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Target volume delineation

R J Cassidy, X Yang, T Liu, M Thomas, S G Nour, A B Jani
PURPOSE: Sexual dysfunction after radiotherapy for prostate cancer remains an important late adverse toxicity. The neurovascular bundles (NVB) that lie posterolaterally to the prostate are typically spared during prostatectomy, but in traditional radiotherapy planning they are not contoured as an organ-at-risk with dose constraints. Our goal was to determine the dosimetric feasibility of "NVB-sparing" prostate radiotherapy while still delivering adequate dose to the prostate. METHODS: Twenty-five consecutive patients with prostate cancer (with no extraprostatic disease on pelvic magnetic resonance imaging [MRI]) who that were treated with external beam radiotherapy, with the same primary planning target volume margins, to a dose of 79...
October 13, 2016: Medical Dosimetry: Official Journal of the American Association of Medical Dosimetrists
Shalini K Vinod, Michael G Jameson, Myo Min, Lois C Holloway
BACKGROUND AND PURPOSE: Volume delineation is a well-recognised potential source of error in radiotherapy. Whilst it is important to quantify the degree of interobserver variability (IOV) in volume delineation, the resulting impact on dosimetry and clinical outcomes is a more relevant endpoint. We performed a literature review of studies evaluating IOV in target volume and organ-at-risk (OAR) delineation in order to analyse these with respect to the metrics used, reporting of dosimetric consequences, and use of statistical tests...
October 8, 2016: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Stephanie Casey, Lara Best, Olga Vujovic, Kevin Jordan, Barbara Fisher, Deborah Carey, Deborah Bourdeau, Edward Yu
PURPOSE : Non-melanotic skin cancers remain the most commonly diagnosed cancers. Radiotherapy and surgery are the most common treatment options. Radiotherapy has a recurrence rate of up to 20% for basal or squamous cell cancers. One of the difficulties is to determine the extent of disease for poorly demarcated tumors. This study utilizes protoporphyrin (PpIX) fluorescence to provide information on the extent of subclinical disease for poorly demarcated tumors treated with radiotherapy...
September 4, 2016: Curēus
Shahram Mashouf, Habib Safigholi, Tomas Merino, Abraam Soliman, Ananth Ravi, Gerard Morton, William Y Song
PURPOSE: There is strong evidence relating postimplant dosimetry for low-dose-rate prostate seed brachytherapy to local control rates. The delineation of the prostate on CT images, however, represents a challenge due to the lack of soft-tissue contrast to identify the prostate borders. This study aims at quantifying the sensitivity of prostate V100 and D90 to contouring uncertainty as clinically relevant parameters for evaluation of target coverage in postimplant dosimetry. METHODS AND MATERIALS: CT images, postoperative plans, and contours of a cohort of patients (n = 43; low risk = 55...
October 5, 2016: Brachytherapy
Oliver Oehlke, Michael Mix, Erika Graf, Tanja Schimek-Jasch, Ursula Nestle, Irina Götz, Sabine Schneider-Fuchs, Astrid Weyerbrock, Irina Mader, Brigitta G Baumert, Susan C Short, Philipp T Meyer, Wolfgang A Weber, Anca-Ligia Grosu
BACKGROUND: The higher specificity of amino-acid positron emission tomography (AA-PET) in the diagnosis of gliomas, as well as in the differentiation between recurrence and treatment-related alterations, in comparison to contrast enhancement in T1-weighted MRI was demonstrated in many studies and is the rationale for their implementation into radiation oncology treatment planning. Several clinical trials have demonstrated the significant differences between AA-PET and standard MRI concerning the definition of the gross tumor volume (GTV)...
October 5, 2016: BMC Cancer
E Metcalfe, L Aspin, R Speight, E Ermiş, S Ramasamy, K Cardale, K E Dyker, M Sen, R J D Prestwich
AIMS: To determine outcomes after adjuvant radiotherapy for squamous cell carcinoma of the oral cavity and to correlate locoregional recurrence patterns with radiotherapy target volumes. MATERIALS AND METHODS: All patients receiving adjuvant radiotherapy±chemotherapy after surgery with curative intent for oral cavity squamous cell carcinoma between 2007 and 2012 were retrospectively analysed. Locoregional recurrences were reconstructed on the planning computed tomography scan by both deformable image co-registration and by visual assessment...
October 3, 2016: Clinical Oncology: a Journal of the Royal College of Radiologists
Michael J Cross, Gail S Lebovic, Joseph Ross, Scott Jones, Arnold Smith, Steven Harms
BACKGROUND: Techniques for accurately delineating the tumor bed after breast-conserving surgery (BCS) can be challenging. As a result, the accuracy, and efficiency of radiation treatment (RT) planning can be negatively impacted. Surgically placed clips or the post-surgical seroma are commonly used to determine target volume; however, these methods can lead to a high degree of uncertainty and variability. A novel 3-dimensional bioabsorbable marker was used during BCS and assessed for its impact on RT planning...
October 5, 2016: World Journal of Surgery
Jun Xing, Yijun Luo, Xiaoli Wang, Min Gao, Mingping Sun, Xiuping Ding, Tingyong Fan, Jinming Yu
PURPOSE: Definitive chemoradiation therapy remains the standard of care for patients with localized esophageal carcinoma who choose nonsurgical management. However, there is no consensus regarding delineation of the nodal clinical target volume (CTVn), especially for lower cervical lymph nodes. This study aimed to map the location of metastatic supraclavicular lymph nodes in thoracic esophageal carcinoma patients with supraclavicular node involvement and generate an atlas to delineate the CTVn for elective nodal radiation of esophageal squamous cell carcinoma...
2016: OncoTargets and Therapy
Nicole Nesvacil, Maximilian P Schmid, Richard Pötter, Gernot Kronreif, Christian Kirisits
PURPOSE: To investigate the feasibility of a treatment planning workflow for three-dimensional image-guided cervix cancer brachytherapy, combining volumetric transrectal ultrasound (TRUS) for target definition with CT for dose optimization to organs at risk (OARs), for settings with no access to MRI. METHODS AND MATERIALS: A workflow for TRUS/CT-based volumetric treatment planning was developed, based on a customized system including ultrasound probe, stepper unit, and software for image volume acquisition...
September 29, 2016: Brachytherapy
Danielle N Margalit, Bhupendra Rawal, Paul J Catalano, Robert I Haddad, Laura A Goguen, Donald J Annino, Sewanti A Limaye, Jochen H Lorch, Annie W Lavigne, Jonathan D Schoenfeld, David J Sher, Roy B Tishler
PURPOSE: To describe patterns of failure (POF) after reirradiation (reRT) with intensity modulated radiation therapy (IMRT) for recurrent/second primary squamous cell carcinoma of the head and neck. METHODS: From 08/2004-02/2013, 75 consecutive patients received reRT with IMRT. Gross tumor was generally treated with a 5mm planning target volume (PTV) margin. For postoperative cases, a 5mm PTV was added to the clinical target volume which included the postoperative bed...
October 2016: Oral Oncology
Mekhail Anwar, Yao Yu, Christine M Glastonbury, Ivan H El-Sayed, Sue S Yom
PURPOSE: The ophthalmic nerve (cranial nerve V-1) runs in close proximity to the globe, optic nerve, chiasm, and brain. The purpose of this study was to provide contouring guidance using computed tomography (CT)-identifiable landmarks, based on an analysis of skin cancer patients with V-1 invasion. METHODS AND MATERIALS: Radiation oncology planning CT scans were analyzed for landmarks to guide V-1 target delineation from the skin surface to the trigeminal ganglion...
March 16, 2016: Practical Radiation Oncology
Karolien Verhoeven, Stéphanie Peeters, Katrien Erven, Hilde Janssen, Isabelle Kindts, Erik Van Limbergen, Annouschka Laenen, Saskia Petillion, Caroline Weltens
PURPOSE: The purpose of this article is to compare isotropic and anisotropic margin expansion with regard to the size of the clinical target volume boost (CTVboost) and the interobserver variability (IOV). METHODS AND MATERIALS: Lumpectomy cavities marked with 3 or more surgical clips were delineated by 6 radiation oncologists who specialized in breast radiation therapy. CTVboost anisotropic was created by manually expanding the tumor bed with an anisotropic margin of 15 mm (20 mm in case of extensive intraductal component) minus the surgical free margins in 6 directions (anteroposterior, craniocaudal, and superoinferior)...
March 19, 2016: Practical Radiation Oncology
Christine H Feng, Yasmin Hasan, Malgorzata Kopec, Hania A Al-Hallaq
We performed a dosimetric comparison of sequential IMRT (sIMRT) and simul-taneously integrated boost (SIB) IMRT to boost PET-avid lymph nodes while concurrently treating pelvic targets to determine the potential of SIB IMRT to reduce overall treatment duration in locally advanced cervical cancer. Ten patients receiving definitive radiation therapy were identified retrospectively. RTOG consensus guidelines were followed to delineate the clinical target volume and organs at risk (OAR), which were then expanded per IMRT consortium guidelines to yield the planning target volume (PTV)...
2016: Journal of Applied Clinical Medical Physics
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
C Zhao, Y Hua, W Xiao, F Han, X Deng
No abstract text is available yet for this article.
October 1, 2016: International Journal of Radiation Oncology, Biology, Physics
J Zhang, J Jin, Z Liang, X Wang, L Jiang
No abstract text is available yet for this article.
October 1, 2016: International Journal of Radiation Oncology, Biology, Physics
Tom Konert, Wouter V Vogel, Sarah Everitt, Michael P MacManus, Daniela Thorwarth, Elena Fidarova, Diana Paez, Jan-Jakob Sonke, Gerard G Hanna
BACKGROUND AND PURPOSE: To assess the impact of a standardized delineation protocol and training interventions on PET/CT-based target volume delineation (TVD) in NSCLC in a multicenter setting. MATERIAL AND METHODS: Over a one-year period, 11 pairs, comprised each of a radiation oncologist and nuclear medicine physician with limited experience in PET/CT-based TVD for NSCLC from nine different countries took part in a training program through an International Atomic Energy Agency (IAEA) study (NCT02247713)...
September 20, 2016: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Neil C Estabrook, Gregory K Bartlett, Julia J Compton, Higinia R Cardenes, Indra J Das
Small bowel dose often represents a limiting factor for radiation treatment of pelvic malignancies. To reduce small bowel toxicity, a belly board device (BBD) with a prone position is often recommended. Intensity modulated radiotherapy (IMRT) could reduce dose to small bowel based on the desired dose-volume constraints. We investigated the efficacy of BBD in conjunction with IMRT. A total of 11 consecutive patients with the diagnosis of rectal cancer, who were candidates for definitive therapy, were selected...
September 12, 2016: Medical Dosimetry: Official Journal of the American Association of Medical Dosimetrists
Soren Moller, Ian Law, Per Munck Af Rosenschold, Junia Costa, Hans Skovgaard Poulsen, Svend Aage Engelholm, Silke Engelholm
BACKGROUND AND PURPOSE: Positron emission tomography (PET) provides quantitative metabolic information and potential biomarkers of treatment outcome. We aimed to determine the prognostic value of early (18)F-fluoroethyl-tyrosine ((18)F-FET) PET scans acquired during re-irradiation for recurrent high-grade glioma (HGG). MATERIAL AND METHODS: A phase I clinical trial of re-irradiation of HGG was carried out. MRI and (18)F-FET PET were used for target delineation and follow-up...
September 9, 2016: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Brock J Debenham, Robyn Banerjee, Heather Warkentin, Sunita Ghosh, Rufus Scrimger, Naresh Jha, Matthew Parliament
PURPOSE: To compare and contrast the patterns of failure in patients with locally advanced squamous cell oropharyngeal cancers undergoing curative-intent treatment with primary surgery or radiotherapy +/- chemotherapy. METHODS AND MATERIALS: Two hundred and thirty-three patients with stage III or IV oropharyngeal squamous cell carcinoma who underwent curative-intent treatment from 2006-2012, were reviewed. The median length of follow-up for patients still alive at the time of analysis was 4...
2016: Curēus
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