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PURPOSE/OBJECTIVE(S): MR-guided SBRT with a 1.5 T MR-Linac is a relatively new therapy for pancreatic tumors with varying expertise levels. Moreover, treatment planning in the upper abdomen can be challenging as target coverage is often compromised by dosimetric constraints of abutting bowel structures. This may lead to large differences between centers in protocols, practices. To increase harmonization a worldwide consortium was founded among 1.5 T MR-Linac users. In this work we report on the outcome of the first phase within this collaboration, which is the assessment of the baseline variation between the treatment planning protocols and subsequent dose distributions...

PURPOSE/OBJECTIVE(S): This study evaluates a novel non-metallic (plastic) dual port expander and clinically utilized single/dual port metallic expanders for intensity modulated proton therapy (IMPT) in order to quantify the dosimetric implications in clinical treatment plans. MATERIALS/METHODS: Four previously treated breast cancer patients (3 left sided, 1 right sided) with tissue expanders were retrospectively planned for IMPT utilizing a treatment planning system...

PURPOSE/OBJECTIVE(S): The lack of recommendation on Linac-based stereotactic radiosurgery (SRS) and radiotherapy (SRT) plan quality for multi-lesion brain metastasis results in planning heterogeneity. The use of MLCs in the delivery is expected to add extra leakage when multi-lesions are treated simultaneously, and no recommendations availability in literature. We aimed to identify conformality indices and plan objectives that would guide multi-brain metastasis SRS & SRT MATERIALS/METHODS: We performed a retrospective analysis of clinically accepted brain metastasis radiotherapy plans treated using SRS and SRT at our department...

PURPOSE: We aimed to describe the association between trigeminal nerve (TN) dose and toxicity and determine a threshold value that leads to TN toxicity in patients with parotid tumors treated with adjuvant conventional fractionated radiation therapy. METHODS AND MATERIALS: Eighteen patients who underwent adjuvant radiotherapy (RT) between 2013 and 2018 were included in this retrospective study. TN and its branches were outlined subsequently on the planning CT scans...

PURPOSE: There is no evidence-based data to guide dose constraints in two-fraction prostate stereotactic ablative radiotherapy (SABR). Using individual patient-data from two prospective trials, we aimed to correlate dosimetric parameters with toxicities and quality of life (QoL) outcomes. MATERIALS AND METHODS: We included 60 patients who had two-fraction prostate SABR in the 2STAR (NCT02031328) and 2SMART (NCT03588819) trials. The prescribed dose was 26Gy to the prostate+/-32Gy boost to the dominant intraprostatic lesions...

Introduction：Tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) is considered to be an effective apoptosis inducer due to its selectivity for tumor cells. However, many cancer cells, especially metastatic cancer cells, often exhibit resistance to TRAIL because their apoptotic pathway is impaired or their pro-survival pathway is overactivated. TRAIL-resistance is the main obstacle to current TRAIL therapy. Nowadays, ceramide analogues represent a new class of potential anticancer agents. Therefore, we hypothesized that disrupting pro-survival signaling with ceramide analogues would increase TRAIL-mediated apoptosis...

Diabetes mellitus (DM) is a collection of metabolic illnesses known as chronic hyperglycaemia. It is one of the most common chronic diseases caused by insulin functions or secretions deficiency, which may cause carbohydrate and lipoprotein metabolism to be disrupted. The pituitary-gonadal axis malfunctions, testicular tissue dysfunctions and poor quality of sperms are all symptoms of DM, which is one of the most common causes of reproductive abnormalities. The current study has been designed to demonstrate the impacts of treatment with Ginseng oil oxidative stress-induced physiological and histological alterations in the male reproductive system of rats with subcutaneous (s/c) injection alloxan...

The National Institute on Aging-Alzheimer's Association's research framework in 2018 proposed a molecular construct for the diagnosis of Alzheimer's disease (AD). Nonetheless, the clinical exclusionary strategy is still the mainstay of AD diagnosis in Pakistan. We looked at the plasma levels of amyloid beta-42 (Aβ-42), phosphorylated tau (P-tau), and neurofilament light (NFL) in patients with Alzheimer's clinical syndrome (ACS) and healthy controls (HC) from the Pakistani population to keep pace with the global efforts towards establishing accessible and affordable biochemical diagnostic markers for AD in Pakistan...

PURPOSE: This study assesses the impact of intra-fraction motion and PTV margin size on target coverage for patients undergoing radiation treatment of pelvic oligometastases. Dosimetric sparing of the bowel as a function of the PTV margin is also evaluated. MATERIALS AND METHODS: Seven patients with pelvic oligometastases previously treated on our MR-linac (35 Gy in 5 fractions) were included in this study. Retrospective adaptive plans were created for each fraction on the daily MRI datasets using PTV margins of 5 mm, 3 mm, and 2 mm...

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OBJECTIVE: To evaluate the change in prostate volume (PV) and relationship to improvement in urinary symptom scores following Rezūm therapy. METHODS: Quality of life outcomes and PV were assessed at baseline and 12months postprocedure. Percent change from baseline in outcomes and PV were calculated, as was the number of Rezum injection to baseline PV ratio. Association between total number of injections and changes in outcomes and PV were evaluated using linear regression models...

Daily precipitation extremes are projected to intensify with increasing moisture under global warming following the Clausius-Clapeyron (CC) relationship at about [Formula: see text]. However, this increase is not spatially homogeneous. Projections in individual models exhibit regions with substantially larger increases than expected from the CC scaling. Here, we leverage theory and observations of the form of the precipitation probability distribution to substantially improve intermodel agreement in the medium to high precipitation intensity regime, and to interpret projected changes in frequency in the Coupled Model Intercomparison Project Phase 6...

PURPOSE: To understand how thyroid eye disease (TED) impacts buccal fat pad (BFP) volume. METHODS: In this cohort study, computed tomography (CT) scans and charts of adult patients with and without TED were obtained from an institutional database. The primary outcome was BFP volume in cubic centimeters. Three independent, blinded observers analyzed scans using Horos, a free, open-source medical image viewing software. Bivariate and multivariable analyses were performed...

BACKGROUND: Rectal artesunate (RAS) is a World Health Organization (WHO) recommended intervention that can save lives of children 6 years and younger suffering from severe malaria and living in remote areas. Access to RAS and a referral system that ensures continuity of care remains a challenge in low resource countries, raising concerns around the value of this intervention. The objective of this study was to inform RAS programming, using practical tools to enhance severe malaria continuum of care when encountered at community level...

PURPOSE: To compare the rectal and bladder doses using two different vaginal packing techniques among uterine cervical cancer patients receiving high-dose-rate (HDR) intracavitary brachytherapy (ICBT). MATERIAL AND METHODS: Forty-five patients with cervical cancer were randomized to receive two sessions of ICBT using tandem and ring applicator (Varian© ), following completion of pelvic external beam radiotherapy treatment. The procedure was performed with vaginal balloon plus gauze packing or vaginal gauze packing alone, each of which was used in one of two sessions...

OBJECTIVE: Online adaptive radiotherapy has demonstrated improved dose conformality in response to inter-fraction geometric variations in the abdomen. The dosimetric impact of Intra-fractional variations in anatomic configuration resulting from breathing, gastric contraction and slow configuration motion, however, have been largely ignored, leading to differences between delivered and planned dose. To investigate the impact of intra-fractional abdominal motions on delivered dose, anatomical deformations due to these three motion modes were extracted from dynamic MRI data using a previously developed hierarchical motion modeling methodology...

OBJECTIVES: Implement scripted automatic breast planning (AP) for breast techniques within Raystation. METHODS: Manual plans (MP) were re-planned and compared with AP plans for whole breast (WB), partial breast (PB), hybrid VMAT SIB and VMAT nodal plans. RESULTS: WB AP plans took 7 min comparing well to MP. One WB AP failed a mandatory dose constraint. Small statistically significant differences showed improved coverage for AP at expense of slightly hotter plans, however absolute differences were small (mean differences < 1% or D 0...

PURPOSE/OBJECTIVE: The purpose of the study is to externally validate published 18 F-FDG-PET radiomic models for outcome prediction in patients with oropharyngeal cancer treated with chemoradiotherapy. MATERIAL/METHODS: Outcome data and pre-radiotherapy PET images of 100 oropharyngeal cancer patients (stage IV:78) treated with concomitant chemotherapy to 66-69 Gy/30 fr were available. Tumors were segmented using a previously validated semi-automatic method; 450 radiomic features (RF) were extracted according to IBSI (Image Biomarker Standardization Initiative) guidelines...

PURPOSE: The virtual cone has been previously introduced as a novel technique for generating small, spherical dose distributions using a high-definition multileaf collimator (MLC) for functional radiosurgery applications. There has been no reported investigation into adapting this technique to a standard MLC for the treatment of solitary intracranial metastases as an alternative to physical stereotactic cones. This study characterizes the virtual cone technique adapted to a standard 5 mm leaf-width MLC (VCSD )...

BACKGROUND: This study investigates the impact of dosimetric parameters on acute and late toxicity for patients with anal squamous cell carcinoma (SCC) treated with image-guided intensity modulated radiation therapy (IG-IMRT) and concurrent chemotherapy. MATERIALS AND METHODS: Patients were enrolled in an observational cohort study between 2008 and 2013 (median follow-up 3.4 years). They were treated with standardized target and organ-at-risk (OAR) contouring, planning, and IG-IMRT...