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Juan-Senabre X.J.,Servicio de Radiofisica y Proteccion Radiologica | Porras I.,University of Granada | Lallena A.M.,University of Granada
Physica Medica | Year: 2013

A variation of TG-43 protocol for seeds with cylindrical symmetry aiming at a better description of the radial and anisotropy functions is proposed. The TG-43 two dimensional formalism is modified by introducing a new anisotropy function. Also new fitting functions that permit a more robust description of the radial and anisotropy functions than usual polynomials are studied. The relationship between the new anisotropy function and the anisotropy factor included in the one-dimensional TG-43 formalism is analyzed. The new formalism is tested for the 125I Nucletron selectSeed brachytherapy source, using Monte Carlo simulations performed with PENELOPE. The goodness of the new parameterizations is discussed. The results obtained indicate that precise fits can be achieved, with a better description than that provided by previous parameterizations. Special care has been taken in the description and fitting of the anisotropy factor near the source. The modified formalism shows advantages with respect to the usual one in the description of the anisotropy functions. The new parameterizations obtained can be easily implemented in the clinical planning calculation systems, provided that the ratio between geometry factors is also modified according to the new dose rate expression. © 2012 Associazione Italiana di Fisica Medica.

Lopez-Tarjuelo J.,Servicio de Radiofisica y Proteccion Radiologica | Morillo-Macias V.,Servicio de Oncologia Radioterapica | Bouche-Babiloni A.,Servicio de Oncologia Radioterapica | Ferrer-Albiach C.,Servicio de Oncologia Radioterapica | And 2 more authors.
Technology in Cancer Research and Treatment | Year: 2015

In vivo dosimetry is recommended in intraoperative electron radiotherapy (IOERT). To perform real-time treatment monitoring, action levels (ALs) have to be calculated. Empirical approaches based on observation of samples have been reported previously, however, our aim is to present a predictive model for calculating ALs and to verify their validity with our experimental data. We considered the range of absorbed doses delivered to our detector by means of the percentage depth dose for the electron beams used. Then, we calculated the absorbed dose histograms and convoluted them with detector responses to obtain probability density functions in order to find ALs as certain probability levels. Our in vivo dosimeters were reinforced TN-502RDM-H mobile metal-oxide-semiconductor field-effect transistors (MOSFETs). Our experimental data came from 30 measurements carried out in patients undergoing IOERT for rectal, breast, sarcoma, and pancreas cancers, among others. The prescribed dose to the tumor bed was 90%, and the maximum absorbed dose was 100%. The theoretical mean absorbed dose was 90.3% and the measured mean was 93.9%. Associated confidence intervals at P =.05 were 89.2% and 91.4% and 91.6% and 96.4%, respectively. With regard to individual comparisons between the model and the experiment, 37% of MOSFET measurements lay outside particular ranges defined by the derived ALs. Calculated confidence intervals at P =.05 ranged from 8.6% to 14.7%. The model can describe global results successfully but cannot match all the experimental data reported. In terms of accuracy, this suggests an eventual underestimation of tumor bed bleeding or detector alignment. In terms of precision, it will be necessary to reduce positioning uncertainties for a wide set of location and treatment postures, and more precise detectors will be required. Planning and imaging tools currently under development will play a fundamental role. © 2015, © The Author(s) 2015.

Lopez-Tarjuelo J.,Servicio de Radiofisica y Proteccion Radiologica | Quiros-Higueras J.D.,Servicio de Radiofisica y Proteccion Radiologica | Bonaque-Alandi J.,Fundacion Hospital Provincial de Castellon | Luquero-Llopis N.,Fundacion Hospital Provincial de Castellon | And 6 more authors.
Radiation Measurements | Year: 2016

Purpose Statistical process control (SPC) has been shown to be a suitable tool for medical physicists to monitor quality and keep variability low and within specifications. We report our findings regarding ionisation chamber stability in our department when using a radioactive stability check device (RSCD) and we compare them with similar previously published records, including calibration results. Methods We retrospectively studied the stability of a PPC 40 parallel-plate chamber, and two Farmer chambers (FC65-G and FC65-P) by checking them with dedicated RSCDs. We analysed the data following SPC methodology which includes plotting I-MR control charts, monitoring out-of-control observations, calculating process capability ratios (Cp), and estimating conformance to specifications. We also estimated the Cp and adherence to specifications of previously published data. Results The PPC40 chamber hardly went out of the control limits over the whole six-year period assessed. However, Farmer chamber verifications drifted in opposite directions in phase II, and the deviations observed did not agree with their calibration records, which only increased by a maximum of 0.5%. In phase I the most unstable chamber was the FC65-P with a Cp equal to 0.9 at a specification level of ±1%. The PPC40 chamber was stable to within a maximum Cp of 1.3. Several sets of analysed data, including ours and those from other authors, fitted well within these limits: within ±1.9% and ±1.5% for a Cp of 1.5 and 1.33 respectively. Conclusions SPC with constant long-term RSCD checking gave us a meaningful plot of the instability of our ionisation chambers. Although a period of two years between calibrations should not be surpassed, in the interim this check can conform to specifications of ±1.5%. © 2016 Elsevier Ltd. All rights reserved.

Lopez-Tarjuelo J.,Servicio de Radiofisica y Proteccion Radiologica | Luquero-Llopis N.,Fundacion Hospital Provincial de Castellon | Garcia-Molla R.,Servicio de Radiofisica y Proteccion Radiologica | Quiros-Higueras J.D.,Servicio de Radiofisica y Proteccion Radiologica | And 6 more authors.
Physica Medica | Year: 2015

Purpose: To assess the electron beam monitoring statistical process control (SPC) in linear accelerator (linac) daily quality control. We present a long-term record of our measurements and evaluate which SPC-led conditions are feasible for maintaining control. Methods: We retrieved our linac beam calibration, symmetry, and flatness daily records for all electron beam energies from January 2008 to December 2013, and retrospectively studied how SPC could have been applied and which of its features could be used in the future. A set of adjustment interventions designed to maintain these parameters under control was also simulated. Results: All phase I data was under control. The dose plots were characterized by rising trends followed by steep drops caused by our attempts to re-center the linac beam calibration. Where flatness and symmetry trends were detected they were less-well defined. The process capability ratios ranged from 1.6 to 9.3 at a 2% specification level. Simulated interventions ranged from 2% to 34% of the total number of measurement sessions. We also noted that if prospective SPC had been applied it would have met quality control specifications. Conclusions: SPC can be used to assess the inherent variability of our electron beam monitoring system. It can also indicate whether a process is capable of maintaining electron parameters under control with respect to established specifications by using a daily checking device, but this is not practical unless a method to establish direct feedback from the device to the linac can be devised. © 2015 Associazione Italiana di Fisica Medica.

Lopez-Tarjuelo J.,Servicio de Radiofisica y Proteccion Radiologica | Bouche-Babiloni A.,Servicio de Oncologia Radioterapica | Santos-Serra A.,Servicio de Radiofisica y Proteccion Radiologica | Morillo-Macias V.,Servicio de Oncologia Radioterapica | And 6 more authors.
Radiotherapy and Oncology | Year: 2014

Background and purpose Industrial companies use failure mode and effect analysis (FMEA) to improve quality. Our objective was to describe an FMEA and subsequent interventions for an automated intraoperative electron radiotherapy (IOERT) procedure with computed tomography simulation, pre-planning, and a fixed conventional linear accelerator. Material and methods A process map, an FMEA, and a fault tree analysis are reported. The equipment considered was the radiance treatment planning system (TPS), the Elekta Precise linac, and TN-502RDM-H metal-oxide-semiconductor-field-effect transistor in vivo dosimeters. Computerized order-entry and treatment-automation were also analyzed. Results Fifty-seven potential modes and effects were identified and classified into 'treatment cancellation' and 'delivering an unintended dose'. They were graded from 'inconvenience' or 'suboptimal treatment' to 'total cancellation' or 'potentially wrong' or 'very wrong administered dose', although these latter effects were never experienced. Risk priority numbers (RPNs) ranged from 3 to 324 and totaled 4804. After interventions such as double checking, interlocking, automation, and structural changes the final total RPN was reduced to 1320. Conclusions FMEA is crucial for prioritizing risk-reduction interventions. In a semi-surgical procedure like IOERT double checking has the potential to reduce risk and improve quality. Interlocks and automation should also be implemented to increase the safety of the procedure. © 2014 Elsevier Ireland Ltd.

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