Margins in SBRT. Mischa Hoogeman
|
|
- Noah Hunt
- 5 years ago
- Views:
Transcription
1 Margins in SBRT Mischa Hoogeman
2 MARGIN CONCEPTS
3 Why do we use margins? Target / tumor To a-priori compensate for (unknown) deviations between the intended target position and the real target position during dose delivery Deviations are estimated from population-based measurements of geometrical errors (can be patient specific, e.g. respiratory motion) Healthy tissue To avoid unintended dose to a critical organs after aligning the beam to the displaced target (in case of differential motion between target and OAR)
4 How large should the margin be? What is the incentive? 99% of the target volume receives 95% of the prescribed dose or more (coverage probability) - Stroom et al. 90% of patients in the population receives a minimum cumulative CTV dose of at least 95% of the prescribed dose - van Herk et al. Not all patients will be treated to 100% of the prescription dose in all fractions M = 2.5S + 0.7s
5 Categorization of Errors: a 2D Example Systematic error S Systematic error M Random error s
6 Probability Density Function: Normal Distribution
7 Random Errors Only: M rand =0.7s The CTV experiences daily shifts of the dose distribution due to daily random variations in the position of the CTV If we add the daily shifted dose distributions the dose distribution appeares to be blurred (motion blurring) The effect of the random error can be calculated by convolving the random error distribution with the dose distribution => blurred dose distribution = random error s
8 Margin Recipe for Random Error Water s p = 3.2 mm Lung s p = 6.4 mm random error s penumbra s p block position 95% 50%
9 Margin Calculation: Random Component The margin that would be needed to ensure a coverage of at least 95% norminv p = 0.95, = 0, s = s p M = 0.7s M = 1.64 s 2 s s2 norminv p2 p = 0.95, = 0, s = s p p 2 s
10 Random Error and Minimum Dose Requirement The margin for random decreases with decreasing prescription isodose line / minimum dose requirement 95% M = b s 2 s - bs p2 73% p 50% Prescription level b 95% % % % 0.25
11 Random Margin and Prescription Level Prescription level b 95% % % % 0.25
12 Systematic Errors Only (M sys = 2.5 S) The systematic set-up errors are described by a 3D Gaussian distribution How to choose M sys to ensure a high probability that the prescribed dose is delivered to the CTV? 95% Choice: for 90% of all possible systematic set-up errors (treatments), the full CTV is within the PTV (=95% isodose)
13 Systematic Errors Only (M sys = 2.5 S) Spherical Tumor 0 M sys p Σ dr = M sys r 2 e π 2 Σ3 r 2 2Σ 2 dr = 0.9 Population (%) S
14 Margin Recipe: Systematic Error and Random Errors Cumulative minimum dose 95% M r = b s 2 +s p2 - bs p Systematic errors are assumed to have an independent effect on the blurred dose distribution 90% of population receives a cumulative CTV dose of 95% M = 2.5S + M r
15 How to Add Various Error Contributions? For a simple criteria as a probability level of the minimum dose the systematic error and random error are added linearly For various systematic errors and various random errors the errors (SDs) should be added in quadrature: S = S 2 a S 2 b S 2 c S = = 10.9(10) Emphasis on large errors!
16 APPLICATION TO SRT AND SBRT
17 Error (mm) Number of Fractions and Residual Systematic Error Limited number of fractions results in a residual shift of the dose distribution Fraction Number Residual error Error after 35 fractions = 0.1 mm Error after 5 fractions = -1.6 mm
18 Effective Standard Deviation of the Errors Effective Systematic Error Error in estimating the average S effective = 1 S 2 s 2 N Effective Random Error s effective 1 = 1 - s N 2 de Boer H C and Heijmen B J 2001 A protocol for the reduction of systematic patient setup errors with minimal portal imaging workload Int. J. Radiat. Oncol. Biol. Phys
19 Margin and Number of Fractions S eff s eff Margin S = 2 mm, s = 2 mm, P=80%
20 Including Error due to Respiratory Motion Respiratory motion modeled as sin 6 t The respiratory motion can be described as a standard deviation for a given amplitude s = 0.358A
21 Intra-fraction error vs. motion amplitude (CC) Intra-fraction error (1 SD) [mm] Without Synchrony Slope = Respiratory motion amplitude (mm) Hoogeman M, Prévost JB, Nuyttens J, Pöll J, Levendag P, Heijmen B, Clinical accuracy of the respiratory tumor tracking system of the cyberknife: assessment by analysis of log files. Int J Radiat Oncol Biol Phys May 1;74(1): t y = y cos 6 0 A ( - ) s = 0.358A
22 PRACTICAL EXAMPLES
23 A Practical Example: SRT Case Intracranial lesion: 3 x 8 80% SD of the penumbra is 3.2 mm E2E test device error (1 SD) = 0.4 mm (measured over a long period) Localization (delineation) error = 1.0 mm (1 SD) Systematic error = 0.5 mm (1 SD) [measured from 30-fraction treatments] Random error = 0.5 mm (1 SD) [measured from 30-fraction treatments] Intra-fraction error = 0.5 mm ( 1 SD) [measured from 30-fraction treatments at end of treatment]
24 A Practical Example: SRT Case Intracranial lesion: 3 x 8 80% N=3, b=0.84 SD of the penumbra is 3.2 mm s pen =3.2 mm E2E test device error (S) = 0.4 mm S 1 =0.4 mm Localization (delineation) error = 1.0 mm (1 SD) S 2 =1.0 mm Systematic error = 0.5 mm (1 SD) S eff =0.58 mm Random error = 0.5 mm (1 SD) s eff =0.41 mm Intra-fraction error = 0.5 mm ( 1 SD) s eff =0.20 mm
25 Results SRT Example No delineation error
26 Evaluation of Treatment Accuracy Seravalli E, van Haaren PM, van der Toorn PP, Hurkmans CW. A comprehensive evaluation of treatment accuracy, including end-to-end tests and clinical data, applied to intracranial stereotactic radiotherapy. Radiother Oncol Jul;116(1):131-8.
27 A Practical Example: SBRT Lung Case T1 primary lung lesion: 3 x 18 80% Alignment on time-averaged tumor position by CBCT Tumor in lung tissue E2E test device error (1 SD) = 0.4 mm (measured over a long period) Localization (delineation) error = 2.0 mm (1 SD) Systematic error = 1.0 mm (1 SD) [measured from 3-fraction treatments] Random error = 1.0 mm (1 SD) [measured from 3-fraction treatments] Intra-fraction amplitude = 1 25 mm
28 A Practical Example: SBRT Lung Case T1 primary lung lesion: 3 x 18 80% N = 3, b = 0.84 Alignment on time-averaged tumor position by CBCT SD of the penumbra is 6.4 mm s pen = 6.4 mm E2E test device error (S) = 0.4 mm S 1 = 0.4 mm Localization (delineation) error = 2.0 mm (1 SD) S 2 = 2.0 mm Systematic error = 1.0 mm (1 SD) S eff = 1.0 mm Random error = 1.0 mm (1 SD) s eff = 1.0 mm Intra-fraction amplitude = 1 25 mm s r = mm
29 Margins SBRT Lung Case No breathing
30 INTERNAL TARGET VOLUME
31 ITV Concept in ICRU-62 Report PTV margin should be derived from Internal Margin (IM) or Internal Target Volume (ITV) Setup Margin IM or ITV should compensate for physiological movements and variations in size, shape, and position of the CTV in relation to an internal reference point ITV often applied in lung SBRT where it encloses the full CTV in all respiratory phases CTV ITV PTV
32 Margin (mm) Margin vs ITV for Perfect Inter-fraction Alignment Amplitude (mm) Margin ITV Margin Water Margin lung
33 Margin Recipe for Random Error % 50%
34 Some Concluding Remarks In radiosurgery often 0-mm margins are being advocated There will always be residual geometrical uncertainties Target definition Errors in image-guidance systems Indirect measures of tumor position Always verify the margin algorithm used in the Treatment Planning System 3D margin algorithm (and not 2D) What is the resolution of the margin algorithm (e.g. CT resolution?) Verify that margin are not truncated to voxel positions, especially in the superior-inferior direction
35 References for Further Reading Stroom JC, de Boer HC, Huizenga H, Visser AG. Inclusion of geometrical uncertainties in radiotherapy treatment planning by means of coverage probability. Int J Radiat Oncol Biol Phys Mar 1;43(4): Van Herk M, Remeijer P, Rasch C, Lebesque JV. The probability of correct target dosage: Dose population histograms for deriving margins in radiotherapy. Int J Radiat Oncol Biol Phys. 2000;47: van Herk M, Remeijer P, Lebesque JV. Inclusion of geometric uncertainties in treatment plan evaluation. Int J Radiat Oncol Biol Phys Apr 1;52(5): Witte MG, van der Geer J, Schneider C, Lebesque JV, van Herk M. The effects of target size and tissue density on the minimum margin required for random errors. Med Phys Nov;31(11): International Commission on Radiation Units and Measurements. Prescribing, recording and reporting photon beam therapy. ICRU Report 50. Bethesda; International Commission on Radiation Units and Measurements. Prescribing, recording and reporting photon beam therapy (Supplement to ICRU Report 50). ICRU Report 62 Bethesda; International Commission on Radiation Units and Measurements. Prescribing, recording and reporting Photon Beam Intensity- Modulated Radiation Therapy (IMRT). ICRU Report 83; Wolthaus JW, Sonke J-J, van Herk M, et al. Comparison of different strategies to use four-dimensional computed tomography in treatment planning for lung cancer patients. Int J Radiat Oncol Biol Phys 2008;70: van Herk M, Witte M, van der Geer J, Schneider C, Lebesque JV Int. J. Radiation Oncology Biol. Phys., Vol. 57, No. 5, pp , Wunderink W PhD Thesis Erasmus University, Rotterdam, The Netherlands Gordon JJ, Siebers JV. Convolution method and CTV-to-PTV margins for finite fractions and small systematic errors. Phys Med Biol Apr 7;52(7):
IGRT Protocol Design and Informed Margins. Conflict of Interest. Outline 7/7/2017. DJ Vile, PhD. I have no conflict of interest to disclose
IGRT Protocol Design and Informed Margins DJ Vile, PhD Conflict of Interest I have no conflict of interest to disclose Outline Overview and definitions Quantification of motion Influences on margin selection
More informationIt s All About Margins. Maaike Milder, Ph.D. Accuray Symposium April 21 st 2018
It s All About Margins Maaike Milder, Ph.D. Accuray Symposium April 21 st 2018 Why margins? The smaller the better! Short Introduction Erasmus MC has been using the CyberKnife Robotic Radiosurgery System
More informationSpecification of Tumor Dose. Prescription dose. Purpose
Specification of Tumor Dose George Starkschall, Ph.D. Department of Radiation Physics U.T. M.D. Anderson Cancer Center Prescription dose What do we mean by a dose prescription of 63 Gy? Isocenter dose
More informationCALCULATION OF OPTIMAL MARGINS BETWEEN CLINICAL TARGET VOLUME (CTV) AND PLANNING TARGET VOLUME (PTV)
Available online at http://www.journalijdr.com ISSN: 2230-9926 International Journal of Development Research Vol. 07, Issue, 10, pp.15773-15779, October, 2017 ORIGINAL RESEARCH ARTICLE ORIGINAL RESEARCH
More informationRadiation therapy treatment plan optimization accounting for random and systematic patient setup uncertainties
Virginia Commonwealth University VCU Scholars Compass Theses and Dissertations Graduate School 211 Radiation therapy treatment plan optimization accounting for random and systematic patient setup uncertainties
More informationImage Fusion, Contouring, and Margins in SRS
Image Fusion, Contouring, and Margins in SRS Sarah Geneser, Ph.D. Department of Radiation Oncology University of California, San Francisco Overview Review SRS uncertainties due to: image registration contouring
More informationREVISITING ICRU VOLUME DEFINITIONS. Eduardo Rosenblatt Vienna, Austria
REVISITING ICRU VOLUME DEFINITIONS Eduardo Rosenblatt Vienna, Austria Objective: To introduce target volumes and organ at risk concepts as defined by ICRU. 3D-CRT is the standard There was a need for a
More information1 : : Medical Physics, Città della Salute e della Scienza, Torino, Italy
Fusella M. 1, Badellino S. 2, Boschetti A. 1, Cadoni F. 1, Giglioli F. R. 1, Guarneri A. 3, Fiandra C. 2, Filippi A. 2, Ricardi U. 2, Ragona R. 2 1 : : Medical Physics, Città della Salute e della Scienza,
More informationStereotaxy. Outlines. Establishing SBRT Program: Physics & Dosimetry. SBRT - Simulation. Body Localizer. Sim. Sim. Sim. Stereotaxy?
Establishing SBRT Program: Physics & Dosimetry Lu Wang, Ph.D. Radiation Oncology Department Fox Chase Cancer Center Outlines Illustrate the difference between SBRT vs. CRT Introduce the major procedures
More informationMeasure the Errors of Treatment Set-Ups of Prostate Cancer Patient Using Electronic Portal Imaging Device (EPID)
IOSR Journal of Applied Physics (IOSR-JAP) e-issn: 2278-4861.Volume 10, Issue 2 Ver. I (Mar. Apr. 2018), PP 55-59 www.iosrjournals.org Measure the Errors of Treatment Set-Ups of Prostate Cancer Patient
More informationDefining Target Volumes and Organs at Risk: a common language
Defining Target Volumes and Organs at Risk: a common language Eduardo Rosenblatt Section Head Applied Radiation Biology and Radiotherapy (ARBR) Section Division of Human Health IAEA Objective: To introduce
More informationJOURNAL OF APPLIED CLINICAL MEDICAL PHYSICS, VOLUME 15, NUMBER 6, 2014
JOURNAL OF APPLIED CLINICAL MEDICAL PHYSICS, VOLUME 15, NUMBER 6, 2014 Inter- and intrafractional setup errors and baseline shifts of fiducial markers in patients with liver tumors receiving free-breathing
More informationRadiation treatment planning in lung cancer
Radiation treatment planning in lung cancer Georg Dietmar 1,2 1 Div. Medical Rad. Phys., Dept. of Radiation Oncology / Medical Univ. Vienna & AKH Wien 2 Christian Doppler Laboratory for Medical Radiation
More informationEstimation of patient setup uncertainty using BrainLAB Exatrac X-Ray 6D system in image-guided radiotherapy
JOURNAL OF APPLIED CLINICAL MEDICAL PHYSICS, VOLUME 16, NUMBER 2, 2015 Estimation of patient setup uncertainty using BrainLAB Exatrac X-Ray 6D system in image-guided radiotherapy Erminia Infusino, a Lucio
More informationRobust Optimization accounting for Uncertainties
Robust Optimization accounting for Uncertainties Thomas Bortfeld Massachusetts General Hospital, Boston tbortfeld@mgh.harvard.edu Supported by: RaySearch Philips Medical Systems Outline 1. Optimality and
More informationLinac or Non-Linac Demystifying And Decoding The Physics Of SBRT/SABR
Linac or Non-Linac Demystifying And Decoding The Physics Of SBRT/SABR PhD, FAAPM, FACR, FASTRO Department of Radiation Oncology Indiana University School of Medicine Indianapolis, IN, USA Indra J. Das,
More informationThe goal of three-dimensional conformal radiotherapy (3D-CRT) is to increase the likelihood
REVIEW ARTICLE UDC: 616-006.4:615.849.1:616-035.2 Arch Oncol 2005;13(3-4):140-4. DOI: 10.2298/AOO0503140M Verification and correction of geometrical uncertainties in conformal radiotherapy Du¹an Mileusniæ
More informationSBRT fundamentals. Outline 8/2/2012. Stereotactic Body Radiation Therapy Quality Assurance Educational Session
Stereotactic Body Radiation Therapy Quality Assurance Educational Session J Perks PhD, UC Davis Medical Center, Sacramento CA SBRT fundamentals Extra-cranial treatments Single or small number (2-5) of
More informationSRS Uncertainty: Linac and CyberKnife Uncertainties
SRS Uncertainty: Linac and CyberKnife Uncertainties Sonja Dieterich, PhD Linac/CyberKnife Technological Uncertainties 1 Linac Mechanical/Radiation Isocenters Depuydt, Tom, et al. "Computer aided analysis
More informationComputational intelligence margin models for radiotherapeutic cancer treatment
Computational intelligence margin models for radiotherapeutic cancer treatment Bongile Mzenda Institute of Industrial Research This thesis is submitted in partial fulfilment of the requirements of the
More information8/2/2012. Transitioning from 3D IMRT to 4D IMRT and the Role of Image Guidance. Part II: Thoracic. Peter Balter, Ph.D.
8/2/2012 Transitioning from 3D IMRT to 4D IMRT and the Role of Image Guidance Part II: Thoracic Peter Balter, Ph.D. Disclosure Dr. Balter is Physics PI on a trial comparing Cyberknife based SBRT with surgery,
More informationQuantifying variability of intrafractional target motion in stereotactic body radiotherapy for lung cancers
Title Quantifying variability of intrafractional target motion in stereotactic body radiotherapy for lung cancers Author(s) CHAN, KH; Kwong, DLW; Tam, E; Tong, A; Ng, CY Citation Journal of Applied Clinical
More information8/3/2016. Outline. Site Specific IGRT Considerations for Clinical Imaging Protocols. Krishni Wijesooriya, PhD University of Virginia
Site Specific IGRT Considerations for Clinical Imaging Protocols Krishni Wijesooriya, PhD University of Virginia Outline Image registration accuracies for different modalities What imaging modality best
More informationPitfalls in SBRT Treatment Planning for a Moving Target
Pitfalls in SBRT Treatment Planning for a Moving Target Cynthia F. Chuang, Ph.D. Department of Radiation Oncology University of California-San Francisco I have no conflicts of interests to disclose In
More informationTherapy of Non-Operable early stage NSCLC
SBRT Stage I NSCLC Therapy of Non-Operable early stage NSCLC Dr. Adnan Al-Hebshi MD, FRCR(UK), FRCP(C), ABR King Faisal Specialist Hospital & Research Centre This is our territory Early Stages NSCLC Surgical
More informationCyberKnife robotic spinal radiosurgery in prone position: dosimetric advantage due to posterior radiation access?
JOURNAL OF APPLIED CLINICAL MEDICAL PHYSICS, VOLUME 15, NUMBER 4, 2014 CyberKnife robotic spinal radiosurgery in prone position: dosimetric advantage due to posterior radiation access? Christoph Fürweger,
More informationWhich Planning CT Should be Used for Lung SBRT? Ping Xia, Ph.D. Head of Medical Physics in Radiation Oncology Cleveland Clinic
Which Planning CT Should be Used for Lung SBRT? Ping Xia, Ph.D. Head of Medical Physics in Radiation Oncology Cleveland Clinic Outline Image quality and image dose Free breathing CT, 4DCT, and synthetic
More information8/2/2017. Improving Dose Prescriptions for Safety, Reporting, and Clinical Guideline Consistency. Part III
Improving Dose Prescriptions for Safety, Reporting, and Clinical Guideline Consistency Part III I Das, J Moran, M Langer Keeping Guidelines On Track: The Effect On Clinical Practice of Neglecting Guidelines
More informationMargins and margin recipes
Margins and margin recipes Marcel van Herk On behalf of the image guidance group The Netherlands Cancer Institute Amsterdam, the Netherlands Classic radiotherapy procedure Tattoo, align and scan patient
More informationOverview of Advanced Techniques in Radiation Therapy
Overview of Advanced Techniques in Radiation Therapy Jacob (Jake) Van Dyk Manager, Physics & Engineering, LRCP Professor, UWO University of Western Ontario Acknowledgements Glenn Bauman Jerry Battista
More informationIGRT Solution for the Living Patient and the Dynamic Treatment Problem
IGRT Solution for the Living Patient and the Dynamic Treatment Problem Lei Dong, Ph.D. Associate Professor Dept. of Radiation Physics University of Texas M. D. Anderson Cancer Center Houston, Texas Learning
More informationSBRT I: Overview of Simulation, Planning, and Delivery
Disclosure SBRT I: Overview of Simulation, Planning, and Delivery I have received research funding from NIH, the Golfers Against Cancer (GAC) foundation, and Philips Health System. Jing Cai, PhD Duke University
More informationPhysics Treatment Margins. Laurence Court University of Texas MD Anderson Cancer Center
Physics Treatment Margins Laurence Court University of Texas MD Anderson Cancer Center Disclosure Employer: UT MD Anderson Cancer Center Grants from: NCI, CPRIT, Varian, Elekta, Mobius Learning Objectives
More informationCombination effects of tissue heterogeneity and geometric targeting error in stereotactic body radiotherapy for lung cancer using CyberKnife
JOURNAL OF APPLIED CLINICAL MEDICAL PHYSICS, VOLUME 16, NUMBER 5, 2015 Combination effects of tissue heterogeneity and geometric targeting error in stereotactic body radiotherapy for lung cancer using
More informationRTTs role in lung SABR
RTTs role in lung SABR Bart van Baaren Lineke van der Weide VU Medical Centre SBRT symposium VUMC 16 December 2017 Flow chart lung SABR Pre-treatment imaging Treatment planning On-line imaging Treatment
More information8/3/2016. Implementation of Pencil Beam Scanning (PBS) Proton Therapy Treatment for Liver Patients. Acknowledgement. Overview
Implementation of Pencil Beam Scanning (PBS) Proton Therapy Treatment for Liver Patients Liyong Lin, PhD, Assistant Professor Department of Radiation Oncology University of Pennsylvania Acknowledgement
More informationICRU Report 91 Was ist neu, was ändert sich?
DEGRO Stereotaxie Meeting 21.10.2017 ICRU Report 91 Was ist neu, was ändert sich? Lotte Wilke, Stephanie Tanadini-Lang, Matthias Guckenberger Klinik für Radio-Onkologie, Universitätsspital Zürich History
More informationUncertainties and Quality Assurance of Localization and Treatment in Lung SBRT Jing Cai, PhD Duke University Medical Center
Uncertainties and Quality Assurance of Localization and Treatment in Lung SBRT Jing Cai, PhD Duke University Medical Center 2013 AAPM 55 th Annual Meeting, Educational Course, Therapy Track, MOC SAM Program
More informationImpact of Contouring Variability on Dose- Volume Metrics used in Treatment Plan Optimization of Prostate IMRT
Open Access Original Article DOI: 10.7759/cureus.144 Impact of Contouring Variability on Dose- Volume Metrics used in Treatment Plan Optimization of Prostate IMRT Arvand Barghi, Carol Johnson 2, Andrew
More informationAccounting for center-of-mass target motion using convolution methods in Monte Carlo-based dose calculations of the lung
Accounting for center-of-mass target motion using convolution methods in Monte Carlo-based dose calculations of the lung Indrin J. Chetty, a) Mihaela Rosu, Daniel L. McShan, Benedick A. Fraass, James M.
More informationPMP. Quantitative Evaluation of Patient Positioning Error Using CBCT 3D Gamma Density Analysis in Radiotherapy. Original Article.
Original Article PMP Progress in Medical Physics 8(4), December 17 https://doi.org/1.14316/pmp.17.8.4.149 pissn 58-4445, eissn 58-4453 Quantitative Evaluation of Patient Positioning Error Using CBCT 3D
More informationImage Guided Stereotactic Radiotherapy of the Lung
Image Guided Stereotactic Radiotherapy of the Lung Jamie Marie Harris, MS DABR Avera McKennan Radiation Oncology September 25, 2015 Stereotactic Body Radiotherapy - Clinical Dose/Fractionation - Normal
More informationDose prescription with spatial uncertainty for peripheral lung SBRT
Received: 12 February 2018 Revised: 16 October 2018 Accepted: 26 October 2018 DOI: 10.1002/acm2.12504 RADIATION ONCOLOGY PHYSICS Dose prescription with spatial uncertainty for peripheral lung SBRT James
More informationDose-Guided Radiotherapy: Potential Benefit of Online Dose Recalculation for Stereotactic Lung Irradiation in Patients With Non-Small-Cell Lung Cancer
International Journal of Radiation Oncology biology physics www.redjournal.org Physics Contribution Dose-Guided Radiotherapy: Potential Benefit of Online Dose Recalculation for Stereotactic Lung Irradiation
More informationReport of ICRU Committee on Volume and Dose Specification for Prescribing, Reporting and Recording in Conformal and IMRT A Progress Report
Report of ICRU Committee on Volume and Dose Specification for Prescribing, Reporting and Recording in Conformal and IMRT A Progress Report Paul M. DeLuca, Jr. 1, Ph.D., Vincent Gregoire 2, M.D., Ph.D.,
More informationRADIATION ONCOLOGY RESIDENCY PROGRAM Competency Evaluation of Resident
Resident s Name: RADIATION ONCOLOGY RESIDENCY PROGRAM Competency Evaluation of Resident Rotation: PHYS 703: Clinical Rotation 2 Inclusive dates of rotation: Feb. 26, 2016 Aug. 25, 2016 Director or Associate
More informationClinical evaluation of interfractional variations for whole breast radiotherapy using 3-dimensional surface imaging
Practical Radiation Oncology (2013) 3, 16 25 www.practicalradonc.org Original Report Clinical evaluation of interfractional variations for whole breast radiotherapy using 3-dimensional surface imaging
More informationUNIVERSITY OF WISCONSIN-LA CROSSE Graduate Studies
UNIVERSITY OF WISCONSIN-LA CROSSE Graduate Studies A SINGLE INSTITUTION S EXPERIENCE IN DEVELOPING A PURPOSEFUL AND EFFICIENT OFF-LINE TECHNIQUE FOR ADAPTIVE RADIOTHERAPY IN A CLINICAL ENVIRONMENT A Research
More informationFrom position verification and correction to adaptive RT Adaptive RT and dose accumulation
From position verification and correction to adaptive RT Adaptive RT and dose accumulation Hans de Boer Move away from Single pre-treatment scan Single treatment plan Treatment corrections by couch shifts
More informationA method to improve dose gradient for robotic radiosurgery
JOURNAL OF APPLIED CLINICAL MEDICAL PHYSICS, VOLUME 16, NUMBER 6, 2015 A method to improve dose gradient for robotic radiosurgery Tianfang Li, a Cihat Ozhasoglu, Steven Burton, John Flickinger, Dwight
More informationA dosimetric comparison of stereotactic body radiation therapy techniques for lung cancer: robotic versus conventional linac-based systems
JOURNAL OF APPLIED CLINICAL MEDICAL PHYSICS, VOLUME 11, NUMBER 3, Summer 2010 A dosimetric comparison of stereotactic body radiation therapy techniques for lung cancer: robotic versus conventional linac-based
More informationSilvia Pella, PhD, DABR Brian Doozan, MS South Florida Radiation Oncology Florida Atlantic University Advanced Radiation Physics Boca Raton, Florida
American Association of Medical Dosimetrists 2015 Silvia Pella, PhD, DABR Brian Doozan, MS South Florida Radiation Oncology Florida Atlantic University Advanced Radiation Physics Boca Raton, Florida Most
More informationIMRT/IGRT Patient Treatment: A Community Hospital Experience. Charles M. Able, Assistant Professor
IMRT/IGRT Patient Treatment: A Community Hospital Experience Charles M. Able, Assistant Professor Disclosures I have no research support or financial interest to disclose. Learning Objectives 1. Review
More informationChapters from Clinical Oncology
Chapters from Clinical Oncology Lecture notes University of Szeged Faculty of Medicine Department of Oncotherapy 2012. 1 RADIOTHERAPY Technical aspects Dr. Elemér Szil Introduction There are three possibilities
More informationAccuracy Requirements and Uncertainty Considerations in Radiation Therapy
Departments of Oncology and Medical Biophysics Accuracy Requirements and Uncertainty Considerations in Radiation Therapy Introduction and Overview 6 August 2013 Jacob (Jake) Van Dyk Conformality 18 16
More informationRequired target margins for image-guided lung SBRT: Assessment of target position intrafraction and correction residuals
Practical Radiation Oncology (2013) 3, 67 73 www.practicalradonc.org Original Report Required target margins for image-guided lung SBRT: Assessment of target position intrafraction and correction residuals
More informationDose prescription, reporting and recording in intensity-modulated radiation therapy: a digest of the ICRU Report 83
Special report Dose prescription, reporting and recording in intensity-modulated radiation therapy: a digest of the ICRU Report 83 Rapid development in imaging techniques, including functional imaging,
More informationFeasibility of 4D IMRT Delivery for Hypofractionated High Dose Partial Prostate Treatments
Feasibility of 4D IMRT Delivery for Hypofractionated High Dose Partial Prostate Treatments R.A. Price Jr., Ph.D., J. Li, Ph.D., A. Pollack, M.D., Ph.D.*, L. Jin, Ph.D., E. Horwitz, M.D., M. Buyyounouski,
More informationImplementing New Technologies for Stereotactic Radiosurgery and Stereotactic Body Radiation Therapy
Implementing New Technologies for Stereotactic Radiosurgery and Stereotactic Body Radiation Therapy Implementation of radiosurgery and SBRT requires a fundamentally sound approach Errors don t blur out
More informationUvA-DARE (Digital Academic Repository) Towards image-guided radiotherapy of prostate cancer Smitsmans, M.H.P. Link to publication
UvA-DARE (Digital Academic Repository) Towards image-guided radiotherapy of prostate cancer Smitsmans, M.H.P. Link to publication Citation for published version (APA): Smitsmans, M. H. P. (2010). Towards
More informationIMRT Planning Basics AAMD Student Webinar
IMRT Planning Basics AAMD Student Webinar March 12, 2014 Karen Chin Snyder, MS Senior Associate Physicist Department of Radiation Oncology Disclosures The presenter has received speaker honoraria from
More informationIROC Liver Phantom. Guidelines for Planning and Irradiating the IROC Liver Phantom. Revised July 2015
IROC Liver Phantom Guidelines for Planning and Irradiating the IROC Liver Phantom. Revised July 2015 The study groups are requests that each institution keep the phantom for no more than 2 weeks. During
More informationEvaluation of Monaco treatment planning system for hypofractionated stereotactic volumetric arc radiotherapy of multiple brain metastases
Evaluation of Monaco treatment planning system for hypofractionated stereotactic volumetric arc radiotherapy of multiple brain metastases CASE STUDY Institution: Odette Cancer Centre Location: Sunnybrook
More informationRadiotherapy Planning (Contouring Lung Cancer for Radiotherapy dose prescription) Dr Raj K Shrimali
Radiotherapy Planning (Contouring Lung Cancer for Radiotherapy dose prescription) Dr Raj K Shrimali Let us keep this simple and stick to some basic rules Patient positioning Must be reproducible Must be
More information8/1/2017. Clinical Indications and Applications of Realtime MRI-Guided Radiotherapy
Clinical Indications and Applications of Realtime MRI-Guided Radiotherapy Michael F Bassetti MD PhD Assistant Professor, Department of Human Oncology University of Wisconsin, Madison. Carbone Cancer Center
More informationTHE TRANSITION FROM 2D TO 3D AND TO IMRT - RATIONALE AND CRITICAL ELEMENTS
THE TRANSITION FROM 2D TO 3D AND TO IMRT - RATIONALE AND CRITICAL ELEMENTS ICTP SCHOOL ON MEDICAL PHYSICS FOR RADIATION THERAPY DOSIMETRY AND TREATMENT PLANNING FOR BASIC AND ADVANCED APPLICATIONS March
More informationIAEA RTC. PET/CT and Planning of Radiation Therapy 20/08/2014. Sarajevo (Bosnia & Hercegovina) Tuesday, June :40-12:20 a.
IAEA RTC PET/CT and Planning of Radiation Therapy Sarajevo (Bosnia & Hercegovina) Tuesday, June 17 2014 11:40-12:20 a.m María José García Velloso Servicio de Medicina Nuclear Clínica Universidad de Navarra
More informationCURRICULUM OUTLINE FOR TRANSITIONING FROM 2-D RT TO 3-D CRT AND IMRT
CURRICULUM OUTLINE FOR TRANSITIONING FROM 2-D RT TO 3-D CRT AND IMRT Purpose The purpose of this curriculum outline is to provide a framework for multidisciplinary training for radiation oncologists, medical
More informationThe impact of dose prescription on treatment volume
The impact of dose prescription on treatment volume Summer Chaudhari 1 st year medical physics resident University of Minnesota Medical Center Advisor: Dr. Patrick Higgins NCCAAPM chapter meeting April
More informationPotential systematic uncertainties in IGRT when FBCT reference images are used for pancreatic tumors
JOURNAL OF APPLIED CLINICAL MEDICAL PHYSICS, VOLUME 16, NUMBER 3, 2015 Potential systematic uncertainties in IGRT when FBCT reference images are used for pancreatic tumors Ahmad Amoush, May Abdel-Wahab,
More information8/1/2016. Motion Management for Proton Lung SBRT. Outline. Protons and motion. Protons and Motion. Proton lung SBRT Future directions
Motion Management for Proton Lung SBRT AAPM 2016 Outline Protons and Motion Dosimetric effects Remedies and mitigation techniques Proton lung SBRT Future directions Protons and motion Dosimetric perturbation
More informationJOURNAL OF APPLIED CLINICAL MEDICAL PHYSICS, VOLUME 16, NUMBER 6, 2015
JOURNAL OF APPLIED CLINICAL MEDICAL PHYSICS, VOLUME 16, NUMBER 6, 2015 Determination of optimal PTV margin for patients receiving CBCT-guided prostate IMRT: comparative analysis based on CBCT dose calculation
More informationWould SBRT Hypofractionated Approach Be as Good? Then Why Bother With Brachytherapy?
Would SBRT Hypofractionated Approach Be as Good? Then Why Bother With Brachytherapy? Yasuo Yoshioka, MD Department of Radiation Oncology Osaka University Graduate School of Medicine Osaka, Japan Disclosure
More informationDosimetric Analysis of 3DCRT or IMRT with Vaginal-cuff Brachytherapy (VCB) for Gynaecological Cancer
Dosimetric Analysis of 3DCRT or IMRT with Vaginal-cuff Brachytherapy (VCB) for Gynaecological Cancer Tan Chek Wee 15 06 2016 National University Cancer Institute, Singapore Clinical Care Education Research
More informationInter- and intrafractional dose uncertainty in hypofractionated Gamma Knife radiosurgery
JOURNAL OF APPLIED CLINICAL MEDICAL PHYSICS, VOLUME 17, NUMBER 2, 2016 Inter- and intrafractional dose uncertainty in hypofractionated Gamma Knife radiosurgery Taeho Kim, 1,3 Jason Sheehan, 2,1 and David
More informationTomohisa FURUYA*, Satoru SUGIMOTO, Chie KUROKAWA, Shuichi OZAWA, Kumiko KARASAWA and Keisuke SASAI
Journal of Radiation Research, 2013, 54, 157 165 doi: 10.1093/jrr/rrs064 Advance Access Publication 1 August 2012 The dosimetric impact of respiratory breast movement and daily setup error on tangential
More informationQuality assurance and credentialing requirements for sites using inverse planned IMRT Techniques
TROG 08.03 RAVES Quality assurance and credentialing requirements for sites using inverse planned IMRT Techniques Introduction Commissioning and quality assurance of planning systems and treatment delivery
More informationAssessing Heterogeneity Correction Algorithms Using the Radiological Physics Center Anthropomorphic Thorax Phantom
Assessing Heterogeneity Correction Algorithms Using the Radiological Physics Center Anthropomorphic Thorax Phantom David Followill, Ph.D. Associate Director Radiological Physics Center RPC History Lesson
More informationLung Spine Phantom. Guidelines for Planning and Irradiating the IROC Spine Phantom. MARCH 2014
Lung Spine Phantom Guidelines for Planning and Irradiating the IROC Spine Phantom. MARCH 2014 The study groups are requesting that each institution keep the phantom for no more than 2 week. During this
More informationThe Canadian National System for Incident Reporting in Radiation Treatment (NSIR-RT) Taxonomy March 11, 2015
The Canadian National System for Incident Reporting in Radiation Treatment (NSIR-RT) Taxonomy March 11, 2015 Taxonomy Data Category Number Description Data Fields and Menu Choices 1. Impact 1.1 Incident
More informationRESEARCH ARTICLE. Abstract. Introduction
DOI:10.22034/APJCP.2017.18.1.37 RESEARCH ARTICLE Delineation of Margins for the Planning Target Volume (PTV) for Image-Guided Radiotherapy (IGRT) of Gastric Cancer Based on Intrafraction Motion Paulina
More informationImpact of sampling interval in training data acquisition on intrafractional predictive accuracy of indirect dynamic tumor-tracking radiotherapy*
Impact of sampling interval in training data acquisition on intrafractional predictive accuracy of indirect dynamic tumor-tracking radiotherapy* Nobutaka Mukumoto a), Mitsuhiro Nakamura, Mami Akimoto,
More informationIntra- and inter-fractional liver and lung tumor motions treated with SBRT under active breathing control
Received: 30 May 2017 Revised: 22 August 2017 Accepted: 21 September 2017 DOI: 10.1002/acm2.12220 RADIATION ONCOLOGY PHYSICS Intra- and inter-fractional liver and lung tumor motions treated with SBRT under
More informationThe Impact of Image Guided Radiotherapy in Breast Boost Radiotherapy
The Impact of Image Guided Radiotherapy in Breast Boost Radiotherapy 1 Donovan EM, 1 Brooks C, 1 Mitchell A, 2 Mukesh M, 2 Coles CE, 3 Evans PM, 1 Harris EJ 1 Joint Department of Physics, The Royal Marsden/Institute
More informationRange Uncertainties in Proton Therapy
Range Uncertainties in Proton Therapy Harald Paganetti PhD Professor of Radiation Oncology, Harvard Medical School Director of Physics Research, Massachusetts General Hospital, Department of Radiation
More informationAn analysis of geometric uncertainty calculations for prostate radiotherapy in clinical practice.
An analysis of geometric uncertainty calculations for prostate radiotherapy in clinical practice. McGarry, C. K., Cosgrove, V. P., Fleming, V. A. L., O'Sullivan, J., & Hounsell, A. R. (2009). An analysis
More informationDosimetric effects of anatomical changes during fractionated photon radiation therapy in pancreatic cancer patients
Received: 17 March 2017 Revised: 22 August 2017 Accepted: 29 August 2017 DOI: 10.1002/acm2.12199 RADIATION ONCOLOGY PHYSICS Dosimetric effects of anatomical changes during fractionated photon radiation
More informationIROC Lung Phantom 3D CRT / IMRT. Guidelines for Planning and Irradiating the IROC Lung Phantom. Revised Dec 2015
IROC Lung Phantom 3D CRT / IMRT Guidelines for Planning and Irradiating the IROC Lung Phantom. Revised Dec 2015 The IROC requests that each institution keep the phantom for no more than 2 weeks. During
More informationdoi: /j.ijrobp CLINICAL INVESTIGATION
doi:10.1016/j.ijrobp.2006.11.004 Int. J. Radiation Oncology Biol. Phys., Vol. 67, No. 5, pp. 1430 1437, 2007 Copyright 2007 Elsevier Inc. Printed in the USA. All rights reserved 0360-3016/07/$ see front
More informationThe effects of motion on the dose distribution of proton radiotherapy for prostate cancer
JOURNAL OF APPLIED CLINICAL MEDICAL PHYSICS, VOLUME 13, NUMBER 3, 2012 The effects of motion on the dose distribution of proton radiotherapy for prostate cancer Sima Qamhiyeh, 1a Dirk Geismar, 1 Christoph
More informationUtilization of cone-beam CT for offline evaluation of target volume coverage during prostate image-guided radiotherapy based on bony anatomy alignment
reports of practical oncology and radiotherapy 1 7 (2 0 1 2) 134 140 Available online at www.sciencedirect.com journal homepage: http://www.elsevier.com/locate/rpor Original research article Utilization
More informationImpact of temporal probability in 4D dose calculation for lung tumors
JOURNAL OF APPLIED CLINICAL MEDICAL PHYSICS, VOLUME 16, NUMBER 6, 2015 Impact of temporal probability in 4D dose calculation for lung tumors Ouided Rouabhi, 1 Mingyu Ma, 2 John Bayouth, 3,4 Junyi Xia 4a
More informationConsiderations when treating lung cancer with passive scatter or active scanning proton therapy
Mini-Review Considerations when treating lung cancer with passive scatter or active scanning proton therapy Sara St. James, Clemens Grassberger, Hsiao-Ming Lu Department of Radiation Oncology, Massachusetts
More informationUvA-DARE (Digital Academic Repository) (Un-)certainties in radiotherapy of rectal cancer Nijkamp, J.A. Link to publication
UvA-DARE (Digital Academic Repository) (Un-)certainties in radiotherapy of rectal cancer Nijkamp, J.A. Link to publication Citation for published version (APA): Nijkamp, J. A. (2012). (Un-)certainties
More informationTreatment Planning for Lung. Kristi Hendrickson, PhD, DABR University of Washington Dept. of Radiation Oncology
Treatment Planning for Lung Kristi Hendrickson, PhD, DABR University of Washington Dept. of Radiation Oncology Outline of Presentation Dosimetric planning strategies for SBRT lung Delivery techniques Examples
More informationHot Topics in SRS: Small Field Dosimetry & Other Treatment Uncertainties. Sonja Dieterich, PhD University of California Davis
Hot Topics in SRS: Small Field Dosimetry & Other Treatment Uncertainties Sonja Dieterich, PhD University of California Davis Lecture in Two Parts SRS Dosimetry Other Uncertainties SRS DOSIMETRY Outline
More informationA Thesis. entitled. based on CBCT Data Dose Calculation. Sukhdeep Kaur Gill. Master of Science Degree in Biomedical Science
A Thesis entitled A Study of Evaluation of Optimal PTV Margins for Patients Receiving Prostate IGRT based on CBCT Data Dose Calculation by Sukhdeep Kaur Gill Submitted to the Graduate Faculty as partial
More informationIs internal target volume accurate for dose evaluation in lung cancer stereotactic body radiotherapy?
/, Vol. 7, No. 16 Is internal target volume accurate for dose evaluation in lung cancer stereotactic body radiotherapy? Jiayuan Peng 1,2, Zhen Zhang 1,2, Jiazhou Wang 1,2, Jiang Xie 1,2, Weigang Hu 1,2
More informationEvaluation of Whole-Field and Split-Field Intensity Modulation Radiation Therapy (IMRT) Techniques in Head and Neck Cancer
1 Charles Poole April Case Study April 30, 2012 Evaluation of Whole-Field and Split-Field Intensity Modulation Radiation Therapy (IMRT) Techniques in Head and Neck Cancer Abstract: Introduction: This study
More information