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1.  Feasibility of concervative breast surgery and intraoperative radiation therapy for early breast cancer: A single-center, open, non-randomized, prospective pilot study 
Oncology Reports  2014;31(4):1539-1546.
Intraoperative radiotherapy (IORT) consists of an accelerated, single-dose, partial breast irradiation, performed immediately after breast conservative surgery. In the present study, we report the results of our feasibility protocol study using IORT between 2005 and 2009. We analyzed the data from a single-center, open, non-randomized, prospective pilot study including patients who underwent breast conservative surgery for invasive breast cancer between January 2005 and December 2009 at our Clinic of Surgery. Patients were divided based on IORT performance and stratified by age (≥48 or <48 years). Data were analyzed using R (version 2.15.2), considering a level of significance at P<0.05. Among the 247 eligible patients, 81 accepted the IORT protocol. Intraoperative IORT feasibility was 95.1% (77/81). In 71.4% (55/77) of the cases no postoperative complication was registered. Concerning local recurrence and overall survival, no significant difference was observed between women who underwent the IORT protocol or standard treatment. Among the patients aged <48 years, no local recurrence was noted after IORT protocol, and among women aged ≥48, local recurrences developed later in patients treated with IORT than with standard treatment. IORT represents a feasible and promising technique for the treatment of early breast cancer, with low morbidity, and beneficial aesthetic and oncologic results. Further studies are required in order to extend the inclusion criteria and offer IORT to a larger number of breast cancer patients.
PMCID: PMC3975985  PMID: 24534891
intraoperative radiotherapy; IORT; breast cancer; breast conservative surgery; early breast cancer; overall survival
2.  Core curriculum for medical physicists in radiology. Recommendations from an EFOMP/ESR working group 
Insights into Imaging  2012;3(3):197-200.
Some years ago it was decided that a European curriculum should be developed for medical physicists professionally engaged in the support of clinical diagnostic imaging departments. With this in mind, EFOMP (European Federation of Organisations for Medical Physics) in association with ESR (European Society of Radiology) nominated an expert working group. This curriculum is now to hand. The curriculum is intended to promote best patient care in radiology departments through the harmonization of education and training of medical physicists to a high standard in diagnostic radiology. It is recommended that a medical physicist working in a radiology department should have an advanced level of professional expertise in X-ray imaging, and additionally, depending on local availability, should acquire knowledge and competencies in overseeing ultrasound imaging, nuclear medicine, and MRI technology. By demonstrating training to a standardized curriculum, medical physicists throughout Europe will enhance their mobility, while maintaining local high standards of medical physics expertise. This document also provides the basis for improved implementation of articles in the European medical exposure directives related to the medical physics expert. The curriculum is divided into three main sections: The first deals with general competencies in the principles of medical physics. The second section describes specific knowledge and skills required for a medical physicist (medical physics expert) to operate clinically in a department of diagnostic radiology. The final section outlines research skills that are also considered to be necessary and appropriate competencies in a career as medical physicist.
PMCID: PMC3369126  PMID: 22696082
Medical physics; Radiology; Education and training; Curriculum
3.  Performance evaluation of three computed radiography systems using methods recommended in American Association of Physicists in Medicine Report 93 
The performances of three clinical computed radiography (CR) systems, (Agfa CR 75 (with CRMD 4.0 image plates), Kodak CR 850 (with Kodak GP plates) and Kodak CR 850A (with Kodak GP plates)) were evaluated using six tests recommended in American Association of Physicists in Medicine Report 93. The results indicated variable performances with majority being within acceptable limits. The variations were mainly attributed to differences in detector formulations, plate readers’ characteristics, and aging effects. The differences of the mean low contrast scores between the imaging systems for three observers were statistically significant for Agfa and Kodak CR 850A (P=0.009) and for Kodak CR systems (P=0.006) probably because of the differences in ages. However, the differences were not statistically significant between Agfa and Kodak CR 850 (P=0.284) suggesting similar perceived image quality. The study demonstrates the need to implement quality control program regularly.
PMCID: PMC3159220  PMID: 21897559
AAPM Report 93; computed radiography systems; performance evaluation
4.  Initial quality performance results using a phantom to simulate chest computed radiography 
The aim of this study was to develop a homemade phantom for quantitative quality control in chest computed radiography (CR). The phantom was constructed from copper, aluminium, and polymenthylmethacrylate (PMMA) plates as well as Styrofoam materials. Depending on combinations, the literature suggests that these materials can simulate the attenuation and scattering characteristics of lung, heart, and mediastinum. The lung, heart, and mediastinum regions were simulated by 10 mm x 10 mm x 0.5 mm, 10 mm x 10 mm x 0.5 mm and 10 mm x 10 mm x 1 mm copper plates, respectively. A test object of 100 mm x 100 mm and 0.2 mm thick copper was positioned to each region for CNR measurements. The phantom was exposed to x-rays generated by different tube potentials that covered settings in clinical use: 110-120 kVp (HVL=4.26-4.66 mm Al) at a source image distance (SID) of 180 cm. An approach similar to the recommended method in digital mammography was applied to determine the CNR values of phantom images produced by a Kodak CR 850A system with post-processing turned off. Subjective contrast-detail studies were also carried out by using images of Leeds TOR CDR test object acquired under similar exposure conditions as during CNR measurements. For clinical kVp conditions relevant to chest radiography, the CNR was highest over 90-100 kVp range. The CNR data correlated with the results of contrast detail observations. The values of clinical tube potentials at which CNR is the highest are regarded to be optimal kVp settings. The simplicity in phantom construction can offer easy implementation of related quality control program.
PMCID: PMC3048950  PMID: 21430855
Computed radiography; contrast-to-noise ratio; image quality; quality control phantom
5.  Implementation and validation of a commercial portal dosimetry software for intensity-modulated radiation therapy pre-treatment verification 
Electronic portal imaging devices (EPIDs) are extensively used for obtaining dosimetric information of pre-treatment field verification and in-vivo dosimetry for intensity-modulated radiotherapy (IMRT). In the present study, we have implemented the newly developed portal dosimetry software using independent dose prediction algorithm EPIDose™ and evaluated this new tool for the pre-treatment IMRT plan quality assurance of Whole Pelvis with Simultaneous Integrated Boost (WP-SIB-IMRT) of prostate cases by comparing with routine two-dimensional (2D) array detector system (MapCHECK™). We have investigated 104 split fields using γ -distributions in terms of predefined γ frequency parameters. The mean γ values are found to be 0.42 (SD: 0.06) and 0.44 (SD: 0.06) for the EPIDose and MapCHECK™, respectively. The average γ∆ for EPIDose and MapCHECK™ are found as 0.51 (SD: 0.06) and 0.53 (SD: 0.07), respectively. Furthermore, the percentage of points with γ < 1, γ < 1.5, and γ > 2 are 97.4%, 99.3%, and 0.56%, respectively for EPIDose and 96.4%, 99.0% and 0.62% for MapCHECK™. Based on our results obtained with EPIDose and strong agreement with MapCHECK™, we may conclude that the EPIDose portal dosimetry system has been successfully implemented and validated with our routine 2D array detector
PMCID: PMC2990112  PMID: 21170182
2D-array detector; Electronic portal imaging device; intensity-modulated radiotherapy; portal dosimetry

Results 1-6 (6)