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Image Guided Radiotherapy

A Zechner, M Stock, D Kellner, I Ziegler, P Keuschnigg, P Huber, U Mayer, F Sedlmayer, H Deutschmann, P Steininger
Image guidance during highly conformal radiotherapy requires accurate geometric calibration of the moving components of the imager. Due to limited manufacturing accuracy and gravity-induced flex, an x-ray imager's deviation from the nominal geometrical definition has to be corrected for. For this purpose a ball bearing phantom applicable for nine degrees of freedom (9-DOF) calibration of a novel cone-beam computed tomography (CBCT) scanner was designed and validated. In order to ensure accurate automated marker detection, as many uniformly distributed markers as possible should be used with a minimum projected inter-marker distance of 10 mm...
November 21, 2016: Physics in Medicine and Biology
Marc Jansen, Sophie Em Veldhuijzen van Zanten, Dannis G Van Vuurden, Marc Huisman, Danielle J Vugts, Otto S Hoekstra, Guus A M S van Dongen, Gert-Jan Jl Kaspers
: Predictive tools to guide therapy in children with brain tumors are urgently needed. We introduced molecular imaging to facilitate this. We investigated whether bevacizumab can reach the tumor in children with diffuse intrinsic pontine glioma (DIPG) by measuring the tumor uptake of zirconium-89((89)Zr)-labeled bevacizumab by PET. In addition we evaluated the safety of the procedure in children and determined the optimal timing of imaging. METHODS: Patients received 0...
October 20, 2016: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
S Tonoli, D Alterio, O Caspiani, A Bacigalupo, F Bunkheila, M Cianciulli, A Merlotti, A Podhradska, M Rampino, D Cante, L Bruschieri, R Gatta, S M Magrini
PURPOSE: To evaluate the outcomes with respect to long-term survival and toxicity in patients with nasopharyngeal carcinoma (NPC) treated in a European country with low incidence. MATERIALS AND METHODS: A prospective observational study carried out by the AIRO Head and Neck group in 12 Italian institutions included 136 consecutive patients treated with radiotherapy (RT) ± chemotherapy (CHT) for NPC (without distant metastasis) between January 1, 2008 and December 31, 2010...
October 19, 2016: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
Matthew P Deek, Sinae Kim, Ning Yue, Rekha Baby, Inaya Ahmed, Wei Zou, John Langenfeld, Joseph Aisner, Salma K Jabbour
BACKGROUND: To investigate the impact of advances in image-guided radiotherapy (IGRT) on the outcomes of patients with non-small cell lung cancer (NSCLC) treated with chemoradiation therapy (CRT). METHODS: We retrospectively reviewed 91 patients with NSCLC treated with definitive CRT using image guidance with daily orthogonal kilovoltage (kV) imaging compared to standard weekly megavoltage (MV) portal verifications. Kaplan-Meier curves for overall survival and locoregional failure were computed and stratified by image guidance techniques...
September 2016: Journal of Thoracic Disease
Eric Vigneault, Khaly Mbodji, Louis-Gabriel Racine, Eric Chevrette, Marie-Claude Lavallée, André-Guy Martin, Philippe Després, Luc Beaulieu
PURPOSE: To evaluate the long-term outcomes of image-guided high-dose-rate (HDR) brachytherapy boost to the dominant intraprostatic lesion (DIL) using multiparametric magnetic resonance imaging (MRI), including spectroscopy (MRI/magnetic resonance spectroscopy [MRS]). METHODS AND MATERIALS: Between December 2009 and March 2011, 20 patients with intermediate-risk prostate cancer underwent multiparametric MRI/MRS protocol before treatment. All patients were treated with an external beam radiotherapy dose of 40 Gy, combined with an HDR brachytherapy boost of 15 Gy...
October 12, 2016: Brachytherapy
C Gzell, M Back, H Wheeler, D Bailey, M Foote
The aim of this review is to explore the changing utility of radiotherapy in the treatment of patients with glioblastoma over the past 60 years. Together with surgery, radiotherapy has always been the cornerstone of treatment of glioblastoma, but techniques have significantly advanced over this time. The exploration of early two-dimensional techniques, investigation of dose escalation, concomitant chemotherapy and modern techniques, including intensity-modulated radiotherapy, image-guided radiotherapy, and volumetric-modulated arc therapy will be covered...
October 13, 2016: Clinical Oncology: a Journal of the Royal College of Radiologists
Chun-Ming Huang, Ming-Yii Huang, Hsiang-Lin Tsai, Ching-Wen Huang, Cheng-Jen Ma, Chih-Hung Lin, Chih-Jen Huang, Jaw-Yuan Wang
The aim of the study was to compare clinical outcomes and toxicity between 3D conformal radiotherapy (3DCRT) and image-guided intensity-modulated radiotherapy (IG-IMRT) administered through helical tomotherapy in locally advanced rectal cancer (LARC) patients receiving preoperative chemoradiotherapy. We reviewed 144 patients with Stage II-III rectal cancer receiving preoperative fluoropyrimidine-based chemoradiotherapy followed by radical resection. Tumor responses following chemoradiotherapy were evaluated using the Dworak tumor regression grade (TRG)...
October 13, 2016: Journal of Radiation Research
Yeon-Joo Kim, Joo-Young Kim, Youngkyong Kim, Young Kyung Lim, Jonghwi Jeong, Chiyoung Jeong, Meyoung Kim, Myong Cheol Lim, Sang-Soo Seo, Sang-Yoon Park
OBJECTIVE: The purpose of this work was to identify prognostic factors for survival after magnetic resonance image (MRI)-guided brachytherapy combined with external beam radiotherapy for cervical cancer. MATERIAL AND METHODS: External beam radiotherapy of 45-50.4 Gy was delivered by either three-dimensional conformal radiotherapy or helical tomotherapy. Patients also received high-dose-rate MRI-guided brachytherapy of 5 Gy in 6 fractions. RESULTS: We analyzed 128 patients with International Federation of Gynecology and Obstetrics stage IB-IVB cervical cancer who underwent MRI-guided brachytherapy...
October 12, 2016: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
Berna A Yildirim, Cem Onal, Yemliha Dolek
PURPOSE: To compare soft-tissue cone-beam computed tomography (CBCT-P) and fiducial marker (CBCT-FM)-based image guided radiotherapy in prostate cancer patients. MATERIALS AND METHODS: Sixteen prostate cancer patients were treated with volumetric modulated arc therapy. Manual alignment using CBCT-P and CBCT-FM was performed for each patient. Couch shifts were calculated and compared between methods in the left-right (x), superior-inferior (y), and anterior-posterior (z) directions...
October 11, 2016: Japanese Journal of Radiology
R Boissier, C Udrescu, X Rebillard, J E Terrier, A Faix, O Chapet, D Azria, M Devonec, P Paparel, A Ruffion
OBJECTIVE: To describe a technique combining the implantation of fiducials and a prostatic spacer (hyaluronic acid (HA)) to decrease the rectal toxicity after an image-guided EBRT with hypofractionation for prostate cancer and to assess the tolerance and the learning curve of the procedure. MATERIAL & METHOD: Thirty patients with prostate cancer at low or intermediate risk were included in a phase II trial: image-guided EBRT of 62Gy in 20 fractions of 3.1Gy with intensity-modulated radiotherapy (IMRT)...
October 7, 2016: Urology
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
Mirjana Josipovic, Gitte F Persson, Jens Peter Bangsgaard, Lena Specht, Marianne C Aznar
OBJECTIVES: We investigated the impact of deep inspiration breath-hold (DIBH) and tumour baseline shifts on image quality and registration uncertainty in image guided DIBH radiotherapy for locally advanced lung cancer. METHODS: Patients treated with daily cone beam CT (CBCT) guided free-breathing (FB) radiotherapy had an additional CBCT in DIBH at three fractions. These CBCTs were off-line rigidly registered (on tumour) to FB and DIBH CTs acquired at planning. All registrations were repeated to evaluate the intra-observer uncertainty...
October 6, 2016: British Journal of Radiology
Karen Moore, Claire Paterson, Jonathan Hicks, Stephen Harrow, Mark McJury
OBJECTIVES: A clinical evaluation of the intrafraction and interfraction set up accuracy of a novel thermoplastic mould immobilisation device and patient position in early stage lung cancer being treated with stereotactic radiotherapy at the Beatson West of Scotland Cancer Centre. METHODS: 35 patients were immobilised in a novel, arms-down position, with a 4 point Klarity clear thermoplastic mould fixed to a SinMed head and neck board. A knee support was also used for patient comfort and support...
October 6, 2016: British Journal of Radiology
Juan-Francisco Calvo-Ortega, Sandra Moragues, Miquel Pozo, Joan Casals
AIM: To investigate the viability of placing the treatment isocenter at the patient midline for breast cancer radiotherapy in order to avoid the risk of collisions during image-guided setup and treatment delivery. BACKGROUND: The use of kilovoltage orthogonal setup images has spread in last years in breast radiotherapy. There is a potential risk of an imaging system-patient collision when the isocenter is laterally placed. MATERIALS AND METHODS: Twenty IMRT plans designed by placing the isocenter within the breast volume ("plan_ref"), were retrospectively replanned by shifting the isocenter at the patient's midline ("plan_off-breast")...
November 2016: Reports of Practical Oncology and Radiotherapy
Chia-Chin Li, Chih-Yi Chen, Chun-Ru Chien
BACKGROUND: Although concurrent chemoradiotherapy (CCRT) coupled with image-guided radiotherapy (IGRT) is associated with a theoretical benefit in non-operated localized esophageal squamous cell carcinoma (NOL-ESCC) patients, there is currently no clinical evidence to support this. RESULTS: The study population in the primary analysis comprised 866 patients who were well balanced in terms of their co-variables. The HR for mortality when group A was compared with group B was 0...
September 26, 2016: Oncotarget
Jeffrey Barber, Jonathan R Sykes, Lois Holloway, David I Thwaites
A series of phantom images using the CIRS Virtual Human Male Pelvis was acquired across available dose ranges for three image-guided radiotherapy (IGRT) imaging systems: Elekta XVI CBCT, Varian TrueBeam CBCT, and TomoTherapy MV CT. Each image was registered to a fan-beam CT within the XVI software 100 times with random initial offsets. The residual registration error was analyzed to assess the role of imaging hardware and reconstruction in the uncertainty of the IGRT process. Residual translation errors were similar for all systems and < 0...
2016: Journal of Applied Clinical Medical Physics
Prabhjot Juneja, Vincent Caillet, Tom Shaw, Judith Martland, Jeremy T Booth
This study presents estimation of typical kV fluoroscopic imaging doses for image-guided real-time adaptive radiotherapy. For a cohort of 10 lung SABR patients the estimated imaging dose to ipsi-lateral lung with real-time adaptation is 9.9-15.1cGy, which is less than the extra lung dose from treatment with potentially larger ITV-based PTV approach.
September 20, 2016: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Zulma Tovar-Spinoza, Hoon Choi
BACKGROUND: Pediatric low-grade gliomas (LGGs) account for approximately half of all pediatric central nervous system tumors. The low-grade gliomas' first line of treatment is gross total resection. However, when gross total resection is not possible, options for adjuvant therapy are limited. MRI-guided laser ablation (magnetic resonance-guided laser interstitial thermal therapy (MRgLITT)) offers a new option for treatment in selected cases. We present a description of the current MRgLITT technology and an exemplary case-series review of our experience in its use in LGGs...
October 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Selcuk Demiral, Ferrat Dincoglan, Omer Sager, Hakan Gamsiz, Bora Uysal, Esin Gundem, Yelda Elcim, Bahar Dirican, Murat Beyzadeoglu
PURPOSE: While microsurgical resection plays a central role in the management of ACMs, extensive surgery may be associated with substantial morbidity particularly for tumors in intimate association with critical structures. In this study, we evaluated the use of HFSRT in the management of ACM. MATERIALS AND METHODS: A total of 22 patients with ACM were treated using HFSRT. Frameless image guided volumetric modulated arc therapy (VMAT) was performed with a 6 MV linear accelerator (LINAC)...
September 22, 2016: Japanese Journal of Radiology
Gareth C Livingston, Andrew J Last, Thomas P Shakespeare, Patrick M Dwyer, Justin Westhuyzen, Michael J McKay, Lisa Connors, Stephanie Leader, Stuart Greenham
INTRODUCTION: For patients receiving radiotherapy for locally advance non-small cell lung cancer (NSCLC), the probability of experiencing severe radiation pneumonitis (RP) appears to rise with an increase in radiation received by the lungs. Intensity modulated radiotherapy (IMRT) provides the ability to reduce planned doses to healthy organs at risk (OAR) and can potentially reduce treatment-related side effects. This study reports toxicity outcomes and provides a dosimetric comparison with three-dimensional conformal radiotherapy (3DCRT)...
September 2016: Journal of Medical Radiation Sciences
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