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Brain srs

SayedMasoud Hashemi, Christopher Huynh, Arjun Sahgal, William Y Song, Håkan Nordström, Markus Eriksson, James G Mainprize, Young Lee, Mark Ruschin
A Contrast and Attenuation-map Linearity Improvement (CALI) framework is proposed for cone-beam CT (CBCT) images used for brain stereotactic radiosurgery (SRS). The proposed framework is tailored to improve soft tissue contrast of a new point-of-care image-guided SRS system that employs a challenging half cone beam geometry, but can be readily reproduced on any CBCT platform. CALI includes a pre- and post-processing step. In pre-processing we apply a shading and beam hardening artifact correction to the projections, and in post-processing step we correct the dome/capping artifact on reconstructed images caused by the spatial variations in X-ray energy generated by the bowtie-filter...
October 19, 2018: Journal of Applied Clinical Medical Physics
Somayeh Taghizadeh, Cecille Labuda, Claus Chunli Yang, Bart Morris, Madhava R Kanakamedala, Srinivasan Vijayakumar, Roberto Rey-Dios, William N Duggar, Edward Florez, Ali Fatemi
Aim: Development of MRI sequences and processing methods for the production of images appropriate for direct use in stereotactic radiosurgery (SRS) treatment planning. Background: MRI is useful in SRS treatment planning, especially for patients with brain lesions or anatomical targets that are poorly distinguished by CT, but its use requires further refinement. This methodology seeks to optimize MRI sequences to generate distortion-free and clinically relevant MR images for MRI-only SRS treatment planning...
January 2019: Reports of Practical Oncology and Radiotherapy
Itzel Jatziri Contreras-García, Luz Adriana Pichardo-Macías, César Emmanuel Santana-Gómez, Karla Sánchez-Huerta, Rogelio Ramírez-Hernández, Beatriz Gómez-González, Luisa Rocha, Julieta G Mendoza Torreblanca
Synaptic vesicle protein 2A (SV2A) has become an attractive target of investigation because of its role in the pathophysiology of epilepsy; SV2A is expressed ubiquitously throughout the brain in all nerve terminals independently of their neurotransmitter content and plays an important but poorly defined role in neurotransmission. Previous studies have shown that modifications in the SV2A protein expression could be a direct consequence of disease severity. Furthermore, these SV2A modifications may depend on specific changes in the nerve tissue following the induction of epilepsy and might be present in both excitatory and inhibitory terminals...
October 15, 2018: Epilepsy & Behavior: E&B
Giuseppina Laura Masucci
Single fraction radiosurgery (SRS) treatment is an effective and recognized alternative to whole brain radiation for brain metastasis. However, SRS is not always possible, especially in tumors of a larger diameter where the administration of high dose in a single fraction is limited by the possibility of acute and late side effects and the dose to the surrounding organs at risk. Hypofractionated radiation therapy allows the delivery of high doses of radiation per fraction while minimizing adverse events, all the while maintaining good local control of lesions...
2018: Frontiers in Oncology
Kira Seiger, Arjun V Pendharkar, Peyman Samghabadi, Steven D Chang, Nam Cho, Clara Y H Choi, Candace Wang, Melanie Hayden Gephart, Scott G Soltys
The development of cavernous malformations many years following conventionally fractionated brain irradiation is well recognized and commonly reported. However, cavernous malformation induction following stereotactic radiosurgery (SRS) is largely unreported. Herein, we describe two cases of cavernous malformation formation years following SRS for brain metastases. A 20-year-old woman with breast cancer brain metastases received treatment with whole brain radiotherapy (WBRT), then salvage SRS 1.4 years later for progression of a previously treated metastasis...
October 17, 2018: Acta Neurochirurgica
Lone Hymøller, Saman Lashkari, Tove N Clausen, Søren K Jensen
Synthetic α-tocopherol has eight isomeric configurations including four 2R (RSS, RRS, RSR, RRR) and four 2S (SRR, SSR, SRS, SSS). Only the RRR stereoisomer is naturally synthesised by plants. A ratio of 1·36:1 in biopotency of RRR-α-tocopheryl acetate to all-rac-α-tocopheryl acetate is generally accepted; however, studies indicate that neither biopotency of α-tocopherol stereoisomers nor bioavailability between them is constant, but depend on dose, time, animal species and organs. A total of forty growing young male mink were, after weaning, assigned one of the following treatments for 90 d: no α-tocopherol in diet (ALFA_0), 40 mg/kg RRR-α-tocopheryl acetate (NAT_40), 40 mg/kg all-rac-α-tocopheryl acetate (SYN_40) and 80 mg/kg feed all-rac-α-tocopheryl acetate (SYN_80)...
October 17, 2018: British Journal of Nutrition
Balamurugan Vellayappan, Char Loo Tan, Clement Yong, Lih Kin Khor, Wee Yao Koh, Tseng Tsai Yeo, Jay Detsky, Simon Lo, Arjun Sahgal
The use of radiotherapy, either in the form of stereotactic radiosurgery (SRS) or whole-brain radiotherapy (WBRT), remains the cornerstone for the treatment of brain metastases (BM). As the survival of patients with BM is being prolonged, due to improved systemic therapy (i.e., for better extra-cranial control) and increased use of SRS (i.e., for improved intra-cranial control), patients are clinically manifesting late effects of radiotherapy. One of these late effects is radiation necrosis (RN). Unfortunately, symptomatic RN is notoriously hard to diagnose and manage...
2018: Frontiers in Oncology
Farkhad Manapov, Lukas Käsmann, Olarn Roengvoraphoj, Maurice Dantes, Nina-Sophie Schmidt-Hegemann, Claus Belka, Chukwuka Eze
Over 10% of small-cell lung cancer (SCLC) patients have brain metastases (BM) at initial diagnosis; more than 50% will develop BM within 2 years. BM are detected in up to 80% of all patients at autopsy. After primary treatment, prophylactic cranial irradiation (PCI) has been established as standard of care in SCLC patients responding to initial therapy. Based on level I evidence, PCI significantly decreases the risk of intracranial relapse and shows a modest survival benefit after 3 years. However, the role of PCI in defined patient subgroups such as resected SCLC, elderly and extensive stage patients with access to magnetic resonance imaging surveillance and stereotactic radiotherapy is yet to be fully clarified...
2018: Lung Cancer: Targets and Therapy
Suneel D Kamath, Priya U Kumthekar
While the CNS has long been viewed as an immune-privileged environment, a paradigm shift in neuro-immunology has elevated the role of systemic immunotherapy for the treatment of metastatic disease. Increasing knowledge regarding the presence of a CNS lymphatic system and the physical and biochemical alteration of the blood brain barrier (BBB) by the tumor microenvironment suggests immune cell trafficking in and out of the CNS is possible. Emerging clinical data suggest immune checkpoint inhibitors (ICIs) can stimulate T cells peripherally to in turn have anti-tumor effects in the CNS...
2018: Frontiers in Oncology
Qianyi Xu, Jinyu Xue, Gregory Kubicek, David Mulvihill, Steven Oh, Warren Goldman, Alan Turtz, Leonard Kim
Purpose In the current Gamma Knife (GK) planning system (GammaPlan, version 10.2, Elekta AB, Stockholm, Sweden), multiple adjacent brain metastasis (BMs) had to be planned sequentially if BMs were drawn separately, leading to less conformal target dose in the composite plan due to inter-target dose contribution and fine-tuning of the shots being quite tedious. We proposed a method to improve target dose conformality and planning efficiency for such cases. Methods and Materials Fifteen patients with multiple BMs treated on the Leksell GK Perfexion system were retrospectively replanned in the Institutional Review Board (IRB) approved study...
July 27, 2018: Curēus
Rushikesh S Joshi, Brian R Hirshman, Mir Amaan Ali, Ali Alattar, Kate Carroll, Osamu Nagano, Hitoshi Aiyama, Toru Serizawa, Masaaki Yamamoto, Clark C Chen
BACKGROUND: The disease-specific Graded Prognostic Assessment (ds-GPA) for patients with gastrointestinal (GI) tract cancer brain metastases (BM) suggests Karnofsky Performance Score (KPS) as the only pertinent prognostic factor. We evaluated the prognostic importance of cumulative intracranial tumor volume (CITV). METHODS: KPS, CITV, and overall survival (OS) were collected from consecutive SRS-treated GI BM patients. Patients were grouped into two independent cohorts for development and validation of the model (termed "exploratory" and "validation" cohorts)...
October 8, 2018: World Neurosurgery
Eric J Lehrer, Heather M McGee, Jennifer L Peterson, Laura Vallow, Henry Ruiz-Garcia, Nicholas G Zaorsky, Sonam Sharma, Daniel M Trifiletti
Brain metastases traditionally carried a poor prognosis with an overall survival of weeks to months in the absence of treatment. Radiation therapy modalities include whole brain radiation therapy (WBRT) and stereotactic radiosurgery (SRS). WBRT delivers a relatively low dose of radiation, has neurocognitive sequelae, and has not been investigated for its immunostimulatory effects. Furthermore, WBRT exposes the entire intracranial tumor immune microenvironment to radiation. SRS delivers a high dose of conformal radiation with image guidance to minimize dose to surrounding normal brain tissue, and appears to promote anti-tumor immunity...
October 7, 2018: International Journal of Molecular Sciences
Heinz Schmidberger, Matthias Rapp, Anne Ebersberger, Silla Hey-Koch, Carmen Loquai, Stephan Grabbe, Arnulf Mayer
PURPOSE: Since the introduction of ipilimumab (IPI) for the treatment of patients with metastatic malignant melanoma, we have observed remarkable responses after hypofractionated whole brain irradiation (WBRT) or stereotactic radiotherapy (STX) for brain metastases of malignant melanoma. We sought to investigate the impact of the sequence of these treatment modalities. METHODS: We retrospectively evaluated the survival of melanoma patients with brain metastases who were treated with WBRT or STX and received IPI in close temporal relation between October 2010 and March 2015...
October 8, 2018: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
Hitoshi Aiyama, Masaaki Yamamoto, Takuya Kawabe, Shinya Watanabe, Takao Koiso, Yasunori Sato, Yoshinori Higuchi, Eiichi Ishikawa, Tetsuya Yamamoto, Akira Matsumura, Hidetoshi Kasuya, Bierta E Barfod
BACKGROUND AND PURPOSE: Complications after stereotactic radiosurgery (SRS) for brain metastases (BMs) were analyzed in detail using our database including nearly 3000 BM patients. MATERIALS AND METHODS: This was an institutional review board-approved, retrospective cohort study using our prospectively accumulated database including 3271 consecutive patients who underwent gamma knife SRS for BMs during the 1998-2016 period. Excluding four patients lost to follow-up, 112 with three-staged treatment and 189 with post-operative irradiation, 2966 who underwent a single-session of SRS only as radical irradiation were studied...
October 4, 2018: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Yuanxuan Xia, Leila A Mashouf, Brock R Baker, Russell Maxwell, Chetan Bettegowda, Kristin J Redmond, Lawrence R Kleinberg, Michael Lim
Introduction Brain metastases are common in patients with advanced systemic cancer and often recur despite treatment with surgical resection and radiotherapy. Whole brain radiation therapy (WBRT) and stereotactic radiosurgery (SRS) have significantly improved local control rates but are limited by complications including neurocognitive deficits and radiation necrosis. These risks can be higher in the re-irradiation setting. Brachytherapy may be an alternative method of additional targeted adjuvant radiotherapy with acceptable rates of toxicity...
July 30, 2018: Curēus
L W Nicholls, M B Pinkham, A Bernard, R Lusk, T Watkins, B Hall, S Olson, M C Foote
AIMS: Select patients with brain metastases receive stereotactic radiosurgery (SRS) with the objective of improving survival and intracranial disease control. Brain metastases number and volume are prognostic factors used to inform patient selection. The aim of this study was to assess the rate of change of brain metastases size and number (growth kinetics) between the diagnostic and day of SRS magnetic resonance imaging (MRI) scans. MATERIALS AND METHODS: All patients treated with Gamma Knife SRS between October 2015 and April 2017 were included in this single-centre retrospective analysis...
September 29, 2018: Clinical Oncology: a Journal of the Royal College of Radiologists
V Sawlani, N Davies, M Patel, R Flintham, C Fong, G Heyes, G Cruickshank, N Steven, A Peet, A Hartley, H Benghiat, S Meade, P Sanghera
AIMS: Following stereotactic radiosurgery (SRS), brain metastases initially increase in size in up to a third of cases, suggesting treatment failure. Current imaging using structural magnetic resonance imaging (MRI) cannot differentiate between tumour recurrence and SRS-induced changes, creating difficulties with patient management. Combining multiparametric MRI techniques, which assess tissue physiological and metabolic information, has shown promise in answering this clinical question...
September 28, 2018: Clinical Oncology: a Journal of the Royal College of Radiologists
David Roberge, Paul D Brown, Anthony Whitton, Chris O'Callaghan, Anne Leis, Jeffrey Greenspoon, Grace Li Smith, Jennifer J Hu, Alan Nichol, Chad Winch, Michael D Chan
Stereotactic radiosurgery (SRS) has replaced whole brain radiotherapy (WBRT) as standard therapy for most patients with four or fewer brain metastases due to improved cognitive outcomes and more favorable health related quality of life (QoL). Whether SRS or WBRT is the optimal radiation modality for patients with five to fifteen brain metastases remains an open question. Efforts are underway to develop prospective evidence to answer this question. One of the planned trials is a Canadian Cancer Trials Group (CCTG)-lead North American intergroup trial...
2018: Frontiers in Oncology
Fabio Y Moraes, Jeff Winter, Eshetu G Atenafu, Archya Dasgputa, Hamid Raziee, Catherine Coolens, Barbara-Ann Millar, Normand Laperriere, Maitry Patel, Mark Bernstein, Paul Kongkham, Gelareh Zadeh, Tatiana Conrad, Caroline Chung, Alejandro Berlin, David B Shultz
Background: At our institution, we have historically treated brain metastasis (BM) ≤2cm in eloquent brain with a radiosurgery (SRS) lower prescription dose (PD) to reduce the risk of radionecrosis (RN). We sought to evaluate the impact of this practice on outcomes. Methods: We analyzed a prospective registry of BM patients treated with SRS between 2008 and 2017. Incidences of local failure (LF) and RN were determined and Cox regression was performed for univariate and multivariable analyses (MVA)...
September 28, 2018: Neuro-oncology
Bohan Zhang, Mengxiong Sun, Yifan Yang, Lingchao Chen, Xiang Zou, Tian Yang, Yingqi Hua, Minbiao Ji
Two-color stimulated Raman scattering (SRS) microscopy with label-free mapping of lipid/protein distributions has shown promise in virtual histology. Despite previous demonstrations of SRS in tumor delineation and diagnosis, the speed and efficiency of the current technique requires further improvements for practical use. Here, we integrate parallel dual-phase SRS detection with strip mosaicing, which reduces the imaging time of a whole mouse brain section from 70 to 8 minutes. We further verified our method in imaging fresh human surgical tissues, showing its great potential for rapid SRS histology, especially for large scale, large quantity imaging tasks...
June 1, 2018: Biomedical Optics Express
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