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Contouring radiotherapy

Tejinder Kataria, Deepak Gupta, Shikha Goyal, Shyam Singh Bisht, Ravi Chaudhary, Kushal Narang, Susovan Banerjee, Trinanjan Basu, Ashu Abhishek, Sasikumar Sambasivam, Nisha T Vishnu
Stereotactic body radiotherapy (SBRT) is being increasingly utilized in the treatment of prostate cancer. With the advent of high precision radiosurgery systems, it is possible to obtain dose distributions akin to High Dose Rate (HDR) brachytherapy with SBRT. However, urethral toxicity has a significant impact on the quality of life in prostate cancer patients. Contouring the male urethra on a computed tomography scan is difficult in the absence of an indwelling catheter. In this pictorial essay, we have used the magnetic resonance imaging obtained for radiotherapy planning to aid in delineation of the male urethra and have attempted to define guidelines for the same...
October 17, 2016: British Journal of Radiology
R J Cassidy, X Yang, T Liu, M Thomas, S G Nour, A B Jani
PURPOSE: Sexual dysfunction after radiotherapy for prostate cancer remains an important late adverse toxicity. The neurovascular bundles (NVB) that lie posterolaterally to the prostate are typically spared during prostatectomy, but in traditional radiotherapy planning they are not contoured as an organ-at-risk with dose constraints. Our goal was to determine the dosimetric feasibility of "NVB-sparing" prostate radiotherapy while still delivering adequate dose to the prostate. METHODS: Twenty-five consecutive patients with prostate cancer (with no extraprostatic disease on pelvic magnetic resonance imaging [MRI]) who that were treated with external beam radiotherapy, with the same primary planning target volume margins, to a dose of 79...
October 13, 2016: Medical Dosimetry: Official Journal of the American Association of Medical Dosimetrists
Angela Botticella, Gilles Defraene, Kristiaan Nackaerts, Christophe M Deroose, Johan Coolen, Philippe Nafteux, Stephanie Peeters, Umberto Ricardi, Dirk De Ruysscher
BACKGROUND: The gross tumor volume (GTV) definition for malignant pleural mesothelioma (MPM) is ill-defined. We therefore investigated which imaging modality is optimal: computed tomography (CT) with intravenous contrast (IVC), positron emission tomography-CT (PET/CT) or magnetic resonance imaging (MRI). MATERIAL AND METHODS: Sixteen consecutive patients with untreated stage I-IV MPM were included. Patients with prior pleurodesis were excluded. CT with IVC, 18FDG-PET/CT and MRI (T2 and contrast-enhanced T1) were obtained...
October 12, 2016: Acta Oncologica
Shalini K Vinod, Michael G Jameson, Myo Min, Lois C Holloway
BACKGROUND AND PURPOSE: Volume delineation is a well-recognised potential source of error in radiotherapy. Whilst it is important to quantify the degree of interobserver variability (IOV) in volume delineation, the resulting impact on dosimetry and clinical outcomes is a more relevant endpoint. We performed a literature review of studies evaluating IOV in target volume and organ-at-risk (OAR) delineation in order to analyse these with respect to the metrics used, reporting of dosimetric consequences, and use of statistical tests...
October 8, 2016: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Luciana Lastrucci, Simona Borghesi, Silvia Bertocci, Chiara Gasperi, Andrea Rampini, Giovanna Buonfrate, Paola Pernici, Roberta De Majo, Pietro Giovanni Gennari
PURPOSE: To compare 3D-conformal radiotherapy (3D-CRT) treatment plans based on free-breathing (FB) and deep inspiration breath hold (DIBH) and investigated whether DIBH technique enables a decrease of cardiac left anterior descending coronary artery (LADCA) and lungs dose with respect to the FB. METHODS: Twenty-three left-sided breast cancer patients referred for breast radiotherapy were included. The planning target volume (PTV) encompassed the breast and organs at risk including heart, LADCA, lungs, and contralateral breast, which were contoured in FB and DIBH CT scans...
September 27, 2016: Tumori
Amir Shahram Yousefi Kashi, Samira Khaledi, Mohammad Houshyari
BACKGROUND: Radiotherapy is the gold standard for treatment of prostrate cancer as it can cover an adequate area of tissues at risk for metastasis. OBJECTIVES: We evaluated the Pelvic lymph node coverage of conventional radiotherapy fields based on bone and vessels landmarks using computed tomography (CT) simulation in patients with prostate cancer referred to Shohada-e-Tajrish hospital. PATIENTS AND METHODS: In this cross sectional study, 40 patients with prostate cancer at the Stage T1c to T3b were studied...
June 2016: Iranian Journal of Cancer Prevention
Gül Alço, Sefik Igdem, Sait Okkan, Maktav Dincer, Dauren Sarsenov, Ahmet Serkan Ilgun, Filiz Agacayak, Filiz Elbüken, Tulay Ercan, Derya Selamoglu, Vahit Ozmen
The aim of the present study was to evaluate the geographic variability of the tumor bed following oncoplastic breast-conserving surgery (OP-BCS), and to assess its relevance for radiotherapy planning. In this prospective study, pre- and postoperative computerized tomography (CT) scans of 22 patients with early-stage breast cancer were fused. The preoperative gross tumor volume or excisional biopsy cavity were contoured under the guidance of preoperative radiological images. Postoperative lumpectomy cavities were contoured under the guidance of surgical clips...
October 2016: Molecular and Clinical Oncology
Damodar Pokhrel, Sumit Sood, Christopher McClinton, Xinglei Shen, Christopher Lominska, Habeeb Saleh, Rajeev Badkul, Hongyu Jiang, Melissa Mitchell, Fen Wang
PURPOSE: To retrospectively evaluate the accuracy, plan quality and efficiency of intensity-modulated arc therapy (IMAT) for hippocampal sparing whole-brain radiotherapy (HS-WBRT) with simultaneous integrated boost (SIB) in patients with multiple brain metastases (m-BM). MATERIALS AND METHODS: A total of 5 patients with m-BM were retrospectively replanned for HS-WBRT with SIB using IMAT treatment planning. The hippocampus was contoured on diagnostic T1-weighted magnetic resonance imaging (MRI) which had been fused with the planning CT image set...
September 27, 2016: Medical Dosimetry: Official Journal of the American Association of Medical Dosimetrists
Sasikarn Chamchod, Clifton D Fuller, Abdallah S R Mohamed, Aaron Grossberg, Jay A Messer, Jolien Heukelom, G Brandon Gunn, Micheal E Kantor, Hillary Eichelberger, Adam S Garden, David I Rosenthal
OBJECTIVES: We undertook a challenge to determine if one or more height-weight formula(e) can be clinically used as a surrogate for direct CT-based imaging assessment of body composition before and after radiotherapy for head and neck cancer (HNC) patients, who are at risk for cancer- and therapy-associated cachexia/sarcopenia. MATERIALS AND METHODS: This retrospective single-institution study included 215 HNC patients, treated with curative radiotherapy between 2003 and 2013...
October 2016: Oral Oncology
Barbara Segedin, Primoz Petric
BACKGROUND: Modern radiotherapy techniques enable delivery of high doses to the target volume without escalating dose to organs at risk, offering the possibility of better local control while preserving good quality of life. Uncertainties in target volume delineation have been demonstrated for most tumour sites, and various studies indicate that inconsistencies in target volume delineation may be larger than errors in all other steps of the treatment planning and delivery process. The aim of this paper is to summarize the degree of delineation uncertainties for different tumour sites reported in the literature and review the effect of strategies to minimize them...
September 1, 2016: Radiology and Oncology
Tom Konert, Wouter V Vogel, Sarah Everitt, Michael P MacManus, Daniela Thorwarth, Elena Fidarova, Diana Paez, Jan-Jakob Sonke, Gerard G Hanna
BACKGROUND AND PURPOSE: To assess the impact of a standardized delineation protocol and training interventions on PET/CT-based target volume delineation (TVD) in NSCLC in a multicenter setting. MATERIAL AND METHODS: Over a one-year period, 11 pairs, comprised each of a radiation oncologist and nuclear medicine physician with limited experience in PET/CT-based TVD for NSCLC from nine different countries took part in a training program through an International Atomic Energy Agency (IAEA) study (NCT02247713)...
September 20, 2016: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Rodolfo Chicas-Sett, Francisco Celada-Alvarez, Susana Roldán, Asunción Torregrosa, Jesus Betancourt, Juan Bautista-Ballesteros, Dolores Farga, Blanca Ibañez, Alejandro Tormo, Jose Perez-Calatayud
PURPOSE: Groupe Européen de Curiethérapie (GEC) and European Society for Radiotherapy & Oncology (ESTRO) has proposed a rectal dose constraint of the most exposed 2-cc volume (D2cc of ≤ 75 Gy EQD2α/β = 3) during external-beam plus high-dose-rate brachytherapy (HDR-BT) in localized prostate cancer patients. This study aimed to evaluate D2cc for rectal contouring via interobserver variability. MATERIAL AND METHODS: Four blinded observers contoured rectums of 5 patients...
August 2016: Journal of Contemporary Brachytherapy
Lars König, Alexander Derksen, Nils Papenberg, Benjamin Haas
BACKGROUND: Deformable image registration (DIR) is a key component in many radiotherapy applications. However, often resulting deformations are not satisfying, since varying deformation properties of different anatomical regions are not considered. To improve the plausibility of DIR in adaptive radiotherapy in the male pelvic area, this work integrates a local rigidity deformation model into a DIR algorithm. METHODS: A DIR framework is extended by constraints, enforcing locally rigid deformation behavior for arbitrary delineated structures...
2016: Radiation Oncology
J Mackenzie, G Graham, I A Olivotto
AIMS: The Canadian Partnership for Quality Radiotherapy quality assurance guidelines recommend that radiation oncologist peer review of curative radiotherapy plans takes place ideally before the first fraction of treatment is delivered. This study documented and evaluated the outcomes of weekly, disease site-specific, radiotherapy peer review, quality assurance rounds at the Tom Baker Cancer Centre in Calgary, Canada with a view to making recommendations about the optimal timing and documentation of peer review during the radiotherapy planning processes...
September 12, 2016: Clinical Oncology: a Journal of the Royal College of Radiologists
Katsumi Hirose, Masahiko Aoki, Mariko Sato, Hiroyoshi Akimoto, Yasuhiro Hashimoto, Atsushi Imai, Noritaka Kamimura, Hideo Kawaguchi, Yoshiomi Hatayama, Ichitaro Fujioka, Mitsuki Tanaka, Chikara Ohyama, Yoshihiro Takai
PURPOSE: The aim was to determine the dose-specific incidence and predictors of seed loss/migration after permanent seed implantation (PI) for localized prostate cancer. MATERIALS AND METHODS: The records of 79 patients with T1c-T3a prostate cancer who underwent prostate brachytherapy with loose iodine-125 seeds were retrospectively reviewed. Of these patients, 33 with low or intermediate risk underwent PI with the prescribed dose of 160 Gy for the clinical target volume (CTV), and 46 with high risk underwent PI with 110 Gy for the CTV followed by external beam radiotherapy (EBRT) with 45 Gy...
September 8, 2016: Japanese Journal of Radiology
Luis Munoz, Amy Ziebell, Jason Morton, Madhava Bhat
An in-house solution for the verification of dose delivered to a moving phantom as required for the clinical implementation of lung stereotactic ablative body radiation therapy was developed. The superior-inferior movement required to simulate tumour motion during a normal breathing cycle was achieved via the novel use of an Arduino Uno™, a low-cost open-source microcontroller board connected to a high torque servo motor. Slow CT imaging was used to acquire the image set and a 4D cone beam CT (4D-CBCT) verified the efficacy of contoured margins before treatment on the moving phantom...
September 15, 2016: Australasian Physical & Engineering Sciences in Medicine
Peng Xu, Yanmei Min, Pierre Blanchard, Mei Feng, Peng Zhang, Yangkun Luo, Zixuan Fan, Jinyi Lang
BACKGROUND: Patients with nasopharyngeal carcinoma (NPC) often present small lymph nodes. The purpose of this study was to determine the prognostic impact on local recurrence of small lymph nodes, defined as smaller than 10 mm in greatest diameter. METHODS: Consecutive patients treated by intensity-modulated radiotherapy (IMRT) for pathologically confirmed NPC were analyzed retrospectively. Those without small lymph nodes were excluded from the study. From January 2005 to January 2011, 275 patients with NPC represented with 2722 small lymph nodes, which were analyzed...
September 14, 2016: Head & Neck
Mahkameh Zare, Marzieh Lashkari, Reza Ghalehtaki, Arash Ghasemi, Hamidreza Dehghan Manshadi, Ali Mir, Somayeh Noorollahi, Mahboobeh Alamolhoda
External radiotherapy is a standard treatment procedure for localized prostate cancer. Given the relatively high long term survival treatment complications have been brought in center of attention. In this planning study, between 2012 and 2014, CT simulation data of 90 consecutive high-risk prostate cancer patients were collected. In the first phase, all were planned for whole pelvis irradiation up to 46Gy in 23 daily fractions. In the second phase, only the prostate gland was the target of radiation. Next, the subjects were divided randomly into three groups and each received a unique 5field conformal radiation plan including Plan A (Gantry angle: 0, 60, 120, 240, and 300), Plan B (Gantry angles: 0, 90, 120, 240, and 270) and Plan C (Gantry angles: 0, 60, 90, 270, and 300)...
September 10, 2016: Medical Dosimetry: Official Journal of the American Association of Medical Dosimetrists
N Pourel
Radiotherapy for small cell lung carcinoma has known significant improvements over the past 10 years especially through routine use of PET-CT in the initial work-up and contouring before treatment. Prophylactic cranial irradiation remains a standard of care for locally advanced disease and is a subject of controversy for metastatic disease. A new indication for thoracic radiotherapy may soon arise for metastatic disease, still confirmation studies are ongoing.
October 2016: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
Eduardo Rodrigues Fregnani, Cláudia Joffily Parahyba, Karina Morais-Faria, Felipe Paiva Fonseca, Pedro Augusto Mendes Ramos, Fábio Yone de Moraes, Karina Gondim Moutinho da Conceição Vasconcelos, Gisela Menegussi, Alan Roger Santos-Silva, Thais B Brandão
BACKGROUND: Radiotherapy (RT) is frequently used in the treatment of head and neck cancer, but different side-effects are frequently reported, including a higher frequency of radiation-related caries, what may be consequence of direct radiation to dental tissue. The intensity-modulated radiotherapy (IMRT) was developed to improve tumor control and decrease patient's morbidity by delivering radiation beams only to tumor shapes and sparing normal tissue. However, teeth are usually not included in IMRT plannings and the real efficacy of IMRT in the dental context has not been addressed...
2016: Radiation Oncology
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