We performed the first comprehensive analysis on the dosimetric properties of an EPID operating at kilovoltage x-ray energies. We characterized the detector performance over a 11-month period. Our results indicate that the imager is a stable and convenient tool for SARRP routine QA tests. We then developed EPID-based tests to perform routine SA-IGRT systems QA tasks, such as verifying constancy of beam quality, energy, output, and profile measurements, relative output factors, and beam targeting.

We developed and validated a novel 2D transit/exit dosimetry for a kV SA-IGRT system using an EPID. We verified the accuracy of our method to measure EPID transit and exit dose distributions for a range of dose rates, beam attenuation, and collimation. Our results indicate that the EPID can be used as a simple, convenient device for kV dose delivery verification in small animal radiotherapy.

Building on previous literature I argue that the principle Maximize Presupposition! as standardly conceived is too permissive in that it sanctions certain utterances that are intuitively infelicitous. I propose as an alternative to MP a novel principle called Logical Integrity and I showed that while LI makes the same prediction as MP for the basic cases it is restrictive enough to account for the problematic cases discussed. Furthermore, I argue that LI without further ado make interesting predictions for a novel type of example, the cases discussed in Magri (2009), and Hurford's Constraint. Finally, I discuss and defused one potential counter-example to LI.

Purpose: The mechanical and geometric accuracy of small animal image-guided radiotherapy (SA-IGRT) systems is critical and is affected by a number of system-related factors. Because of the small dimensions involved in preclinical radiotherapy research, such factors can individually and/or cumulatively contribute to significant errors in the small animal radiation research. In this study, we developed and implemented a comprehensive quality assurance (QA) framework for characterizing the mechanical and geometric constancy and accuracy of the small animal radiation research platform (SARRP) system. Methods: We quantified the accuracy of gantry and stage rotation isocentricity and positional stage translations. We determined the accuracy and symmetry of field sizes formed by collimators. We evaluated collimator assembly system performance by characterization of collimator axis alignment along the beam axis during gantry rotation. Furthermore, we quantified the end-to-end precision and accuracy of image-guided delivery by examining the congruence of intended (e.g., imaging) and actual delivery (measured during experiment) isocenters. Results: The fine and broad beams showed different central axes. The center of the beam was offset toward the cathode (0.22 AE 0.05 mm) when switching the beam from a fine to a broad focus. Larger (custom-made) collimators were more symmetrically centered than smaller (standard) collimators. The field formed by a 1-mm circular collimator was found to deviate from the circular shape, measuring 1.55 mm and 1.25 mm in the X and Y directions, respectively. The 40-mm collimator showed a field that was 1.65 (4.13%) and 1.3 (3.25%) mm smaller than nominal values in the X and Y directions, respectively, and the 30-mm collimator field was smaller by 0.75 mm (2.5%) in the X direction. Results showed that fields formed by other collimators were accurate in both directions and had ≤2% error. The size of the gantry rotation isocenter was 1.45 AE 0.15 mm. While the gantry rotated, lateral and longitudinal isocenter displacements ranged from 0 to À0.34 and À0.44 to 0.33 mm, respectively. Maximum lateral and longitudinal displacements were found at obliques gantry angles of À135°and 45°, respectively. The stage translational accuracies were 0.015, 0.010, and 0 mm in the X, Y, and Z directions, respectively. The size of the stage rotation runout was 2.73 AE 0.3 mm. Maximum displacements of the stage rotational axis were À0.38 (X direction) and À0.26 (Y direction) mm at stage angles of À45°and À135°, respectively. We found that displacements of intended and actual delivery isocenters were 0.24 AE 0.10, 0.12 AE 0.62, and 0.12 AE 0.42 mm in the X, Y, and Z directions, respectively. Conclusion: We used the SARRP built-in electronic portal imaging device (EPID) to perform most of the geometric QA tests, demonstrating the utility of the EPID for characterizing the geometric accuracy and precision of the SA-IGRT system. However, in principle, the methodology and tests developed here are applicable to any digita...

Purpose: To accomplish novel radiation treatment techniques in preclinical radiation research, small animal image-guided radiotherapy systems have been increasingly integrated into preclinical radiation research over the last decade. Although such systems have sophisticated tools (such as conebeam computed tomography-based image guidance, robotic couch, treatment planning system (TPS), and electronic portal imaging devices [EPIDs]). To our knowledge, no established technique can perform independent and online verification of the delivered dose during radiotherapy. In this study, we implement an online EPID dosimetry for each administered SA-IGRT fraction in a rat orthotopic model of prostate cancer. Methods: To verify the accuracy of delivered dose to rat, we compared the two-dimensional (2D) calculated dose distribution by TPS as the planned dose, with online dose distribution estimated using an EPID as the delivered dose. Since image acquisition software was not capable of acquiring integrated images over a long period of time, we used the EPID to estimate dose rate rather than dose. The central axis (CAX) dose rate values at the beam's exit surface were compared. In addition, 2D dose distributions were also compared under different gamma criteria. To verify the accuracy of our EPID dosimetry technique, we measured transit and exit doses with film during animal treatment. In this study, 20-mm cone was used to collimate beam. We previously observed that the EPID response was independent of collimator size for collimator size ≥15-mm, we did not apply for additional correction factor. Results: Comparison of exit CAX dose rate values of TPS-calculated and EPID-estimated showed that the average difference was 3.1%, with a maximum of 9.3%. Results of gamma analysis for 2D comparison indicated an average of 90% passing rate with global gamma criterion of 2 mm/5%. We observed that TPS could not calculate dose accurately in peripheral regions in which the penumbra effect was dominant. Dose rate values estimated by EPID were within 2.1% agreement with film at both the imager plane and the beam's exit surface for 4 randomly selected animals for which film measurement verification was performed. Conclusions: The small animal radiation research platform (SARRP) system's built-in EPID was utilized to estimate dose delivered to rats at kilovoltage energy x-rays. The results of this study suggest that the EPID is an invaluable tool for verifying delivered dose to small animal to help validate conclusions made from preclinical radiation research.

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Prostate cancer is the second most frequent cancer among males worldwide. 1,2 Most cases are locoregional disease, with excellent prognosis; 5-, 10-, and 15 year relative survival rates are 99%, 98%, and 96%, respectively. Among patients treated for locoregional disease, approximately one-third receive some form of radiation therapy (RT). 3 Given the high rates of long-term survival of these patients, increased interest has focused on long-term post-RT toxicities, which include radiation-induced erectile dysfunction (RiED), bowel dysfunction, and urinary dysfunction. 4 Mounting evidence from clinical studies, including the Prostate Cancer Outcomes Study 4 and the recently matured multi institutional Phase III randomized ProtecT trial, 5 indicates that patients with posttreatment side-effects consistently experience moderate-to-severe loss of quality of life (QoL).Approaches to mitigate post-RT toxicity are based on: (a) dosimetric avoidance of critical structures through more frequent image guidance, RT plan optimization, and in-room real-time motion monitoring, as well as realtime adaptive dose delivery 6 ; (b) phosphodiesterase Type