Physics in medicine and biology
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Randomized Controlled Trial Comparative Study
A feasibility study of using conventional jaws to deliver IMRT plans in the treatment of prostate cancer.
The aim of this study is to investigate the feasibility of using conventional jaws to deliver inverse planned intensity-modulated radiotherapy (IMRT) plans for patients with prostate cancer. For ten patients, each had one three-dimensional conformal plan (3D plan) and seven inverse IMRT plans using direct aperture optimization. For IMRT plans using conventional jaws (JO plans), the number of apertures per beam angle was set from two to seven while three apertures per beam angle were set for the multi-leaf collimator (MLC) plans. ⋯ Based on the average DVHs, no difference was found among 3D, JO-4A and MLC plans with regard to the planning target volume and rectum, but the DVHs for the bladder and penile bulb were significantly better with inverse IMRT plans than those with 3D plans. When compared with the plan conformity, the average COIN values for 3D, JO-4A and MLC plans were 0.61 +/- 0.07, 0.73 +/- 0.05 and 0.83 +/- 0.05, respectively. In conclusion, inverse IMRT plans using conventional jaws are clinically feasible, achieving better plan quality than 3D-CRT plans.
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Optical emission computed tomography (optical-ECT) is a technique for imaging the three-dimensional (3D) distribution of fluorescent probes in biological tissue specimens with high contrast and spatial resolution. In optical-ECT, functional information can be imaged by (i) systemic application of functional labels (e.g. fluorophore labelled proteins) and/or (ii) endogenous expression of fluorescent reporter proteins (e.g. red fluorescent protein (RFP), green fluorescent protein (GFP)) in vivo. An essential prerequisite for optical-ECT is optical clearing, a procedure where tissue specimens are made transparent to light by sequential perfusion with fixing, dehydrating and clearing agents. ⋯ After ethanol fixation, the RFP and GFP fluorescence proved remarkably robust to subsequent exposure to either methyl salicylate or BABB. The optimized optical clearing procedure of ethanol fixation followed by methyl salicylate clearing preserved the fluorescence of constitutive RFP in whole xenograft tumour specimens, about 1 cc in dimension, indicating successful extension from cell plating experiments to whole tissue samples. Finally, the feasibility of imaging the 3D distribution of viable tumour cells (as indicated by the RFP emission) is demonstrated by optical-ECT imaging of cleared xenograft tumours using an in-house system.
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The van Herk margin formula (VHMF) relies on the accuracy of the convolution method (CM) to determine clinical target volume (CTV) to planning target volume (PTV) margins. This work (1) evaluates the accuracy of the CM and VHMF as a function of the number of fractions N and other parameters, and (2) proposes an alternative margin algorithm which ensures target coverage for a wider range of parameter values. Dose coverage was evaluated for a spherical target with uniform margin, using the same simplified dose model and CTV coverage criterion as were used in development of the VHMF. ⋯ For 0.1 cm < or = sigma < or = 0.75 cm, 0 < or = gamma < or = 1 and 5 < or = N < or = 30, the VHMF underestimates margins by as much as 33%. With the alternative margin algorithm, the maximum underestimate is 7%. These results suggest that the VHMF should be used with caution for hypofractionated treatment and in adaptive therapy.