Radiation Medicine Commons^™

Multi-Parametric Mri For Radiotherapy Simulation, Tian Li, Jihong Wang, Yingli Yang, Carri K Glide-Hurst, Ning Wen, Jing Cai

Faculty, Staff and Student Publications

Magnetic resonance imaging (MRI) has become an important imaging modality in the field of radiotherapy (RT) in the past decade, especially with the development of various novel MRI and image-guidance techniques. In this review article, we will describe recent developments and discuss the applications of multi-parametric MRI (mpMRI) in RT simulation. In this review, mpMRI refers to a general and loose definition which includes various multi-contrast MRI techniques. Specifically, we will focus on the implementation, challenges, and future directions of mpMRI techniques for RT simulation.

Longitudinal Diffusion And Volumetric Kinetics Of Head And Neck Cancer Magnetic Resonance On A 15 T Mr-Linear Accelerator Hybrid System: A Prospective R-Ideal Stage 2a Imaging Biomarker Characterization/Pre-Qualification Study, Joint Head And Neck Radiation Therapy-Mri Development Cooperative, Mr-Linac Consortium Head And Neck Tumor Site Group

Faculty, Staff and Student Publications

Objectives: We aim to characterize the serial quantitative apparent diffusion coefficient (ADC) changes of the target disease volume using diffusion-weighted imaging (DWI) acquired weekly during radiation therapy (RT) on a 1.5 T MR-Linac and correlate these changes with tumor response and oncologic outcomes for head and neck squamous cell carcinoma (HNSCC) patients as part of a programmatic R-IDEAL biomarker characterization effort.

Methods:Thirty patients with HNSCC who received curative-intent RT at MD Anderson Cancer Center, were included. Baseline and weekly MRI were obtained, and various ADC parameters were extracted from the regions of interest (ROIs). Baseline and weekly ADC parameters were …

Addressing The Global Expertise Gap In Radiation Oncology: The Radiation Planning Assistant, Laurence Court, Ajay Aggarwal, Hester Burger, Carlos Cardenas, Christine Chung, Raphael Douglas, Monique Du Toit, David Jaffray, Anuja Jhingran, Michael Mejia, Raymond Mumme, Sikudhani Muya, Komeela Naidoo, Jerry Ndumbalo, Kelly Nealon, Tucker Netherton, Callistus Nguyen, Niki Olanrewaju, Jeannette Parkes, Willie Shaw, Christoph Trauernicht, Melody Xu, Jinzhong Yang, Lifei Zhang, Hannah Simonds, Beth M Beadle

Faculty, Staff and Student Publications

PURPOSE: Automation, including the use of artificial intelligence, has been identified as a possible opportunity to help reduce the gap in access and quality for radiotherapy and other aspects of cancer care. The Radiation Planning Assistant (RPA) project was conceived in 2015 (and funded in 2016) to use automated contouring and treatment planning algorithms to support the efforts of oncologists in low- and middle-income countries, allowing them to scale their efforts and treat more patients safely and efficiently (to increase access).

DESIGN: In this review, we discuss the development of the RPA, with a particular focus on clinical acceptability and …

Differences In Clinical Outcomes Based On Molecular Markers In Glioblastoma Patients Treated With Concurrent Tumor-Treating Fields And Chemoradiation: Exploratory Analysis Of The Spare Trial, Louis Cappelli, Mehak Majid Khan, Allison Kayne, Spencer Poiset, Ryan Miller, Ayesha Ali, Muneeb Khan Niazi, Wenyin Shi, Iyad Alnahhas

Department of Radiation Oncology Faculty Papers

Background: Glioblastoma (GBM) is the most common primary malignant brain tumor in adults. Despite enormous research efforts, GBM remains a deadly disease. The standard-of-care treatment for patients with newly diagnosed with GBM as per the National Cancer Comprehensive Cancer Network (NCCN) is maximal safe surgical resection followed by concurrent chemoradiation and maintenance temozolomide (TMZ) with adjuvant tumor treating fields (TTF). TTF is a non-pharmacological intervention that delivers low-intensity, intermediate frequency alternating electric fields that arrests cell proliferation by disrupting the mitotic spindle. TTF have been shown in a large clinical trial to improve patient outcomes when added to radiation and …

Long-Term Outcomes Of Bevacizumab And Chemoradiation For Locoregionally Advanced Nasopharyngeal Carcinoma: A Nonrandomized Controlled Trial, Nancy Y. Lee, Jonathan Harris, John Kim, Adam Garden, James Mechalakos, David G. Pfister, Anthony T.C. Chan, Kenneth Hu, A. Dimitrios Colevas, Steven Frank, George Shenouda, Voichita Bar-Ad, John N. Waldron, Paul M. Harari, Adam Raben, Pedro Torres-Saavedra, Quynh-Thu Le

Department of Radiation Oncology Faculty Papers

IMPORTANCE: The long-term outcomes associated with adding bevacizumab, a vascular endothelial growth factor inhibitor, to standard chemoradiation have continued to be favorable for a group of patients with locoregionally advanced nasopharyngeal carcinoma (NPC).

OBJECTIVE: To assess long-term toxic effects and clinical outcomes associated with chemotherapy, radiation therapy (RT), and bevacizumab for NPC.

DESIGN, SETTING, AND PARTICIPANTS: This single-arm phase II nonrandomized controlled trial was conducted by the National Cancer Trials Network group and NRG Oncology (formerly Radiation Therapy Oncology Group), with accrual from December 13, 2006, to February 5, 2009, and data analysis from June 26 to July 1, 2019. …

Physician Perceptions On Cancer Screening For Lgbtq+ Patients, Nicolas Nelson, Joseph F. Lombardo, Ayako Shimada, Marissa L. Ruggiero, Alexandria P. Smith, Kevin Ko, Amy E. Leader, Edith P. Mitchell, Nicole L. Simone

Department of Radiation Oncology Faculty Papers

The LGBTQ+ community experiences cancer disparities due to increased risk factors and lower screening rates, attributable to health literacy gaps and systemic barriers. We sought to understand the experiences, perceptions, and knowledge base of healthcare providers regarding cancer screening for LGBTQ+ patients. A 20-item IRB-approved survey was distributed to physicians through professional organizations. The survey assessed experiences and education regarding the LGBTQ+ community and perceptions of patient concerns with different cancer screenings on a 5-point Likert scale. Complete responses were collected from 355 providers. Only 100 (28%) reported past LGBTQ+-related training and were more likely to be female (p = …

Prospective Validation Of Diffusion-Weighted Mri As A Biomarker Of Tumor Response And Oncologic Outcomes In Head And Neck Cancer: Results From An Observational Biomarker Pre-Qualification Study, Abdallah S R Mohamed, Abdelrahman Abusaif, Renjie He, Kareem A Wahid, Vivian Salama, Sara Youssef, Brigid A Mcdonald, Mohamed Naser, Yao Ding, Travis C Salzillo, Moamen A Abobakr, Jihong Wang, Stephen Y Lai, Clifton D Fuller

Faculty, Staff and Student Publications

PURPOSE: To determine DWI parameters associated with tumor response and oncologic outcomes in head and neck (HNC) patients treated with radiotherapy (RT).

METHODS: HNC patients in a prospective study were included. Patients had MRIs pre-, mid-, and post-RT completion. We used T2-weighted sequences for tumor segmentation which were co-registered to respective DWIs for extraction of apparent diffusion coefficient (ADC) measurements. Treatment response was assessed at mid- and post-RT and was defined as: complete response (CR) vs. non-complete response (non-CR). The Mann-Whitney U test was used to compare ADC between CR and non-CR. Recursive partitioning analysis (RPA) was performed to identify …

Investigate The Delivery Efficiency Improvement For Sparc Compared To Impt, Peilin Liu, B A. De Jong, S Chang, Lewei Zhao, G Liu, Craig Stevens, Rohan Deraniyagala, E W. Korevaar, J A. Langendijk, Xiaoqiang Li, Xuanfeng Ding

Conference Presentation Abstracts

Purpose: To assess the efficiency improvement of SPArc compared to IMPT in proton clinical operation.Methods: A random clinical operation day at a proton therapy center with a two room system. Aa total of 10 Head & Neck cancer cases treated on Jan 6th, 2021were selected and SPArc plans were generated for all the cases with similar target coverage and dose constraints of organ at risk (OARs). 3% range uncertainties and 3mm setup uncertainties were applied for robust optimization. The log files of clinical IMPT were exported to calculate true treatment delivery time. The machine-specific delivery sequence model was utilized to …

A Comprehensive Investigation Of Linear Energy Transfer Optimization Effectiveness In Intensity-Modulated Proton Therapy Via Alternating Direction Method Of Multipliers (Impt Let-Admm), Q Fan, G Liu, Lewei Zhao, Xiaoqiang Li, Xuanfeng Ding, S Dai

Conference Presentation Abstracts

Linear energy transfer (LET)-guided optimization in intensity-modulated proton therapy (IMPT) via alternating direction method of multipliers (ADMM) has the potential to improve its biological effectiveness (IMPTLET- ADMM), in which the LET distribution in target can be escalated, while the LET distribution in the organs at risk can be mitigated. This study aims to quantitatively investigate the effectiveness of LET optimization in IMPT via ADMM with different solvers in its iteration loop. Methods: The clinical dose-volume-histogram (DVH) constraint noted dose sub-problem and clinical LET -volume-histogram (LVH) constraint noted LET sub-problem are combined to generate a composite objective function, which is available …

Does Proton Arc Therapy Has Potential Clinical Benefits For Hepatocellular Carcinoma?, Peilin Liu, R Dalfsen, M Soukup, Shupeng Chen, Lewei Zhao, Z Wang, X S. Gao, Thomas Quinn, Craig Stevens, Rohan Deraniyagala, Xiaoqiang Li, Xuanfeng Ding

Conference Presentation Abstracts

Purpose: To investigate the potential clinical benefits and dose-averaged Linear Energy Transfer (LETd) sparing, utilizing proton arc plan for Hepatocellular carcinoma (HCC) patients in comparison with Intensity Modulated Proton Therapy (IMPT). Methods: Ten HCC patients have been retrospectively selected. Two planning groups were created: Proton Arc plans using Monaco ver. 6 and the clinical IMPT plan. Both planning groups used the same robustness parameters. The prescription dose is 67.5 Gy (RBE) in 15 fractions/ 66 GyE in 10 fractions of the Clinical Target Volume (CTV) following clinical IMPT plan. Robustness evaluations were performed to ensure target dose coverage. Normal Tissue …

An Analytic Model Of The External Beam Dose Rate Effect On Immune Cells In Blood Dosimetry, Lewei Zhao, Peilin Liu, G Liu, Xuanfeng Ding

Conference Presentation Abstracts

Purpose: Radiation therapy is a double-edged sword with regard to its immunomodulatory effect. It is critical to find how it is affected by dose rate. Thus, we developed an analytic model for calculating the number of immune cells receiving radiation. Methods: Suppose the blood is received radiation by constant dose rate. The blood is one-way flow without circulation in the radiation delivery at a constant velocity. Two kinds of lung treatment regimens were considered standard delivery 2Gy per fx total 30fx and hypo-fractionation SBRT 12 Gy per fx total 5 fx. Two different dose rates were simulated for standard treatment: …

Particle Arc Single-Isocenter Stereotactic Radiosurgery Of Multiple Brain Metastases, L Volz, S Mein, T Tessonnier, Peilin Liu, A Mairani, M Durante, Xuanfeng Ding, C Graeff, T Li

Conference Presentation Abstracts

Purpose: To develop spot-scanning proton (SPArc) and heavy ion (SHArc) arc therapy for single-isocenter stereotatic radiosurgery (SISRS) of multiple brain metastases (MBMs). First results achieved with dedicated planning infrastructure are compared to state-of-the -art volumetric modulated photon arc therapy (HA-VMAT). Methods: A multi-institutional collaboration was established to develop bespoke SPArc and SHArc SISRS infrastructure with available research and commercial treatment planning systems. Devised planning and delivery methods considered dedicated energy, spot, and multi-arc selection strategies. SPArc and SHArc (carbon and helium ions) plans were generated for MBM patients exhibiting 3-12 intracranial lesions with GTV volumes between 0.03ccm and 19.8ccm, at …

The Clinical Usability, Efficiency, And Accuracy Of Combining Deep-Learning-Based Synthetic Ct And Auto-Contouring For Daily Cbct-Based Online Adaptive Radiation Therapy, An Qin, J Xu, N O'Connell, Xuanfeng Ding, Shupeng Chen, D Thill

Conference Presentation Abstracts

Purpose: To evaluate the feasibility of deep-learning and CBCT-based online adaptive radiotherapy(ART) in thorax, Head&Neck, and pelvic regions. Methods: The study utilized ADMIRE(Advanced Medical Image Registration Engine), a research software designed to enable fast online ART through: (1)synthetic CT(sCT) generation from CBCT, (2)automatic segmentation of critical organs(OARs), and(3)deformable image registration(DIR) to transfer the target volume. ADMIRE trained a modified Cycle-Generative-Adversarial-Networks with Structural Similarity Index Map(SSIM) loss term to generate sCT, while the auto-segmentation model was based on a 3D-ResUnet with modification. Site-specific models were trained for three anatomic sites: thorax, pelvic, and head&neck, and for both networks. The study included …

Internal Lead Shielding For Clinical Electron Treatments, Patrick N. Mcdermott

Conference Presentation Abstracts

Purpose: Electron beams are often used to treat superficial lesions of the lip, cheek, nose and ear. Lead is frequently used to block distal structures. It is customary to place an internal bolus of low atomic number in between the tissue and the lead to reduce electron backscatter from the lead. Space for the lead and the internal bolus is quite limited. The current method, recommended by TG25, for estimating the thickness of the lead plus internal bolus is not self-consistent and leads to a larger than necessary thickness. Furthermore, this method uses an older expression for the electron backscatter …

A Novel Planning Framework For The Efficient Spot-Scanning Proton Arc Therapy Via The Particle Swarm Optimization (Sparc-Particle Swarm), Y Qian, R Dao, G Liu, Xiaoqiang Li, H Quan, Xuanfeng Ding

Conference Presentation Abstracts

Purpose: The delivery efficiency is the bottleneck of spot-scanning proton arc therapy (SPArc) because of the numerous energy layers (EL) ascending switches. This study aims to develop a new algorithm to mitigate the need of EL ascending via water equivalent thickness (WET) sector selection followed by the particle swarm optimization (SPArc- particle swarm). Methods: SPArc- particle swarm divided the full arc trajectory into the optimal sectors based on the K-means clustering analysis of the relative mean WET. Within the sector, particle swarm optimization was used to minimize the total energy switch time, in which it optimized the energy selection integrated …

Application Of A Novel Optical Tool For Linac Calibrations, Cory S. Knill, Brian Loughery, Raminder P. Sandhu, Lifeng Lin, Mark Stefani

Conference Presentation Abstracts

Purpose: Maintaining a linac within tight stereotactic isocentricity tolerances requires minimizing errors in individual components of the linac. However, while isocentricity can be measured using a Winston-Lutz test, contributions from individual components can be difficult to discern. The disconnect between how individual components contribute to isocentricity can lead to lengthy troubleshooting exercises when isocentricity is outside tolerance. To provide more info rmation to physicists and increase the speed of isocentricity adjustments, a new tool that uses optical tracking to investigate and adjust individual linac components that contribute to isocentricity was tested on three clinical linacs. Methods: The optical tracking tool …

Individual Vmat Beam Complexity Indices Have Limited Predictive Value For Qa Pass-Rates, Jian Liang, Q Liu, David T. To, Michael G. Snyder

Conference Presentation Abstracts

Purpose: Previous studies with sample sizes <400 have indicated that VMAT beam complexity indices may have a relationship with measured QA pass-rates. The aim of this study is to evaluate such relationships on a large scale to further investigate their strength. Methods: Total of 17,273 VMAT QA results across 8 Elekta Agility machines were used in this study. All beams were flattened 6MV or 10MV. Sun Nuclear ArcCheck was used for QA measurements with γ-analysis parameters of 10% threshold, 3% dose difference, 2mm distance to agreement, and 95% passing threshold. A total 214 Beams (1.23%) failed QA. QA distributions in Pinnacle were calculated with 2 degree gantry intervals and a dose grid of 2mm. Four complexity indices (MCSv, MU weighted Segment Area, Segment Area/Perimeter, and Average Leaf Gap) were computed. Spearman’s correlations were evaluated for each, and cut-off values for the indices were sought to indicate values above which no QA failures would be expected. Results: Evaluation of the 4 complexity metrics showed weak correlation with QA pass rates (< ±0.42) with high significance (p < 0.001). When metrics were evaluated independently, cut-off values from correlation plots separated only 0.67%, 0.72%, 2.2%, 6.3% guaranteed passing beams from the total sample, respectively. When evaluating whether anymetric for a given beam exceeded its cut-off, the fraction of guaranteed passing beams rose to only 6.6%. However, when cut-off values for one metric were allowed to be functionally dependent upon another, the fraction of guaranteed passing beams increased. For MU weighted Segment Area andAverage Leaf Gap, a dependent approach separated 19.1% guaranteed passing beams from the sample. Conclusion: Individual complexity metrics have weak predictive utility in assessing plan performance. However, using multiple complexity cut-off functions with dependence upon more than one metric increased the fraction of predicted passing beams by around 300%.

Linac-Based Srs Treatments Slow Down Unnecessarily Due To Parked Leaf Optimization, Brian Loughery, Cory S. Knill, Raminder P. Sandhu, Lifeng Lin, Jian Liang

Conference Presentation Abstracts

Purpose: It was observed on a VersaHD that clinical SRS deliveries created in the Elements treatment planning system (TPS) slowed gantry rotation and dose rate to allow parked MLC leaves to move into position for use in an upcoming control point. Gantry rotation slowed suddenly, visibly backtracking to previous gantry angles. The purpose of this work is to study the effect of parked MLC positioning parameters in Elements on cranial SRS delivery speed and gantry motion on a VersaHD. Methods: To study the effect of parked MLC leaf positions on VersaHD deliverability, cranial SRS plans were generated with different TPS …

Develop A Novel Beam Orientation Optimization Algorithm For Let (Linear Energy Transfer) Incorporated Impt (Intensity Modulated Proton Therapy) (Imptlet, R Dao, Y Qian, Xiaoqiang Li, H Quan, Xuanfeng Ding, G Liu

Conference Presentation Abstracts

Purpose: To improve the dose and LET distribution in the IMPTLET, we introduce a new optimization algorithm to search for the optimal beam orientation and count through the arc trajectory (BOC-IMPTLET). Methods: We introduce kmeans clustering analysis in the BOC-IMPTLET algorithm by analyzing the distribution of LET in the target from the full arc trajectory. The optimal of cluster count was used as beam count, which was determined based on the SSE (Sum of Square Error) value and the angle of the corresponding centroid of each cluster was used as beam orientation, respectively. The BOC-IMPTLET algorithm was implemented in the …

Comparison Of Vmat Beam Complexity With Different Mlc Collimator Rotation And Their Impact On Psqa Pass Rates, David T. To, Michael G. Snyder, Jian Liang

Conference Presentation Abstracts

Purpose: I t has been previously shown that utilizing a collimator angle of ±45° has demonstrated a reduction in MU and VMAT beam complexity. Studies have demonstrated this for VMAT prostate plans with small sample size. In this study we evaluate multiple collimator angles with a larger sample size and different treatment sites. Methods: A total of 17273 VMAT beams were evaluated with beam collimator rotations of 0°, ±5°, ±10°, ±15°, ±30°, ±45°, and ±90°. QA Gamma pass rates for our institution use a 3%/2mm criteria 10% threshold with 95% limit pass rate utilizing Sun Nuclear ArcCheck (helical diode array). …

Predicting Tumor Voxel Dose-Response Using Deep Learning On Serial Fdg-Pet Feedback Images, Shupeng Chen, Di Yan, An Qin, Rohan Deraniyagala, Daniel Krauss, Peter Chen, Craig Stevens

Conference Presentation Abstracts

Purpose: Tumor voxel dose-response matrix (DRM) can be assessed using a series of FDG-PET/CT feedback images acquired during radiotherapy. Predicting the tumor voxel DRM earlier is crucial for treatment adaptation. However, it is also challenging due to FDG fluctuation in tumor cells. This study investigated the feasibility of predicting DRM during early treatment weeks using deep learning (DL). Methods: FDG-PET images were acquired at the pretreatment (preTx), the 2nd and 4th weeks during chemo-radiotherapy (35×2Gy) from 50 head and neck patients. The reference value of tumor voxel DRM (DRMref), representing the average metabolic change ratio during the treatment, was determined …

Fiducial Markers Allow Accurate And Reproducible Delivery Of Liver Stereotactic Body Radiation Therapy, Marina Moskalenko, Bernard L. Jones, Adam Mueller, Shirley Lewis, Jay C. Shiao, Sara J. Zakem, Tyler P. Robin, Karyn A. Goodman

Department of Radiation Oncology Faculty Papers

Fiducial markers are utilized for image guided radiotherapy (IGRT) alignment during the delivery of liver stereotactic body radiosurgery (SBRT). There are limited data demonstrating the impact of matching fiducials on the accuracy of liver SBRT. This study quantifies the benefit of fiducial-based alignment and improvements in inter-observer reliability. Nineteen patients with 24 liver lesions were treated with SBRT. Target localization was performed using fiducial markers on cone-beam computed tomography (CBCT). Each CBCT procedure was retrospectively realigned to match both the liver edge and fiducial markers. The shifts were recorded by seven independent observers. Inter-observer variability was analyzed by calculating the …

Clinical Outcomes Of Immunotherapy Continued Beyond Radiographic Disease Progression In Older Adult Patients With Advanced Non-Small Cell Lung Cancer, Eric K Singhi, Frank Mott, Michelle Worst, Cheuk Hong Leung, J Jack Lee, Brett Carter, Carolyn J Presley, John V Heymach, Mehmet Altan

Faculty, Staff and Student Publications

Immunotherapy is an effective and generally well-tolerated treatment strategy for older adult patients (aged ≥70 years) with advanced non-small cell lung cancer (NSCLC). Unfortunately, most patients who receive immunotherapy eventually exhibit disease progression during treatment. The present study reports on a subset of older adult patients with advanced NSCLC who could effectively continue immunotherapy beyond radiographic disease progression due to perceived clinical benefit. Local consolidative radiotherapy may be used in select older adult patients to prolong the duration of immunotherapy they receive, with a particular consideration of their preexisting co-morbidities, performance status and tolerance of potential toxicities associated with combined …

Tumor Locations Impact On Cardiac Toxicity In Women That Received Partial Breast Irradiation, Sara Diltz, Muayad Almahariq, Joshua Dilworth

Posters

Accelerated partial breast irradiation (APBI) is an appropriate modality for select women with low-risk breast cancer. While APBI delivers radiation dose to a smaller volume of breast tissue compared to whole breast irradiation, dose to the heart and coronary vessels may be relatively high, depending on the proximity of the treatment device to these structures. The primary goal of this study is to determine if the risk of adverse cardiac events depends on tumor location in women receiving APBI.

High Dose Rate Brachytherapy Monotherapy Versus External Beam Radiotherapy With Hdr Brachytherapy Boost For Unfavorable Intermediate Prostate Cancer Patients, Doyle Lang, Benjamin Willen, Daniel J. Krauss, Sirisha R. Nandalur

Posters

Prostate cancer is the most common male malignancy by incidence in the world. Treatment differs by the patient’s risk stratification. For the treatment of unfavorable intermediate-risk prostate cancer, external beam radiotherapy with high-dose-rate brachytherapy boost was the accepted treatment but high-dose-rate brachytherapy as monotherapy has been proposed as a potentially viable treatment option. External beam radiotherapy treatment involves shooting high-energy photons or particle radiation through normal healthy tissue to hit the tumor directly. High-dose-rate brachytherapy involves inserting radioactive seeds into the tumor. Studies are needed to compare toxicity profiles and relative outcomes between the two treatment options.

Improving Dose-Response Correlations For Locally Advanced Nsclc Patients Treated With Imrt Or Pspt, Yulun He

Dissertations and Theses (Open Access)

The standard of care for locally advanced non-small cell lung cancer (NSCLC) is concurrent chemo-radiotherapy. Despite recent advancements in radiation delivery methods, the median survival time of NSCLC patients remains below 28 months. Higher tumor dose has been found to increase survival but also a higher rate of radiation pneumonitis (RP) that affects breathing capability. In fear of such toxicity, less-aggressive treatment plans are often clinically preferred, leading to metastasis and recurrence. Therefore, accurate RP prediction is crucial to ensure tumor coverage to improve treatment outcome. Current models have associated RP with increased dose but with limited accuracy as they …

Automating The Radiation Therapy Treatment Planning Process For Pediatric Patients With Medulloblastoma, Soleil Hernandez

Dissertations and Theses (Open Access)

Over the past 50 years, pediatric cancer 5-year survival rates increased from 20% to 80% in high-income countries, however, these trends have not been mirrored in low-and-middle-income countries (LMICs). This is due in part to delayed diagnosis, higher rates of advanced disease at presentation and a growing lack of access to high quality medical personnel and technology necessary to deliver complex treatments.

The long-term goal of this study was to alleviate demanding workflows and increase global access to high-quality pediatric radiation therapy by harnessing the power of artificial intelligence to automate the radiation therapy treatment planning process for pediatric patients …

Impact Of Structured Reporting Template On The Quality Of Hrct Radiology Reports For Interstitial Lung Disease, Han G. Ngo, Girish B. Nair, Sayf Al-Katib

Posters

This QI study compared the completeness of HRCT radiology reports before and after the implementation of a disease-specific structured reporting template for suspected cases of interstitial lung disease (ILD).

Dose To The Left Anterior Descending Artery Correlates With Cardiac Events After Irradiation For Breast Cancer, Brittany Silverman, Andrew Zureick, Vincent Grzywacz, Muayad Almahariq, Aleksander Vayntraub, Joshua Dilworth

Posters

Although global heart dose has been associated with late cardiac toxic effects in patients who received radiation therapy for breast cancer, data detailing the clinical significance of cardiac substructure dosimetry are limited. We investigated whether dose to the left anterior descending artery (LAD) correlates with adverse cardiac events.

Influence Of Pretreatment Magnetic Resonance Imaging On Local Therapy Decisions For Intermediate-Risk Prostate Cancer Patients, Christian Skowronski, Andrew Shanholtzer, Brent Yelton, Muayad Almahariq, Daniel Krauss

Posters

Prostate cancer has the third highest incidence rate and is the second leading cause of cancer death for men in the United States. Magnetic resonance imaging (MRI) provides superior soft tissue delineation serving as a valuable tool for both diagnosis and treatment planning. With minimal data regarding utility on diagnosis and treatment planning for intermediate-risk prostate cancer, the National Comprehensive Cancer Network’s guidelines indicate MRI as optional in intermediate-risk prostate cancer evaluation. This project aims to elucidate whether MRI affects radiation treatment decisions for intermediate-risk prostate cancer.