Biomedical subjects

K Paskalev

Publications and source records attributed to K Paskalev.

5 recordsLinked to original sources

PubMed2006

Ultra-thin TLDs for skin dose determination in high energy photon beams.

Estimation of surface dose is very important for patients undergoing radiation therapy. In this work we investigate the dose at the surface of a water phantom and at a depth of 0.007 cm, the practical reference depth for skin as recommended by ICRP and ICRU, with ultra-thin TLDs and Monte Carlo calculations. The calculations and measurements were carried out for fields ranging from 5 x 5 cm2 to 20 x 20 cm2 for 6 MV, 10 MV and 18 MV photon beams. The variation of the surface dose with angle of incidence and field size was investigated. Also, the exit dose was computed and measured for the same fields and angles of incidence. The dose at the ICRU reference depth was computed. Good agreement (+/-5%) was achieved between measurements and calculations. The surface dose at the entrance increased with the angle of incidence and/or the field size. The exit dose decreased with the angle of incidence but it increased with field size. The dose at the surface of the patient is mostly dependent on the beam energy, modality and beam obliquity rather than the field size and field separation. By correlating TLD measurements with Monte Carlo calculations, we were able to predict the dose at the skin surface with good accuracy. Knowing the dose received at the surface of the patient can lead to prediction of skin reactions helping with the design of new treatment techniques and alternative dose fractionation schemes.

Breast Neoplasms↗

PubMed2006

Investigation of MR image distortion for radiotherapy treatment planning of prostate cancer.

MR imaging based treatment planning for radiotherapy of prostate cancer is limited due to MR imaging system related geometrical distortions, especially for patients with large body sizes. On our 0.23 T open scanner equipped with the gradient distortion correction (GDC) software, the residual image distortions after the GDC were <5 mm within the central 36 cm x 36 cm area for a standard 48 cm field of view (FOV). In order to use MR imaging alone for treatment planning the effect of residual MR distortions on external patient contour determination, especially for the peripheral regions outside the 36 cm x 36 cm area, must be investigated and corrected. In this work, we performed phantom measurements to quantify MR system related residual geometric distortions after the GDC and the effective FOV. Our results show that for patients with larger lateral dimensions (>36 cm), the differences in patient external contours between distortion-free CT images and GDC-corrected MR images were 1-2 cm because of the combination of greater gradient distortion and loss of field homogeneity away from the isocentre and the uncertainties in patient setup during CT and MRI scans. The measured distortion maps were used to perform point-by-point corrections for patients with large dimensions inside the effective FOV. Using the point-by-point method, the geometrical distortion after the GDC were reduced to <3 mm for external contour determination and the effective FOV was expanded from 36 cm to 42 cm.

Humans↗

PubMed2005

Elongated beamlets: a simple technique for segment and MU reduction for sMLC IMRT delivery on accelerators utilizing 5 mm leaf widths.

The focus of this work is to demonstrate the effects of using an elongated beamlet to achieve similar dose conformity as achieved with a square beamlet while reducing the number of segments and subsequent MU required. A series of 10 patients were planned for IMRT delivery to the prostate using minimum beamlet sizes of 5x5 mm2 (default scheme), 10x5 mm2 with the short axis parallel to the prostate-rectum interface (scheme 1), and 10x5 mm2 with the short axis perpendicular to the prostate-rectum interface (scheme 2). All other parameters between plans were left unchanged. Plans were appropriately normalized and evaluated for R65, R40, conformity index, total number of segments and MU. All plans were generated using the Corvus inverse planning system. The average number of segments in this study decreased by approximately 49% for both schemes 1 and 2. The subsequent number of MU required decreased by approximately 34.6%. The resultant modified modulation scaling factor (MSFmod) decreased by approximately 34.3%. Additionally, we found that each isodose distribution using scheme 2 would still meet our clinical acceptance criteria with no visible degradation in the dose distribution as compared with the default scheme. In conclusion, we have demonstrated that it is possible to achieve similar results as those obtained using a 5x5 mm2 beamlet with respect to target coverage and critical structure sparing by using strategically oriented elongated beamlets. This technique directly translates to a decreased MSF(mod) allowing for decreased leakage dose to the patient, a decreased risk of exceeding secondary shielding limits in pre-existing vaults, and shorter treatment times.

Algorithms↗

PubMed2005

A method for repositioning of stereotactic brain patients with the aid of real-time CT image guidance.

This note presents a method that recalculates the coordinates of the isocentre for patients undergoing stereotactic radiotherapy to the brain with a relocatable head frame based on a pre-treatment CT scan. The method was evaluated by comparing initial stereotactic coordinates of the isocentre with the recalculated coordinates for eight single-fraction patients. These patients had the Brown-Roberts-Wells (BRW) frame fixed to the outer table of the skull, and therefore the coordinates of any anatomical point should be identical between the initial scan and the pre-treatment scan. The differences between the two sets of coordinates were attributed to errors in the method. The results showed that the systematic errors in the recalculated coordinates were less than 0.05 mm, and they were not statistically significant. The random errors (one standard deviation) were from 0.35 mm (lateral) to 0.58 mm (vertical). The average value of the combined 3D difference was 0.75 mm.

Algorithms↗

PubMed2004

Daily target localization for prostate patients based on 3D image correlation.

There are several localization techniques that have been used for prostate treatment. Recently, the potential use of a variety of CT-based equipment in the treatment room has been discussed. The goal of our study was to develop an automated procedure for daily treatment table shift calculation based on two CT data sets: simulation CT data and localization CT data. The method suggested in this study is a 3D image cross-correlation of small regions of interest (ROI) within the two data sets. The relative position of the two ROIs with respect to each other is determined by the maximum value of the normalized cross-correlation function, calculated for all possible relative locations of the two ROIs. After the best match is found the shifts are given by the vector connecting the treatment isocentre and the planning isocentre (both determined by the radio opaque fiducial markers on the patient's skin). The results have been compared with shifts calculated through manual fusion. The shift differences, averaged over 17 statistically independent shift calculations, are less then 1 mm in the lateral and longitudinal directions, and about 1 mm in the AP direction. The impact of image noise on the performance of the algorithm has been tested. The results show that the algorithm accurately adjusts for target positional changes even with Gaussian noise levels as high as 20% inserted.

Algorithms↗