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Midgley S.M.,Monash University | Midgley S.M.,William Buckland Radiotherapy Center
Physics in Medicine and Biology | Year: 2014

A parametric model for the x-ray linear attenuation coefficient is used to describe the compositional dependence of Hounsfield numbers measured by medical CT scanners. Measurements with materials of known density and composition, that span and evenly sample the compositional range of tissues, are written as linear simultaneous equations and solved for model coefficients. An algorithm is identified for this purpose. Results are expressed as atomic cross-sections in units of barn per electron divided by the attenuation coefficient for water. With the CT scanner characterised, a virtual CT scan can be simulated to predict HN for tissues based upon their known density and composition. Similar calculations using the tabulations and mixture rule deliver attenuation coefficients and mass energy absorption coefficients for mono-energetic radiation 10 keV to 20 MeV. Results are presented for measurements with a radiotherapy CT simulator, the RMI-467 phantom with tissue substitute materials, plus common polymer materials and silicon. Published measurements with earlier generations of the phantom and tissue substitutes using different CT scanners are also considered. Measured atomic cross-sections differ from expectations for mono-energetic radiation due to the use of a filtered spectrum and energy integrating detection system. The cross-sections for different CT scanners are similar, without large variations with kVp. Results are presented showing the relationship between predicted HN for tissues, electron density and photon interaction coefficients for healthy tissues and mono-energetic radiation. A strategy is suggested for accommodating strongly attenuating materials such as calculi and metallic implants. © 2014 Institute of Physics and Engineering in Medicine.

Annabell N.,RMIT University | Yagi N.,Japan Synchrotron Radiation Research Institute | Umetani K.,Japan Synchrotron Radiation Research Institute | Wong C.,William Buckland Radiotherapy Center | Geso M.,RMIT University
Journal of Synchrotron Radiation | Year: 2012

Synchrotron-generated microbeam radiotherapy holds great promise for future treatment, but the high dose gradients present conventional dosimetry with a challenge. Measuring the important peak-to-valley dose ratio (PVDR) of a microbeam-collimated synchrotron source requires both a dosimeter and an analysis method capable of exceptional spatial resolution. The PVDR is of great interest since it is the limiting factor for potential application of the microbeam radiation therapy technique clinically for its tissue-sparing properties (i.e. the valley dose should be below the tolerance of normal tissue). In this work a new method of measuring the dose response of PRESAGE dosimeters is introduced using the fluorescence from a 638 nm laser on a confocal laser-scanning microscope. This fluorescent microscopy method produces dosimetry data at a pixel size as low as 78 nm, giving a much better spatial resolution than optical computed tomography, which is normally used for scanning PRESAGE dosimeters. Using this technique the PVDR of the BL28B2 microbeam at the SPring-8 synchrotron in Japan is estimated to be approximately 52:1 at a depth of 2.5 mm. The PVDR was also estimated with EBT2 GAFchromic films as 30.5:1 at the surface in order to compare the PRESAGE fluorescent results with a more established dosimetry system. This estimation is in good agreement with previously measured ratios using other dosimeters and Monte Carlo simulations. This means that it is possible to use PRESAGE dosimeters with confocal microscopy for the determination of PVDR. © 2012 International Union of Crystallography.

Gokula K.,Universiti Sains Malaysia | Gokula K.,National University of Singapore | Gokula K.,William Buckland Radiotherapy Center | Earnest A.,Quantitative Medicine | Wong L.C.,National University of Singapore
Radiation Oncology | Year: 2013

Background: This meta-analysis aims to ascertain the significance of early lung toxicity with 3-Dimensional (3D) conformal irradiation for breast carcinomas and identify the sub-groups of patients with increased risk.Methods: Electronic databases, reference sections of major oncological textbooks and identified studies were searched for synonyms of breast radiotherapy and radiation pneumonitis (RP). Major studies in thoracic irradiation were reviewed to identify factors frequently associated with RP. Meta-analysis for RP incidence estimation and odds ratio calculation were carried out.Results: The overall incidence of Clinical and Radiological RP is 14% and 42% respectively. Ten studies were identified. Dose-volume Histogram (DVH) related dosimetric factors (Volume of lung receiving certain dose, Vdose and Mean lung Dose, MLD), supraclavicular fossa (SCF) irradiation and age are significantly associated with RP, but not sequential chemotherapy and concomitant use of Tamoxifen. A poorly powered study in IMN group contributed to the negative finding. Smoking has a trend towards protective effect against RP.Conclusion: Use of other modalities may be considered when Ipsilateral lung V20Gy > 30% or MLD > 15 Gy. Extra caution is needed in SCF and IMN irradiation as they are likely to influence these dosimetric parameters. © 2013 Gokula et al.; licensee BioMed Central Ltd.

Na A.,Royal Melbourne Hospital | Haghigi N.,William Buckland Radiotherapy Center | Drummond K.J.,University of Melbourne
Asia-Pacific Journal of Clinical Oncology | Year: 2014

Cerebral radiation-induced injury ranges from acute reversible edema to late irreversible radiation necrosis (RN). Cerebral RN is poorly responsive to treatment, is associated with permanent neurological deficits and occasionally progresses to death. We review the literature regarding cerebral RN after radiotherapy for various brain and head and neck lesions and discuss its clinical features, imaging characteristics, pathophysiology and treatment. For new enhancing lesions on computed tomography or magnetic resonance imaging, apart from tumor progression or recurrence, RN needs to be considered in the differential diagnosis. Further studies are required to design chemoradiotherapy protocols that are effective in treating tumors while minimizing risk of RN. Current available treatments for RN, steroid and surgery, only relieve the mass effect. None of the experimental treatments to date have consistently been shown to reverse the pathologic process of RN. © 2013 Wiley Publishing Asia Pty Ltd.

Taylor M.L.,RMIT University | Taylor M.L.,Peter MacCallum Cancer Center | Taylor M.L.,William Buckland Radiotherapy Center | Kron T.,RMIT University | And 2 more authors.
Acta Oncologica | Year: 2011

Objective. The advantages of highly localised, conformal treatments achievable with stereotactic radiotherapy (SRT) are increasingly being extended to extracranial sites as stereotactic body radiotherapy with advancements in imaging and beam collimation. One of the challenges in stereotactic treatment lies in the significant complexities associated with small field dosimetry and dose calculation. This review provides a comprehensive overview of the complexities associated with stereotactic radiotherapy and the potential for detriment. Methods. This study is based on a comprehensive review of literature accessible via PubMed and other sources, covering stereotactic radiotherapy, small-field dosimetry and dose calculation. Findings. Several key issues were identified in the literature. They pertain to dose prescription, dose measurement and dose calculation within and beyond the treatment field. Field-edge regions and penumbrae occupy a significant portion of the total field size. Spectral and dosimetric characteristics are difficult to determine and are compounded by effects of tissue inhomogeneity. Measurement of small-fields is made difficult by detector volume averaging and energy response. Available dosimeters are compared, and emphasis is given to gel dosimetry which offers the greatest potential for three-dimensional small-field dosimetry. The limitations of treatment planning system algorithms as applied to small-fields (particularly in the presence of heterogeneities) is explained, and a review of Monte Carlo dose calculation is provided, including simplified treatment planning implementations. Not incorporated into treatment planning, there is evidence that far from the primary field, doses to patients (and corresponding risks of radiocarcinogenesis) from leakage/scatter in SRT are similar to large fields. Conclusions. Improved knowledge of dosimetric issues is essential to the accurate measurement and calculation of dose as well as the interpretation and assessment of planned and delivered treatments. This review highlights such issues and the potential benefit that may be gained from Monte Carlo dose calculation and verification via three-dimensional dosimetric methods (such as gel dosimetry) being introduced into routine clinical practice. © 2011 Informa Healthcare.

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