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At least 757 records · Page 42

A Novel Approach to Postmastectomy Radiation Therapy Using Scanned Proton Beams

Purpose: Postmastectomy radiation therapy (PMRT), currently offered at Massachusetts General Hospital, uses proton pencil beam scanning (PBS) with intensity modulation, achieving complete target coverage of the chest wall and all nodal regions and reduced dose to the cardiac structures. This work presents the current methodology for such treatment and the ongoing effort for its improvements. Methods and Materials: A single PBS field is optimized to ensure appropriate target coverage and heart/lung sparing, using an in–house-developed proton planning system with the capability of multicriteria optimization. The dose to the chest wall skin is controlled as a separate objective in the optimization. Surface imaging is used for setup because it is a suitable surrogate for superficial target volumes. In order to minimize the effect of beam range uncertainties, the relative proton stopping power ratio of the material in breast implants was determined through separate measurements. Phantom measurements were also made to validate the accuracy of skin dose calculation in the treatment planning system. Additionally, the treatment planning robustness was evaluated relative to setup perturbations and patient breathing motion. Results: PBS PMRT planning resulted in appropriate target coverage and organ sparing, comparable to treatments by passive scattering (PS) beams but much improved in nodal coverage and cardiac sparing compared to conventional treatments by photon/electron beams. The overall treatment time was much shorter than PS and also shorter than conventional photon/electron treatment. The accuracy of the skin dose calculation by the planning system was within ±2%. The treatment was shown to be adequately robust relative to both setup uncertainties and patient breathing motion, resulting in clinically satisfying dose distributions. Conclusions: More than 25 PMRT patients have been successfully treated at Massachusetts General Hospital by using single-PBS fields. The methodology and robustness of both the setup and the treatment have been discussed.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

A Flux Detection Probe to Quantify Dynamic Groundwater-Surface Water Exchange in the Hyporheic Zone

A new probe was designed to quantify groundwater-surface water exchange in the hyporheic zone under dynamic stage condition. Current methods focus on either vertical pore water velocity or Darcy flux measurements. Both parameters must be understood to evaluate residence time and mass flux of constituents. Furthermore, most instruments are not well suited for monitoring instantaneous velocity or flux under dynamic exchange conditions. For this reason, the flux detection probe (FDP) was designed that employs electrogeophysical measurements to estimate in situ sediment porosity, which can be used to convert pore water velocity to Darcy flux. Dynamic pore water velocity is obtained by monitoring fluid conductivity and temperature along the FDP probe. Pressure sensors deployed at the top and bottom of the probe provide the additional information necessary to estimate vertical permeability. This study focuses on the use of a geophysical method to estimate pore water velocity, porosity, and permeability within a controlled soil column where simulated river water displaces simulated groundwater. The difference between probe derived and theoretical pore water velocity using natural tracers such as electrical conductivity and temperature was -4.9 and 3.9% for downward flow and 1.1 and 12.8% for upward flow, respectively. The difference in porosity calculated from mass and volume packed in the soil column and probe measure porosity ranged between -3.2% and 1.5%. Also, the calculated hydraulic conductivity differed from probe derived values by -8.9%.

54 ENVIRONMENTAL SCIENCES↗

Carbon Dioxide Removal Troubleshooting aboard the International Space Station (ISS) during Space Shuttle (STS) Docked Operations

The International Space Station (ISS) represents a largely closed-system habitable volume which requires active control of atmospheric constituents, including removal of exhaled Carbon Dioxide (CO2). The ISS provides a unique opportunity to observe system requirements for (CO2) removal. CO2 removal is managed by the Carbon Dioxide Removal Assembly (CDRA) aboard the US segment of ISS and by Lithium Hydroxide (LiOH) aboard the Space Shuttle (STS). While the ISS and STS are docked, various methods are used to balance the CO2 levels between the two vehicles, including mechanical air handling and management of general crew locations. Over the course of ISS operation, several unexpected anomalies have occurred which have required troubleshooting, including possible compromised performance of the CDRA and LiOH systems, and possible imbalance in CO2 levels between the ISS and STS while docked. This paper will cover efforts to troubleshoot the CO2 removal systems aboard the ISS and docked STS.

Matty, Christopher M.↗

Reversible, on-demand generation of aqueous two-phase microdroplets

The present invention provides methods of on-demand, reversible generation of aqueous two-phase microdroplets core-shell microbeads, microparticle preparations comprising the core-shell microbeads, and drug delivery formulation comprising the microparticle preparations. Because these aqueous microdroplets have volumes comparable to those of cells, they provide an approach to mimicking the dynamic microcompartmentation of biomaterial that naturally occurs within the cytoplasm of cells. Hence, the present methods generate femtoliter aqueous two-phase droplets within a microfluidic oil channel using gated pressure pulses to generate individual, stationary two-phase microdroplets with a well-defined time zero for carrying out controlled and sequential phase transformations over time. Reversible phase transitions between single-phase, two-phase, and core-shell microbead states are obtained via evaporation-induced dehydration and water rehydration.

59 BASIC BIOLOGICAL SCIENCES↗

A Remote, Human-in-the-Loop Evaluation of a Multiple-Drone Delivery Operation

Over time, advances in unmanned aircraft systems (UAS) have enabled a shift in the operational paradigm from one operator managing one aircraft to that of multiple operators working together to manage multiple aircraft. This shift has highlighted the need for effective human-autonomy teaming methods to maintain manageable workload levels for operators as well as high standards of system performance and safety. This paper presents a study aimed at evaluating whether automation can help operators manage workload during small UAS (sUAS) package delivery scenarios featuring contingency situations. These contingency situations, resulting from unplanned UAS Volume Reservations (UVRs), required flight path reroutes for multiple aircraft simultaneously. The study manipulated the number of aircraft affected by the UVRs and the level of automation support. The presence of terrain conflicts was also controlled within each scenario. Due to the COVID-19 pandemic, subjects were not able to gain direct access to the Ground Control System (GCS). Therefore, the study was conducted using a subject-surrogate paradigm that required subjects to relay commands through a verbal protocol from remote locations outside of the lab to a researcher surrogate who had direct control of the GCS interfaces at the lab location. Results show that the automated support condition was associated with faster reroute response times, more efficient reroute maneuvers, and significantly lower levels of perceived workload than the manual reroute condition. However, the automation support level did not significantly impact pilots’ ability to avoid the UVR successfully; pilots were overwhelmingly capable of avoiding the UVR in all conditions. The presence of terrain conflicts primarily impacted pilot performance by leading to multiple uploads per vehicle, which was not typically required when pilots only needed to maneuver laterally. Although subjects did not have direct control over the GCS, subjective ratings indicate that the displays under test provided them with sufficient information to manage their aircraft and promptly respond to the unplanned UVRs. Overall, the objective and subjective data strongly suggest that the verbal protocol and subject-surrogate paradigm were effective methods for collecting data remotely amid the COVID-19 pandemic.

multi-UAS↗

PAN AIR: A computer program for predicting subsonic or supersonic linear potential flows about arbitrary configurations using a higher order panel method. Volume 4: Maintenance document (version 1.1)

The Maintenance Document is a guide to the PAN AIR software system, a system which computes the subsonic or supersonic linear potential flow about a body of nearly arbitrary shape, using a higher order panel method. The document describes the over-all system and each program module of the system. Sufficient detail is given for program maintenance, updating and modification. It is assumed that the reader is familiar with programming and CDC (Control Data Corporation) computer systems. The PAN AIR system was written in FORTRAN 4 language except for a few COMPASS language subroutines which exist in the PAN AIR library. Structured programming techniques were used to provide code documentation and maintainability. The operating systems accommodated are NOS 1.2, NOS/BE and SCOPE 2.1.3 on the CDC 6600, 7600 and Cyber 175 computing systems. The system is comprised of a data management system, a program library, an execution control module and nine separate FORTRAN technical modules. Each module calculates part of the posed PAN AIR problem. The data base manager is used to communicate between modules and within modules. The technical modules must be run in a prescribed fashion for each PAN AIR problem. In order to ease the problem of supplying the many JCL cards required to execute the modules, a separate module called MEC (Module Execution Control) was created to automatically supply most of the JCL cards. In addition to the MEC generated JCL, there is an additional set of user supplied JCL cards to initiate the JCL sequence stored on the system.

Baruah, P. K.↗

AMCC casting development. Volume 1: Executive Summary

The Advanced Combustion Chamber Casting (AMCC) has been a technically challenging part due to its size, configuration, and alloy type. The height and weight of the wax pattern assembly necessitated the development of a hollow gating system to ensure structural integrity of the shell throughout the investment process. The complexity in the jacket area of the casting required the development of an innovative casting technology that PCC has termed 'TGC' or Thermal Gradient Control. This method, of setting up thermal gradients in the casting during solidification, represents a significant process improvement for PCC and has been successfully implemented on other programs. Metallurgical integrity of the final four castings was very good. Only the areas of the parts that utilized 'TGC Shape & Location System #2' showed any significant areas of microshrinkage when evaluated by non-destructive tests. Alumina oxides detected by FPI on the 'float' surfaces (top sid surfaces of the casting during solidification) of the part were almost entirely less than the acceptance criteria of .032 inches in diameter. Destructive chem mill of the castings was required to determine the effect of the process variables used during the processing of these last four parts (with the exception of the 'Shape & Location of TGC' variable).

Source record↗

Systematic evaluation of four-dimensional hybrid depth scanning for carbon-ion lung therapy

Purpose: Irradiation of a moving target with a scanning beam requires a comprehensive understanding of organ motion as well as a robust dose error mitigation technique. The authors studied the effects of intrafractional respiratory motion for carbon-ion pencil beam scanning with phase-controlled rescanning on dose distributions for lung tumors. To address density variations, they used 4DCT data. Methods: Dose distributions for various rescanning methods, such as simple layer rescanning (LR), volumetric rescanning, and phase-controlled rescanning (PCR), were calculated for a lung phantom and a lung patient studies. To ensure realism, they set the scanning parameters such as scanning velocity and energy variation time to be similar to those used at our institution. Evaluation metrics were determined with regard to clinical relevance, and consisted of (i) phase-controlled rescanning, (ii) sweep direction, (iii) target motion (direction and amplitude), (iv) respiratory cycle, and (v) prescribed dose. Spot weight maps were calculated by using a beam field-specific target volume, which takes account of range variations for respective respiratory phases. To emphasize the impact of intrafractional motion on the dose distribution, respiratory gating was not used. The accumulated dose was calculated by applying a B-spline-based deformable image registration, and the results for phase-controlled layered rescanning (PCR{sub L}) and phase-controlled volumetric rescanning (PCR{sub V}) were compared. Results: For the phantom study, simple LR was unable to improve the dose distributions for an increased number of rescannings. The phase-controlled technique without rescanning (1 Multiplication-Sign PCR{sub L} and 1 Multiplication-Sign PCR{sub V}) degraded dose conformity significantly due to a reduced scan velocity. In contrast, 4 Multiplication-Sign PCR{sub L} or more significantly and consistently improved dose distribution. PCR{sub V} showed interference effects, but in general also improved dose homogeneity with higher numbers of rescannings. Dose distributions with single PCR{sub L}/PCR{sub V} with a sweep direction perpendicular to motion direction showed large hot/cold spots; however, this effect vanished with higher numbers of rescannings for both methods. Similar observations were obtained for the other dose metrics, such as target motion (SI/AP), amplitude (6-22 mm peak-to-peak) and respiratory period (3.0-5.0 s). For four or more rescannings, both methods showed significantly better results, albeit that volumetric PCR was more affected by interference effects, which lead to severe degradation of a few dose distributions. The clinical example showed the same tendencies as the phantom study. Dose assessment metrics (D95, Dmax/Dmin, homogeneity index) were improved with an increasing number of PCR{sub L}/PCR{sub V}, but with PCR{sub L} being more robust. Conclusions: PCR{sub L} requires a longer treatment time than PCR{sub V} for high numbers of rescannings in the NIRS scanning system but is more robust. Although four or more rescans provided good dose homogeneity and conformity, the authors prefer to use more rescannings for clinical cases to further minimize dose degradation effects due to organ motion.

60 APPLIED LIFE SCIENCES↗

Cardiovascular response to lower body negative pressure stimulation before, during, and after space flight

BACKGROUND: It is well known that space travel cause post-flight orthostatic hypotension and it was assumed that autonomic cardiovascular control deteriorates in space. Lower body negative pressure (LBNP) was used to assess autonomic function of the cardiovascular system. METHODS: LBNP tests were performed on six crew-members before and on the first days post-flight in a series of three space missions. Additionally, two of the subjects performed LBNP tests in-flight. LBNP mimics fluid distribution of upright posture in a gravity independent way. It causes an artificial sequestration of blood, reduces preload, and filtrates plasma into the lower part of the body. Fluid distribution was assessed by bioelectrical impedance and anthropometric measurements. RESULTS: Heart rate, blood pressure, and total peripheral resistance increased significantly during LBNP experiments in-flight. The decrease in stroke volume, the increased pooling of blood, and the increased filtration of plasma into the lower limbs during LBNP indicated that a plasma volume reduction and a deficit of the interstitial volume of lower limbs rather than a change in cardiovascular control was responsible for the in-flight response. Post-flight LBNP showed no signs of cardiovascular deterioration. The still more pronounced haemodynamic changes during LBNP reflected the expected behaviour of cardiovascular control faced with less intravascular volume. In-flight, the status of an intra-and extravascular fluid deficit increases sympathetic activity, the release of vasoactive substances and consequently blood pressure. Post-flight, blood pressure decreases significantly below pre-flight values after restoration of volume deficits. CONCLUSION: We conclude that the cardiovascular changes in-flight are a consequence of a fluid deficit rather than a consequence of changes in autonomic signal processing.

manned↗

Particle control near reticle and optics using showerhead

A method and an apparatus to protect a reticle against particles and chemicals in an actinic EUV reticle inspection tool are presented. The method and apparatus utilizes a pair of porous metal diffusers in the form of showerheads to provide a continual flow of clean gas. The main showerhead bathes the reticle surface to be inspected in smoothly flowing, low pressure gas, isolating it from particles coming from surrounding volumes. The secondary showerhead faces away from the reticle and toward the EUV illumination and projection optics, supplying them with purge gas while at the same time creating a buffer zone that is kept free of any particle contamination originating from those optics.

36 MATERIALS SCIENCE↗

Anomalous solute transport in saturated porous media: Relating transport model parameters to electrical and nuclear magnetic resonance properties

Abstract The advection‐dispersion equation (ADE) fails to describe commonly observed non‐Fickian solute transport in saturated porous media, necessitating the use of other models such as the dual‐domain mass‐transfer (DDMT) model. DDMT model parameters are commonly calibrated via curve fitting, providing little insight into the relation between effective parameters and physical properties of the medium. There is a clear need for material characterization techniques that can provide insight into the geometry and connectedness of pore spaces related to transport model parameters. Here, we consider proton nuclear magnetic resonance (NMR), direct‐current (DC) resistivity, and complex conductivity (CC) measurements for this purpose, and assess these methods using glass beads as a control and two different samples of the zeolite clinoptilolite, a material that demonstrates non‐Fickian transport due to intragranular porosity. We estimate DDMT parameters via calibration of a transport model to column‐scale solute tracer tests, and compare NMR, DC resistivity, CC results, which reveal that grain size alone does not control transport properties and measured geophysical parameters; rather, volume and arrangement of the pore space play important roles. NMR cannot provide estimates of more‐mobile and less‐mobile pore volumes in the absence of tracer tests because these estimates depend critically on the selection of a material‐dependent and flow‐dependent cutoff time. Increased electrical connectedness from DC resistivity measurements are associated with greater mobile pore space determined from transport model calibration. CC was hypothesized to be related to length scales of mass transfer, but the CC response is unrelated to DDMT.

Swanson, Ryan D.↗

High performance porous Si anode enabled by an organic-solvent assisted etching process

Silicon (Si) is a promising anode for the next generation of lithium-ion batteries, but its large volume changes (~300 %) during cycling hindered its practical applications. One method to improve its stability is to etch micron sized Si/SiO 2 particles to form porous Si (p-Si) and accommodate volume changes internally. However, the conventional HF etching method generates excess gas/heat and is difficult to scale up. Herein, we developed an organic-solvent-assisted HF etching process (O-HF) using a mixture of benzene and saturated HF aqueous solution. The organic solvent can be preferentially absorbed on the surface of Si/SiO 2 powder so etching rate of SiO 2 can be controlled to avoid rapid gas/heat generation. This method can also prevent over-etching of Si by minimizing direct contact/react between water and newly exposed Si. Si||NMC622 cells using carbon coated p-Si particles prepared by optimized O-HF etching process demonstrate a capacity retention of 82.0 % after 500 cycles, which is much better than those prepared by conventional HF etching (73.7 %). The thickness of Si anode increases only ~10 % during the initial lithiation, which is comparable with those of graphite anode. In conclusion, the O-HF etching strategy developed in this work can also be applied to the etching of a broad range of materials.

HF etching↗

Making ultrafine and highly-dispersive multimetallic nanoparticles in three-dimensional graphene with supercritical fluid as excellent electrocatalyst for oxygen reduction reaction

Three-dimensional (3D) graphene showed an advanced support for designing porous electrode materials due to its high specific surface area, large pore volume, and excellent electronic property. However, the electrochemical properties of reported porous electrode materials still need to be improved further. The current challenge is how to deposit desirable nanoparticles (NPs) with controllable structure, loading and composition in 3D graphene while maintaining the high dispersion. Herein, we demonstrate a modified supercritical fluid (SCF) technique to address this issue by controlling the SCF system. Using this superior method, a series of Pt-based/3D graphene materials with the ultrafine-sized, highly dispersive and controllable composition multimetallic NPs were successfully synthesized. Specifically, the resultant Pt40Fe60/3D graphene showed a significant enhancement in electrocatalytic performance for the oxygen reduction reaction (ORR), including a factor of 14.2 enhancement in mass activity (1.70 A mgPt 1), a factor of 11.9 enhancement in specific activity (1.55 mA cm 2 ), and higher durability compared with that of Pt/C catalyst. After careful comparison, the Pt40Fe60/3D graphene catalyst shows the higher ORR activity than most of the reported similar 3D graphene-based catalysts. The successful synthesis of such attractive materials by this method also paves the way to develop 3D graphene in widespread applications.

37 INORGANIC, ORGANIC, PHYSICAL, AND ANALYTICAL CH↗

Structure of iso-density sets in supersonic isothermal turbulence

Context: The gas density structure of the cold molecular phase of the interstellar medium is the main controller of star formation. Aims: A theoretical framework is proposed to describe the structural content of the density field in isothermal supersonic turbulence. Methods: It makes use of correlation and structure functions of the phase indicator field defined for different iso-density values. The relations between these two-point statistics and the geometrical features of iso-density sets such as the volume fraction, the surface density, the curvature, and fractal characteristics are provided. An exact scale-by-scale budget equation is further derived revealing the role of the turbulent cascade and dilation on the structural evolution of the density field. Although applicable to many flow situations, this tool is here first invoked for characterising supersonic isothermal turbulence, using data from the currently best-resolved numerical simulation. Results: We show that iso-density sets are surface fractals rather than mass fractals, with dimensions that markedly differ between dilute, neutral, and dense regions. The surface–size relation is established for different iso-density values. We further find that the turbulent cascade of iso-density sets is directed from large towards smaller scales, in agreement with the classical picture that turbulence acts to concentrate more surface into smaller volumes. Intriguingly, there is no range of scales that complies with a constant transfer rate in the cascade, challenging our fundamental understanding of interstellar turbulence. Finally, we recast the virial theorem in a new formulation drawing an explicit relation between the aforementioned geometrical measures and the dynamics of iso-density sets.

79 ASTRONOMY AND ASTROPHYSICS↗

Development of a simultaneous Hugoniot and temperature measurement for preheated-metal shock experiments: Melting temperatures of Ta at pressures of 100 GPa

Equations of state of metals are important issues in earth science and planetary science. A major limitation of them is the lack of experimental data for determining pressure-volume and temperature of shocked metal simultaneously. By measuring them in a single experiment, a major source of systematic error is eliminated in determining from which shock pressure release pressure originates. Hence, a non-contact fast optical method was developed and demonstrated to simultaneously measure a Hugoniot pressure-volume (P{sub H}-V{sub H}) point and interfacial temperature T{sub R} on the release of Hugoniot pressure (P{sub R}) for preheated metals up to 1000 K. Experimental details in our investigation are (i) a Ni-Cr resistance coil field placed around the metal specimen to generate a controllable and stable heating source, (ii) a fiber-optic probe with an optical lens coupling system and optical pyrometer with ns time resolution to carry out non-contact fast optical measurements for determining P{sub H}-V{sub H} and T{sub R}. The shock response of preheated tantalum (Ta) at 773 K was investigated in our work. Measured data for shock velocity versus particle velocity at an initial state of room temperature was in agreement with previous shock compression results, while the measured shock data between 248 and 307 GPa initially heated to 773 K were below the Hugoniot evaluation from its off-Hugoniot states. Obtained interfacial temperatures on release of Hugoniot pressures (100-170 GPa) were in agreement with shock-melting points at initial ambient condition and ab initio calculations of melting curve. It indicates a good consistency for shock melting data of Ta at different initial temperatures. Our combined diagnostics for Hugoniot and temperature provides an important approach for studying EOS and the temperature effect of shocked metals. In particular, our measured melting temperatures of Ta address the current controversy about the difference by more than a factor of 2 between the melting temperatures measured under shock and those measured in a laser-heated diamond anvil cell at {approx}100 GPa.

36 MATERIALS SCIENCE↗

Doping incorporation paths in catalyst-free Be-doped GaAs nanowires

The incorporation paths of Be in GaAs nanowires grown by the Ga-assisted method in molecular beam epitaxy have been investigated by electrical measurements of nanowires with different doping profiles. We find that Be atoms incorporate preferentially via the nanowire side facets, while the incorporation path through the Ga droplet is negligible. We also show that Be can diffuse into the volume of the nanowire giving an alternative incorporation path. This work is an important step towards controlled doping of nanowires and will serve as a help for designing future devices based on nanowires.

77 NANOSCIENCE AND NANOTECHNOLOGY↗

Electronic desalting for controlling the ionic environment in droplet-based biosensing platforms

The ability to control the ionic environment in saline waters and aqueous electrolytes is useful for desalination as well as electronic biosensing. We demonstrate a method of electronic desalting at micro-scale through on-chip micro electrodes. We show that, while desalting is limited in bulk solutions with unlimited availability of salts, significant desalting of ≥1 mM solutions can be achieved in sub-nanoliter volume droplets with diameters of ∼250 μm. Within these droplets, by using platinum-black microelectrodes and electrochemical surface treatments, we can enhance the electrode surface area to achieve >99% and 41% salt removal in 1 mM and 10 mM salt concentrations, respectively. Through self-consistent simulations and experimental measurements, we demonstrate that conventional double-layer theory over-predicts the desalting capacity and, hence, cannot be used to model systems that are mass limited or undergoing significant salt removal from the bulk. Our results will provide a better understanding of capacitive desalination, as well as a method for salt manipulation in high-throughput droplet-based microfluidic sensing platforms.

37 INORGANIC, ORGANIC, PHYSICAL, AND ANALYTICAL CH↗

Biological effect of dose distortion by fiducial markers in spot-scanning proton therapy with a limited number of fields: A simulation study

Purpose: In accurate proton spot-scanning therapy, continuous target tracking by fluoroscopic x ray during irradiation is beneficial not only for respiratory moving tumors of lung and liver but also for relatively stationary tumors of prostate. Implanted gold markers have been used with great effect for positioning the target volume by a fluoroscopy, especially for the cases of liver and prostate with the targets surrounded by water-equivalent tissues. However, recent studies have revealed that gold markers can cause a significant underdose in proton therapy. This paper focuses on prostate cancer and explores the possibility that multiple-field irradiation improves the underdose effect by markers on tumor-control probability (TCP). Methods: A Monte Carlo simulation was performed to evaluate the dose distortion effect. A spherical gold marker was placed at several characteristic points in a water phantom. The markers were with two different diameters of 2 and 1.5 mm, both visible on fluoroscopy. Three beam arrangements of single-field uniform dose (SFUD) were examined: one lateral field, two opposite lateral fields, and three fields (two opposite lateral fields + anterior field). The relative biological effectiveness (RBE) was set to 1.1 and a dose of 74 Gy (RBE) was delivered to the target of a typical prostate size in 37 fractions. The ratios of TCP to that without the marker (TCP{sub r}) were compared with the parameters of the marker sizes, number of fields, and marker positions. To take into account the dependence of biological parameters in TCP model, {alpha}/{beta} values of 1.5, 3, and 10 Gy (RBE) were considered. Results: It was found that the marker of 1.5 mm diameter does not affect the TCPs with all {alpha}/{beta} values when two or more fields are used. On the other hand, if the marker diameter is 2 mm, more than two irradiation fields are required to suppress the decrease in TCP from TCP{sub r} by less than 3%. This is especially true when multiple (two or three) markers are used for alignment of a patient. Conclusions: It is recommended that 1.5-mm markers be used to avoid the reduction of TCP as well as to spare the surrounding critical organs, as long as the markers are visible on x-ray fluoroscopy. When 2-mm markers are implanted, more than two fields should be used and the markers should not be placed close to the distal edge of any of the beams.

60 APPLIED LIFE SCIENCES↗