Comprehensive Brachytherapy: Physical and Clinical Aspects
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Purpose: There is a growing interest in the radiation oncology community to use the biological effective dose (BED) rather than the physical dose (PD) in treatment plan evaluation and optimization due to its stronger correlation with radiobiological effects. Radiotherapy patients may receive treatments involving a single only phase or multiple phases (e.g., primary and boost). Since most treatment planning systems cannot calculate the analytical BED distribution in multiphase treatments, an approximate multiphase BED expression, which is based on the total physical dose distribution, has been used. The purpose of this paper is to reveal the mathematical properties of the approximate BED formulation, relative to the true BED. Methods: The mathematical properties of the approximate multiphase BED equation are analyzed and evaluated. In order to better understand the accuracy of the approximate multiphase BED equation, the true multiphase BED equation was derived and the mathematical differences between the true and approximate multiphase BED equations were determined. The magnitude of its inaccuracies under common clinical circumstances was also studied. All calculations were performed on a voxel-by-voxel basis using the three-dimensional dose matrices. Results: Results showed that the approximate multiphase BED equation is accurate only when the dose-per-fractions (DPFs) in both the first and second phases are equal, which occur when the dose distribution does not significantly change between the phases. In the case of heterogeneous dose distributions, which significantly vary between the phases, there are fewer occurrences of equal DPFs and hence the inaccuracy of the approximate multiphase BED is greater. These characteristics are usually seen in the dose distributions being delivered to organs at risk rather than to targets. Conclusions: The finding of this study indicates that the true multiphase BED equation should be implemented in the treatment planning systems due to the inconsistent accuracy of the approximate multiphase BED equation in most of the clinical situations.
Purpose: The development in the last few years of photon-counting pixel detectors creates an important and significant opportunity for x-ray spectroscopy to be applied in diagnostics. The energy weighting technique was originally developed to obtain the maximum benefit from the spectroscopic information. In all previous published papers the concept of an energy weighting function was tested on relatively simple test objects having only two materials with different absorption coefficients. Methods: In this study the shape of the energy weighting function was investigated with a set of ten trabecular bone test objects each with a similar geometry and structure but with different attenuation properties. In previous publications it was determined that the function E-3 was a very good choice for the weighting function (wi). Results: The most important Result from this study was the discovery that a single function of the form E-b was not sufficient to explain the energy dependence of the different types of materials that might be used to describe common bodily tissues such as trabecular bone. It was also determined from the data contained in this paper that the exponent b is often significantly dependent upon the attenuation properties of the materials that were used to make the test objects. Conclusion: Studies of the attenuation properties will be useful in further studies involving energy weighting.
Purpose: The accuracy of PET-based post-treatment dosimetry of yttrium-90 microspheres has been improving over the past decade and is now at a stage, permitting volumetric dose-outcome studies. We outline the recent advances and identify the physical limitations to the accuracy of the dose calculations. Methods: Convolution of the measured PET activity density distribution with a pre-calculated voxel-dose-kernel (VDK) is the most widely used method for dose reconstruction. Therefore, accurate knowledge of the beta+ branching ratio as well as the micro-dosimetric characteristics of electron interactions within the microsphere is essential for the computation of the dose kernel. We implement a model of the microspheres used in our clinic to calculate the modified electron energy spectrum at the microsphere’s surface and to determine the impact of self-shielding on the dose reconstruction. The three-dimensional dose distributions obtained for 10 patients treated with radio-embolization with yttrium-90 microspheres are evaluated and various DVH markers are investigated for correlation with outcome. Results: The methods for reducing the overall computation uncertainty are systematically outlined in this presentation. Since the latest experimental data on yttrium-90 beta+ branching ratio has a relative uncertainty of 1.5%, all contributing factors derived from Monte Carlo simulations must be brought to a sub 1% level. The self-shielding within the microspheres is found to be responsible for up to 6% reduction of the reconstructed dose in low-gradient regions and must be taken into account. The contribution of trace amounts of other beta+ emitters introduced during the manufacturing process is also discussed. Conclusion: The accelerating pace of clinical adoption of PET-based post-treatment dosimetry is mainly due to advances in both quantitative PET imaging and physical models of dose deposition. We show that the overall physical dose uncertainty in the convolution step can be further reduced, thus making ongoing multi-institutional dose-outcome studies even more reliable.
Increased use of SBRT and hypo fractionation in radiation oncology practice has posted a number of challenges to medical physicist, ranging from planning, image-guided patient setup and on-treatment monitoring, to quality assurance (QA) and dose delivery. This symposium is designed to provide updated knowledge necessary for the safe and efficient implementation of SBRT in various linac platforms, including the emerging digital linacs equipped with high dose rate FFF beams. Issues related to 4D CT, PET and MRI simulations, 3D/4D CBCT guided patient setup, real-time image guidance during SBRT dose delivery using gated/un-gated VMAT or IMRT, and technical advancements in QA of SBRT (in particular, strategies dealing with high dose rate FFF beams) will be addressed. The symposium will help the attendees to gain a comprehensive understanding of the SBRT workflow and facilitate their clinical implementation of the state-of-art imaging and planning techniques. Learning Objectives: Present background knowledge of SBRT, describe essential requirements for safe implementation of SBRT, and discuss issues specific to SBRT treatment planning and QA. Update on the use of multi-dimensional (3D and 4D) and multi-modality (CT, beam-level X-ray imaging, pre- and on-treatment 3D/4D MRI, PET, robotic ultrasound, etc.) for reliable guidance of SBRT. Provide a comprehensive overview of emerging digital linacs and summarize the key geometric and dosimetric features of the new generation of linacs for substantially improved SBRT. Discuss treatment planning and quality assurance issues specific to SBRT. Research grant from Varian Medical Systems.
As part of the AAPM’s Scope of Practice, medical physicists are expected to collaborate effectively with practioners and allied health care providers. Interpersonal skills such as communication, negotiation and persuasion are vital for successful collaboration to achieve shared goals. This session will provide some theoretical background of these interpersonal skills as well as specific techniques and practical tools to influence others. Applications of these interpersonal skills for administrative and human resource management purposes vital to medical physicists will be shared. Session attendees will gain knowledge and tools to help them effectively collaborate with administrative and physician leaders in areas such as capital and human resource selection, prioritization, and implementation. Participants will hear methods of how to articulate their goals and to understand the goals of administration, helping ensure alignment of purpose. Session speakers will present one of the topics: equipment selection, budget creation, contracts, and program-related policy development. Specifics may include designing a business case in language that administrators understand, calculating the prioritization of budget requests, and influencing policies for safe and effective care. Human resource topics may include staffing justification, recruitment for fit, employment contracts, and benefits. Speakers will provide examples in both radiation therapy and diagnostic imaging departments and will share experiences and outcomes of their approaches for better results. Learning Objectives: After this course attendees will be better able to Understand the shared goal between administrative and physicist leadership. Articulate the “why” of the technical or human resource need. Utilize communication, negotiation and persuasion tools to improve collaboration.
Since the introduction of radiochromic films (RCF) for radiation dosimetry, the scope of RCF dosimetry has expanded steadily to include many medical applications, such as radiation therapy and diagnostic radiology. The AAPM Task Group (TG) 55 published a report on the recommendations for RCF dosimetry in 1998. As the technology is advancing rapidly, and its routine clinical use is expanding, TG 235 has been formed to provide an update to TG-55 on radiochromic film dosimetry. RCF dosimetry applications in clinical radiotherapy have become even more widespread, expanding from primarily brachytherapy and radiosurgery applications, and gravitating towards (but not limited to) external beam therapy (photon, electron and protons), such as quality assurance for IMRT, VMAT, Tomotherapy, SRS/SRT, and SBRT. In addition, RCF applications now extend to measurements of radiation dose in particle beams and patients undergoing medical exams, especially fluoroscopically guided interventional procedures and CT. The densitometers/scanners used for RCF dosimetry have also evolved from the He-Ne laser scanner to CCD-based scanners, including roller-based scanner, light box-based digital camera, and flatbed color scanner. More recently, multichannel RCF dosimetry introduced a new paradigm for external beam dose QA for its high accuracy and efficiency. This course covers in detail the recent advancements in RCF dosimetry. Learning Objectives: Introduce the paradigm shift on multichannel film dosimetry Outline the procedures to achieve accurate dosimetry with a RCF dosimetry system Provide comprehensive guidelines on RCF dosimetry for various clinical applications One of the speakers has a research agreement from Ashland Inc., the manufacturer of Gafchromic film.
Increased use of SBRT and hypofractionation in radiation oncology practice has posted a number of challenges to medical physicist, ranging from planning, image-guided patient setup and on-treatment monitoring, to quality assurance (QA) and dose delivery. This symposium is designed to provide current knowledge necessary for the safe and efficient implementation of SBRT in various linac platforms, including the emerging digital linacs equipped with high dose rate FFF beams. Issues related to 4D CT, PET and MRI simulations, 3D/4D CBCT guided patient setup, real-time image guidance during SBRT dose delivery using gated/un-gated VMAT/IMRT, and technical advancements in QA of SBRT (in particular, strategies dealing with high dose rate FFF beams) will be addressed. The symposium will help the attendees to gain a comprehensive understanding of the SBRT workflow and facilitate their clinical implementation of the state-of-art imaging and planning techniques. Learning Objectives: Present background knowledge of SBRT, describe essential requirements for safe implementation of SBRT, and discuss issues specific to SBRT treatment planning and QA. Update on the use of multi-dimensional and multi-modality imaging for reliable guidance of SBRT. Discuss treatment planning and QA issues specific to SBRT. Provide a comprehensive overview of emerging digital linacs and summarize the key geometric and dosimetric features of the new generation of linacs for substantially improved SBRT. NIH/NCI; Varian Medical Systems; F. Yin, Duke University has a research agreement with Varian Medical Systems. In addition to research grant, I had a technology license agreement with Varian Medical Systems.
Identification of nutrients present in the environment is a challenge common to all organisms. Sulfur is an important nutrient source found in proteins, lipids, and electron carriers that are required for the survival of filamentous fungi such as Neurospora crassa .
The possibility of formation of molybdenum and tungsten polyoxides in the Mo–W–Al{sub 2}O{sub 3}–H{sub 2} system at T = 2400 K and P = 1 bar in a controlled Ar + H{sub 2} atmosphere has been investigated by the method of thermodynamic analysis. The formation of polyoxides is found to occur both due to the processes involving Al{sub 2}O{sub 3} melt and in the absence of the latter. It is established that metals (Mo and W) and their mono-, di-, and even trioxides (in the latter case, mediated polymerization occurs) can be used as initial components to form polyoxides. It is shown that polyoxides themselves may interact with one of their main sources: Al{sub 2}O{sub 3} melt.
Special features of the effect of the electron shell on alpha decay that have important experimental implications are studied within the adiabatic approach. The magnitude of the effect is about several tenths of a percent or smaller, depending on the transition energy and on the atomic number. A dominant role of inner shells is shown: more than 80% of the effect is saturated by 1s electrons. This circumstance plays a crucial role for experiments, making it possible to measure this small effect by a difference method in the same storage rings via a comparison of, for example, decay probabilities in bare nuclei and heliumlike ions. The reasons behind the relative success and the applicability limits of the frozen-shell model, which has been used to calculate the effect in question for more than half a century, are analyzed. An interesting experiment aimed at studying charged alpha-particle states is proposed. This experiment will furnish unique information for testing our ideas of the interplay of nonadiabatic and adiabatic processes.
The evolution of the structure of the Ti50Ni25Cu25 crystalline alloy during high-pressure torsion at room temperature has been studied. The torsional moment variation curve as a function of the strain value was fixed in situ, which allowed directly observing the transition of the material from the crystalline state to the amorphous state during the HPT. It was found that the amorphization of the material in the course of the HPT begins on the grain boundaries and fragments of the crystalline phase. Amorphized boundaries form a “grain-boundary carcass” in the cells of which the high-defect nanocrystalline phase is formed. Growth of deformation leads to broadening of the “grain-boundary carcass,” loss of stability of the crystalline phase, and, as a consequence, to the phase transition “crystal → amorphous” state.
It has been shown that the fundamental results obtained in the works by Levine, Polevoi, and Rytov (1980) and Polevoi (1990) adequately describe the rate of radiative heat exchange and dissipative frictional force in a system of two parallel plates in relative lateral motion. Within the framework of the Levine–Polevoi–Rytov theory, a new expression has been obtained for the force of fluctuation-electromagnetic friction of two plates in the terms of local dielectric permittivities and magnetic permeabilities of the plate materials.
Recent applications of machine-learned normalizing flows to sampling in lattice field theory suggest that such methods may be able to mitigate critical slowing down and topological freezing. However, these demonstrations have been at the scale of toy models, and it remains to be determined whether they can be applied to state-of-the-art lattice quantum chromodynamics calculations. Assessing the viability of sampling algorithms for lattice field theory at scale has traditionally been accomplished using simple cost scaling laws, but as we discuss in this work, their utility is limited for flow-based approaches. We conclude that flow-based approaches to sampling are better thought of as a broad family of algorithms with different scaling properties, and that scalability must be assessed experimentally.
The Muon Collider is one of the most promising future collider facilities with the potential to reach multi-TeV center-of-mass energy and high luminosity. Due to the significant Higgs boson production cross section in muon-antimuon collisions at such high energies, the collider offers an excellent opportunity for in-depth exploration of Higgs boson properties. It holds the capability to significantly advance our understanding of the Higgs sector to a very high level of precision. However, the presence of beam-induced background resulting from the decay of the beam muons poses unique challenges for detector development and event reconstruction. In this paper, the prospects for measuring various Higgs boson properties at a center-of-mass energy of 3 TeV are presented, using a detailed detector simulation in a realistic environment. The study demonstrates the feasibility of achieving high precision results with the current state-of-the-art detector design. In addition, the paper discusses the detector requirements necessary to achieve this level of accuracy.
The one phonon γ-vibrational bands in 154Gd are compared with the theories existing at that time (1960) showing the best agreement with the rotation–vibration model of Faessler and Greiner. Nuclear shape coexistence was first discovered in both 72 Se and 184–188 Hg with the Frankfurt Generalized Collective Model reproducing the two different shapes. In recent years experimental evidences have been found for both one, two, and possibly three phonon γ bands in the A = 103–110 region including the first such bands in odd N-even Z and even N-odd Z nuclei. Cluster radioactivity predicted by Sandulescu, Poenaru and Greiner has been observed. Here, maximum cluster radioactivity is seen in the zero neutron emission in cold binary and ternary fission of 252 Cf. Finally, recent super heavy element discoveries of the new elements 115, 117 and 118 are described. The half-lives in 117 which is closest in N to N = 184 on the Island of Stability support the theoretical predictions of the long-lived island.
The Langlands program is a vast mathematical projection linking number theory and geometry. In high-energy physics, a connection with mirror symmetry has been suggested in string theory, but it has been little studied in low-energy physics. In the framework of the Langlands program, we present a unified description of the integer and fractional quantum Hall effect and the duality found in the fractal nature of the energy spectrum of two-dimensional Bloch electrons, statistical physics, and quantum computation. The new unified view of existing dualism presented in this paper raises the entirely new question of how each theory of physics is connected as a piece of the Langlands program.
In this paper, we describe our work on spin polarization in high-energy electron storage rings which we base on the Full Bloch equation (FBE) for the polarization density and which aims towards the [Formula: see text] option of the proposed Future Circular Collider (FCC-ee) and the proposed Circular Electron Positron Collider (CEPC). The FBE takes into account non spin-flip and spin-flip effects due to synchrotron radiation including the spin-diffusion effects and the Sokolov–Ternov effect with its Baier–Katkov generalization as well as the kinetic-polarization effect. This mathematical model is an alternative to the standard mathematical model based on the Derbenev–Kondratenko formulas. For our numerical and analytical studies of the FBE, we develop an approximation to the latter to obtain an effective FBE. This is accomplished by finding a third mathematical model based on a system of stochastic differential equations (SDEs) underlying the FBE and by approximating that system via the method of averaging from perturbative ODE theory. We also give an overview of our algorithm for numerically integrating the effective FBE. This discretizes the phase space using spectral methods and discretizes time via the additive Runge–Kutta (ARK) method which is a high-order semi-implicit method. We also discuss the relevance of the third mathematical model for spin tracking.