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Investigation of a real-time EPID-based patient dose monitoring safety system using site-specific control limits

Overview of attention for article published in Radiation Oncology, August 2016
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Title
Investigation of a real-time EPID-based patient dose monitoring safety system using site-specific control limits
Published in
Radiation Oncology, August 2016
DOI 10.1186/s13014-016-0682-y
Pubmed ID
Authors

Todsaporn Fuangrod, Peter B. Greer, Henry C. Woodruff, John Simpson, Shashank Bhatia, Benjamin Zwan, Timothy A. vanBeek, Boyd M.C. McCurdy, Richard H. Middleton

Abstract

The aim of this study is to investigate the performance and limitations of a real-time transit electronic portal imaging device (EPID) dosimetry system for error detection during dynamic intensity modulated radiation therapy (IMRT) treatment delivery. Sites studied are prostate, head and neck (HN), and rectal cancer treatments. The system compares measured cumulative transit EPID image frames with predicted cumulative image frames in real-time during treatment using a χ comparison with 4 %, 4 mm criteria. The treatment site-specific thresholds (prostate, HN and rectum IMRT) were determined using initial data collected from 137 patients (274 measured treatment fractions) and a statistical process control methodology. These thresholds were then applied to data from 15 selected patients including 5 prostate, 5 HN, and 5 rectum IMRT treatments for system evaluation and classification of error sources. Clinical demonstration of real-time transit EPID dosimetry in IMRT was presented. For error simulation, the system could detect gross errors (i.e. wrong patient, wrong plan, wrong gantry angle) immediately after EPID stabilisation; 2 seconds after the start of treatment. The average rate of error detection was 7.0 % (prostate = 5.6 %, HN= 8.7 % and rectum = 6.7 %). The detected errors were classified as either clinical in origin (e.g. patient anatomical changes), or non-clinical in origin (e.g. detection system errors). Classified errors were 3.2 % clinical and 3.9 % non-clinical. An EPID-based real-time error detection method for treatment verification during dynamic IMRT has been developed and tested for its performance and limitations. The system is able to detect gross errors in real-time, however improvement in system robustness is required to reduce the non-clinical sources of error detection.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 36 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 36 100%

Demographic breakdown

Readers by professional status Count As %
Student > Ph. D. Student 8 22%
Student > Master 4 11%
Researcher 4 11%
Other 2 6%
Student > Postgraduate 2 6%
Other 4 11%
Unknown 12 33%
Readers by discipline Count As %
Physics and Astronomy 11 31%
Engineering 6 17%
Medicine and Dentistry 2 6%
Nursing and Health Professions 1 3%
Unknown 16 44%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 13 August 2016.
All research outputs
#20,337,210
of 22,882,389 outputs
Outputs from Radiation Oncology
#1,680
of 2,060 outputs
Outputs of similar age
#311,454
of 355,875 outputs
Outputs of similar age from Radiation Oncology
#32
of 39 outputs
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We're also able to compare this research output to 39 others from the same source and published within six weeks on either side of this one. This one is in the 1st percentile – i.e., 1% of its contemporaries scored the same or lower than it.