Flash radiotherapy is a kind of radiotherapy method using ultra-high dose rate radiation. Compared with the traditional dose rate radiotherapy, it has unique radiobiological advantages. In this paper, the principle of flash radiotherapy, the process and results of biological experiments are summarized. At the same time, the advantages and challenges of flash radiotherapy are analyzed, and the future clinical application is prospected.
Radiotherapy/methods* ; Radiotherapy Dosage ; Technology

PURPOSETo validate that DMPO model for "one step" algorithm can reduce the total MLC segments number, we compare the dosage distribution of "one-step" algorithm with "two-step" algorithm for generating IMRT MLC segments.

METHODSOn the platform of "Pinnacle 8.0h" version radiation treatment planning system developed by Philips, we respectively select one head and neck tumor case, one thorax tumor case and one abdomen tumor case, by means of designing seven fields IMRT planning, then utilized "one-step" algorithm and "two-step" algorithm to optimize and generate IMRT MLC segments, and then calculated dosage distribution, evaluated dosage distribution lines and DVH diagram, in order to compare the two MLC segment groups generated by the two different algorithm.

RESULTFor the three IMRT plans selected by us, the number of MLC segments generated by "two-step" algorithm appear to be larger than "one-step" algorithm but dosage distribution seems to be worse than the latter.

DISCUSSIONFor utilizing the "Pinnacle" plan system to design IMRT plan, "one-step" algorithm with "DMPO" definitely can effectively reduce the number of MLC segments, what's more, the result of dosage distribution seems to be better.

Algorithms ; Radiotherapy Dosage ; Radiotherapy, Intensity-Modulated ; methods

OBJECTIVETo validate the efficiency of an improved Demons deformable registration algorithm and evaluate its application in registration of the treatment image and the planning image in image-guided radiotherapy (IGRT).

METHODSBased on Brox's gradient constancy assumption and Malis's efficient second-order minimization algorithm, a grey value gradient similarity term was added into the original energy function, and a formula was derived to calculate the update of transformation field. The limited Broyden-Fletcher-Goldfarb-Shanno (L-BFGS) algorithm was used to optimize the energy function for automatic determination of the iteration number. The proposed algorithm was validated using mathematically deformed images, physically deformed phantom images and clinical tumor images.

RESULTSCompared with the original Additive Demons algorithm, the improved Demons algorithm achieved a higher precision and a faster convergence speed.

CONCLUSIONDue to the influence of different scanning conditions in fractionated radiation, the density range of the treatment image and the planning image may be different. The improved Demons algorithm can achieve faster and more accurate radiotherapy.

Algorithms ; Humans ; Liver Neoplasms ; radiotherapy ; Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted ; methods ; Radiotherapy, Conformal ; methods ; Radiotherapy, Image-Guided ; methods

In this paper, two new concepts of DR (Dose Repulsion) and DG (Dose Gravitation) are presented with their calculation formulas. For the problem of selecting beam arcs in x-knife radiotherapy Planning system, a mathematics model of constrained optimization has been built. Furthermore, we have produced a feasible project of automatic selecting optimized beam arcs plan using SA (Simulated Annealing) arithmetic based on the distribution of the fields of DR and DG in the reduced phase space.
Algorithms ; Brain Neoplasms ; radiotherapy ; Models, Theoretical ; Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted ; methods ; Radiotherapy, Conformal ; methods

OBJECTIVETo research the method of dosimetric verification of the intensity modulated radiation therapy (IMRT).

METHODSThe IMRT treatment plans were designed by Eclipse TPS and were implemented in Varian ClinacIX LA with 6MV X-ray. The absolute point doses were measured using a PTW 0.6 cc ion chamber with UNIDOS E dosimeter and the planes dose distributions were measured using PTW 2D-Array ion chamber in the phantom.

RESULTSThe error between the measured dose and calculated dose in the interesting points was less than 3%. The points passed ratio was more than 90% in gamma analysis method (3 mm 13%) about the plane dose distribution verification.

CONCLUSIONThe method of dosimetric verification of IMRT is reliable and efficient in the implementation.

Radiometry ; methods ; Radiotherapy Dosage ; Radiotherapy, Intensity-Modulated ; methods

Conformal radiation therapy using multi-leaf collimator (MLC) is considered as a conventional technology in the hospital nowadays. However the stepped leaf edge caused by the finite width of the leaves could influence the conformality that could be achievable. In this paper, the effect produced by rotating the collimator angle on the conformality was investigated. A method, in which multiple MLC fields of various rotation angles are applied, has been proposed to have the targets be more uniformly irradiated and thus to eliminate the cold spots on the targets and hot spots in normal tissues. By simulation, it has been shown that the multiple MLC field method can eliminate the stepped leaf edges and improve the conformality significantly, moreover, the PTV can receive a more uniform delivery with cold spot eliminated.
Humans ; Radiometry ; methods ; Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted ; instrumentation ; methods ; Radiotherapy, Conformal ; methods

OBJECTIVETo implement dose reconstruction and dose-guided intensity modulated radiotherapy for helical tomotherapy.

METHODSDose reconstruction was implemented on adaptive helical tomotherapy with the online megavoltage CT (MVCT) imaging from a patient with nasopharyngeal cancer. The differences of isodose line between actual and planned deposition were analysis in 3D distribution, on which the hot spot and cold spot were lined. The dose delivered to these areas was modulated in later fractions to keep the planned requirement.

RESULTSThe differences between actual and planned isodose line were shown on the image visually. The modulation to the hot spot and cold spot in later fraction corrected the incorrectly delivered dose to achieve the requirement of primary plan.

CONCLUSIONSThe dose reconstruction and dose-guided intensity modulated radiotherapy can be implemented in adaptive helical tomotherapy.

Humans ; Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted ; methods ; Radiotherapy, Intensity-Modulated ; methods ; Tomography, Spiral Computed ; methods

The purpose of this study is to establish and apply a correction method for titanium alloy implant in spinal IMRT plan, a corrected CT-density table was revised from normal CT-density table to include the density of titanium alloy implant. Dose distribution after and before correction were calculated and compared to evaluate the dose deviation. Plans were also copied to a spinal cancer simulation phantom. A titanium alloy fixation system for spine was implanted in this phantom. Plans were recalculated and compared with the measurement result. The result of this study shows that the max dose of spinal cord showed significant difference after correction, and the deviation between calculation results and measurement results was reduced after correction. The method for expanding the range CT-density table, which means that the density of titanium alloy was included, can reduce the error in calculation.
Radiotherapy, Intensity-Modulated/methods* ; Titanium ; Radiotherapy Dosage ; Alloys ; Radiometry/methods* ; Radiotherapy Planning, Computer-Assisted/methods*

OBJECTIVE: To study the feasibility and potential benefits of beam angle optimization (BAO) to automated planning in liver cancer. METHODS: An approach of beam angle sampling is proposed to implement BAO along with the module Auto-planning in treatment planning system (TPS) Pinnacle. An in-house developed plan quality metric (PQM) is taken as the preferred evaluating method during the sampling. The process is driven automatically by in-house made Pinnacle scripts both in sampling and scoring. In addition, dosimetry analysis and physician's opinion are also performed as the supplementary and compared with the result of PQM. RESULTS: It is revealed by the numerical analysis of PQM scores that only 15% patients whose superior trials evaluated by PQM are also the initial trials. Gantry optimization can bring benefit to plan quality along with auto-planning in liver cancer. Similar results are provided by both dose comparison and physician's opinion. CONCLUSIONS It is possible to introduce a full automated approach of beam angle optimization to automated planning process. The advantages of this procedure can be observed both in numerical analysis and physician's opinion.
Humans ; Radiotherapy Planning, Computer-Assisted/methods* ; Feasibility Studies ; Radiometry/methods* ; Liver Neoplasms/radiotherapy* ; Radiotherapy, Intensity-Modulated/methods* ; Radiotherapy Dosage

Fourteen patients with pancreatic carcinoma were selected. Two treatment plans were designed for each patient, including gamma knife and Tomotherapy. The dose characteristics were evaluated by DVH and were compared. The results showed that the gamma knife plan had the higher maximal and mean target dose than Tomotherapy. Body gamma knife can increase the target dose significantly, and decrease the OAR dose. Tomotherapy had excellent dose-target conformality, and it can control doses of duodenum and stomach easily, but it had larger low dose region.
Humans ; Pancreatic Neoplasms ; radiotherapy ; Radiosurgery ; methods ; Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted ; methods