Publications (8) View all
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Article: Intelligent ePR system for evidence-based research in radiotherapy: proton therapy for prostate cancer.
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ABSTRACT: Proton therapy (PT) utilizes high energy particle proton beam to kill cancer cells at the target region for target cancer therapy. Due to the physical properties of the proton beam, PT delivers dose with higher precision and no exit dose compared to conventional radiotherapy. In PT, patient data are distributed among multiple systems, a hindrance to research on efficacy and effectiveness. A data mining method and a treatment plan navigator utilizing the infrastructure and data repository of a PT electronic patient record (ePR) was developed to minimize radiation toxicity and improve outcomes in prostate cancer treatment. MATERIALS/METHOD(S): The workflow of a proton therapy treatment in a radiation oncology department was reviewed, and a clinical data model and data flow were designed. A prototype PT ePR system with DICOM compliance was developed to manage prostate cancer patient images, treatment plans, and related clinical data. The ePR system consists of four main components: (1) Data Gateway; (2) ePR Server; (3) Decision Support Tools; and (4) Visualization and Display Tools. Decision support and visualization tools are currently developed based on DICOM images, DICOM-RT and DICOM-RT-ION objects data from prostate cancer patients treated with hypofractionation protocol proton therapy were used for evaluating ePR system effectiveness. Each patient data set includes a set of computed tomography (CT) DICOM images and four DICOM-RT and RT-ION objects. In addition, clinical outcomes data collected from PT cases were included to establish a knowledge base for outcomes analysis. A data mining search engine and an intelligent treatment plan navigator (ITPN) were developed and integrated with the ePR system. Evaluation was based on a data set of 39 PT patients and a hypothetical patient. The ePR system was able to facilitate the proton therapy workflow. The PT ePR system was feasible for prostate cancer patient treated with hypofractionation protocol in proton therapy. This ePR system improves efficiency in data collection and integration to facilitate outcomes analysis.International Journal of Computer Assisted Radiology and Surgery 03/2011; 6(6):769-84. · 1.48 Impact Factor -
Article: Tissue equivalency of phantom materials for neutron dosimetry in proton therapy.
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ABSTRACT: Previous Monte Carlo and experimental studies involving secondary neutrons in proton therapy have employed a number of phantom materials that are designed to represent human tissue. In this study, the authors determined the suitability of common phantom materials for dosimetry of secondary neutrons, specifically for pediatric and intracranial proton therapy treatments. This was achieved through comparison of the absorbed dose and dose equivalent from neutrons generated within the phantom materials and various ICRP tissues. The phantom materials chosen for comparison were Lucite, liquid water, solid water, and A150 tissue equivalent plastic, These phantom materials were compared to brain, muscle, and adipose tissues. The magnitude of the doses observed were smaller than those reported in previous experimental and Monte Carlo studies, which incorporated neutrons generated in the treatment head. The results show that for both neutron absorbed dose and dose equivalent, no single phantom material gives agreement with tissue within 5% at all the points considered. Solid water gave the smallest mean variation with the tissues out of field where neutrons are the primary contributor to the total dose. Of the phantom materials considered, solid water shows best agreement with tissues out of field.Medical Physics 12/2009; 36(12):5412-9. · 2.83 Impact Factor -
Article: RBE estimation of proton radiation fields using a DeltaE-E telescope.
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ABSTRACT: A new monolithic silicon DeltaE-E telescope was evaluated in unmodulated and modulated 100 MeV proton beams used for hadron therapy. Compared to a classical microdosimetry detector, which provides one-dimensional information on lineal energy of charged particles, this detector system provides two-dimensional information on lineal energy and particle energy based on energy depositions, collected in coincidence, within the DeltaE and E stages of the detector. The authors investigated the possibility to use the information obtained with the DeltaE-E telescope to determine the relative biological effectiveness (RBE) at defined locations within the proton Bragg peak and spread-out Bragg peak (SOBP). An RBE matrix based on the established in vitro V79 cell survival data was developed to link the output of the device directly to RBE(alpha), the RBE in the low-dose limit, at various depths in a homogeneous polystyrene phantom. In the SOBP of a 100 MeV proton beam, the RBE(alpha) increased from 4.04 proximal to the SOBP to a maximum value of 5.4 at the distal edge. The DeltaE-E telescope, with its high spatial resolution, has potential applications to biologically weighted hadron treatment planning as it provides a compact and portable means for estimating the RBE in rapidly changing hadron radiation fields within phantoms.Medical Physics 10/2009; 36(10):4486-94. · 2.83 Impact Factor -
Article: Out-of-field dose equivalents delivered by passively scattered therapeutic proton beams for clinically relevant field configurations.
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ABSTRACT: Microdosimetric measurements were performed at Massachusetts General Hospital, Boston, MA, to assess the dose equivalent external to passively delivered proton fields for various clinical treatment scenarios. Treatment fields evaluated included a prostate cancer field, cranial and spinal medulloblastoma fields, ocular melanoma field, and a field for an intracranial stereotactic treatment. Measurements were completed with patient-specific configurations of clinically relevant treatment settings using a silicon-on-insulator microdosimeter placed on the surface of and at various depths within a homogeneous Lucite phantom. The dose equivalent and average quality factor were assessed as a function of both lateral displacement from the treatment field edge and distance downstream of the beam's distal edge. Dose-equivalent value range was 8.3-0.3 mSv/Gy (2.5-60-cm lateral displacement) for a typical prostate cancer field, 10.8-0.58 mSv/Gy (2.5-40-cm lateral displacement) for the cranial medulloblastoma field, 2.5-0.58 mSv/Gy (5-20-cm lateral displacement) for the spinal medulloblastoma field, and 0.5-0.08 mSv/Gy (2.5-10-cm lateral displacement) for the ocular melanoma field. Measurements of external field dose equivalent for the stereotactic field case showed differences as high as 50% depending on the modality of beam collimation. Average quality factors derived from this work ranged from 2-7, with the value dependent on the position within the phantom in relation to the primary beam. This work provides a valuable and clinically relevant comparison of the external field dose equivalents for various passively scattered proton treatment fields.International journal of radiation oncology, biology, physics 02/2009; 73(1):306-13. · 4.59 Impact Factor -
Article: Out-of-field dose equivalents delivered by proton therapy of prostate cancer.
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ABSTRACT: Measurements were performed to assess the dose equivalent outside a primary proton treatment field, using a silicon-on-insulator (SOI) microdosimeter. The SOI microdosimeter was placed on the surface of an anthropomorphic phantom and dose equivalents were determined as a function of lateral distance from a typical passively scattered and modulated prostate treatment field. Measurements were also completed within a polystyrene plate phantom as a function of depth for a distance of 5 cm from the field edge, as function of lateral distance from field edge at two different depths, and as a function of distance from the distal edge on the central beam axis. The dose equivalent at the surface of the anthropomorphic phantom decreases from 3.9 to 0.18 mSv/Gy when the lateral distance from the proton field edge increases from 2.5 to 60 cm. Measurements along the proton depth dose distribution at a constant distance of 5 cm from the primary field edge indicate a decrease in dose equivalent as a function of depth, with a 38% decrease relative to the surface dose at a depth of 5 cm in polystyrene. Measurements completed as a function of lateral distance from the primary field at two separate depths within polystyrene illustrate a convergence of the dose equivalent at approximately 20 cm from the primary field edge. Past the distal edge of the spread-out Bragg peak dose equivalents decrease exponentially for increasing distance, with an initial value of 1.6 mSv/Gy at 0.6 cm from the distal edge. Silicon microdosimetry measurements were also compared with published results obtained utilizing different measurement techniques. This study demonstrates the applicability of SOI microdosimetry in determining the dose equivalent outside proton treatment fields, and provides valuable information on the dose equivalent both at the surface and at depth experienced by prostate cancer patients treated with protons.Medical Physics 10/2007; 34(9):3449-56. · 2.83 Impact Factor
