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E Vigneault, G Morton, W R Parulekar, T M Niazi, C W Springer, M Barkati, P Chung, W Koll, A Kamran, M Monreal, K Ding, A Loblaw
AIMS: We conducted a multicentre feasibility study to assess the ability to randomise patients between image-guided radiotherapy (IGRT) and IGRT + high dose rate (HDR) brachytherapy boost and to adhere to appropriate radiation quality assurance standards. MATERIALS AND METHODS: The primary end point was to determine the ability to randomise 60 patients over an 18 month period. Arm 1 (IGRT) patients received 78 Gy in 39 fractions or 60 Gy in 20 fractions (physician's preference), whereas arm 2 (IGRT + HDR) received 37...
June 11, 2018: Clinical Oncology: a Journal of the Royal College of Radiologists
Katsumi Hirose, Mariko Sato, Yoshiomi Hatayama, Hideo Kawaguchi, Fumio Komai, Makoto Sohma, Hideki Obara, Masashi Suzuki, Mitsuki Tanaka, Ichitaro Fujioka, Koji Ichise, Yoshihiro Takai, Masahiko Aoki
BACKGROUND: The purpose of this study was to evaluate the impact of markerless on-board kilovoltage (kV) cone-beam computed tomography (CBCT)-based positioning uncertainty on determination of the planning target volume (PTV) margin by comparison with kV on-board imaging (OBI) with gold fiducial markers (FMs), and to validate a methodology for the evaluation of PTV margins for markerless kV-CBCT in prostate image-guided radiotherapy (IGRT). METHODS: A total of 1177 pre- and 1177 post-treatment kV-OBI and 1177 pre- and 206 post-treatment kV-CBCT images were analyzed in 25 patients who received prostate IGRT with daily localization by implanted FMs...
June 7, 2018: Radiation Oncology
Daniel R Gomez, Heng Li, Joe Y Chang
In the setting of early-stage non-small cell lung cancer (NSCLC), defining the optimal clinical context for proton beam therapy (PBT) is challenging due to the increasing evidence demonstrating high rates of local control and good tolerance of stereotactic ablative body radiation (SABR). Given the relatively small percentage of lung and other critical structures treated with SABR, dosimetric studies comparing the two techniques have typically concluded that there are modest advantages to PBT, typically by reducing the low dose volumes, such as volume of lung receiving 5 Gy...
April 2018: Translational Lung Cancer Research
Eric D Morris, Ryan G Price, Joshua Kim, Lonni Schultz, M Salim Siddiqui, Indrin Chetty, Carri Glide-Hurst
PURPOSE: Recent advancements in synthetic computed tomography (synCT) from magnetic resonance (MR) imaging data have made MRI-only treatment planning feasible in the brain, although synCT performance for image guided radiation therapy (IGRT) is not well understood. This work compares geometric equivalence of digitally reconstructed radiographs (DRRs) from CTs and synCTs for brain cancer patients and quantifies performance for partial brain IGRT. METHODS AND MATERIALS: Ten brain cancer patients (12 lesions, 7 postsurgical) underwent MR-SIM and CT-SIM...
April 6, 2018: Practical Radiation Oncology
Olga L Green, Leith J Rankine, Austen Curcuru, Rojano Kashani, Vivian Rodriguez, H Harold Li, Parag J Parikh, Clifford G Robinson, Jeffrey R Olsen, Sasa Mutic, S M Goddu, Lakshmi Santanam
PURPOSE: We describe the acceptance testing, commissioning, periodic quality assurance, and workflow procedures developed for the first clinically-implemented magnetic resonance imaging-guided radiation therapy (MR-IGRT) system for real-time tracking and beam control. METHODS: The system utilizes real-time cine imaging capabilities at 4 frames per second for real-time tracking and beam control. Testing of the system was performed using an in-house developed motion platform and a commercially available motion phantom...
May 28, 2018: Medical Physics
Olga Green, Lauren E Henke, Parag Parikh, Michael C Roach, Jeff M Michalski, H Michael Gach
Fractionated radiotherapy presents a new challenge in the screening of patients undergoing magnetic resonance imaging-guided radiotherapy (MR-IGRT). In our institution, patients are evaluated at the time of consult, simulation, and first fraction using a thorough MRI questionnaire identical to the one used for diagnostic radiology patients. For each subsequent fraction, the therapists are trained to inquire about any procedures the patient may have had between the last and current fractions. Patients are also advised to avoid food and fluid intake at least two but not beyond four hours prior to treatment...
March 22, 2018: Curēus
Antony R Parker, Caroline Bradley, Stephen Harding, Silvia Sánchez-Ramón, Stephen Jolles, Sorena Kiani-Alikhan
Response to polysaccharide vaccination can be an invaluable tool for assessing functionality of the adaptive immune system. Measurement of antibodies raised in response to Pneumovax®23 is the current gold standard test, but there are significant challenges and constraints in both the measurement and interpretation of the response. An alternative polysaccharide vaccine approach (Salmonella typhi Vi capsule (ViCPS)) has been suggested. In the present article, we review current evidence for the measurement of ViCPS antibodies in the diagnosis of primary and secondary antibody deficiencies...
May 22, 2018: Journal of Immunological Methods
Shahil Mehta, Shefali R Gajjar, Kyle R Padgett, David Asher, Radka Stoyanova, John C Ford, Eric A Mellon
Radiation therapy (RT) plays a critical role in the treatment of glioblastoma. Studies of brain imaging during RT for glioblastoma have demonstrated changes in the brain during RT. However, frequent or daily utilization of standalone magnetic resonance imaging (MRI) scans during RT have limited feasibility. The recent release of the tri-cobalt-60 MRI-guided RT (MR-IGRT) device (ViewRay MRIdian, Cleveland, OH) allows for daily brain MRI for the RT setup. Daily MRI of three postoperative patients undergoing RT and temozolomide for glioblastoma over a six-week course allowed for the identification of changes to the cavity, edema, and visible tumor on a daily basis...
March 19, 2018: Curēus
Paul J Keall, Doan Trang Nguyen, Ricky O'Brien, Pengpeng Zhang, Laura Happersett, Jenny Bertholet, Per R Poulsen
PURPOSE: To review real-time 3-dimensional (3D) image guided radiation therapy (IGRT) on standard-equipped cancer radiation therapy systems, focusing on clinically implemented solutions. METHODS AND MATERIALS: Three groups in 3 continents have clinically implemented novel real-time 3D IGRT solutions on standard-equipped linear accelerators. These technologies encompass kilovoltage, combined megavoltage-kilovoltage, and combined kilovoltage-optical imaging. The cancer sites treated span pelvic and abdominal tumors for which respiratory motion is present...
April 14, 2018: International Journal of Radiation Oncology, Biology, Physics
Hiroshi Watanabe, Shuichi Ozawa, Atsuyuki Ohashi, Koji Ikenaga, Kentaro Miki, Akito Saito, Teiji Nishio, Yuji Murakami, Yasushi Nagata
It is a useful method for the adaptive radiotherapy (ART) to calculate absorbed dose accurately on the image set taken by on-board cone beam computed tomography (CBCT) attached to linac for image-guided radiation therapy (IGRT). For this purpose, a simple and accurate calculation method is necessary. Several papers report that it is possible to calculate easily and accurately by using several methods of researches in the neck and prostate, but the lung density varies greatly depending on patient thorax condition...
2018: Nihon Hoshasen Gijutsu Gakkai Zasshi
Donna H Murrell, Andrew Warner, Quinn Benwell, Wendy Wells, Danielle Scott, Vikram Velker, George Hajdok, David P D'Souza
BACKGROUND: Intensity modulated radiotherapy (IMRT) is increasingly being used to treat gynaecological malignancies in the postoperative setting. The purpose of this study was to evaluate the use of image-guided radiotherapy (IGRT) using cone-beam computed tomography (CBCT) with fiducial markers for daily localization. MATERIAL AND METHODS: A single institution study was performed of consecutive cervical or endometrial cancer patients receiving adjuvant external beam radiotherapy (n = 15)...
May 18, 2018: Acta Oncologica
Catriona Hargrave, Timothy Deegan, Michael Poulsen, Tomasz Bednarz, Fiona Harden, Kerrie Mengersen
PURPOSE: To develop a method for scoring online cone-beam CT (CBCT)-to-planning CT image feature alignment to inform prostate image-guided radiotherapy (IGRT) decision-making. The feasibility of incorporating volume variation metric thresholds, predictive of delivering planned dose into weighted functions, was investigated. METHODS: Radiation therapists and radiation oncologists participated in workshops where they reviewed prostate CBCT-IGRT case examples and completed a paper-based survey of image feature matching practices...
May 17, 2018: Medical Physics
Catriona Hargrave, Timothy Deegan, Tomasz Bednarz, Michael Poulsen, Fiona Harden, Kerrie Mengersen
PURPOSE: To describe a Bayesian network (BN) and complementary visualization tool, that aim to support decision-making during online cone-beam computed tomography (CBCT)-based image guide radiotherapy (IGRT) for prostate cancer patients. METHODS: The BN was created to represent relationships between observed prostate, proximal seminal vesicle (PSV), bladder and rectum volume variations, an image feature alignment score (FASTV _ OAR ), delivered dose and treatment plan compliance (TPC)...
May 17, 2018: Medical Physics
Lara Farhat, Jasmeen Dara, Susan Duberstein, Aliva De
A 17-year-old male with history of neuromyelitis optica and seizures presented to the pulmonology clinic for evaluation of recurrent pneumonias. He had received rituximab for the past 6 years. Over the past 2 years, he experienced four episodes of pneumonia. In between these episodes, he would improve briefly but continued to have daily cough that was productive with yellow phlegm. He also had recurrent rhinitis and sinusitis despite multiple antibiotic courses. Review of chest X-rays revealed localized right middle lobe and right lower lobe infiltrates...
May 11, 2018: Drug Safety—Case Reports
Kathy Rock, Shao Hui Huang, Albert Tiong, Lin Lu, Wei Xu, Jolie Ringash, Scott V Bratman, Li Tong, Biu Chan, John Cho, Meredith Giuliani, Andrew Hope, Andrew Bayley, John Kim, John R de Almeida, Brian O'Sullivan, John Waldron
PURPOSE: To assess the impact of the radiation therapy (RT) regimen and image guidance (image guided radiation therapy [IGRT]) protocol on local control (LC) for T2N0 glottic cancer treated with partial laryngeal intensity modulated radiation therapy (IMRT). METHODS AND MATERIALS: All patients with T2N0 glottic cancer treated with IMRT from 2006 to 2013 at a single institution were retrospectively reviewed. The gross tumor volume (GTV), delineated from endoscopic and/or radiologic findings, was expanded 0...
March 30, 2018: International Journal of Radiation Oncology, Biology, Physics
Akbar Anvari, Yannick Poirier, Amit Sawant
PURPOSE: Although small animal image-guided radiotherapy (SA-IGRT) systems are used increasingly in preclinical research, tools for performing routine quality assurance (QA) have not been optimized and are not readily available. Robust, efficient, and reliable QA tools are needed to ensure the accuracy and reproducibility of SA-IGRT systems. Several investigators have reported custom-made phantoms and protocols for SA-IGRT systems QA. These are typically time and resource intensive and are therefore not well suited to the preclinical radiotherapy environment, in which physics support is limited and routine QA is performed by technical staff...
April 28, 2018: Medical Physics
Jian Zhu, Tong Bai, Jiabing Gu, Ziwen Sun, Yumei Wei, Baosheng Li, Yong Yin
BACKGROUND: To evaluate the effect of pretreatment megavoltage computed tomographic (MVCT) scan methodology on setup verification and adaptive dose calculation in helical TomoTherapy. METHODS: Both anthropomorphic heterogeneous chest and pelvic phantoms were planned with virtual targets by TomoTherapy Physicist Station and were scanned with TomoTherapy megavoltage image-guided radiotherapy (IGRT) system consisted of six groups of options: three different acquisition pitches (APs) of 'fine', 'normal' and 'coarse' were implemented by multiplying 2 different corresponding reconstruction intervals (RIs)...
April 27, 2018: Radiation Oncology
Avani D Rao, Eun Ji Shin, Sarah E Beck, Caroline Garrett, Seong-Hun Kim, Nam Ju Lee, Eleni Liapi, John Wong, Joseph Herman, Amol Narang, Kai Ding
PURPOSE: To test the feasibility and safety of injecting a high-contrast hydrogel marker at the head of the pancreas (HOP) and duodenum interface and assesses the marker visibility on cone beam computed tomography (CBCT) to localize this important boundary during image guided radiation therapy in a porcine model. METHODS AND MATERIALS: This was a 2-stage study. The feasibility/visibility stage evaluated the ability to place the hydrogel using endoscopic ultrasound guidance on 8 swine (4 euthanized at post-injection day 8, 4 euthanized at post-injection day 22) and assessed the quality of visibility of the marked location on CBCT in the longer-surviving group...
July 1, 2018: International Journal of Radiation Oncology, Biology, Physics
G S Ibbott
The introduction of image guidance in radiation therapy and its subsequent innovations have revolutionised the delivery of cancer treatment. Modern imaging systems can supplement and often replace the historical practice of relying on external landmarks and laser alignment systems. Rather than depending on markings on the patient's skin, image-guided radiation therapy (IGRT), using techniques such as computed tomography (CT), cone beam CT, MV on-board imaging (OBI), and kV OBI, allows the patient to be positioned based on the internal anatomy...
January 1, 2018: Annals of the ICRP
Gang Wang, Wen-Ling Wang, Yi-Qun Liu, Hong-Min Dong, Yin-Xiang Hu
Objective: In this study, prostate cancer patients were treated with image-guided radiotherapy (IGRT). The translational positioning errors were discussed to provide the basis for determining margins of the planning target volume (PTV). Methods: Thirty prostate cancer patients were treated with radical radiotherapy using the IGRT system. Patients were placed in the supine position and underwent kilovoltage cone beam computed tomography (KVCBCT) scans before radiotherapy...
2018: OncoTargets and Therapy
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