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Technical note: TROG 15.01 SPARK trial multi-institutional imaging dose measurement.

ABSTRACT: The Trans-Tasman Radiation Oncology Group (TROG) 15.01 Stereotactic Prostate Adaptive Radiotherapy utilizing Kilovoltage intrafraction monitoring (SPARK) trial is a multicenter trial using Kilovoltage Intrafraction Monitoring (KIM) to monitor prostate position during the delivery of prostate radiation therapy. KIM increases the accuracy of prostate radiation therapy treatments and allows for hypofractionation. However, an additional imaging dose is delivered to the patient. A standardized procedure to determine the imaging dose per frame delivered using KIM was developed and applied at four radiation therapy centers on three different types of linear accelerator.Dose per frame for kilovoltage imaging in fluoroscopy mode was measured in air at isocenter using an ion chamber. Beam quality and dose were determined for a Varian Clinac iX linear accelerator, a Varian Trilogy, four Varian Truebeams and one Elekta Synergy at four different radiation therapy centers. The imaging parameters used on the Varian machines were 125 kV, 80 mA, and 13 ms. The Elekta machine was measured at 120 kV, 80 mA, and 12 ms. Absorbed doses to the skin and the prostate for a typical SBRT prostate treatment length were estimated according to the IPEMB protocol.The average dose per kV frame to the skin was 0.24 ± 0.03 mGy. The average estimated absorbed dose to the prostate for all five treatment fractions across all machines measured was 39.9 ± 2.6 mGy for 1 Hz imaging, 199.7 ± 13.2 mGy for 5 Hz imaging and 439.3 ± 29.0 mGy for 11 Hz imaging.All machines measured agreed to within 20%. Additional dose to the prostate from using KIM is at most 1.3% of the prescribed dose of 36.25 Gy in five fractions delivered during the trial.

SUBMITTER: Legge K

PROVIDER: S-EPMC5875840 | biostudies-literature | 2017 Sep

REPOSITORIES: biostudies-literature

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Technical note: TROG 15.01 SPARK trial multi-institutional imaging dose measurement.

Legge Kimberley K Greer Peter B PB Keall Paul J PJ Booth Jeremy T JT Arumugam Sankar S Moodie Trevor T Nguyen Doan T DT Martin Jarad J O'Connor Daryl John DJ Lehmann Joerg J

Journal of applied clinical medical physics 20170802 5

<h4>Purpose</h4>The Trans-Tasman Radiation Oncology Group (TROG) 15.01 Stereotactic Prostate Adaptive Radiotherapy utilizing Kilovoltage intrafraction monitoring (SPARK) trial is a multicenter trial using Kilovoltage Intrafraction Monitoring (KIM) to monitor prostate position during the delivery of prostate radiation therapy. KIM increases the accuracy of prostate radiation therapy treatments and allows for hypofractionation. However, an additional imaging dose is delivered to the patient. A sta ...[more]

PMID: 28766904

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Project description:BackgroundQuantifying lower-limb load and asymmetry during team sport match-play may be important for injury prevention and understanding performance. However, current analysis methods of lower-limb symmetry during match-play employ wearable microtechnology that may not be best suited to the task. A popular microtechnology is global positioning systems (GPS), which are torso worn. The torso location, and the summary workload measures calculated by GPS are not suited to the calculation of lower-limb load. Instead, research grade accelerometers placed directly on the lower-limb may provide better load information than GPS. This study proposes a new technique to quantify external mechanical load, and lower-limb asymmetry during on-field team sport play using inertial measurement units.MethodsFour professional rugby league players (Age: 23.4 ± 3.1 years; Height: 1.89 ± 0.05 m; Mass: 107.0 ± 12.9 kg) wore two accelerometers, one attached to each foot by the boot laces, during match simulations. Custom Matlab (R2017b, The Mathworks Inc, Natick, MA) code was used to calculate total time, area under the curve (AUC), and percentage of time (%Time) spent in seven acceleration categories (negative to very high, <0 g to >16 g), as well as minimum and maximum acceleration during match simulations. Lower-limb AUC and %Time asymmetry was calculated using the Symmetry Angle Equation, which does not require normalization to a reference leg.ResultsThe range of accelerations experienced across all participants on the left and right sides were 15.68-17.53 g, and 16.18-17.69 g, respectively. Clinically significant asymmetry in AUC and %Time was observed for all but one participant, and only in negative (<0 g) and very high accelerations (>16 g). Clinically significant AUC differences in very high accelerations ranged from 19.10%-26.71%. Clinically significant %Time differences in negative accelerations ranged from 12.65%-25.14%, and in very high accelerations from 18.59%-25.30%. All participants experienced the most AUC at very low accelerations (2-4 g), and the least AUC at very high accelerations (165.00-194.00 AU vs. 0.32-3.59 AU). The %Time results indicated that all participants spent the majority of match-play (73.82-92.06%) in extremely low (0-2 g) to low (4-6 g) acceleration intensities, and the least %Time in very high accelerations (0.01%-0.05%).DiscussionA wearable located on the footwear to measure lower-limb load and asymmetry is feasible to use during rugby league match-play. The location of the sensor on the boot is suited to minimize injury risk occurring from impact to the sensor. This technique is able to quantify external mechanical load and detect inter limb asymmetries during match-play at the source of impact and loading, and is therefore likely to be better than current torso based methods. The results of this study may assist in preparing athletes for match-play, and in preventing injury.

Project description:PurposeThere is an increasing availability of large imaging cohorts [such as through The Cancer Imaging Archive (TCIA)] for computational model development and imaging research. To ensure development of generalizable computerized models, there is a need to quickly determine relative quality differences in these cohorts, especially when considering MRI datasets which can exhibit wide variations in image appearance. The purpose of this study is to present a quantitative quality control tool, MRQy, to help interrogate MR imaging datasets for: (a) site- or scanner-specific variations in image resolution or image contrast, and (b) imaging artifacts such as noise or inhomogeneity; which need correction prior to model development.MethodsUnlike existing imaging quality control tools, MRQy has been generalized to work with images from any body region to efficiently extract a series of quality measures (e.g., noise ratios, variation metrics) and MR image metadata (e.g., voxel resolution and image dimensions). MRQy also offers a specialized HTML5-based front-end designed for real-time filtering and trend visualization of quality measures.ResultsMRQy was used to evaluate (a) n = 133 brain MRIs from TCIA (7 sites) and (b) n = 104 rectal MRIs (3 local sites). MRQy measures revealed significant site-specific variations in both cohorts, indicating potential batch effects. Before processing, MRQy measures could be used to identify each of the seven sites within the TCIA cohort with 87.5%, 86.4%, 90%, 93%, 90%, 60%, and 92.9% accuracy and the three sites within the rectal cohort with 91%, 82.8%, and 88.9% accuracy using unsupervised clustering. After processing, none of the sites could be distinctively clustered via MRQy measures in either cohort; suggesting that batch effects had been largely accounted for. Marked differences in specific MRQy measures were also able to identify outlier MRI datasets that needed to be corrected for common acquisition artifacts.ConclusionsMRQy is designed to be a standalone, unsupervised tool that can be efficiently run on a standard desktop computer. It has been made freely accessible and open-source at http://github.com/ccipd/MRQy for community use and feedback.

Dataset Information

Technical note: TROG 15.01 SPARK trial multi-institutional imaging dose measurement.

Publications

Technical note: TROG 15.01 SPARK trial multi-institutional imaging dose measurement.

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