Measurement and Analysis of PDDs Profile and Output Factors for Small Field Sizes by cc13 and Micro-Chamber cc01

Small radiation fields are abundantly used in modern radiotherapy techniques like in IMRT and SRS. In order to commission these techniques, dosimetric data for small fields is required. The purpose of this study is to compare dosimetric measurements with two different ion chambers cc13, and cc01 for smaller fields. Dosimetric measurements are beam profile, output factor, pdds, and collimator factor. Dosimetric data is acquired in water phantom for two different photon beam energies 6 MV and 15 MV with zero gantry angle. In beam profiles cc13 chamber, measure wider penumbra as compare to cc01. And this wider measurement of penumbra occurs for smaller as well as for larger field sizes. Accumulated relative error in the measurement of penumbra for number of field sizes and 6 MV at dmax, and at 10 cm depth are 34.32% and 27.72% respectively. Accumulated relative error in the measurement of penumbra for number of field sizes and 15 MV at dmax, and at 10 cm depth are 28.49% and 23.92%. In case of output factor for smaller fields cc13 underestimates the output factor relative to cc01, with non-linear increase for smaller fields. But for larger fields, this increase in output factor is almost linear difference of two chambers is decreased. For very smaller fields × 2 cm, relative error in output factor of cc13 and cc01 is greater than 5% and rapidly increases with decreasing field size. But for lager fields, this relative error is negligible. In measurement of pdds after the buildup region difference occurs in the response of two chambers cc13 and cc01 for smaller fields. For field sizes ≤2 cm × 2 cm average cc13-cc01 at various depths 30 cm, 40 cm, 50 cm, 60 cm, 70 cm, and 80 cm is almost greater than 0.5 cm. And similarly as output factor, this difference (cc13-cc01) increases with field size decreasing.

Inter-Observer Variability in the Interpretation of 68Ga-PSMA PET-CT Scan according to PROMISE Criteria

Aims & Objectives: Aim of the study was to evaluate inter-observer variability in interpretation of Gallium-68 labeled Prostate Specific Membrane Antigen sub-type 11 (68Ga-PSMA-11) Positron Emission Tomography-Computed Tomography PET_CT scan according to Prostate Cancer Molecular Imaging Standardized Evaluation (PROMISE) criteria. Method and Materials: Forty-four consecutive patients of prostate cancer were prospectively studied between the duration of January 2021 to June 2021 at Institute of Nuclear Medicine and Oncology (INMOL), Lahore. All PET-CT scans were assessed by a researcher and 3 nuclear physicians and divided into two groups, interpreted in two phases. In the first phase, each group independently evaluated the scans while in the second phase, a consensus meeting was held and all the cases with discordance were discussed. Cohen’s Kappa test was used to measure interobserver variability with the cut-off of K’s alpha Results: The study showed 41 out of 44 scans with positive PSMA findings while 03 scans were negative for any PSMA avid disease. In the first phase of image analysis, the level of agreement was slight in T stage (Kappa = 0.068, p = 0.65), moderate in the miN stage (Kappa = 0.46, p = 0.02) and substantial in miM stage (Kappa = 0.77, p ≤ 0.001) was seen. For PSMA score, overall agreement was substantial agreement (Kappa = 0.64, p Conclusion: Remarkable inter-observer agreement was seen in PROMISE criteria.