Volume 65, Issue 12 e27395
RESEARCH ARTICLE

Feasibility and accuracy of UF/NCI phantoms and Monte Carlo retrospective dosimetry in children treated on National Wilms Tumor Study protocols

John A. Kalapurakal

Corresponding Author

John A. Kalapurakal

Department of Radiation Oncology, Northwestern University, Chicago, Illinois

Correspondence

John A. Kalapurakal, MD, Department of Radiation Oncology, Northwestern University, Chicago, IL.

Email: [email protected]

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Mahesh Gopalakrishnan

Mahesh Gopalakrishnan

Department of Radiation Oncology, Northwestern University, Chicago, Illinois

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Matthew Mille

Matthew Mille

Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institute of Health, Bethesda, Maryland

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Irene Helenowski

Irene Helenowski

Northwestern University, Chicago, Illinois

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Susan Peterson

Susan Peterson

Fred Hutchinson Cancer Center, Seattle, Washington

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Cynthia Rigsby

Cynthia Rigsby

Department of Medical Imaging, Ann and Robert Lurie Children's Hospital, Chicago, Illinois

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Fran Laurie

Fran Laurie

Quality Assurance Review Center, Lincoln, Rhode Island

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Jae Won Jung

Jae Won Jung

Department of Physics, East Carolina University, Greenville, North Carolina

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Thomas J. Fitzgerald

Thomas J. Fitzgerald

Quality Assurance Review Center, Lincoln, Rhode Island

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Choonsik Lee

Choonsik Lee

Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institute of Health, Bethesda, Maryland

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First published: 12 August 2018
Citations: 8

Abstract

Purpose

This pilot study was done to determine the feasibility and accuracy of University of Florida/National Cancer Institute (UF/NCI) phantoms and Monte Carlo (MC) retrospective dosimetry and had two aims: (1) to determine the anatomic accuracy of UF/NCI phantoms by comparing 3D organ doses in National Wilms Tumor Study (NWTS) patient-matched UF/NCI phantoms to organ doses in corresponding patient-matched CT scans and (2) to compare infield and out-of-field organ dosimetry using two dosimetry methods—standard radiation therapy (RT) treatment planning systems (TPS) and MC dosimetry in these two anatomic models.

Methods

Twenty NWTS patient-matched Digital Imaging and Communications in Medicine (DICOM) files of UF/NCI phantoms and CT scans were imported into the Pinnacle RT TPS. The NWTS RT fields (whole abdomen, flank, whole lung, or a combination) and RT doses (10–45 Gy) were reconstructed in both models. Both TPS and MC dose calculations were performed. For aim 1, the mean doses to the heart, kidney, thyroid gland, testes, and ovaries using TPS and MC in both models were statistically compared. For aim 2, the TPS and MC dosimetry for these organs in both models were statistically compared.

Results

For aim 1, there was no significant difference between phantom and CT scan dosimetry for any of the organs using either TPS or MC dosimetry. For aim 2, there was a significant difference between TPS and MC dosimetry for both CT scan and phantoms for all organs. Although the doses for infield organs were similar for both TPS and MC, the doses for near-field and out-of-field organs were consistently higher for 90% to 100% of MC doses; however, the absolute dose difference was small (<1 Gy).

Conclusions

This pilot study has demonstrated that the patient-matched UF/NCI phantoms together with MC dosimetry is an accurate model for performing retrospective 3D dosimetry in large-scale epidemiology studies such as the NWTS.

CONFLICTS OF INTEREST

None.

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