Evidence map›Paper›PMID 39495820›Full record

ArticleJournal of applied clinical medical physics2025

Comparative analysis of fetal dose sparing between a C-arm linac and an O-ring linac in a SIB-VMAT sarcoma treatment for a pregnant patient: A technical note and case report.

Wesley Rivais, Louis Constine, Matthew Pacella, Neil Joyce, Maimuna Nagey, Matthew Webster, Jihyung Yoon, Hyunuk Jung, Sean Tanny, Olga Maria Dona Lemus and 1 more

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In one paragraph

Article in Journal of applied clinical medical physics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Wesley RivaisDepartment of Radiation Oncology, University of Rochester Medical Center, Rochester, New York, USA.
Louis ConstineDepartment of Radiation Oncology, University of Rochester Medical Center, Rochester, New York, USA.
Matthew PacellaDepartment of Radiation Oncology, University of Rochester Medical Center, Rochester, New York, USA.
Neil JoyceDepartment of Radiation Oncology, University of Rochester Medical Center, Rochester, New York, USA.
Maimuna NageyDepartment of Medical Physics, Creighton University, Omaha, Nebraska, USA.
Matthew WebsterDepartment of Radiation Oncology, University of Rochester Medical Center, Rochester, New York, USA.
Jihyung YoonDepartment of Radiation Oncology, University of Rochester Medical Center, Rochester, New York, USA.
Hyunuk JungDepartment of Radiation Oncology, University of Rochester Medical Center, Rochester, New York, USA.
Sean TannyDepartment of Radiation Oncology, University of Rochester Medical Center, Rochester, New York, USA.ORCID https://orcid.org/0000-0002-0915-9187
Olga Maria Dona LemusDepartment of Radiation Oncology, University of Rochester Medical Center, Rochester, New York, USA.
Dandan ZhengDepartment of Radiation Oncology, University of Rochester Medical Center, Rochester, New York, USA.ORCID https://orcid.org/0000-0003-2259-1633

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo compare the effect of two linacs designs on fetal dose sparing on a pregnant patient, including estimation of the fetal dose, and the effect of a lead apron.

methodsA patient with a high-grade sarcoma located in the right knee/lower thigh was prescribed 51 Gy (1.7 Gy/Fx) with a simultaneous-integrated-boost (SIB) of 60 Gy to a smaller volume, starting in the 26th gestational week. Volumetric modulated radiation therapy (VMAT) plans with 6MV-FFF were developed using identical dosimetric constraints on a Varian Truebeam Edge with HD-MLC and a Varian Halcyon with double-stacked MLC. Based on patient dimension measurements, an anthropomorphic phantom was constructed using a Rando phantom and saline bags in the patient's Vac-Lok bag. Phantom measurements were performed using OSLDs and TLDs placed at three different planes, corresponding to the pubis, the umbilicus, and the fundus based on patient measurements and projected gestational age, to estimate the fetal dose. Three experimental scenarios were measured, each with CBCT-based image guidance for an accurate, reproducible setup: Edge, Halcyon, and Halcyon with a tri-folded lead apron (0.5 mm × 3 = 1.5 mm Pb) over the phantom abdomen.

resultsPlan quality and total MUs are comparable between the Edge and Halcyon plans. The OSLD-measured whole-course dose to the pubis, umbilicus, and fundus were 18.8, 13.1, and 11.7 cGy, respectively, on Halcyon, on average 27.8% lower than Edge. The repeatability within either dosimeter was good, although TLD showed systematically lower doses. Importantly, both dosimetry systems showed a lower measured fetal dose for the Halcyon plan compared with the Edge plan. Adding a tri-folded lead apron over the abdomen did not meaningfully lower the measured dose.

conclusionIn this case study, Halcyon demonstrated a better sparing of out-of-field fetal dose compared to TrueBeam Edge. It was shown that lead aprons do not provide additional fetal dose sparing.

Indexed as

FetusOrgans at RiskParticle AcceleratorsPhantoms, ImagingRadiotherapy DosageRadiotherapy, Intensity-ModulatedRadiotherapy Planning, Computer-AssistedSarcomaAdultFemaleHumansOrgan Sparing TreatmentsPregnancyc‐armfetal doseO‐ringradiotherapySIBVMAT

Identifiers

PMID39495820
PMCPMC11713124

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.