294 Abstracts / Physica Medica 32 (2016) 284–339
DEEP INSPIRATION BREATH-HOLD TECHNIQUE USING AN
ARDUINO
P. Gallego a,*, J. Pérez-Alija a, E. Ambroa b, S. Olivares a, S. Loscos a, P.
Agustí a
a ogy’s type, mechanical and dosimetric tests results and network
Radiation Oncology Department, Hospital Plató, Barcelona, Spain
b upgrade.
Medical Physics Unit, Radiation Oncology Department, Consorci
Sanitari de Terrassa, Barcelona, Spain
⇑ Corresponding author.
Introduction. A large effort has been made in recent years to
develop techniques to reduce the dose to normal tissue (especially
heart dose) for patients receiving radiation treatment for breast
cancer.
Purpose. The aim of this work was both to develop a DIBH method
using an Arduino Uno microcontroller board (SmartProyects, Ivrea,
Italia) and a simple software to visualize the patient’s level of
inspiration. This method provides a cheaper solution to the more
expensives commercial ones.
Materials and methods. Arduino is an open-source electronics
platform based on an easy-to-use hardware and software. We
plugged a tri-axial low-g digital acceleration sensor (Bosch’s
BMA180) to our Arduino board. This accelerometer is then placed
on the patient and used as a surrogate to measure the expansion
of the patient’s thorax during breathing.
We measure the orientation change in our BMA180 inside the
gravitational field. However, this orientation change is good enough
to accurately measure the changes in the patient’s breath cycle.
Results. We were able to build a DIBH system using both an Ardu-
ino board and an accelerometer. We visualize the patient’s breathe
cycle with an In-house software and establish a threshold based
on its amplitude. We provide patients with a real-time breathe cycle
visualization, so they can have a visual feedback mechanism in order
to properly hold their breath when required.
Conclusion. We have developed an In-house DIBH system with all
the functionalities required to implement this technique in our
clinic. Building this system is really cheap and amounts to nearly
60 Euros.
Disclosure. There is no conflict of interest.
http://dx.doi.org/10.1016/j.ejmp.2016.07.125
PRACTICAL USE OF DYNALOGS ANALYSIS IN SEVEN LINACS IN
IMRT AND VMAT TECHNIQUES OVER THAN 20 MONTHS
D. Pimparel *, J. Lencart, J.A.M. Santos
Medical Physics Department, Portuguese Institute of Oncology, Porto,
Portugal
Medical Physics, Radiobiology and Radiation Protection Group, Research
Centre, Portuguese Institute of Oncology, Porto, Portugal
⇑ Corresponding author.
Introduction. Dynalog files’s (DLGf) analysis can provide impor-
tant information about deviations from planned and actual move-
ment (positioning and velocity) of the MLC, during an IMRT or
VMAT treatment delivery. Pre-treatment verification (QA) allows
the comparison of the calculated and delivered dose distributions.
In case of failure, the treatment plan must be reviewed and possible
sources of fault must be tracked.
Purpose. The aim of this study is to substantiate a possible corre-
lation between MLC behavior (through the analysis of the DLGf using
FractionCheck software) and the failure of the QA procedure.
Materials and methods. Data from IMRT and VMAT DLGf
acquired from May 2014 to February 2016 in 7 linacs was statistical
analyzed as a complementary data source for the QA procedures. The
analyzed results were expressed in ‘‘Warning” and ‘‘Fail” accordingly
to the tolerances in TG142 report. Other parameters were also ana-
lyzed by the software: RMS, Beam-On, 95P, MaxRMS, MaxLag and
Gamma-function distribution. Results were reviewed considering
several factors: gantry angle, MLC maintenance, day time, pathol-
Results. No correlation between Dynalog information and the
results obtained from the QA measurements (VerySoft analysis)
was verified. For an increase in the dose rate, the 95P’s, MaxRMS’s
and RMS’s (for each leaf) parameters worsen.
Conclusion. Although the information obtained from DLGf can be
very useful in some particular situations, it does not predict the out-
come of IMRT or VMAT QA procedures. MLC’s performance does not
depend on the treatment’s pathology, gantry angle, or day time due
to possible linac’s overheating.
Disclosure. The authors have no relevant financial or non-
financial relationships to disclose.
http://dx.doi.org/10.1016/j.ejmp.2016.07.126
COMPARISON OF THREE DOSE CALCULATION METHODOLOGIES
FOR 90-Y MICROSPHERES RADIOEMBOLIZATION
V. Antunes a,b,*, J.A.M. Santos a,b,c
a
Medical Physics, Radiobiology and Radiation Protection Group,
Research Centre, Portuguese Institute of Oncology, Rua Bernardino de
Almeida, 4200-072 Porto, Portugal
b
Medical Physics Department, Portuguese Institute of Oncology, Rua
Bernardino de Almeida, 4200-072 Porto, Portugal
c
Instituto de Ciências Biomédicas Abel Salazar da Universidade do Porto,
Rua J Viterbo Ferreira 228, 4050-313 Porto, Portugal
⇑ Corresponding author.
Introduction. According to 2013/59/Euratom BSS, for all medical
exposure of patients for radiotherapeutic purposes, including
Nuclear Medicine, doses in target volumes shall be individually
planned. Furthermore, doses to non-target volumes (e.g organs-at-
risk) shall be as-low-as-reasonably-achievable and consistent with
the intended radiotherapeutic purposes. For Y-90 microspheres
radioembolization, three methods of activity calculation to be admi-
nistered are usually used: empirical, body-surface-area (BSA) and
partition methods.
Purpose. Accuracy and effectiveness of dose distribution calcula-
tion in the liver was compared using these three methods.
Materials and methods. A Tc-99m:MAA SPECT/CT image is used
to predict microspheres distribution, possible gastro-intestinal
implication and to estimate dose distribution after radioemboliza-
tion. A 90-Y SPECT/CT image is acquired after the radioembolization
and compared with the previous Tc-99m:MAA images. Dose calcula-
tion using the three methods and based in the 99m-Tc and 90-Y
SPECT/CT images were systematically evaluated for 15 patients.
Results. Administered activities based on the three methods can
show large variations for the same patient, leading to very different
dose distributions (e.g. 70% in the tumor and healthy liver parench-
yma). Different Tc-99m:MAA and Y-90 microspheres distribution
also occur and is a major problem which can imply healthy liver par-
enchyma irradiation higher than the maximum dose recommenda-
tion (70 Gy).
Conclusion. Empirical and BSA methods are not suitable for a
minimal acceptable accuracy of dose distribution calculation (10–
20%). Although the partition model is the most accurate, different
Tc-99m:MAA and Y-90 microspheres distribution leads also to large
errors in the final dosimetry calculation. New approaches, such as
the use of 99m-Tc labeled microspheres instead of Tc-99m:MAA,
should be pursued.