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Contouring guideline

Wei Yu, Wei Hu, Yongjie Shui, Xiaoyang Zhu, Chao Li, Xiaoqiu Ren, Xueli Bai, Risheng Yu, Li Shen, Tingbo Liang, Lei Zheng, Qichun Wei
OBJECTIVES: To explore the areas at highest risk for postoperative pancreatic cancer local recurrence according to the spatial location of local failures, with the aim to provide a precise target volume for pancreatic cancer adjuvant radiotherapy. METHODS: Patients with pancreatic cancer who had undergone surgery for the primary tumor in pancreas at our institution from January 2010 to August 2015 were retrospectively analyzed. All local recurrences were plotted on the computed tomography (CT) image of a representative patient according to their relative coordinates to superior mesenteric artery (SMA) or celiac axis (CA)...
October 19, 2016: Radiation Oncology
Tejinder Kataria, Deepak Gupta, Shikha Goyal, Shyam Singh Bisht, Ravi Chaudhary, Kushal Narang, Susovan Banerjee, Trinanjan Basu, Ashu Abhishek, Sasikumar Sambasivam, Nisha T Vishnu
Stereotactic body radiotherapy (SBRT) is being increasingly utilized in the treatment of prostate cancer. With the advent of high precision radiosurgery systems, it is possible to obtain dose distributions akin to High Dose Rate (HDR) brachytherapy with SBRT. However, urethral toxicity has a significant impact on the quality of life in prostate cancer patients. Contouring the male urethra on a computed tomography scan is difficult in the absence of an indwelling catheter. In this pictorial essay, we have used the magnetic resonance imaging obtained for radiotherapy planning to aid in delineation of the male urethra and have attempted to define guidelines for the same...
October 17, 2016: British Journal of Radiology
Christina K Speirs, Todd A DeWees, Sana Rehman, Alerson Molotievschi, Maria A Velez, Daniel Mullen, Sandra Fergus, Marco Trovo, Jeffrey D Bradley, Cliff G Robinson
INTRODUCTION: In the randomized trial of standard vs high dose chemoradiotherapy (CRT) for locally advanced non-small cell lung cancer (LA-NSCLC) (RTOG 0617), overall survival (OS) was worse in the high dose arm. While heart dose was suggested as a contributing factor, actionable parameters have not been established. We present an analysis of clinical and dosimetric parameters impacting OS in this patient population, focusing on heart dose. METHODS: Clinical data was collected on 416 patients with LA-NSLC treated at a single institution, with a subset of 333 available treatment plans re-contoured using RTOG normal tissue guidelines...
October 12, 2016: Journal of Thoracic Oncology
Damodar Pokhrel, Sumit Sood, Christopher McClinton, Xinglei Shen, Christopher Lominska, Habeeb Saleh, Rajeev Badkul, Hongyu Jiang, Melissa Mitchell, Fen Wang
PURPOSE: To retrospectively evaluate the accuracy, plan quality and efficiency of intensity-modulated arc therapy (IMAT) for hippocampal sparing whole-brain radiotherapy (HS-WBRT) with simultaneous integrated boost (SIB) in patients with multiple brain metastases (m-BM). MATERIALS AND METHODS: A total of 5 patients with m-BM were retrospectively replanned for HS-WBRT with SIB using IMAT treatment planning. The hippocampus was contoured on diagnostic T1-weighted magnetic resonance imaging (MRI) which had been fused with the planning CT image set...
September 27, 2016: Medical Dosimetry: Official Journal of the American Association of Medical Dosimetrists
Krishna Patel, Kathleyn Brandstetter
Allogenic implants are an effective alternative to autologous grafts in the reconstruction of facial defects. These implants are used to reconstruct a variety of bony and soft-tissue defects, including the frontal and temporal regions; internal orbit; infraorbital rim; malar, paranasal, and nasal regions; mandible; and chin. In comparison to their autologous counterparts, alloplastic materials are more readily available, lack donor-site morbidity, decrease surgical time and cost, and still have relatively good postoperative tissue tolerance...
October 2016: Facial Plastic Surgery: FPS
Barbara Segedin, Primoz Petric
BACKGROUND: Modern radiotherapy techniques enable delivery of high doses to the target volume without escalating dose to organs at risk, offering the possibility of better local control while preserving good quality of life. Uncertainties in target volume delineation have been demonstrated for most tumour sites, and various studies indicate that inconsistencies in target volume delineation may be larger than errors in all other steps of the treatment planning and delivery process. The aim of this paper is to summarize the degree of delineation uncertainties for different tumour sites reported in the literature and review the effect of strategies to minimize them...
September 1, 2016: Radiology and Oncology
J Mackenzie, G Graham, I A Olivotto
AIMS: The Canadian Partnership for Quality Radiotherapy quality assurance guidelines recommend that radiation oncologist peer review of curative radiotherapy plans takes place ideally before the first fraction of treatment is delivered. This study documented and evaluated the outcomes of weekly, disease site-specific, radiotherapy peer review, quality assurance rounds at the Tom Baker Cancer Centre in Calgary, Canada with a view to making recommendations about the optimal timing and documentation of peer review during the radiotherapy planning processes...
September 12, 2016: Clinical Oncology: a Journal of the Royal College of Radiologists
S Orlandini, B Pasquini, C Caprini, M Del Bubba, L Squarcialupi, V Colotta, S Furlanetto
A comprehensive strategy involving the use of mixture-process variable (MPV) approach and Quality by Design principles has been applied in the development of a capillary electrophoresis method for the simultaneous determination of the anti-inflammatory drug diclofenac and its five related substances. The selected operative mode consisted in microemulsion electrokinetic chromatography with the addition of methyl-β-cyclodextrin. The critical process parameters included both the mixture components (MCs) of the microemulsion and the process variables (PVs)...
September 30, 2016: Journal of Chromatography. A
Shailesh Shah, Bhavin Marolia, Pintu Prajapati, Kunjan Bharatkumar Bodiwala, Jeenal Thakor
A rapid, sensitive, and stability-indicating high-performance thin-layer chromatographic method was developed and validated to study degradation kinetics of Alogliptin benzoate (ALG) in an alkaline medium. ALG was degraded under acidic, alkaline, oxidative, and thermal stress conditions. The degraded samples were chromatographed on silica gel 60F254-TLC plates, developed using a quaternary-solvent system (chloroform-methanol-ethyl acetate-triethyl amine, 9+1+1+0.5, v/v/v/v), and scanned at 278 nm. The developed method was validated per International Conference on Harmonization guidelines using validation parameters such as specificity, linearity and range, precision, accuracy, LOD, and LOQ...
September 7, 2016: Journal of AOAC International
Veena D Manwar, Bibhuti B Mandal, Asim K Pal
BACKGROUND: Noise mapping being an established practice in Europe is hardly practiced for noise management in India although it is mandatory in Indian mines as per guidelines of the Directorate General of Mines Safety (DGMS). As a pilot study, noise mapping was conducted in an opencast mine with three different models; one based on the baseline operating conditions in two shifts (Situation A), and two other virtual situations where either production targets were enhanced by extending working hours to three shifts (Situation B) or only by increased mechanization and not changing the duration of work (Situation C)...
July 2016: Noise & Health
Shalini K Vinod, Karen Lim, Lauren Bell, Jacqueline Veera, Lucy Ohanessian, Ewa Juresic, Nira Borok, Phillip Chan, Raphael Chee, Viet Do, Geetha Govindarajulu, Swetha Sridharan, Carol Johnson, Daniel Moses, Sylvia Van Dyk, Lois Holloway
INTRODUCTION: Image-based brachytherapy for cervical cancer using MRI has been implemented in Australia and New Zealand. The aims of this study were to measure variability in High-risk CTV (HR-CTV) delineation and evaluate dosimetric consequences of this. METHODS: Nine radiation oncologists, one radiation therapist and two radiologists contoured HR-CTV on 3T MRI datasets from ten consecutive patients undergoing cervical brachytherapy at a single institution. Contour comparisons were performed using the Dice Similarity Coefficient (DSC) and Mean Absolute Surface Distance (MASD)...
August 16, 2016: Journal of Medical Imaging and Radiation Oncology
Brian C Baumann, Walter R Bosch, Amit Bahl, Alison J Birtle, Rodney H Breau, Amarnath Challapalli, Albert J Chang, Ananya Choudhury, Sia Daneshmand, Ali El-Gayed, Adam Feldman, Steven E Finkelstein, Thomas J Guzzo, Serena Hilman, Ashesh Jani, S Bruce Malkowicz, Constantine A Mantz, Viraj Master, Anita V Mitra, Vedang Murthy, Sima P Porten, Pierre M Richaud, Paul Sargos, Jason A Efstathiou, Libni J Eapen, John P Christodouleas
PURPOSE: To develop multi-institutional consensus clinical target volumes (CTVs) and organs at risk (OARs) for male and female bladder cancer patients undergoing adjuvant radiation therapy (RT) in clinical trials. METHODS AND MATERIALS: We convened a multidisciplinary group of bladder cancer specialists from 15 centers and 5 countries. Six radiation oncologists and 7 urologists participated in the development of the initial contours. The group proposed initial language for the CTVs and OARs, and each radiation oncologist contoured them on computed tomography scans of a male and female cystectomy patient with input from ≥1 urologist...
September 1, 2016: International Journal of Radiation Oncology, Biology, Physics
Carolina Franco Uliaque, Francisco Javier Pardo Berdún, Ricardo Laborda Herrero, Carmen Pérez Lórenz
OBJECTIVE: To evaluate the diagnostic capacity of ultrasonography (US) for differentiating between malignant and benign thyroid nodules and its usefulness in obviating unnecessary invasive procedures. PATIENTS AND METHODS: From January 2012 through December 2014, a total of 321 fine-needle aspiration biopsy (FNAB) procedures were done in 302 patients selected according to the criteria recommended by the American Association of Clinical Endocrinology guidelines and the American Thyroid Association guidelines...
September 2016: Radiología
P M Parizel, A J L Van Hoyweghen, A Bali, J Van Goethem, L Van Den Hauwe
Degenerative disease of the spine, in the form of intervertebral disc degeneration and bony growth, causing osteophytes and impinging upon the spinal canal and neural foramina, is the most frequent disorder affecting the spine. In this chapter we first discuss briefly the indications for computed tomography or magnetic resonance imaging in suspected degenerative spine disease. We then describe changes of disc height, signal intensity, and disc contour with aging and repeated microtrauma, as well as the imaging techniques most appropriate to image them...
2016: Handbook of Clinical Neurology
Eli Gibson, Glenn S Bauman, Cesare Romagnoli, Derek W Cool, Matthew Bastian-Jordan, Zahra Kassam, Mena Gaed, Madeleine Moussa, José A Gómez, Stephen E Pautler, Joseph L Chin, Cathie Crukley, Masoom A Haider, Aaron Fenster, Aaron D Ward
PURPOSE: Defining prostate cancer (PCa) lesion clinical target volumes (CTVs) for multiparametric magnetic resonance imaging (mpMRI) could support focal boosting or treatment to improve outcomes or lower morbidity, necessitating appropriate CTV margins for mpMRI-defined gross tumor volumes (GTVs). This study aimed to identify CTV margins yielding 95% coverage of PCa tumors for prospective cases with high likelihood. METHODS AND MATERIALS: Twenty-five men with biopsy-confirmed clinical stage T1 or T2 PCa underwent pre-prostatectomy mpMRI, yielding T2-weighted, dynamic contrast-enhanced, and apparent diffusion coefficient images...
September 1, 2016: International Journal of Radiation Oncology, Biology, Physics
Anne F Klassen, Stefan J Cano, Amy Alderman, Charles East, Lydia Badia, Stephen B Baker, Sam Robson, Andrea L Pusic
BACKGROUND: The use of screening scales in cosmetic practices may help to identify patients who require education to modify inappropriate expectations and/or psychological support. OBJECTIVES: To describe the development and validation of scales that measure expectations (about how one's appearance and quality of life might change with cosmetic treatments) and appearance-related psychosocial distress. METHODS: The scales were field-tested in patients 18 years and older seeking facial aesthetic or body contouring treatments...
October 2016: Aesthetic Surgery Journal
Martha A Nance
This manuscript describes the ways in which genetic counseling has evolved since John Pearson and Sheldon Reed first promoted "a genetic education" in the 1950s as a voluntary, non-directive clinical tool for permitting individual decision making. It reviews how the emergence of Huntington's disease (HD) registries and patient support organizations, genetic testing, and the discovery of a disease-causing CAG repeat expansion changed the contours of genetic counseling for families with HD. It also reviews the guidelines, outcomes, ethical and laboratory challenges, and uptake of predictive, prenatal, and preimplantation testing, and it casts a vision for how clinicians can better make use of genetic counseling to reach a broader pool of families that may be affected by HD and to ensure that genetic counseling is associated with the best levels of care...
May 13, 2016: American Journal of Medical Genetics. Part B, Neuropsychiatric Genetics
Shalini K Vinod, Myo Min, Michael G Jameson, Lois C Holloway
INTRODUCTION: Inter-observer variability (IOV) in target volume and organ-at-risk (OAR) delineation is a source of potential error in radiation therapy treatment. The aims of this study were to identify interventions shown to reduce IOV in volume delineation. METHODS: Medline and Pubmed databases were queried for relevant articles using various keywords to identify articles which evaluated IOV in target or OAR delineation for multiple (>2) observers. The search was limited to English language articles and to those published from 1 January 2000 to 31 December 2014...
June 2016: Journal of Medical Imaging and Radiation Oncology
Damodar Pokhrel, Sumit Sood, Rajeev Badkul, Hongyu Jiang, Christopher McClinton, Christopher Lominska, Parvesh Kumar, Fen Wang
The purpose of the study was to evaluate Monte Carlo-generated dose distributions with the X-ray Voxel Monte Carlo (XVMC) algorithm in the treatment of peripheral lung cancer patients using stereotactic body radiotherapy (SBRT) with non-protocol dose-volume normalization and to assess plan outcomes utilizing RTOG 0915 dosimetric compliance criteria. The Radiation Therapy Oncology Group (RTOG) protocols for non-small cell lung cancer (NSCLC) currently require radiation dose to be calculated using tissue density heterogeneity corrections...
2016: Journal of Applied Clinical Medical Physics
Samuel Swisher-McClure, Lingshu Yin, Mark Rosen, Sonny Batra, Abigail T Berman, Stefan Both, Neha Vapiwala
PURPOSE/OBJECTIVES: To optimize delivery of post-prostatectomy radiation (PPRT) with protons by examining dosimetric effects of variations in physician contouring, organ motion, and patient alignment during a course of PPRT. MATERIAL AND METHODS: We enrolled 10 patients receiving PPRT in a prospective imaging study. All patients underwent combined computed tomography (CT)/magnetic resonance imaging (MRI) simulation with endorectal balloon (ERB) and received intensity modulated radiation therapy (IMRT) per institutional standards...
July 2016: Acta Oncologica
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