Purpose/Objective: Most dose-escalation trials in glioblastoma patients integrate the escalated dose throughout the standard course by targeting a specific subvolume. We hypothesize that anatomical changes during irradiation may affect the dose coverage of this subvolume for both proton- and photon-based radiotherapy. Material and Methods: For 24 glioblastoma patients a photon- and proton-based dose escalation treatment plan (of 75 Gy/30 fr) was simulated on the dedicated radiotherapy planning MRI obtained before treatment. The escalated dose was planned to cover the resection cavity and/or contrast enhancing lesion on the T1w post-gadolinium MRI sequence. To analyze the effect of anatomical changes during treatment, we evaluated on an additional MRI that was obtained during treatment the changes of the dose distribution on this specific high dose region. Results: The median time between the planning MRI and additional MRI was 26 days (range 16–37 days). The median time between the planning MRI and start of radiotherapy was relatively short (7 days, range 3–11 days). In 3 patients (12.5%) changes were observed which resulted in a substantial deterioration of both the photon and proton treatment plans. All these patients underwent a subtotal resection, and a decrease in dose coverage of more than 5% and 10% was observed for the photon- and proton-based treatment plans, respectively. Conclusion: Our study showed that only for a limited number of patients anatomical changes during photon or proton based radiotherapy resulted in a potentially clinically relevant underdosage in the subvolume. Therefore, volume changes during treatment are unlikely to be responsible for the negative outcome of dose-escalation studies.
This paper evaluates a design procedure which is able to scale one-dimensional quadratic-residue diffusers, with integrated Helmholtz resonators. These acoustic structures can be tuned to room modes while fitting within a specified volume. An algorithmic solver is used to control geometric parameters in order to achieve a target frequency. The effect of the diffuser on a room is estimated using Pachyderm. Values obtained with simplified models, that make use of analytically derived coefficients, are compared with those obtained by simulating the full geometry. The predictive power of the simplified modeling made it preferable over simulating the full geometry in comparable scenarios. CFD simulations and measurements taken from a 1:1 scale prototype, are used to evaluate the applicability of lumped mass models to predict resonance frequency and absorption of slit Helmholtz resonators. Although the obtained results remain inconclusive, they indicate a higher inertial attached length for semi-infinite slit resonators, than typically found in literature. If these results can be validated, then the procedure should provide reliable designs.
