PMID- 33992490
OWN - NLM
STAT- MEDLINE
DCOM- 20211124
LR  - 20211124
IS  - 1873-4022 (Electronic)
IS  - 1873-4022 (Linking)
VI  - 46
IP  - 4
DP  - 2021 Winter
TI  - Multiple case dosimetric evaluation of VMAT scalp irradiation using 3D milled 
      bolus.
PG  - 324-327
LID - S0958-3947(21)00028-5 [pii]
LID - 10.1016/j.meddos.2021.03.007 [doi]
AB  - Adequate dose homogeneity and full prescription dose delivery to the scalp still 
      remains a dosimetric problem during scalp irradiation due to the anatomical shape 
      of the cranium. Confounding variables such as gravity, the irregular and convex 
      shape of the cranium, air gaps between scalp surface and commercial bolus, and 
      potential inconsistencies in a 3D printed bolus can negatively impact the dose 
      delivered to the scalp surface during scalp irradiation. The purpose of this 
      retrospective case study was to implement the use of a 3D milled rigid bolus 
      technique combined with volumetric modulated arc therapy (VMAT) treatment 
      planning and evaluate the dosimetric efficacy in delivering dose to the surface 
      of the scalp. The 8-patient retrospective case study consisted of patients with a 
      scalp lesion treated using a 3D milled bolus, VMAT, 6 megavoltage (MV) photon 
      beams, and aligned for treatment using daily conebeam computed tomography (CT) 
      and 6 degrees  of freedom couch positioning. Dose volume histograms (DVHs) were used to 
      evaluate maximum dose delivered to the planning target volumes (PTVs) while the 
      dose homogeneity index (DHI) was calculated and compared to that of an ideal 
      value of 1. The researchers evaluated the minimum dose delivered to the 
      individual PTVs after plan normalization. The researchers found that the 3D 
      milled bolus coupled with volumetric modulated arc therapy increased surface dose 
      homogeneity, while also increasing the percentage of planning target volumes 
      receiving full prescription dose. With statistically significant results, patient 
      specific 3D milled rigid bolus offers a viable bolus option for treatment of 
      superficial scalp lesions when combined with volumetric modulated arc therapy 
      treatment planning. However, a larger sample size used in a scientific research 
      study across multiple institutions would be desirable to validate these case 
      study findings.
CI  - Copyright (c) 2021 American Association of Medical Dosimetrists. Published by 
      Elsevier Inc. All rights reserved.
FAU - Casto, Zachary
AU  - Casto Z
AD  - Medical Dosimetry Program at the University of Wisconsin - La Crosse, WI 43113, 
      USA. Electronic address: zcasto73@gmail.com.
FAU - Liu, Michal
AU  - Liu M
AD  - Medical Dosimetry Program at the University of Wisconsin - La Crosse, WI 43113, 
      USA.
FAU - Lenards, Nishele
AU  - Lenards N
AD  - Medical Dosimetry Program at the University of Wisconsin - La Crosse, WI 43113, 
      USA.
FAU - Hunzeker, Ashley
AU  - Hunzeker A
AD  - Medical Dosimetry Program at the University of Wisconsin - La Crosse, WI 43113, 
      USA.
FAU - Zoller, Wesley
AU  - Zoller W
AD  - Medical Dosimetry Program at the University of Wisconsin - La Crosse, WI 43113, 
      USA.
FAU - Blakaj, Dukagjin M
AU  - Blakaj DM
AD  - Medical Dosimetry Program at the University of Wisconsin - La Crosse, WI 43113, 
      USA.
LA  - eng
PT  - Case Reports
DEP - 20210512
PL  - United States
TA  - Med Dosim
JT  - Medical dosimetry : official journal of the American Association of Medical 
      Dosimetrists
JID - 8908862
SB  - IM
MH  - Humans
MH  - Radiotherapy Dosage
MH  - Radiotherapy Planning, Computer-Assisted
MH  - *Radiotherapy, Intensity-Modulated
MH  - Retrospective Studies
MH  - Scalp
OTO - NOTNLM
OT  - 3D milled bolus
OT  - Radiotherapy
OT  - Scalp irradiation
OT  - VMAT
COIS- Declaration of Competing Interest There are no conflicts of interest.
EDAT- 2021/05/17 06:00
MHDA- 2021/11/25 06:00
CRDT- 2021/05/16 20:30
PHST- 2020/12/08 00:00 [received]
PHST- 2021/03/18 00:00 [accepted]
PHST- 2021/05/17 06:00 [pubmed]
PHST- 2021/11/25 06:00 [medline]
PHST- 2021/05/16 20:30 [entrez]
AID - S0958-3947(21)00028-5 [pii]
AID - 10.1016/j.meddos.2021.03.007 [doi]
PST - ppublish
SO  - Med Dosim. 2021 Winter;46(4):324-327. doi: 10.1016/j.meddos.2021.03.007. Epub 
      2021 May 12.