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Is the in vivo dosimetry with the OneDosePlusTM system able to detect intra-fraction motion? A retrospective analysis of in vivo data from breast and prostate patients.

Falco MD, D'Andrea M, Bosco AL, Rebuzzi M, Ponti E, Tolu B, Tortorelli G, Barbarino R, Di Murro L, Santoni R - Radiat Oncol (2012)

Bottom Line: The ATs have been found to be very similar (5.0% for TPS1 and 4.5% for TPS2).From statistical data analysis, the system has been found not sensitive enough to reveal displacements smaller than 1 cm (within two standard deviations).Splitting data into medial and lateral field, two patients have been found to move during all these sessions; the others, instead, moved only in the second part of the treatment.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiotherapy, Tor Vergata University General Hospital, V.le Oxford 81, 00133, Rome, Italy. mdanielafalco@hotmail.com

ABSTRACT

Background: The OneDosePlusTM system, based on MOSFET solid-state radiation detectors and a handheld dosimetry reader, has been used to evaluate intra-fraction movements of patients with breast and prostate cancer.

Methods: An Action Threshold (AT), defined as the maximum acceptable discrepancy between measured dose and dose calculated with the Treatment Planning System (TPS) (for each field) has been determined from phantom data. To investigate the sensitivity of the system to direction of the patient movements, fixed displacements have been simulated in phantom. The AT has been used as an indicator to establish if patients move during a treatment session, after having verified the set-up with 2D and/or 3D images. Phantom tests have been performed matching different linear accelerators and two TPSs (TPS1 and TPS2).

Results: The ATs have been found to be very similar (5.0% for TPS1 and 4.5% for TPS2). From statistical data analysis, the system has been found not sensitive enough to reveal displacements smaller than 1 cm (within two standard deviations). The ATs applied to in vivo treatments showed that among the twenty five patients treated for breast cancer, only four of them moved during each measurement session. Splitting data into medial and lateral field, two patients have been found to move during all these sessions; the others, instead, moved only in the second part of the treatment. Patients with prostate cancer have behaved better than patients with breast cancer. Only two out of twenty five moved in each measurement session.

Conclusions: The method described in the paper, easily implemented in the clinical practice, combines all the advantages of in vivo procedures using the OneDosePlusTM system with the possibility of detecting intra-fraction patient movements.

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Related in: MedlinePlus

Prostate treatment with the Elekta Synergy S. Average discrepancy using TPS2 and a 3D-CBCT verification system along the entire treatment course.
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Figure 8: Prostate treatment with the Elekta Synergy S. Average discrepancy using TPS2 and a 3D-CBCT verification system along the entire treatment course.

Mentions: In Figure8, data for prostate patients using TPS2 and a 3D-CBCT verification system, are displayed. The mean discrepancy was −1.6% with a SD of 3.0%. Red dots mark the patients whose Δ values have been found to exceed AT2 in each treatment session. The first one, had a Δ value negative, indicating a displacement towards the source. The other, had a positive discrepancy indicating that the patient moves away from the source. A wider data dispersion, however, can be observed in the patients treated with Elekta Synergy S (SD = 3.0%) compared to those treated with Elekta Precise (SD = 1.9%). In the statistical analysis of patients treated with Elekta Synergy S, except for patients # 1 and 14 (that can be considered as “outliers”), the data dispersion is similar (SD = 2.0%) to that obtained for patients treated with Elekta Precise (SD = 1.9%), with a similar mean discrepancy too (−0.8% compared to −1.0%). Finally, it can be observed that, again except for patients # 1 and 14, the data dispersion for each patient is less wide than that obtained in patients treated with Elekta Precise, shown in Figure7.


Is the in vivo dosimetry with the OneDosePlusTM system able to detect intra-fraction motion? A retrospective analysis of in vivo data from breast and prostate patients.

Falco MD, D'Andrea M, Bosco AL, Rebuzzi M, Ponti E, Tolu B, Tortorelli G, Barbarino R, Di Murro L, Santoni R - Radiat Oncol (2012)

Prostate treatment with the Elekta Synergy S. Average discrepancy using TPS2 and a 3D-CBCT verification system along the entire treatment course.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3526469&req=5

Figure 8: Prostate treatment with the Elekta Synergy S. Average discrepancy using TPS2 and a 3D-CBCT verification system along the entire treatment course.
Mentions: In Figure8, data for prostate patients using TPS2 and a 3D-CBCT verification system, are displayed. The mean discrepancy was −1.6% with a SD of 3.0%. Red dots mark the patients whose Δ values have been found to exceed AT2 in each treatment session. The first one, had a Δ value negative, indicating a displacement towards the source. The other, had a positive discrepancy indicating that the patient moves away from the source. A wider data dispersion, however, can be observed in the patients treated with Elekta Synergy S (SD = 3.0%) compared to those treated with Elekta Precise (SD = 1.9%). In the statistical analysis of patients treated with Elekta Synergy S, except for patients # 1 and 14 (that can be considered as “outliers”), the data dispersion is similar (SD = 2.0%) to that obtained for patients treated with Elekta Precise (SD = 1.9%), with a similar mean discrepancy too (−0.8% compared to −1.0%). Finally, it can be observed that, again except for patients # 1 and 14, the data dispersion for each patient is less wide than that obtained in patients treated with Elekta Precise, shown in Figure7.

Bottom Line: The ATs have been found to be very similar (5.0% for TPS1 and 4.5% for TPS2).From statistical data analysis, the system has been found not sensitive enough to reveal displacements smaller than 1 cm (within two standard deviations).Splitting data into medial and lateral field, two patients have been found to move during all these sessions; the others, instead, moved only in the second part of the treatment.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiotherapy, Tor Vergata University General Hospital, V.le Oxford 81, 00133, Rome, Italy. mdanielafalco@hotmail.com

ABSTRACT

Background: The OneDosePlusTM system, based on MOSFET solid-state radiation detectors and a handheld dosimetry reader, has been used to evaluate intra-fraction movements of patients with breast and prostate cancer.

Methods: An Action Threshold (AT), defined as the maximum acceptable discrepancy between measured dose and dose calculated with the Treatment Planning System (TPS) (for each field) has been determined from phantom data. To investigate the sensitivity of the system to direction of the patient movements, fixed displacements have been simulated in phantom. The AT has been used as an indicator to establish if patients move during a treatment session, after having verified the set-up with 2D and/or 3D images. Phantom tests have been performed matching different linear accelerators and two TPSs (TPS1 and TPS2).

Results: The ATs have been found to be very similar (5.0% for TPS1 and 4.5% for TPS2). From statistical data analysis, the system has been found not sensitive enough to reveal displacements smaller than 1 cm (within two standard deviations). The ATs applied to in vivo treatments showed that among the twenty five patients treated for breast cancer, only four of them moved during each measurement session. Splitting data into medial and lateral field, two patients have been found to move during all these sessions; the others, instead, moved only in the second part of the treatment. Patients with prostate cancer have behaved better than patients with breast cancer. Only two out of twenty five moved in each measurement session.

Conclusions: The method described in the paper, easily implemented in the clinical practice, combines all the advantages of in vivo procedures using the OneDosePlusTM system with the possibility of detecting intra-fraction patient movements.

Show MeSH
Related in: MedlinePlus