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Nikos Papanikolaou

Publications and source records attributed to Nikos Papanikolaou.

7 recordsLinked to original sources

An inhomogeneity correction algorithm for irregular fields of high-energy photon beams based on Clarkson integration and the 3D beam subtraction method.

A number of treatment-planning systems still use conventional correction methods for body inhomogeneities. Most of these methods (power law method, tissue-air ratio (TAR), etc.) consider only on-axis points, rectangular fields, and inhomogeneous slabs covering the whole irradiating field. A new method is proposed that overcomes the above limitations. The new method uses the principle of the Clarkson method on sector integration to take into account the position and lateral extent of the inhomogeneity with respect to the point of calculation, as well as the shape of the irradiating field. The field is divided into angular sectors, and each sector is then treated separately for the presence of inhomogeneities using a conventional correction method. Applying this method, we can predict the correction factors for Co-60 and 6-MV photon beams for irregular fields that include inhomogeneities of lower or higher densities relative to water. Validation of the predicted corrections factors was made against Monte Carlo calculations for the same geometries. The agreement between the predicted correction factors and the Monte Carlo calculations was within 1.5%. In addition, the new method was able to predict the behavior of the correction factor when the point of calculation was approaching or moving away from the interface between two materials.

Algorithms↗

An assessment of biologically-based optimization (BORT) in the IMRT era.

The purpose of this study was to investigate the role of biological-based IMRT (BORT) in treatment planning development; more specifically, to assess the possible advantages of BORT over the classic 3-dimensional conformal radiation therapy (3DRT) and dose-based IMRT based on quantitative and qualitative indices. Three clinical cases are presented to evaluate the differences of BORT, IMRT, and 3DRT. 3DRT, IMRT, and BORT plans were generated for each case using a commercially available treatment planning system (Pinnacle by Philips). The plans were compared by evaluating biological endpoints such as tumor control probability (TCP), normal tissue control probability (NTCP), and uncomplicated tumor control probability (P+), as well as isodose line distribution, dose-volume histograms (DVHs), and dose uniformity. In all cases of this study, BORT yielded improved isodose coverage and P+. Our preliminary results suggest that BORT could play an important role in treatment planning optimization, especially as biological models and predictive assays become more accurate. Further case studies are needed to establish a definitive role for this type of optimization.

Brain Neoplasms↗

Feasibility of cranio-spinal axis radiation with the Hi-Art tomotherapy system.

BACKGROUND AND PURPOSE: Helical tomotherapy can eliminate the need for junction lines. The goal of this study is to evaluate tomotherapy in the delivery of CSA radiation and measurement of plan quality using physical parameters in comparing conventional (CSA-RT) and helical tomotherapy (CSA-TOMO) plans. PATIENTS AND METHODS: CSA-TOMO and CSA-RT plans were created for dosimetric comparison. Integral dose values were calculated. The ratios D50% (dose received by 50% of the organ at risk's volume) and D10% (dose received by 10% of the organ at risk's volume) were calculated representing large volumes and small volumes of organs at risk receiving significant dose. RESULTS: When considering D50% and D10%, CSA-TOMO has a dosimetric advantage over CSA-RT for most organs at risk. The body integral dose was higher for the CSA-TOMO plan by approximately 6.5%. CONCLUSIONS: Tomotherapy is a feasible alternative for treatment of CSA. Analysis shows that tomotherapy improves dose ratios over conventional radiation for most organs at risk. The impact of a small increase in whole body integral dose is unknown. Long-term follow-up will be needed to answer this question as others have argued of the possibility of increased risk of secondary malignancies due to delivery of radiotherapy with IMRT.

Brain↗

Fast radiographic film calibration procedure for helical tomotherapy intensity modulated radiation therapy dose verification.

Film dosimetry offers an advantageous in-phantom planar dose verification tool in terms of spatial resolution and ease of handling for quality assurance (QA) of intensity modulated radiation therapy (IMRT) plans. A critical step in the success of such a technique is that the film calibration be appropriately conducted. This paper presents a fast and efficient film calibration method for a helical tomotherapy unit using a single sheet of film. Considering the unique un-flattened cone shaped profile from a helical tomotherapy beam, a custom leaf control file (sinogram) was created, to produce a valley shaped intensity pattern. There are eleven intensity steps in the valley pattern, representing varying dose values from 38 to 265 cGy. This dose range covers the most commonly prescribed doses in fractionated IMRT treatments. An ion chamber in a solid water phantom was used to measure the dose in each of the eleven steps. For daily film calibration the whole procedure, including film exposure, processing, digitization and analysis, can be completed within 15 min, making it practical to use this technique routinely. This method is applicable to film calibration on a helical tomotherapy unit and is particularly useful in IMRT planar dose verification due to its efficiency and reproducibility. In this work, we characterized the dose response of the KODAK EDR2 ready-pack film which was used to develop the step valley dose maps and the IMRT QA planar doses. A comparison between the step valley technique and multifilm based calibration showed that both calibration methods agreed with less than 0.4% deviation in the clinically useful dose ranges.

Calibration↗

Dosimetric considerations for patients with HIP prostheses undergoing pelvic irradiation. Report of the AAPM Radiation Therapy Committee Task Group 63.

This document is the report of a task group of the Radiation Therapy Committee of the AAPM and has been prepared primarily to advise hospital physicists involved in external beam treatment of patients with pelvic malignancies who have high atomic number (Z) hip prostheses. The purpose of the report is to make the radiation oncology community aware of the problems arising from the presence of these devices in the radiation beam, to quantify the dose perturbations they cause, and, finally, to provide recommendations for treatment planning and delivery. Some of the data and recommendations are also applicable to patients having implanted high-Z prosthetic devices such as pins, humeral head replacements. The scientific understanding and methodology of clinical dosimetry for these situations is still incomplete. This report is intended to reflect the current state of scientific understanding and technical methodology in clinical dosimetry for radiation oncology patients with high-Z hip prostheses.

Advisory Committees↗

Transtympanic iontophoresis with a biocompatible paramagnetic solution at MR imaging: experimental feasibility study in rabbits.

PURPOSE: To determine the feasibility of transtympanic iontophoresis in experimental animals with a paramagnetic contrast agent at magnetic resonance (MR) imaging. MATERIALS AND METHODS: Optimal MR sequence parameters and appropriate paramagnetic ion concentrations of a water and gadopentetate dimeglumine solution were initially assessed with phantoms. Iontophoresis was performed in left ears of five rabbits after the external auditory canals were filled with a solution of water and gadopentetate dimeglumine of optimal concentration, and right ears were used as controls. Signal-to-structural noise ratio (SSNR) and contrast-to-structural noise ratio (CSNR) were measured by using regions of interest, and the overall image quality was assessed subjectively. RESULTS: Spin-echo (SE) MR sequences were superior to gradient-echo (GRE) MR sequences in terms of SSNR, CSNR, and overall image quality. Highest SSNR and CSNR values were achieved with 2 mmol/L (2 mM) of gadopentetate dimeglumine solution with both SE (repetition time msec/echo time msec, 500/12; flip angle, 90 degrees ) and GRE (300/10; flip angle, 90 degrees ) sequences in both phantoms and animals. The high signal intensity of gadopentetate dimeglumine solution was recognized in middle ears, vestibules, and semicircular canals of all rabbit ears that had undergone iontophoresis and in none of the control ears. CONCLUSION: With the solution of water and gadopentetate dimeglumine, the maximum SSNR and CSNR with both SE and GRE MR imaging sequences were achieved. The solution can be transferred to the middle and inner ear cavities across an intact tympanic membrane by using transtympanic iontophoresis.

Animals↗