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Objective:To explore the value of using the mean gamma index (GI) in targer area receiving 50% prescribed dose as reference in VMAT planned dose verification through model-based dose calculation and measurement-based dose reconstruction.Methods:Based on Compass dose verificantion system, the VMAT plans for 70 patients were validated using two method. The mean GI and passing rate in target area receiving 50% of prescribed dose area for each validation plan were obtained to evaluate its application value in dose validation. First, plan information obtained by TPS calculation was input into the Compass system for performing independent dose calculation based on the accelerator data model, and obtain a three-dimensional dose based on the independent model calculation. The planned fluence measured for each patient′s treatment plan on the accelerator was reconstructed through the Compass system to obtain a three-dimensional dose based on measurement reconstruction. The three-dimensional dose obtained by the two method were compared with the three-dimensional dose calculated by TPS.Results:Combined with the gamma criteria of 3%/3 mm in the error setting condition of GI analysis, the mean GI in the area receiving 50% of prescribed dose was evaluated. GI≤0.4 was classified as PASS, 0.4 < GI ≤ 0.6 as being clinically acceptable, and GI > 0.6 as FAIL. The VMAT planned dose verification for 70 patients showed that the model-based independent calculation was in a better agreement with the TPS calculation. The GI values were all < 0.6: GI≤0.4 for 67 patients and 0.4 <GI≤ 0.6 for the other 3 patients, with gamma passing rate larger than 92%. The in- vivo measurement-based reconstructed 3D dose are slightly lesser than the model-based planed result ; theGI values were all < 0.6: GI ≤0.4 for 35 patients and 0.4 < GI ≤ 0.6 for other 35 patients, with gamma pass rate larger than 88%, of which gamma passing rate > 90% for 88 patients and < 90% for other 2, all meeting the requirements of clinical dose verification. The model-based independent dose verification is better than the measurement-based reconstructed dose verificantion, and the difference is statistically significant ( t=15.20, 10.71, P < 0.05). Conclusions:The mean GI in target area receiving 50% of prescribed dose can be used as a reference to judge the operatability of clinical plan in clinical dose verification. The mean GI value, in combination with the comprehensive result of gamma passing rate, is more convincing to evaluate dose verification. A combination of model-based dose verification, despite time-saving and labor-saving, and the measurement-based dose verification could become a reliable dose verification method for clinical application.
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Falar de emergência significa que houve algo inesperado e contingente que obrigou todo o mundo a responder à questão: e agora, o que fazer? Mas na resposta, isto é, no modo de tratarou de lidar com isso que aconteceu,não há apenas um fazer mas também um ou vários dizeres; daí que importe interrogar o que é este dizer, esta língua que usamos, é abusada ou nos abusa, conforme o caso, mas que por vezes implica igualmente uma certa torção que importa não perder de vista na prática analítica, pois é ela, porventura, a bússola que nos orienta
Parler d'urgence signifie qu'il s'est passé quelque chose d'inattendu et de contingent qui a obligé tout le monde à répondre à la question : et maintenant, que faire ? Mais dans la réponse, c'est-à-dire dans la façon dont nous traitons ou nous occupons de ce qui s'est passé, il n'y a pas seulement une chose à faire, mais aussi une ou plusieurs choses à dire; c'est pourquoi il est important dese demander ce qu'est ce dicton, ce langage que nous utilisons, qui est malmené ou qui nous abuse, selon le cas, mais qui implique aussi parfois une certaine torsion qu'il est important de ne pas perdre de vue dans la pratique analytique, car c'est peut-être la boussole qui nous guide
Speaking of emergency means that there was something unexpected and contingent that forced everyone to answer the following question: what are we to do now? But in the answer to this question, in the way we address or deal with what has happened, there are not only things to do, but also one or more things to say; that is why it is important to ask what this saying is, this language that we use, abuse or abuses us, as the case may be, but italso sometimes implies a certain twist that we must not lose sight of in analytical practice, since it might be the compass that guides us
Subject(s)
Psychoanalysis , Psychoanalytic Theory , Therapeutics , Emergencies , LanguageABSTRACT
A pesar de la tragedia que el último atentado terrorista provocó en las ramblas de Barcelona, la comunidad cardiológica catalana tuvo que reponerse rápidamente para ser anfitriona del mayor evento cardiovascular de Europa: el ESC CONGRESS 2017. Del 26 al 30 de agosto, en decenas de mesas redondas, más de 31.000 cardiólogos de todo el mundo se reunieron para actualizar sus conocimientos e intercambiar novedades en ciencia, innovación e investigación en cardiología en más de 500 sesiones y más de 4.500 presentaciones de abstracts (1). Se presentaron nuevas guías para el manejo del infarto agudo de miocardio, enfermedad valvular, enfermedad arterial periférica y recomendaciones para el uso de terapia antiplaquetaria dual. Se celebraron los 40 años de la intervención coronaria percutánea (PCI), realizada por Andreas Grüntzig por primera vez el 16 de setiembre de 1977(1). Realizaremos un breve resumen de algunos de los principales trabajos científicos presentados durante este evento que sin duda tendrán un impacto en nuestra práctica clínica diaria. - Canakinumab Anti-Inflammatory Thrombosis Outcome Study: CANTOS. - Global Anticoagulant Registry in the Field-Atrial Fibrillation (Registro Global de Anticoagulantes en el Campo de la Fibrilación Auricular): GARFIELD-AF. - Catheter ablation versus standard conventional treatment in patients with left ventricular dysfunction and atrial fibrillation: CASTLE-AF. - Cardiovascular OutcoMes for People using Anticoagulation StrategieS (COMPASS) trial: Primary Results
Despite the last terrorist attack tragedy at La Rambla in Barcelona, Catalonian cardiologic community had to quickly recover from the episode to host the major European cardiovascular event: the ESC CONGRESS 2017. From august 26th to 30th, more than 31.000 cardiologists from all over the world met to update their knowledge and share the state of the art science, innovation and cardiologic investigation in more than 500 sessions and more than 4.500 abstracts presentations. New guidelines for the management of acute ST-segment elevation myocardial infarction, valvular heart disease, peripheral vascular disease and recommendations on dual antiplatelet therapy were presented. Fourty years of percutaneous coronary intervention (PCI), performed for the first time by Andreas Grüntzig on September 16th, 1977, was celebrated. We will expose a brief summary of some of the main scientific works presented at the congress which will undoubtedly have an impact on our daily clinical practice. - Canakinumab Anti-Inflammatory Thrombosis Outcome Study: CANTOS. - Global Anticoagulant Registry in the Field-Atrial Fibrillation: GARFIELD-AF. - Catheter ablation versus standard conventional treatment in patients with left ventricular dysfunction and atrial fibrillation: CASTLE-AF. - Cardiovascular OutcoMes for People using Anticoagulation StrategieS (COMPASS) trial: Primary Results
Subject(s)
Congress , CardiologyABSTRACT
Objective To investigate the dosimetric performance of COMPASS system,a novel 3D quality assurance system for the verification of nasopharyngeal carcinoma volumetric modulated therapy (VMAT) treatment plan.Methods Eight VMAT treatment plans of nasopharyngeal carcinoma patients were performed with MasterPlan,a treatment planning system (TPS),and then these treatment plans were sent to the COMPASS and MOSAIQ system,a coherent control system,respectively.Comparison of the COMPASS reconstructed dose versus TPS dose was conducted by using the dose volume-based indices:dose received by 95％ volume of target ( D95％ ),mean dose ( Dmean ) and γ pass rate,dose to the 1％ of the spinal cord and brain stem volume ( D1％ ),mean dose of leaf and right parotid ( Dmean ),and the volume received 30 Gy for left and right parotid (V30).COMPASS can reconstruct dose with the real measured delivery fluence after detector commissioning.Results The average dose difference for the target volumes was within 1％,the difference for D95 was within 3％ for most treatment plans,and the γ pass rate was higher than 95％ for all target volumes.The average differences for the D1％ values of spinal cord and brain stem were ( 4.3 ± 3.0) ％ and ( 5.9± 2.9 ) ％ respectively,and the average differences for the Dmean values of spinal cord and brain stem were ( 5.3 ± 3.0 ) ％ and ( 8.0 ± 3.5 ) ％ respectively.In general the COMPASS measured doses were all smaller than the TPS calculated doses for these two organs.The average differences of the Dmean values of the left and right parotids were( 6.1± 3.1 ) ％ and ( 4.7 ± 4.4 ) ％ respectively,and the average differences of the V30 values of the left and right parotids were (9.4 ± 7.5 ) ％ and (9.4 ± 9.9)％ respectively.Conclusions An ideal tool for the VMAT verification,the patient anatomy based COMPASS 3D dose verification system can check the dose difference between the real delivery and TPS calculation directly for each individual organ,either target volumes or critical organs.
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A presente pesquisa teve por finalidade a avaliação das medidas do comprimento aparente do dente, obtidaspela régua endodôntica milimetrada em comparação com as obtidas através do compasso de pontaseca, em radiografias periapicais, iniciais de tratamentos endodônticos, realizados na Clínica de Endodontia IIda Universidade Federal de Pernambuco. Foram coletadas 200 radiografias periapicais que foram analisadasno negatoscópio com o auxílio de uma lupa com 5X de magnificação. As aferições do comprimento aparentedo dente foram realizadas com régua endodôntica milimetrada e com compasso de ponta seca. Os dados obtidos foram tabulados e analisados estatisticamente. A margem de erro utilizada na decisão dos testesestatísticos foi de 5,0%. O coeficiente de correlação de concordância entre os dois métodos de avaliação foi0,80 com intervalo 0,75 a 0,84. A média do comprimento foi 0,62 mm mais elevada, quando o método foia medida do compasso de ponta seca do que a medida do prontuário do paciente. De acordo com a metodologia empregada, conclui-se que não houve concordância entre os dois métodos avaliativos. A média do comprimento aparente do dente foi mais elevada, quando a medição foi realizada com o compasso de ponta seca do que com a régua endodôntica milimetrada.
The aim of this research was to evaluate the apparent tooth length, obtained by the endodonticmillimetered ruler, compared with those obtained through the compass needle point in periapicalradiographs of the endodontic treatment at Clinical of Endodontics II of the Federal University of Pernambuco.Two hundred periapical radiographs were analyzed in the light box with the aid of a magnifyinglens with 5X magnification. The apparent tooth length?s measurements were performed with amillimetered ruler and compass needle point. The data were statistically analyzed. The error?s margin inthe decision of the statistical tests was 5.0%. The concordance correlation coefficient between the twomethods was 0.80 with interval 0.75 to 0.84. The average length was 0.62mm higher when the methodwas the compass needle point measurement than the millimetered ruler measurement. According tothe methodology used, it was concluded that there was no agreement between the two evaluationmethods. The average of the apparent tooth length was higher when the measurement was taken with the compass needle point than with the endodontic millimetered ruler.