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Contouring guideline

Benjamin D Smith, Jennifer R Bellon, Rachel Blitzblau, Gary Freedman, Bruce Haffty, Carol Hahn, Francine Halberg, Karen Hoffman, Kathleen Horst, Jean Moran, Caroline Patton, Jane Perlmutter, Laura Warren, Timothy Whelan, Jean L Wright, Reshma Jagsi
INTRODUCTION: The purpose of this guideline is to offer recommendations on fractionation for whole breast irradiation (WBI) with or without a tumor bed boost and guidance on treatment planning and delivery. METHODS AND MATERIALS: The American Society for Radiation Oncology (ASTRO) convened a task force to address 5 key questions focused on dose-fractionation for WBI, indications and dose-fractionation for tumor bed boost, and treatment planning techniques for WBI and tumor bed boost...
March 8, 2018: Practical Radiation Oncology
Lorna G Keenan, Kathy Rock, Aini Azmi, Osama Salib, Charles Gillham, Orla McArdle
INTRODUCTION: Previous studies have investigated the anatomical distribution of para-aortic lymph nodes (PAN) in patients with cervical cancer. However, an atlas for accurate clinical target volume (CTV) delineation has yet to be defined. The purpose of this study was to design and verify a computerized tomography (CT) atlas to provide guidance for contouring the PAN CTV in patients with cervical cancer. MATERIALS AND METHODS: This prospective study included 21 cervical cancer patients (design cohort) with 39 pathological PAN identified on (18)F-FDG PET-CT...
March 6, 2018: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Andrea Lazzati, Sandrine Katsahian, David Maladry, Emma Gerard, Sonia Gaucher
BACKGROUND: Bariatric patients are often candidates for plastic surgery. However, the rate of postbariatric procedures is not known. OBJECTIVES: The aim of this study was to analyze the rate of plastic surgery, and factors related to surgery, in bariatric patients. SETTING: University hospital, France. METHODS: This was a cohort study based on administrative data. All adult patients who received bariatric surgery in France between 2007 and 2013 were included to estimate the rate of plastic surgery and related predictive factors...
January 12, 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Daddi Fadel
PURPOSE: To summarize the research findings on the ocular surface profile, to provide a definition and a classification of the corneoscleral shape, and to offer guidelines in selecting scleral lens design. METHODS: The definition of rotational symmetry and rotational asymmetry was inquired and PubMed searches were conducted. RESULTS: The better understanding of the scleral contact lens comportment on the eye and the introduction of new diagnostic instruments to measure the anterior ocular surface have led to improve comprehension of corneoscleral contour formulating new scleral lens designs...
February 26, 2018: Contact Lens & Anterior Eye: the Journal of the British Contact Lens Association
Carl Salembier, Geert Villeirs, Berardino De Bari, Peter Hoskin, Bradley R Pieters, Marco Van Vulpen, Vincent Khoo, Ann Henry, Alberto Bossi, Gert De Meerleer, Valérie Fonteyne
BACKGROUND AND PURPOSE: Delineation of clinical target volumes (CTVs) remains a weak link in radiation therapy (RT), and large inter-observer variation is seen. Guidelines for target and organs at risk delineation for prostate cancer in the primary setting are scarce. The aim was to develop a delineation guideline obtained by consensus between a broad European group of radiation oncologists. MATERIAL AND METHODS: An ESTRO contouring consensus panel consisting of leading radiation oncologists and one radiologist with known subspecialty expertise in prostate cancer was asked to delineate the prostate, seminal vesicles and rectum on co-registered CT and MRI scans...
February 26, 2018: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Ali Fatemi, Somayeh Taghizadeh, Claus Chunli Yang, Madhava R Kanakamedala, Bart Morris, Srinivasan Vijayakumar
Purpose Magnetic resonance (MR) images are necessary for accurate contouring of intracranial targets, determination of gross target volume and evaluation of organs at risk during stereotactic radiosurgery (SRS) treatment planning procedures. Many centers use magnetic resonance imaging (MRI) simulators or regular diagnostic MRI machines for SRS treatment planning; while both types of machine require two stages of quality control (QC), both machine- and patient-specific, before use for SRS, no accepted guidelines for such QC currently exist...
December 18, 2017: Curēus
Li Lin, Yao Lu, Xiao-Ju Wang, Hui Chen, Sha Yu, Jiao Tian, Guan-Qun Zhou, Lu-Lu Zhang, Zhen-Yu Qi, Jiang Hu, Jun Ma, Ying Sun
PURPOSE: To establish the regional lymph node (LN) distribution probability map and draw the neck clinical target volume specific to nasopharyngeal carcinoma (NPC). METHODS AND MATERIALS: One thousand patients with pathologically proven NPC were enrolled from January 2010 to December 2011. The center point of the LNs with a minimal axial diameter of ≥4 mm was marked on a single treatment planning computed tomography scan. The neck LN levels I to X using the 2013 updated international consensus guidelines were also contoured...
March 15, 2018: International Journal of Radiation Oncology, Biology, Physics
Tiziano Testori, Tommaso Weinstein, Fabio Scutellà, Hom-Lay Wang, Giovanni Zucchelli
Patient expectations from implant treatment have changed over the years and esthetics plays an important role in defining what is now called success of rehabilitation. Of the many factors that influence the outcome of the rehabilitation, the two main ones are the bone and soft-tissue deficiencies at the intended implant site. Many surgical approaches are described in terms of timing of implant placement and management of regenerative procedures. The aim of this article is to discuss the different implant placement alternatives in the esthetic area, in particular: (i) the timing of implant placement/regenerative procedures/skeletal growth/altered passive eruption; (ii) the correct three-dimensional position of the fixture between the cuspids and in the premolar area; (iii) multiple missing teeth in the esthetic area with single tooth/pontic or cantilevered options/prosthetic compensation; (iv) placement of implants into infected sites; and (v) the influence of abutment and crown morphology on implant position...
February 27, 2018: Periodontology 2000
Jakob Wollborn, Eva Ruetten, Bjoern Schlueter, Joerg Haberstroh, Ulrich Goebel, Martin A Schick
AIM: Standardized modeling of cardiac arrest and cardiopulmonary resuscitation (CPR) is crucial to evaluate new treatment options. Experimental porcine models are ideal, closely mimicking human-like physiology. However, anteroposterior chest diameter differs significantly, being larger in pigs and thus poses a challenge to achieve adequate perfusion pressures and consequently hemodynamics during CPR, which are commonly achieved during human resuscitation. The aim was to prove that standardized resuscitation is feasible and renders adequate hemodynamics and perfusion in pigs, using a specifically designed resuscitation board for a pneumatic chest compression device...
January 22, 2018: American Journal of Emergency Medicine
Rachel B Ger, Carlos E Cardenas, Brian M Anderson, Jinzhong Yang, Dennis S Mackin, Lifei Zhang, Laurence E Court
Imaging Biomarker Explorer (IBEX) is an open-source tool for medical imaging radiomics work. The purpose of this paper is to describe how to use IBEX's graphical user interface (GUI) and to demonstrate how IBEX calculated features have been used in clinical studies. IBEX allows for the import of DICOM images with DICOM radiation therapy structure files or Pinnacle files. Once the images are imported, IBEX has tools within the Data Selection GUI to manipulate the viewing of the images, measure voxel values and distances, and create and edit contours...
January 8, 2018: Journal of Visualized Experiments: JoVE
Hendrik Dapper, Gregor Habl, Christoph Hirche, Stefan Münch, Markus Oechsner, Michael Mayinger, Christina Sauter, Stephanie E Combs, Daniel Habermehl
INTRODUCTION: The ano-inguinal lymphatic drainage (AILD) is located in the subcutaneous adipose tissue of the proximal medial thigh. Findings from fluorescence methods give us new information about anatomical conditions of the AILD. Current contouring guidelines do not advise the inclusion of the 'true' AILD into the clinical target volume (CTV). Aim of this work was the retrospective analysis of the incidental dose to the AILD in an anal cancer (AC) patient cohort who underwent definitive chemoradiation (CRT) therapy with Volumetric Arc Therapy - Intensity Modulated Radiation Therapy (VMAT-IMRT)...
January 3, 2018: Acta Oncologica
Karunakaran Kaviarasu, N Arunai Nambi Raj, Misba Hamid, A Ananda Giri Babu, Lingampally Sreenivas, Kammari Krishna Murthy
Aim: The purpose of this study is to verify the accuracy of the commissioning of intensity-modulated radiation therapy (IMRT) and volumetric-modulated arc therapy (VMAT) based on the recommendation of the American Association of Physicists in Medicine Task Group 119 (TG-119). Materials and Methods: TG-119 proposes a set of clinical test cases to verify the accuracy of IMRT planning and delivery system. For these test cases, we generated two sets of treatment plans, the first plan using 7-9 IMRT fields and a second plan utilizing two-arc VMAT technique for both 6 MV and 15 MV photon beams...
October 2017: Journal of Medical Physics
Geraldine Jacobson, Nicole Bunda-Randall, Sijin Wen, Matthew Miller
Purpose: The American College of Surgeons Oncology Group Z0011 trial indicated no benefit from axillary lymph node (LN) dissection after a positive sentinel LN biopsy in patients receiving breast irradiation, suggesting that level I-II LNs were covered in tangential fields. Methods and materials: We evaluated 50 computed tomography-based tangential breast plans and contoured level I-III axillary LNs using the Radiation Therapy Oncology Group guidelines. The volumes of level I-III LN regions covered by 90% and 95% of the prescription dose (PD) were calculated and correlated with the V20 ipsilateral lung and mean heart dose...
October 2017: Advances in Radiation Oncology
Guler Yavas, Cagdas Yavas, Gokcen Inan
A 33-year-old premenopausal multiparous woman with the history of septate uterus was referred to the hospital with menorrhagia and inter-menstrual bleeding occurring for the last 6 months. Work-up revealed a stage IIB cervical cancer. The patient underwent curative chemo/radiotherapy. The patient's septate uterus presented several difficulties during application. Brachytherapy was applied using standard computed tomography-compatible tandem and ovoids. The high-risk clinical target volume (HR-CTV), intermediate risk CTV, and organs at risk were contoured according to the Groupe Européen de Curiethérapie - European Society for Radiology and Oncology (GEC-ESTRO) guidelines...
October 2017: Journal of Contemporary Brachytherapy
Lotte Poulsen, Anne Klassen, Michael Rose, Kirsten K Roessler, Claus Bogh Juhl, René Klinkby Støving, Stefan Cano, Jens Ahm Sørensen
Background: A well-developed patient-reported outcome instrument is needed for use in Danish bariatric and body contouring patients. The BODY-Q is designed to measure changes in important patient outcomes over the entire patient journey, from obesity to post-body contouring surgery. The current study aims to psychometrically validate the BODY-Q for use in Danish patients. Methods: The process consisted of 3 stages: translation and linguistic validation, field-test, and data analysis...
October 2017: Plastic and Reconstructive Surgery. Global Open
Herma Lennaerts, Marieke Groot, Maxime Steppe, Jenny T van der Steen, Marieke Van den Brand, Dorian van Amelsvoort, Kris Vissers, Marten Munneke, Bastiaan R Bloem
BACKGROUND: Parkinson's disease (PD) is a chronic, progressive neurological disorder with many intractable consequences for patients and their family caregivers. Little is known about the possibilities that palliative care could offer to patients and their proxies. Guidelines strongly recommend palliative care to improve the quality of life and - if needed - the quality of dying. However, providing palliative care to persons with PD involves specific challenges. For example, a timely initiation of palliative interventions is difficult because due to the gradually progressive nature of PD, there is often no clear marker for the transition from curative towards palliative care...
November 25, 2017: BMC Palliative Care
Roland Tomasi, David Betz, Sophie Schlager, Tobias Kammerer, Dominik J Hoechter, Thomas Weig, Peter Slinger, Laura V Klotz, Bernhard Zwißler, Nandor Marczin, Vera von Dossow
OBJECTIVE: Although increasing evidence in lung transplantation (LTx) suggests that intraoperative management could influence outcomes, there are no guidelines available regarding intraoperative management of LTx. The overall goal of the study was to assess geographic and center volume-specific clinical practices in perioperative management. DESIGN: Prospective data analysis. SETTING: Online survey from a single-center university hospital...
February 2018: Journal of Cardiothoracic and Vascular Anesthesia
Hany Soliman, Mark Ruschin, Lilyana Angelov, Paul D Brown, Veronica L S Chiang, John P Kirkpatrick, Simon S Lo, Anita Mahajan, Kevin S Oh, Jason P Sheehan, Scott G Soltys, Arjun Sahgal
PURPOSE: To propose contouring guidelines based on consensus contours generated by 10 international experts for cavity stereotactic radiosurgery (SRS), an emerging treatment option after surgical resection of brain metastases. No guidelines for contouring the surgical cavity volume have been previously reported. METHODS AND MATERIALS: Ten postoperative completely resected cases with varying clinical scenarios and locations within the brain were selected. For each case, 10 experts independently contoured the surgical cavity clinical target volume (CTV)...
February 1, 2018: International Journal of Radiation Oncology, Biology, Physics
Santhosh Kumar Nagarajan, Sathya Babu, Honglae Sohn, Panneer Devaraju, Thirumurthy Madhavan
Rho Kinases (ROCK) has been found to regulate a wide range of fundamental cell functions such as contraction, motility, proliferation, and apoptosis. Recent experiments have defined new functions of ROCKs in cells, including centrosome positioning and cell-size regulation, which might contribute to various physiological and pathological states. In this study, we have performed pharmacophore modeling and 3D QSAR studies on a series of 36 indoles and 7-azoindoles derivatives as ROCK2 inhibitors to elucidate the structural variations with their inhibitory activities...
December 2017: Computational Biology and Chemistry
Anne W Lee, Wai Tong Ng, Jian Ji Pan, Sharon S Poh, Yong Chan Ahn, Hussain AlHussain, June Corry, Cai Grau, Vincent Grégoire, Kevin J Harrington, Chao Su Hu, Dora L Kwong, Johannes A Langendijk, Quynh Thu Le, Nancy Y Lee, Jin Ching Lin, Tai Xiang Lu, William M Mendenhall, Brian O'Sullivan, Enis Ozyar, Lester J Peters, David I Rosenthal, Yoke Lim Soong, Yungan Tao, Sue S Yom, Joseph T Wee
PURPOSE: Target delineation in nasopharyngeal carcinoma (NPC) often proves challenging because of the notoriously narrow therapeutic margin. High doses are needed to achieve optimal levels of tumour control, and dosimetric inadequacy remains one of the most important independent factors affecting treatment outcome. METHOD: A review of the available literature addressing the natural behaviour of NPC and correlation between clinical and pathological aspects of the disease was conducted...
January 2018: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
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