The authors have developed a simplified and efficient protocol to measure doses delivered by an IMRT or VMAT plan using only the patient film, one calibration film, one unexposed film, and applying a single scan to acquire a digital image for calculation and analysis. The simplification and timesaving offer a potential practical solution for using radiochromic film for routine treatment plan quality assurance without sacrificing spatial resolution for convenience.

Many forms of relevant systematic errors can go undetected when the currently prevalent metrics for IMRT∕VMAT commissioning are used. If alternative methods and metrics are used instead of (or in addition to) the conventional metrics, these errors are more likely to be detected, and only once they are detected can they be properly diagnosed and rooted out of the system. Removing systematic errors should be a goal not only of commissioning by the end users but also product validation by the manufacturers. For any systematic errors that cannot be removed, detecting and quantifying them is important as it will help the physicist understand the limits of the system and work with the manufacturer on improvements. In summary, IMRT and VMAT commissioning, along with product validation, would benefit from the retirement of the 3%/3 mm passing rates as a primary metric of performance, and the adoption instead of tighter tolerances, more diligent diagnostics, and more thorough analysis.

No abstract

Objective To review the performance of non-invasive prenatal testing (NIPT) by low-coverage whole-genome sequencing of maternal plasma DNA at a single center. Methods

Objective To report secondary or additional findings arising from introduction of non-invasive prenatal testing (NIPT) for aneuploidy by whole genome sequencing as a clinical service.Methods Five cases with secondary findings were reviewed. ResultsIn Case 1, NIPT revealed a large duplication in chromosome 18p, which was supported by arrayCGH of amniocyte DNA, with final karyotype showing mosaic tetrasomy 18p. In Case 2, a deletion in the proximal long arm of chromosome 18 of maternal origin was suspected and confirmed by arrayCGH of maternal white cell DNA. In Case 3, NIPT was negative for trisomies 21 and 18. In-depth analysis for deletions/duplications was requested when fetal structural anomalies were detected at routine scan. A deletion in the proximal long arm of chromosome 3 was found and confirmed by karyotyping. In Case 4, NIPT correctly predicted confined placental mosaicism with triple trisomy involving chromosomes X, 7 and 21. In Case 5, NIPT correctly detected a previously unknown maternal mosaicism for 45X.Conclusion Non-invasive prenatal testing is able to detect a wide range of fetal, placental and maternal chromosomal abnormalities. This has important implications on patient counseling when an abnormality is detected by NIPT.

The work reported elaborates on the process using the correction procedures to eliminate the lateral response artifact and demonstrates improvements in the accuracy of radiochromic film dosimetry for the radiation therapy quality assurance applications.

Purpose: To study and compare the dose response curves of the new GafChromic EBT3 film for megavoltage and kilovoltage x-ray beams, with different spatial resolutions. Methods: EBT3 films (lot#A101711-02) were exposed to each x-ray beam (6 MV, 15 MV, and 50 kV) at 7 dose values (50-3200 cGy). Each film piece was scanned three consecutive times in the center of Epson 10000XL flatbed scanner in 48-bit color at two separate spatial resolutions of 75 and 300 dpi. The data were analyzed using ImageJ and, for each scanned image, a region of interest (ROI) of 2 × 2 cm 2 at the field center was selected to obtain the mean pixel value with its standard deviation in the ROI. For each energy, dose value and spatial resolution, the average net optical density (netOD) and its associated uncertainty were determined. The Student's t-test was performed to evaluate the statistical differences between the net OD/dose values of the three energy modalities, with different color channels and spatial resolutions. Results and Discussion: The dose response curves for the three energy modalities were compared in three color channels. Weak energy dependence was found. For doses above 100 cGy, no statistical differences were observed between 6 and 15 MV beams, regardless of spatial resolution and color channel. However, statistical differences were observed between 50 kV and the megavoltage beams. The degree of energy dependence (from MV to 50 kV) was found to be a function of color channel, dose level, and spatial resolution. Conclusions: The dose response curves for GafChromic EBT3 films were found to be weakly dependent on the energy of the photon beams from 6 MV to 15 MV. For very low energy photon (e.g. 50 kV), variation of more than 11% due to the energy-dependence is observed, depending on the absorbed dose, spatial resolution and color channel used.

Non-invasive prenatal screening for fetal Down syndrome (NIFTY) by maternal plasma sequencing was performed in 12 subjects with twin pregnancies, including 11 with normal fetuses and 1 with discordant fetal Trisomy 21. For every sample, it was processed, sequenced and reported as soon as it was collected as other clinical samples for singleton pregnancies. The NIFTY test was negative in the 11 pregnancies carried normal fetuses, and was positive (high risk) in the case with discordant fetal Trisomy 21. The sensitivity and specificity were both 100%. This small case series suggested the NIFTY as a screening test for fetal Trisomy 21 is feasible in twin pregnancies.