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Lung volume reduction

Jessica L Conway, Leigh Conroy, Lindsay Harper, Marie Scheifele, Haocheng Li, Wendy L Smith, Tannis Graham, Tien Phan, Ivo A Olivotto
PURPOSE: The goal of the work described here was to determine whether deep inspiration breath-hold (DIBH) produces a clinically meaningful reduction in pulmonary dose compared with free breathing (FB) during locoregional radiation for right-sided breast cancer. METHODS AND MATERIALS: Four-field, modified-wide tangent plans with full nodal coverage were developed for 30 consecutive patients on paired DIBH and FB CT scans. Nodes were contoured according to European Society for Radiotherapy and Oncology guidelines...
October 19, 2016: Practical Radiation Oncology
Márcio V F Donadio, João P Heinzmann-Filho, Fernanda M Vendrusculo, Patrícia X H Frasson, Paulo J C Marostica
OBJECTIVE: To evaluate the association of 6-minute walk test (6MWT) and other variables (anthropometry, chronic Pseudomonas aeroginosa colonization, pulmonary function, and respiratory muscle strength) with the risk of hospitalization for pulmonary exacerbation in children and adolescents with cystic fibrosis (CF). STUDY DESIGN: Cohort study that included patients with CF aged 6-18 years. All participants underwent spirometry, manovacuometry, and 6MWT during the 5-year follow-up...
January 10, 2017: Journal of Pediatrics
Kathrin Kahnert, Tanja Lucke, Frank Biertz, Andreas Lechner, Henrik Watz, Peter Alter, Robert Bals, Jürgen Behr, Rolf Holle, Rudolf M Huber, Stefan Karrasch, Beate Stubbe, Margarethe Wacker, Sandra Söhler, Emiel F M Wouters, Claus Vogelmeier, Rudolf A Jörres
BACKGROUND: An impairment of CO diffusing capacity has been shown in diabetic patients without lung disease. We analyzed how diffusing capacity in patients with COPD is affected by the concurrent diagnosis of diabetes. METHODS: Data from the initial visit of the German COPD cohort COSYCONET were used for analysis. 2575 patients with complete lung function data were included, among them 358 defined as diabetics with a reported physician diagnosis of diabetes and/or specific medication...
January 13, 2017: Respiratory Research
Wendy Harris, You Zhang, Fang-Fang Yin, Lei Ren
PURPOSE: To investigate the feasibility of using structural-based principal component analysis (PCA) motion-modeling and weighted free-form deformation to estimate on-board 4D-CBCT using prior information and extremely limited angle projections for potential 4D target verification of lung radiotherapy. METHODS: A technique for lung 4D-CBCT reconstruction has been previously developed using a deformation field map (DFM)-based strategy. In the previous method, each phase of the 4D-CBCT was generated by deforming a prior CT volume...
January 12, 2017: Medical Physics
Louise Rose, Neill Kj Adhikari, David Leasa, Dean A Fergusson, Douglas McKim
BACKGROUND: There are various reasons why weaning and extubation failure occur, but ineffective cough and secretion retention can play a significant role. Cough augmentation techniques, such as lung volume recruitment or manually- and mechanically-assisted cough, are used to prevent and manage respiratory complications associated with chronic conditions, particularly neuromuscular disease, and may improve short- and long-term outcomes for people with acute respiratory failure. However, the role of cough augmentation to facilitate extubation and prevent post-extubation respiratory failure is unclear...
January 11, 2017: Cochrane Database of Systematic Reviews
Hualiang Zhong, Salim Siddiqui, Benjamin Movsas, Indrin Chetty
The purpose of this study was to develop metrics to evaluate uncertainties in deformable dose accumulation (DDA) for patients with non-small cell lung cancer (NSCLC). Initial treatment plans (primary) and cone-beam CT (CBCT) images were retrospectively processed for seven NSCLC patients, who showed significant tumor regression during the course of treatment. Each plan was developed with IMRT for 2 Gy��33 fractions. A B-spline-based DIR algorithm was used to register weekly CBCT images to a reference image acquired at fraction 21 and the resultant displacement vector fields (DVFs) were then modified using a finite element method (FEM)...
January 10, 2017: Physics in Medicine and Biology
M Fast, C Kamerling, S Crijns, M Menten, S Nill, B Raaymakers, U Oelfke
PURPOSE: In tracked dynamic multi-leaf collimator (MLC) treatments, segments are continuously adapted to the target centroid motion in beams-eye-view. On-the-fly segment adaptation, however, potentially induces dosimetric errors due to the finite MLC leaf width and non-rigid target motion. In this study, we outline a novel tool for computing the 4d dose of lung SBRT plans delivered with MLC tracking. METHODS: The following automated workflow was developed: A) centroid tracking, where the initial segments are morphed to each 4dCT phase based on the beams-eye-view GTV shift (followed by a dose calculation on each phase); B) re-optimized tracking, in which all morphed initial plans from (A) are further optimised ("warm-started") in each 4dCT phase using the initial optimisation parameters but phase-specific volume definitions...
June 2016: Medical Physics
S Lee, Y Zheng, D Albani, V Colussi, J Dorth, J Sohn
PURPOSE: To reduce internal target volume (ITV), respiratory management is a must in imaging and treatment for lung, liver, and breast cancers. We investigated the dosimetric accuracy of VMAT treatment delivery with a Response™ gating system linked to linear accelerator. METHODS: The Response™ gating module designed to directly control radiation beam by breath-holding with a ABC system (Elekta AB, Stockholm, Sweden) was tested for VMAT treatments. Seven VMAT plans including three conventional and four stereotactic body radiotherapy (SBRT) cases were evaluated...
June 2016: Medical Physics
J Paul, E Gore, X Li
PURPOSE: Tumor treatment response may potentially be assessed during radiation therapy (RT) by analyzing changes in CT-textures. We investigated the different early RT-responses between small cell (SCLC) and non-small cell lung cancer (NSCLC) as assessed by CT-texture. METHODS: Daily diagnostic-quality CT acquired during routine CT-guided RT using a CT-on-Rails for 13-NSCLC and 5-SCLC patients were analyzed. These patient had ages ranging from 45-78 and 38-63 years, respectively, for NSCLC and SCLC groups, and tumor-stages ranging from T2-T4, and were treated with either RT or chemotherapy and RT with 45-66Gy/ 20-34 fractions...
June 2016: Medical Physics
Y Feng
PURPOSE: To spare normal tissue by reducing the location uncertainty of a moving target, we proposed an ultra-high dose rate system and evaluated. METHODS: High energy electrons generated with a linear accelerator were injected into a storage ring to be accumulated. The number of the electrons in the ring was determined based on the prescribed radiation dose. The dose was delivered within a millisecond, when an online imaging system found that the target was in the position that was consistent with that in a treatment plan...
June 2016: Medical Physics
Dominic DiCostanzo, Christian L Barney, Jose G Bazan
PURPOSE: Recent clinical studies have shown a correlation between radiation dose to the thoracic vertebral bodies (TVB) and the development of hematologic toxicity (HT) in patients receiving chemoradiation (CRT) for lung cancer (LuCa). The feasibility of a bone-marrow sparing (BMS) approach in this group of patients is unknown. We hypothesized that radiation dose to the TVB can be reduced with an intensity modulated radiation therapy(IMRT)/volumetric modulated arc radiotherapy(VMAT) without affecting plan quality...
June 2016: Medical Physics
R Badkul, D Pokhrel, T Ramanjappa, H Jiang, C Lominska, F Wang
PURPOSE: Intra-fractional tumor motion due to respiration may potentially compromise dose delivery for SBRT of lung tumors. Even sufficient margins are used to ensure there is no geometric miss of target volume, there is potential dose blurring effect may present due to motion and could impact the tumor coverage if motions are larger. In this study we investigated dose blurring effect of open fields as well as Lung SBRT patients planned using 2 non-coplanar dynamic conformal arcs(NCDCA) and few conformal beams(CB) calculated with Monte Carlo (MC) based algorithm utilizing phantom with 2D-diode array(MapCheck) and ion-chamber...
June 2016: Medical Physics
D Mohatt, H Malhotra
PURPOSE: Conventional treatment plans for lung radiotherapy are created using either the free breathing (FB) scheme which represents the tumor at an arbitrary breathing phase of the patient's respiratory cycle, or the average computed tomography (ACT) intensity projection over 10-binned phases. Neither method is entirely accurate because of the absence of time dependence of tumor movement. In the present "Hybrid" method, the HU of tumor in 3D space is determined by relative weighting of the HU of the tumor and lung in proportion to the time they spend at that location during the entire breathing cycle...
June 2016: Medical Physics
X Liang, C Wang, Z Chang, F Yin, J Cai
PURPOSE: This study aims to develop a DIR error correction method capable of utilizing sparse ground-truth motion information and recovering missing data with the Kolmogorov-Zurbenko (KZ) filter. METHODS: The error correction method employs a two-step approach. First, sparse ground-truth displacement vectors are integrated into a pre-correction deformable vector field (DVF) to estimate a post-correction DVF with coarse resolution. Second, the coarse post-correction DVF is boosted to a full-resolution DVF through convolution with the KZ filter...
June 2016: Medical Physics
Q Liang, P Shah, S Li, C Miyamoto
PURPOSE: To investigate the feasibility of applying ALARA principles to current treatment planning CT scans. The study aims to quantitatively verify lower dose scans does not alter treatment planning. METHOD: Gammex 467 tissue characterization phantom with inserts of 14 different materials was scanned at seven different mA levels (30∼300 mA). CT numbers of different inserts were measured. Auto contouring for bone and lung in treatment planning system (Pinnacle) was used to evaluate the effect of CT number accuracy from treatment planning aspect, on the 30 and 300 mA-scanned images...
June 2016: Medical Physics
S Al-Ward, A Kim, C McCann, M Ruschin, P Cheung, A Sahgal, B Keller
PURPOSE: To simulate tumor tracking in an Elekta MRI-linac (MRL) and to compare this tracking method with our current ITV approach in terms of OAR sparing for lung cancer patients. METHODS: Five SABR-NSCLC patients with central lung tumors were selected for reasons of potential enhancement of tumor-tissue delineation using MRI. The Monaco TPS was used to compare the current clinical ITV approach to a simulated, novel tracking method which used a 7MV MRL beam in the presence of an orthogonal 1...
June 2016: Medical Physics
Y Sheng, T Li, S Yoo, F Yin, R Blitzblau, J Horton, M Palta, C Hahn, Y Ge, Q Wu
PURPOSE: To enable near-real-time (<20sec) and interactive planning without compromising quality for whole breast RT treatment planning using tangential fields. METHODS: Whole breast RT plans from 20 patients treated with single energy (SE, 6MV, 10 patients) or mixed energy (ME, 6/15MV, 10 patients) were randomly selected for model training. Additional 20 cases were used as validation cohort. The planning process for a new case consists of three fully automated steps:1...
June 2016: Medical Physics
Y Qin, I Chetty
PURPOSE: To evaluate the dosimetric impact of target volume overrides on the quality of IMRT and VMAT lung, SBRT treatment plans. METHODS: Ninety one patients previously treated with lung SBRT at our institution were retrospectively studied. IMRT and VMAT plans were created on 5 image sets for each patient: free breathing scans(FB), average scans(AVE), average scan with internal target volume overridden to tumor density(ITVoverride), average scan with planning target volume overridden(PTVoverride), and a hybrid method where the internal target volume was set to tumor density and the set-up margin was set to an intermediate density between lung and tumor(HBoverride)...
June 2016: Medical Physics
N Cao, A Kalet, L Fang, C Dempsey, L Young, J Kim, N Mayr, M Lavilla, H Richardson, R McClure, J Meyer
PURPOSE: This retrospective study of left sided whole breast radiation therapy (RT) patients investigates possible predictive parameters correlating to cardiac and left lung dose sparing by deep inspiration breath-hold (DIBH) technique compared to free-breathing (FB). METHODS: Thirty-one patients having both DIBH and FB CT scans were included in the study. All patients were planned with a standard step-and-shoot tangential technique using MV photons, with prescription of 50Gy or 50...
June 2016: Medical Physics
Michael F Beers, Lars Knudsen, Yaniv Tomer, Julian Maronn, Ming Zhao, Matthias Ochs, Surafel Mulugeta
The lipid transporter, ATP binding cassette class A3 (ABCA3), plays a critical role in the biogenesis of alveolar type 2 (AT2) cell lamellar bodies (LBs). A relatively large number of mutations in the ABCA3 gene have been identified in association with diffuse parenchymal lung disease (DPLD), the most common of which is a missense mutation (valine substitution for lysine at residue 292 (ABCA3(E292V))) that leads to functional impairment of the transporter in vitro. The consequences of ABCA3(E292)(V) gene expression in vivo are unknown...
December 26, 2016: Annals of Anatomy, Anatomischer Anzeiger: Official Organ of the Anatomische Gesellschaft
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