Linac Twins in Radiotherapy

In a radiotherapy department having more than one linear accelerator, it is rather common to match the dose output of all machines. In particular, the recently developed flattening filter free mode requires new investigations regarding the feasibility of matching and the consequences for quality assurance and workload. This refers also to the beam model of the radiotherapy treatment planning system. Our results show that matching is possible not only for flat beams but also for flattening filter free mode. Therefore, the machines can substitute each other in the case of breakdown or service without new treatment planning even in the case of complex intensity-modulated radiotherapy or volumetric-modulated arc therapy. The quality assurance is reduced to only one data set for both the linear accelerators and the radiotherapy treatment planning system

Measurement of Similarity in Academic Contexts

We propose some reflections, comments and suggestions about the measurement of similar and matched content in scientific papers and documents, and the need to develop appropriate tools and standards for an ethically fair and equitable treatment of authors

MLP: a MATLAB toolbox for rapid and reliable auditory threshold estimation

In this paper, we present MLP, a MATLAB toolbox enabling auditory thresholds estimation via the adaptive Maximum Likelihood procedure proposed by David Green (1990, 1993). This adaptive procedure is particularly appealing for those psychologists that need to estimate thresholds with a good degree of accuracy and in a short time. Together with a description of the toolbox, the current text provides an introduction to the threshold estimation theory and a theoretical explanation of the maximum likelihood adaptive procedure. MLP comes with a graphical interface and it is provided with several built-in, classic psychoacoustics experiments ready to use at a mouse click

The psychophysics of uneconomical choice: non-linear reward evaluation by a nectar feeder

Uneconomical choices by humans or animals that evaluate reward options challenge the expectation that decision-makers always maximize the return currency. One possible explanation for such deviations from optimality is that the ability to sense differences in physical value between available alternatives is constrained by the sensory and cognitive processes for encoding profitability. In this study, we investigated the capacity of a nectarivorous bat species (Glossophaga commissarisi) to discriminate between sugar solutions with different concentrations. We conducted a two-alternative free-choice experiment on a population of wild electronically tagged bats foraging at an array of computer-automated artificial flowers that recorded individual choices. We used a Bayesian approach to fit individual psychometric functions, relating the strength of preferring the higher concentration option to the intensity of the presented stimulus. Psychometric analysis revealed that discrimination ability increases non-linearly with respect to intensity. We combined this result with a previous psychometric analysis of volume perception. Our theoretical analysis of choice for rewards that vary in two quality dimensions revealed regions of parameter combinations where uneconomic choice is expected. Discrimination ability may be constrained by non-linear perceptual and cognitive encoding processes that result in uneconomical choice

Evaluation of volumetric modulated arc therapy (VMAT) with Oncentra MasterPlan® for the treatment of head and neck cancer

Background Several comparison studies have shown the capability of VMAT to achieve similar or better plan quality as IMRT, while reducing the treatment time. The experience of VMAT in a multi vendor environment is limited. We compared the plan quality and performance of VMAT to IMRT and we investigate the effects of varying various user-selectable parameters. Methods IMRT, single arc VMAT and dual arc VMAT were compared for four different head-and-neck tumors. For VMAT, the effect of varying gantry angle spacing and treatment time on the plan quality was investigated. A comparison of monitor units and treatment time was performed. Results IMRT and dual arc VMAT achieved a similar plan quality, while single arc could not provide an acceptable plan quality. Increasing the number of control points does not improve the plan quality. Dual arc VMAT delivery time is about 30% of IMRT delivery time. Conclusions Dual arc VMAT is a fast and accurate technique for the treatment of head and neck cancer. It applies similar number of MUs as IMRT, but the treatment time is strongly reduced, maintaining similar or better dose conformity to the PTV and OAR sparing

Haptic Perception of Object Curvature in Parkinson's Disease

The haptic perception of the curvature of an object is essential for adequate object manipulation and critical for our guidance of actions. This study investigated how the ability to perceive the curvature of an object is altered by Parkinson's disease (PD).Eight healthy subjects and 11 patients with mild to moderate PD had to judge, without vision, the curvature of a virtual "box" created by a robotic manipulandum. Their hands were either moved passively along a defined curved path or they actively explored the curved curvature of a virtual wall. The curvature was either concave or convex (bulging to the left or right) and was judged in two locations of the hand workspace--a left workspace location, where the curved hand path was associated with curved shoulder and elbow joint paths, and a right workspace location in which these joint paths were nearly linear. After exploring the curvature of the virtual object, subjects had to judge whether the curvature was concave or convex. Based on these data, thresholds for curvature sensitivity were established. The main findings of the study are: First, 9 out 11 PD patients (82%) showed elevated thresholds for detecting convex curvatures in at least one test condition. The respective median threshold for the PD group was increased by 343% when compared to the control group. Second, when distal hand paths became less associated with proximal joint paths (right workspace), haptic acuity was reduced substantially in both groups. Third, sensitivity to hand trajectory curvature was not improved during active exploration in either group.Our data demonstrate that PD is associated with a decreased acuity of the haptic sense, which may occur already at an early stage of the disease

Application of volumetric modulated arc therapy (VMAT) in a dual-vendor environment

Background and Purpose The purpose of this study was to assess plan quality and treatment time achievable with the new VMAT optimization tool implemented in the treatment planning system Oncentra MasterPlan® as compared to IMRT for Elekta SynergyS® linear accelerators. Materials and methods VMAT was implemented on a SynergyS® linear accelerator (Elekta Ltd., Crawley, UK) with Mosaiq® record and verify system (IMPAC Medical Systems, Sunnyvale, CA) and the treatment planning system Oncentra MasterPlan® (Nucletron BV, Veenendaal, the Netherlands). VMAT planning was conducted for three typical target types of prostate cancer, hypopharynx/larynx cancer and vertebral metastases, and compared to standard IMRT with respect to plan quality, number of monitor units (MU), and treatment time. Results For prostate cancer and vertebral metastases single arc VMAT led to similar plan quality as compared to IMRT. For treatment of the hypopharynx/larynx cancer, a second arc was necessary to achieve sufficient plan quality. Treatment time was reduced in all cases to 35% to 43% as compared to IMRT. Times required for optimization and dose calculation, however, increased by a factor of 5.0 to 6.8. Conclusion Similar or improved plan quality can be achieved with VMAT as compared to IMRT at reduced treatment times but increased calculation times