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Luca Monaco, Chiara Biagi, Valentino Conti, Mauro Melis, Monia Donati, Mauro Venegoni, Alberto Vaccheri, Domenico Motola
AIM: Direct oral anticoagulants (DOACs) have shown non-inferiority to warfarin for stroke prevention in non-valvular atrial fibrillation (AF) and a more promising safety profile. Unanswered safety aspects remain to addressed and available evidence on the risk associated with these drugs are conflicting. In order to contribute to the debate on their safety profile, we conducted a comparative analysis of the reports of suspected adverse drug reactions (ADRs) associated with DOACs in VigiBase...
January 10, 2017: British Journal of Clinical Pharmacology
Michele Correale, Giovanna Elisiana Carpagnano, Natale Daniele Brunetti, Lucia Forte, Ilenia Monaco, Armando Ferraretti, Roberto Sabato, Maria Pia Foschino Barbaro, Matteo Di Biase, Donato Lacedonia
No abstract text is available yet for this article.
December 27, 2016: International Journal of Cardiology
R Garrett Morgan, Massimo Venturelli, Cole Gross, Cantor Tarperi, Federico Schena, Carlo Reggiani, Fabio Naro, Anna Pedrinolla, Lucia Monaco, Russell S Richardson, Anthony J Donato
BACKGROUND: ALU element instability could contribute to gene function variance in aging, and may partly explain variation in human lifespan. OBJECTIVE: To assess the role of ALU element instability in human aging and the potential efficacy of ALU element content as a marker of biological aging and survival. DESIGN: Preliminary cohort study. METHODS: We measured two high frequency ALU element subfamilies, ALU-J and ALU-Sx, by a single qPCR assay and compared ALU-J/Sx content in white blood cell (WBCs) and skeletal muscle cell (SMCs) biopsies from twenty-three elderly adults with sixteen healthy sex-balanced young adults; all-cause survival rates of elderly adults predicted by ALU-J/Sx content in both tissues; and cardiovascular disease (CVD)- and cancer-specific survival rates of elderly adults predicted by ALU-J/Sx content in both tissues, as planned subgroup analyses...
2017: PloS One
D Winkel, G H Bol, B van Asselen, J Hes, V Scholten, Lgw Kerkmeijer, B W Raaymakers
PURPOSE: To develop an automated radiotherapy treatment planning and optimization workflow for prostate cancer in order to generate clinical treatment plans. METHODS: A fully automated radiotherapy treatment planning and optimization workflow was developed based on the treatment planning system Monaco (Elekta AB, Stockholm, Sweden). To evaluate our method, a retrospective planning study (n=100) was performed on patients treated for prostate cancer with 5 field intensity modulated radiotherapy, receiving a dose of 35×2Gy to the prostate and vesicles and a simultaneous integrated boost of 35×0...
June 2016: Medical Physics
R Leung, M Wong, V Lee, S Cheung, K Lee, G Law, M Chan
PURPOSE: To evaluate the use of measurement guided dose reconstruction (MGDR) in quality assurance (QA) of stereotactic radiosurgery (SRS) of multiple brain metastases (MBM) planned with single isocenter (SI). METHODS: Seven clinically approved multi-isocenter MBM (MI-MBM) plans were re-optimized using SI (SI-MBM) by coplanar volumetric arc therapy (VMAT) in Monaco v5.0 (Elekta CMS, Maryland Heights, MO, USA). These plans were delivered on an Elekta Agiltiy Linac and measured by OCTAVIUS 4D system with OCTAVIUS 1500 2D array (PTW, Freiburg, Germany)...
June 2016: Medical Physics
J E Roring, A Alexandrian, N Papanikolaou, S Stathakis
PURPOSE: There is a variety of treatment planning systems (TPS) available for clinical use all with highly variable settings to calculate patient dose. Patient specific IMRT QA is often a daily procedure at most clinics and each clinic devises their own policy on the TPS settings for testing the quality of the patient plan against a measured dose on IMRT QA phantoms. With this in mind, it is the aim of this study to evaluate the effect of dose calculation parameters on IMRT QA. METHODS: Six patient plans were optimized and calculated using Pinnacle(3) (v9...
June 2016: Medical Physics
D Manigandan, M Kumar, P Mohandas, A Puri, N Bhalla
PURPOSE: Validation of iBEAM™ evo couch-top for different relative electron density (RED) combination during photon beam dose calculation in Monaco- TPS. METHODS: The iBEAM™ evo couch-top has two layers:outer carbon fiber (CF) and inner foam core (FC). To study the beam intensity attenuation of couch-top, measured doses were compared with doses calculated for different REDs. Measurements were performed in solid water phantom with PTW-0.125cc ion-chamber positioned at center of the phantom with 5...
June 2016: Medical Physics
D Manigandan, M Kumar, P Mohandas, A Puri, N Bhalla
PURPOSE: To study the impact of different photon beam combination during VMAT planning and treatment delivery. METHODS: Five prostate patients with no nodal involvement were chosen for the study and only prostate was considered as target (7920cGy/44fractions). In each case, three different VMAT plans were generated with two arcs (200°-160°&160°-200°). First plan used only 6MV in both arcs (6X-6X) and second utilized 6MV&15MV (6X-15X), whereas third one used 15MV&15MV (15X-15X)...
June 2016: Medical Physics
D Saenz, S Stathakis
PURPOSE: Deep inspiration breath-hold (DIBH) is used for left-sided breast radiotherapy to spare the heart and lung. The magnitude of sparing has been shown to be significant. Monte Carlo, furthermore, has the potential to calculate most accurately the dose in the heterogeneous lung medium at the interface with the lung wall. The lung dose was investigated in Monaco to determine the level of sparing relative to that calculated in Pinnacle(3) . METHODS: Five patients undergoing DIBH radiotherapy on an Elekta Versa HD linear accelerator in conjunction with the Catalyst C-RAD surface imaging system were planned using Phillips Pinnacle(3) ...
June 2016: Medical Physics
S Gholampourkashi, J E Cygler, J Belec, M Vujicic, Heath
PURPOSE: To validate 4D Monte Carlo (MC) simulations of dose delivery by an Elekta Agility linear accelerator to a moving phantom. METHODS: Monte Carlo simulations were performed using the 4DdefDOSXYZnrc/EGSnrc user code which samples a new geometry for each incident particle and calculates the dose in a continuously moving anatomy. A Quasar respiratory motion phantom with a lung insert containing a 3 cm diameter tumor was used for dose measurements on an Elekta Agility linac with the phantom in stationary and moving states...
June 2016: Medical Physics
T C F van Heijst, N Hoekstra, M E P Philippens, D Eschbach, J J W Lagendijk, H J G D van den Bongard, B van Asselen
PURPOSE: The Utrecht MRI-linac (MRL) design enables new MR-guided radiotherapy (RT) approaches. This is a feasibility study for a single-fraction high dose (boost) to individual lymph nodes (LNs) in breast-cancer patients, after breast-conserving surgery (BCS) and hypofractionated whole-breast irradiation (WBI) with conventional axillary RT (AxRT). METHODS: After written informed consent, 5 breast-cancer patients (cT1-3N0) were enrolled (NL500460.041.14 trial) and underwent 1...
June 2016: Medical Physics
N Miri, J Lehmann, P Vial, P Greer
PURPOSE: We propose a novel dosimetric audit method for clinical trials using EPID measurements at each center and a standardized EPID to dose conversion algorithm. The aim of this work is to investigate the applicability of the EPID method to different linear accelerator, EPID and treatment planning system (TPS) combinations. METHODS: Combination of delivery and planning systems were three Varian linacs including one Pinnacle and two Eclipse TPS and, two ELEKTA linacs including one Pinnacle and one Monaco TPS...
June 2016: Medical Physics
K Jassal, B Sarkar, T Ganesh, H Kaur, U Giri, B Mohanti, A Munshi
PURPOSE: The study investigates the effect of fluence smoothing parameter on VMAT plans for ten head-neck cancer patients using Monaco5.00.04. METHODS: VMAT plans were created using Monaco5.00.04 planning system for 10 head-neck patients. Four plans were generated for each patient using available smoothing parameters i.e. high, medium, low and off. The number of monitor units required to deliver 1 cGy was defined as a modulation degree; and was taken as a measure of plan complexity...
June 2016: Medical Physics
J Duan
PURPOSE: The aim of this work is to study the dosimetric impact of leaf interdigitation in prostate cancer dynamic IMRT treatment planning. METHODS: Fifteen previously treated prostate cancer patients were replanned for dynamic IMRT (dMLC) with and without leaf interdigitation using Monaco 3.3 TPS on the Elekta Synergy linear accelerator. The prescription dose of PTV was 70Gy/35 fractions. Various dosimetric variables, such as PTV coverage, OAR sparing, delivery efficiency and optimization time, were evaluated for each plan...
June 2016: Medical Physics
B Tuazon, P Mavroidis, N Papanikolaou, S Stathakis
PURPOSE: The purpose of this study was to evaluate, compare and investigate the differences of SBRT treatment plans on dose calculation and plan metrics between Pinnacle and Monaco treatment planning systems (TPS). METHODS: 14 previously treated patients' files were exported from the Pinnacle treatment planning system to Monaco. All of the treatment plans were created in Pinnacle and delivered on a Varian Novalis with the HD120 multi-leaf collimator. The plans were recalculated within Monaco using a Monte-Carlo algorithm...
June 2016: Medical Physics
A Molineu, S Kry, P Alvarez, N Hernandez, T Nguyen, D Followill
PURPOSE: To report the results of SRS phantom irradiations METHODS: Anthropomorphic SRS head phantoms were sent to institutions participating in NCI sponsored SRS clinical trials and institutions interested in verifying SRS treatment delivery. The phantom shell was purchased from Phantom Laboratory and altered to house dosimetry and imaging inserts. The imaging insert has 1.9 cm diameter spherical target. The dosimetry insert holds two TLD capsules and radiochromic film in the coronal and sagittal planes through the center of the target...
June 2016: Medical Physics
R Qiu, A Vassil, A Godley
PURPOSE: Prostate treatment with volumetric-modulated arc therapy (VMAT) in conjunction with small PTV margins, allows the dose to the rectum and bladder to be minimized, at the potential cost of prostate coverage. Coverage can be restored by online adaptive planning. Here, the deformed planning dose is used as the goal for adaptive plan optimization. METHODS: 9 prostate patients with CT-on-Rails (CTOR) imaging were replanned using Monaco (Elekta AB, Stockholm, Sweden) with 2 VMAT arcs, and 70 Gy to 95% of the PTV...
June 2016: Medical Physics
R Zhang, W Bai
PURPOSE: Because of statistical noise in Monte Carlo dose calculations, effective point doses may not be accurate. Volume spheres are useful for evaluating dose in Monte Carlo plans, which have an inherent statistical uncertainty.We use a user-defined sphere volume instead of a point, take sphere sampling around effective point make the dose statistics to decrease the stochastic errors. METHODS: Direct dose measurements were made using a 0.125cc Semiflex ion chamber (IC) 31010 isocentrically placed in the center of a homogeneous Cylindric sliced RW3 phantom (PTW, Germany)...
June 2016: Medical Physics
N Karthikeyan, K M Ganesh, R Sambasivaselli, V Senniandavar, Jain Sandeep
PURPOSE: To validate the Monaco montecorlo beam model for a range of small field in the heterogeneous medium. METHODS: A in-house phantom with three different medium of Foam, PMMA and derlin resembling the densities of lung, soft tissue, and bone was used for the study. The field sizes of 8, 16, 24, 32 and 48mm were studied for the validation of montecarlo algorithm using 0.01cc volume ionchamber and gafchromic films. The 6MV photon beam from Elekta Beam modulator was used with 100cm SAD setup...
June 2016: Medical Physics
S Lim-Reinders, B Keller, C McCann, A Sahgal, J Lee, A Kim
PURPOSE: Hypofractionated partial breast irradiation (HPBI) is being used at our clinic to treat inoperable breast cancer patients who have advanced disease. We are investigating how these patients could benefit from being treated in an MRI-linac, where real-time daily MRI tumor imaging and plan adaptation would be possible. As a first step, this study evaluates the dosimetric impact of the magnetic field for different radiation beam geometries on relevant OARs. METHODS: Five patients previously treated using HPBI were selected...
June 2016: Medical Physics
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