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Image Guided Radiotherapy

Bastien Rigaud, Antoine Simon, Maxime Gobeli, Caroline Lafond, Julie Leseur, Anais Barateau, Nicolas Jaksic, Joël Castelli, Danièle Williaume, Pascal Haigron, Renaud De Crevoisier
PURPOSE: In the context of adaptive radiation therapy (ART) for locally advanced cervical carcinoma (LACC), this study proposed an original cone-beam computed tomography (CBCT)-guided "Evolutive library" and evaluated it against four other known radiotherapy (RT) strategies. MATERIAL AND METHODS: For 20 patients who underwent intensity-modulated radiation therapy (IMRT) for LACC, three planning CTs (with empty [EB], intermediate [IB], and full [FB] bladder volumes), a CT scan at 20 Gy and bi-weekly CBCTs for 5 weeks were performed...
February 17, 2018: Medical Physics
Berardino De Bari, Laëtitia Lestrade, Alessandra Franzetti-Pellanda, Raphael Jumeau, Maira Biggiogero, Melpomeni Kountouri, Oscar Matzinger, Raymond Miralbell, Jean Bourhis, Mahmut Ozsahin, Thomas Zilli
PURPOSE: To report outcomes of a population of anal cancer patients treated with modern intensity-modulated radiotherapy and daily image-guided radiotherapy techniques. METHODS: We analyzed data of 155 patients consecutively treated with intensity-modulated radiotherapy +/- chemotherapy in three radiotherapy departments. One hundred twenty-two patients presented a stage II-IIIA disease. Chemotherapy was administered in 138 patients, mainly using mitomycin C and 5-fluorouracil (n = 81)...
February 13, 2018: Journal of Cancer Research and Clinical Oncology
Ramin Jaberi, Zahra Siavashpour, Mahmoud Reza Aghamiri, Christian Kirisits, Reza Ghaderi
Purpose: Intra-fractional organs at risk (OARs) deformations can lead to dose variation during image-guided adaptive brachytherapy (IGABT). The aim of this study was to modify the final accepted brachytherapy treatment plan to dosimetrically compensate for these intra-fractional organs-applicators position variations and, at the same time, fulfilling the dosimetric criteria. Material and methods: Thirty patients with locally advanced cervical cancer, after external beam radiotherapy (EBRT) of 45-50 Gy over five to six weeks with concomitant weekly chemotherapy, and qualified for intracavitary high-dose-rate (HDR) brachytherapy with tandem-ovoid applicators were selected for this study...
December 2017: Journal of Contemporary Brachytherapy
Seo Hee Choi, Jinsil Seong
With increasing clinical use, radiotherapy (RT) has been considered reliable and effective method for hepatocellular carcinoma (HCC) treatment, depending on extent of disease and patient characteristics. RT for HCC can improve therapeutic outcomes through excellent local control, downstaging, conversion from unresectable to resectable status, and treatments of unresectable HCCs with vessel invasion or multiple intrahepatic metastases. In addition, further development of modern RT technologies, including image-guided radiotherapy (IGRT), intensity-modulated radiotherapy (IMRT), and stereotactic body radiotherapy, has expanded the indication of RT...
February 14, 2018: Clinical and Molecular Hepatology
Shyam Kishore Shrivastava, Shirley Lewis, Supriya Chopra Sastri, G Lavanya, Umesh Mahantshetty, Reena Engineer
Carcinoma cervix is a common cancer among Indian women. Evidence based management is essential for best practice in treatment of carcinoma cervix for its effective control. The current imaging system like CT, MRI and PET CT scans have contributed in identifying the patients for optimal treatment and delivering treatment accurately. For stages IB2 to IV, concurrent chemoradiation is advocated with improvement in overall survival proven with randomized trials. Brachytherapy is an integral part in the radiation treatment...
January 12, 2018: Current Problems in Cancer
Chiara Paganelli, Danny Lee, John Kipritidis, Brendan Whelan, Peter B Greer, Guido Baroni, Marco Riboldi, Paul Keall
INTRODUCTION: In-room MRI is a promising image guidance strategy in external beam radiotherapy to acquire volumetric information for moving targets. However, limitations in spatio-temporal resolution led several authors to use 2D orthogonal images for guidance. The aim of this work is to present a method to concurrently compensate for non-rigid tumour motion and provide an approach for 3D reconstruction from 2D orthogonal cine-MRI slices for MRI-guided treatments. METHODS: Free-breathing sagittal/coronal interleaved 2D cine-MRI were acquired in addition to a pre-treatment 3D volume in two patients...
February 11, 2018: Journal of Medical Imaging and Radiation Oncology
Manuel Blessing, Anna Arns, Hansjoerg Wertz, Dzmitry Stsepankou, Judit Boda-Heggemann, Juergen Hesser, Frederik Wenz, Frank Lohr
PURPOSE: To establish a fully automated kV-MV CBCT imaging method on a clinical linear accelerator that allows image acquisition of thoracic targets for patient positioning within one breath-hold (∼15s) under realistic clinical conditions. METHODS AND MATERIALS: Our previously developed FPGA-based hardware unit which allows synchronized kV-MV CBCT projection acquisition is connected to a clinical linear accelerator system via a multi-pin switch; i.e. either kV-MV imaging or conventional clinical mode can be selected...
February 8, 2018: Zeitschrift Für Medizinische Physik
Paul J Keall, Doan Trang Nguyen, Ricky O'Brien, Vincent Caillet, Emily Hewson, Per Rugaard Poulsen, Regina Bromley, Linda Bell, Thomas Eade, Andrew Kneebone, Jarad Martin, Jeremy T Booth
PURPOSE: Until now, real-time image guided adaptive radiation therapy (IGART) has been the domain of dedicated cancer radiotherapy systems. The purpose of this study was to clinically implement and investigate real-time IGART using a standard linear accelerator. MATERIALS/METHODS: We developed and implemented two real-time technologies for standard linear accelerators: (1) Kilovoltage Intrafraction Monitoring (KIM) that finds the target and (2) multileaf collimator (MLC) tracking that aligns the radiation beam to the target...
February 7, 2018: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Andres Huertas, Isabelle Dumas, Alexandre Escande, Eleonor Rivin Del Campo, Tony Felefly, Charles-Henri Canova, Anne Tailleur, Sebastien Gouy, Enrica Bentivegna, Philippe Morice, Christine Haie-Meder, Cyrus Chargari, Renaud Mazeron
PURPOSE: Primary vaginal cancer is a rare disease for which treatment has been modeled based on cervical cancer. We report our experience in the use of image-guided adaptive brachytherapy (IGABT) in this indication. METHODS AND MATERIALS: Patients treated for vaginal cancer with a combination of external beam radiation therapy and IGABT were identified through electronic search. The Groupe Européen de Curiethérapie-European Society for Radiotherapy and Oncology recommendations for cervical cancer have been extrapolated with the definition of two clinical target volumes (CTVs) corresponding to the residual disease after external beam radiation therapy (CTV BT ), assessed from clinical and imaging findings, and the so-called CTV i , comprising the CTV BT with directional margins and at least the initial disease at diagnosis...
February 6, 2018: Brachytherapy
Mireille Conrad, Grégory Bolard, Marie Nowak, Berardino De Bari, Wendy Jeanneret-Sozzi, Jean Bourhis, Jean-François Germond, François Bochud, Raphaël Moeckli
PURPOSE: Image guided radiotherapy (IGRT) improves patient positioning for treatment delivery at the cost of an additional dose. This work aimed to calculate the effective dose (as an indicator of dose) for head & neck (H&N) and breast IGRT treatments by implementing dose calculation models to determine the dose distributions. METHODS: The kV dose-models were created for the IGRT systems of Elekta Synergy (XVI) and Varian Clinac (OBI) linear accelerators within Philips Pinnacle TPS...
February 6, 2018: Zeitschrift Für Medizinische Physik
Cynthia Ménard, Eric Paulson, Tufve Nyholm, Patrick McLaughlin, Gary Liney, Piet Dirix, Uulke A van der Heide
The use of prostate MR imaging in radiotherapy continues to evolve. This article describes its current application in the selection of treatment regimens, integration in treatment planning or simulation, and assessment of response. An expert consensus statement from the annual MR in RT symposium is presented, as a list of 21 key quality indicators for the practice of MR imaging simulation in prostate cancer. Although imaging requirements generally follow PIRADSv2 guidelines, additional requirements specific to radiotherapy planning are described...
March 2018: Radiologic Clinics of North America
Ayman Oweida, Siham Sabri, Areej Al-Rabea, Mojgan Ebrahimi, Russel Ruo, Richard Fraser, Jan Seuntjens, Bassam Abdulkarim
Stereotactic ablative radiotherapy (SABR) is the main treatment for inoperable early-stage non-small cell lung cancer (NSCLC). Despite the widespread use of SABR, the biological determinants of response to SABR remain poorly investigated. We developed an orthotopic NSCLC animal model to study the response to clinically-relevant doses of SABR. Image-guided intra-thoracic injection of NSCLC cells was performed in the right lung of nude rats. A highly conformal dose of 34 Gy was delivered in a single fraction using clinical photon energies...
January 5, 2018: Oncotarget
Jaegi Lee, Sung-Joon Ye
Magnetic resonance imaging-guided radiotherapy provides real-time imaging with a superior soft-tissue contrast without radiation exposure. Recently, several groups have been developing such a new technology. Strong magnetic fields can influence trajectories of the secondary electrons by the Lorentz force. The reference dosimetry using an ion-chamber in magnetic fields needs additional correction factors [1]. In this study, we calculated magnetic field correction factors by the Monte Carlo method for the reference dosimetry using a parallel-plate ion-chamber...
January 2018: Physica Medica: PM
Hiroshi Doi, Shogo Harui, Hiroki Nakajima, Akira Ando, Keiji Kamino, Masayuki Fujiwara, Takayoshi Nakajima, Shinichi Ikura, Tsukasa Aihara, Naoki Yamanaka
A 0.5%-iron-containing fiducial marker, Gold AnchorTM (Naslund Medical AB, Huddinge, Sweden), has been recently developed. Herein, we report our initial experiences with the clinical use of the Gold AnchorTM (GA) in radiotherapy for liver tumors. Data of four consecutive patients with liver tumors, including two liver metastases and two hepatocellular carcinomas, were retrospectively analyzed. The GA was percutaneously placed under local anesthesia, close to the tumor. Gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging (MRI) was performed after the placement of the GA...
December 1, 2017: Curēus
Hanne Tøndel, Jo-Åsmund Lund, Stian Lydersen, Anne D Wanderås, Bjørg Aksnessæther, Christer Andre Jensen, Stein Kaasa, Arne Solberg
BACKGROUND: Novel cancer drugs are subject to strict scientific evaluation of safety and efficacy and usually undergo a cost effectiveness analysis before approval for use in clinical practice. For new techniques in radiotherapy (RT) such as image-guided radiotherapy (IGRT), this is often not the case. We performed a randomized controlled trial to compare daily cone beam computer tomography (CBCT) IGRT with reduced planning target volume (PTV) margins vs weekly orthogonal portal imaging with conventional PTV margins...
February 2, 2018: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Mikiko Yamashita, Ryo Takahashi, Masaki Kokubo, Kenji Takayama, Hiroaki Tanabe, Masaki Sueoka, Masao Ishii, Hidenobu Tachibana
Dose verification for a gimbal-mounted image-guided radiotherapy system, Vero4DRT (Mitsubishi Heavy Industries Ltd., Tokyo, Japan) is usually carried out by pretreatment measurement. Independent verification calculations using Monte Carlo methods for Vero4DRT have been published. As the Clarkson method is faster and easier to use than measurement and Monte Carlo methods, we evaluated the accuracy of an independent calculation verification program and its feasibility as a secondary check for Vero4DRT. Computed tomography (CT)-based dose calculation was performed using a modified Clarkson-based algorithm...
January 25, 2018: Medical Dosimetry: Official Journal of the American Association of Medical Dosimetrists
Panayiotis Mavroidis, Kevin A Pearlstein, John Dooley, Jasmine Sun, Srinivas Saripalli, Shiva K Das, Andrew Z Wang, Ronald C Chen
BACKGROUND: To estimate the radiobiological parameters of three popular normal tissue complication probability (NTCP) models, which describe the dose-response relations of bladder regarding different acute urinary symptoms during post-prostatectomy radiotherapy (RT). To evaluate the goodness-of-fit and the correlation of those models with those symptoms. METHODS: Ninety-three consecutive patients treated from 2010 to 2015 with post-prostatectomy image-guided intensity modulated radiotherapy (IMRT) were included in this study...
February 2, 2018: Radiation Oncology
Julian Emmerich, Frederik B Laun, Asja Pfaffenberger, Rebecca Schilling, Michael Denoix, Florian Maier, Florian Sterzing, Tilman Bostel, Sina Straub
PURPOSE: To investigate the extent of MR image distortions in the pelvis caused by susceptibility-induced field inhomogeneities in MR images in the context of a study on MR-guided radiotherapy. METHODS: Using a high-bandwidth double-echo gradient echo sequence, field maps and distortion maps of the pelvis were calculated and evaluated for 219 exams (92 of female and 127 of male patients) to investigate patient-related image distortions caused by susceptibility differences in an ongoing study on MR-guided radiotherapy...
February 2, 2018: Medical Physics
Corrinne J Brooks, Laurence Bernier, Vibeke N Hansen, Diana M Tait
OBJECTIVE: Literature regarding image-guidance and interfractional motion of the anal canal (AC) during anal cancer radiotherapy is sparse. This study investigates interfractional AC motion during anal cancer radiotherapy. METHODS: Bone matched cone-beam computed tomography (CBCT) images were acquired for 20 patients receiving anal cancer radiotherapy allowing population systematic and random error calculations. 12 were selected to investigate interfractional AC motion...
February 2, 2018: British Journal of Radiology
Constantin Dreher, Markus Oechsner, Michael Mayinger, Stefanie Beierl, Marciana-Nona Duma, Stephanie E Combs, Daniel Habermehl
BACKGROUND: The purpose of this study is to evaluate the tumor movement and accuracy of patient immobilization in stereotactic body radiotherapy of liver tumors with low pressure foil or abdominal compression. METHODS: Fifty-four liver tumors treated with stereotactic body radiotherapy were included in this study. Forty patients were immobilized by a vacuum couch with low pressure foil, 14 patients by abdominal compression. We evaluated the ratio of gross tumor volume/internal target volume, the tumor movement in 4D-computed tomography scans and daily online adjustments after cone beam computed tomography scans...
January 30, 2018: Radiation Oncology
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