Radiochromic film <i>in vivo</i> dosimetry predicts early the risk of acute skin toxicity for brachytherapy partial breast irradiation
Bibliographic record
Abstract
Abstract Brachytherapy accelerated partial breast irradiation (APBI) is well tolerated, but reported acute toxicities including moist desquamation rates range from 7% to 39%. Moist desquamation is correlated to long-term skin toxicity and high skin dose is the main risk factor. This study uses radiochromic films for in vivo skin dosimetry of low dose rate (LDR) APBI brachytherapy and prediction of skin toxicity. Patients participating in a clinical trial assessing skin toxicity of LDR seed brachytherapy were included in this study. Following the seed implantation procedure, patients were asked to wear a customized oval shaped radiochromic film on the skin projection of the planned target volume (PTV) for 24 h. Exposed films were collected, and maximum point doses were measured. In addition, maximum doses to a small skin volume (D 0.2cc ) were calculated on the pre- and post-implant CT-scan. Acute skin toxicities (redness, pigmentation, induration and dermatitis) were scored by the treating physician for 2 months during follow-up visits. Skin dose measurements and acute toxicity were available for 18 consecutive patients. The post-implant calculated maximum skin doses (D 0.2cc ), 60.8 Gy (SD ± 41.0), were on average 30% higher than those measured in vivo (D max-film ), 46.6 Gy (SD ± 19.3), but those values were highly significantly correlated (Spearman’s rho 0.827, p < 0.001). Also, dermatitis and induration were significantly correlated with higher in vivo measured and post-implant calculated skin dose. Pre-implant dosimetry was not correlated with measured or post-implant skin dose or side effects. Radiochromic films can reliably diagnose excess dose to the skin during the first 24 h and predict skin toxicity, which enables preventative measures. Trial registration : Nederlands Trial Register ( www.trialregister.nl ), NTR6549, the trial was registered prospectively on 27 June 2017. ABR number: NL56210.078.16
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".