This study aims to compare two methods for the organ dose evaluation in computed tomography (CT) in the head- and thorax regions: an experimental method, using radiochromic films, and a computational one, using a commercial software. Gafchromic® XR-QA2 and EBT-3 were characterized in terms of energetic, angular, and irradiation configurations dependence. Two free-in-air irradiation calibration configurations were employed using a CT scanner: with the sensitive surface of the film orthogonal (OC) and parallel (PC) to the beam axis. Different dose-response curves were obtained by varying the irradiation configurations and the beam quality (BQ). Subsequently, films were irradiated within an anthropomorphic phantom using CT-thorax and -head protocols, and the organ dose values obtained were compared with those provided by the commercial software. At different configurations, an unchanged dose response was achieved with EBT-3, while a dose response of 15% was obtained with XR-QA2. By varying BQ, XR-QA2 showed a different response below 10%, while EBT-3 showed a variation below 5% for dose values >20 mGy. For films irradiation angle equal to 90°, the normalized to 0° relative response was 41% for the XR-QA2 model and 83% for the EBT-3 one. Organ dose values obtained with EBT-3 for both configurations and with XR-QA2 for OC were in agreement with the DW values, showing percentage discrepancies of less than 25%. The obtained results showed the potential of EBT-3 in CT patient dosimetry since the lower angular dependence, compared to XR-QA2, compensates for low sensitivity in the diagnostic dose range.

This study assessed the accuracy of average glandular dose (AGD) calculations for two Selenia Dimensions mammography systems using data from the online dose management DoseWatch software version 3.3.5.1. Mammographic images acquired between January 2021 and December 2022 were retrospectively analyzed. The AGD values displayed by the systems were compared with those independently calculated using the Dance and Boone methods. Additionally, real glandular composition of breast was estimated using LIBRA (Laboratory for Individualized Breast Radiodensity Assessment) software version 1.0.4 for a selected subgroup of patients. Results showed that the AGD values displayed by the systems were generally consistent with those calculated using the Dance method, but discrepancies emerged when applying the Boone method, especially when using estimated glandular composition. Most mammograms fell within acceptable and achievable dose limits according to European guidelines, though a small percentage exceeded these thresholds. The findings suggest that the Dance method, using glandular composition estimated through LIBRA, provides a reliable and accurate AGD calculation, offering a simpler alternative to more complex individualized calculations. The study highlights the importance of accurate glandularity estimation for proper dose management in mammography.

Breast-conserving surgery followed by external beam Radiotherapy (RT) is a standard approach for early-stage Breast Cancer (BC). This retrospective study aims to determine the risk of RT-induced lung cancer for both standard and hypofractionated treatments. Fifty-eight Sicilian women treated at Humanitas Istituto Clinico Catanese (Misterbianco, Italy) between 2015 and 2021 with standard fractionated 3D-CRT (50 Gy in 2 Gy/fraction) were included. All treatment plans were designed using a hypofractionated schedule (42.56 Gy in 2.66 Gy/fraction). An Eclipse™ plug-in script was developed using the Eclipse Scripting Application Programming Interface (ESAPI) to extract patient and treatment data from the Treatment Planning System and compute Organ At Risk (OAR) volume, Organ Equivalent Dose (OED), Excess Absolute Risk (EAR), and Lifetime Attributable Risk (LAR) using the Schneider Mechanistic Model and reference data from regional populations, A-bomb survivors, and patients with Hodgkin’s Disease (HD). The OED distributions exhibited a statistically significant shift toward higher values in standard fractionated plans (p < 0.01, one-tailed paired Student’s t-test), leading to increased EAR and LAR. These results indicate that hypofractionated treatment may lower the risk of radiation-induced lung cancer. The feasibility of a priori risk estimation was evaluated by integrating the script into the TPS, allowing rapid comparison of SF and HF plans during planning.

Background: In vivo transit dosimetry using an electronic portal imaging device (EPID‐IVTD) is an important tool for verifying the accuracy of radiation therapy treatments. Despite its potential, the implementation of EPID‐IVTD in breast intensity modulated radiation therapy (IMRT) treatments has not yet been standardized, limiting its clinical adoption. A standardized EPID‐IVTD method could enhance treatment accuracy and improve patient safety in routine clinical practice.Purpose: This study aims to develop a method for EPID‐IVTD for whole breast IMRT treatment.Methods: Gamma passing rates (GPRs) analysis was the basis of the work conducted on a dataset of 50 patients. The first phase of the work focused on the identification of the reference fraction. In the second phase a method for performing EPID‐IVTD was implemented. Lower‐tolerance and ‐action limits (l‐TL and l‐AL), as introduced by AAPM TG 218, were employed to determine the reference fraction and used as alert and alarm thresholds, respectively, in EPID‐IVTD monitoring.Results: The first treatment fraction demonstrated the best dosimetric agreement with the theoretical plan and was therefore used as the reference in the second phase of the study. EPID‐IVTD results showed that 75% of the GPRs ranged from 97.5% to 99.9%, 93.83% were above the l‐TL, 4.31% fell between l‐TL and l‐AL, and 1.86% were below l‐AL.Conclusions: A method for the implementation of an effective EPID‐IVTD in whole breast IMRT treatment was developed and is now routinely applied at our center, enabling efficient monitoring in clinical practice.