The vmat vs other recent radiotherapy techniquesM'dee Phechudi
VMAT is a new type of intensity-modulated radiation therapy (IMRT) treatment technique that uses the same hardware (i.e. a digital linear accelerator) as used for IMRT or conformal treatment, but delivers the radiotherapy treatment using a rotational or arc geometry rather than several static beams.
This technique uses continuous modulation (i.e. moving the collimator leaves) of the multileaf collimator (MLC) fields, continuous change of the fluence rate (the intensity of the X rays) and gantry rotation speed across a single or multiple 360 degree rotations
The vmat vs other recent radiotherapy techniquesM'dee Phechudi
VMAT is a new type of intensity-modulated radiation therapy (IMRT) treatment technique that uses the same hardware (i.e. a digital linear accelerator) as used for IMRT or conformal treatment, but delivers the radiotherapy treatment using a rotational or arc geometry rather than several static beams.
This technique uses continuous modulation (i.e. moving the collimator leaves) of the multileaf collimator (MLC) fields, continuous change of the fluence rate (the intensity of the X rays) and gantry rotation speed across a single or multiple 360 degree rotations
This seminar is presented as a part of weekly journal club and seminar presented in Apollo Hospital,Kolkata Department of Radiation Oncology.This seminar is moderated by Dr Tanweer Shahid.
1.Aim of Radiotherapy
The goal of radiotherapy is to deliver a prescribed dose of radiation to the Target while sparing surrounding Healthy tissues to the largest extent possible
2.Organ Motion
Intra-fraction motion
during the fraction
Heartbeat
Swallowing
Coughing
Eye movement
Inter-fraction motion
- in between the fractions
Tumour change
Weight gain/loss
Positioning deviation
Breathing
Bowel and rectal filling
Bladder filling
Muscle relaxation/tension
3. Respiratory motion affects:
Respiratory motion affects all tumour sites in the thorax, abdomen and Pelvis. Tumours in the Lung, Liver, Pancreas, Oesophagus, Breast, Kidneys, prostate
Tumour displacement varies depending on the site and organ Location
Lung tumours can move several cm in any direction during irradiation
It is most prevalent and prominent in Lung cancers
4. Problems associated with respiratory motion during RT
Image acquisition limitations
Treatment planning limitations
Radiation delivery limitations
5. Methods to Account for Respiratory Motion
1. Motion encompassing methods
2. Respiratory gating methods
3. Breath hold methods
4. Forced shallow breathing with abdominal compression
5. Real-time tumor tracking methods
Summary:
The management of respiratory motion in radiation oncology is an evolving field
IGRT provides a solution for combating organ motion in radiotherapy
Delivering higher dose to tumor and less dose to normal tissue.
Limited clinical studies, needs to be studied further
IGRT – the future of radiotherapy
A review of advances in Brachytherapy treatment planning and delivery in last decade or so, with main focus on brachytherapy for Prostate cancer, Breast cancer and Cervical cancer
This seminar is presented as a part of weekly journal club and seminar presented in Apollo Hospital,Kolkata Department of Radiation Oncology.This seminar is moderated by Dr Tanweer Shahid.
1.Aim of Radiotherapy
The goal of radiotherapy is to deliver a prescribed dose of radiation to the Target while sparing surrounding Healthy tissues to the largest extent possible
2.Organ Motion
Intra-fraction motion
during the fraction
Heartbeat
Swallowing
Coughing
Eye movement
Inter-fraction motion
- in between the fractions
Tumour change
Weight gain/loss
Positioning deviation
Breathing
Bowel and rectal filling
Bladder filling
Muscle relaxation/tension
3. Respiratory motion affects:
Respiratory motion affects all tumour sites in the thorax, abdomen and Pelvis. Tumours in the Lung, Liver, Pancreas, Oesophagus, Breast, Kidneys, prostate
Tumour displacement varies depending on the site and organ Location
Lung tumours can move several cm in any direction during irradiation
It is most prevalent and prominent in Lung cancers
4. Problems associated with respiratory motion during RT
Image acquisition limitations
Treatment planning limitations
Radiation delivery limitations
5. Methods to Account for Respiratory Motion
1. Motion encompassing methods
2. Respiratory gating methods
3. Breath hold methods
4. Forced shallow breathing with abdominal compression
5. Real-time tumor tracking methods
Summary:
The management of respiratory motion in radiation oncology is an evolving field
IGRT provides a solution for combating organ motion in radiotherapy
Delivering higher dose to tumor and less dose to normal tissue.
Limited clinical studies, needs to be studied further
IGRT – the future of radiotherapy
A review of advances in Brachytherapy treatment planning and delivery in last decade or so, with main focus on brachytherapy for Prostate cancer, Breast cancer and Cervical cancer
Comparative dosimetry of forward and inverse treatment planning for Intensity...iosrjce
IOSR Journal of Applied Physics (IOSR-JAP) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of physics and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications in applied physics. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
A summary of recent innovations in radiation oncology focussing on the priniciples of different techniques and their application. An overview of clinical results has also been given
Model Attribute Check Company Auto PropertyCeline George
In Odoo, the multi-company feature allows you to manage multiple companies within a single Odoo database instance. Each company can have its own configurations while still sharing common resources such as products, customers, and suppliers.
Francesca Gottschalk - How can education support child empowerment.pptxEduSkills OECD
Francesca Gottschalk from the OECD’s Centre for Educational Research and Innovation presents at the Ask an Expert Webinar: How can education support child empowerment?
June 3, 2024 Anti-Semitism Letter Sent to MIT President Kornbluth and MIT Cor...Levi Shapiro
Letter from the Congress of the United States regarding Anti-Semitism sent June 3rd to MIT President Sally Kornbluth, MIT Corp Chair, Mark Gorenberg
Dear Dr. Kornbluth and Mr. Gorenberg,
The US House of Representatives is deeply concerned by ongoing and pervasive acts of antisemitic
harassment and intimidation at the Massachusetts Institute of Technology (MIT). Failing to act decisively to ensure a safe learning environment for all students would be a grave dereliction of your responsibilities as President of MIT and Chair of the MIT Corporation.
This Congress will not stand idly by and allow an environment hostile to Jewish students to persist. The House believes that your institution is in violation of Title VI of the Civil Rights Act, and the inability or
unwillingness to rectify this violation through action requires accountability.
Postsecondary education is a unique opportunity for students to learn and have their ideas and beliefs challenged. However, universities receiving hundreds of millions of federal funds annually have denied
students that opportunity and have been hijacked to become venues for the promotion of terrorism, antisemitic harassment and intimidation, unlawful encampments, and in some cases, assaults and riots.
The House of Representatives will not countenance the use of federal funds to indoctrinate students into hateful, antisemitic, anti-American supporters of terrorism. Investigations into campus antisemitism by the Committee on Education and the Workforce and the Committee on Ways and Means have been expanded into a Congress-wide probe across all relevant jurisdictions to address this national crisis. The undersigned Committees will conduct oversight into the use of federal funds at MIT and its learning environment under authorities granted to each Committee.
• The Committee on Education and the Workforce has been investigating your institution since December 7, 2023. The Committee has broad jurisdiction over postsecondary education, including its compliance with Title VI of the Civil Rights Act, campus safety concerns over disruptions to the learning environment, and the awarding of federal student aid under the Higher Education Act.
• The Committee on Oversight and Accountability is investigating the sources of funding and other support flowing to groups espousing pro-Hamas propaganda and engaged in antisemitic harassment and intimidation of students. The Committee on Oversight and Accountability is the principal oversight committee of the US House of Representatives and has broad authority to investigate “any matter” at “any time” under House Rule X.
• The Committee on Ways and Means has been investigating several universities since November 15, 2023, when the Committee held a hearing entitled From Ivory Towers to Dark Corners: Investigating the Nexus Between Antisemitism, Tax-Exempt Universities, and Terror Financing. The Committee followed the hearing with letters to those institutions on January 10, 202
Embracing GenAI - A Strategic ImperativePeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
The Roman Empire A Historical Colossus.pdfkaushalkr1407
The Roman Empire, a vast and enduring power, stands as one of history's most remarkable civilizations, leaving an indelible imprint on the world. It emerged from the Roman Republic, transitioning into an imperial powerhouse under the leadership of Augustus Caesar in 27 BCE. This transformation marked the beginning of an era defined by unprecedented territorial expansion, architectural marvels, and profound cultural influence.
The empire's roots lie in the city of Rome, founded, according to legend, by Romulus in 753 BCE. Over centuries, Rome evolved from a small settlement to a formidable republic, characterized by a complex political system with elected officials and checks on power. However, internal strife, class conflicts, and military ambitions paved the way for the end of the Republic. Julius Caesar’s dictatorship and subsequent assassination in 44 BCE created a power vacuum, leading to a civil war. Octavian, later Augustus, emerged victorious, heralding the Roman Empire’s birth.
Under Augustus, the empire experienced the Pax Romana, a 200-year period of relative peace and stability. Augustus reformed the military, established efficient administrative systems, and initiated grand construction projects. The empire's borders expanded, encompassing territories from Britain to Egypt and from Spain to the Euphrates. Roman legions, renowned for their discipline and engineering prowess, secured and maintained these vast territories, building roads, fortifications, and cities that facilitated control and integration.
The Roman Empire’s society was hierarchical, with a rigid class system. At the top were the patricians, wealthy elites who held significant political power. Below them were the plebeians, free citizens with limited political influence, and the vast numbers of slaves who formed the backbone of the economy. The family unit was central, governed by the paterfamilias, the male head who held absolute authority.
Culturally, the Romans were eclectic, absorbing and adapting elements from the civilizations they encountered, particularly the Greeks. Roman art, literature, and philosophy reflected this synthesis, creating a rich cultural tapestry. Latin, the Roman language, became the lingua franca of the Western world, influencing numerous modern languages.
Roman architecture and engineering achievements were monumental. They perfected the arch, vault, and dome, constructing enduring structures like the Colosseum, Pantheon, and aqueducts. These engineering marvels not only showcased Roman ingenuity but also served practical purposes, from public entertainment to water supply.
Introduction to AI for Nonprofits with Tapp NetworkTechSoup
Dive into the world of AI! Experts Jon Hill and Tareq Monaur will guide you through AI's role in enhancing nonprofit websites and basic marketing strategies, making it easy to understand and apply.
Biological screening of herbal drugs: Introduction and Need for
Phyto-Pharmacological Screening, New Strategies for evaluating
Natural Products, In vitro evaluation techniques for Antioxidants, Antimicrobial and Anticancer drugs. In vivo evaluation techniques
for Anti-inflammatory, Antiulcer, Anticancer, Wound healing, Antidiabetic, Hepatoprotective, Cardio protective, Diuretics and
Antifertility, Toxicity studies as per OECD guidelines
Synthetic Fiber Construction in lab .pptxPavel ( NSTU)
Synthetic fiber production is a fascinating and complex field that blends chemistry, engineering, and environmental science. By understanding these aspects, students can gain a comprehensive view of synthetic fiber production, its impact on society and the environment, and the potential for future innovations. Synthetic fibers play a crucial role in modern society, impacting various aspects of daily life, industry, and the environment. ynthetic fibers are integral to modern life, offering a range of benefits from cost-effectiveness and versatility to innovative applications and performance characteristics. While they pose environmental challenges, ongoing research and development aim to create more sustainable and eco-friendly alternatives. Understanding the importance of synthetic fibers helps in appreciating their role in the economy, industry, and daily life, while also emphasizing the need for sustainable practices and innovation.
2. INTRODUCTION
With the introduction of miniaturized brachytherapy sources, the
sophisticated 3-D source localization methods have been
introduced, which can be linked to computerized methods for dose
calculation.
Therefore, a common language is valuable to provide a method of
dose specification and reporting which can be used for implants of
all types of interstitial brachytherapy procedures.
3. 1985: ICRU Report 38,
Was written regarding the Dose and volume specification as
well as reporting intracavitary Brachytherapy in GYN.
1997: ICRU Report 58,
Was written to generate a guideline about the dose and
volumes specification for reporting interstitial Brachytherapy.
4. ICRU 58
Aim: to develop a common language based on existing Concepts.
1. usable to describe what has been done.
2. closely related to the outcome of the treatment.
3. generally understood.
Consistency with external beam radiotherapy (EBT)
definition of volumes – the same.
ICRU reference point for dosimetry in EBT – cannot be
taken over directly for interstitial BT.
5. ICRU 58
There are several historic systems of prescribing brachytherapy
• –Manchester system
• –Paris system
• Quimby system
6. • The term “system” denotes a set of rules which takes into account the
source types , strengths, geometry and method of application to
obtain suitable dose distributions over the volume(s) to be treated.
The system also provides a means of calculating and specifying dose.
• It is important to remember that while an implant may follow the
source distribution rules of a system, it does not comply with the
system unless the method of dose specification and prescription
are also followed.
ICRU 58
7. ICRU
Two important type of implants in ICRU 58 are,
1. Temporary implant
2. Permanent implant
8. Temporary Implant
• The radioactive sources are removed from the tissue after the treatment is
completed.
• Radionuclide used have typically longer half life.
Permanent Implant
• The brachytherapy sources remain in the patient, and they will not be removed.
• Radionuclide used have typically shorter half life.
ICRU 58
9. ICRU 58
Traditionally, the temporary implants were performed
with the linear (like wires) radioactive sources or seeds
arranged in a linear fashion (i.e. ribbons, etc.).
However, in a permanent implants, multiple loose
sources were distributed in random orientations.
10. With the design of the low energy radioactive
sources in the form of stranded seeds or
radioactive wires, now the permanent implant
can also be performed with linear or
prearranged ribbons.
The loose seed implants are
considered separately in this report.
ICRU 58
11. For Planning
permanent implants
The number of sources
depends on,
a. Their initial strength.
b. Type of the radioisotope.
For Planning temporary
implants
The total time of implantation
depends on,
a. Number of sources
b. Strengths and source
c. Pattern of distribution of sources
12. Planning boost permanent and temporary implants,
the number of seeds and the initial activity of the seeds are
adjusted upon the external beam radiation dose.
13. KERMA (Kinetic Energy
Released in Matter)
The sum of the initial kinetic energie of
all the ionizing charged particles
liberated by uncharged ionizing particles.
K = dEtr/ dm
ABSORBED DOSE
The mean energy imparted by radiation
to a unit
mass of medium
D=dE/dm
1Gy = 1J/Kg
14. Reference Air Kerma rate
Reference Air Kerma Rate = Air Kerma Rate at a reference point of 1 cm
or 1 m.
OR
It is defined as the air kerma rate measured at one meter
along the perpendicular bisector of the long axis of the
source,corrected for air attenuation and scattering.
Unit : 1 U = μGy/h
The term m^2 is not included inthe unit,since it is inherent
in the definition itself.
15. Total Reference Air Kerma (TRAK)
TRAK= Σti . Si
Where;
Si = Reference air kerma rate for
each source.
ti = Irradiation time for each source.
16. Description of Source Patterns
single plane: implant is defined as an implant containing two or more
sources, which lie in the same plane.
two-plane (double-plane): implant contains two planes, which are
generally parallel to each other.
Multi-plane: implant, contains three or more planes.
non-plane: sphere or cylinder.
18. Gross Tumor Volume (GTV)
The palpable or visible/demonstrable extent
and location of the malignant growth.
Clinical Target Volume (CTV)
The volume of the tissue that contains a
gross tumor volume and/or subclinical
microscopic malignant disease which has to
be eliminated.
19. Planning Target Volume (PTV)
The volume of tissue receiving the
prescribed irradiation.
For an interstitial brachytherapy, the PTV is,
in general, identical to the CTV.
Treatment Volume (TV)
The volume of tissue, which is encompassed
by an isodose surface that has been
specified by the radiation oncologist.
The dose value at this isodose surface is the
minimum target dose
21. CENTRAL PLANE
The plane that is perpendicular to the main
direction of the linear sources and passing
through the estimated center of the implant.
22. Central Plane (continue)
The plane that is perpendicular to the main
direction of the linear sources and passing
through the estimated center of the implant.
23. Description of Dose
distribution
Interstitial Brachytherapy
Implants:
1. Non Homogeneous dose
Distribution .
2. High Regions around
Sources.
3. Regions of plateau dose
or local minimum doses.
The dose distribution in a plane perpendicular to linear
and parallel sources, shows a plateau dose region of low
dose gradient. In this example of three sources of 6 cm
long and with 1.5 cm spacing, the dose varies by less than
2% between the sources.
24. Dose Distribution in One or More Planes
through the Implant
1. The minimum information needed for the dose distribution of
an implant is,
The isodose curves in at least one plane either in tabular form or
by graphical Presentation.
2. The central plane of the implant should be used, If only one
plane is chose.
25. Prescription Dose
The prescribed dose is defined as the dose, which the physician
intends to give, and enters in the patient’s treatment chart.
Minimum Target Dose (MTD): The minimum dose at the
periphery of the CTV = Minimum dose decided upon by the clinician as
adequate to treat the CTV (minimum peripheral dose).
MTD≅ 90% of the prescribed dose in the Manchsteer system for
interstitial therapy.
26. Prescription Dose (continue)
Mean Central Dose (MCD) : Dm
The minimum dose at the periphery of the CTV
= Arithmetic mean of the local minimum doses between sources, in the central
planes.
27. Prescription Dose (continue)
High Dose Volume
The volume of tissue that is encompassed that will receive more than
150% of the mean central dose be reported.
Low Dose Volume
A low dose volume should be defined as a volume within the clinical
target volume, encompassed by an isodose corresponding to 90% of the
prescribed dose. The maximum dimension of the low dose volume in
any plane calculated should be reported.
28. Prescription Dose (continue)
Dose Uniformity Parameters
ICRU defines the following two methods for the dose uniformity
1. The spread of the individual minimum doses used to calculate the mean
central dose in the central plane (expressed as a percentage of the
mean central dose).
2. The dose homogeneity index; defined as the ratio of minimum
target dose to the mean central dose.
29. Time Dose Factors
Time and Dose Rates for Temporary Implants
Time = Prescribed dose/initial dose rate
Time Dose Pattern for Temporary Implants
a. Continuous irradiation
b. Non-continuous irradiation
c. Pulsed irradiation
30. Recommendations for Recording and Reporting
Parameters Required for Recording and Reporting
. Description of Volumes : GTV, PTV,…….
. Description of Sources :
1. Radioisotope and filtration
2. Pattern of source distribution
• Description of Technique and Source pattern
31. Table 1: Levels of priority for reporting
temporary interstitial implants
33. a. Priority
1 . Concerned with doses in the central plan
2 . Required calculations outside the central plan. If this is not
available, then a more detailed description of source pattern under
priority 1 is required.
3 . Additional information mostly of clinical research interest
b. Level of computation
1. No computer needed
2. Hand calculation and/or computer calculation in central plane.
3. 3-D computation needed
c. Essential to establish consistent reporting and related to
past experience, necessary for comparison of brachytherapy data
and for relating outcome to treatment.
34. Table 3: Levels of priority for reporting implants
with a single stationary source line.
35. Table 4: Levels of priority for reporting
implants with a moving source.
36. Table 5: Levels of priority for reporting implants with a
surface applicators
37. CONCLUSION
It is very important to follow these
recommendations to achieve the aim of
brachytherapy.
In this presentation, the ICRU-58
recommended concepts and procedures for dose
specifications and reporting of the interstitial
brachytherapy implants has reviewed.
38. Selected reference
1. ICRU Report 38: Dose and Volume Specification for Reporting
Intracavitary Gynecology (1985)
2. ICRU Report 58: Dose and Volume Specification for Reporting
Interstitial Therapy (1997)
3. The GEC ESTRO Handbook of Brachytherapy, Editors: Alain
Gerbaulet, Richard Pötter, Jean-Jacques Mazeron, Erik van
Limbergen (2002;107;3225-332
4. ESMP 2013 Reporting in Brachytherapy,Lecture 5 Brachytherapy
Implantation.s
