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https://www.readbyqxmd.com/read/28994665/combining-deep-learning-with-anatomy-analysis-for-segmentation-of-portal-vein-for-liver-sbrt-planning
#1
Bulat Ibragimov, Diego Toesca, Daniel Chang, Albert Koong, Lei Xing
Automated segmentation of portal vein (PV) for liver radiotherapy planning is a challenging task due to potentially low vasculature contrast, complex PV anatomy and image artifacts originated from fiducial markers and vasculature stents. In this paper, we propose a novel framework for automated PV segmentation from computed tomography (CT) images. We apply convolutional neural networks (CNN) to learn consistent appearance patterns of PV using a training set of CT images with reference annotations and then enhance PV in previously unseen CT images...
October 10, 2017: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/28992962/the-long-and-short-term-variability-of-breathing-induced-tumor-motion-in-lung-and-liver-over-the-course-of-a-radiotherapy-treatment
#2
Jennifer Dhont, Jef Vandemeulebroucke, Manuela Burghelea, Kenneth Poels, Tom Depuydt, Robbe Van Den Begin, Cyril Jaudet, Christine Collen, Benedikt Engels, Truus Reynders, Marlies Boussaer, Thierry Gevaert, Mark De Ridder, Dirk Verellen
PURPOSE: To evaluate the short and long-term variability of breathing induced tumor motion. MATERIALS AND METHODS: 3D tumor motion of 19 lung and 18 liver lesions captured over the course of an SBRT treatment were evaluated and compared to the motion on 4D-CT. An implanted fiducial could be used for unambiguous motion information. Fast orthogonal fluoroscopy (FF) sequences, included in the treatment workflow, were used to evaluate motion during treatment. Several motion parameters were compared between different FF sequences from the same fraction to evaluate the intrafraction variability...
October 6, 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/28975835/role-and-future-directions-of-external-beam-radiotherapy-for-primary-liver-cancer
#3
Florence K Keane, Theodore S Hong
The incidence of primary liver cancers continues to increase in the United States and worldwide. The majority of patients with primary liver cancer are not candidates for curative therapies such as surgical resection or orthotopic liver transplantation due to tumor size, vascular invasion, or underlying comorbidities. Therefore, while primary liver cancer is the sixth-most common cancer diagnosis worldwide, it represents the second leading cause of cancer-related deaths. Radiotherapy traditionally played a limited role in the treatment of primary liver cancer due to concerns over hepatic tolerance and the inability to deliver a tumoricidal dose of radiotherapy while still sparing normal hepatic parenchyma...
July 2017: Cancer Control: Journal of the Moffitt Cancer Center
https://www.readbyqxmd.com/read/28975831/stereotactic-body-radiation-therapy-for-hepatocellular-carcinoma-and-intrahepatic-cholangiocarcinoma
#4
Puja S Venkat, Sarah E Hoffe, Jessica M Frakes
The role of external beam radiation therapy for primary liver malignancies has historically been limited due to the risk of radiation-induced liver disease. However, with the advent of stereotactic body radiotherapy (SBRT), we are able to dose escalate while safely sparing critical nearby structures. This review explores the evidence surrounding the use of SBRT for the treatment of primary liver malignancies. A review of the literature was performed. This article discusses the challenges, efficacy, and safety of SBRT for primary liver malignancies in order to conceptualize its role within a multidisciplinary framework...
July 2017: Cancer Control: Journal of the Moffitt Cancer Center
https://www.readbyqxmd.com/read/28954285/phase-ii-study-of-proton-based-stereotactic-body-radiation-therapy-for-liver-metastases-importance-of-tumor-genotype
#5
Theodore S Hong, Jennifer Y Wo, Darrell R Borger, Beow Y Yeap, Erin I McDonnell, Henning Willers, Lawrence S Blaszkowsky, Eunice L Kwak, Jill N Allen, Jeffrey W Clark, Shyam Tanguturi, Lipika Goyal, Janet E Murphy, John A Wolfgang, Lorraine C Drapek, Ronald S Arellano, Harvey J Mamon, John T Mullen, Kenneth K Tanabe, Cristina R Ferrone, David P Ryan, A John Iafrate, Thomas F DeLaney, Andrew X Zhu
Background: We evaluated the efficacy and safety of risk-adapted, proton-based stereotactic body radiation therapy (SBRT) for liver metastases from solid tumors. Methods: This single-arm phase II single institutional study (NCT01239381) included patients with limited extrahepatic disease, 800 mL or greater of uninvolved liver, and no cirrhosis or Child-Pugh A, who had received proton-based SBRT to one to four liver metastases from solid tumors. Treatment comprised 30 to 50 Gray equivalent (GyE) in five fractions based on the effective volume of liver irradiated...
September 1, 2017: Journal of the National Cancer Institute
https://www.readbyqxmd.com/read/28951010/spatiotemporal-fractionation-schemes-for-liver-stereotactic-body-radiotherapy
#6
Jan Unkelbach, Dávid Papp, Melissa R Gaddy, Nicolaus Andratschke, Theodore Hong, Matthias Guckenberger
BACKGROUND AND PURPOSE: Dose prescription in stereotactic body radiotherapy (SBRT) for liver tumors is often limited by the mean liver dose. We explore the concept of spatiotemporal fractionation as an approach to facilitate further dose escalation in liver SBRT. MATERIALS AND METHODS: Spatiotemporal fractionation schemes aim at partial hypofractionation in the tumor along with near-uniform fractionation in normal tissues. This is achieved by delivering distinct dose distributions in different fractions, which are designed such that each fraction delivers a high single fraction dose to complementary parts of the tumor while creating a similar dose bath in the surrounding noninvolved liver...
September 23, 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/28943046/radical-radiation-therapy-for-oligometastatic-breast-cancer-results-of-a-prospective-phase-ii-trial
#7
Marco Trovo, Carlo Furlan, Jerry Polesel, Francesco Fiorica, Stefano Arcangeli, Niccolò Giaj-Levra, Filippo Alongi, Alessandro Del Conte, Loredana Militello, Elena Muraro, Debora Martorelli, Simon Spazzapan, Massimiliano Berretta
BACKGROUND AND PURPOSE: We conducted a prospective phase II multicentric trial to determine if radical radiation therapy to all metastatic sites might improve the progression-free survival (PFS) in oligometastatic breast cancer patients. Secondary endpoints were local control (LC), overall survival (OS) and toxicity. METHODS AND MATERIALS: Inclusion criteria were the following: oligometastatic breast cancer with ≤5 metastatic sites, FDG-PET/CT staging, no brain metastases, primary tumor controlled...
September 21, 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/28920500/acute-toxicity-of-the-bowel-after-stereotactic-robotic-radiotherapy-for-abdominopelvic-oligometastases
#8
Michael Frelinghuysen, Wilco Schillemans, Lieke Hol, Cornelis Verhoef, Mischa Hoogeman, Joost Jan Nuyttens
AIM: To correlate dose-volume histogram (DVH) parameters with appearance of grade ≥2 acute and late gastrointestinal toxicity of stereotactic body radiotherapy (SBRT) in patients with abdominopelvic solitary or oligometastatic disease outside the liver. MATERIAL AND METHODS: Acute and late bowel toxicity of 84 abdominopelvic oligometastatic patients was registered. A logistic regression was performed between different DVH parameters and presence of grade ≥2 acute and late toxicity...
September 18, 2017: Acta Oncologica
https://www.readbyqxmd.com/read/28917253/re-irradiation-with-stereotactic-body-radiation-therapy-sbrt
#9
Morten Høyer
Stereotactic body radiation therapy (SBRT) is a potential treatment option for patients who develop a relapse within or marginal to a previously irradiated volume, but it seems underused because of sparse knowledge on the efficacy and morbidity related to the treatment. Normal tissues often recover some of the damage caused by the primary radiotherapy with time, but the kinetics of recovery is not clearly described in the literature. There is a growing number of publications on SBRT reirradiation, but the literature consists mainly of retrospective cohort studies...
September 2017: Chinese Clinical Oncology
https://www.readbyqxmd.com/read/28917250/emerging-technologies-in-stereotactic-body-radiotherapy
#10
Lijun Ma, Lei Wang, Chia-Lin Tseng, Arjun Sahgal
Stereotactic body radiation therapy (SBRT) stems from the initial developments of intra-cranial stereotactic radiosurgery (SRS). Despite similarity in their names and clinical goals of delivering a sufficiently high tumoricidal dose, maximal sparing of the surrounding normal tissues and a short treatment course, SBRT technologies have transformed from the early days of body frame-based treatments with X-ray verification to primarily image-guided procedures with cone-beam CT or stereoscopic X-ray systems and non-rigid body immo-bilization...
September 2017: Chinese Clinical Oncology
https://www.readbyqxmd.com/read/28917249/challenges-in-imaging-assessment-following-liver-stereotactic-body-radiotherapy-pitfalls-to-avoid-in-clinical-practice
#11
Connie Yip, Gary J R Cook, Kasia Owczarczyk, Vicky Goh
Stereotactic body radiotherapy (SBRT) is increasingly used in the management of unresectable liver metastases and hepatocellular carcinoma (HCC) as it allows delivery of high-dose conformal radiotherapy with limited toxicities. However, it may be difficult to differentiate viable tumour from radiotherapy-related changes after SBRT. The imaging changes observed after SBRT may also differ from those observed following conventionally fractionated radiotherapy. Hence, we aim to review the imaging changes that occur within the tumour and adjacent normal liver after SBRT which may help to identify local relapse in clinical practice...
September 2017: Chinese Clinical Oncology
https://www.readbyqxmd.com/read/28875297/breathing-motion-compensated-robotic-guided-stereotactic-body-radiation-therapy-patterns-of-failure-analysis
#12
Susanne Stera, Panagiotis Balermpas, Mark K H Chan, Stefan Huttenlocher, Stefan Wurster, Christian Keller, Detlef Imhoff, Dirk Rades, Jürgen Dunst, Claus Rödel, Guido Hildebrandt, Oliver Blanck
PURPOSE: We retrospectively evaluated the patterns of failure for robotic guided real-time breathing-motion-compensated (BMC) stereotactic body radiation therapy (SBRT) in the treatment of tumors in moving organs. PATIENTS AND METHODS: Between 2011 and 2016, a total of 198 patients with 280 lung, liver, and abdominal tumors were treated with BMC-SBRT. The median gross tumor volume (GTV) was 12.3 cc (0.1-372.0 cc). Medians of mean GTV BEDα/β =10  Gy (BED = biological effective dose) was 148...
September 5, 2017: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
https://www.readbyqxmd.com/read/28871989/long-term-outcomes-of-phase-1-and-2-studies-of-sbrt-for-hepatic-colorectal-metastases
#13
Andrew McPartlin, Anand Swaminath, Ri Wang, Melania Pintilie, James Brierley, John Kim, Jolie Ringash, Rebecca Wong, Rob Dinniwell, Tim Craig, Laura A Dawson
PURPOSE: To report mature outcomes of prospective phase 1 and 2 studies of stereotactic body radiation therapy (SBRT) for the treatment of colorectal liver metastases (CLMs). METHODS AND MATERIALS: Patients with histologically confirmed CLMs unsuitable for resection or standard therapies were eligible for sequential phase 1 and 2 studies conducted from 2003 to 2012. RESULTS: Of 60 patients treated, 82% had received previous chemotherapy, 23% had undergone previous focal liver treatment, and 38% had extrahepatic disease at the time of SBRT...
October 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28844122/clinical-significance-of-radiation-induced-liver-disease-after-stereotactic-body-radiation-therapy-for-hepatocellular-carcinoma
#14
Baek Gyu Jun, Young Don Kim, Gab Jin Cheon, Eun Seog Kim, Eunjin Jwa, Sang Gyune Kim, Young Seok Kim, Boo Sung Kim, Soung Won Jeong, Jae Young Jang, Sae Hwan Lee, Hong Soo Kim
Background/Aims: The aim of this study was to investigate parameters that predict radiation-induced liver disease (RILD) following stereotactic body radiotherapy (SBRT) in patients with hepatocellular carcinoma (HCC) and to identify the clinical significance of RILD. Methods: We retrospectively reviewed the medical records of 117 HCC patients who were treated by SBRT from March 2011 to February 2015. RILD was defined as elevated liver transaminases more than five times the upper normal limit or a worsening of Child-Pugh (CP) score by 2 within 3 months after SBRT...
August 28, 2017: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/28839988/prognostic-significance-of-sites-of-extrathoracic-metastasis-in-patients-with-non-small-cell-lung-cancer
#15
James E Bates, Michael T Milano
BACKGROUND: Metastatic non-small cell lung cancer (NSCLC) continues to have a poor prognosis despite recent advances in both targeted radiotherapy methodologies such as stereotactic body radiotherapy (SBRT) and immunotherapies. The impact of location of metastatic disease in patients with NSCLC has not been investigated; we aimed to investigate this using the Surveillance, Epidemiology, and End Results (SEER) database. METHODS: We included 39,910 patients from the SEER database treated for M1b NSCLC from 2010-2013...
July 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28796864/individualized-adaptive-stereotactic-body-radiotherapy-for-liver-tumors-in-patients-at-high-risk-for-liver-damage-a-phase-2-clinical-trial
#16
Mary Feng, Krithika Suresh, Matthew J Schipper, Latifa Bazzi, Edgar Ben-Josef, Martha M Matuszak, Neehar D Parikh, Theodore H Welling, Daniel Normolle, Randall K Ten Haken, Theodore S Lawrence
Importance: Patients with preexisting liver dysfunction could benefit the most from personalized therapy for liver tumors to balance maximal tumor control and minimal risk of liver failure. We designed an individualized adaptive trial testing the hypothesis that adapting treatment based on change in liver function could optimize the therapeutic index for each patient. Objective: To characterize the safety and efficacy of individualized adaptive stereotactic body radiotherapy (SRBT) for liver tumors in patients who have preexisting liver dysfunction...
August 10, 2017: JAMA Oncology
https://www.readbyqxmd.com/read/28740893/stereotactic-body-radiotherapy-sbrt-for-locally-advanced-extrahepatic-and-intrahepatic-cholangiocarcinoma
#17
Kiri A Sandler, Darlene Veruttipong, Vatche G Agopian, Richard S Finn, Johnny C Hong, Fady M Kaldas, Saeed Sadeghi, Ronald W Busuttil, Percy Lee
OBJECTIVES: We report single-institution clinical efficacy and safety outcomes for patients with unresectable locally advanced cholangiocarcinoma who were treated with stereotactic body radiation therapy (SBRT) and a subset of patients who received neoadjuvant SBRT and chemotherapy as part of an orthotopic liver transplantation (OLT) protocol. METHODS AND MATERIALS: From October 2008 to June 2015, 31 consecutive patients with unresectable extrahepatic (n = 25) or intrahepatic (n = 6) cholangiocarcinoma were treated with SBRT and retrospectively analyzed...
October 2016: Advances in Radiation Oncology
https://www.readbyqxmd.com/read/28736648/the-utility-of-positron-emission-tomography-computed-tomography-in-target-delineation-for-stereotactic-body-radiotherapy-for-liver-metastasis-from-primary-gastric-cancer-an-illustrative-case-report-and-literature-review
#18
Gary D Lewis, Stephen B Chiang, E Brian Butler, Bin S Teh
The liver is a common site for metastatic disease for many cancers. Radiation therapy is one means of treatment for liver metastases, especially for patients unable to undergo surgery or ineligible for systemic chemotherapy. In particular, stereotactic body radiotherapy (SBRT) has become an important option in the treatment of metastatic disease in the liver. SBRT delivers ablative doses of radiation in relatively few fractions. As such, precise and clear imaging plays an important role in maximizing disease control while minimizing normal tissue toxicity...
June 2017: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28712715/split-vmat-technique-to-control-the-expiratory-breath-hold-time-in-liver-stereotactic-body-radiation-therapy
#19
Yen Hwa Lin, Shuichi Ozawa, Hideharu Miura, Katsunori Yogo, Takeo Nakashima, Kentaro Miki, Shintaro Tsuda, Yusuke Ochi, Daisuke Kawahara, Tomoki Kimura, Akito Saito, Yasushi Nagata
PURPOSE: In this study, we demonstrate the feasibility of using split-arcs in volumetric modulated arc therapy (VMAT), tailored for expiratory breath-hold in stereotactic body radiation therapy (SBRT) for liver tumors. We compare it with three-dimensional conformal radiation therapy (3D-CRT) and continuous-VMAT, for ten randomly selected hepatocellular carcinoma cases. METHODS: Four coplanar and four non-coplanar beams were used for the 3D-CRT plans. A pair of partial arcs, chosen using a back-and-forth rotating motion, were used for the continuous-VMAT plans...
August 2017: Physica Medica: PM
https://www.readbyqxmd.com/read/28712274/stereotactic-body-radiation-therapy-for-liver-oligo-recurrence-and-oligo-progression-from-various-tumors
#20
Yu Jin Cha, Mi-Sook Kim, Won-Il Jang, Young Seok Seo, Chul Koo Cho, Hyung Jun Yoo, Eun Kyung Paik
PURPOSE: To evaluate the outcomes of stereotactic body radiation therapy (SBRT) for patients with liver oligo-recurrence and oligo-progression from various primary tumors. MATERIALS AND METHODS: Between 2002 and 2013, 72 patients with liver oligo-recurrence (oligo-metastasis with a controlled primary tumor) and oligo-progression (contradictory progression of a few sites of disease despite an overall tumor burden response to therapy) underwent SBRT. Of these, 9 and 8 patients with uncontrollable distant metastases and patients immediate loss to follow-up, respectively, were excluded...
June 2017: Radiation Oncology Journal
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