Recommendations Of Task Group Research Articles

Recommendations for clinical electron beam dosimetry: Supplement to the recommendations of Task Group 25

The goal of Task Group 25 (TG-25) of the Radiation Therapy Committee of the American Association of.Physicists in Medicine (AAPM) was to provide a methodology and set of procedures for a medical physicist performing clinical electron beam dosimetry in the nominal energy range of 5-25 MeV. Specifically, the task group recommended procedures for acquiring basic information required for acceptance testing and treatment planning of new accelerators with therapeutic electron beams. Since the publication of the TG-25 report, significant advances have taken place in the field of electron beam dosimetry, the most significant being that primary standards laboratories around the world have shifted from calibration standards based on exposure or air kerma to standards based on absorbed dose to water. The AAPM has published a new calibration protocol, TG-51, for the calibration of high-energy photon and electron beams. The formalism and dosimetry procedures recommended in this protocol are based on the absorbed dose to water calibration coefficient of an ionization chamber at 60Co energy, N60Co(D,w), together with the theoretical beam quality conversion coefficient k(Q) for the determination of absorbed dose to water in high-energy photon and electron beams. Task Group 70 was charged to reassess and update the recommendations in TG-25 to bring them into alignment with report TG-51 and to recommend new methodologies and procedures that would allow the practicing medical physicist to initiate and continue a high quality program in clinical electron beam dosimetry. This TG-70 report is a supplement to the TG-25 report and enhances the TG-25 report by including new topics and topics that were not covered in depth in the TG-25 report. These topics include procedures for obtaining data to commission a treatment planning computer, determining dose in irregularly shaped electron fields, and commissioning of sophisticated special procedures using high-energy electron beams. The use of radiochromic film for electrons is addressed, and radiographic film that is no longer available has been replaced by film that is available. Realistic stopping-power data are incorporated when appropriate along with enhanced tables of electron fluence data. A larger list of clinical applications of electron beams is included in the full TG-70 report available at http://www.aapm.org/pubs/reports. Descriptions of the techniques in the clinical sections are not exhaustive but do describe key elements of the procedures and how to initiate these programs in the clinic. There have been no major changes since the TG-25 report relating to flatness and symmetry, surface dose, use of thermoluminescent dosimeters or diodes, virtual source position designation, air gap corrections, oblique incidence, or corrections for inhomogeneities. Thus these topics are not addressed in the TG-70 report.

TU-E-BRB-03: Performance-Based QA for Radiotherapy: TG-135 - QA for Robotic Radiosurgery

History: TG‐135 was approved by AAPM at the 2006 Annual Meeting. The intent of this TG was to fill the gap between TG‐40, which does not cover certain QA aspects of newer radiation delivery devices, and TG‐100, which will revise our current QA paradigm. General Outline of Report: The report consists of three major sections: (1) QA for individual system components, (2) QA for the integrated systems, (3) a summary with QA checklists. At the time of publication there is only one FDA‐approved roboticradiosurgery system (Cyberknife, Accuray Inc, Sunnyvale, CA) on the market, therefore the report is often vendor‐specific. Technologies which became available in the clinic after the report was submitted for review (e.g. IRIS collimator, XSight lung tracking) were not included. Major Highlights: Each individual Cyberknife component will be discussed, with reference to applicable AAPM reports and additional QA recommendations if necessary. We also highlight areas in which a good QA approach has not yet been developed. Those include the QA of the imager systems, but also periodic QA of individual beam pointing accuracy. The second section, QA for integrated systems, explains how the various subsystems interact, and how to design a QA program for the feedback loops. Similar to the individual component QA, there are areas in the integrated systems QA where more work needs to be done. This includes e.g. QA of the interaction between image quality and tracking algorithm accuracy, and individual beam pointing QA for non‐isocentric plans. The Task Group's recommendations on patient‐like and individual patient QA are also included. The report summarizes daily, monthly, annual and special considerations (software and hardware upgrades, earthquakes, etc). Report as it relates to TG‐100: This report is intended to give QA recommendations based on the philosophy of TG‐40. The QM approach to roboticradiosurgery will have to be adapted to the TG‐100 philosophy after its publication, which includes the data collection for a FMEA analysis for this relatively new technology. Implementation Plan: The recommendations of TG‐135 should be critically evaluated by the site physicist after the report is published. Changes to the existing QA program should be made at the next scheduled incidence (i.e. changes for the annual QA at the next annual QA). Roboticradiosurgery is a fast‐evolving field, therefore keeping informed through reading peer‐reviewed literature and attending CE programs on QA is essential. Timeline for Report Release: At the time of abstract submission, TG‐135 was undergoing the second revision within its subcommittee, with the goal of being submitted to the TPC for review and a publication in summer/fall of 2009. Learning Objectives: 1. Be aware of the estimated publication date for the report, report structure, and implementation plan. 2. Understand the difference between individual component QA and integrated systems QA. 3. Know which areas of roboticradiosurgery QA are still under development. 4. Anticipate the future change of QA philosophy for roboticradiosurgery with TG‐100.

TH‐SAMS‐AUD B‐01: Introduction To: Quality Assurance for Advanced RT Technologies—The Challenge for RT Clinical Trials

We as medical physicists have a crucial role to play in ensuring that all patients on radiotherapy protocols are treated comparably. Without this comparability, the validity of outcome results from the pooled patient data may be jeopardized. Advances in radiation therapy technology and delivery techniques have naturally led to the desire to incorporate such new tools into clinical trials, yet standardized quality assurance (QA) procedures are not fully developed and widely practiced. Although several task groups within the AAPM have been formed to set standards for QA for these new technologies, a major challenge is to conduct clinical trials that involve both the old and new technologies without overwhelming individual physicists with additional testing. National and international multi‐institutional clinical trials uniquely challenge the medical physics community to maintain comparability while at the same time requiring or permitting patient treatments that incorporate advanced technologies such as IMRT, image guided radiotherapy, image fusion, and other techniques.The AAPM Working Group on Clinical Trials presents this continuing education symposium in order to discuss the efforts underway to design QA methods for advanced radiotherapy technologies especially in the context of clinical trials with the intent to address the issue of comparability and standardization of protocol data. We will present the work of Task Group 113, an important player in these efforts, on providing guidance as to physics practice standards for QA for radiotherapy clinical trials. The task group's recommendations on QA procedures and reporting methods are intended to facilitate highly consistent protocol treatments and data submission.The Working Group on clinical trials has identified several topics that pose significant challenges with respect to consistency of physics practices: dose calculations with heterogeneity corrections, localization verification, image fusion techniques, and the treatment of moving targets. In this course, the history and the current state of the art will be described for each topic. The discussion about these areas should be of interest whether or not one is involved in clinical trials.Educational Objectives:1. Understand the quality assurance issues facing Medical Physicists using advanced technologies and how these relate to clinical trial data validity.2. Learn what Task Group 113 is doing to address the accuracy and consistency of data we send to quality assurance review centers.3. Understand the problems and potential solutions to controversies in quality assurance measures for image fusion, target motion, patient localization, and heterogeneity corrections.

TH-A-M100E-01: Introduction To: Quality Assurance for Advanced RT Technologies-The Challenge for RT Clinical Trials

We as medical physicists have a crucial role to play in ensuring that all patients on radiotherapy protocols are treated comparably. Without this comparability, the validity of outcome results from the pooled patient data may be jeopardized. Advances in radiation therapy technology and delivery techniques have naturally led to the desire to incorporate such new tools into clinical trials, yet standardized quality assurance (QA) procedures are not fully developed and widely practiced. Although several task groups within the AAPM have been formed to set standards for QA for these new technologies, a major challenge is to conduct clinical trials that involve both the old and new technologies without overwhelming individual physicists with additional testing. National and international multi‐institutional clinical trials uniquely challenge the medical physics community to maintain comparability while at the same time requiring or permitting patient treatments that incorporate advanced technologies such as IMRT, image guided radiotherapy,imagefusion, and other techniques. The AAPM Working Group on Clinical Trials presents this continuing education symposium in order to discuss the efforts underway to design QA methods for advanced radiotherapy technologies especially in the context of clinical trials with the intent to address the issue of comparability and standardization of protocol data. We will present the work of Task Group 113, an important player in these efforts, on providing guidance as to physics practice standards for QA for radiotherapy clinical trials. The task group's recommendations on QA procedures and reporting methods are intended to facilitate highly consistent protocol treatments and data submission. The Working Group on clinical trials has identified several topics that pose significant challenges with respect to consistency of physics practices: dose calculations with heterogeneity corrections, localization verification, imagefusion techniques, and the treatment of moving targets. In this course, the history and the current state of the art will be described for each topic. The discussion about these areas should be of interest whether or not one is involved in clinical trials. Learning objectives for the entire CE course: 1. Understand the quality assurance issues facing Medical Physicists using advanced technologies and how these relate to clinical trial data validity. 2. Learn what Task Group 113 is doing to address the accuracy and consistency of data we send to quality assurance review centers. 3. Understand the problems and potential solutions to controversies in quality assurance measures for imagefusion, target motion, patient localization, and heterogeneity corrections.

Radiochromic film dosimetry

The object of this paper is to give a new user some practical information on the use of radiochromic films for medical applications. While various aspects of radiochromic film dosimetry for medical applications have been covered in some detail in several other excellent review articles which have appeared in the last few years [Niroomand-Rad, A., Blackwell, C.R., Coursey, B.M., Gall, K.P., McLaughlin, W.L., Meigooni, A.S., Nath, R., Rodgers, J.E., Soares, C.G., 1998. Radiochromic dosimetry: recommendations of the AAPM Radiation Therapy Committee Task Group 55. Med. Phys. 25, 2093–2115; Dempsey, J.F., Low, D.A., Mutic, S., Markman, J., Kirov, A.S., Nussbaum, G.H., Williamson, J.F., 2000. Validation of a precision radiochromic film dosimetry system for quantitative two-dimensional imaging of acute exposure dose distributions. Med. Phys. 27, 2462–2475; Butson, M.J., Yu, P.K.N., Cheung, T., Metcalfe, P., 2003. Radiochromic film for medical radiation dosimetry. Mater. Sci. Eng. R41, 61–120], it is the intent of the present author to present material from a more user-oriented and practical standpoint. That is, how the films work will be stressed much less than how to make the films work well. The strength of radiochromic films is most evident in applications where there is a very high dose gradient and relatively high absorbed dose rates. These conditions are associated with brachytherapy applications, measurement of small fields, and at the edges (penumbra regions) of larger fields.

12-YEAR OUTCOMES FOLLOWING PERMANENT PROSTATE BRACHYTHERAPY IN PATIENTS WITH CLINICALLY LOCALIZED PROSTATE CANCER

We reviewed the outcomes in men treated with permanent prostate brachytherapy (PPB). A total of 1,449 consecutive patients with a mean age of 68 years treated with PPB between 1992 and 2000 and mean pretreatment prostate specific antigen (PSA) 10.1 ng/ml were included in this study. Of the patients 55% presented with Gleason 6 tumors and 28% had Gleason 7 disease. A total of 400 patients (27%) were treated with neoadjuvant hormones and 301 (20%) were treated in combination with external radiation plus PPB. Several biochemical freedom from recurrence (BFR) definitions were determined. Statistical analysis consisted of log rank testing, Kaplan-Meier estimates and Cox regression analysis. Median followup was 82 months with 39 patients at risk at for 144 months. Overall and disease specific survival at 12 years was 81% and 93%, respectively. The 12-year BFR was 81%, 78%, 74% and 77% according to the American Society for Therapeutic Radiology and Oncology (ASTRO), ASTRO-Kattan, ASTRO-Last Call and Houston definitions, respectively. The 12-year ASTRO-Kattan BFR using risk stratification was 89%, 78% and 63% in patients at low, intermediate and high risk, respectively (p = 0.0001). Multivariate analysis identified the dose that 90% of the target volume received (p <0.0001), pretreatment PSA (p = 0.001), Gleason score (p = 0.002), the percent positive core biopsies (p = 0.037), clinical stage (p = 0.689), the addition of hormones (p = 0.655) and the addition of external radiation (p = 0.724) for predicting BFR-ASTRO. Five-year disease specific survival was 44% in patients with a PSA doubling time of less than 12 months vs 88% in those with a PSA doubling time of 12 months or greater (p = 0.0001). PPB offers acceptable 12-year BFR in patients who present with clinically localized prostate cancer. Implant dosimetry continues as an important predictor for BFR, while the addition of adjuvant therapies such as hormones and external radiation are insignificant. In patients who experience biochemical failure it appears that PSA doubling time is an important predictor of survival.

A technical evaluation of the Nucletron FIRST system: Conformance of a remote afterloading brachytherapy seed implantation system to manufacturer specifications and AAPM Task Group report recommendations

The Fully Integrated Real‐time Seed Treatment (FIRST™) system by Nucletron has been available in Europe since November 2001 and is being used more and more in Canada and the United States. Like the conventional transrectal ultrasound implant procedure, the FIRST system utilizes an ultrasound probe, needles, and brachytherapy seeds. However, this system is unique in that it (1) utilizes a low‐dose‐rate brachytherapy seed remote afterloader (the seedSelectron), (2) utilizes 3D image reconstruction acquired from electromechanically controlled, nonstepping rotation of the ultrasound probe, (3) integrates the control of a remote afterloader with electromechanical control of the ultrasound probe for integrating the clinical procedure into a single system, and (4) automates the transfer of planning information and seed delivery to improve quality assurance and radiation safety. This automated delivery system is specifically intended to address reproducibility and accuracy of seed positioning during implantation. The FIRST computer system includes two software environments: SPOT PRO™ and seedSelectron™; both are used to facilitate treatment planning and brachytherapy seed implantation from beginning to completion of the entire procedure. In addition to these features, the system is reported to meet certain product specifications for seed delivery positioning accuracy and reproducibility, seed calibration accuracy and reliability, and brachytherapy dosimetry calculations. Consequently, a technical evaluation of the FIRST system was performed to determine adherence to manufacturer specifications and to the American Association of Physicists in Medicine (AAPM) Task Group Reports 43, 53, 56, 59, and 64 and recommendations of the American Brachytherapy Society (ABS). The United States Nuclear Regulatory Commission (NRC) has recently added Licensing Guidance for the seedSelectron system under 10 CFR 35.1000. Adherence to licensing guidance is made by referencing applicable AAPM Task Group recommendations. In general, results of this evaluation indicated that the system met its claimed specifications as well as the applicable recommendations outlined in the AAPM and ABS reports.PACS number(s): 87.53.Xd, 87.53.Jw

Comments on “Dosimetry of interstitial brachytherapy sources: Recommendations of the AAPM Radiation Therapy Committee Task Group 43” [Med. Phys. 22 , 209-234 (1995)

Medical PhysicsVolume 23, Issue 9 p. 1579-1579 Comments on “Dosimetry of interstitial brachytherapy sources: Recommendations of the AAPM Radiation Therapy Committee Task Group 43” [Med. Phys. 22, 209–234 (1995)] Robert W. Kline, Robert W. Kline Mayo Clinic, 200 1st St. SW, Rochester, Minnesota 55905Search for more papers by this author Robert W. Kline, Robert W. Kline Mayo Clinic, 200 1st St. SW, Rochester, Minnesota 55905Search for more papers by this author First published: September 1996 https://doi.org/10.1118/1.597889Citations: 11AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article.Citing Literature Volume23, Issue9September 1996Pages 1579-1579 RelatedInformation

Response to “Comments on ‘Dosimetry of interstitial brachytherapy sources: Recommendations of the AAPM Radiation Therapy Committee Task Group No. 43’ ” [Med. Phys. 22 , 209-234 (1995)

Response to “Comments on ‘Dosimetry of interstitial brachytherapy sources: Recommendations of the AAPM Radiation Therapy Committee Task Group No. 43’ ” [Med. Phys. <b>22</b> , 209-234 (1995)

Dosimetry of interstitial brachytherapy sources: Recommendations of the AAPM Radiation Therapy Committee Task Group No. 43

Dosimetry of interstitial brachytherapy sources: Recommendations of the AAPM Radiation Therapy Committee Task Group No. 43

A brief review of the GAO task group's recommendations on management guidelines for pricing computer services in the federal government

Computer systems and software applications in the Federal government have provided many wide-ranging benefits. Data processing activities and systems presently consume over $10 billion - about $3 out of every $100 in the Federal budget. All indications are pointing to even greater utilization of data processing systems in the future to:--conserve other resources,--maintain and improve the quality of services, and--enable more efficient and effective delivery of services.