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Biomedical subjects

A Eklöf

Publications and source records attributed to A Eklöf.

5 recordsLinked to original sources

The final phase in acute myeloid leukaemia (AML): a study of cause of death, place of death and type of care during the last week of life.

The aim of this study was to increase the knowledge of the final phase in acute myeloid leukaemia (AML), a period which entails many complex medical and psychosocial decisions. Data on cause and place of death were gathered through a retrospective review of medical and nursing records of 106 patients with AML who had died during 1995-1997. We focused on the actual phase of the disease and to what extent the patients were prescribed palliative care. With increased knowledge of the dying process in AML there are options to discuss which approach would be the most preferred final phase for an AML patient.

Acute Disease↗

Aspects on the optimal photon beam energy for radiation therapy.

The selection of optimal photon beam energy is investigated both for realistic clinical bremsstrahlung beams and for monoenergetic photon beams. The photon energies covered in this investigation range from 60Co to bremsstrahlung and monoenergetic beams with maximum energies up to 50 MeV. One head and neck tumor and an advanced cervix tumor are investigated and the influence of beam direction is considered. It is shown that the use of optimized intensity modulated photon beams significantly reduces the need of beam energy selection. The most suitable single accelerator potential will generally be in the range 6-15 MV for both superficially located and deep-seated targets, provided intensity-modulated dose delivery is employed. It is also shown that a narrow penumbra region of a photon beam ideally should contain low-energy photons (< or =4 MV), whereas the gross tumor volume, particularly when deep-seated targets are concerned, should be irradiated by high-energy photons. The regions where low photon energies are most beneficial are where organs at risk are laterally close to the target volume. The situation is completely changed when uniform or wedged beams are used. The selection of optimal beam energy then becomes a very important task in line with the experience from traditional treatment techniques. However, even with a large number of uniform beam portals, the treatment outcome is substantially lower than with a few optimized intensity-modulated beams.

Female↗

Composite energy deposition kernels for focused point monodirectional photon beams.

A 3D volume overlap algorithm has been developed for converting energy deposition kernels between arbitrary 2D and 3D irradiation geometries. The kernels can be used as convolution kernels in inverse radiation therapy planning and as accurate descriptions of the dose distributions for clinically important beam geometries. The new method of dose calculation combining Monte Carlo and analytical methods has introduced an improved accuracy in dose calculation on the fractional per cent level. The comparisons are also made for a wide range of photon spectra and irradiation geometries from narrow point monodirectional pencil beams to finite uniform beams, 4pi steradians isotropically converging beams and divergent beams from isotropic point sources. It is seen that the photon scatter penumbra is highest at low photon energies whereas the secondary electron penumbra is widest at high photon energies, making low energy beams more interesting for small targets and high energy beams most useful for large deep-seated targets.

Phantoms, Imaging↗

Photon beam energy deposition kernels for inverse radiotherapy planning.

A method for calculating energy deposition kernels for planar convergent isotropic irradiations of a point target has been developed. A geometric overlap algorithm is applied to pencil beam energy deposition kernels calculated by convolution of Monte Carlo generated point spread functions with the energy released by a point monodirectional photon beam. The geometric overlap interpolation technique is energy conservative and hence, for dosimetric purposes, more precise than interpolations based on smoothing techniques. Furthermore, due to the integration processes involved, most of the statistical noise in the original Monte Carlo data is eliminated. The resulting kernels have a precision and noise level corresponding to 10(9) - 10(10) Monte Carlo simulated photons. The kernels are useful for inverse conformation therapy planning, and for dose planning with small target volumes.

Humans↗

Shaping of arbitrary dose distributions by dynamic multileaf collimation.

Traditionally, the shaping of non-uniform dose distributions has been performed by using wedges or compensating filters. The advent of high resolution multileaf collimators may largely eliminate the need for material attenuators for modification of the beam. This is achieved by a new technique for the shaping of arbitrary dose distributions by dynamic motion of the collimator leaves. By employing narrow elementary slit beams that correspond to the smallest possible opening of the multileaf collimator, the optimal density of such slit beams, i.e. opening density, can be determined automatically using a newly developed inversion algorithm. The present method has two major advantages (1) internal structures in the field can be created, controlled solely by steering the collimator leaves, (2) the opening density determined by the algorithm never gives rise to underdosage: this is important from a radiobiological point of view.

Humans↗