Background: Receiving exact dose by the patients is vital in radiotherapy. The TECDOC1583 protocol is used to achieve this goal. This study aimed to evaluate several levels and steps of TREATMENT PLANNING، in order to calculate the precise dose received by the patient، and to compare it with actual results.Methods: The distribution of doses for single، multiple and complicated multiple field beams of TREATMENT PLANNING were calculated using TiGRT. Results were compared with the measured results of anthropomorphic phantom in different phases.Findings: According to the TECDOC1583 protocol، all the results were accepted; but in the fifth level of the test، percent of error in the lung was 4.3% which made a 0.3% of discrepancy. In the sixth level of the test، the percent of error in soft tissue was 5.7% with about 2.7% of discrepancy.Conclusion: Due to the lack of electronic density in lung tissue، a TREATMENT PLANNING software with higher accuracy is needed for evaluations. Our findings showed that technicians’ knowledge regarding to the application of TREATMENT PLANNING software is essential in this regard. Since the produced error would not be acceptable in this area، and the accuracy of the TREATMENT PLANNING software is no more confident، so working based on correct algorithm of TREATMENT PLANNING software should be checked and system restarting and commissioning must be re-evaluated periodically.

Purpose: The aim of this study was to compare higher-order aberrations between personalized TREATMENT (PT) versus personalized TREATMENT advanced (PTA) photorefractive keratectomy (PRK) for myopia and myopic astigmatism.Methods: In this clinical trial, 80 eyes of 40 patients who met inclusion criteria were enrolled. They underwent PRK using PT or PTA algorithm randomly. Higher-order aberrations were measured and compared between the study groups pre-operatively and at months 3 and 6 postoperatively.Results: The two study groups were comparable in terms of preoperative higher-order aberrations.Compared to the preoperative values, higher-order aberrations were significantly increased in the PT group (p<0.001), but decreased in the PTA group (p<0.001). Spherical aberration exhibited a significant increase postoperatively in the PT group (p<0.001) but remained unchanged in the PTA group (P=0.57).Conclusion: PRK using PT algorithm resulted in an increase higher-order aberrations. PTA algorithm provided better results in terms of postoperative higher-order aberrations and could treat pre-existing higher-order aberrations.

system using pencil beam convolution algorithm for enhanced dynamic wedges with symmetric and asymmetric fields Background: The dosimetric performance of Eclipse 6.5 three dimensional TREATMENT PLANNING system (3DTPS) is evaluated by comparing the calculated and measured dose in two dimensions following the guide lines of American Association for Physicists in Medicine Task Group 53. Materials and Methods: The calculations were performed by the 3DTPS for symmetric as well as asymmetric fields for standard source to surface distance (SSD) at dmax, 5, 10 and 20cm depths in water phantom using 45° and 60° enhanced dynamic wedges (EDWs) in a field of 15 cm×15 cm size for 6 MV photon beams. Measurements were carried out for 6 MV photon beams produced by a linear accelerator, Clinac EX - 2100, equipped with EDWs using 0.125cc volume PTW ionization chamber and PTW UNIDOS electrometer for beam axis and two off axis points. Results: The deviations between the calculated dose (Dcalc) and the measured dose (Dmeas) at toe, centre and heel at different depths for symmetric as well as asymmetric fields for both the wedge angles is less than 2% at all the points and in all geometries. For 45° EDW the deviation was maximum at 20 cm depth and in asymmetric geometry. For 60°EDW the deviation was maximum at 20 cm depth but in symmetric geometry. Conclusion: The results indicate that the accuracy of Eclipse 6.5 (version 7.3.10) three dimensional TREATMENT PLANNING system used with the EDWs in symmetric as well asymmetric fields is adequate in clinical applications under the studied experimental conditions.

ABSTRACT The attention of contemporary planners to environmental factors and increasing awareness and communication of man with his surrounding environment has increased the layers and defining factors of design and PLANNING concepts. In such a way, a common problem with the issue of environmental capabilities to respond was put in front of the planners. The collection of ideas presented in this era was in the form of responsive PLANNING, focusing on the maximum use of environmental capabilities. The necessity of the emergence of a comprehensive discourse to overcome the plurality of factors, definitions and design methods in the environmental fields has been given less attention. Based on this, the current research aims to organize the leading theories in this field in a targeted manner and seeks to improve them based on their synergy. The structural question of this research is the meanings, examples and meaningful contexts of flexibility in various aspects and scales of urban PLANNING. The research method used is qualitative thematic analysis with the help of artificial intelligence in MAXQDA software in a 6-step processing process. The important application of this research is to structure the minds of the planners of this field to reduce the scattered and interdisciplinary problems of the resources. The results of this research revealed dimensions such as identification and recognizability, diversity and changeability, adaptability and expandability, distribution, separation and continuity, organization and compatibility in the field of flexibility and related to the corresponding parts in urban PLANNING   Extended Abstract Introduction Responsiveness-based design and PLANNING emphasizing the maximum use of environmental capacities to meet users' needs implicitly cause a targeted improvement of environmental quality. As the environmental awareness of contemporary man has expanded and the platforms have become more diverse, many challenges are raised in the field of environment-oriented in the field of infrastructure quality and service provision. Urban developments and new developments in cities should be interpreted with integrated conceptualization. The conceptualization of interpretive flexibility in the PLANNING and designing of public spaces in the city is used as an interdisciplinary perspective in urban space design to open and discuss its connection and potential as an approach to strengthening social cohesion and inclusion. The general definition of flexibility is that it can create places with new forms of meaning and be used for different groups to strengthen its coherence and multidisciplinary inclusion in terms of design and PLANNING of space and body. On this basis, the concept of flexibility is proposed as a principle in the context of design and PLANNING due to its wide range of effects on background phenomena. The history of such a role can be seen in the diversity of users' needs. In such a way, it is impossible to express the specific time and area of the need to pay attention to this concept. This is in line with Oldenburg's theory of "social public spaces," in which being in public space, communicating with people and the environment through observing the streets, sidewalks, squares, and parks of the city is a necessary step for people as a part of their social life. The meaningfulness of the design of the artificial environment was considered. In any case, in the contemporary era, on the one hand, at the same time as the quantitative and qualitative increase of human environmental awareness, there is no longer any phenomenon in the eyes of contemporary man arising from a unique aspect and range of factors. On the other hand, his life needs in the individual and collective dimensions have seen a high diversity, which has led to the formation of multiple semantic domains of past flexibility. The meaning of flexibility in such an interdisciplinary platform and basic design refers to the concept of understanding and responding quickly and efficiently to environmental changes. Such a holistic definition for this broad field of environmental design means the implicit acceptance of the role of scale in the meaningful domain of these concepts. On a macro scale, it means making design options to increase the presence, participation, and power of choices of users of the environment in participatory urban PLANNING and design methods, and on a small scale, it means making design options to increase spatial quality and, as a result, the quality of activities. The daily activities of environmental users are through selection against the "dominant space." Flexibility at different scales is crucial for dimensional optimization, shaping, and structuring spatial features, leading to improved performance of space components and spaces. The development of the concept of "flexibility" from various studies in metropolitan to micro scales, such as interior architecture, allows it to pass the discourse of responsiveness to provide a broad approach to environmental design in which different values, interests, and priorities are prioritized. As a result, the issue of flexibility in environmental design has been raised as a multi-dimensional field in the design and PLANNING of the basic environment. The breadth and complexity of this concept have made the researchers of this field deal with it in one or more ways, and it has been avoided to provide a comprehensive framework about the nature and structuring processes. The current research presents a structured view of flexibility in architecture and urban PLANNING with an environmental approach.   Methodology The methodology to achieve this goal is to use the macro research method and achieve a comprehensive framework by combining categorized interpretations. In such a way that by sorting and categorizing these concepts and bases in a new way, he has found a new level of theoretical findings, which will be a suitable answer for the gaps in scientific knowledge and scientific methods created in this field. In this context, the research method "thematic analysis" has been used with a qualitative approach and the use of library resources. Also, to overcome the breadth and complexity of these concepts and the multi-layer networking of concepts in this research method, artificial intelligence has been used in MAXQDA research assistance software.   Results and discussion In the meantime, attention should also be paid to the fields of influence and application of the results of this research because designers refer to flexibility as the creator of environmental qualities, including dynamism. Also, since flexibility, along with the principles of readability and adaptability, affect the lifestyle and behavioral patterns of the audience of environmental design in architecture and urban PLANNING, it will also be effective in dealing with the challenge of complexity in environmental design factors. One of the key questions for achieving research goals on this issue is how flexibility in environmental design impacts the relationship between flexibility and scale.   Conclusion The most important finding of this research suggests that first, it requires a focus on the conditions under which the processes of perceiving human abilities and discovering the needs of the human audience can manifest. The theoretical framework arises from a comparative approach between design disciplines. These conditions are independent of the final state of the design product, and strengthening the environmental capacities will lead to a direction and an area that includes environmental flexibility. By responding to new situations, the construction of the space and the body within a space building can be adapted to various configurations. Even though the environment may remain constant, the designed place will continue functioning as a strong living system over time.  It also seems that the nature of issues related to flexibility has complexity. Considering that the quality of flexibility in urban PLANNING and architecture is significant in multilevel and multifaceted scales from micro to macro, it is important to pay attention to the scale of different variables. In order to reduce this problem, the consistency and adjustment of the scale of the variables measured in a specific analysis should be considered in the first step.   Funding There is no funding support.   Authors’ Contribution All of the authors approved the content of the manuscript and agreed on all aspects of the work.   Conflict of Interest Authors declared no conflict of interest.   Acknowledgments We are grateful to all the scientific.

Introduction: Due to the limited target volume and irregular body surface, irradiating the chest wall (CW) and lymphatic nodes is more challenging. IMRT and VMAT (volumetric modulated arc therapy) are two TREATMENT delivery techniques that help to improve dose coverage and homogeneity while reducing irradiation to the heart and ipsilateral (I/L) lung. The use of a hybrid TREATMENT PLANNING approach for the ca-breast will impact the TREATMENT plan. The hybrid PLANNING system must be reviewed and compared to alternative TREATMENT options for ca-breast cancer. Material and Methods: For 10 patients undergoing left-sided breast chest wall irradiation, the 3 distinct PLANNING techniques (FiF [Field-in-field], IMRT, and Hybrid IMRT) were evaluated. A prescription dose of 40 Gy in 15 fractions was used for the planned target volume (PTV). To compare plans, dose-volume histograms (DVHs) were assessed for PTV and organs at risk. Results: D95% of PTV was 37. 10 ±,0. 48 Gy in FiF, but considerably raised to 39. 32 ±,0. 34 Gy and 38. 39 ±,0. 29 Gy in IMRT (p=0. 01) and Hybrid IMRT (p=0. 01). When compared to IMRT (0. 981 ±,0. 014) and Hybrid IMRT (0. 970 ±,0. 013) FiF plans have the lowest CI value of 0. 931 ±,0. 026. IMRT plans (0. 087 ±,0. 021) were found to be more homogeneous than other 2 PLANNING techniques (0. 111 ±,0. 013 [FiF, p=0. 016], 0. 107 ±,0. 021[hybrid IMRT, p=0. 056]). Conclusion: Hybrid IMRT TREATMENT plans for the ca-breast are recommended because they provide superior and similar PTV dose coverage and OAR sparing compared to FiF and IMRT plans. Hybrid IMRT plans feature lower MU and BOT, as well as a smaller low dose volume in comparison to IMRT.

People with Parkinson's disease (PD) often have walking difficulty in the advanced stages of the disease and also suffer from balance problems. They perform their functional movements in a smaller range and at a slower rate, which will cause difficulty in performing daily activities. Patients with PD face many difficulties in outdoor activities, community participation, personal tasks, and fine motor skills (e. g. writing). They usually need the help of others. For two decades, a new TREATMENT called Lee Silverman Voice TREATMENT (LSVT) has been used by the speech therapists to treat speech and swallowing disorders in PD patients based on evidence and principles of neuroplasticity. The BIG protocol was added to this method in 2010 (LSVT-BIG). In this method, the whole body is involved and its main focus is on motor skills, which are guided by a physiotherapist and occupational therapist. The main goal of this new method is to improve patient’ s skilled movement in PD, as opposed to the old methods that introduce muscle stiffness as the main problem in these patients. In this method, patients will be required to perform a series of special exercises in sitting and standing positions in a larger range than usual with a specific schedule and in a one-month intensive period. Doing the BIG protocol correctly can make the range of motion softer and larger. The studies also show that the LSVT BIG method is very effective for improving patients' walking patterns and daily activities and significantly increases the quality of life in PD patients. Eventually, the PD patients will be able to perform their motor tasks automatically. Considering the useful results of this method and also the growing trend of its application around the world, it is necessary to enable therapists with this new method and provide more complete services for PD patients.

Radiation therapy (RT), staging, TREATMENT PLANNING, monitoring and evaluation of response are traditionally based on Computed Tomography (CT) and Magnetic Resonance Imaging (MRI). These radiological investigations have the significant advantage to show the anatomy with a high resolution, being also called anatomical imaging. In recent years, so called biological imaging methods which visualize metabolic pathways have been developed. To date, the most prominent biological imaging system in use is Positron Emission Tomography (PET), whose diagnostic properties have clinically been evaluated for years. The combination of PET and CT in a single system (PET/CT) to form an inherently fused anatomical and functional dataset has provided an imaging modality which could be used as the prime tool in the delineation of tumor volumes and the preparation of patient TREATMENT plans, especially when integrated with virtual simulation. This powerful method offer complementary imaging of various aspects of tumor biology. The aim of this review is to discuss the valences and implications of PET/CT in RT. The focus will be on evaluation of the following topics: the role of biological imaging for tumor tissue detection/delineation of the gross tumor volume (GTV) and for the visualization of heterogeneous tumor biology. The role of fluorodeoxyglucose-PET in lung will be discussed. There was also evidence for utility of PET in head and neck cancers, lymphoma and in esophageal cancers, with promising preliminary data in many other cancers. The best available approach employs integrated PET/CT images, acquired on a dual scanner in the radiotherapy TREATMENT position after administration of tracer according to a standardized protocol, with careful optimization of images within the RT PLANNING system and carefully considered rules for contouring tumor volumes. The impact of amino acids (AA) -PET in target volume delineation of brain gliomas was discussed.Furthermore, it is summarized the data of the literature about tumor hypoxia and proliferation visualized by PET. It concluded that regarding TREATMENT PLANNING in radiotherapy, PET offers advantages in terms of tumor delineation and the description of biological processes. PET/CT will play an increasing valuable role in RT PLANNING for a wide range of cancers.

Unicystic ameloblastoma is a tumor of odontogenic origin. It is not a rare neoplasm and most often the lesion is asympthomatic. However, large lesions may cause painless swelling of the jaws. Here we report a case of unicystic ameloblastoma with pain, swelling of the posterior jaws along with teeth mobility. Samples of incisional biopsy of the lesion and also interaoperative frozen section were sent for pathology and for both samples pathology report was solid ameloblastoma. Due to observing a thick fibrotic wall during the operation, the surgeon decided to perform enucleation.Knowing histopathologic variations of odontogenic tumors and also knowledge about differential diagnosis and clinical and radiographic features can lead to appropriate diagnosis and TREATMENT PLANNING.