a b s t r a c tPurpose: To determine whether voluntary deep-inspiratory breath-hold (v_DIBH) and deep-inspiratory breath-hold with the active breathing coordinator™ (ABC_DIBH) in patients undergoing left breast radiotherapy are comparable in terms of normal-tissue sparing, positional reproducibility and feasibility of delivery. Methods: Following surgery for early breast cancer, patients underwent planning-CT scans in v_DIBH and ABC_DIBH. Patients were randomised to receive one technique for fractions 1-7 and the second technique for fractions 8-15 (40 Gy/15 fractions total). Daily electronic portal imaging (EPI) was performed and matched to digitally-reconstructed radiographs. Cone-beam CT (CBCT) images were acquired for 6/15 fractions and matched to planning-CT data. Population systematic (R) and random errors (r) were estimated. Heart, left-anterior-descending coronary artery, and lung doses were calculated. Patient comfort, radiographer satisfaction and scanning/treatment times were recorded. Within-patient comparisons between the two techniques used the paired t-test or Wilcoxon signed-rank test. Results: Twenty-three patients were recruited. All completed treatment with both techniques. EPIderived R were 61.8 mm (v_DIBH) and 62.0 mm (ABC_DIBH) and r 62.5 mm (v_DIBH) and 62.2 mm (ABC_DIBH) (all p non-significant). CBCT-derived R were 63.9 mm (v_DIBH) and 64.9 mm (ABC_DIBH) and r 6 4.1 mm (v_DIBH) and 6 3.8 mm (ABC_DIBH). There was no significant difference between techniques in terms of normal-tissue doses (all p non-significant). Patients and radiographers preferred v_DIBH (p = 0.007, p = 0.03, respectively). Scanning/treatment setup times were shorter for v_DIBH (p = 0.02, p = 0.04, respectively). Conclusions: v_DIBH and ABC_DIBH are comparable in terms of positional reproducibility and normal tissue sparing. v_DIBH is preferred by patients and radiographers, takes less time to deliver, and is cheaper than ABC_DIBH.
This work is a feasibility study to use a four-dimensional computed tomography (4D CT) dataset generated by a continuous motion model for treatment planning in lung radiotherapy. The model-based 4D CT data were derived from multiple breathing cycles. Four patients were included in this retrospective study. Treatment plans were optimized at end-exhale for each patient and the effect of respiratory motion on the dose delivery investigated. The accuracy of the delivered dose as determined by the number of intermediate respiratory phases used for the calculation was considered. The time-averaged geometry of the anatomy representing the mid-ventilation phase of the breathing cycle was generated using the motion model and a treatment plan was optimized for this phase for one patient. With respiratory motion included, the mid-ventilation plan achieved better target coverage than the plan optimized at end-exhale when standard margins were used to expand the clinical target volume (CTV) to planning target volume (PTV). Using a margin to account for set-up uncertainty only, resulted in poorer target coverage and healthy tissue sparing. For this patient cohort, the results suggest that conventional three-dimensional treatment planning was sufficient to maintain target coverage despite respiratory motion. The motion model has proved a useful tool in 4D treatment planning.
Planck is a European Space Agency (ESA) satellite, launched in May 2009, which will map the cosmic microwave background anisotropies in intensity and polarisation with unprecedented detail and sensitivity. It will also provide full-sky maps of astrophysical foregrounds. An accurate knowledge of the telescope beam patterns is an essential element for a correct analysis of the acquired astrophysical data. We present a detailed description of the optical design of the High Frequency Instrument (HFI) together with some of the optical performances measured during the calibration campaigns. We report on the evolution of the knowledge of the pre-launch HFI beam patterns when coupled to ideal telescope elements, and on their significance for the HFI data analysis procedure.
Breath-holding techniques reduce the amount of radiation received by cardiac structures during tangential-field left breast radiotherapy. With these techniques, patients hold their breath while radiotherapy is delivered, pushing the heart down and away from the radiotherapy field. Despite clear dosimetric benefits, these techniques are not yet in widespread use. One reason for this is that commercially available solutions require specialist equipment, necessitating not only significant capital investment, but often also incurring ongoing costs such as a need for daily disposable mouthpieces. The voluntary breath-hold technique described here does not require any additional specialist equipment. All breathholding techniques require a surrogate to monitor breath-hold consistency and whether breath-hold is maintained. Voluntary breath-hold uses the distance moved by the anterior and lateral reference marks (tattoos) away from the treatment room lasers in breath-hold to monitor consistency at CT-planning and treatment setup. Light fields are then used to monitor breath-hold consistency prior to and during radiotherapy delivery.
Multi-moded horn antennas are now being proposed for far-IR space imaging systems in which diraction limited resolution is not required (e.g. the High-Frequency Instrument (HFI) on the ESA PLANCK Surveyor). In such systems individual modes in the waveguide ®lter section feeding the horn can couple independently to an overmoded detector (such as a bolometer in an integrating cavity). The number of modes is chosen to optimize the coupling eciency to the source without compromising any spillover losses. We consider in detail the case of a cylindrically symmetric corrugated con®guration, presenting two alternative techniques for modelling such few-moded systems. The ®rst approach is based on a mode-matching description of propagation in a non-uniform waveguide structure, while the second approach makes use of hybrid mode solutions for a waveguide with corrugated walls assuming a uniform but non-isotropic impedance. We present practical examples comparing the radiation patterns predicted by both models.
The Planck High Frequency Instrument, HFI, has been designed to allow a clear unobscured view of the CMB sky through an offaxis Gregorian telescope. The prime science target is to measure the polarized anisotropy of the CMB with a sensitivity of 1 part in 10 6 with a maximum spatial resolution of 5 arcmin (C l ∼ 3000) in four spectral bands with two further high-frequency channels measuring total power for foreground removal. These requirements place critical constraints on both the telescope configuration and the receiver coupling and require precise determination of the spectral and spatial characteristics at the pixel level, whilst maintaining control of the polarisation. To meet with the sensitivity requirements, the focal plane needs to be cooled with the optics at a few Kelvin and detectors at 100 mK. To limit inherent instrumental thermal emission and diffraction effects, there is no vacuum window, so the detector feedhorns view the telescope secondary directly. This requires that the instrument is launched warm with the cooler chain only being activated during its cruise to L2. Here we present the novel optical configuration designed to meet with all the above criteria.
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