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Improvement of the robustness to set up error by a virtual bolus in total scalp irradiation with Helical TomoTherapy

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Abstract

Intensity-modulated radiation therapy has recently been used for total scalp irradiation. In inverse planning, the treatment planning system increases the fluence of tangential beam near the skin surface to counter the build-up region. Consequently, the dose to the skin surface increases even with small setup errors. Replacing the electron density of the surrounding air of some thickness with a virtual bolus during optimization could suppress the extremely high fluence near the skin. We confirmed the usefulness of a virtual bolus in total scalp irradiation. For each patient, two beams were planned, one with and the other without a virtual bolus. The dose distribution was calculated using computed tomography images that were shifted to simulate setup errors. The hot spot dose was suppressed in the plans using a virtual bolus. In conclusion, using a virtual bolus improved the robustness to setup errors.

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Authors and Affiliations

  1. Department of Radiology, University of Tokyo Hospital, 7-3-1Bunkyo-ku, HongoTokyo, 113-8655, Japan

    Ryosuke Takenaka, Kanabu Nawa, Yamashita Hideomi & Keiichi Nakagawa

  2. Department of Medical Image Informatics, Tokushima University, Tokushima, Japan

    Akihiro Haga

Authors
  1. Ryosuke Takenaka
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  2. Akihiro Haga
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  3. Kanabu Nawa
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  4. Yamashita Hideomi
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  5. Keiichi Nakagawa
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Corresponding author

Correspondence to Ryosuke Takenaka.

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Conflicts of interest

The authors have no conflicts of interest. This is a simulation study using previously acquired information. This study was ethically approved by the institutional review board of the University of Tokyo Hospital, with reference No. 3372.

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Takenaka, R., Haga, A., Nawa, K. et al. Improvement of the robustness to set up error by a virtual bolus in total scalp irradiation with Helical TomoTherapy. Radiol Phys Technol 12, 433–437 (2019). https://doi.org/10.1007/s12194-019-00539-1

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  • DOI: https://doi.org/10.1007/s12194-019-00539-1

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