On-line optimization of intraoperative electron beam radiotherapy of the breast

Agostinelli, S.; Gusinu, M.; Cavagnetto, F.; Garelli, S.; Zeverino, M.; Guenzi, M.; Corvò, Renzo; Taccini, G.

doi:10.1016/j.radonc.2012.01.009

Cited by 16 publications

(24 citation statements)

References 18 publications

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“…With respect to the uncertainties of the dosimeters, they are comparable with those that can be found in the literature [5,6,9] and not greater. The standard deviation of the measured absorbed doses is about two or three times the detector uncertainty, but this is not a pitfall from the point of view of the authors.…”

Section: Discussionsupporting

confidence: 87%

“…Detectors based on metal oxide semiconductor field-effect transistors (MOSFETs) [6][7][8][9] and radiochromic films [10,11] have been investigated for these purposes. MOSFETs can be used as dosimeters when appropriately operated [12][13][14].…”

mentioning

confidence: 99%

“…Agostinelli et al [9] reported measurements performed on 91 patients suffering from breast cancer and treated with a mobile linac LIAC. Their substantially spread data show the difficulty of matching the measured and prescribed absorbed dose, which made the authors develop an optimization tool to better calculate the theoretical absorbed dose delivered to the MOSFET.…”

mentioning

confidence: 99%

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In vivo dosimetry in intraoperative electron radiotherapy

et al. 2014

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Section: Discussionsupporting

confidence: 87%

mentioning

confidence: 99%

mentioning

confidence: 99%

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In vivo dosimetry in intraoperative electron radiotherapy

et al. 2014

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“…Even experienced users who mostly treat breast cancers experience a large amount of variability with in vivo dosimetry results and have therefore tried to develop treatment optimization tools. 7 These factors, for which our set of discrepant data can be considered illustrative, prove the need for better investigation and development of planning and imaging tools. 7,8,[26][27][28][29][30][31] When we are able to accurately calculate dosimetric values and place in vivo dosimeters in the tumor bed with precision, we will be able to derive ALs simply from the quadratic sum of the calculation and detector uncertainty.…”

Section: Justification Of Planning Toolsmentioning

confidence: 98%

Defining Action Levels for In Vivo Dosimetry in Intraoperative Electron Radiotherapy

López-Tarjuelo

Morillo-Macías

Bouché-Babiloni

et al. 2015

Technol Cancer Res Treat

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In vivo dosimetry is recommended in intraoperative electron radiotherapy (IOERT). To perform real-time treatment monitoring, action levels (ALs) have to be calculated. Empirical approaches based on observation of samples have been reported previously, however, our aim is to present a predictive model for calculating ALs and to verify their validity with our experimental data. We considered the range of absorbed doses delivered to our detector by means of the percentage depth dose for the electron beams used. Then, we calculated the absorbed dose histograms and convoluted them with detector responses to obtain probability density functions in order to find ALs as certain probability levels. Our in vivo dosimeters were reinforced TN-502RDM-H mobile metal-oxide-semiconductor field-effect transistors (MOSFETs). Our experimental data came from 30 measurements carried out in patients undergoing IOERT for rectal, breast, sarcoma, and pancreas cancers, among others. The prescribed dose to the tumor bed was 90%, and the maximum absorbed dose was 100%. The theoretical mean absorbed dose was 90.3% and the measured mean was 93.9%. Associated confidence intervals at P ¼ .05 were 89.2% and 91.4% and 91.6% and 96.4%, respectively. With regard to individual comparisons between the model and the experiment, 37% of MOSFET measurements lay outside particular ranges defined by the derived ALs. Calculated confidence intervals at P ¼ .05 ranged from 8.6% to 14.7%. The model can describe global results successfully but cannot match all the experimental data reported. In terms of accuracy, this suggests an eventual underestimation of tumor bed bleeding or detector alignment. In terms of precision, it will be necessary to reduce positioning uncertainties for a wide set of location and treatment postures, and more precise detectors will be required. Planning and imaging tools currently under development will play a fundamental role.

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“…This optimization can help to reduce unnecessary large over-dosage regions and allows introducing reliable action levels for in-vivo dosimetry [18].…”

Section: Surgical and Radiotherapy Timementioning

confidence: 99%