Medicine and Health Sciences Commons^™

Stereotactic Mr-Guided On-Table Adaptive Radiation Therapy (Smart) For Borderline Resectable And Locally Advanced Pancreatic Cancer: A Multi-Center, Open-Label Phase 2 Study, Michael Chuong, Percy Lee, Daniel Low, Joshua Kim, Kathryn Mittauer, Michael Bassetti, Carri Glide-Hurst, Ann Raldow, Yingli Yang, Lorraine Portelance, Kyle Padgett, Bassem Zaki, Rongxiao Zhang, Hyun Kim, Lauren Henke, Alex Price, Joseph Mancias, Christopher Williams, John Ng, Ryan Pennell, M Raphael Pfeffer, Daphne Levin, Adam Mueller, Karen Mooney, Patrick Kelly, Amish Shah, Luca Boldrini, Lorenzo Placidi, Martin Fuss, Parag Jitendra Parikh

Department of Radiation Oncology Faculty Papers

BACKGROUND AND PURPOSE: Radiation dose escalation may improve local control (LC) and overall survival (OS) in select pancreatic ductal adenocarcinoma (PDAC) patients. We prospectively evaluated the safety and efficacy of ablative stereotactic magnetic resonance (MR)-guided adaptive radiation therapy (SMART) for borderline resectable (BRPC) and locally advanced pancreas cancer (LAPC). The primary endpoint of acute grade ≥ 3 gastrointestinal (GI) toxicity definitely related to SMART was previously published with median follow-up (FU) 8.8 months from SMART. We now present more mature outcomes including OS and late toxicity.

MATERIALS AND METHODS: This prospective, multi-center, single-arm open-label phase 2 trial (NCT03621644) enrolled 136 …

Prediction Of Rapid Early Progression And Survival Risk With Pre-Radiation Mri In Who Grade 4 Glioma Patients, Walia Farzana, Mustafa M. Basree, Norou Diawara, Zeina Shboul, Sagel Dubey, Marie M. Lockheart, Mohamed Hamza, Joshua D. Palmer, Khan Iftekharuddin

Electrical & Computer Engineering Faculty Publications

Rapid early progression (REP) has been defined as increased nodular enhancement at the border of the resection cavity, the appearance of new lesions outside the resection cavity, or increased enhancement of the residual disease after surgery and before radiation. Patients with REP have worse survival compared to patients without REP (non-REP). Therefore, a reliable method for differentiating REP from non-REP is hypothesized to assist in personlized treatment planning. A potential approach is to use the radiomics and fractal texture features extracted from brain tumors to characterize morphological and physiological properties. We propose a random sampling-based ensemble classification model. The proposed …

Automation Of Radiation Treatment Planning For Cervical Cancer, Dong Joo Rhee

Dissertations & Theses (Open Access)

Cervical cancer is one of the most common cancer in low- and middle-income countries (LMICs). The mortality rate can be reduced if radiation treatment becomes widely available. However, due to the lack of radiation treatment facilities and human resources, many cervical cancer patients in Africa are not able to receive timely treatments or advanced therapies. To increase the availability of radiation treatment in low-and middle-income countries (LMICs) including African countries, many attempts have been made to reduce the cost of medical linear accelerators. However, increasing the number of treatment machines would not instantly resolve the issues, as there would be …

Impact Of Flattening Filter-Free Field On Online Adaptive Radiotherapy Using Virtual Couch Shift (Vcs) Technique, Q Liu, J Liang, D Yan

Conference Presentation Abstracts

No abstract provided.

Therapy And Medical Imaging Applications Of Focusing Polycapillary X-Ray Optics, Weiyuan Sun

Legacy Theses & Dissertations (2009 - 2024)

Focusing polycapillary optics yield high gains in intensity and increased spatial resolution for a variety of clinical, lab-based, synchrotron, or in situ analysis applications. In this dissertation we investigate the extension of two applications of focusing polycapillary optics. The first is the application of polycapillary optics in radiation therapy. This discussion includes measurements and calculation of dose for focused beam orthovoltage therapy. A system has been designed to investigate whether the polycapillary optics can produce an X-ray beam which can give more accurate dose painting due to the higher dose concentration at the focal spot. X-ray exposures were measured with …

Analytical Setup Margin For Spinal Sbrt Based On Measured Errors, Audrey Copeland

LSU Master's Theses

Purpose: No consensus currently exists in the radiotherapy community about the correct margin size to use for spinal SBRT. Margins have been proposed to account for various errors individually, but not with all errors combined to result in a single margin value. The purpose of this work was to determine a setup margin for spinal SBRT based on known and measurable errors during radiotherapy to achieve at least 90% coverage of the clinical target volume (CTV) with the prescription dose for at least 90% of patients and not exceed a 30 Gy point dose or 23 Gy to 10% of …

Synthesis Of Radioluminescent Caf2:Ln Core, Mesoporous Silica Shell Nanoparticles For Use In X-Ray Based Theranostics, Hayden Winter, Megan J. Neufeld, Lydia Makotamo, Conroy Sun, Andrea M. Goforth

Chemistry Faculty Publications and Presentations

X-ray radiotherapy is a common method of treating cancerous tumors or other malignant lesions. The side effects of this treatment, however, can be deleterious to patient quality of life if critical tissues are affected. To potentially lower the effective doses of radiation and negative side-effects, new classes of nanoparticles are being developed to enhance reactive oxygen species production during irradiation. This report presents the synthesis and radiotherapeutic efficacy evaluation of a new nanoparticle formulation designed for this purpose, composed of a CaF₂ core, mesoporous silica shell, and polyethylene glycol coating. The construct was additionally doped with Tb and Eu …

Commissioning Of Micro-Cube Thermoluminescent Dosimeters For Small Field Dosimetry Quality Assurance In Radiotherapy, Brandon Luckett

Dissertations & Theses (Open Access)

Small field dosimetry presents complications and uncertainties that could be circumvented by using detectors which are smaller than the radiation field. This study evaluates the reproducibility and accuracy of TLD micro-cubes for use in stereotactic radiosurgery (SRS) remote auditing quality assurance (QA) for treatment centers participating in clinical trials. This study tested the hypothesis that TLD micro-cubes could be commissioned to evaluate small field dosimetry, and provide reproducibility within 3%, as well as assure agreement between measured dose and calculated doses to within 5%.

The aims of this thesis were to characterize and commission TLD micro-cubes as well as to …

High Frequency Percussive Ventilation For Tumor Motion Immobilization, Ina Marina Sala

Wayne State University Dissertations

This work investigates the use of High Frequency Percussive Ventilation as a technique for respiratory motion mitigation in radiotherapy. This technique was extensively investigated in several prospective and retrospective studies.

In an initial prospective study, we evaluated the feasibility of HFPV and chest-wall motion reduction, by recruiting 15 healthy volunteers to undergo HFPV with three commercially available interfaces. For direct tumor motion immobilization, a second prospective study was performed in which with ten lung cancer patients underwent HFPV while imaged with high frame rate fluoroscopy. Diaphragm motion and image artifacts were quantified in a prospective study of a healthy volunteer …

Utilizing Log Files For Treatment Planning And Delivery Qa In Radiotherapy, Carl W. Stanhope

Wayne State University Theses

Purpose: Monte Carlo-based log file quality assurance (LF-MC QA) is investigated as an alternative method to phantom-based patient-specific quality assurance in radiotherapy (e.g. ArcCHECK QA (AC QA)).

Methods: First, the shortcomings of AC QA were investigated. The sensitivity dependence of ArcCHECK diodes on dose rate (in-field) and energy (primarily out-of-field) was quantified. LF-MC QA was then analyzed on the phantom geometry. Planned (‘Plan’) and LF-reconstructed CS and MC doses were compared with each other and AC measurement via statistical (mean ± StdDev(σ)) and gamma analyses to isolate dosimetric uncertainties and quantify the relative accuracies of AC QA and LF-MC QA. …

Exploring Subcellular Responses Of Prostate Cancer Cells To X-Ray Exposure By Raman Mapping, Maciej Roman, Agnieszka Panek, Hugh Byrne, Tomasz P Wrobel, Esen Efeoglu, Czeslawa Paluszkiewicz, Wojciech Maria Kwiatek

Articles

Understanding the response of cancer cells to ionising radiation is a crucial step in modern radiotherapy. Raman microspectroscopy, together with Partial Least Squares Regression (PLSR) analysis has been shown to be a powerful tool for monitoring biochemical changes of irradiated cells on the subcellular level. However, to date, the majority of Raman studies have been performed using a single spectrum per cell, giving a limited view of the total biochemical response of the cell. In the current study, Raman mapping of the whole cell area was undertaken to ensure a more comprehensive understanding of the changes induced by X-ray radiation. …

Evaluation Of Presage® As A 3d Dose Verification Tool In Proton Beams, Mitchell Carroll

Dissertations & Theses (Open Access)

Radiotherapy techniques have advanced and radiation dose plans have become much more complex over the last decade. This is especially true in proton therapy, which involves extremely steep dose gradients as a result of positioning the Bragg peak to cover the volumes to be treated. The Bragg peak can be shifted significantly in the patient as a result of nonuniformities in the tissue composition in its path, which can result in treatment complications. Some traditional dose verification tools used in proton beam commissioning and treatment plan verification are film, TLD, and ionization chambers. Such 0D and 2D dosimeters are incapable …

Proposed Method For Measuring The Let Of Radiotherapeutic Particle Beams, Stephen D. Bello

Physics & Astronomy ETDs

The Bragg peak geometry of the depth dose distributions for hadrons allows for precise and effective dose delivery to tumors while sparing neighboring healthy tissue. Further, compared against other forms of radiotherapeutic treatments, such as electron beam therapy (EBT) or photons (x and \(\gamma\)-rays), hadrons create denser ionization events along the particle track, which induces irreparable damage to DNA, and thus are more effective at inactivating cancerous cells. The measurement of radiation's ability to inactivate cellular reproduction is the relative biological effectiveness (RBE). A quality related to the RBE that is a measurable physical property is the linear energy transfer …

Treatment Pathway Of Bone Sarcoma In Children, Adolescents, And Young Adults, Damon R. Reed, Masanori Hayashi, Lars M. Wagner, Odion Binitie, Diana A. Steppan, Andrew S. Brohl, Eric T. Shinohara, Julia A. Bridge, David M. Loeb, Scott C. Borinstein, Michael S. Isakoff

Pediatrics Faculty Publications

When pediatric, adolescent, and young adult patients present with a bone sarcoma, treatment decisions, especially after relapse, are complex and require a multidisciplinary approach. This review presents scenarios commonly encountered in the therapy of bone sarcomas with the goal of objectively presenting a consensus, multidisciplinary management approach. Little variation was found in the authors' group with respect to local control or systemic therapy. Clinical trials were universally prioritized in all settings. Decisions regarding relapse therapies in the absence of a clinical trial had very minor variations initially, but a consensus was reached after a literature review and discussion. This review …

Neoadjuvant Or Adjuvant Therapy For Resectable Esophageal Cancer: A Systematic Review And Meta-Analysis, Richard Malthaner, Rebecca Wong, R. Rumble, Lisa Zuraw

Richard A. Malthaner

Background: Carcinoma of the esophagus is an aggressive malignancy with an increasing incidence. Its virulence, in terms of symptoms and mortality, justifies a continued search for optimal therapy. The large and growing number of patients affected, the high mortality rates, the worldwide geographic variation in practice, and the large body of good quality research warrants a systematic review with meta-analysis.

Methods: A systematic review and meta-analysis investigating the impact of neoadjuvant or adjuvant therapy on resectable thoracic esophageal cancer to inform evidence-based practice was produced.MEDLINE, CANCERLIT, Cochrane Library, EMBASE, and abstracts from the American Society of Clinical Oncology and the …

Neoadjuvant Or Adjuvant Therapy For Resectable Esophageal Cancer: A Clinical Practice Guideline, Richard Malthaner, Rebecca Wong, R. Rumble, Lisa Zuraw

Richard A. Malthaner

Background: Carcinoma of the esophagus is an aggressive malignancy with an increasing incidence. Its virulence, in terms of symptoms and mortality, justifies a continued search for optimal therapy. A clinical practice guideline was developed based on a systematic review investigating neoadjuvant or adjuvant therapy on resectable thoracic esophageal cancer. Methods: A systematic review with meta-analysis was developed and clinical recommendations were drafted. External review of the practice guideline report by practitioners in Ontario, Canada was obtained through a mailed survey, and incorporated. Final approval of the practice guideline was obtained from the Practice Guidelines Coordinating Committee. Results: The systematic review …

Neoadjuvant Or Adjuvant Therapy For Resectable Esophageal Cancer: A Systematic Review And Meta-Analysis, Richard Malthaner, Rebecca Wong, R. Rumble, Lisa Zuraw

Richard A. Malthaner

Background: Carcinoma of the esophagus is an aggressive malignancy with an increasing incidence. Its virulence, in terms of symptoms and mortality, justifies a continued search for optimal therapy. The large and growing number of patients affected, the high mortality rates, the worldwide geographic variation in practice, and the large body of good quality research warrants a systematic review with meta-analysis.

Methods: A systematic review and meta-analysis investigating the impact of neoadjuvant or adjuvant therapy on resectable thoracic esophageal cancer to inform evidence-based practice was produced.MEDLINE, CANCERLIT, Cochrane Library, EMBASE, and abstracts from the American Society of Clinical Oncology and the …

Neoadjuvant Or Adjuvant Therapy For Resectable Esophageal Cancer: A Clinical Practice Guideline, Richard Malthaner, Rebecca Wong, R. Rumble, Lisa Zuraw

Richard A. Malthaner

Background: Carcinoma of the esophagus is an aggressive malignancy with an increasing incidence. Its virulence, in terms of symptoms and mortality, justifies a continued search for optimal therapy. A clinical practice guideline was developed based on a systematic review investigating neoadjuvant or adjuvant therapy on resectable thoracic esophageal cancer.

Methods: A systematic review with meta-analysis was developed and clinical recommendations were drafted. External review of the practice guideline report by practitioners in Ontario, Canada was obtained through a mailed survey, and incorporated. Final approval of the practice guideline was obtained from the Practice Guidelines Coordinating Committee.

Results: The systematic review …

Gate Monte Carlo Simulations In A Cloud Computing Environment, Blake Austin Rowedder

UNLV Theses, Dissertations, Professional Papers, and Capstones

The GEANT4-based GATE is a unique and powerful Monte Carlo (MC) platform, which provides a single code library allowing the simulation of specific medical physics applications, e.g. PET, SPECT, CT, radiotherapy, and hadron therapy. However, this rigorous yet flexible platform is used only sparingly in the clinic due to its lengthy calculation time. By accessing the powerful computational resources of a cloud computing environment, GATE's runtime can be significantly reduced to clinically feasible levels without the sizable investment of a local high performance cluster. This study investigated a reliable and efficient execution of GATE MC simulations using a commercial cloud …

Alternative Hull Detection Techniques For Preprocessing In Proton Computed Tomography Reconstruction, Blake Edward Schultze

Theses Digitization Project

The purpose of this study was to develop computationally efficient hull detection techniques appropriate for image reconstruction using sparse matrices. The hull detection techniques investigated were space carving (SC), modified space carving (MSC), and space modeling (SM) and these were compared to the cone-beam version of filtered back projection (FBP) algorithm in terms of their computation time and the quality of the object hull they produced.

Impact Of Varied Low Resolution Phantoms On Intensity Modulated Proton Therapy Dose Distributions, Aarohi Shyam Padhye

Theses Digitization Project

The primary purpose of this thesis is to discuss the usefulness of image segmentation techniques in creating accurate proton dose distribution plans. The calculation of the proton dose distribution has to take into account the material (tissue, bone, brain) in the treatment area of the patients body.

Prediction Of Radiation Pneumonitis By Dose-Volume Histogram Parameters In Lung Cancer--A Systematic Review, George Rodrigues, Michael Lock, David D'Souza, Edward Yu, Jake Van Dyk

Michael Lock

BACKGROUND AND PURPOSE: To perform a systematic review of the predictive ability of various dose-volume histogram (DVH) parameters (V(dose), mean lung dose (MLD), and normal tissue complication probability (NTCP)) in the incidence of radiation pneumonitis (RP) caused by external-beam radiation therapy.

METHODS AND MATERIALS: Studies assessing the relationship between CT-based DVH reduction parameters and RP rate in radically treated lung cancer were eligible for the review. Synonyms for RP, lung cancer, DVH and its associated parameters (NTCP, V(20), V(30), MLD) were combined in a search strategy involving electronic databases, secondary reference searching, and consultation with experts. Individual or group data …

Assessment Of The Dependence Of Ventilation Image Calculation From 4d-Ct On Deformation And Ventilation Algorithms, Kujtim Latifi

USF Tampa Graduate Theses and Dissertations

Ventilation imaging using 4D-CT is a convenient and cost effective functional imaging methodology which might be of value in radiotherapy treatment planning to spare functional lung volumes. To calculate ventilation imaging from 4D-CT we must use deformable image registration (DIR). This study validates the DIR methods and investigates the dependence of calculated ventilation on DIR methods and ventilation algorithms.

The first hypothesis is if ventilation algorithms are robust then they will be insensitive to the precise DIR used provided the DIR is accurate. The second hypothesis is that the change in Houndsfield Unit (HU) method is less dependent on the …

Reordered Subsets Reconstruction Of Proton Computed Tomography, Wenzhe Xue

Theses Digitization Project

This project investigates the improvement of iterative reconstruction using reordered subsets. Block iterative projection and Ordered Subset reconstruction algorithms are developed to improve the performance of image reconstruction. Contains source code.

Radiotherapy Optimal Design: An Academic Radiotherapy Treatment Design System, R Acosta, W Brick, A Hanna, Allen Holder, D Lara, G Mcquillen, D Nevin, P Uhlig, B Salter

Mathematical Sciences Technical Reports (MSTR)

Optimally designing radiotherapy and radiosurgery treatments to increase the likelihood of a successful recovery from cancer is an important application of operations research. Researchers have been hindered by the lack of academic software that supports head-to-head comparisons of different techniques, and this article addresses the inherent difficulties of designing and implementing an academic treatment planning system. In particular, this article details the algorithms and the software design of Radiotherapy optimAl Design (RAD).

A Stochastic Model For Psa Levels: Behavior Of Solutions And Population Statistics, Pavel Bělík, P W A Dayananda, John T. Kemper, Mikhail M. Shvartsman

Faculty Authored Articles

This paper investigates the partial differential equation for the evolving distribution of prostate-specific antigen (PSA) levels following radiotherapy. We also present results on the behavior of moments for the evolving distribution of PSA levels and estimate the probability of long-term treatment success and failure related to values of treatment and disease parameters. Results apply to a much wider range of parameter values than was considered in earlier studies, including parameter combinations that are patient specific.

Prediction Of Radiation Pneumonitis By Dose-Volume Histogram Parameters In Lung Cancer--A Systematic Review, George Rodrigues, Michael Lock, David D'Souza, Edward Yu, Jake Van Dyk

Edward Yu

BACKGROUND AND PURPOSE: To perform a systematic review of the predictive ability of various dose-volume histogram (DVH) parameters (V(dose), mean lung dose (MLD), and normal tissue complication probability (NTCP)) in the incidence of radiation pneumonitis (RP) caused by external-beam radiation therapy. METHODS AND MATERIALS: Studies assessing the relationship between CT-based DVH reduction parameters and RP rate in radically treated lung cancer were eligible for the review. Synonyms for RP, lung cancer, DVH and its associated parameters (NTCP, V(20), V(30), MLD) were combined in a search strategy involving electronic databases, secondary reference searching, and consultation with experts. Individual or group data …