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Article Comparison: Trade Publication Article vs. Peer Reviewed Article

Joanne Li
Part I: Trade Publication Article
Trade publication magazine, also called professional magazine, provides articles from a
particular industry professional.1 It services as free resource of advertisements, news, trends, and
even job listings for people working in the field. It is free to access and download articles from
the magazine website. The free print edition sometimes may require subscription registered
through the website for free or given by salespeople. I will review an article from Radiology
Today Magazine website entitled Managing Dose by Beth W. Orenstein, a freelance medical
writer and regular contributor to Radiology Today.2 I want to evaluate the accuracy of the
information given in the article and its strengths and the weaknesses to see how much I can
benefit from this article for professional education on medical dosimetry.
In the article, the author introduced two initiatives on radiation dose safety released by
Medical Imaging & Technology Alliance (MITA).2 MITA is an association representing the CT
equipment manufacturers, such as Philips, Siemens, GE Healthcare, and Toshiba. The first
initiative is dose-check of patient exposure level in medical imaging; the second initiative is a
safeguard alarm installed in CT systems to stop harmful radiation dose during therapeutic
treatment. The MITA also recommends regional reference values for radiation dose and eight key
principles for industry and practitioners to minimize patient radiation dose. The author also
checked how the radiation therapy equipment manufacturers implemented the MITA initiatives
by interviewing a few big companies chief leaders. It seemed those manufacturers have invested
considerable effort to reduce radiation dose and medical errors by implementing the MITA
initiatives and proactively working on their own ways. All manufacturers support tremendous
training to users through various methods to implement their common goal of minimizing patient
radiation exposure and improving patient safety.
The article introduced very useful solutions and technologies for clinical users on
improving patient radiation safety. As the author wrote the article mostly from the manufacturers
point of view, I can see the strong and weak aspects of the article in a trade magazine. Even
though the author was talking about an imaging industry issue, his focus was on so called clinical
solutions to accelerate development of technologies in radiation equipment. It seems the author
got very current firsthand information from some leading radiation equipment manufacturers.

However, their chiefs strongly represent their companies and may intensively exaggerate the
promises of their equipment. We dont know how well the radiation facilities had implemented
the new technologies from the manufacturers and if the health care providers as the users were
satisfied with the use of the equipment and the solutions. In the article, the author emphasized the
manufacturers effort on improving their promise to patient safety, which seemed to give readers
such a good impression on their perfect equipment. However, as trade article is not research
based, the article could serve as a good advisement or guide for readers of interest to this field.
The statistics given in the article also improved the accuracy and credibility of the statement.
The article just like the title Managing Dose is very inspiring for both medical dosimetry
students and practicing medical dosimetrist. Planning accurate radiation dose with minimum
harm to patients has been a challenge and an ongoing goal for practicing medical dosimetrist.
The safeguard and alert could prevent radiation dose errors and timely stop harmful dose to
patients. This is helpful for medical dosimetrist especially for non-experienced ones in creating
treatment plans. With this safeguard, the experienced medical dosimetrist could have better
control of more challenging dose distribution in complicate treatment plans. The three checkpoints announced in the MITA initiative: pretreatment quality assurance (QA), verification of
beam-modifying accessories, and a patient-positioning confirmation also bring the physicist,
radiation therapist, medical dosimetrist, as well as the radiation oncologist as a whole to manage
patient exposure dose. Any steps in preceding the treatment with an alert or alarm will stop the
treatment and call all the team members to evaluate the situation. It is apparent that patients will
benefit the most from the technologies and solutions stated in the article with longer survival
from cancer diseases and less side effects from radiation treatment.
References
1. Trade Magazine. Wikipedia Website. https://en.wikipedia.org/wiki/Trade_magazine.
Accessed March 1, 2016.
2. Orenstein. BW. (2010, October). Managing dose. Radiology Today, (11)10:18-21.
Retrieved from http://viewer.zmags.com/publication/a0b5deab#/a0b5deab/19. Accessed
March 1, 2016.

Part II: Peer Reviewed Research Article

Peer reviewed research article as reflected in the name is a professional research in a
specialized field and critically reviewed by recognized scholars in the same field.1 As a historical
record, peer reviewed research articles must be in formal writing with professional language and
certain designed research structure. Unlike trade magazine articles, research articles do not aim
to give advisements, but rather introduce and present the process and findings of the research or
issue to the scholars and researchers in the field. The process to publish as long as the publishers
are more restrict than trade magazine articles. After exploring the Medical Dosimetry magazine,
I decided to analyze a peer reviewed research article entitled Skin Dose Differences Between
Intensity-modulated Radiation Therapy and Volumetric-modulated Arc Therapy and Between
Boost and Integrated Treatment Regimens for Treating Head and Neck and Other Cancer Sites in
Patients.2 The authors Penoncello GP and Ding GX are the experts from Radiation Oncology
field. Based on the scholarly peer reviewed research journal criteria, my goal is to evaluate the
articles literature review with adequate background and hypothesis, the design and structure of
the research, the accuracy and practical value of the finding, and my impression of the research.
The purpose of the study was clearly stated in the abstract and introduction sections
which was to determine lower skin dose in radiation treatment with appropriate techniques and
regimens. As skin is unavoidable part in all radiotherapies, sparing skin dose as much as possible
is the goal of using all radiation techniques and regimens. In the research, a group of cancer
patients with different tumor locations were evaluated with Intensity-modulated Radiation
Therapy (IMRT) and Volumetric-modulated Arc Therapy (VMAT) and traditional or integrated
boost regimens. By comparing the skin dose in VMAT and IMRT plans with traditional and
integrated boost regimens, the study found VMAT technique and traditional regimens for certain
location treatment could spare skin better with lower skin dose.
The study was well designed with constructed research subsections: abstract,
introduction, material and methods, results, discussion, conclusion, and references from other
literatures. After reading the abstract, readers are able to gain an overview idea about the study.
In the beginning of introduction part, a short literature review about VMAT, IMRT, traditional
regimens and integrated boost regimens followed by the purpose of the study were clearly stated.
Therefore, readers understand the necessary of the study in the field by reading the background.
In the methods section, the researchers strived to provide sufficient data and evidence
from 19 treatment plans to investigate the skin dose difference. As the anatomies and cancer

regions as well as the stages of cancer vary in each plan, the design of the treatment plans for
sample patients was complex. Overall, 9 patients with head and neck cancer, 5 patients with
prostate cancer, 5 patients with brain cancer were planned with VMAT and IMRT; one plan with
boost from each group was performed. Among the 9 head and neck plans, 6 plans used
traditional sequential boost regimens, two plans were planned with integrated boost techniques,
and one of the two integrated plans was also planned with a traditional boost regimen. The mean
and maximum skin dose in a continuous 2 cm2 and 5 cm2 of certain skin regions were obtained
from each plan.
Skin dose and differences for each plan were compared in three tables for each group.
Three typical plans from each group were selected to show dose distribution and differences with
VMAT and IMRT in axial, coronal, and sagittal planes with colored figures and the
corresponding dose-volume histogram (DVH) plot. These statistical tables and color-printed
figures clearly showed the results, which strongly supported the finding in the research. The
researchers were able to clearly analyze and interpret their results and findings in the discussion
section. The overall result reflected VMAT technique has the superiority over IMRT on skin
sparing. However, the deference of sparing capability between VMAT and IMRT depends on the
nature of the two techniques, the range of angles, and skin surface to target distance. IMRT has
more capacity to increase skin sparing capability if the number of entry beams could be
increased. Skin dose increases when target is close to skin surface. At the end of the article, the
researchers were able to concisely conclude their finding with statistical percentages in
comparison with the techniques and regimens used in the study. A wide range of sources from
different literatures in the field supported the study with most current related studies mostly from
the years of 2011 to 2013.
Overall, the study on skin dose difference between VMAT and IMRT and between boost
and integrated treatment regimens was well designed and constructed by professional researchers
in the radiation oncology field. I was first attracted by the topic of the study to expand my
knowledge on VMAT and IMRT, and was more impressed after reading the article. The first, I
was impressed by the researchers knowledge and skills in this field. Because of that, they were
able to select very complex typical samples among various individuals, diseases, and stages of
cancer for this study. The second, I was impressed by the colored figures and DVH plots
typically from each group which is very helpful for visual readers like me. The third, I was also
impressed by the researchers honesties on their limitations of study. In discussion section, the

authors acknowledged their limiting practice in increasing the number of static IMRT entry
beams to further evaluate the skin dose difference. My overall impression was the concise
writing and the statistical numbers in the article which made easier for readers to understand and
evaluate the finding and also improved the credibility of the study. I believe the finding of the
study was true. However, to be more practical for all patient treatments, more studies and
statistics are needed. Skin dose is also affected by many factors. Readers from different treatment
centers still need to rationally evaluate their situations when selecting treatment techniques and
regimens.
References
1. Lenards N, Weege M. Reading & Writing in Radiation Therapy and Medical Dosimetry.
[Powerpoint]. La Crosse, WI: UW-L Medical Dosimetry Program; 2016.
2. Penoncello GP, Ding GX. Skin dose differences between intensity-modulated radiation
therapy and volumetric-modulated arc therapy and between boost and integrated
treatment regimens for treating head and neck and other cancer sites in patients. Med
Dosim. 2016; 41(1): 80-86. http://dx.doi.org/10.1016/j.meddos.2015.09.001

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