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Determining the optimal dose size and dosing frequency in pharmacotherapy is crucial for achieving therapeutic effectiveness while minimizing adverse effects. This article explores the methodologies employed in determining these parameters, focusing on their significance and interplay to tailor dosing regimens.Dose Size: Dose size refers to the amount of a drug administered in a single dose. It is determined based on the drug's pharmacodynamics and pharmacokinetics properties and...
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A wedge is a simple machine that serves various purposes, such as adjusting the elevation of structural or mechanical parts, providing stability for heavy objects, and splitting a body into two parts. This versatile tool can amplify an applied force, making it easier to manipulate large or heavy objects.
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Precision in Wedge Off-axis Using Independent Dose Verification.

Hiroyuki Shimizu1, Masanobu Itano2, Takeshi Yamazaki2

  • 1Department of Radiological Technology, Kitasato University Medical Center.

Igaku Butsuri : Nihon Igaku Butsuri Gakkai Kikanshi = Japanese Journal of Medical Physics : an Official Journal of Japan Society of Medical Physics
|July 14, 2017
PubMed
Summary

Independent verification of radiation therapy plans using wedge off-axis calculations improves precision. This study suggests a 5% tolerance level for wedge off-axis plans, enhancing patient safety in radiotherapy quality assurance.

Keywords:
confidence limitindependent dose verificationmulti-institutional studywedge off-axis

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Area of Science:

  • Medical Physics
  • Radiation Oncology
  • Radiotherapy Quality Assurance

Background:

  • Independent verification of patient treatment plans is crucial for radiation therapy safety.
  • Existing guidelines (AAPM TG114) address non-IMRT calculations but may not fully cover wedge-based techniques.
  • The precision of monitor unit (MU) verification, especially with off-axis wedge factors, requires detailed investigation.

Purpose of the Study:

  • To assess the precision of independent MU verification when incorporating wedge off-axis calculations.
  • To compare the accuracy of MU verification with and without wedge off-axis calculations.
  • To establish an appropriate tolerance level for independent verification of plans utilizing wedge off-axis calculations.

Main Methods:

  • A multi-institutional study involving twelve centers was conducted.
  • Independent MU verification was performed with and without wedge off-axis calculations.
  • Phantom studies and retrospective patient data analysis were utilized to evaluate results.
  • Confidence limits for verification accuracy were calculated.

Main Results:

  • Wedge off-axis calculations demonstrated improved agreement with treatment planning system (TPS) results compared to calculations without it.
  • In patient studies, confidence limits were 2.2±3.4% (physical wedge) and 2.0±4.3% (non-physical wedge) with off-axis calculation.
  • Confidence limits exceeded 5% when wedge off-axis calculations were omitted.
  • The study identified a potential 5% tolerance level for wedge off-axis plans.

Conclusions:

  • Incorporating wedge off-axis calculations significantly enhances the precision of independent MU verification in radiotherapy.
  • The proposed 5% tolerance level for wedge off-axis plans aligns with conventional techniques, ensuring robust quality assurance.
  • These findings support the refinement of quality assurance protocols for complex radiotherapy planning.