Suarez Saunders (orchidmask13)

itional simulation training during the course of a clinical rotation remains unclear in the short term. The incorporation of a simulation training curriculum for CR and casting of pediatric distal forearm fractures resulted in statistically significant, however, marginally improved postreduction radiographic parameters and LOR rates among orthopaedic residents. The utility of repeated additional simulation training during the course of a clinical rotation remains unclear in the short term. The goal of this work is to validate the user-friendly Geant4-based Monte Carlo toolkit TOol for PArticle Simulation (TOPAS) for brachytherapy applications. Brachytherapy simulations performed with TOPAS were systematically compared with published TG-186 reference data. The photon emission energy spectrum, the air-kerma strength, and the dose-rate constant of the model-based dose calculation algorithm (MBDCA)-WG generic Ir-192 source were extracted. For dose calculations, a track-length estimator was implemented. The four Joint AAPM/ESTRO/ABG MBDCA-WG test cases were evaluated through histograms of the local and global dose difference volumes. A prostate, a palliative lung, and a breast case were simulated. For each case, the dose ratio map, the histogram of the global dose difference volume, and cumulative dose-volume histograms were calculated. The air-kerma strength was (9.772±0.001)×10 U Bq (within 0.3% of the reference value). The dose-rate constant was 1.1107±0.0005cGyh U (within 0.01% of the reference value). For all cases, at least 96.9% of voxels had a local dose difference within [-1%, 1%] and at least 99.9% of voxels had a global dose difference within [-0.1%, 0.1%]. The implemented track-length estimator scorer was more efficient than the default analog dose scorer by a factor of 237. For all clinical cases, at least 97.5% of voxels had a global dose difference within [-1%, 1%]. Dose-volume histograms were consistent with the reference data. TOPAS was validated for high-dose-rate brachytherapy simulations following the TG-186 recommended approach for MBDCAs. Built on top of Geant4, TOPAS provides broad access to a state-of-the-art Monte Carlo code for brachytherapy simulations. TOPAS was validated for high-dose-rate brachytherapy simulations following the TG-186 recommended approach for MBDCAs. Built on top of Geant4, TOPAS provides broad access to a state-of-the-art Monte Carlo code for brachytherapy simulations. The purpose of the study was to elucidate the usefulness of a dose evaluation method for reducing late genitourinary (GU) toxicity in high-dose-rate brachytherapy (HDR-BT) of prostate cancer. GU toxicity was scored in accordance with the Common Terminology Criteria for Adverse Events version 4.0. The prostatic urethra was divided into three segments (base=B, midgland=M, apex=A), which were subclassified into seven subgroups (B, M, A, BM, BA, MA, BMA) using a D color map of the urethra. Significance testing was conducted on urethral D and D among the seven subgroups. Grade < 2 GU toxicity was also implemented. Data of 174 patients with localized prostate cancer treated with HDR-BT combined with external beam radiotherapy between November 2011 and July 2014 were analyzed retrospectively. Median age was 74 (53-84) years, and median followup period was 44 (6-69) months. The number of Grade < 2 and Grade ≥ 2 toxicity was significantly different in the M subgroup than in the other subgroups (p<0.05), suggesting increased radioresistance in the midgland urethra. A high-dose-area evaluation method using a urethral D color map may be helpful in reducing late GU toxicity in HDR-BT for prostate cancer. A high-dose-area evaluation method using a urethral D10% color map may be helpful in reducing late GU toxicity in HDR-BT for prostate cancer. A well functioning arteriove