Patient Specific Quality Assurance Tool For High Dose Rate Brachytherapy For Rectal Cancer Patients

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Patient Specific Quality Assurance Tool For High Dose Rate Brachytherapy For Rectal Cancer Patients

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Author : Saeid Asgharizadeh
language : en
Publisher:
Release Date : 2014

Patient Specific Quality Assurance Tool For High Dose Rate Brachytherapy For Rectal Cancer Patients written by Saeid Asgharizadeh and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2014 with categories.

"In radiation therapy, accurate dose determination and precise dose delivery to the tumour are directly associated with better treatment outcomes in terms of higher tumour control and lower post radiation therapy complications. In the past, film dosimetry was developed into a powerful tool for external beam radiotherapy treatment verification and quality assurance. The objective of this thesis was the development and clinical application of the EBT-3GafChromicTMfilm model patient specific based quality assurance (QA) procedures in brachytherapy. The lack of clinical measurements and patient specific QA procedures (similar to that in intensity modulated radiotherapy (IMRT) delivery) in high dose rate brachytherapy (HDRBT) were the motivation to improve both the QA program of delivery and patient safety during brachytherapy procedures.Patient specific QA tools for pre-operative brachytherapy in rectal cancer developed in this thesis use a radiochromic film dosimetry system together with gamma function evaluation method to compare calculated and measured dose distributions. We also created a dedicated phantom for a brachytherapy applicator used for treatment of rectal cancer patients, which enabled us to compare calculated dose distributions to measured ones in high and low dose gradient regions. Starting from the same passing criteria used for external IMRT QA (3%, 3 mm), passing criteria for high and low dose regions were subsequently discussed. Finally, we investigated the QA system's sensitivity to source positional errors by introducing intentional and controlled mistakes on selected patient plans.Results presented in this thesis demonstrated that radiochromic film dosimetry based QA for brachytherapy can be used not only for patient specific quality assurance, but as a part of the commissioning process and periodic QA as well." --

Achieving Quality In Brachytherapy

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Author : B.R. Thomadsen
language : en
Publisher: CRC Press
Release Date : 1999-01-01

Achieving Quality In Brachytherapy written by B.R. Thomadsen and has been published by CRC Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 1999-01-01 with Science categories.

Achieving Quality in Brachytherapy addresses the main issues that often prevent correct delivery of brachytherapy treatment. The book explains how to set up a functional quality assurance program in brachytherapy and covers all the steps needed to undertake particular treatment plans, from the initial planning required to the detailed specification. It highlights the importance of planning as a means of controlling and dealing with errors during the treatment process and advises on what to check and how to check during treatment to ensure effective quality assurance. This comprehensive reference is ideal for professionals working in brachytherapy, physics, and radiation oncology, and serves as an introduction for trainees with an undergraduate degree in medical physics or clinical radiation oncology.

Brachytherapy Physics

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Author : Bruce Thomadsen
language : en
Publisher: Medical Physics Publishing Corporation
Release Date : 2005

Brachytherapy Physics written by Bruce Thomadsen and has been published by Medical Physics Publishing Corporation this book supported file pdf, txt, epub, kindle and other format this book has been release on 2005 with Science categories.

This text is organized into 6 sections: Fundamentals; Dosimetry; Interstitial Fundamentals; Interstitial Applications; Intercavitary Applications for Gynecological Cancer, and Unconventiional Delivery Systems. The book includes a CD-ROM containing an electronic version of the book (with many illustrations in full color) plus a compiled list of references.

Stereotactic Body Radiation Therapy

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Author : Simon S. Lo
language : en
Publisher: Springer Science & Business Media
Release Date : 2012-08-28

Stereotactic Body Radiation Therapy written by Simon S. Lo and has been published by Springer Science & Business Media this book supported file pdf, txt, epub, kindle and other format this book has been release on 2012-08-28 with Medical categories.

Stereotactic body radiation therapy (SBRT) has emerged as an important innovative treatment for various primary and metastatic cancers. This book provides a comprehensive and up-to-date account of the physical/technological, biological, and clinical aspects of SBRT. It will serve as a detailed resource for this rapidly developing treatment modality. The organ sites covered include lung, liver, spine, pancreas, prostate, adrenal, head and neck, and female reproductive tract. Retrospective studies and prospective clinical trials on SBRT for various organ sites from around the world are examined, and toxicities and normal tissue constraints are discussed. This book features unique insights from world-renowned experts in SBRT from North America, Asia, and Europe. It will be necessary reading for radiation oncologists, radiation oncology residents and fellows, medical physicists, medical physics residents, medical oncologists, surgical oncologists, and cancer scientists.

Re Irradiation New Frontiers

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Author : Carsten Nieder
language : en
Publisher: Springer
Release Date : 2016-10-25

Re Irradiation New Frontiers written by Carsten Nieder and has been published by Springer this book supported file pdf, txt, epub, kindle and other format this book has been release on 2016-10-25 with Medical categories.

This book, now in its second edition, provides a comprehensive overview of current re-irradiation strategies, with detailed discussion of re-irradiation methods, technical aspects, the role of combined therapy with anticancer drugs and hyperthermia, and normal tissue tolerance. In addition, disease specific chapters document recent clinical results and future research directions. All chapters from the first edition have been revised and updated to take account of the latest developments and research findings, including those from prospective studies. Due attention is paid to the exciting developments in the fields of proton irradiation and frameless image-guided ablative radiotherapy. The book documents fully how refined combined modality approaches and significant technical advances in radiation treatment planning and delivery have facilitated the re-irradiation of previously exposed volumes, allowing both palliative and curative approaches to be pursued at various disease sites. Professionals involved in radiation treatment planning and multimodal oncology treatment will find it to be an invaluable aid in understanding the benefits and limitations of re-irradiation and in designing prospective trials.

Advanced Age Geriatric Care

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Author : Nages Nagaratnam
language : en
Publisher: Springer
Release Date : 2018-11-26

Advanced Age Geriatric Care written by Nages Nagaratnam and has been published by Springer this book supported file pdf, txt, epub, kindle and other format this book has been release on 2018-11-26 with Medical categories.

As the Baby Boomers age, concerns over healthcare systems' abilities to accommodate geriatric patients grow increasingly challenging. This is especially true with the population deemed to be “the oldest of the old,” specifically those over the age of 85. Unlike any other time in history, this demographic is the fastest growing segment of most developed countries. In the United States the oldest old is projected to double from 4.3 million to 9.6 million by 2030. The increased life expectancy of the population since the early 1900s has been built on the improvement of living conditions, diet, public health and advancement in medical care. With this we have seen a steady decline in the age-specific prevalence of vascular and heart diseases, stroke and even dementia. Older persons are healthier today than their counterparts decades ago. More importantly than in any other age group, the care of the oldest old must be individualized; management decisions should be made taking into consideration the older persons’ expressed wishes, quality of life, function and mental capacity. The inevitable consequence is that there will be an increase in the prevalence of older persons with chronic diseases, multiple co-existing pathologies and neuro-degenerative diseases. The oldest of the aging population are often excluded from drug trials and their treatments are largely based on findings extrapolated from that of the younger old. Furthermore, among the oldest old, physiologically they are more diverse than other segments of the population. Their demographic characteristics are unparalleled and different compared to that of the younger old. Several studies have drawn attention to the differing attitudes among health professionals towards elderly people and many show prejudice because they are old. As a result, the use of age as a criteria in determining the appropriateness of treatment is of very limited validity, yet there are limited resources that guide physicians through these challenges. This book creates a greater awareness of these challenges and offers practical guidelines for working within the infrastructures vital to this demographic. This book is designed for geriatricians, primary care physicians, junior medical officers, specialty geriatrics nurses, and gerontologists. It is divided into 3 sections: General Considerations, Chronic diseases and Geriatric Syndromes. Each chapter provides a summary of important and essential information under the heading of Key Points. Case studies are included in some of the chapters to highlight the principles of management.

Treatment Planning Of High Dose Rate Brachytherapy Mathematical Modelling And Optimization

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Author : Björn Morén
language : sv
Publisher: Linköping University Electronic Press
Release Date : 2021-01-12

Treatment Planning Of High Dose Rate Brachytherapy Mathematical Modelling And Optimization written by Björn Morén and has been published by Linköping University Electronic Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2021-01-12 with Electronic books categories.

Cancer is a widespread class of diseases that each year affects millions of people. It is mostly treated with chemotherapy, surgery, radiation therapy, or combinations thereof. High doserate (HDR) brachytherapy (BT) is one modality of radiation therapy, which is used to treat for example prostate cancer and gynecologic cancer. In BT, catheters (i.e., hollow needles) or applicators are used to place a single, small, but highly radioactive source of ionizing radiation close to or within a tumour, at dwell positions. An emerging technique for HDR BT treatment is intensity modulated brachytherapy (IMBT), in which static or dynamic shields are used to further shape the dose distribution, by hindering the radiation in certain directions. The topic of this thesis is the application of mathematical optimization to model and solve the treatment planning problem. The treatment planning includes decisions on catheter placement, that is, how many catheters to use and where to place them, as well as decisions for dwell times. Our focus is on the latter decisions. The primary treatment goals are to give the tumour a sufficiently high radiation dose while limiting the dose to the surrounding healthy organs, to avoid severe side effects. Because these aims are typically in conflict, optimization models of the treatment planning problem are inherently multiobjective. Compared to manual treatment planning, there are several advantages of using mathematical optimization for treatment planning. First, the optimization of treatment plans requires less time, compared to the time-consuming manual planning. Secondly, treatment plan quality can be improved by using optimization models and algorithms. Finally, with the use of sophisticated optimization models and algorithms the requirements of experience and skill level for the planners are lower. The use of optimization for treatment planning of IMBT is especially important because the degrees of freedom are too many for manual planning. The contributions of this thesis include the study of properties of treatment planning models, suggestions for extensions and improvements of proposed models, and the development of new optimization models that take clinically relevant, but uncustomary aspects, into account in the treatment planning. A common theme is the modelling of constraints on dosimetric indices, each of which is a restriction on the portion of a volume that receives at least a specified dose, or on the lowest dose that is received by a portion of a volume. Modelling dosimetric indices explicitly yields mixed-integer programs which are computationally demanding to solve. We have therefore investigated approximations of dosimetric indices, for example using smooth non-linear functions or convex functions. Contributions of this thesis are also a literature review of proposed treatment planning models for HDR BT, including mathematical analyses and comparisons of models, and a study of treatment planning for IMBT, which shows how robust optimization can be used to mitigate the risks from rotational errors in the shield placement. Cancer är en grupp av sjukdomar som varje år drabbar miljontals människor. De vanligaste behandlingsformerna är cellgifter, kirurgi, strålbehandling eller en kombination av dessa. I denna avhandling studeras högdosrat brachyterapi (HDR BT), vilket är en form av strålbehandling som till exempel används vid behandling av prostatacancer och gynekologisk cancer. Vid brachyterapibehandling används ihåliga nålar eller applikatorer för att placera en millimeterstor strålkälla antingen inuti eller intill en tumör. I varje nål finns det ett antal så kallade dröjpositioner där strålkällan kan stanna en viss tid för att bestråla den omkringliggande vävnaden, i alla riktningar. Genom att välja lämpliga tider för dröjpositionerna kan dosfördelningen formas efter patientens anatomi. Utöver HDR BT studeras också den nya tekniken intensitetsmodulerad brachyterapi (IMBT) vilket är en variation på HDR BT där skärmning används för att minska strålningen i vissa riktningar vilket gör det möjligt att forma dosfördelningen bättre. Planeringen av en behandling med HDR BT omfattar hur många nålar som ska användas, var de ska placeras samt hur länge strålkällan ska stanna i de olika dröjpositionerna. För HDR BT kan dessa vara flera hundra stycken medan det för IMBT snarare handlar om tusentals möjliga kombinationer av dröjpositioner och inställningar av skärmarna. Planeringen resulterar i en dosplan som beskriver hur hög stråldos som tumören och intilliggande frisk vävnad och riskorgan utsätts för. Dosplaneringen kan formuleras som ett matematiskt optimeringsproblem vilket är ämnet för avhandlingen. De övergripande målsättningarna för behandlingen är att ge en tillräckligt hög stråldos till tumören, för att döda alla cancerceller, samt att undvika att bestråla riskorgan eftersom det kan ge allvarliga biverkningar. Då alla målsättningarna inte samtidigt kan uppnås fullt ut så fås optimeringsproblem där flera målsättningar behöver prioriteras mot varandra. Utöver att dosplanen uppfyller kliniska behandlingsriktlinjer så är också tidsaspekten av planeringen viktig eftersom det är vanligt att den görs medan patienten är bedövad eller sövd. Vid utvärdering av en dosplan används dos-volymmått. För en tumör anger ett dosvolymmått hur stor andel av tumören som får en stråldos som är högre än en specificerad nivå. Dos-volymmått utgör en viktig del av målen för dosplaner som tas upp i kliniska behandlingsriktlinjer och ett exempel på ett sådant mål vid behandling av prostatacancer är att 95% av prostatans volym ska få en stråldos som är minst den föreskrivna dosen. Dos-volymmått utläses ur de kliniskt betydelsefulla dos-volym histogrammen som för varje stråldosnivå anger motsvarande volym som erhåller den dosen. En fördel med att använda matematisk optimering för dosplanering är att det kan spara tid jämfört med manuell planering. Med väl utvecklade modeller så finns det också möjlighet att skapa bättre dosplaner, till exempel genom att riskorganen nås av en lägre dos men med bibehållen dos till tumören. Vidare så finns det även fördelar med en process som inte är lika personberoende och som inte kräver erfarenhet i lika stor utsträckning som manuell dosplanering i dagsläget gör. Vid IMBT är det dessutom så många frihetsgrader att manuell planering i stort sett blir omöjligt. I avhandlingen ligger fokus på hur dos-volymmått kan användas och modelleras explicit i optimeringsmodeller, så kallade dos-volymmodeller. Detta omfattar såväl analys av egenskaper hos befintliga modeller, utvidgningar av tidigare använda modeller samt utveckling av nya optimeringsmodeller. Eftersom dos-volymmodeller modelleras som heltalsproblem, vilka är beräkningskrävande att lösa, så är det också viktigt att utveckla algoritmer som kan lösa dem tillräckligt snabbt för klinisk användning. Ett annat mål för modellutvecklingen är att kunna ta hänsyn till fler kriterier som är kliniskt relevanta men som inte ingår i dos-volymmodeller. En sådan kategori av mått är hur dosen är fördelad rumsligt, exempelvis att volymen av sammanhängande områden som får en alldeles för hög dos ska vara liten. Sådana områden går dock inte att undvika helt eftersom det är typiskt för dosplaner för brachyterapi att stråldosen fördelar sig ojämnt, med väldigt höga doser till små volymer precis intill strålkällorna. Vidare studeras hur små fel i inställningarna av skärmningen i IMBT påverkar dosplanens kvalitet och de olika utvärderingsmått som används kliniskt. Robust optimering har använts för att säkerställa att en dosplan tas fram som är robust sett till dessa möjliga fel i hur skärmningen är placerad. Slutligen ges en omfattande översikt över optimeringsmodeller för dosplanering av HDR BT och speciellt hur optimeringsmodellerna hanterar de motstridiga målsättningarna.

Accelerated Partial Breast Irradiation

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Author : Douglas W. Arthur
language : en
Publisher: Springer
Release Date : 2006-05-23

Accelerated Partial Breast Irradiation written by Douglas W. Arthur and has been published by Springer this book supported file pdf, txt, epub, kindle and other format this book has been release on 2006-05-23 with Medical categories.

This text is a concise handbook designed to assist the clinician in the implementation of Accelerated Partial Breast Irradiation (APBI). It includes a review of the principles that underlie APBI, a practical and detailed description of each technique for APBI, a review of current clinical results of APBI, and a review of the incidence and management of treatment related complications. The book encompasses a number of different techniques and approaches that include brachytherapy, intraoperative, and external beam techniques. There is currently no single source that describes these techniques and their clinical implementation.

A Practical Guide To Quality Control Of Brachytherapy Equipment

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Author : Margaret Bidmead
language : en
Publisher:
Release Date : 2004

A Practical Guide To Quality Control Of Brachytherapy Equipment written by Margaret Bidmead and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2004 with Europe categories.

Adaptive Radiation Therapy

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Author : X. Allen Li
language : en
Publisher: CRC Press
Release Date : 2011-01-27

Adaptive Radiation Therapy written by X. Allen Li and has been published by CRC Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2011-01-27 with Medical categories.

Modern medical imaging and radiation therapy technologies are so complex and computer driven that it is difficult for physicians and technologists to know exactly what is happening at the point-of-care. Medical physicists responsible for filling this gap in knowledge must stay abreast of the latest advances at the intersection of medical imaging an