ArticleJournal of applied clinical medical physics2024
Total scalp irradiation: A study comparing multiple types of bolus and VMAT optimization techniques.
Article in Journal of applied clinical medical physics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- A patch-based bolus technique for total scalp irradiation: dosimetric impact of conformity and reproducibility.Journal of radiation research · 2026Article
- Beam geometry optimization and convergence mode evaluation for knowledge-based planning of hippocampal avoidance whole-brain radiotherapy: A cross-platform study with quantitative scorecard assessment.Journal of applied clinical medical physics · 2026Article
- Dosimetric impact of aperture-restricted VMAT on heart dose in breast cancer treated with regional nodal irradiation.Journal of applied clinical medical physics · 2026Article
- Total scalp irradiation: A study comparing multiple types of bolus and VMAT optimization techniques.Journal of applied clinical medical physics · 2024Article
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Authors and funding
9 authors.
Funding
Abstract
purposeTo investigate bolus design and VMAT optimization settings for total scalp irradiation.
methodsThree silicone bolus designs (flat, hat, and custom) from .decimal were evaluated for adherence to five anthropomorphic head phantoms. Flat bolus was cut from a silicone sheet. Generic hat bolus resembles an elongated swim cap while custom bolus is manufactured by injecting silicone into a 3D printed mold. Bolus placement time was recorded. Air gaps between bolus and scalp were quantified on CT images. The dosimetric effect of air gaps on target coverage was evaluated in a treatment planning study where the scalp was planned to 60 Gy in 30 fractions. A noncoplanar VMAT technique based on gEUD penalties was investigated that explored the full range of gEUD alpha values to determine which settings achieve sufficient target coverage while minimizing brain dose. ANOVA and the t-test were used to evaluate statistically significant differences (threshold = 0.05).
resultsThe flat bolus took 32 ± 5.9 min to construct and place, which was significantly longer (p < 0.001) compared with 0.67 ± 0.2 min for the generic hat bolus or 0.53 ± 0.10 min for the custom bolus. The air gap volumes were 38 ± 9.3 cc, 32 ± 14 cc, and 17 ± 7.0 cc for the flat, hat, and custom boluses, respectively. While the air gap differences between the flat and custom boluses were significant (p = 0.011), there were no significant dosimetric differences in PTV coverage at V57Gy or V60Gy. In the VMAT optimization study, a gEUD alpha of 2 was found to minimize the mean brain dose.
conclusionsTwo challenging aspects of total scalp irradiation were investigated: bolus design and plan optimization. Results from this study show opportunities to shorten bolus fabrication time during simulation and create high quality treatment plans using a straightforward VMAT template with simple optimization settings.
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