were performed using a small animal OI system. A sequence of images was acquired for 24 h in order to study the decay of the luminescence signal. The difference between the luminescence decay half life and well-known Tc-99m half life was equal to 1%. in vivo imaging was performed by injecting one control nude mice with Tc-99m-MDP. Optical images obtained with equipment designed for bioluminescence imaging showed that a visible light emission was distinguishable and correctly localized in the bladder region where a higher concentration of Tc-99m-MDP was expected. The bladder to background ratio was always greater than 1. We conclude that the experimental data presented in this paper show that it is possible to detect in vivo luminescence optical photons induced by Tc-99m. This is important especially considering the large number of Tc-99m-based radiopharmaceutical currently available

Validation of an elastic registration technique to estimate anatomical lung modification in Non-Small-Cell Lung Cancer Tomotherapy

<p>Abstract</p> <p>Background</p> <p>The study of lung parenchyma anatomical modification is useful to estimate dose discrepancies during the radiation treatment of Non-Small-Cell Lung Cancer (NSCLC) patients. We propose and validate a method, based on free-form deformation and mutual information, to elastically register planning kVCT with daily MVCT images, to estimate lung parenchyma modification during Tomotherapy.</p> <p>Methods</p> <p>We analyzed 15 registrations between the planning kVCT and 3 MVCT images for each of the 5 NSCLC patients. Image registration accuracy was evaluated by visual inspection and, quantitatively, by Correlation Coefficients (CC) and Target Registration Errors (TRE). Finally, a lung volume correspondence analysis was performed to specifically evaluate registration accuracy in lungs.</p> <p>Results</p> <p>Results showed that elastic registration was always satisfactory, both qualitatively and quantitatively: TRE after elastic registration (average value of 3.6 mm) remained comparable and often smaller than voxel resolution. Lung volume variations were well estimated by elastic registration (average volume and centroid errors of 1.78% and 0.87 mm, respectively).</p> <p>Conclusions</p> <p>Our results demonstrate that this method is able to estimate lung deformations in thorax MVCT, with an accuracy within 3.6 mm comparable or smaller than the voxel dimension of the kVCT and MVCT images. It could be used to estimate lung parenchyma dose variations in thoracic Tomotherapy.</p

Relazione tecnica sulle attività della campagna oceanografica “Evatir 2016”

La presente relazione tecnica descrive tutte le attività svolte nella Campagna oceanografica “Evatir 2017” condotta a bordo della N/O “G. Dallaporta” (dal 25 luglio al 21 agosto 2016). La Campagna “Evati 2016” è parte integrante del Progetto "Estensione della Campagna acustica Medias (Mediterranean International Acoustic Survey) nelle sub aree geografiche (GSA) 9 (Mar Ligure e Mar Tirreno settentrionale) e 10 (Mar Tirreno centrale e meridionale)", finanziato dal Ministero delle politiche agricole alimentari e forestali (Mipaaf) nell'ambito del Fondo Europeo per gli Affari Marittimi e la Pesca (FEAMP). E’ la sesta campagna rivolta alla valutazione acustica e alla distribuzione spaziale delle popolazioni di piccoli pelagici, insieme allo studio delle condizioni ambientali dell’area di studio. Le specie target del progetto sono state l’acciuga europea (Engraulis encrasicolus) e la sardina (Sardina pilchardus), specie chiave sia a livello commerciale che ecologico. La gestione di tali risorse è abbastanza complessa a causa del loro breve ciclo di vita e dall’ampia oscillazioni inter-annuali nell’abbondanza dello stock, legata al successo o al fallimento del reclutamento annuale. Insieme alle attività di acquisizione acustiche sono stati realizzati campionamenti bilogici, misurazioni, misurazioni di parametri fisico-chimici, rilevamenti di variabili oceanografiche e campionamento di acque (nei Golfi di Salerno, Napoli e Gaeta), monitoraggio della rete da pesca e campionamenti di fitoplancton, zooplancton, solidi sospesi e rilievo delle principali variabili oceanografiche (in prossimità dello stabilimento SOLVAY di Rosignano)

Relazione tecnica sulle attività della campagna oceanografica ANCHEVA 2018

La gestione sostenibile delle risorse alieutiche è un tema sempre più rilevante nel contesto della pesca mondiale, anche a causa del progressivo aumento della capacità e dello sforzo di pesca. I prelievi eccessivi hanno portato all’impoverimento delle risorse ittiche determinando effetti negativi, diretti e indiretti, sia in termini ecologici che socio-economici. Le alterazioni si possono evidenziare sia a livello di comunità che a livello di funzionalità ecosistemica.Per tali ragioni si sono rese necessarie misure di gestione sostenibile delle risorse ittiche che preservino la capacità degli ecosistemi di fornire beni e servizi alle generazioni presenti e future. In tale contesto da alcuni anni, nel mar Mediterraneo, vengono condotti con regolarità survey acustici per la valutazione dell’abbondanza e della distribuzione della biomassa pelagica degli stock di acciughe (Engraulis encrasicolus), sardine (Sardina pilchardus) e suri (Trachurus trachurus) con l’utilizzo di strumentazione elettroacustica

Skin dose calculation during radiotherapy of head and neck cancer using deformable image registration of planning and mega-voltage computed tomography scans

Background and Purpose: Head-Neck (HN) patients may experience severe acute skin complications that can cause treatment interruption and increase the risk of late fibrosis. This study assessed a method for accurately monitoring skin dose changes during helical tomotherapy for HN cancer based on deformable image registration of planning computed tomography (CT) and mega-voltage CT (MVCT). Materials and Methods: Planning CTs of nine patients were deformably registered to mid-treatment MVCT (MV15) images resulting in CTdef images. The original plans were recalculated on both CTdef and mid-treatment kilo-voltage CT (CT15) taken as ground truth. Superficial layers (SL) of the body with thicknesses of 2, 3 and 5 mm (SL2, SL3, SL5) were considered as derma surrogates. SL V95%, V97%, V98%, V100%, V102%, V105% and V107% of the prescribed PTV dose were extracted for CT15/CTdef and compared (considering patients with skin dose > 95%). For comparison, doses were calculated directly on the calibrated MVCT and analyzed in the same way. Results: Differences between SL2/SL3/SL5 V95%-V107% in CT15/CTdef were very small: for eight of nine patients the difference between the considered SL2 Vd% computed on CTdef and CT15 was less than 1.4 cm3 for all d%. A larger value was found when using MVCT for skin dose calculation (4.8 cm3 for SL2), although CTdef body contour matched CT15 body with accuracy similar to that of MV15. Conclusions: Deforming the planning CT-to-MVCT was shown to be accurate considering external body contours and skin DVHs. The method was able to accurately identify superficial overdosing. Keywords: Skin dose, DIR, MVCT, Dose of the day, Tomotherap

Megavoltage CT images of helical tomotherapy unit for radiation treatment simulation: impact on feasibility of treatment planning in a prostate cancer patient with bilateral femoral prostheses

Metal prosthesis artefacts on CT images can be a significant problem in the definition of volumes of interest, dose calculation and patient setup in modern radiotherapy. We experienced considerable difficulties in defining the organs at risk and treatment volumes on kVCT images of standard CT simulation in a prostate cancer patient due to the presence of bilateral femoral prostheses causing artefacts. As shown in the current case, MVCT images of the patient in the treatment position obtained using a helical tomotherapy unit can provide sufficient morphological information to define the pelvic anatomic structures for radical prostate treatment planning. The patient completed the planned treatment and at 90 days after the end of treatment no severe side effects were recorded. Since there have been few reports on the use of MVCT images to overcome the problem of hip prosthesis artefacts, a brief literature review was also carried out

Adenoid cystic carcinoma of trachea treated with adjuvant hypofractionated tomotherapy. Case report and literature review

Adenoid cystic carcinoma, also called cylindroma, is the second most common histological type of tracheal malignancy but represents 1% of all respiratory tract cancers. We report a case of a 59-year-old patient submitted to an incomplete resection of the trachea and subsequently treated with adjuvant tomotherapy. There have been no reports in the literature regarding intensity-modulated radiation therapy with linac or tomotherapy systems in adenoid cystic carcinoma of the trachea. The present clinical case demonstrates the feasibility of adjuvant intensity-modulated radiation therapy techniques for optimizing the dose coverage of the tumor bed while sparing surrounding normal tissues. A dosimetric comparison between the tomotherapy plan and a 3-dimensional conformal radiotherapy plan is also reported. We demonstrate that tomotherapy permits an increase in the dose per fraction without important acute adverse effects. At 24 months' follow-up, our patient shows no evidence of disease with negative histological findings