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Deep Inspiration And End Exhale Breathhold Evaluation For The Treatment Of Locally Advanced Pancreatic Adenocarcinoma Using The Viewray Mridian Linactm, Tatum McGlynn 2022 Grand Valley State University

Deep Inspiration And End Exhale Breathhold Evaluation For The Treatment Of Locally Advanced Pancreatic Adenocarcinoma Using The Viewray Mridian Linactm, Tatum Mcglynn

Culminating Experience Projects

Introduction

Radiation therapy has been limited in the treatment of locally advanced pancreatic cancer. This is due to the dose tolerance to nearby organs at risk and breathing motion. Advancements in radiation treatment technology have now allowed pancreatic patients to be treated to higher doses in fewer fractions using stereotactic body radiotherapy treatment. With the use of MRI-guided treatments, using the ViewRay MRIdian linac, doses can be escalated using online adaptive treatment planning and real time tracking. However, there has yet to be an optimal breathhold technique investigated that can aid in this process.

Methods

Five patients that had been ...


Dosimetric Comparison Of Static Imrt And Vmat Apbi Treatment Planning In The Prone Position For Breast Conservation Therapy, Kelly A. Foucher 2022 Grand Valley State University

Dosimetric Comparison Of Static Imrt And Vmat Apbi Treatment Planning In The Prone Position For Breast Conservation Therapy, Kelly A. Foucher

Culminating Experience Projects

Introduction

Prevalence of early-stage breast cancer is increasing with the aid of preventative screenings and early diagnosis. The standard of care is transforming from conventional approaches with long treatment regimens towards hypofractionation and tissue sparing techniques. Based on studies over the past ten years, there are reasons to consider a partial-breast, hypo fractionated treatment option in the supine position. In practice, aPBI is often produced using several static intensity modulated beams to control dose to the normal breast tissue and limit dose to the heart and lungs. Patients may also be treated in the prone treatment setup in order to ...


Development Of Advanced Mr-Guided Adaptive Radiation Therapy Methods For Head & Neck Cancers On The 1.5t Mr-Linac, Brigid McDonald 2022 The Texas Medical Center Library

Development Of Advanced Mr-Guided Adaptive Radiation Therapy Methods For Head & Neck Cancers On The 1.5t Mr-Linac, Brigid Mcdonald

The University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences Dissertations and Theses (Open Access)

The 1.5T hybrid MRI/linear accelerator (MR-linac) has recently been introduced into clinical practice and used for the treatment of head and neck cancers (HNC). This device enables on-line adaptive radiation therapy (ART) based on anatomical changes throughout treatment and variations in patient position. This novel technology also has the potential for advanced ART strategies such as dose-optimized ART, in which the treatment plan is optimized based on the accumulated dose over previous fractions, or biological image-guided ART, in which the plan is adapted based on individual tumor response as measured through quantitative imaging techniques such as diffusion-weighted imaging ...


A Quantitative Investigation At Dose To Tissue When Using Physical Constraints Versus Biological Based Constraints In Pancreatic Carcinoma Patients, Kelly R. Alley 2022 Grand Valley State University

A Quantitative Investigation At Dose To Tissue When Using Physical Constraints Versus Biological Based Constraints In Pancreatic Carcinoma Patients, Kelly R. Alley

Culminating Experience Projects

Introduction

The purpose of this study was to compare dose to organs at risk as well as PTV coverage. Physical objectives, biological objectives, and a combination of the two were utilized to compare which technique provided the best coverage of the PTV while also preserving the greatest amount of healthy tissue.

Methods

Each randomly selected patient had three separate plans created for them. The first plan used only physical based constraints in the form of upper objectives. The second plan used only biological based constraints in the form of gEUD objectives. The third plan used a combination of both upper ...


Development Of A Novel Rodent Model Of Radiation-Induced Implant Capsular Contracture, Tanya DeLyzer 2022 The University of Western Ontario

Development Of A Novel Rodent Model Of Radiation-Induced Implant Capsular Contracture, Tanya Delyzer

Electronic Thesis and Dissertation Repository

Radiation-induced implant capsular contracture is a challenging complication of post-mastectomy breast reconstruction. The objective of this thesis was to establish a novel rodent model that replicates the critical properties of this complication. Retired breeder female Sprague-Dawley rats underwent surgery with custom smooth silicone implants placed under the right 4th mammary fat pad. Half these rats received 26Gy of ionizing radiation to the implant and fat pad. Radiated implants had both higher Baker grades of capsular contracture and Kumar scores denoting radiation-induced fibrosis. Irradiated capsules showed increased Masson’s trichrome staining and significantly higher hydroxyproline to total protein ratio compared ...


Tumor Vasculature Changes Before Or During Treatment To Predict Response To Systemic Therapy, Avinash Ramkissoon, Faria Ali, Thomas Vander Woude, Stephen Brown, James Ewing, Lisa Rogers 2022 Wayne State University

Tumor Vasculature Changes Before Or During Treatment To Predict Response To Systemic Therapy, Avinash Ramkissoon, Faria Ali, Thomas Vander Woude, Stephen Brown, James Ewing, Lisa Rogers

Medical Student Research Symposium

A diagnosis of non-small cell lung cancer (NSCLC) carries a grim prognosis, with 5-year survival rates of 25%. 25-30% of NSCLC patients have brain metastases at initial presentation, which carries an even worse prognosis. New systemic therapies such as targeted-therapies and immuno-therapies have potential to provide better outcomes, but are not without challenges. First, efficacy is limited to a subset of patients. Second, the blood-brain barrier limits penetration, which varies among patients. Third, toxicities can be considerable. Current practice involves waiting 3-6 months to follow-up and assess tumor response; however, by then, it is later than ideal to try other ...


Variation In Molecularly Defined Prostate Tumor Subtypes By Self-Identified Race, Kevin H. Kensler, H. Lee Moffitt Cancer Center and Research Institute, Mohamed Alshalalfa, Bruce J. Trock, Stephen J. Freedland, Michael R. Freeman, Sungyong You, Brandon A. Mahal, Robert Den, Adam Dicker, R. Jeffrey Karnes, Eric A. Klein, Priti Lal, Yang Liu, Elai Davicioni, Walter Rayford, Kosj Yamoah, Timothy R. Rebbeck 2022 Weill Cornell Medicine

Variation In Molecularly Defined Prostate Tumor Subtypes By Self-Identified Race, Kevin H. Kensler, H. Lee Moffitt Cancer Center And Research Institute, Mohamed Alshalalfa, Bruce J. Trock, Stephen J. Freedland, Michael R. Freeman, Sungyong You, Brandon A. Mahal, Robert Den, Adam Dicker, R. Jeffrey Karnes, Eric A. Klein, Priti Lal, Yang Liu, Elai Davicioni, Walter Rayford, Kosj Yamoah, Timothy R. Rebbeck

Department of Radiation Oncology Faculty Papers

Background: Socioeconomic and health care utilization factors are major drivers of prostate cancer (PC) mortality disparities in the USA; however, tumor molecular heterogeneity may also contribute to the higher mortality among Black men. Objective: To compare differences in PC subtype frequency and genomic aggressiveness by self-identified race. Design, setting, and participants: Five molecular subtype classifiers were applied for 426 Black and 762 White PC patients in the Decipher Genomics Resource Information Database (GRID). Outcome measurements and statistical analysis: Differences in subtype frequency and tumor genomic risk (Decipher score >0.6) by race were evaluated using χ2 tests and multivariable-adjusted logistic ...


Financial Toxicity Tumor Board: A Multi-Disciplinary Team Activity Required In Low And Middle-Income Countries (Lmic), Ahmed Nadeem Abbasi, Sohail Rasool, Laraib Khan 2022 Aga Khan University

Financial Toxicity Tumor Board: A Multi-Disciplinary Team Activity Required In Low And Middle-Income Countries (Lmic), Ahmed Nadeem Abbasi, Sohail Rasool, Laraib Khan

Department of Radiation Oncology

No abstract provided.


In-Phantom Film Measurements Of Two Treatment Planning Systems For Single-Fraction Spine Sbrt, Michael J. Taylor 2022 Louisiana State University and Agricultural and Mechanical College

In-Phantom Film Measurements Of Two Treatment Planning Systems For Single-Fraction Spine Sbrt, Michael J. Taylor

LSU Master's Theses

Purpose: Treatment planning accuracy for spine stereotactic body radiation therapy (SBRT) varies depending on the dose calculation algorithm utilized in the treatment planning system (TPS). This project compared the end-to-end accuracy between spine SBRT plans calculated in a convolution-superposition based TPS (TPSCS) and Monte Carlo based TPS (TPSMC) with radiochromic film measurements. The hypothesis was that TPSMC would calculate the dose gradient in the critical region between the vertebral body and the spinal cord more accurately than TPSCS.

Methods: Single-fraction spine SBRT treatments following RTOG 0631 and local institutional guidelines were planned in TPSCS and ...


Integration Of Biomedical Imaging And Translational Approaches For Management Of Head And Neck Cancer, Abdallah Mohamed, Abdallah Mohamed 2022 The University of Texas MD Anderson Cancer Center

Integration Of Biomedical Imaging And Translational Approaches For Management Of Head And Neck Cancer, Abdallah Mohamed, Abdallah Mohamed

The University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences Dissertations and Theses (Open Access)

The aim of the clinical component of this work was to determine whether the currently available clinical imaging tools can be integrated with radiotherapy (RT) platforms for monitoring and adaptation of radiation dose, prediction of tumor response and disease outcomes, and characterization of patterns of failure and normal tissue toxicity in head and neck cancer (HNC) patients with potentially curable tumors. In Aim 1, we showed that the currently available clinical imaging modalities can be successfully used to adapt RT dose based-on dynamic tumor response, predict oncologic disease outcomes, characterize RT-induced toxicity, and identify the patterns of disease failure. We ...


A Quantitative Dose Pertubation Comparison Study Between Gold And Platinum Visicoil Fiducial Markers In Proton Beam Therapy, Xuanfeng Ding, Gang Liu, Weili Zheng, Jessica Vadas, Xiaoqiang Li, Lewei Zhao, An Qin, Daniel Krauss, Di Yan 2022 Beaumont Health

A Quantitative Dose Pertubation Comparison Study Between Gold And Platinum Visicoil Fiducial Markers In Proton Beam Therapy, Xuanfeng Ding, Gang Liu, Weili Zheng, Jessica Vadas, Xiaoqiang Li, Lewei Zhao, An Qin, Daniel Krauss, Di Yan

Conference Presentation Abstracts

Purpose: To quantitatively investigate the dose perturbations difference between gold and platinum VISICOILTM fiducial markers in proton beam therapy Method: Gold and platinum VISICOILTM fiducial markers with two different dimensions were tested, including 0.35 & 0.5mm in diameter and 5mm in length. Total four kinds of markers. Gafchromic EBT2 was used to measure dose perturbations along the beam path in a ‘‘sandwich’’ setup (Figure 1). Dose perturbation was reported in each depth (0.3mm, 1.65mm, 3.00mm, 5.40mm, 7.80mm, 10.20mm, 12.60mm, 18.15mm). Relative proton stopping power relative to water were calculated through National Institute of Standards and Technology database and SRIM (version -2013) in the therapeutic energy range (70- 220MeV). Result: There is no statistical difference between gold and platinum VISICOILTM fiducial markers in all the depth with diameter 0.35mm (p¼0.125), and 0.5mm (p¼0.130). The maximum point dose perturbation between Au and Pt marker with the same dimension are similar (0.35mm diameter at 7.8mm WET: 2.85%62.31% Au vs. 2.70%62.60% Pt; 0.5mm diameter at 5.4mm WET: 8.81%62.60% Au vs. 8.81%62.57% Pt.) (Figure 2). Bilateral treatment field arrangement could further reduce the dose perturbation by half. The relative stopping power ratio to water was calculated based on gold and platinum materials. The result showed there are about 3.5% difference between the two materials. Conclusion: The study indicated that ...


The First Modeling Of The Spot-Scanning Proton Arc(Sparc) Delivery Sequence And Investigating Its Efficiency Improvement, Xuanfeng Ding, Gang Liu, Lewei Zhao, Rohan Deraniyagala, Craig Stevens, Di Yan, Xiaoqiang Li 2022 Beaumont Health

The First Modeling Of The Spot-Scanning Proton Arc(Sparc) Delivery Sequence And Investigating Its Efficiency Improvement, Xuanfeng Ding, Gang Liu, Lewei Zhao, Rohan Deraniyagala, Craig Stevens, Di Yan, Xiaoqiang Li

Conference Presentation Abstracts

Purpose: Introduce an experimental approach to model a precise prototype arc system and quantitatively assess its efficiency improvement in the routine proton clinical operation. Methods: The SPArc delivery sequence model(DSMSPArc) includes two kinds of parameters:(1) mechanical parameters. (2) irradiation parameters. Log files and an independent gantry inclinometer were used to derive the irradiation parameters through a series of test plans. The in-house DSMSPArc was established by fitting both mechanical and irradiation parameters. Eight SPArc plans from different disease sites were used to validate the model’s accuracy. To assess the treatment efficiency improvement, the DSMSPArc was used to ...


A Direct Machine-Specific Parameters Incorporated Spot-Scanning Proton Arc (Sparc) Algorithm, Gang Liu, Lewei Zhao, Di Yan, Xiaoqiang Li, Xuanfeng Ding 2022 Beaumont Health

A Direct Machine-Specific Parameters Incorporated Spot-Scanning Proton Arc (Sparc) Algorithm, Gang Liu, Lewei Zhao, Di Yan, Xiaoqiang Li, Xuanfeng Ding

Conference Presentation Abstracts

Purpose: To address the challenges of generating a deliverable and efficient spot-scanning proton arc (SPArc) plan for a proton therapy system. We developed a novel SPArc optimization algorithm (SPArcDMSP) by directly incorporating machinespecific parameters such as mechanical constraints and delivery sequence. Method and Material: A SPArc delivery sequence model (DSMarc) was built based on the machine-specific parameters of the prototype arc delivery system IBA ProteusONEt. The SPArcDMSP resamples and adjusts each control point’s delivery speed based on the DSMarc calculation through the iterative approach (Fig1). Users could set the expected delivery time and gantry max acceleration as a mechanical ...


Assessing The Interplay Effect Based On A Precise Machine-Specific Delivery Sequence And Time For Cyclotron Accelerator Proton Therapy System., Lewei Zhao, Gang Liu, Jiajian Sher, Andrew Lee, Di Yan, Rohan Deraniyagala, Craig Stevens, Xiaoqiang Li, Shikui Tang, Xuanfeng Ding 2022 Beaumont Health

Assessing The Interplay Effect Based On A Precise Machine-Specific Delivery Sequence And Time For Cyclotron Accelerator Proton Therapy System., Lewei Zhao, Gang Liu, Jiajian Sher, Andrew Lee, Di Yan, Rohan Deraniyagala, Craig Stevens, Xiaoqiang Li, Shikui Tang, Xuanfeng Ding

Conference Presentation Abstracts

Purpose: We proposed an experimental approach to build a precise machine-specific model for standard, volumetric, and layer repainting delivery based on a cyclotron accelerator system. Then, we assessed the interplay effect using a 4D mobile lung target phantom compared to a generic delivery sequence model from West German Proton Therapy Essen (WPE). Methods: The machine delivery log files, from an IBA ProteusPLUSt system, were retrospectively analyzed to quantitatively model energy layer switching time, spot switching time, and spot drill time for standard and volumetric repainting delivery. To quantitatively evaluate the interplay effect, a series of digital thoracic 4DCT image sets ...


Contralateral Control Rate With Unilateral Proton Beam Radiotherapy For Oropharyngeal Scc: A Multi-Institutional Prospective Study From The Proton Collaborative Group, Aleksander Vayntraub, Thomas Quinn, John Chang, Noah Kalman, Sanford Katz, James Urbanic, Arpi Thukral, Jason Molitoris, Craig Stevens, Rohan Deraniyagala 2022 Beaumont Health Resident

Contralateral Control Rate With Unilateral Proton Beam Radiotherapy For Oropharyngeal Scc: A Multi-Institutional Prospective Study From The Proton Collaborative Group, Aleksander Vayntraub, Thomas Quinn, John Chang, Noah Kalman, Sanford Katz, James Urbanic, Arpi Thukral, Jason Molitoris, Craig Stevens, Rohan Deraniyagala

Conference Presentation Abstracts

Introduction: Select patients with oropharyngeal SCC are candidates for unilateral radiation therapy. We sought to investigate if ipsilateral targeting leads to increased contralateral recurrences. Methods: We queried the PCG database for patients treated with unilateral proton RT for head and neck SCC from 2015 – 2020 at 12 institutions. DICOMs were evaluated to ensure dose delivered matched a unilateral proton treatment plan. Demographic, clinical and pathological, toxicity and dosimetry information were compiled. Results: We found 43 cases treated with unilateral proton RT. 94% (n¼16) of recurrent cases received prior radiation. Oropharyngeal sites included tonsillar fossa (n¼32), and base of tongue (n¼11 ...


Coeliac Plexus Radiosurgery For Pain Management In Patients With Advanced Cancer : Study Protocol For A Phase Ii Clinical Trial, Galia Jacobson, Ronen Fluss, Amira Dany-BenShushan, Talia Golan, Tikva Meron, Camilla Zimmermann, Laura A Dawson, Aisling Barry, Marcin Miszczyk, Michael Buckstein, Dayssy Diaz Pardo, Artur Aguiar, Liat Hammer, Adam Dicker, Maoz Ben-Ailan, Ofir Morag, David Hausner, Zvi Symon, Yaacov R Lawrence 2022 MD Anderson Cancer Center

Coeliac Plexus Radiosurgery For Pain Management In Patients With Advanced Cancer : Study Protocol For A Phase Ii Clinical Trial, Galia Jacobson, Ronen Fluss, Amira Dany-Benshushan, Talia Golan, Tikva Meron, Camilla Zimmermann, Laura A Dawson, Aisling Barry, Marcin Miszczyk, Michael Buckstein, Dayssy Diaz Pardo, Artur Aguiar, Liat Hammer, Adam Dicker, Maoz Ben-Ailan, Ofir Morag, David Hausner, Zvi Symon, Yaacov R Lawrence

Department of Radiation Oncology Faculty Papers

Introduction: Pancreatic cancer is characterised by severe mid-back and epigastric pain caused by tumour invasion of the coeliac nerve plexus. This pain is often poorly managed with standard treatments. This clinical trial investigates a novel approach in which high-dose radiation (radiosurgery) is targeted to the retroperitoneal coeliac plexus nerve bundle. Preliminary results from a single institution pilot trial are promising: pain relief is substantial and side effects minimal. The goals of this study are to validate these findings in an international multisetting, and investigate the impact on quality of life and functional status among patients with terminal cancer.

Methods and ...


Clinical Evaluation Of An Auto-Segmentation Tool For Spine Sbrt Treatment., Yingxuan Chen, Yevgeniy Vinogradskiy, Yan Yu, Wenyin Shi, Haisong Liu 2022 Thomas Jefferson University

Clinical Evaluation Of An Auto-Segmentation Tool For Spine Sbrt Treatment., Yingxuan Chen, Yevgeniy Vinogradskiy, Yan Yu, Wenyin Shi, Haisong Liu

Department of Radiation Oncology Faculty Papers

Purpose: Spine SBRT target delineation is time-consuming due to the complex bone structure. Recently, Elements SmartBrush Spine (ESS) was developed by Brainlab to automatically generate a clinical target volume (CTV) based on gross tumor volume (GTV). The aim of this project is to evaluate the accuracy and efficiency of ESS auto-segmentation.

Methods: Twenty spine SBRT patients with 21 target sites treated at our institution were used for this retrospective comparison study. Planning CT/MRI images and physician-drawn GTVs were inputs for ESS. ESS can automatically segment the vertebra, split the vertebra into 6 sectors, and generate a CTV based on ...


Clinical Evaluation Of An Auto-Segmentation Tool For Spine Sbrt Treatment, Yingxuan Chen, Yevgeniy Vinogradskiy, Yan Yu, Wenyin Shi, Haisong Lui 2022 Thomas Jefferson University

Clinical Evaluation Of An Auto-Segmentation Tool For Spine Sbrt Treatment, Yingxuan Chen, Yevgeniy Vinogradskiy, Yan Yu, Wenyin Shi, Haisong Lui

Department of Radiation Oncology Faculty Papers

Purpose: Spine SBRT target delineation is time-consuming due to the complex bone structure. Recently, Elements SmartBrush Spine (ESS) was developed by Brainlab to automatically generate a clinical target volume (CTV) based on gross tumor volume (GTV). The aim of this project is to evaluate the accuracy and efficiency of ESS auto-segmentation.

Methods: Twenty spine SBRT patients with 21 target sites treated at our institution were used for this retrospective comparison study. Planning CT/MRI images and physician-drawn GTVs were inputs for ESS. ESS can automatically segment the vertebra, split the vertebra into 6 sectors, and generate a CTV based on ...


A Measure Of Srs/Srt Plan Quality: Quantitative Limits For Intermediate Dose Spill (R50%) In Linac-Based Delivery, Dharmin D. Desai, Ivan L. Cordrey, Ellis L. Johnson 2022 CHI Memorial Hospital

A Measure Of Srs/Srt Plan Quality: Quantitative Limits For Intermediate Dose Spill (R50%) In Linac-Based Delivery, Dharmin D. Desai, Ivan L. Cordrey, Ellis L. Johnson

Radiation Medicine Faculty Publications

Stereotactic radiosurgery (SRS) and stereotactic radiotherapy (SRT) of multiple cranial targets using a single isocenter on conventional C-arm linear accelerators are rapidly developing clinical techniques. However, no universal guidelines for acceptable intermediate dose spill limits are currently available or widely accepted. In this work, we propose an intermediate dose spill guidance range for cranial SRS/SRT delivered on C-arm linacs with MLC collimation for single PTV plans and single isocenter multiple target plans with PTV volumes in the range 0.02–57.9 cm3. We quantify intermediate dose spill with the R50% metric (R50% = volume of 50% of prescription ...


Role Of Surgery In Multifocal Glioblastoma, Syeda Kubra Kishwar Jafri, Syed Sarmad Bukhari, Muhammad Shahzad Shamim 2022 Aga Khan University

Role Of Surgery In Multifocal Glioblastoma, Syeda Kubra Kishwar Jafri, Syed Sarmad Bukhari, Muhammad Shahzad Shamim

Section of Neurosurgery

The management of multifocal glioblastomas is a point of constant discussion amongst neuro-oncologists. Best outcomes in glioblastoma management come from gross total resection (GTR) followed by concomitant radiation and chemotherapy (CCRT). Multifocal disease is resistant to GTR. Conventional management of these lesion is usually biopsy only followed by CCRT. Recent evidence has shown that there may be some benefit to attempting GTR of the largest lesion whenever safe to do so.


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