Purpose: SRS/SBRT combines hypofractionation with excellent dose distributions. However, extremely steep gradients across the target along with dose escalation, if not administered accurately, may lead to serious complications, recurrences, or even fatalities. Existing commercial QA products either lack adequate spatial resolution or the 3D aspect. By contrast, the new CrystalBall™ mailed high‐resolution 3D dosimetry service removes the above limitations while reducing the overall workload on medical physics staff. The exposed dosimeters, which change optical density in proportion to local dose, are sent back to the manufacturer (MGS Research Inc., Madison, CT) for sub‐millimeter‐resolution laser‐CT scanning and QA data analysis. QA report is returned electronically within 24 hours. The purpose of this study was to evaluate the dose calibration accuracy in this system. Methods: Two spherical CrystalBall™ polymer gel dosimeters from the same batch, 166 mm diameter, with embedded 3D image registration markers, were mounted in a special phantom designed for reproducible positioning. For full end to end testing, the optical guidance array was mounted onto the phantom and a CT was taken. Two separate Rapid Arc SRS plans were designed. Varian Medical Systems optical guidance system was used to position the phantom and the SRS treatment plans were delivered to the two spheres on Varian's Trilogy Accelerator. Exposed dosimeters were mailed back to the manufacturer for laser CT scanning and analysis. Results: For each plan, 3D gamma passing rate was 100% for 2%/2mm distance‐to‐agreement criteria above 50% isodose level. The two calibration curves, generated using volumetric dose and optical density data, showed excellent mutual agreement (max difference 2.2%, median difference 0.75%). Conclusion: The clinical utility of new CrystalBall™ mailed QA service for SRS/SBRT and high accuracy of dose calibration have been validated. The workflow associated with the use of the CrystalBall™ in clinical setting was found to be minimal. The presenting author is the founder of and has an ownership in MGS Research Inc which manufactures the CrystalBall system for 3D dosimetry.
PurposeA multicenter, double‐arm, central core lab, retrospective study was performed to compare the rectal dosimetry of patients implanted with two injectable, biodegradable perirectal spacers, in conventional fractionation (CF), as well as ultrahypofractionation (UH) treatment plans.Methods and materialsFifty‐nine patients were enrolled into the study in five centers: two centers in Europe, which implanted a biodegradable balloon spacer in a total of 24 subjects and three centers in the US, which implanted the SpaceOAR in 35 subjects. Anonymized CTs (pre and post‐implantation) were reviewed by the central core lab. For VMAT CF plans rectal V50, V60, V70, and V80 were calculated. For UH plans, a corresponding rectal V22.6, V27.1, V31.37, and V36.25 were established representing 62.5%, 75%, 87.5%, and 100% of the 36.25 Gy prescribed dose.ResultsFor CF VMAT, a comparison between the balloon spacer and the SpaceOAR revealed a significant difference of 33.4% decrease in mean rectal V50 (71.9% vs. 38.5%, p < 0.001), 27.7% in mean rectal V60 (79.6% vs. 51.9%, p < 0.001), 17.1% difference in mean rectal V70 (84.1% vs. 67.0%, p = 0.001), and a significant difference of 3.0% (p = 0.019) in mean rectal V80 (87.2% vs. 84.2%). With UH analysis, the mean rectal dose reduction for the balloon spacer compared to the SpaceOAR was 79.2% and 53.3% for V27.1 (p < 0.001), 84.1% and 68.1% for V31.71 (p = 0.001), and 89.7% and 84.8% for V36.25 (p = 0.012), respectively.ConclusionRectal dosimetry is more favorable for treatment with the balloon spacer compared with SpaceOAR. Further research, particularly in the context of a prospective randomized clinical trial design, is needed to assess the acute and late toxicity experience as well as physician satisfaction with achieving symmetrical implantation, and ease of use in light of increasing clinical use.
Purpose: Varian's new RapidArc radiotherapy technology is a fast form of precise radiotherapy that targets tumor dose while minimizing dose to surrounding healthy tissue. Treatment is given in as little as one gantry rotation. Most QA analysis of RapidArc plans is based upon a single plane. The assumption is that if the QA passes in one plane, the results are sufficient for all planes. Dosimetry Check (Math Resolutions, LLC) recently implemented software to verify the volumetric dose throughout the patients CT data set using EPID images. The purpose of this work is to present the results of patient's volumetric verification utilizing the EPID detector and Dosimetry Check software. Methods and Material: 1) A RapidArc plan is generated for a patient 2) The patient's RapidArc QA plan is scheduled for QA on the LINAC. An integrated image sequence template is associated with the plan for EPID imaging. 3) As the treatment is delivered to EPID, the beam is turned on/off to generate 36 subarcs every 10 degrees. A 10×10 calibrate image is measured. 4) The EPID image along with the 10×10 calibration film is transferred to Dosimetry Check. The patients 3D CT dicom data set along with the structure set and dose matrix is transferred to dosimetry check. Results: RapidArc treatments were verified with Dosimetry Check software. The average gamma using criteria of 3% dose difference/3mm DTA was 98%. The measured verse predicted DVHs of PTVs as well as critical structure showed excellent results. The isodose overlays, dose profiles, point doses, dose differentials and GammaValue histogram were within acceptable tolerances. Conclusion Due to the complexity of the delivery of 3D dose using RapidArc technology, a tool to evaluate the 3D dose distribution is needed. The results using Dosimetry Check validated our RapidArc treatments in our Clinac.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.