{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T05:23:00Z","timestamp":1773984180937,"version":"3.50.1"},"reference-count":23,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2018,5,6]],"date-time":"2018-05-06T00:00:00Z","timestamp":1525564800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01EB023909"],"award-info":[{"award-number":["R01EB023909"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["F31CA192473"],"award-info":[{"award-number":["F31CA192473"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["aapm.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Medical Physics"],"published-print":{"date-parts":[[2018,6]]},"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p>The purpose of this study was to identify the optimal treatment geometry for total skin electron therapy (TSET) using a new optimization metric from Cherenkov image analysis, and to investigate the sensitivity of the Cherenkov imaging method to floor scatter effects in this unique treatment setup.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Cherenkov imaging using an intensified charge coupled device (ICCD) was employed to measure the relative surface dose distribution as a 2D image in the total skin electron treatment plane. A 1.2 m \u00d7 2.2 m \u00d7 1 cm white polyethylene sheet was placed vertically at a source to surface distance (SSD) of 300 cm, and irradiated with 6 MeV high dose rate TSET beams. The linear accelerator coordinate system used stipulates 0\u00b0 is the bottom of the gantry arc, and progresses counterclockwise so that gantry angle 270\u00b0 produces a horizontal beam orthogonal to the treatment plane. First, all unique pairs of treatment beams were analyzed to determine the performance of the currently recommended symmetric treatment angles (\u00b120\u00b0 from the horizontal), compared to treatment geometries unconstrained to upholding gantry angle symmetry. This was performed on two medical linear accelerators (linacs). Second, the extent of the floor scatter contributions to measured surface dose at the extended SSD required for TSET were imaged using three gantry angles of incidence: 270\u00b0 (horizontal), 253\u00b0 (\u221217\u00b0), and 240\u00b0 (\u221230\u00b0). Images of the surface dose profile at each angle were compared to the standard concrete floor when steel plates, polyvinyl chloride (PVC), and solid water were placed on the ground at the base of the treatment plane. Postprocessing of these images allowed for comparison of floor material\u2010based scatter profiles with previously published simulation results.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Analysis of the symmetric treatment geometry (270 \u00b1 20\u00b0) and the identified optimal treatment geometry (270 + 23\u00b0 and 270 \u2212 17\u00b0) showed a 16% increase in the 90% isodose area for the latter field pair on the first linac. The optimal asymmetric pair for the second linac (270 + 25\u00b0 and 270 \u2212 17\u00b0) provided a 52% increase in the 90% isodose area when compared to the symmetric geometry. Difference images between Cherenkov images captured with test materials (steel, PVC, and solid water) and the control (concrete floor) demonstrated relative changes in the two\u2010dimensional (2D) dose profile over a 1 \u00d7 1.9 m region of interest (ROI) that were consistent with published simulation data. Qualitative observation of the residual images demonstrates localized increases and decreases with respect to the change in floor material and gantry angle. The most significant changes occurred when the beam was most directly impinging the floor (gantry angle 240\u00b0, horizontal \u221230\u00b0), where the PVC floor material decreased scatter dose by 1\u20133% in 7.2% of the total ROI area, and the steel plate increased scatter dose by 1\u20133% in 7.0% of the total ROI area.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>An updated Cherenkov imaging method identified asymmetric, machine\u2010dependent TSET field angle pairs that provided much larger 90% isodose areas than the commonly adopted symmetric geometry suggested by Task Group 30 Report 23. A novel demonstration of scatter dose Cherenkov imaging in the TSET field was established.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mp.12917","type":"journal-article","created":{"date-parts":[[2018,4,17]],"date-time":"2018-04-17T04:24:29Z","timestamp":1523939069000},"page":"2639-2646","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Improving treatment geometries in total skin electron therapy: Experimental investigation of linac angles and floor scatter dose contributions using Cherenkov imaging"],"prefix":"10.1002","volume":"45","author":[{"given":"Jacqueline M.","family":"Andreozzi","sequence":"first","affiliation":[{"name":"Thayer School of Engineering Dartmouth College Hanover NH 03755 USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Petr","family":"Br\u016f\u017ea","sequence":"additional","affiliation":[{"name":"Thayer School of Engineering Dartmouth College Hanover NH 03755 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