Journal of Medical Physics
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   2007| January-March  | Volume 32 | Issue 1  
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Dosimetric comparison of linear accelerator-based stereotactic radiosurgery systems
SD Sharma, Sudhir Kumar, SS Dagaonkar, Geetika Bisht, S Dayanand, Reena Devi, SS Deshpande, S Chaudhary, BC Bhatt, S Kannan
January-March 2007, 32(1):18-23
DOI:10.4103/0971-6203.31145  PMID:21217914
Stereotactic radiosurgery (SRS) is a special radiotherapy technique used to irradiate intracranial lesions by 3-D arrangements of narrow photon beams eliminating the needs of invasive surgery. Three different tertiary collimators, namely BrainLab and Radionics circular cones and BrainLab micro multileaf collimator (mMLC), are used for linear accelerator-based SRS systems (X-Knife). Output factor (St), tissue maximum ratio (TMR) and off axis ratio (OAR) of these three SRS systems were measured using CC01 (Scanditronix/ Welhofer) and Pinpoint (PTW) cylindrical and Markus plane parallel ionization chambers as well as TLD and radiochromic film. Measurement results of CC01 and Pinpoint chambers were very close to each other which indicate that further reduction in volume and physical dimensions of cylindrical ionization chamber is not necessary for SRS/SRT dosimetry. Output factors of BrainLab and Radionics SRS cones were very close to each other while output factors of equivalent diameter mMLC field were different from SRS circular cones. TMR of the three SRS systems compared were very close to one another. OAR of Radionics cone and BrainLab mMLC were very close to each other, within 2%. However, OARs of BrainLab cone were found comparable to OARs of Radionics cone and BrainLab mMLC within maximum variation of 4%. In addition, user-measured similar data of other three mMLC X-Knives were compared with the mMLC X-Knife data measured in this work and found comparable. The concept of switching over to mMLC-based SRS/SRT is thus validated from dosimetric characteristics as well.
  4 9,402 866
Impact of different breathing conditions on the dose to surrounding normal structures in tangential field breast radiotherapy
Ramachandran Prabhakar, Ganesh Tharmar, Pramod K Julka, Goura K Rath, Rakesh C Joshi, Anil K Bansal, RK Bisht, N Gopishankar, GS Pant, S Thulkar
January-March 2007, 32(1):24-28
DOI:10.4103/0971-6203.31146  PMID:21217915
Cardiac toxicity is an important concern in tangential field breast radiotherapy. In this study, the impact of three different breathing conditions on the dose to surrounding normal structures such as heart, ipsilateral lung, liver and contralateral breast has been assessed. Thirteen patients with early breast cancer who underwent conservative surgery (nine left-sided and four right-sided breast cancer patients) were selected in this study. Spiral CT scans were performed for all the three breathing conditions, viz., deep inspiration breath-hold (DIBH), normal breathing phase (NB) and deep expiration breath-hold (DEBH). Conventional tangential fields were placed on the 3D-CT dataset, and the parameters such as V30 (volume covered by dose >30 Gy) for heart, V20 (volume covered by dose >20 Gy) for ipsilateral lung and V50 (volume receiving >50% of the prescription dose) for heart and liver were studied. The average reduction in cardiac dose due to DIBH was 64% (range: 26.5-100%) and 74% (range: 37-100%) as compared to NB and DEBH respectively. For right breast cancer, DIBH resulted in excellent liver sparing. Our results indicate that in patients with breast cancer, delivering radiation in deep inspiration breath-hold condition can considerably reduce the dose to the surrounding normal structures, particularly heart and liver.
  4 5,098 410
Principles and limitations of NMR diffusion measurements
Jan Hrabe, Gurjinder Kaur, David N Guilfoyle
January-March 2007, 32(1):34-42
DOI:10.4103/0971-6203.31148  PMID:21217917
Diffusion spectroscopy, imaging and particularly diffusion tensor imaging have become popular thanks to their numerous clinical and research applications which span from brain stroke evaluation to fiber tracking. With a few exceptions, these methods are rooted in the classic Stejskal-Tanner formula for the diffusion-attenuated signal, usually obtained by solving the Bloch-Torrey partial differential equations. Here we derive the Stejskal-Tanner formula in the simplest possible manner, avoiding integrals and differential equations. This approach makes it easy to understand the origin of the diffusion signal attenuation, the effects of various diffusion sequence parameters, and also the numerous important pitfalls, which are discussed in the last section.
  4 10,504 746
A year of JMP online
AS Pradhan
January-March 2007, 32(1):1-2
DOI:10.4103/0971-6203.31142  PMID:21217911
  2 2,913 242
Characterizing and configuring motorized wedge for a new generation telecobalt machine in a treatment planning system
Rajesh A Kinhikar, Smriti Sharma, Rituraj Upreti, Chandrashekhar M Tambe, Deepak D Deshpande
January-March 2007, 32(1):29-33
DOI:10.4103/0971-6203.31147  PMID:21217916
A new generation telecobalt unit, Theratron Equinox-80, (MDS Nordion, Canada) has been evaluated. It is equipped with a single 60-degree motorized wedge (MW), four universal wedges (UW) for 150, 300, 450 and 600. MW was configured in Eclipse (Varian, Palo Alto, USA) 3D treatment planning system (TPS). The profiles and central axis depth doses (CADD) were measured with radiation field analyzer blue water phantom for MW. These profiles and CADD for MW were compared with UW in a homogeneous phantom generated in Eclipse for various field sizes. The absolute dose was measured for a field size of 10 x 10 cm2 only in a MEDTEC water phantom at 10 cm depth with a 0.13 cc thimble ion chamber (Scanditronix Wellhofer, Uppsala, Sweden) and a NE electrometer (Nuclear Enterprises, UK). Measured dose with ion chamber was compared with the TPS predicted dose. MW angle was verified on the Equinox for four angles (15o, 30o, 45o and 60o). The variation in measured and calculated dose at 10 cm depth was within 2%. The measured and the calculated wedge angles were in well agreement within 2o. The motorized wedges were successfully configured in Eclipse for four wedge angles.
  2 6,837 482
Advantages of mini-multileaf in stereotactic radiotherapy
PGG Kurup, V Murali, A Sankar
January-March 2007, 32(1):12-17
DOI:10.4103/0971-6203.31144  PMID:21217913
Over the past few decades, cones of different diameter (12.5 mm to 40 mm) were used for treatment of intracranial lesions. These give very focused dose delivery to the target with minimum dose to outside normal brain tissues. This study is intended to compare the older method of arc-based stereotactic treatments using cones with the new mini-multileaf collimator (mMLC). Treatment plans are made for various sites of intracranial lesions with the cones and mMLC. In case of nonspherical lesions, more than one isocenter is used to get an optimum dose distribution with cones, while a single isocenter is sufficient with mMLC. Treatment plans are compared for irregular lesions using cones with multiple isocenters and mMLC. It is observed that conformity index and dose heterogeneity are better for mMLC based treatments.
  1 4,403 426
Determination of absorbed dose to water for high-energy photon and electron beams-comparison of the standards DIN 6800-2 (1997), IAEA TRS 398 (2000) and DIN 6800-2 (2006)
Golam Abu Zakaria, Wilhelm Schuette
January-March 2007, 32(1):3-11
DOI:10.4103/0971-6203.31143  PMID:21217912
For the determination of the absorbed dose to water for high-energy photon and electron beams the IAEA code of practice TRS-398 (2000) is applied internationally. In Germany, the German dosimetry protocol DIN 6800-2 (1997) is used. Recently, the DIN standard has been revised and published as Draft National Standard DIN 6800-2 (2006). It has adopted widely the methodology and dosimetric data of the code of practice. This paper compares these three dosimetry protocols systematically and identifies similarities as well as differences. The investigation was done with 6 and 18 MV photon as well as 5 to 21 MeV electron beams. While only cylindrical chambers were used for photon beams, measurements of electron beams were performed using cylindrical as well as plane-parallel chambers. The discrepancies in the determination of absorbed dose to water between the three protocols were 0.4% for photon beams and 1.5% for electron beams. Comparative measurements showed a deviation of less than 0.5% between our measurements following protocol DIN 6800-2 (2006) and TLD inter-comparison procedure in an external audit.
  - 10,721 967
T Ganesh
January-March 2007, 32(1):43-44
  - 2,713 172
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