Displaying publications 61 - 79 of 79 in total

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  1. Jong WL, Ung NM, Vannyat A, Rosenfeld AB, Wong JHD
    Phys Med, 2017 Oct;42:39-46.
    PMID: 29173919 DOI: 10.1016/j.ejmp.2017.08.011
    Challenges in treating lung tumours are related to the respiratory-induced tumour motion and the accuracy of dose calculation in charged particle disequilibrium condition. The dosimetric characteristics near the interface of lung and Perspex media in a moving phantom during respiratory-gated and non-gated radiotherapy were investigated using Gafchromic EBT2 and the MOSkin detector. The MOSkin detectors showed good agreement with the EBT2 films during static and gated radiotherapy. In static radiotherapy, the penumbral widths were found to be 3.66mm and 7.22mm in Perspex and lung media, respectively. In non-gated (moving) radiotherapy with 40mm respiratory amplitude, dose smearing effect was observed and the penumbral widths were increased to 28.81mm and 26.40mm, respectively. This has been reduced to 6.85mm and 9.81mm, respectively, in gated radiotherapy with 25% gating window. There were still some dose discrepancies as compared to static radiotherapy due to the residual motion. This should be taken into account in the margin generation for the target tumour.
    Matched MeSH terms: Radiometry/instrumentation
  2. Begum M, Rahman AK, Abdul-Rashid HA, Yusoff Z, Begum M, Mat-Sharif KA, et al.
    Appl Radiat Isot, 2015 Jun;100:79-83.
    PMID: 25468288 DOI: 10.1016/j.apradiso.2014.10.025
    Important thermoluminescence (TL) properties of five (5) different core sizes Ge-doped optical fibers have been studied to develop new TL material with better response. These are drawn from same preform applying different speed and tension during drawing phase to produce Ge-doped optical fibers with five (5) different core sizes. The results of the investigations are also compared with most commonly used standard TLD-100 chips (LiF:Mg,Ti) and commercial multimode Ge-doped optical fiber (Yangtze Optical Fiber, China). Scanning Electron Microscope (SEM) and EDX analysis of the fibers are also performed to map Ge distribution across the deposited region. Standard Gamma radiation source in Secondary Standard Dosimetry Lab (SSDL) was used for irradiation covering dose range from 1Gy to 10Gy. The essential dosimetric parameters that have been studied are TL linearity, reproducibility and fading. Prior to irradiation all samples ∼0.5cm length are annealed at temperature of 400°C for 1h period to standardize their sensitivities and background. Standard TLD-100 chips are also annealed for 1h at 400°C and subsequently 2h at 100°C to yield the highest sensitivity. TL responses of these fibers show linearity over a wide gamma radiation dose that is an important property for radiation dosimetry. Among all fibers used in this study, 100μm core diameter fiber provides highest response that is 2.6 times than that of smallest core (20μm core) optical fiber. These fiber-samples demonstrate better response than commercial multi-mode optical fiber and also provide low degree of fading about 20% over a period of fifteen days for gamma radiation. Effective atomic number (Zeff) is found in the range (13.25-13.69) which is higher than soft tissue (7.5) however within the range of human-bone (11.6-13.8). All the fibers can also be re-used several times as a detector after annealing. TL properties of the Ge-doped optical fibers indicate promising applications in ionizing radiation dosimetry.
    Matched MeSH terms: Radiometry
  3. Islam MM, Islam MT, Faruque MR
    ScientificWorldJournal, 2013;2013:378420.
    PMID: 24385878 DOI: 10.1155/2013/378420
    The dual-band operation of a microstrip patch antenna on a Duroid 5870 substrate for Ku- and K-bands is presented. The fabrication of the proposed antenna is performed with slots and a Duroid 5870 dielectric substrate and is excited by a 50 Ω microstrip transmission line. A high-frequency structural simulator (HFSS) is used which is based on the finite element method (FEM) in this research. The measured impedance bandwidth (2 : 1 VSWR) achieved is 1.07 GHz (15.93 GHz-14.86 GHz) on the lower band and 0.94 GHz (20.67-19.73 GHz) on the upper band. A stable omnidirectional radiation pattern is observed in the operating frequency band. The proposed prototype antenna behavior is discussed in terms of the comparisons of the measured and simulated results.
    Matched MeSH terms: Radiometry
  4. Tan KC, Lim HS, Matjafri MZ, Abdullah K
    Environ Monit Assess, 2012 Jun;184(6):3813-29.
    PMID: 21755424 DOI: 10.1007/s10661-011-2226-0
    Atmospheric corrections for multi-temporal optical satellite images are necessary, especially in change detection analyses, such as normalized difference vegetation index (NDVI) rationing. Abrupt change detection analysis using remote-sensing techniques requires radiometric congruity and atmospheric correction to monitor terrestrial surfaces over time. Two atmospheric correction methods were used for this study: relative radiometric normalization and the simplified method for atmospheric correction (SMAC) in the solar spectrum. A multi-temporal data set consisting of two sets of Landsat images from the period between 1991 and 2002 of Penang Island, Malaysia, was used to compare NDVI maps, which were generated using the proposed atmospheric correction methods. Land surface temperature (LST) was retrieved using ATCOR3_T in PCI Geomatica 10.1 image processing software. Linear regression analysis was utilized to analyze the relationship between NDVI and LST. This study reveals that both of the proposed atmospheric correction methods yielded high accuracy through examination of the linear correlation coefficients. To check for the accuracy of the equation obtained through linear regression analysis for every single satellite image, 20 points were randomly chosen. The results showed that the SMAC method yielded a constant value (in terms of error) to predict the NDVI value from linear regression analysis-derived equation. The errors (average) from both proposed atmospheric correction methods were less than 10%.
    Matched MeSH terms: Radiometry
  5. Ismail AH, Jaafar MS
    Appl Radiat Isot, 2011 Mar;69(3):559-66.
    PMID: 21208807 DOI: 10.1016/j.apradiso.2010.11.004
    Complete blood counts were analyzed for 30 samples of human blood with radiation dose rate ranging between 10 and 41 μSv/h using a Radium-226 source with different time of exposure. A new technique involving a nuclear track detector type CR-39(CR-39 NTDs) was used to estimate the alpha particle density incident on the blood samples. The results show that the ranges of alpha particle in blood samples and on the surface of CR-39NTDs vary exponentially with energy of alpha particles. This depends on the restricted energy loss and target density. Changes in the blood components due to irradiation occurred for different durations of irradiation, and the duration of irradiation that influenced the blood samples in this study was 6 min. The change in red blood cell (RBC) was negligible, so it is less affected than other blood components. In addition, most changes in the blood contents began at a low radiation dose (10.38-13.41 μSv/h). For the doses 13.41-21.77 μSv/h, platelet (PLT) counts increased rapidly and adversely with the RBC and white blood cell (WBC) due to chromosomal aberration. Besides, rapid PLT count reduction rapidly at high dose (42.1 μSvh) causes thrombocytopenia; in contrast, WBC increased, which is an indication of cancer caused due to increase in alpha particle dose. Generally, our results are in agreement with the essentials of blood content and the principles of biological radiation interaction.
    Matched MeSH terms: Radiometry
  6. Asaad H. Ismail, Mohamad S. Jafaar
    MyJurnal
    The aim of this study is to design radon irradiation technique in the field of hematology for an invitro study. In addition, deposit of alpha particles into the human blood surface and its effects on the thrombocytopenia estimated using nuclear track detectors (NTDs). In this technique, amount of radon gas (2210±5.1Bq/m 3 ) collected in a tight PVC container with the appropriate engineering dimension using two sources of radium (5μCi). Blood samples (10 male and 10 female) and CR-39NTDs (40 pieces) are exposed to radon gas at various exposure time. Complete blood test and the computer scanning for each piece of CR-39NTDs before and after exposure has done. The results show that the present technique has a good efficiency (96%) to the invitro exposure of human blood. When the radon gas moved on the surface of blood sample, alpha tracks registered into CR-39NTDs. Thus, this technique improved that the comparative method to evaluate alpha particle density into exposure blood samples is an effective way; this depended on the geometry of design and the sensitivity of CR-39NTDs to track registration. Radon detector version 7 (RAD7) used to make a certain suitability of CR- 39NTDs. Amount of radon concentration losses during the exposure process, in the present work it was variable from 0.41% to 1.4%. Radon concentration effected on the thrombocytopenia; this depended on time of exposure and alpha energy loss into the blood and CR-39 through the atomic displacements. At the time of exposure of 10 minutes, rate of absorption dose was 2.255±0.11μSv (39%), and the platelet (PLT) cont reduced rapidly (high effected on reduce PLT, this makes thrombocytopenia.
    Matched MeSH terms: Radiometry
  7. Tan SK, Yeong CH, Ng KH, Abdul Aziz YF, Sun Z
    PLoS One, 2016;11(8):e0161543.
    PMID: 27552224 DOI: 10.1371/journal.pone.0161543
    OBJECTIVES: This study aimed to measure the absorbed doses in selected organs for prospectively ECG-triggered coronary computed tomography angiography (CCTA) using five different generations CT scanners in a female adult anthropomorphic phantom and to estimate the effective dose (HE).

    MATERIALS AND METHODS: Prospectively ECG-triggered CCTA was performed using five commercially available CT scanners: 64-detector-row single source CT (SSCT), 2 × 32-detector-row-dual source CT (DSCT), 2 × 64-detector-row DSCT and 320-detector-row SSCT scanners. Absorbed doses were measured in 34 organs using pre-calibrated optically stimulated luminescence dosimeters (OSLDs) placed inside a standard female adult anthropomorphic phantom. HE was calculated from the measured organ doses and compared to the HE derived from the air kerma-length product (PKL) using the conversion coefficient of 0.014 mSv∙mGy-1∙cm-1 for the chest region.

    RESULTS: Both breasts and lungs received the highest radiation dose during CCTA examination. The highest HE was received from 2 × 32-detector-row DSCT scanner (6.06 ± 0.72 mSv), followed by 64-detector-row SSCT (5.60 ± 0.68 and 5.02 ± 0.73 mSv), 2 × 64-detector-row DSCT (1.88 ± 0.25 mSv) and 320-detector-row SSCT (1.34 ± 0.48 mSv) scanners. HE calculated from the measured organ doses were about 38 to 53% higher than the HE derived from the PKL-to-HE conversion factor.

    CONCLUSION: The radiation doses received from a prospectively ECG-triggered CCTA are relatively small and are depending on the scanner technology and imaging protocols. HE as low as 1.34 and 1.88 mSv can be achieved in prospectively ECG-triggered CCTA using 320-detector-row SSCT and 2 × 64-detector-row DSCT scanners.

    Matched MeSH terms: Radiometry
  8. Yeong CH, Ng KH, Abdullah BJJ, Chung LY, Goh KL, Perkins AC
    Appl Radiat Isot, 2014 Dec;94:216-220.
    PMID: 25222875 DOI: 10.1016/j.apradiso.2014.08.009
    Radionuclide imaging using (111)In, (99m)Tc and (153)Sm is commonly undertaken for the clinical investigation of gastric emptying, intestinal motility and whole gut transit. However the documented evidence concerning internal radiation dosimetry for such studies is not readily available. This communication documents the internal radiation dosimetry for whole gastrointestinal transit studies using (111)In, (99m)Tc and (153)Sm labeled formulations. The findings were compared to the diagnostic reference levels recommended by the United Kingdom Administration of Radioactive Substances Advisory Committee, for gastrointestinal transit studies.
    Matched MeSH terms: Radiometry/methods*
  9. Zaman ZK, Ung NM, Malik RA, Ho GF, Phua VC, Jamalludin Z, et al.
    Phys Med, 2014 Dec;30(8):980-4.
    PMID: 25086486 DOI: 10.1016/j.ejmp.2014.07.002
    Cobalt-60 (Co-60) is a relatively new source for the application of high-dose rate (HDR) brachytherapy. Radiation dose to the rectum is often a limiting factor in achieving the full prescribed dose to the target during brachytherapy of cervical cancer. The aim of this study was to measure radiation doses to the rectum in-vivo during HDR Co-60 brachytherapy. A total of eleven HDR brachytherapy treatments of cervical cancer were recruited in this study. A series of diodes incorporated in a rectal probe was inserted into the patient's rectum during each brachytherapy procedure. Real-time measured rectal doses were compared to calculated doses by the treatment planning system (TPS). The differences between calculated and measured dose ranged from 8.5% to 41.2%. This corresponds to absolute dose differences ranging from 0.3 Gy to 1.5 Gy. A linear relationship was observed between calculated and measured doses with linear regression R(2) value of 0.88, indicating close association between the measured and calculated doses. In general, absorbed doses for the rectum as calculated by TPS were observed to be higher than the doses measured using the diode probe. In-vivo dosimetry is an important quality assurance method for HDR brachytherapy of cervical cancer. It provides information that can contribute to the reduction of errors and discrepancies in dose delivery. Our study has shown that in-vivo dosimetry is feasible and can be performed to estimate the dose to the rectum during HDR brachytherapy using Co-60.
    Matched MeSH terms: Radiometry/methods
  10. Khandaker MU, Jojo PJ, Kassim HA, Amin YM
    Radiat Prot Dosimetry, 2012 Nov;152(1-3):33-7.
    PMID: 22887119 DOI: 10.1093/rpd/ncs145
    Concentrations of primordial radionuclides in common construction materials collected from the south-west coastal region of India were determined using a high-purity germanium gamma-ray spectrometer. Average specific activities (Bq kg(-1)) for (238)U((226)Ra) in cement, brick, soil and stone samples were obtained as 54 ± 13, 21 ± 4, 50 ± 12 and 46 ± 8, respectively. Respective values of (232)Th were obtained as 65 ± 10, 21 ± 3, 58 ± 10 and 57 ± 12. Concentrations of (40)K radionuclide in cement, brick, soil and stone samples were found to be 440 ± 91, 290 ± 20, 380 ± 61 and 432 ± 64, respectively. To evaluate the radiological hazards, radium equivalent activity, various hazard indices, absorbed dose rate and annual effective dose have been calculated, and compared with the literature values. Obtained data could be used as reference information to assess any radiological contamination due to construction materials in future.
    Matched MeSH terms: Radiometry/methods
  11. Yahya N, Chua XJ, Manan HA, Ismail F
    Strahlenther Onkol, 2018 08;194(8):780-786.
    PMID: 29774397 DOI: 10.1007/s00066-018-1303-5
    PURPOSE: This systematic review evaluates the completeness of dosimetric features and their inclusion as covariates in genetic-toxicity association studies.

    MATERIALS AND METHODS: Original research studies associating genetic features and normal tissue complications following radiotherapy were identified from PubMed. The use of dosimetric data was determined by mining the statement of prescription dose, dose fractionation, target volume selection or arrangement and dose distribution. The consideration of the dosimetric data as covariates was based on the statement mentioned in the statistical analysis section. The significance of these covariates was extracted from the results section. Descriptive analyses were performed to determine their completeness and inclusion as covariates.

    RESULTS: A total of 174 studies were found to satisfy the inclusion criteria. Studies published ≥2010 showed increased use of dose distribution information (p = 0.07). 33% of studies did not include any dose features in the analysis of gene-toxicity associations. Only 29% included dose distribution features as covariates and reported the results. 59% of studies which included dose distribution features found significant associations to toxicity.

    CONCLUSION: A large proportion of studies on the correlation of genetic markers with radiotherapy-related side effects considered no dosimetric parameters. Significance of dose distribution features was found in more than half of the studies including these features, emphasizing their importance. Completeness of radiation-specific clinical data may have increased in recent years which may improve gene-toxicity association studies.

    Matched MeSH terms: Radiometry/methods*
  12. Sabarudin A, Sun Z, Ng KH
    Radiat Prot Dosimetry, 2013;154(3):301-7.
    PMID: 22972797 DOI: 10.1093/rpd/ncs243
    A retrospective analysis was performed in patients undergoing prospective ECG-triggered coronary computed tomography (CT) angiography (CCTA) with the single-source 64-slice CT (SSCT), dual-source 64-slice CT (DSCT), dual-source 128-slice CT and 320-slice CT with the aim of comparing the radiation dose associated with different CT generations. A total of 164 patients undergoing prospective ECG-triggered CCTA with different types of CT scanners were studied with the mean effective doses estimated at 6.8 ± 3.2, 4.2 ± 1.9, 4.1±0.6 and 3.8 ± 1.4 mSv corresponding to the 128-slice DSCT, 64-slice DSCT, 64-slice SSCT and 320-slice CT scanners. In this study a positive relationship was found between the effective dose and the body mass index (BMI). A low radiation dose is achieved in prospective ECG-triggered CCTA, regardless of the CT scanner generation. BMI is identified as the major factor that has a direct impact on the effective dose associated with prospective ECG-triggered CCTA.
    Matched MeSH terms: Radiometry/statistics & numerical data
  13. Sabarudin A, Md Yusof AK, Tay MF, Ng KH, Sun Z
    Radiat Prot Dosimetry, 2013;153(4):441-7.
    PMID: 22807493 DOI: 10.1093/rpd/ncs127
    This study was conducted to investigate the effectiveness of dose-saving protocols in dual-source computed tomography (CT) coronary angiography compared with invasive coronary angiography (ICA). On 50 patients who underwent coronary CT angiography was performed dual-source CT (DSCT) and compared with ICA procedures. Entrance skin dose (ESD), which was measured at the thyroid gland, and effective dose (E) were assessed for both imaging modalities. The mean ESD measured at the thyroid gland was the highest at 120 kVp, followed by the 100 kVp DSCT and the ICA protocols with 4.0±1.8, 2.7±1.0 and 1.1±1.2 mGy, respectively. The mean E was estimated to be 10.3±2.1, 6.2±2.3 and 5.3±3.4 mSv corresponding to the 120-kVp, 100-kVp DSCT and ICA protocols, respectively. The application of 100 kVp in DSCT coronary angiography is feasible only in patients with a low body mass index of <25 kg m(-2), which leads to a significant dose reduction with the radiation dose being equivalent to that of ICA.
    Matched MeSH terms: Radiometry/methods
  14. Kodaira S, Konishi T, Kobayashi A, Maeda T, Ahmad TA, Yang G, et al.
    J Radiat Res, 2015 Mar;56(2):360-5.
    PMID: 25324538 DOI: 10.1093/jrr/rru091
    The geometric locations of ion traversals in mammalian cells constitute important information in the study of heavy ion-induced biological effect. Single ion traversal through a cellular nucleus produces complex and massive DNA damage at a nanometer level, leading to cell inactivation, mutations and transformation. We present a novel approach that uses a fluorescent nuclear track detector (FNTD) for the simultaneous detection of the geometrical images of ion traversals and DNA damage in single cells using confocal microscopy. HT1080 or HT1080-53BP1-GFP cells were cultured on the surface of a FNTD and exposed to 5.1-MeV/n neon ions. The positions of the ion traversals were obtained as fluorescent images of a FNTD. Localized DNA damage in cells was identified as fluorescent spots of γ-H2AX or 53BP1-GFP. These track images and images of damaged DNA were obtained in a short time using a confocal laser scanning microscope. The geometrical distribution of DNA damage indicated by fluorescent γ-H2AX spots in fixed cells or fluorescent 53BP1-GFP spots in living cells was found to correlate well with the distribution of the ion traversals. This method will be useful for evaluating the number of ion hits on individual cells, not only for micro-beam but also for random-beam experiments.
    Matched MeSH terms: Radiometry/instrumentation*
  15. Alkhorayef M, Sulieman A, Babikir E, Daar E, Alnaaimi M, Alduaij M, et al.
    Appl Radiat Isot, 2018 Aug;138:14-17.
    PMID: 28830729 DOI: 10.1016/j.apradiso.2017.08.010
    A pacemaker, which is used for heart resynchronization with electrical impulses, is used to manage many clinical conditions. Recently, the frequency of pacemaker implantation procedures has increased to more than 50% worldwide. During this procedure, patients can be exposed to excessive radiation exposure. Wide range of doses has been reported in previous studies, suggesting that optimization of this procedure has not been fulfilled yet. The current study evaluated patient radiation exposure during cardiac pacemaker procedures and quantified the patient effective dose. A total of 145 procedures were performed for five pacemaker procedures (VVI, VVIR, VVD, VVDR, and DDDR) at two hospitals. Patient doses were measured using the kerma-area product meter. Effective doses were estimated using software based on Monte Carlo simulation from the National Radiological Protection Board (NRPB, now The Health Protection Agency). The effective dose values were used to estimate cancer risk from the pacemaker procedure. Patient demographic data and exposure parameters for fluoroscopy and radiography were quantified. The mean patient doses ± SD per procedure (Gycm2) for VVI, VVIR, VVD, VVDR, and DDDR were 1.52 ± 0.13 (1.43-1.61), 3.28 ± 2.34 (0.29-8.73), 3.04 ± 1.67 (1.57-4.86), 6.04 ± 2.326 3.29-8.58), and 8.8 ± 3.6 (4.5-26.20), respectively. The overall patient effective dose was 1.1mSv per procedure. It is obvious that the DDDR procedure exposed patients to the highest radiation dose. Patient dose variation can be attributed to procedure type, exposure parameter settings, and fluoroscopy time. The results of this study showed that patient doses during different pacemaker procedures are lower compared to previous reported values. Patient risk from pacemaker procedure is low, compared to other cardiac interventional procedures. Patients' exposures were mainly influenced by the type of procedures and the clinical indication.
    Matched MeSH terms: Radiometry/statistics & numerical data
  16. Mahyuddin NM, Russell G
    ScientificWorldJournal, 2014;2014:876435.
    PMID: 24782671 DOI: 10.1155/2014/876435
    Technology scaling relies on reduced nodal capacitances and lower voltages in order to improve performance and power consumption, resulting in significant increase in layout density, thus making these submicron technologies more susceptible to soft errors. Previous analysis indicates a significant improvement in SEU tolerance of the driver when the bias current is injected into the circuit but results in increase of power dissipation. Subsequently, other alternatives are considered. The impact of transistor sizes and temperature on SEU tolerance is tested. Results indicate no significant changes in Q(crit) when the effective transistor length is increased by 10%, but there is an improvement when high temperature and high bias currents are applied. However, this is due to other process parameters that are temperature dependent, which contribute to the sharp increase in Q(crit). It is found that, with temperature, there is no clear factor that can justify the direct impact of temperature on the SEU tolerance. Thus, in order to improve the SEU tolerance, high bias currents are still considered to be the most effective method in improving the SEU sensitivity. However, good trade-off is required for the low-swing driver in order to meet the reliability target with minimal power overhead.
    Matched MeSH terms: Radiometry
  17. Yahya N, Ebert MA, Bulsara M, Haworth A, Kennedy A, Joseph DJ, et al.
    Radiother Oncol, 2015 Jul;116(1):112-8.
    PMID: 26163088 DOI: 10.1016/j.radonc.2015.06.011
    To identify dosimetry, clinical factors and medication intake impacting urinary symptoms after prostate radiotherapy.
    Matched MeSH terms: Radiometry
  18. Jamalludin Z, Jong WL, Malik RA, Rosenfeld AB, Ung NM
    Phys Med, 2020 Jan;69:52-60.
    PMID: 31830631 DOI: 10.1016/j.ejmp.2019.11.025
    PURPOSE: Dose to the rectum during brachytherapy treatment may differ from an approved treatment plan which can be quantified with in vivo dosimetry (IVD). This study compares the planned with in vivo doses measured with MOSkin and PTW 9112 rectal probe in patients undergoing CT based HDR cervical brachytherapy with Co-60 source.

    METHODS: Dose measurement of a standard pear-shaped plan carried out in phantom to verify the MOSkin dose measurement accuracy. With MOSkin attached to the third diode, RP3 of the PTW 9112, both detectors were inserted into patients' rectum. The RP3 and MOSkin measured doses in 18 sessions as well as the maximum measured doses from PTW 9112, RPmax in 48 sessions were compared to the planned doses.

    RESULTS: Percentage dose differences ΔD (%) in phantom study for two MOSkin found to be 2.22 ± 0.07% and 2.5 ± 0.07%. IVD of 18 sessions resulted in ΔD(%) of -16.3% to 14.9% with MOSkin and ΔD(%) of -35.7% to -2.1% with RP3. In 48 sessions, RPmax recorded ΔD(%) of -37.1% to 11.0%. MOSkin_measured doses were higher in 44.4% (8/18) sessions, while RP3_measured were lower than planned doses in all sessions. RPmax_measured were lower in 87.5% of applications (42/47).

    CONCLUSIONS: The delivered doses proven to deviate from planned doses due to unavoidable shift between imaging and treatment as measured with MOSkin and PTW 9112 detectors. The integration of MOSkin on commercial PTW 9112 surface found to be feasible for rectal dose IVD during cervical HDR ICBT.

    Matched MeSH terms: Radiometry
  19. Cheah SK, Matthews T, Teh BS
    Asian Pac J Cancer Prev, 2016;17(9):4233-4235.
    PMID: 27797223
    BACKGROUND: Whole brain radiotherapy (WBRT) and stereotactic radiosurgery were frequently used to palliate patients with brain metastases. It remains controversial which modality or combination of therapy is superior especially in the setting of limited number of brain metastases. The availability of newer medical therapy that improves survival highlighted the importance of reducing long term radiation toxicity associated with WBRT. In this study, we aim to demonstrate the hippocampal sparing technique with whole brain and integrated simultaneous boost Materials and Methods: Planning data from 10 patients with 1-5 brain metastases treated with SRS were identified. Based on the contouring guideline from RTOG atlas, we identified and contoured the hippocampus with 5mm isocentric expansion to form the hippocampal avoidance structure. The plan was to deliver hippocampal sparing whole brain radiotherapy (HSWBRT) of 30 Gy in 10 fractions and simultaneous boost to metastatic lesions of 30 Gy in 10 fractions each.

    RESULTS: The PTV, hippocampus and hippocampal avoidance volumes ranges between 1.00 - 39.00 cc., 2.50 - 5.30 cc and 26.47 - 36.30 cc respectively. The mean hippocampus dose for the HSWBRT and HSWBRT and SIB plans was 8.06 Gy and 12.47 respectively. The max dose of optic nerve, optic chiasm and brainstem were kept below acceptable range of 37.5 Gy.

    CONCLUSIONS: The findings from this dosimetric study demonstrated the feasibility and safety of treating limited brain metastases with HSWBRT and SIB. It is possible to achieve the best of both worlds by combining HSWBRT and SIB to achieve maximal local intracranial control while maintaining as low a dose as possible to the hippocampus thereby preserving memory and quality of life.

    Matched MeSH terms: Radiometry
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