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Contouring radiotherapy

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https://www.readbyqxmd.com/read/29123458/comparison-of-mri-sequences-in-ideal-fiducial-maker-based-radiotherapy-for-prostate-cancer
#1
Osamu Tanaka, Hisao Komeda, Mitsuyoshi Hattori, Shigeki Hirose, Eiichi Yama, Masayuki Matsuo
Aim: Prostate contouring using CT alone is difficult. To overcome the uncertainty, CT/MRI registration using a fiducial marker is generally performed. However, visualization of the marker itself can be difficult with MRI. This study aimed to determine the optimal MRI pulse sequence for defining the marker as well as the prostate outline among five sequences. Materials and methods: A total of 21 consecutive patients with prostate cancer were enrolled. Two gold fiducial markers were placed before CT/MRI examination...
November 2017: Reports of Practical Oncology and Radiotherapy
https://www.readbyqxmd.com/read/29123013/-68-ga-psma-pet-ct-mapping-of-prostate-cancer-biochemical-recurrence-following-radical-prostatectomy-in-270-patients-with-psa-1-0ng-ml-impact-on-salvage-radiotherapy-planning
#2
Jérémie Calais, Johannes Czernin, Minsong Cao, Amar U Kishan, John V Hegde, Narek Shaverdian, Kiri A Sandler, Fang-I Chu, Chris R King, Michael L Steinberg, Isabel Rausher, Nina-Sophie Schmidt-Hegemann, Thorsten Poeppel, Philipp Hetkamp, Francesco Ceci, Ken Herrmann, Wolfgang P Fendler, Matthias Eiber, Nicholas G Nickols
Background: Target volume delineations for prostate cancer (PCa) salvage radiotherapy (SRT) after radical prostatectomy are usually drawn in the absence of visibly recurrent disease. Gallium-68 Prostate Specific Membrane Antigen Positron Emission Tomography/Computed Tomography ((68)Ga-PSMA-11 PET/CT) detects recurrent PCa with sensitivity superior to standard of care imaging at serum prostate specific antigen (PSA) values low enough to impact target volume delineations for routine SRT. OBJECTIVE: To i) map the recurrence pattern of PCa early biochemical recurrence (BCR) after radical prostatectomy with (68)Ga-PSMA-11 PET/CT in patients with serum PSA levels <1 ng/ml, ii) determine how often consensus clinical target volumes (CTV) based on the Radiation Therapy Oncology Group (RTOG) guidelines cover (68)Ga-PSMA-11 PET/CT-defined disease, and iii) assess the potential impact of (68)Ga-PSMA-11 PET/CT on SRT...
November 9, 2017: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
https://www.readbyqxmd.com/read/29119677/minimal-mask-immobilization-with-optical-surface-guidance-for-head-and-neck-radiotherapy
#3
Bo Zhao, Genevieve Maquilan, Steve Jiang, David L Schwartz
PURPOSE: Full face and neck thermoplastic masks provide standard-of-care immobilization for patients receiving H&N IMRT. However, these masks are uncomfortable and increase skin dose. The purpose of this pilot trial was to investigate the feasibility and setup accuracy of minimal face and neck mask immobilization with optical surface guidance. METHODS: Twenty patients enrolled onto this IRB-approved protocol. Patients were immobilized with masks securing only forehead and chin...
November 9, 2017: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/29119069/targeting-the-tumor-assessing-the-impact-of-bladder-volume-and-position-on-accuracy-of-radiation-delivery-for-patients-with-bladder-cancer
#4
Andrew Kochan, Ryan Rivest, Katie Galloway, Pascal Lambert, Aldrich Ong, Rashmi Koul, Shahida Ahmed, Bashir Bashir, Harvey Quon
Context Daily variations in bladder size and position can negatively impact the ability to accurately deliver radiation. Aims We attempted to quantify how bladder volumes and positions change over the course of radiotherapy for muscle invasive bladder cancer and the planning target volume (PTV) margins required to account for such changes. Methods and material Cone-beam computed tomography (CT) images of 28 patients during their first, second, and third fractions and weekly thereafter were acquired. Bladders were contoured and the volume, centre of mass, and the maximal positions were recorded and compared to the planning CT scan...
September 1, 2017: Curēus
https://www.readbyqxmd.com/read/29104835/online-adaptive-radiation-therapy-implementation-of-a-new-process-of-care
#5
James Lamb, Minsong Cao, Amar Kishan, Nzhde Agazaryan, David H Thomas, Narek Shaverdian, Yingli Yang, Suzette Ray, Daniel A Low, Ann Raldow, Michael L Steinberg, Percy Lee
Onboard magnetic resonance imaging (MRI) guided radiotherapy is now clinically available in nine centers in the world. This technology has facilitated the clinical implementation of online adaptive radiotherapy (OART), or the ability to alter the daily treatment plan based on tumor and anatomical changes in real-time while the patient is on the treatment table. However, due to the time sensitive nature of OART, implementation in a large and busy clinic has many potential obstacles as well as patient-related safety considerations...
August 27, 2017: Curēus
https://www.readbyqxmd.com/read/29099727/supplemental-computational-phantoms-to-estimate-out-of-field-absorbed-dose-in-photon-radiotherapy
#6
Kyle Joseph Gallagher, Jaad Tannous, Racile Nabha, Joelle Ann Feghali, Zeina Ayoub, Wassim T Jalbout, Bassem Youssef, Phillip J Taddei
The purpose of this study was to develop a straightforward method of supplementing patient anatomy and estimating out-of-field absorbed dose for a cohort of pediatric radiotherapy patients with limited recorded anatomy. A cohort of nine children, aged 2 to 14 years, who received three-dimensional conformal radiotherapy for low grade localized brain tumors (LBTs), were randomly selected for this study. The extents of these patients' computed tomography simulation image sets were cranial only. To approximate their missing anatomy, we supplemented the LBT patients' image sets with computed tomography images of patients in a previous study with larger extents of matched sex, height, and mass and for whom contours of organs at risk for radiogenic cancer had already been delineated...
November 3, 2017: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/29097012/intensity-based-dual-model-method-for-generation-of-synthetic-ct-images-from-standard-t2-weighted-mr-images-generalized-technique-for-four-different-mr-scanners
#7
Lauri Koivula, Mika Kapanen, Tiina Seppälä, Juhani Collan, Jason A Dowling, Peter B Greer, Christian Gustafsson, Adalsteinn Gunnlaugsson, Lars E Olsson, Leonard Wee, Juha Korhonen
BACKGROUND AND PURPOSE: Recent studies have shown that it is possible to conduct entire radiotherapy treatment planning (RTP) workflow using only MR images. This study aims to develop a generalized intensity-based method to generate synthetic CT (sCT) images from standard T2-weighted (T2w) MR images of the pelvis. MATERIALS AND METHODS: This study developed a generalized dual model HU conversion method to convert standard T2w MR image intensity values to synthetic HU values, separately inside and outside of atlas-segmented bone volume contour...
October 30, 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/29096619/incorporating-18-fdg-pet-defined-pelvic-active-bone-marrow-in-the-automatic-treatment-planning-process-of-anal-cancer-patients-undergoing-chemo-radiation
#8
Pierfrancesco Franco, Christian Fiandra, Francesca Arcadipane, Elisabetta Trino, Francesca Romana Giglioli, Riccardo Ragona, Umberto Ricardi
BACKGROUND: To investigate whether the incorporation of (18)FDG-PET into the automatic treatment planning process may be able to decrease the dose to active bone marrow (BM) for locally advanced anal cancer patients undergoing concurrent chemo-radiation (CHT-RT). METHODS: Ten patients with locally advanced anal cancer were selected. Bone marrow within the pelvis was outlined as the whole outer contour of pelvic bones or employing (18)FDG-PET to identify active BM within osseous structures...
November 2, 2017: BMC Cancer
https://www.readbyqxmd.com/read/29076457/investigating-the-generalisation-of-an-atlas-based-synthetic-ct-algorithm-to-another-centre-and-mr-scanner-for-prostate-mr-only-radiotherapy
#9
Jonathan Wyatt, Jason A Dowling, Charles G Kelly, Jill McKenna, Emily Johnstone, Richard Speight, Ann Henry, Peter B Greer, Hazel Mhairi McCallum
There is increasing interest in MR-only radiotherapy planning since it provides superb soft-tissue contrast without the registration uncertainties inherent in a CT-MR registration. However MR images cannot readily provide the electron density information necessary for radiotherapy dose calculation. An algorithm which generates synthetic CT's for dose calculations from MR images of the prostate using an atlas of 3 T MR images has been previously reported by two of the authors. This paper aimed to evaluate this algorithm using MR data acquired at a different field strength and a different centre to the algorithm atlas...
October 27, 2017: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/29061455/epidermal-growth-factor-receptor-expression-predicts-time-and-patterns-of-recurrence-in-glioblastoma-patients-following-radiotherapy-and-temozolomide
#10
Paolo Tini, Valerio Nardone, Pierpaolo Pastina, Giuseppe Battaglia, Clelia Miracco, Salvatore Francesco Carbone, Lucio Sebaste, Giovanni Rubino, Alfonso Cerase, Luigi Pirtoli
BACKGROUND: and Purpose: The aim is to investigate the potential role of EGFR protein expression in predicting the modality of treatment failure in Glioblastoma (GB). MATERIAL AND METHOD: Patients with unifocal GB undergoing surgery and postoperative radio-chemotherapy (RT-TMZ) from February 2008 to July 2015 were included into the study. The EGFR protein expression level was assessed by immunohistochemistry in GB tissues and classified into High (H-EGFR) and Low (L-EGFR) expression...
October 20, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29050954/the-trendy-multi-center-randomized-trial-on-hepatocellular-carcinoma-trial-qa-including-automated-treatment-planning-and-benchmark-case-results
#11
Steven J M Habraken, Abdul Wahab M Sharfo, Jeroen Buijsen, Wilko F A R Verbakel, Cornelis J A Haasbeek, Michel C Öllers, Henrike Westerveld, Niek van Wieringen, Onne Reerink, Enrica Seravalli, Pètra M Braam, Markus Wendling, Thomas Lacornerie, Xavier Mirabel, Reinhilde Weytjens, Lieselotte Depuydt, Stephanie Tanadini-Lang, Oliver Riesterer, Karin Haustermans, Tom Depuydt, Roy S Dwarkasing, François E J A Willemssen, Ben J M Heijmen, Alejandra Méndez Romero
BACKGROUND AND PURPOSE: The TRENDY trial is an international multi-center phase-II study, randomizing hepatocellular carcinoma (HCC) patients between transarterial chemoembolization (TACE) and stereotactic body radiation therapy (SBRT) with a target dose of 48-54 Gy in six fractions. The radiotherapy quality assurance (QA) program, including prospective plan feedback based on automated treatment planning, is described and results are reported. MATERIALS AND METHODS: Scans of a single patient were used as a benchmark case...
October 16, 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/29029832/tumour-auto-contouring-on-2d-cine-mri-for-locally-advanced-lung-cancer-a-comparative-study
#12
Martin F Fast, Björn Eiben, Martin J Menten, Andreas Wetscherek, David J Hawkes, Jamie R McClelland, Uwe Oelfke
BACKGROUND AND PURPOSE: Radiotherapy guidance based on magnetic resonance imaging (MRI) is currently becoming a clinical reality. Fast 2d cine MRI sequences are expected to increase the precision of radiation delivery by facilitating tumour delineation during treatment. This study compares four auto-contouring algorithms for the task of delineating the primary tumour in six locally advanced (LA) lung cancer patients. MATERIAL AND METHODS: Twenty-two cine MRI sequences were acquired using either a balanced steady-state free precession or a spoiled gradient echo imaging technique...
October 10, 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/29019109/automatic-delineation-of-functional-lung-volumes-with-68-ga-ventilation-perfusion-pet-ct
#13
Pierre-Yves Le Roux, Shankar Siva, Jason Callahan, Yannis Claudic, David Bourhis, Daniel P Steinfort, Rodney J Hicks, Michael S Hofman
BACKGROUND: Functional volumes computed from (68)Ga-ventilation/perfusion (V/Q) PET/CT, which we have shown to correlate with pulmonary function test parameters (PFTs), have potential diagnostic utility in a variety of clinical applications, including radiotherapy planning. An automatic segmentation method would facilitate delineation of such volumes. The aim of this study was to develop an automated threshold-based approach to delineate functional volumes that best correlates with manual delineation...
October 10, 2017: EJNMMI Research
https://www.readbyqxmd.com/read/28993798/challenges-for-quality-assurance-of-target-volume-delineation-in-clinical-trials
#14
REVIEW
Amy Tien Yee Chang, Li Tee Tan, Simon Duke, Wai-Tong Ng
In recent years, new radiotherapy techniques have emerged that aim to improve treatment outcome and reduce toxicity. The standard method of evaluating such techniques is to conduct large scale multicenter clinical trials, often across continents. A major challenge for such trials is quality assurance to ensure consistency of treatment across all participating centers. Analyses from previous studies have shown that poor compliance and protocol violation have a significant adverse effect on treatment outcomes...
2017: Frontiers in Oncology
https://www.readbyqxmd.com/read/28988705/implementing-head-and-neck-contouring-peer-review-without-pathway-delay-the-on-demand-approach
#15
C Fong, P Sanghera, J Good, P Nightingale, A Hartley
AIMS: Peer review of contour volume is a priority in the radiotherapy treatment quality assurance process for head and neck cancer. It is essential that incorporation of peer review activity does not introduce additional delays. An on-demand peer review process was piloted to assess the feasibility and efficiency of this approach, as compared with a historic scheduled weekly approach. MATERIALS AND METHODS: Between November 2016 and April 2017 four head and neck clinicians in one centre took part in an on-demand peer review process...
October 5, 2017: Clinical Oncology: a Journal of the Royal College of Radiologists
https://www.readbyqxmd.com/read/28987748/consequences-of-introducing-geometric-gtv-to-ctv-margin-expansion-in-dahanca-contouring-guidelines-for-head-and-neck-radiotherapy
#16
Christian Rønn Hansen, Jørgen Johansen, Eva Samsøe, Elo Andersen, Jørgen B B Petersen, Kenneth Jensen, Lisbeth J Andersen, Hella M B Sand, Anders S Bertelsen, Cai Grau
BACKGROUND AND PURPOSE: Defining margins around the Gross Tumour Volume (GTV) to create a Clinical Target Volume (CTV) for head and neck cancer radiotherapy has traditionally been based on presumed knowledge of anatomical routes of spread. However, using a concentric geometric expansion around the GTV may be more reproducible. The purpose of this study was to analyse the inter-observer consistency of geometric CTV delineation with adaptation for anatomical boundaries versus anatomically defined CTVs...
October 4, 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/28963789/-18-f-fluoromisonidazole-positron-emission-tomography-ct-guided-volumetric-modulated-arc-therapy-based-dose-escalation-for-hypoxic-subvolume-in-nasopharyngeal-carcinomas-a-feasibility-study
#17
Jianjian Qiu, Bo Lv, Meina Fu, Xianglian Wang, Xiangpeng Zheng, Weihai Zhuo
BACKGROUND: The purpose of this study is to investigate the feasibility of a simultaneously integrated boost to the hypoxic subvolume of nasopharyngeal carcinomas (NCPs) under the guidance of (18) F-fluoromisonidazole (FMISO) positron emission tomography (PET)/CT using volumetric-modulated arc therapy (VMAT) and intensity-modulated radiotherapy (IMRT) techniques. METHODS: Eight patients with NPC were treated with simultaneous integrated boost-IMRT (treatment plan named IMRT70) with dose prescriptions of 70 Gy, 66 Gy, 60 Gy, and 54 Gy to the gross tumor volume (GTV), positive neck nodes, the planning target volume (PTV), and the clinically negative neck, respectively...
September 30, 2017: Head & Neck
https://www.readbyqxmd.com/read/28963779/automatic-segmentation-of-the-clinical-target-volume-and-organs-at-risk-in-the-planning-ct-for-rectal-cancer-using-deep-dilated-convolutional-neural-networks
#18
Kuo Men, Jianrong Dai, Yexiong Li
PURPOSE: Delineation of the clinical target volume (CTV) and organs at risk (OARs) is very important for radiotherapy but is time-consuming and prone to inter-observer variation. Here, we proposed a novel deep dilated convolutional neural network (DDCNN)-based method for fast and consistent auto-segmentation of these structures. METHODS: Our DDCNN method was an end-to-end architecture enabling fast training and testing. Specifically, it employed a novel multiple-scale convolutional architecture to extract multiple-scale context features in the early layers, which contain the original information on fine texture and boundaries and which are very useful for accurate auto-segmentation...
September 30, 2017: Medical Physics
https://www.readbyqxmd.com/read/28958472/evaluation-of-dose-recalculation-vs-dose-deformation-in-a-commercial-platform-for-deformable-image-registration-with-a-computational-phantom
#19
Marco Fusella, Francesca R Giglioli, Christian Fiandra, Riccardo Ragona
Deformable image registration (DIR) is an important tool for mapping both dose and contours of a new set of planning images when recurrent, that is, adaptive radiotherapy, or further treatment, that is, re-treatment, is required. The aim of this study was to evaluate the need for plan recalculation in deformed anatomies and to develop a reliable workflow for validating the DIR algorithm to be applied to dose warping such as dose accumulation (DA) for adaptive radiation therapy, and dose summation (DS) in the case of re-treatment...
September 25, 2017: Medical Dosimetry: Official Journal of the American Association of Medical Dosimetrists
https://www.readbyqxmd.com/read/28951754/assessing-dose-contribution-to-pelvic-lymph-nodes-in-intracavitary-brachytherapy-for-cervical-cancer
#20
Gail Wan Ying Chua, Yong Wee Foo, Guan Heng Tay, David Boon Harn Tan
PURPOSE: In radical radiotherapy for cervical cancer, high-dose-rate (HDR) brachytherapy is commonly used after external beam radiation therapy (EBRT) to deliver a cumulative EQD2 of 80 to 90 Gy to the primary tumor. However, there is less certainty regarding brachytherapy dose contribution to the pelvic lymph nodes. This poses a challenge as to how high a preceding EBRT dose should be prescribed to gross nodal disease, in order to achieve a cumulative tumoricidal effect. Hence, this study aims to quantify brachytherapy dose contribution to individual pelvic nodal groups, using computed tomography (CT) planning with the Manchester system...
August 2017: Journal of Contemporary Brachytherapy
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