Technology (new threads)

IMRT Plan Normalization

Thu, 03 Feb 2011 13:57:40 +0000

IMRT involves complex Treatment Planning Process & rigorous plan evaluation. Even when a plan is devised that meets many treatment-planning objectives, limitations in the planner’s ability to further adjust beam characteristics may require the radiation dose prescription to be normalized to an isodose level that best covers the target volume.

Commercial Treatment Planning Systems contain various plan normalization options

e.g

1. No Plan Normalization
2. Plan Normalization at Isocenter
3. Plan Normalization at Target Mean
4. Plan normalization at Target Minimum
5. Plan normalization at Target Maximum
6. % of Volume should Receive _ % of dose
7. Etc.,

Normalization at Isocenter is no long applicable to IMRT

Most of the institute uses no plan normalization. But the pitfall of this normalization method is it may be under dose / over dose to target if the constraints are not properly handled by the planner. So, it is purely depends on the planner constraints & priorities.

I personally would like to use plan "normalization at target mean / Median", which can standardize the plan normalization method in IMRT and it is “independent” of the Planner / user dose constraints & priorities.

I will appreciate if the forum further discuss about plan normalization in IMRT and their institute protocols of IMRT Plan normalization.

Portal Dosimetry and Gamma Histograms

Thu, 03 Feb 2011 09:43:07 +0000

Would be interested to know how many / which centers are using portal dosimetry for radiotherapy plan evaluation :

1.Do you use Gamma Histograms to evaluate calculated dose distributions against measured ( Portal Dosimetry)?
2.Do you use Gamma Histograms to validate your planning systems ?
3.Is it acceptable to use an acceptance criteria of 3% Dose Difference & 3mm Distance To Agreement (DTA) for all sites?
4.Is it a valid concern that commercially available planning systems bundling different algorithms for Treatment Planning & Dose Calculation and a Monte Carlo for inter-comparison using Gamma Histograms OR Portal Dosimetry licenses for inter-comparison using Gamma Histograms might give a false sense of security during IMRT QA since they are on the same platform and from the same vendor?

Kodak 2000RT CR Plus System

Sun, 30 Jan 2011 03:02:16 +0000

Dear group members,
I am rquesting for information from Radiotherapist / Medical Physicists about the equipment & its uses. details of the users experience, as we are proposing to have it in our Hospital.

Thanking You
Das

Open Source Treatment Planning Systems

Thu, 20 Jan 2011 17:49:53 +0000

If any one of you had seen the contouring sessions we organized you will realize one of the most important things missing from it was the ability to change windows. The reason - these are not DICOM RT files you are seeing but plain image files. For the moderators who created the system it was a greater pain in the ass - we had to take screenshots, upload them to scribblar in seperate pages and then contour them and then embed them on the page.
On the top of that several users reported they were unable to see the window - scribblar does require flash installed in your browser and a relatively speedy connection.
While searching for solutions I had found educase earlier but the site looks very ill maintained.
What we really need is a TPS - and guess what I searched for open source TPS and found not one but two

Both are open source solutions doing a lot more than what we require. What I want is some help from any of you guys for any ideas on how to itegrate them with us. What I have in mind is hosting them from a webserver and allowing users to login remotely via internet and using it for contouring purposes. We need an online collaborative environement so a given number of users may contour on the same patient at the same time
Any ideas guys?

Nanotechnology

Wed, 19 Jan 2011 08:16:26 +0000

A forum thread said "Targeted Radioisotopes will bring the inhomogenity to new levels - allowing EBRT to hit the target diffusely and doing inhomogenous hard hitting with radioisotopes."

Got any ideas about how this might happen?

Anyone got any potential for research with a nanotechnology team?

Developing IGRT protocols

Sun, 26 Dec 2010 14:37:50 +0000

Dear Collegues,
There is a need to develop/ agree on protocols for imaging in IGRT considering the following issues:
1. Differences with different sites and technique employed
2. The type of registeration/ fusion (manual or automated)
3. Bony vs soft tissue vs fiducial matching
4. Which bony, soft tissue landmarks to take
5. The correction strategy (offline, daily online corrections)
6. When to do autoshift vs shift on markers
7. Threshold for calling physician and physicist
8. Frequancy of imaging in different sites
These issues may be different for different vendor solutions with different resolutions.
Like to get peoples experience utilizing literature information.

Survey - Do you care about IGRT Training?

Fri, 17 Dec 2010 03:22:34 +0000

Dear Friends
Our department at Tata Medical Center, Kolkata is planning to develop a course on IGRT concepts and applications for trainee radiation oncologists in India. Prior to embarking on a project like this we are conducting a survey of trainees (junior and senior registrars, fellows etc) to assess the scope and demand for IGRT training in India. Can I request you to participate in this survey and also forward this link to other trainees you know. We are hoping for as many participants as possible. The survey is on till Dec 22nd.

Link to the survey
http://www.surveymonkey.com/s/MVL5V32

Regards
Indranil

Zotero Citation Styles

Fri, 03 Dec 2010 05:21:57 +0000

Hi all,
I am an avid user of zotero (www.zotero.org). As I have created some citation styles ment for radiation oncology specific journals I plan to upload them here as well as the main zotero svn. Please do tell me if you need additional citation styles and I will be glad to help.
P.S. Since this is a forum I will upload them in the technology site group. Please correct me if you feel thats not right.
Cheerio
Santam

Hyperthermia Units from University of California - Sacramento

Mon, 15 Nov 2010 13:09:44 +0000

We received a message from Dr Preetham Kumar PhD:

We have recently installed two hyperthermia treatment units at Mahavir Cancer Sansthan, Patna, and in Christian Medical College Hospital, Vellore. We are interested in setting up more centers in India, to help the large number of cancer patients.

Hyperthermia is applied by using radio frequency sources on the tumor volume, just before radiation or chemotherapy. Studies have showed that the application of hyperthermia before these standards forms of cancer treatment, significantly increases the therapy efficiency, and also patient survival rate.

In both the centers in Patna and Vellore, we obtained grants from UICC for the equipment, and we can do similar effort for your center. I will be happy to visit your center and give some training on this treatment aspect.

Please Contact:

Dr. Preetham B. Kumar Ph.D
Graduate Coordinator
Department of Electrical and Electronic Engineering
California State University,Sacramento
6000 J Street
Sacramento, CA-95819-6019

Tel: (916)-278-7949
Fax: (916)-278-7215
E-mail: ude.susc.sce|pramuk#ude.susc.sce|pramuk

Quality assurance test/kit for cobalt unit

Fri, 12 Nov 2010 01:07:37 +0000

Dear members, I wanted to know the routine QA mandatory tests for cobalt units.I have a particular request to Medical Physicists to reply to my question, whether it is essential to have QA Kits for the tests. Please send me the details of procedures and equipments required for it and references.
With best regards,
Dr N Das

Zotero Anyone - The poll

Wed, 07 Jul 2010 13:58:45 +0000

[HOWTO] - Use social media for keeping up to date with the literature

Tue, 06 Jul 2010 18:16:05 +0000

Keeping upto date with the latest advances in oncology is a daunting task. Every week pubmed indexes about 100 new articles on radiation oncology alone (how do i know ? See below). Keeping upto date with your reading list is a daunting list for the busy practitioner. Social media like Twitter, Orkut, Facebook and Google Buzz are great ways to keep in touch with your friends and families. You can leaveage the power to keep upto date with the reading list and also use the power of social media to learn with your colleagues.
First the prerequisites:

A google account - a gmail account if you have one will do
Access to internet.
Willingness to do a bit of typing :-)

The services required will be:

Gmail and Google Buzz (integrated in gmail)
Google reader
Pubmed / Sciencedirect / Any other major publishing house website / Journal

The basis behind the howto is to leverage the power of RSS feeds to allow the articles published in various journals come to you instead of the other way round. To know more about RSS you can check this page out.

The first step is therefore to go to pubmed and do a search in a topic of your interest that you want to keep reading about in the future.

Click on the RSS link to get a drop down. You can edit the number of items you will like to read each week (choose 100 if you are searching for something non specific like IMRT in head and neck cancer). You can change the title of the feed too if you want.

Clicking on the create RSS feed button will generate a small pop up window
Click on the orange xml button to get another page which will allow you to subscribe to the feed. Choose Google from the drop down menu.

A new page will then open that will allow you to choose if you want to see the feed in google home page or google reader. I like the reader interface.

Choosing google reader will allow you to access google reader after you have authenticated yourself with your gmail user id and password. The interface is neat and designed to allow you to read the articles without distractions. You will see a series of buttons below each article. Clicking on the share button will allow you to share it with your google buzz friends
You can choose to add a note or comment on the article to share your insight on the article with your friends.
Clicking on share will send the article to your google buzz account for viewing by your colleagues who can in turn see the link and add their own comments.

The biggest advantage of the system is that you and your colleagues can filter out articles really fast and using the comment feature learn more from them. Google buzz is a free service that you can learn more about here. Most likely its activated in your gmail account. Using your orkut / gmail friend circle you can have a nice GD / JC sort of thing on it easily.

You can view a presentation of the thing here http://docs.google.com/present/view?id=df4tz246_408c4fk4whs

P.S. How did i know that figure . Google reader has a interesting service called trends that allows you to see what is going on with the feed. You can use this technique to find a happening topic for your next research idea !!!!

Radiotherapy: developing a world class service

Mon, 24 May 2010 13:27:20 +0000

this based on the report provided by Rohit from 2007 dealing with the NHS. We shouldn't deal with the specifics, but there are some interesting discussion points there. http://www.axrem.org.uk/radiotheraphy_papers/DH_Radiotheraphy_developing_first_class_service_NRAG.pdf

THROUGHPUT WITH NEW TECHNOLOGY

Tue, 18 May 2010 10:27:12 +0000

I was talking to a friend recently about possible throughputs.

Department will be all Varian with SmartArc (not a plug, that's what has been bought). How many patients per day are possible?
Will throughput be dependent on how much IMRT is used?
Will SmartArc IMRT for palliation be faster than "conventional" (read 'field-based') approaches?

Assume "enough" RTs, ROs, RPs and an 8 hour day!

NEW,NEWER,NEWEST

Thu, 06 May 2010 13:41:11 +0000

Hi all!
I have to suggest to my administrators an upgradation option from my present Linear Accelerator for the future!Can IGRT with kV/MV,cyberknife and Tomotherapy be compared?If so , how?Physics,biology,management(breakdowns/support/network support)/logistic problems and clinical experiences and articles from your collective wisdom are solicited.

newer technology-whither blows the wind

Wed, 17 Mar 2010 12:39:00 +0000

With the advent of IMRT,suddenly conformal RT has taken a quantum leap.What shape do you think the future of radiation oncology is taking-will it be conformal radiation,biological radiation or the death knell for radiation?
I had a senior colleague from the radiodiagnosis deptt ask me-Have any of these treatment modalities improved survival ?If the jury is still confined for deliberations-the decreased toxicity is what you are actually offering with these-something like enteric coated tablets ( a very expensive variant ).Is varian,Siemens ,Elekta , nucleotron the keepers of the future for the radiation oncology community?Monopolistic !!!!

A question for Dr Andrew

Wed, 03 Mar 2010 20:09:28 +0000

Dr Andrew, I just went through your website at http://dlab.uow.edu.au/coi/ and am really curious about what exactly is being done in the radiation oncology informatics. Particularly interested in the concept of the clinical markup language. Your introductory page does give a very good and succint idea about what you are attempting to do. However can you add some information as I find these things very interseting. I like the idea that perhaps we can extrapolate the data from the routine clinical practice directly into trials. Indeed it will be a new paradigm in conducting clinical trials
Santam

Radiation Errors

Tue, 02 Mar 2010 17:14:14 +0000

Another new article has come up in which inadvertent overdose of 76 patients due to SRS. Apparently it was due to the fact the chief physicist choosing a wrong chamber (??). News articles state the BrainLab representative was present during the calibration process. Now that the physicist no longer works there and can't defend himself is this a case of blame shifting?

What are the thoughts of the house on this incident?
Do you feel physicist are under pressure by the management to perform specially in private centers (I have heard personally from a physicist in a recently opened private centre how much pressure he was under to ratify a wrong building plan in order to save money.)?
Do you feel an external audit should be made mandatory during installation and commissioning of a new equipments?
Do you feel vendors are interested in selling and not in post selling machine upkeep?

Here is the link for the story
http://www.ky3.com/news/local/85241082.html

Newer technologies

Mon, 22 Feb 2010 14:54:52 +0000

Nanoparticles are all the flavour in the literature.However applications of this technology in our field are very difficult to find.The ability to target the tumor cells accurately and reproducibly is perhaps the great challenge in radiation oncology,however the power of small is presently increasingly being used to target the tumor cells(1).How does this impact our practise in the days to come.Will nanoparticle aided imaging and therapeutic modalities be the future of cancer therapy(2) and are we in forefront of this future?

The use of particle therapy is also increasingly getting popular the world over(3).Will particles ever ring the death knell for photons?Or is this a quantum state where both will coexist .

Then the eternal question:is radioactive isotope based therapy-Co-60 on the way out .Is the future in X-rays only .What is the future of cobalt therapy(4)(tomotherapy).And with cyberknife,Rapid Arc,IGRT-cone beam,Kv,Linac based tomotherapy etc what is the future of radiation oncology

A few random reads for those in the mood:
1.Isolation of rare circulating tumour cells in cancer patients by microchip technology Letter in Nature 450, 1235-1239 (20 December 2007)
2.Cancer Nanotechnology:Opportunities and challenges:Mauro Ferrari:Nature Review cancer;Vol5 (Mar 2005):161-171
3.Maximum proton kinetic energy and patient-generated neutron fluence considerations in proton beam arc delivery radiation therapy
Med. Phys. Volume 36, Issue 2, pp. 364-372 (February 2009)
4. Practical and clinical considerations in Cobalt-60 tomotherapy.Chandra P Joshi, Sandeep Dhanesar, Johnson Darko, Andrew Kerr, PB Vidyasagar, L John Schreiner.2009 :34 (3);137-140

The views expressed here are merely the waves on the surface of the sea-the tsunami is beneath the surface.

Contouring Online

Sat, 06 Feb 2010 18:37:29 +0000

I found this website http://www.annotate.org/#top that supposedly allows us to contour and collaborate on DICOM images in real time. will test it out over the weekend and report