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Commissioning of total body irradiation using plastic bead bags.

ABSTRACT: The goal of total body irradiation (TBI) is to deliver a dose to the whole body with uniformity within ±10%. The purpose of this study was to establish the technique of TBI using plastic bead bags. A lifting TBI bed, Model ORP-TBI-MN, was used. The space between the patient's body and the acrylic walls of the bed was filled with polyacetal bead bags. Patients were irradiated by a 10 MV photon beam with a source to mid-plane distance of 400 cm. The monitor unit (MU) was calculated by dose-per-MU, tissue-phantom-ratio and a spoiler factor measured in solid water using an ionization chamber. The phantom-scatter correction factor, off-center ratio and the effective density of the beads were also measured. Diode detectors were used for in vivo dosimetry (IVD). The effective density of the beads was 0.90 ± 0.09. The point doses calculated in an I'mRT phantom with and without heterogeneity material showed good agreement, with measurements within 3%. An end-to-end test was performed using a RANDO phantom. The mean ± SD (range) of the differences between the calculated and IVD-measured mid-plane doses was 1.1 ± 4.8% (-5.9 to 5.0%). The differences between the IVD-measured doses and the doses calculated with Acuros XB of the Eclipse treatment planning system (TPS) were within 5%. For two patients treated with this method, the differences between the calculated and IVD-measured doses were within ±6% when excluding the chest region. We have established the technique of TBI using plastic bead bags. The TPS may be useful to roughly estimate patient dose.

SUBMITTER: Akino Y

PROVIDER: S-EPMC7674696 | biostudies-literature | 2020 Nov

REPOSITORIES: biostudies-literature

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Commissioning of total body irradiation using plastic bead bags.

Akino Yuichi Y Maruoka Shintaro S Yano Katsuyuki K Abe Hiroshi H Isohashi Fumiaki F Seo Yuji Y Tamari Keisuke K Hirata Takero T Kawakami Manabu M Nakae Yoshiki Y Tanaka Yoshihiro Y Ogawa Kazuhiko K

Journal of radiation research 20201101 6

The goal of total body irradiation (TBI) is to deliver a dose to the whole body with uniformity within ±10%. The purpose of this study was to establish the technique of TBI using plastic bead bags. A lifting TBI bed, Model ORP-TBI-MN, was used. The space between the patient's body and the acrylic walls of the bed was filled with polyacetal bead bags. Patients were irradiated by a 10 MV photon beam with a source to mid-plane distance of 400 cm. The monitor unit (MU) was calculated by dose-per-MU, ...[more]

PMID: 32876686

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Project description:BACKGROUND:Volumetric Modulated Arc Therapy (VMAT) techniques have recently been implemented in clinical practice for total-body irradiation (TBI). To date, most techniques still use special couches, translational tables, or other self-made immobilization devices for dose delivery. Aim of the present study was to report the first results of a newly developed rotatable tabletop designed for VMAT-TBI. METHODS:The VMAT-TBI technique theoretically allows the use of any standard positioning device at the linear accelerator. Nevertheless, the main problem is that patients taller than 120 cm cannot be treated in one position due to the limited cranial-caudal couch shift capacities of the linac. Therefore, patients are usually turned from a head-first supine position (HFS) to a feet-first supine position (FFS) to overcome this limitation. The newly developed rotatable tabletop consists completely of carbon fiber, including the ball bearing within the base plate of the rotation unit. The patient can be turned 180° from a HFS to a FFS position within a few seconds, without the need of repositioning. RESULTS:The first 20 patients had a median age of 47 years, and received TBI before bone marrow transplantation for acute myeloid leukemia. Most patients (13/20) received a TBI dose of 4 Gy in 2 fractions, twice daily. The mean number of applied monitor units (MU) was 6476 MU using a multi-arcs and multi-isocenter VMAT-TBI technique. The tabletop has been successfully used in daily clinical practice and helped to keep the treatment times at an acceptable level. During the first treatment fraction, the mean overall treatment time (OTT) was 57 min. Since no additional image guidance was used in fraction 2 of the same day, the OTT was reduced to mean 38 min. CONCLUSIONS:The easy and reproducible rotation of the patient on the treatment couch using the rotatable tabletop, is time-efficient and overcomes the need of repositioning the patient after turning from a HFS to a FFS position during VMAT TBI. Furthermore, it prevents couch-gantry collisions, incorrect isocenter shifts and beam mix-up due to predicted absolute table coordinates, which are recorded to the R + V system with the corresponding beams.

Project description:Plastics are of great significance in today's world due to their extensive use such as packaging food and carrying other goods, which have improved the quality of human life. However, plastics have low biodegradability and are persistent in the environment, becoming a major source of pollution. With regard to the current methods used in the management of plastic wastes, the degradation of plastics using beneficial soil microorganisms has recently gained attention due to their ability to degrade different types of plastics including polyethylene (PE) polymers. The study herein was conducted to isolate and identify microorganisms from agricultural soils capable of degrading plastics. Soil samples were inoculated into nutrient, potato dextrose, and starch-casein agar for the isolation of bacteria, fungi, and actinomycetes, respectively. During isolation, fungi and bacterial plates were incubated for 5 days and for 14 days, respectively. The population of bacteria ranged from 1 × 105 to 1.215 × 105 and that of fungi from 1.604 × 104 to 8.6 × 104 whereby actinomycetes ranged from 1.045 × 105 to 2.995 × 105 CFU/g of soil. However, the tested microorganisms showed significant (p ≤ 0.05) differences in the ability to degrade PE bags and bottles as depicted by the diameters of clear zones around the colonies. The diameters of clear zones ranged from 19.3 to 47.5 mm and 25.9 to 32.2 mm after 17 days for bacteria and actinomycetes, respectively, and those of fungi ranged from 30.0 to 66.3 mm after 13 days. Among the bacteria, actinomycetes, and fungi, unsequenced bacterial and actinomycete isolates B1 and A3 as well as Aspergillus sp. (F7) were the most efficient degraders of PE plastic bags. This retrospective study sheds light on our understanding and the need for the bioprospecting of agricultural soils, water bodies, and landfills containing plastic wastes that could lead to the identification of more efficient microbial species with the ability to degrade plastics.

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Commissioning of total body irradiation using plastic bead bags.

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Commissioning of total body irradiation using plastic bead bags.

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