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Evaluation of normal tissue complication probability (NTCP) dose-response models predicting acute Pneumonitis in patients treated with conformal radiation therapy for non-small cell lung cancer, and development of a NTCP calculation software toolGrout, Ioannis 23 November 2007 (has links)
A set of mathematical models, known as radiobiological Dose-Response models, have
been developed, to model the biological effects and complications that arise following irradiation. The overall objective is to be able to apply these in clinical practice with confidence, and ensure more successful treatments are given to patients.
This investigation serves to assess these models and their predictive power of NTCP
following irradiation of the lung. Clinical data, from patients treated for inoperable
stage III non-small cell lung cancer is obtained and the consequent biological effect
(severity of pneumonitis) observed as a result of this radiation treatment is assessed by the models.
By gaining more knowledge about the 3D dose-distribution and the incidence of radiation pneumonitis through the evaluation of the models, the main treatment goal, which is to maximise TCP and minimise NTCP can be achieved. Post treatment data is obtained regarding the clinical outcome or clinical endpoint for each patient, considered to be Radiation Pneumonitis. The clinical endpoint is a specific biological effect that may or may not have occurred,after a certain period, following irradiation.
The models are assessed on their ability to predict a NTCP value that corresponds to
the resulting clinical endpoint following treatment. Furthermore a software tool for
the calculation of NTCP’s by the models is developed, in an attempt to provide an
important tool for optimization of radiotherapy treatment planning.
With our findings from this study, our aim is to further strengthen, support and challenge already existing literature on dose-response modelling. / -
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Patient radiation dosimetry in MSCT examinations / Δοσιμετρία ασθενών σε εξετάσεις υπολογιστικής τομογραφίας πολλαπλών τομώνΘαλασσινού, Στέλλα 05 September 2011 (has links)
MultiDetector-row Computed Tomography (MDCT) or MultiSlice Computed Tomography (MSCT) has undergone remarkable progress since its first introduction at the end of the 1990s. Given that CT examinations are generally recognized as a relatively high-dose procedure, concern has been expressed at the associated increase in doses. The International Committee on Radiation Protection (ICRP) noted in their report No.87 that absorbed doses in tissues from CT are among the highest observed in diagnostic radiology (i.e. 10–100 mGy).
Therefore, the purpose of this thesis is to calculate the dosimetric quantities for brain, chest, and abdomen-pelvis examinations that were carried out using Philips Brilliance 16 and Brilliance 64 CT Scanners of the University General Hospital “Attikon”, as well as to perform their intercomparison.
For brain examinations, axial technique was utilized. However, for chest and abdomen-pelvis examinations, spiral technique was applied. The effect of overranging (or overscanning) is connected with spiral mode and its contribution to patient dose is really important in case of MSCT scanners. Therefore, the contribution of the overrange effect for body examinations carried out was calculated.
In the framework of this thesis, the contribution of overrange to the effective dose received by patients submitted to the forementioned examinations is calculated.
Additionally, dose measurements were carried out in order to estimate the radiation burden to the eye lenses and the thyroid during the typical brain examination, both when eye lenses are inside and outside the irradiation field. / Οι Υπολογιστικοί Τομογράφοι (ΥΤ) πολλαπλών τομών έχουν σημειώσει μεγάλη πρόοδο από την κλινική εφαρμογή τους στις αρχές του 1990. Λαμβάνοντας υπ’ όψιν ότι οι εξετάσεις ΥΤ συνεπάγονται υψηλή ακτινική επιβάρυνση του ασθενή, η μελέτη τους έχει συγκεντρώσει το ερευνητικό ενδιαφέρον της επιστημονικής κοινότητας. Η Διεθνής Επιτροπή Ακτινοπροστασίας (ICRP) επισημαίνει στην αναφορά Νο 87 ότι η απορροφούμενη δόση στους ιστούς από εξετάσεις ΥΤ είναι από τις υψηλότερες στη διαγνωστική ακτινολογία (10-100 mGy).
Συνεπώς, σκοπός της παρούσας διπλωματικής εργασίας είναι ο υπολογισμός των δοσιμετρικών μεγεθών για τις συνήθεις εξετάσεις εγκεφάλου, θώρακος και άνω-κάτω κοιλίας, οι οποίες πραγματοποιούνται με τους ΥΤ πολλαπλών τομών Brilliance 16 και Βrilliance 64 της Philips στο Π.Γ.Ν “ΑΤΤΙΚΟΝ ”,καθώς επίσης και η σύγκριση των αντίστοιχων δόσεων μεταξύ των συγκεκριμένων ΥΤ.
Οι ασθενείς που υποβάλλονται σε εξετάσεις θώρακος και άνω-κάτω κοιλίας που πραγματοποιούνται με ελικοειδή τεχνική λαμβάνουν επιπλέον δόση (overscan) που οφείλεται στην τεχνική αυτή. Η συνεισφορά του “overscan” είναι ιδιαίτερα σημαντική στους ΥΤ πολλαπλών τομών, οπότε επιπλέον στόχος αυτής της διπλωματικής είναι ο υπολογισμός της.
Τέλος, πραγματοποιήθηκαν μετρήσεις της δόσης του θυρεοειδή και των φακών των οφθαλμών κατά την υποβολή ασθενών στη συνήθη εξέταση εγκεφάλου, τόσο στην περίπτωση παρουσίας των οφθαλμών εντός όσο και εκτός πεδίου ακτινοβόλησης.
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