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Target volume delineation

Yingbing Wang, Otto Rapalino, Pedram Heidari, Jay Loeffler, Helen A Shih, Kevin Oh, Umar Mahmood
PURPOSE/OBJECTIVES: Response criteria of glioblastoma after chemoradiation do not account for metabolic changes that occur after treatment. The purpose of this study is to evaluate the utility of positron emission tomography imaging with C11 Methionine (MET-PET) for detecting changes that occur after chemoradiation therapy and the value of molecular biomarkers for predicting magnitude of metabolic response. MATERIALS AND METHODS: Newly diagnosed glioblastoma patients undergoing standard chemoradiation treatment were enrolled in this prospective imaging study with MET-PET scan performed within 3 days following surgical resection and again at 4 weeks after completion of chemoradiation...
June 15, 2018: International Journal of Radiation Oncology, Biology, Physics
Sadegh Riyahi, Wookjin Choi, Chia-Ju Liu, Hualiang Zhong, Abraham J Wu, James G Mechalakos, Wei Lu
We proposed a framework to detect and quantify local tumor morphological changes due to chemo-radiotherapy (CRT) using Jacobian map and to extract quantitative radiomic features from the Jacobian map to predict the pathologic tumor response in locally advanced esophageal cancer patients. In 20 patients who underwent CRT, a multi-resolution BSpline deformable registration was performed to register the follow-up (post-CRT) CT to the baseline CT image. Jacobian map (J) was computed as the determinant of the gradient of the Deformation Vector Field...
June 18, 2018: Physics in Medicine and Biology
Ying-Lin Peng, Li Chen, Guan-Zhu Shen, Ya-Ning Li, Ji-Jin Yao, Wei-Wei Xiao, Lin Yang, Shu Zhou, Jia-Xin Li, Wan-Qin Cheng, Ying Guan, Hai-Qun Xia, Shuai Liu, Chong Zhao, Xiao-Wu Deng
OBJECTIVE: This study aimed to (a) assess the differences in the delineation of target volumes and organs-at-risk (OARs) by different physicians designing an intensity-modulated radiation therapy (IMRT) for nasopharyngeal carcinoma (NPC) and (b) analyze the impact of these differences on the treatment plan optimization. MATERIALS AND METHODS: The planning target volumes (PTVs) and OARs for radiotherapy were manually delineated from computed tomography images of a patient with NPC, and a standard delineation was determined using the STAPLE algorithm of ABAS software...
July 2018: Oral Oncology
Patricia M de Groot, Girish S Shroff, Judy Ahrar, Bradley S Sabloff, Garret M Gladish, Cesar Moran, Sanjay Gupta, Gregory W Gladish, Joe Y Chang, Jeremy J Erasmus
Purpose: Precision radiation therapy such as stereotactic body radiation therapy and limited resection are being used more frequently to treat intrathoracic malignancies. Effective local control requires precise radiation target delineation or complete resection. Lung biopsy tracts (LBT) on computed tomography (CT) scans after the use of tract sealants can mimic malignant tract seeding (MTS) and it is unclear whether these LBTs should be included in the calculated tumor volume or resected...
April 2018: Advances in Radiation Oncology
Hans Ligtenberg, Tim Schakel, Jan Willem Dankbaar, Lilian N Ruiter, Boris Peltenburg, Stefan M Willems, Nicolien Kasperts, Chris H J Terhaard, Cornelis P J Raaijmakers, Marielle E P Philippens
In radiotherapy treatment planning, tumor delineation based on diffusion-weighted imaging (DWI) by magnetic resonance imaging (MRI) is a promising technique. MR-only-based target definition becomes important with the recent development of MRI integrated radiotherapy treatment modalities. In this case series, DWI-based gross tumor volume (GTV) was validated using pathology and compared with a clinical GTV based on computed tomography (CT) imaging and MRI. This case series includes three patients with a laryngeal tumor...
April 11, 2018: Curēus
Kuo Men, Tao Zhang, Xinyuan Chen, Bo Chen, Yu Tang, Shulian Wang, Yexiong Li, Jianrong Dai
PURPOSE: To train and evaluate a very deep dilated residual network (DD-ResNet) for fast and consistent auto-segmentation of the clinical target volume (CTV) for breast cancer (BC) radiotherapy with big data. METHODS: DD-ResNet was an end-to-end model enabling fast training and testing. We used big data comprising 800 patients who underwent breast-conserving therapy for evaluation. The CTV were validated by experienced radiation oncologists. We performed a fivefold cross-validation to test the performance of the model...
June 2018: Physica Medica: PM
Karthik S Rishi, Ram Charith Alva, Amrit Raghav Kadam, Sanjiv Sharma
Locally advanced cancer of the cervix is treated by concurrent chemoradiation followed by brachytherapy. Interstitial brachytherapy is used to treat large tumors with involvement of parametrium, post-hysterectomy, and narrow, conical vagina. The GYN GEC-ESTRO working group described target volume delineation and also 3D image-based planning using MRI and 3D dose-volume parameters for brachytherapy of carcinoma cervix. CT-based as compared to MR-based image-guided brachytherapy (IGBT) is much more feasible and practical because MR access is still difficult for most departments...
June 2018: Indian Journal of Surgical Oncology
Renáta Kószó, Linda Varga, Emese Fodor, Zsuzsanna Kahán, Adrienne Cserháti, Katalin Hideghéty, Zsófia Együd, Csilla Szabó, Emőke Borzási, Dorottya Szabó, Kitti Müllner, Zoltán Varga, Anikó Maráz
The presence of normal tissues in the irradiated volume limits dose escalation during pelvic radiotherapy (RT) for prostate cancer. Supine and prone positions on a belly board were compared by analyzing the exposure of organs at risk (OARs) using intensity modulated RT (IMRT). The prospective trial included 55 high risk, localized or locally advanced prostate cancer patients, receiving definitive image-guided RT. Computed tomography scanning for irradiation planning was carried out in both positions. Gross tumor volume, clinical and planning target volumes (PTV) and OARs were delineated, defining subprostatic and periprostatic rectal subsegments...
June 7, 2018: Pathology Oncology Research: POR
Philip E Mosley, David Smith, Terry Coyne, Peter Silburn, Michael Breakspear, Alistair Perry
Deep brain stimulation of the subthalamic nucleus for Parkinson's disease is an established advanced therapy that addresses motor symptoms and improves quality of life. However, it has also been associated with neuropsychiatric symptoms such as impulsivity and hypomania. When significant, these symptoms can be distressing, necessitating psychiatric intervention. However, a comprehensive analysis of neurocognitive and neuropsychiatric outcomes with reference to the site of subthalamic stimulation has not been undertaken...
2018: NeuroImage: Clinical
Chris Monten, Liv Veldeman, Katrien Vandecasteele, Luiza Oltéanu, Werner De Gersem, Tom Vercauteren, Thomas Mulliez, Rudy Van Den Broecke, Herman Depypere, Wilfried De Neve, Yolande Lievens
INTRODUCTION: In view of the limited incremental benefit between whole breast irradiation (WBI), accelerated partial breast irradiation (APBI) and omission of radiotherapy in favorable early-stage breast cancer (ESBC), APBI can only be justified if it combines adequate target coverage with the lowest achievable toxicity. Interobserver exercises demonstrated the difficulty of precise target delineation, especially in prone position; information on accuracy is even scarcer. We tested the impact of inserting an additional indicator clip, marking the depth of the tumor in the breast, and the added value of a preoperative CT in treatment position on precision and accuracy...
June 6, 2018: Acta Oncologica
Kyle R Padgett, Garrett N Simpson, Ricardo Llorente, Michael A Samuels, Nesrin Dogan
Online adaptive radiotherapy (ART) with frequent imaging has the potential to improve dosimetric accuracy by accounting for anatomical and functional changes during the course of radiotherapy. Presented are three interesting cases that provide an assessment of online adaptive magnetic resonance-guided radiotherapy (MRgRT) for lung stereotactic body radiotherapy (SBRT). The study includes three lung SBRT cases, treated on an MRgRT system where MR images were acquired for planning and prior to each treatment fraction...
April 4, 2018: Curēus
Willem Grootjans, Lioe-Fee de Geus-Oei, Johan Bussink
With a worldwide annual incidence of 1.8 million cases, lung cancer is the most diagnosed form of cancer in men and the second most diagnosed form of cancer in women. Histologically, 80-85% of all lung cancers can be categorized as non-small cell lung cancer (NSCLC). For patients with locally advanced NSCLC, standard of care is fractionated radiotherapy combined with chemotherapy. With the aim of improving clinical outcome of patients with locally advanced NSCLC, combined and intensified treatment approaches are increasingly being used...
June 4, 2018: Quarterly Journal of Nuclear Medicine and Molecular Imaging
Philippe Bulens, Melissa Thomas, Christophe M Deroose, Karin Haustermans
Radiotherapy is the standard of care in the multimodality treatment of a variety of gastrointestinal (GI) tumours, such as oesophageal cancer, gastric cancer, rectal cancer and anal cancer. Additionally, radiotherapy has served as an alternative for surgery in patients with liver cancer, cancer of the biliary tract and pancreatic cancer. Positron-emission tomography (PET), generally in combination with computed tomography (CT), has an established role in the diagnosis, response assessment and (re-)staging of several GI tumours...
June 4, 2018: Quarterly Journal of Nuclear Medicine and Molecular Imaging
Bettina Beuthien-Baumann, Stefan A Koerber
The integration of data from positron-emission-tomography, combined with computed tomography as PET/CT or combined with magnet resonance imaging as PET/MRI, into radiation treatment planning of prostate cancer is gaining higher impact with the development of more sensitive and specific radioligands. The classic PET-tracer for prostate cancer imaging are [11C]choline and [11C]acetate, which are currently outperformed by ligands binding to the prostate-specific- membrane-antigen (PSMA). [68Ga]PSMA-11, which is the most frequently applied tracer, has shown to detect lymph node metastases, local recurrences, distant metastases and intraprostatic foci with high sensitivity, even at relatively low PSA levels...
June 4, 2018: Quarterly Journal of Nuclear Medicine and Molecular Imaging
T P Hellebust
Imaging has probably been the most important driving force for the development of brachytherapy treatments the last 20 years. Due to implementation of three-dimensional imaging, brachytherapy is nowadays a highly accurate and reliable treatment option for many cancer patients. To be able to optimize the dose distribution in brachytherapy the anatomy and the applicator(s) or sources should be correctly localised in the images. For computed tomography (CT) the later criteria is easily fulfilled for most brachytherapy sites...
May 29, 2018: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
An-Chuan Li, Ying-Ying Zhang, Chi Zhang, De-Sheng Wang, Ben-Hua Xu
INTRODUCTION: The clinical target volume (CTV) delineation is crucial for tumour control and normal tissue protection. This study investigated the contralateral extension of nasopharyngeal carcinoma (NPC) in patients with a clinically diagnosed unilateral tumour to pursue the possibility of CTV reduction. METHODS: Twenty NPC patients with localized tumours confined to only one side of the nasopharynx as shown by magnetic resonance imaging and fibreoptic endoscopy were selected for biopsy...
May 28, 2018: Journal of Medical Imaging and Radiation Oncology
Raphael Jakubovic, Mark Ruschin, Chia-Lin Tseng, Ana Pejovic-Milic, Arjun Sahgal, Victor X D Yang
BACKGROUND: The clinical paradigm for spinal tumors with epidural involvement is challenging considering the rigid dose tolerance of the spinal cord. One effective approach involves open surgery for tumor resection, followed by stereotactic body radiotherapy (SBRT). Resection extent is often determined by the neurosurgeon's clinical expertise, without considering optimal subsequent post-operative SBRT treatment. OBJECTIVE: To quantify the effect of incremental epidural disease resection on tumor coverage for spine SBRT in an effort to working towards integrating radiotherapy planning within the operating room...
May 15, 2018: Neurosurgery
Helena Sandström, Hidefumi Jokura, Caroline Chung, Iuliana Toma-Dasu
BACKGROUND: Although accurate delineation of the target is a key factor of success in radiosurgery there are no consensus guidelines for target contouring. AIM: The aim of the present study was therefore to quantify the variability in target delineation and discuss the potential clinical implications, for six targets regarded as common in stereotactic radiosurgery. MATERIAL AND METHODS: Twelve Gamma Knife centers participated in the study by contouring the targets and organs at risks and performing the treatment plans...
May 22, 2018: Acta Oncologica
I Fumagalli, C Haie-Méder, C Chargari
Brachytherapy has known major improvements in recent decades. It represents an essential component of local treatment of cervix cancers. One major breakthrough was the advent of 3D imaging for image-guided brachytherapy. Doses could be prescribed to volumes. This allows better delineation and coverage of target volumes, as well as organs at risk (bladder, rectum, sigmoid) protection. Local recurrences have been consequently reduced and survival has been improved. In addition, improvement and development of new applicators have facilitated the delivery of interstitial treatments...
May 15, 2018: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
Yujiao Li, Xiaomin Ou, Chunying Shen, Tingting Xu, Weiwei Li, Chaosu Hu
Background: To demonstrate the robustness of clinical target volume delineation for nasopharyngeal carcinoma (NPC) patients, this study makes a detailed analysis of the initial irradiated dose of the recurrent site and local failure patterns after intensity-modulated radiation therapy (IMRT). Based on this analysis, further improvement of delineation recommendations may be made in order to improve the quality-of-life in NPC, without decreasing the local control and survival rate. Methods: In total, 382 newly diagnosed non-metastatic NPC patients were retrospectively enrolled, receiving elective neck irradiation to levels II, III, and VA...
2018: OncoTargets and Therapy
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