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Giorgia Nicolini

Giorgia Nicolini
Radiqa Services · Medical Physics Team

About

174
Publications
64,159
Reads
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5,063
Citations
Additional affiliations
July 2016 - August 2020
Radiqa Developments
Position
  • Senior Medical Physicist
October 1998 - October 2002
Ospedale di Circolo e Fondazione Macchi Varese
Position
  • Servizio di Fisica Sanitaria
October 2002 - December 2014
Oncologist Institute of Southern Switzerland (IOSI)
Position
  • Medical Professional

Publications

Publications (174)
Article
Full-text available
Purpose: Volumetric modulated arc therapy (VMAT) for left breast treatments allows heart sparing without compromising PTV coverage. However, this technique may require highly complex plans. Deep Inspiration Breath Hold (DIBH) procedure increases the heart-to-breast distance, facilitating the dose sparing of the heart. The aim of the present work wa...
Article
Purpose The concept of quality assurance in radiotherapy encompasses a comprehensive approach to all activities in the department. When hypo-fractionation regiment is adopted, the need of a continuous quality procedures updating is self-evident. At this aim, the Lean Six Sigma Methodology (LSSM) has been applied. LSSM was introduced in industry for...
Article
Purpose Radiotherapy with intensity modulation (IMRT and VMAT) implies the setup of adequate QA programs to guarantee safe treatments. Concerning this issue, amorphous silicon EPID technologies are particularly interesting due to their high spatial resolution, large area, stability, dynamic range, and real-time acquisition capabilities. In this con...
Article
Background & purpose: Lean Six Sigma Methodology (LSSM) was introduced in industry to provide near-perfect services to large processes, by reducing improbable occurrence. LSSM has been applied to redesign the 2D-2D breast repositioning process (Lean) by the retrospective analysis of the database (Six Sigma). Materials & methods: Breast patients...
Article
Full-text available
Purpose To evaluate the performance of a model-based optimisation process for volumetric modulated arc therapy, VMAT, applied to whole breast irradiation. Methods and Materials A set of 150 VMAT dose plans with simultaneous integrated boost were selected to train a model for the prediction of dose-volume constraints. The dosimetric validation was...
Article
Full-text available
Background: To evaluate the performance of a broad scope model-based optimisation process for volumetric modulated arc therapy applied to esophageal cancer. Methods and materials: A set of 70 previously treated patients in two different institutions, were selected to train a model for the prediction of dose-volume constraints. The model was buil...
Article
Full-text available
Background: Machine Performance Check (MPC) is an application to verify geometry and beam performances of TrueBeam Linacs, through automated checks based on their kV-MV imaging systems. In this study, preliminary tests with MPC were analyzed using all photon beam energies of our TrueBeam, comparing whenever possible with external independent check...
Article
To evaluate the performance of a model-based optimisation process for volumetric modulated arc therapy applied to advanced lung cancer and to low risk prostate carcinoma patients.Methods and materialsTwo sets each of 27 previously treated patients, were selected to train models for the prediction of dose–volume constraints. The models were validate...
Article
Full-text available
Background To evaluate in-silico the performance of a model-based optimization process for volumetric modulated arc therapy (RapidArc) applied to hepatocellular cancer treatments.Patients and methods45 clinically accepted RA plans were selected to train a knowledge-based engine for the prediction of individualized dose-volume constraints. The model...
Article
Full-text available
Background To appraise the robustness of VMAT dose distributions against uncertainties in the positioning of the patients when single fraction SABRT treatments are planned. Methods A set of 18 patients (8 lung, 5 brain, 5 spinal or para-spinal) treated with VMAT in a single fraction of 24Gy were retrospectively analyzed. All approved plans were re...
Article
Phase-space files for Monte Carlo simulation of the Varian TrueBeam beams have been made available by Varian. The aim of this study is to evaluate the accuracy of the distributed phase-space files for flattening filter free (FFF) beams, against experimental measurements from ten TrueBeam Linacs. The phase-space files have been used as input in PRIM...
Article
New definitions for some dosimetric parameters for use in quality assurance of flattening filter free (FFF) beams generated by medical linear accelerators have been suggested. The present study aims to validate these suggestions and to propose possible reference levels. The main characteristics of FFF photon beams were described in terms of: field...
Article
Full-text available
Purpose To evaluate the dosimetric consequences of inaccurate isocenter positioning during treatment of total marrow (lymph‐node) irradiation (TMI‐TMLI) using volumetric modulated arc therapy (VMAT). Methods Four patients treated with TMI and TMLI were randomly selected from the internal database. Plans were optimized with VMAT technique. Planning...
Article
Full-text available
Purpose To demonstrate the feasibility of portal dosimetry with an amorphous silicon mega voltage imager for flattening filter free (FFF) photon beams by means of the GLAaS methodology and to validate it for pretreatment quality assurance of volumetric modulated arc therapy (RapidArc). Methods The GLAaS algorithm, developed for flattened beams, wa...
Article
Full-text available
Purpose The accuracy of photon dose calculation algorithms in out‐of‐field regions is often neglected, despite its importance for organs at risk and peripheral dose evaluation. The present work has assessed this for the anisotropic analytical algorithm (AAA) and the Acuros‐XB algorithms implemented in the Eclipse treatment planning system. Specific...
Article
Full-text available
Background: The accuracy of the two dose calculation engines available for RapidArc planning (both released for clinical use) is investigated in comparison to the COMPASS data. Methods: Two dose calculation algorithms (Acuros-XB and Anisotropic Analytic Algorithm (AAA)) were used to calculate RA plans and compared to calculations with the Collap...
Article
Full-text available
Objective: To evaluate the use of volumetric-modulated arc therapy [VMAT, RapidArc® (RA); Varian Medical Systems, Palo Alto, CA] for the treatment of cutaneous Kaposi's sarcoma (KS) of lower extremities with adequate target coverage and high bone sparing, and to compare VMAT with electron beam therapy. Methods: 10 patients were planned with eith...
Article
Purpose: Complex radiotherapy fields delivered using a tertiary multileaf collimator (MLC) often feature small open segments surrounded by large areas of the beam only shielded by the MLC. The aim of this study was to test the ability of two modern dose calculation algorithms to accurately calculate the dose in these fields which would be common,...
Article
Full-text available
Purpose : Flattening filter free (FFF) beams generated by medical linear accelerators have recently started to be used in radiotherapy clinical practice. Such beams present fundamental differences with respect to the standard filter flattened (FF) beams, making the generally used dosimetric parameters and definitions not always viable. The present...
Article
Full-text available
Background To report results in terms of feasibility and early toxicity of hypofractionated simultaneous integrated boost (SIB) approach with Volumetric Modulated Arc Therapy (VMAT) as adjuvant treatment after breast-conserving surgery. Methods Between September 2010 and May 2011, 50 consecutive patients presenting early-stage breast cancer were s...
Article
Full-text available
Background: To appraise the potential of volumetric modulated arc therapy (VMAT, RapidArc) and proton beams to simultaneously achieve target coverage and enhanced sparing of bone tissue in the treatment of soft-tissue sarcoma with adequate target coverage. Material and methods: Ten patients presenting with soft-tissue sarcoma of the leg were col...
Article
Full-text available
The goal of the work was to assess the role of RapidArc treatments in chest wall irradiation after mastectomy and determine the potential benefit of flattening filter free beams. Planning CT scans of 10 women requiring post-mastectomy chest wall radiotherapy were included in the study. A dose of 50 Gy in 2 Gy fractions was prescribed. Organs at ris...
Article
A feasibility study was performed to evaluate RapidArc (RA), and the potential benefit of flattening filter-free beams, on advanced esophageal cancer against intensity-modulated radiotherapy (IMRT) and three-dimensional conformal radiotherapy (3D-CRT). The plans for 3D-CRT and IMRT with three to seven and five to seven fixed beams were compared aga...
Article
To assess the clinical impact of the Acuros XB algorithm (implemented in the Varian Eclipse treatment-planning system) in non-small-cell lung cancer (NSCLC) cases. A CT dataset of 10 patients presenting with advanced NSCLC was selected and contoured for planning target volume, lungs, heart, and spinal cord. Plans were created for 6-MV and 15-MV bea...
Article
The RapidArc volumetric modulated arc therapy (VMAT) planning process is based on a core engine, the so-called progressive resolution optimizer (PRO). This is the optimization algorithm used to determine the combination of field shapes, segment weights (with dose rate and gantry speed variations), which best approximate the desired dose distributio...
Article
To assess the accuracy against measurements of two photon dose calculation algorithms (Acuros XB and the Anisotropic Analytical algorithm AAA) for small fields usable in stereotactic treatments with particular focus on RapidArc(®). Acuros XB and AAA were configured for stereotactic use. Baseline accuracy was assessed on small jaw-collimated open fi...
Article
Full-text available
A new-generation low-energy linear accelerator (UNIQUE) was introduced in the clinical arena during 2009 by Varian Medical Systems. The world's first UNIQUE was installed at Oncology Institute of Southern Switzerland and put into clinical operation in June 2010. The aim of the present contribution was to report experience about its commissioning an...
Article
Full-text available
A new algorithm for photon dose calculation, Acuros XB, has been recently introduced in the Eclipse, Varian treatment planning system, allowing, similarly to the classic Monte Carlo methods, for accurate modelling of dose deposition in media. Aim of the present study was the assessment of its behaviour in clinical cases. Datasets from ten breast pa...
Data
Dose profiles rescaled to water for phantom A. Profiles at mid-depth of the heterogeneity insert. Dose rescaled to water calculations for VMC++, Acuros XB version 10, and AAA in phantom A. In columns: Normal Lung, Light Lung, Bone; in rows: SF and LF for 6X, SF and LF for 15X.
Data
GAI for dose rescaled to water. Histograms of the GAI. Global gamma calculation for each sector of phantoms A and B, for dose rescaled to water calculations for Acuros XB version 10 (red horizontal hatching) and AAA (green diagonal hatching). Each bin represents the two threshold results of 2%, 2 mm (thin cross-hatching) and 3%, 3 mm (thick cross-h...
Data
DD rescaled to water for phantom A. Depth dose curves (DD) at -4 cm off-axis. Dose rescaled to water calculations for VMC++, Acuros XB version 10, and AAA in phantom A. In columns: Normal Lung, Light Lung, Bone; in rows: SF and LF for 6X, SF and LF for 15X.
Data
Dose profiles to water for phantom A. Profiles at mid-depth of the heterogeneity insert. Dose to water calculations for VMC++, Acuros XB version 10, and AAA in phantom A. In columns: Normal Lung, Light Lung, Bone; in rows: SF and LF for 6X, SF and LF for 15X.
Data
DD to water for phantom B. Depth dose curves (DD) at beam central axis. Dose to water calculations for VMC++, Acuros XB version 10, and AAA in phantom B. In columns: SF, LF; in rows: 6X, 15X.
Data
DD rescaled to water for phantom B. Depth dose curves (DD) at beam central axis. Dose rescaled to water calculations for VMC++, Acuros XB version 10, and AAA in phantom B. In columns: SF, LF; in rows: 6X, 15X.
Data
GAI for dose to water. Histograms of the GAI. Global gamma calculation for each sector of phantoms A and B, for dose to water calculations for Acuros XB version 10 (red horizontal hatching) and AAA (green diagonal hatching). Each bin represents the two threshold results of 2%, 2 mm (thin cross-hatching) and 3%, 3 mm (thick cross-hatching). In colum...
Article
Full-text available
A study was realised to evaluate and determine relative figures of merit of a new algorithm for photon dose calculation when applied to inhomogeneous media. The new Acuros XB algorithm implemented in the Varian Eclipse treatment planning system was compared against a Monte Carlo method (VMC++), and the Analytical Anisotropic Algorithm (AAA). The st...
Article
In breast radiotherapy with intensity modulation, it is a well established practice to extend the dose fluence outside the limit of the body contour to account for small changes in size and position of the target and the rest of the tissues due to respiration or to possible oedema. A simple approach is not applicable with RapidArc volumetric modula...
Article
A preclinical investigation was undertaken to explore a treatment technique for total marrow irradiation using RapidArc, a volumetric modulated arc technique. Computed tomography datasets of 5 patients were included. Plans with eight overlapping coaxial arcs were optimized for 6-MV photon beams. Dose prescription was 12 Gy in 2 Gy per fraction, nor...