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https://www.readbyqxmd.com/read/28054139/-local-ablative-radiotherapy-of-oligometastatic-colorectal-cancer
#1
C Petersen, T Gauer
BACKGROUND: Colorectal cancer (CRC) often presents as oligometastatic disease. Currently available intensive systemic treatment regimens, including combination chemotherapy and molecular targeted agents, result in tumor response and transient to long-term disease control in a high percentage of patients, thus raising the question of further management. Secondary resection and ablation, e.g. by surgery or radiofrequency may contribute to long-term survival and even be curative or at least allow a relevant chemotherapy-free interval...
January 4, 2017: Der Radiologe
https://www.readbyqxmd.com/read/28048711/tu-b-brb-01-panel-member
#2
A Brade
: In this interactive session, liver SBRT patient cases will be presented to highlight real-world considerations for ensuring safe and accurate treatment delivery. An expert panel of speakers will discuss approaches to challenges specific to liver SBRT including motion management, target delineation and imaging strategies, online treatment alignment, and appropriate prescription regimens and OAR dose limits. Audience participation will be encouraged. LEARNING OBJECTIVES: This panel session is designed to provide case demonstration and review for liver SBRT in terms of 1...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048527/su-f-t-544-development-of-a-clinically-feasible-workflow-of-4d-mri-based-treatment-planning-for-liver-sbrt
#3
S Han, F Yin, B Czito, M Palta, J Cai
PURPOSE: To develop a clinically feasible workflow of 4D MRI-based treatment planning for liver SBRT. METHODS: A clinical workflow based on 4D MRI for liver SBRT was designed to largely simulate the same procedure as 4D CT for lung SBRT. Key features of the workflow include: (1) contouring tumor volume at each phases (2) contouring more structures, (3) assigning CT numbers to structures for dose calculation. Uncertainties (bone delineation, MRI distortion, CT number assignment, etc...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048462/su-d-brb-01-a-comparison-of-learning-methods-for-knowledge-based-dose-prediction-for-coplanar-and-non-coplanar-liver-radiotherapy
#4
A Tran, D Ruan, K Woods, V Yu, D Nguyen, K Sheng
PURPOSE: The predictive power of knowledge based planning (KBP) has considerable potential in the development of automated treatment planning. Here, we examine the predictive capabilities and accuracy of previously reported KBP methods, as well as an artificial neural networks (ANN) method. Furthermore, we compare the predictive accuracy of these methods on coplanar volumetric-modulated arc therapy (VMAT) and non-coplanar 4π radiotherapy. METHODS: 30 liver SBRT patients previously treated using coplanar VMAT were selected for this study...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048359/su-f-j-121-dosimetric-evaluation-of-active-breathing-coordinator-response-gating-system-linked-to-linear-accelerator-in-volumetric-modulated-arc-therapy
#5
S Lee, Y Zheng, D Albani, V Colussi, J Dorth, J Sohn
PURPOSE: To reduce internal target volume (ITV), respiratory management is a must in imaging and treatment for lung, liver, and breast cancers. We investigated the dosimetric accuracy of VMAT treatment delivery with a Response™ gating system linked to linear accelerator. METHODS: The Response™ gating module designed to directly control radiation beam by breath-holding with a ABC system (Elekta AB, Stockholm, Sweden) was tested for VMAT treatments. Seven VMAT plans including three conventional and four stereotactic body radiotherapy (SBRT) cases were evaluated...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048292/su-g-jep4-06-evaluation-of-interfractional-and-intrafractional-tumor-motion-in-stereotactic-liver-radiotherapy-based-on-four-dimensional-cone-beam-computed-tomography-using-fiducial-markers
#6
Y Shimohigashi, F Araki, R Toya, M Maruyama, Y Nakaguchi
PURPOSE: The purpose of this study was to evaluate the interfractional and intrafractional motion of liver tumors in stereotactic body radiation therapy (SBRT), based on four-dimensional cone-beam computed tomography using fiducial markers. (4D-CBCT). METHODS: Seven patients with liver tumors were treated by SBRT with abdominal compression (AC) in five fractions with image guidance based on 4D-CBCT. The 4D-CBCT studies were performed to determine the individualized internal margin for the planning simulation...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048247/we-fg-202-10-assessing-hepatocellular-carcinoma-hcc-response-to-sbrt-using-dce-mri
#7
Y Yuan, M Buckstein, M Chao, K Rosenzweig, Y Lo
PURPOSE: To investigate the feasibility of using DCE-MRI to assess treatment response of HCC to SBRT. METHODS: For seven liver HCC patients treated by photon SBRT with radiation dose ranging from 35 to 50 Gy in 5 fractions, T1-weighted DCE-MRI was performed before and at 1-3 months after the treatment. Each study included one pre-contrast and five post Gd-EOB-DTPA-enhanced imaging series. The target tumor and the liver were manually outlined on the arterial phase images...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048202/we-h-brc-02-failure-mode-and-effect-analysis-of-liver-stereotactic-body-radiotherapy
#8
I Rusu, T Thomas, J Roeske, J Price, C Perino, I Mescioglu, M Surucu
PURPOSE: To identify areas of improvement in our liver stereotactic body radiation therapy (SBRT) program, using failure mode and effect analysis (FMEA). METHODS: A multidisciplinary group consisting of one physician, three physicists, one dosimetrist and two therapists was formed. A process map covering 10 major stages of the liver SBRT program from the initial diagnosis to post treatment follow-up was generated. A total of 102 failure modes, together with their causes and effects, were identified...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048155/th-ef-brb-04-4%C3%AF-dynamic-conformal-arc-therapy-dynamic-conformal-arc-therapy-dcat-for-sbrt
#9
T Chiu, T Long, A Modiri, Z Tian, A Sawant, Y Yan, S Jiang, X Gu
PURPOSE: To develop an efficient and effective trajectory optimization methodology for 4π dynamic conformal arc treatment (4π DCAT) with synchronized gantry and couch motion; and to investigate potential clinical benefits for stereotactic body radiation therapy (SBRT) to breast, lung, liver and spine tumors. METHODS: The entire optimization framework for 4π DCAT inverse planning consists of two parts: 1) integer programming algorithm and 2) particle swarm optimization (PSO) algorithm...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048142/su-f-j-89-assessment-of-delivered-dose-in-understanding-hcc-tumor-progression-following-sbrt
#10
M McCulloch, G Cazoulat, D Polan, M Schipper, T Lawrence, M Feng, K Brock
PURPOSE: It is well documented that the delivered dose to patients undergoing radiotherapy (RT) is often different from the planned dose due to geometric variability and uncertainties in patient positioning. Recent work suggests that accumulated dose to the GTV is a better predictor of progression compared to the minimum planned dose to the PTV. The purpose of this study is to evaluate if deviations from the planned dose can contributed to tumor progression. METHODS: From 2010 to 2014 an in-house Phase II clinical trial of adaptive stereotactic body RT was completed...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048048/tu-b-brb-02-panel-member
#11
T Craig
: In this interactive session, liver SBRT patient cases will be presented to highlight real-world considerations for ensuring safe and accurate treatment delivery. An expert panel of speakers will discuss approaches to challenges specific to liver SBRT including motion management, target delineation and imaging strategies, online treatment alignment, and appropriate prescription regimens and OAR dose limits. Audience participation will be encouraged. LEARNING OBJECTIVES: This panel session is designed to provide case demonstration and review for liver SBRT in terms of 1...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047943/su-f-t-412-spatiotemporal-distribution-of-dose-rates-in-vmat-plans
#12
P Mackeprang, W Volken, D Terribilini, D Frauchiger, N Klippel, K Zaugg, D M Aebersold, M K Fix, P Manser
PURPOSE: To assess dose rates in volumetric modulated arc therapy (VMAT) plans. METHODS: For dose rate analysis, using Monte Carlo methods, dose distributions are calculated in sectors of consecutive DICOM control points and each multiplied with the MU-rate obtaining dose rate distributions for every voxel at every time-point during a treatment fraction. Dose rate distributions were calculated for a clinical head and neck, cranial (2 Gy fraction dose) and a SBRT liver treatment case (5 Gy per fraction)...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047828/su-f-t-563-delivered-dose-reconstruction-of-moving-targets-for-gated-volumetric-modulated-arc-therapy-vmat
#13
H Chung, C Jeong, S Cho, B Cho
PURPOSE: Actual delivered dose of moving tumors treated with gated volumetric arc therapy (VMAT) may significantly differ from the planned dose assuming static target. In this study, we developed a method which reconstructs actual delivered dose distribution of moving target by taking into account both tumor motion and dynamic beam delivery of gated VMAT, and applied to abdominal tumors. METHODS: Fifteen dual-arc VMAT plans (Eclipse, Varian Medical Systems) for 5 lung, 5 pancreatic, and 5 liver cancer patients treated with gated VMAT stereotactic body radiotherapy (SBRT) were studied...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047646/su-f-t-606-monte-carlo-evaluation-of-tissue-inhomogeneity-corrections-in-the-treatment-of-liver-cancer-patients-using-stereotactic-body-radiotherapy
#14
D Pokhrel, S Sood, R Badkul, C McClinton, H Jiang, H Saleh, C Lominska
PURPOSE: To evaluate the dosimetric performance of X-ray Voxel Monte Carlo(XVMC) algorithm in effort to clinically validate Monte Carlo-approach in heterogeneous liver phantom and liver SBRT plans. METHODS: An anthropomorphic RPC liver phantom incorporating a liver structure with two cylindrical targets and organs-at-risk (OARs) was used in phantom validation. Subsequently, five patients with metastatic liver cancer were treated using heterogeneity-corrected pencil-beam(PB-hete)algorithm were analyzed following RTOG-1112 criteria ...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047608/su-d-brb-05-quantum-learning-for-knowledge-based-response-adaptive-radiotherapy
#15
I El Naqa, R Ten
PURPOSE: There is tremendous excitement in radiotherapy about applying data-driven methods to develop personalized clinical decisions for real-time response-based adaptation. However, classical statistical learning methods lack in terms of efficiency and ability to predict outcomes under conditions of uncertainty and incomplete information. Therefore, we are investigating physics-inspired machine learning approaches by utilizing quantum principles for developing a robust framework to dynamically adapt treatments to individual patient's characteristics and optimize outcomes...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047539/su-f-j-136-impact-of-audiovisual-biofeedback-on-interfraction-motion-over-a-course-of-liver-cancer-stereotactic-body-radiotherapy
#16
S Pollock, R Tse, D Martin, L McLean, M Pham, D Tait, R Estoesta, G Whittington, J Turley, C Kearney, G Cho, R Hill, S Pickard, P Aston, K Makhija, R O'Brien, P Keall
PURPOSE: In abdominal radiotherapy inconsistent interfraction respiratory motion can result in deviations during treatment from what was planned in terms of target position and motion. Audiovisual biofeedback (AVB) is an interactive respiratory guide that produces a guiding interface that the patient follows over a course of radiotherapy to facilitate regular respiratory motion. This study assessed the impact of AVB on interfraction motion consistency over a course of liver cancer SBRT...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047522/su-f-t-636-comprehensive-approach-to-motion-assessment-for-liver-and-pancreas-sbrt-patients
#17
P Halvorsen, I Iftimia, K Hunter
PURPOSE: Our past practice for liver and pancreas SBRT consisted of free breathing (FB) with gated treatment delivery using a 30-70% phase window. We have recently adopted an assessment method leading to individualized motion management to minimize target motion. We present our results from 47 patients treated with this new approach. METHODS: We perform an initial patient coaching and assessment session in our conventional simulator suite to observe the motion of the implanted fiducials with FB anterior and lateral 20-second cine acquisitions...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047427/su-f-t-121-abdominal-compression-effectively-reduces-the-interplay-effect-and-enables-pencil-beam-scanning-proton-therapy-of-liver-tumors
#18
K Souris, A Glick, M Kang, G Janssens, E Sterpin, H Lin, J McDonough, C Simone, T Solberg, E Ben-Josef, J Lee, L Lin
PURPOSE: To study if abdominal compression can reduce breathing motion and mitigate interplay effect in pencil beam scanning proton therapy (PBSPT) treatment of liver tumors in order to better spare healthy liver volumes compared with photon therapy. METHODS: Ten patients, six having large tumors initially treated with IMRT and four having small tumors treated with SBRT, were replanned for PBSPT. ITV and beam-specific PTVs based on 4D-CT were used to ensure target coverage in PBSPT...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047328/mo-fg-campus-jep3-05-evaluation-of-4d-ct-on-rails-target-localization-methods-for-free-breathing-liver-stereotactic-body-radiotherapy-sbrt
#19
J Fan, T Lin, L Jin, L Chen, I Veltchev, L Wang, A Eldib, O Chibani, B Wang, Q Xu, R Price, C Ma
PURPOSE: Liver SBRT patients unable to tolerate breath-hold for radiotherapy are treated free-breathing with image guidance. Target localization using 3D CBCT requires extra margins to accommodate the respiratory motion. The purpose of this study is to evaluate the accuracy and reproducibility of 4D CT-on-rails in target localization for free-breathing liver SBRT. METHODS: A Siemens SOMATOM CT-on-Rails 4D with Anzai Pressure Belt system was used both as the simulation and the localization CT...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047290/tu-h-brc-02-biological-dose-escalation-for-liver-sbrt-through-spatiotemporal-fractionation
#20
J Unkelbach, Z Perko, J Wolfgang, T Hong
PURPOSE: Stereotactic body radiotherapy (SBRT) has become an established treatment option for liver cancer. For patients with large tumors, the prescription dose is often limited by constraints on the mean liver dose, leading to tumor recurrence. In this work, we demonstrate that spatiotemporal fractionation schemes, ie delivering distinct dose distributions in different fractions, may allow for a 10% increase in biologically effective dose (BED) in the tumor compared to current practice where each fraction delivers the same dose distribution...
June 2016: Medical Physics
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