Radiation Medicine Commons^™

Vidutolimod In Combination With Atezolizumab With And Without Radiation Therapy In Patients With Programmed Cell Death Protein 1 Or Programmed Death-Ligand 1 Blockade-Resistant Advanced Nsclc, Marcelo V Negrao, Vassiliki A Papadimitrakopoulou, Andrew C Price, Alda L Tam, Muhammad Furqan, Sandeep T Laroia, Erminia Massarelli, Jose Pacheco, John V Heymach, Anne S Tsao, Gary V Walker, Lalit Vora, David Mauro, Heather Kelley, James E Wooldridge, Arthur M Krieg, Jiaxin Niu

Faculty, Staff and Student Publications

INTRODUCTION: Vidutolimod, a CpG-A TLR9 agonist, was investigated in a phase 1b study (CMP-001-003; ClinicalTrials.gov, NCT03438318) in combination with atezolizumab with and without radiation therapy (RT) in patients with advanced NSCLC.

METHODS: Patients with progressive disease after anti-programmed cell death protein 1 or programmed death-ligand 1 therapy received either vidutolimod and atezolizumab (part A) or vidutolimod, atezolizumab, and RT (part B). The primary objective was to evaluate the safety of vidutolimod and atezolizumab with and without RT. Key secondary end point was best objective response rate per Response Evaluation Criteria in Solid Tumors, version 1.1.

RESULTS: Between March 28, 2018, …

Circulating Neutrophils And Tumor-Associated Myeloid Cells Function As A Powerful Biomarker For Response To Chemoradiation In Locally Advanced Cervical Cancer, Olsi Gjyshi, Adam Grippin, Lauren Andring, Anuja Jhingran, Lilie L Lin, Julianna Bronk, Patricia J Eifel, Melissa M Joyner, Jagannadha K Sastry, Kyoko Yoshida-Court, Travis N Solley, Tatiana Cisneros Napravnik, Madison P O'Hara, Venkatesh L Hegde, Lauren E Colbert, Ann H Klopp

Faculty, Staff and Student Publications

PURPOSE: The immune system's role in mediating the cytotoxic effects of chemoradiotherapy remains not completely understood. The integration of immunotherapies into treatment will require insight into features and timing of the immune microenvironment associated with treatment response. Here, we investigated the role of circulating neutrophils and tumor-associated myeloid cells (TSAMs) as potential agents and biomarkers for disease-related outcomes in locally advanced cervical cancer (LACC).

MATERIAL AND METHODS: Hematologic parameters for two LACC patient cohorts, a retrospective clinical and a prospective translational cohort, were obtained at baseline, weekly during chemoradiotherapy for the retrospective cohort, biweekly during chemoradiotherapy for the prospective cohort, …

Carbon Fiber-Reinforced Polyetheretherketone Spinal Implants For Treatment Of Spinal Tumors: Perceived Advantages And Limitations, Christopher Alvarez-Breckenridge, Romulo De Almeida, Ali Haider, Matthew Muir, Justin Bird, Robert North, Laurence Rhines, Claudio Tatsui

Faculty, Staff and Student Publications

PURPOSE: Carbon-fiber reinforced polyetheretherketone (CFRP)-based spinal implants are an alternative to titanium, offering less image artifact as their metallic counterparts while maintaining similar biomechanical and biocompatibility properties. Its use in the management of spinal tumors has been reported, however the perceived advantages related to improved imaging quality, radiation treatment planning, and detection of tumor recurrence have not been fully assessed.

METHODS: We performed a retrospective review of medical records amongst oncologic patients treated at MD Anderson Cancer Center with CFRP implants. Histology, tumor location, construct features, time of follow-up, adjuvant radiation, recurrences, overall survival, and hardware-related complications were recorded.

RESULTS: …

Radiation Therapy For Retroperitoneal Sarcomas: A Strass-Ful Situation, Ahsan S Farooqi, B Ashleigh Guadagnolo, Devarati Mitra, Andrew J Bishop

Faculty, Staff and Student Publications

Locoregional recurrence (LRR) is the predominant pattern of relapse and often the cause of death in patients with retroperitoneal sarcomas (RPS). As a result, reducing LRR is a critical objective for RPS patients. However, unlike soft tissue sarcomas (STS) of the superficial trunk and extremity where the benefits of radiation therapy (RT) are well-established, the role of RT in the retroperitoneum remains controversial. Historically, preoperative or postoperative RT, either alone or in combination with intraoperative radiation (IORT), was commonly justified for RPS based on extrapolation from the superficial trunk and extremity STS literature. However, long-awaited results were recently published from …

Breast Cancer Characterization Using Artificial Intelligence In Screening And Diagnostic Mammogram Of Thai Women, Jaroonroj Wongnil

Chulalongkorn University Theses and Dissertations (Chula ETD)

Breast cancer is a significant health issue in Thailand, necessitating accurate detection and characterization for effective treatment. This thesis focuses on leveraging artificial intelligence techniques to develop breast cancer screening and diagnosis using mammography images of Thai women. Furthermore, detecting and classifying mammography calcifications, crucial indicators of malignant or benign conditions had also been focused using RCNN and YOLOv4 in this study. AlexNet CNN was developed to increase the robustness of the RCNN model. AlexNet was tested with three different datasets, each consisting of 4,000 cropped ROI images. These datasets were divided into an 80% training set and a 20% …

Determination Of Kinetic Parameters For Bone Turnover In Chronic Kidney Disease With Hemodialysis Patients Using Dynamics 18f-Naf Pet/Ct Imaging, Viyada Sanoesan

Chulalongkorn University Theses and Dissertations (Chula ETD)

Bone turnover measurement using 18F-NaF PET/CT serves as a valuable imaging biomarker for studying bone metabolism at various sites of skeleton. This study aimed to determine the kinetic parameters (Ki–Patlak) for bone turnover prediction as a non-invasive biomarker from dynamic 18F-NaF PET/CT in chronic kidney disease (CKD) patients with hemodialysis. Moreover, we aimed to investigate whether Ki–Patlak derived from shortened scan time can provide a prediction equivalent to that obtained from routine dynamic scan. Twenty-seven Thai CKD patients on hemodialysis (48 scans) from December 2021 to December 2023 were recruited. After intravenous injection of 18F-NaF of 133±39.3 MBq, dynamic PET/CT …

Characteristics Of Two-Dimensional Ionization Chamber Array For Patient-Specific Quality Assurance In Pencil Beam Scanning Proton Therapy, Nuttida Rawiwan

Chulalongkorn University Theses and Dissertations (Chula ETD)

Proton therapy is an advanced technique that uses positive particles in external treatment. It can spare normal tissue and increase tumor control probability. In radiotherapy, patient-specific quality assurance is an important part, but according to protons’ characteristics, especially finite range, it is challenging to do verification because when the density has changed the finite range will have drastic changes. Although the two-dimensional ionization chamber array is used for patient-specific quality assurance in pencil beam scanning proton therapy, most studies investigate the IBA MatriXX as the dosimetry device, and few studies explored the PTW OCTAVIUS 1500XDR. This research aims to determine …

Determination Of The Surface Dose Correction Factors For Various Detectors In Proton Scanning Therapy, Pakjira Saruang

Chulalongkorn University Theses and Dissertations (Chula ETD)

Proton therapy delivers tumors doses precisely but concerns about skin toxicity due to energy dispersion beyond the Bragg peak remain. Accurate surface dose measurement is crucial for calculating the radiation dose patients receive. Studying factors that improve measurement accuracy is essential, as current methods are challenging and often inaccurate. This research aims to determine the surface dose correction factors (Scf) for various detectors in spot scanning beam proton therapy and study the effect of surface dose according to various clinical factors. The PTW Advanced Markus, PTW Roos chamber and IBA FC65-G Farmer chamber were utilized to measure the surface dose …

Dosimetric Comparison Of Imrt, Co-Planar Vmat, Non-Coplanar Vmat And Hyperarc For Multiple Brain Metastases Srs, Aksarapak Thawornnittayakul

Chulalongkorn University Theses and Dissertations (Chula ETD)

Multiple brain metastases patients are typically treated by stereotactic radiosurgery (SRS) or whole brain radiation therapy (WBRT). In addition, there are advanced techniques for treating multiple brain metastases such as 3-dimensional Conformal Radiation Therapy (3D-CRT), Intensity Modulated Radiation Therapy (IMRT), and Volumetric Modulated Arc Therapy (VMAT). A new isocentric VMAT technique called HyperArc was developed for non-coplanar, it is an automated setting for couch angle and collimator angle. This study aims to compare the dosimetric effect for a single isocenter among Intensity Modulated Radiation Therapy, Volumetric Modulated Arc Therapy, and HyperArc for multiple brain metastases stereotactic radiosurgery. For 25 patients …

Accuracy Of 177lu Quantification For Dosimetry Calculation Using 12-Swiveling Czt Detectors Spect/Ct Camera, Panattha Damthongsen

Chulalongkorn University Theses and Dissertations (Chula ETD)

Recently, the 12-cadmium zinc telluride (CZT) based digital detectors SPECT/CT system has been introduced for advanced technology in nuclear medicine instrument, which outperforms conventional cameras. Moreover, the voxel S value-based dosimetry is important and offers more accurate in personalized dosimetry treatment using targeted radionuclide therapy. This study aimed to determine the accuracy of 177Lu quantification through an IEC/NEMA phantom study and to evaluate total-body dosimetry in patients undergoing 177Lu therapy using 12-swiveling digital CZT detectors SPECT/CT camera. The NEMA/IEC body phantom inserted with six fillable spheres (10-, 13-, 17-, 22-, 28-, and 37-mm inner diameter), filled with 177Lu solution of …

Impact Of Contrast Agent Administration On Water Equivalent Diameter For Ssde Calculation In Chest Ct Angiography Examination, Nuttanit Kaewsan

Chulalongkorn University Theses and Dissertations (Chula ETD)

This study aimed to determine the impact of intravenous contrast enhancement on the calculation of water equivalent diameter (Dw) for size-specific dose estimate (SSDE) in chest CT angiography (CTA) using different calculation methods in non-contrast and arterial phase images. A cohort of 231 adult patients who underwent chest CT angiography at King Chulalongkorn Memorial Hospital (KCMH) were included. The 3D Slicer image computing software was used to automatically draw the ROI in each axial CT image to measure area and mean CT number. The Dw values were calculated following the American Association of Physicists in Medicine (AAPM) Report No.220 utilizing …

Dose Evaluation Of A Deep Learning-Based Synthetic Ct Generation In Head And Neck Cancer For Photon And Proton Therapy, Ailada Kuibumrung

Chulalongkorn University Theses and Dissertations (Chula ETD)

MRI has been increasingly implemented for the treatment planning process and the MRI-only workflow in both photon and proton therapy. This study aims to investigate and explore the accuracy of dose calculations in head and neck region based on synthetic CT (sCT) images, using the commercial software methods for both volumetric modulated arc therapy (VMAT) and intensity modulated proton therapy (IMPT) plans. The sCT images were generated from MRI images for five head and neck cancer cases that underwent VMAT and IMPT by MRI Planner commercial software. The mean absolute error (MAE) and mean error (ME) within the body, bone …

Characterization Of A Solid-State Detector For Dosimetry In The Diagnostic Energy Range With Verification Via Monte Carlo Estimation Of Average Breast Dose In Mammography, Areej Aljabal

Theses and Dissertations

This dissertation aims to develop a simplified QA metric for estimating radiation dose in mammography. This metric, the Mid-Breast Dose (MDB) Index, maybe be proposed as an alternative dose index, consistent with average glandular dose (AGD), for routine QA. MBD was obtained using “Phantom mid-point Air Kerma (AK) measurement” for conventional mammography. The advantage of this method is that MBD can be measured directly without requiring multiple conversion factors. The accuracy of clinical measurements in computing the MBD was assessed by comparing it with the AGD estimated by the Dance formalism experimentally and Monte Carlo simulation.

MBD methodology relies on …

Comparison Of Modified Formalism Output And Trs-398 Absorbed Dose To Water In Electron Beams Reference Dosimetry In Multiple Radiotherapy Centers, Yasumon Thinka

Chulalongkorn University Theses and Dissertations (Chula ETD)

The study aimed to investigate the feasibility and efficacy of utilizing modified calibration with cylindrical chambers for reference dosimetry in electron beam radiotherapy, challenging the recommendation of using plane-parallel chambers in low-energy electron beams by IAEA's TRS-398 and AAPM's TG-51 standards. Data collection involved six radiotherapy centers in Bangkok using Varian linear accelerators, with chambers including the IBA FC65-G, PTW 30013 cylindrical chambers, and PPC40, Roos plane-parallel chambers. Results of dose comparison between modified and TRS-398 protocols fell within ±2%. For low-energy electron beams, percent dose discrepancies ranged from -1.57% to 0.91%, and from -0.37% to 0.91% for high-energy. The …

Evaluation Of Patient Radiation Dose And Risk Of Cancer From Ct Examinations, Saowapark Poosiri

Chulalongkorn University Theses and Dissertations (Chula ETD)

Computed Tomography (CT) examinations have been increasingly requested and become the major sources of patient exposure. The cancer risk from CT scans is contingent upon the amount of organ absorbed dose. This study aims to evaluate the cumulative effective doses (CED) and risk of cancer incidence and mortality from recurrent CT examinations in a single day. The patient data at aged 15 to 75 years old performed CT examinations during the period of five years from January 2018 to December 2022 were collected from two academic centers. The CED and organ doses were evaluated using Radimetrics™ Enterprise Platform from Monte …

Safety Of Concurrent Radiation Therapy With Brentuximab Vedotin In The Treatment Of Lymphoma, Susan Y Wu, Penny Q Fang, Ethan B Wang, Sairah Ahmed, Madeleine Duvic, Preetesh Jain, Luis E Malpica Castillo, Ranjit Nair, Raphael E Steiner, Paolo Strati, Auris O Huen, Swaminathan P Iyer, Chelsea C Pinnix, Bouthaina S Dabaja, Jillian R Gunther

Faculty, Staff and Student Publications

PURPOSE: Purpose: Radiation therapy (RT) and the antibody-drug conjugate brentuximab vedotin (BV) are standard-of-care treatment options for patients with certain B and T-cell lymphomas; however, there are limited data exploring the safety of concurrent BV and RT (BVRT).

METHODS AND MATERIALS: We performed a single institutional retrospective review of 44 patients who received BVRT.

RESULTS: Twenty percent of patients (9/44) developed new grade 2 or higher (G2+) hematologic toxicity (HT) after BVRT, which was associated with radiation dose (median dose of 35 Gy in those with new G2+ HT compared with 15 Gy in those without;

CONCLUSIONS: Our analysis demonstrates …

Deep Learning-Based Dose Prediction For Automated, Individualized Quality Assurance Of Head And Neck Radiation Therapy Plans, Mary P Gronberg, Beth M Beadle, Adam S Garden, Heath Skinner, Skylar Gay, Tucker Netherton, Wenhua Cao, Carlos E Cardenas, Christine Chung, David T Fuentes, Clifton D Fuller, Rebecca M Howell, Anuja Jhingran, Tze Yee Lim, Barbara Marquez, Raymond Mumme, Adenike M Olanrewaju, Christine B Peterson, Ivan Vazquez, Thomas J Whitaker, Zachary Wooten, Ming Yang, Laurence E Court

Faculty, Staff and Student Publications

PURPOSE: This study aimed to use deep learning-based dose prediction to assess head and neck (HN) plan quality and identify suboptimal plans.

METHODS AND MATERIALS: A total of 245 volumetric modulated arc therapy HN plans were created using RapidPlan knowledge-based planning (KBP). A subset of 112 high-quality plans was selected under the supervision of an HN radiation oncologist. We trained a 3D Dense Dilated U-Net architecture to predict 3-dimensional dose distributions using 3-fold cross-validation on 90 plans. Model inputs included computed tomography images, target prescriptions, and contours for targets and organs at risk (OARs). The model's performance was assessed on …

Validation Of An Automated Contouring And Treatment Planning Tool For Pediatric Craniospinal Radiation Therapy, Soleil Hernandez, Hester Burger, Callistus Nguyen, Arnold C Paulino, John T Lucas, Austin M Faught, Jack Duryea, Tucker Netherton, Dong Joo Rhee, Carlos Cardenas, Rebecca Howell, David Fuentes, Julianne Pollard-Larkin, Laurence Court, Jeannette Parkes

Faculty, Staff and Student Publications

PURPOSE: Treatment planning for craniospinal irradiation (CSI) is complex and time-consuming, especially for resource-constrained centers. To alleviate demanding workflows, we successfully automated the pediatric CSI planning pipeline in previous work. In this work, we validated our CSI autosegmentation and autoplanning tool on a large dataset from St. Jude Children's Research Hospital.

METHODS: Sixty-three CSI patient CT scans were involved in the study. Pre-planning scripts were used to automatically verify anatomical compatibility with the autoplanning tool. The autoplanning pipeline generated 15 contours and a composite CSI treatment plan for each of the compatible test patients (n=51). Plan quality was evaluated quantitatively …

Head And Neck Radiation Therapy Patterns Of Practice Variability Identified As A Challenge To Real-World Big Data: Results From The Learning From Analysis Of Multicentre Big Data Aggregation (Lambda) Consortium, Amanda Caissie, Michelle Mierzwa, Clifton David Fuller, Murali Rajaraman, Alex Lin, Andrew Macdonald, Richard Popple, Ying Xiao, Lisanne Vandijk, Peter Balter, Helen Fong, Heping Xu, Matthew Kovoor, Joonsang Lee, Arvind Rao, Mary Martel, Reid Thompson, Brandon Merz, John Yao, Charles Mayo

Faculty, Staff and Student Publications

PURPOSE: Outside of randomized clinical trials, it is difficult to develop clinically relevant evidence-based recommendations for radiation therapy (RT) practice guidelines owing to lack of comprehensive real-world data. To address this knowledge gap, we formed the Learning from Analysis of Multicenter Big Data Aggregation consortium to cooperatively implement RT data standardization, develop software solutions for data analysis, and recommend clinical practice change based on real-world data analyzed. The first phase of this "Big Data" study aimed at characterizing variability in clinical practice patterns of dosimetric data for organs at risk (OARs) that would undermine subsequent use of large-scale, electronically aggregated …

Dose Escalation For Pancreas Sbrt: Potential And Limitations Of Using Daily Online Adaptive Radiation Therapy And An Iterative Isotoxicity Automated Planning Approach, Dong Joo Rhee, Sam Beddar, Joseph Abi Jaoude, Gabriel Sawakuchi, Rachael Martin, Luis Perles, Cenji Yu, Yulun He, Laurence E Court, Ethan B Ludmir, Albert C Koong, Prajnan Das, Eugene J Koay, Cullen Taniguichi, Joshua S Niedzielski

Faculty, Staff and Student Publications

PURPOSE: To determine the dosimetric limitations of daily online adaptive pancreas stereotactic body radiation treatment by using an automated dose escalation approach.

METHODS AND MATERIALS: We collected 108 planning and daily computed tomography (CT) scans from 18 patients (18 patients × 6 CT scans) who received 5-fraction pancreas stereotactic body radiation treatment at MD Anderson Cancer Center. Dose metrics from the original non-dose-escalated clinical plan (non-DE), the dose-escalated plan created on the original planning CT (DE-ORI), and the dose-escalated plan created on daily adaptive radiation therapy CT (DE-ART) were analyzed. We developed a dose-escalation planning algorithm within the radiation treatment …

Predictive Digital Twin For Optimizing Patient-Specific Radiotherapy Regimens Under Uncertainty In High-Grade Gliomas, Anirban Chaudhuri, Graham Pash, David A Hormuth, Guillermo Lorenzo, Michael Kapteyn, Chengyue Wu, Ernesto A B F Lima, Thomas E Yankeelov, Karen Willcox

Faculty, Staff and Student Publications

We develop a methodology to create data-driven predictive digital twins for optimal risk-aware clinical decision-making. We illustrate the methodology as an enabler for an anticipatory personalized treatment that accounts for uncertainties in the underlying tumor biology in high-grade gliomas, where heterogeneity in the response to standard-of-care (SOC) radiotherapy contributes to sub-optimal patient outcomes. The digital twin is initialized through prior distributions derived from population-level clinical data in the literature for a mechanistic model's parameters. Then the digital twin is personalized using Bayesian model calibration for assimilating patient-specific magnetic resonance imaging data. The calibrated digital twin is used to propose optimal …

Comparison Of Machine-Learning And Deep-Learning Methods For The Prediction Of Osteoradionecrosis Resulting From Head And Neck Cancer Radiation Therapy, Brandon Reber, Lisanne Van Dijk, Brian Anderson, Abdallah Sherif Radwan Mohamed, Clifton Fuller, Stephen Lai, Kristy Brock

Faculty, Staff and Student Publications

PURPOSE: Deep-learning (DL) techniques have been successful in disease-prediction tasks and could improve the prediction of mandible osteoradionecrosis (ORN) resulting from head and neck cancer (HNC) radiation therapy. In this study, we retrospectively compared the performance of DL algorithms and traditional machine-learning (ML) techniques to predict mandible ORN binary outcome in an extensive cohort of patients with HNC.

METHODS AND MATERIALS: Patients who received HNC radiation therapy at the University of Texas MD Anderson Cancer Center from 2005 to 2015 were identified for the ML (n = 1259) and DL (n = 1236) studies. The subjects were followed for ORN …

Using Patient Flow Analysis With Real-Time Patient Tracking To Optimize Radiation Oncology Consultation Visits, Shane Mesko, Julius Weng, Prajnan Das, Albert C Koong, Joseph M Herman, Dorothy Elrod-Joplin, Ashley Kerr, Thomas Aloia, John Frenzel, Katy E French, Wendi Martinez, Iris Recinos, Abdulaziz Alshaikh, Utpala Daftary, Amy C Moreno, Quynh-Nhu Nguyen

Faculty, Staff and Student Publications

PURPOSE: Clinical efficiency is a key component of the value-based care model and a driver of patient satisfaction. The purpose of this study was to identify and address inefficiencies at a high-volume radiation oncology clinic.

METHODS AND MATERIALS: Patient flow analysis (PFA) was used to create process maps and optimize the workflow of consultation visits in a gastrointestinal radiation oncology clinic at a large academic cancer center. Metrics such as cycle times, waiting times, and rooming times were assessed by using a real-time patient status function in the electronic medical record for 556 consults and compared between before vs after …

Quantitative Apparent Diffusion Coefficients From Peritumoral Regions As Early Predictors Of Response To Neoadjuvant Systemic Therapy In Triple-Negative Breast Cancer, Benjamin C Musall, Beatriz E Adrada, Rosalind P Candelaria, Rania M M Mohamed, Abeer H Abdelhafez, Jong Bum Son, Jia Sun, Lumarie Santiago, Gary J Whitman, Tanya W Moseley, Marion E Scoggins, Hagar S Mahmoud, Jason B White, Ken-Pin Hwang, Nabil A Elshafeey, Medine Boge, Shu Zhang, Jennifer K Litton, Vicente Valero, Debu Tripathy, Alastair M Thompson, Clinton Yam, Peng Wei, Stacy L Moulder, Mark D Pagel, Wei T Yang, Jingfei Ma, Gaiane M Rauch

Faculty, Staff and Student Publications

BACKGROUND: Pathologic complete response (pCR) to neoadjuvant systemic therapy (NAST) in triple-negative breast cancer (TNBC) is a strong predictor of patient survival. Edema in the peritumoral region (PTR) has been reported to be a negative prognostic factor in TNBC.

PURPOSE: To determine whether quantitative apparent diffusion coefficient (ADC) features from PTRs on reduced field-of-view (rFOV) diffusion-weighted imaging (DWI) predict the response to NAST in TNBC.

STUDY TYPE: Prospective.

POPULATION/SUBJECTS: A total of 108 patients with biopsy-proven TNBC who underwent NAST and definitive surgery during 2015-2020.

FIELD STRENGTH/SEQUENCE: A 3.0 T/rFOV single-shot diffusion-weighted echo-planar imaging sequence (DWI).

ASSESSMENT: Three scans were …

Expansion Of The Detrusor Muscular Ring Surrounding The Bladder Neck On Mri: Moving Beyond The Prostate As An Etiology Of Lower Urinary Tract Symptoms Due To Benign Prostatic Hyperplasia, Kiran Nandalur, David Walker, Hong Ye, Sayf A. Al-Katib, Brian Seifman, David Gangwish, Abhay Dhaliwal, Connor Ervin, Kayla Dobies, Channing Sesoko, Sirisha Nandalur, Bernadette Zwaans, Jennifer Nguyen, Jason Hafron

Conference Presentation Abstracts

Purpose: The etiology of lower urinary tract symptoms secondary to benign prostatic hyperplasia (LUTS/BPH) remains uncertain. The purpose of our study was to quantitatively analyze pelvic anatomic characteristics on magnetic resonance imaging (MRI) to assess for independent factors for symptoms.
*Methods and Materials: This retrospective single-institution study evaluated treatment-naïve men who underwent prostate MRI within 3 months of International Prostate Symptom Score (IPSS) from June 2021 to February 2022. Factors measured on MRI included: detrusor muscular ring surrounding the bladder neck measured as area and alternatively diameter, central gland (CG) mean apparent diffusion coefficient (ADC), levator hiatus (LH) volume, intrapelvic …

Multi-Organ Segmentation Of Abdominal Structures From Non-Contrast And Contrast Enhanced Ct Images, Cenji Yu, Chidinma P Anakwenze, Yao Zhao, Rachael M Martin, Ethan B Ludmir, Joshua S Niedzielski, Asad Qureshi, Prajnan Das, Emma B Holliday, Ann C Raldow, Callistus M Nguyen, Raymond P Mumme, Tucker J Netherton, Dong Joo Rhee, Skylar S Gay, Jinzhong Yang, Laurence E Court, Carlos E Cardenas

Faculty, Staff and Student Publications

Manually delineating upper abdominal organs at risk (OARs) is a time-consuming task. To develop a deep-learning-based tool for accurate and robust auto-segmentation of these OARs, forty pancreatic cancer patients with contrast-enhanced breath-hold computed tomographic (CT) images were selected. We trained a three-dimensional (3D) U-Net ensemble that automatically segments all organ contours concurrently with the self-configuring nnU-Net framework. Our tool's performance was assessed on a held-out test set of 30 patients quantitatively. Five radiation oncologists from three different institutions assessed the performance of the tool using a 5-point Likert scale on an additional 75 randomly selected test patients. The mean (± …

Radiation Therapy Induces Immunosenescence Mediated By P90rsk, Masaki Imanishi, Haizi Cheng, Sivareddy Kotla, Anita Deswal, Nhat-Tu Le, Eduardo Chini, Kyung Ae Ko, Venkata S K Samanthapudi, Ling-Ling Lee, Joerg Herrmann, Xiaolei Xu, Cielito Reyes-Gibby, Sai-Ching J Yeung, Keri L Schadler, Syed Wamique Yusuf, Zhongxing Liao, Roza Nurieva, El-Ad David Amir, Jared K Burks, Nicolas L Palaskas, John P Cooke, Steven H Lin, Michihiro Kobayashi, Momoko Yoshimoto, Jun-Ichi Abe

Faculty, Staff and Student Publications

Radiation therapy (RT) to the chest increases the patients’ risk of cardiovascular disease (CVD). A complete understanding of the mechanisms by which RT induces CVD could lead to specific preventive, therapeutic approaches. It is becoming evident that both genotoxic chemotherapy agents and radiation induce mitochondrial dysfunction and cellular senescence. Notably, one of the common phenotypes observed in cancer survivors is accelerated senescence, and immunosenescence is closely related to both cancer risk and CVD development. Therefore, suppression of immunosenescence can be an ideal target to prevent cancer treatment-induced CVD. However, the mechanism(s) by which cancer treatments induce immunosenescence are incompletely characterized. …

Optimisation Of Imaging Parameters During Ct Guided Interventional Procedures In Patients With Total Hip Arthroplasty, Anish Patel, Christine Azzopardi, Scott Evans, A Mark Davies, Steven James, Rajesh Botchu

Faculty, Staff and Student Publications

OBJECTIVE: To determine the optimal KV and mAs settings during CT guided injections in the presence of a total hip arthroplasty so that image quality is maintained whist keeping the dose as low as reasonably achievable.

METHODS: A total hip arthroplasty phantom with needles with differing gauges was scanned using different CT parameters (from low dose to high dose) and evaluating if this had any effect on needle conspicuity. Conspicuity was graded from 1 to 3 by 2 independent blinded reviewers.

RESULTS: Irrespective of the CT settings used (high dose or low dose parameters) needle conspicuity was not adversely affected …

Diagnostic Value Of Ultrasound In Children With Transverse Testicular Ectopia, Wei Zhou, Shoulin Li, Hao Wang, Jianchun Yin, Xiaodong Liu, Junhai Jiang, Guanglun Zhou, Jianguo Wen

Faculty, Staff and Student Publications

OBJECTIVE: The study aimed to investigate the diagnostic value of ultrasound in children's transverse testicular ectopia (TTE).

MATERIALS AND METHODS: We retrospectively studies all TTE cases diagnosed in our hospital from January 2017 to December 2021. All cases were evaluated by ultrasound examination and compared to physical examination and diagnostic laparoscopy results.

RESULTS: This study included 14 TTE patients in total, with a median age was 1.08 years. In the 14 TTE, physical examination found 10 TTE cases, of which nine testes were located in the opposite scrotum, one testis was located in the opposite groin, and the other four …

Distinguishing Intrathyroid Parathyroid Adenoma From Colloid Nodules And Papillary Thyroid Carcinomas Using Multiphasic Multidetector Computed Tomography, J Matthew Debnam, T Linda Chi, Michael Kwon, Jia Sun, Dawid Schellingerhout, Brandon T Golant, Salmaan Ahmed, Nancy D Perrier, Thinh Vu

Faculty, Staff and Student Publications

OBJECTIVE: The aim of the study is to determine whether multiphase multidetector computed tomography (4D-MDCT) can differentiate between intrathyroid parathyroid adenomas (ITPAs), colloid nodules, and papillary thyroid carcinoma (PTC).

METHODS: We studied 22 ITPAs, 22 colloid nodules, and 11 PTCs in 55 patients. Hounsfield unit (HU) values of the nodules were measured on 4D-MDCT in the precontrast, arterial, venous, and delayed phases. Raw HU values, phase with peak enhancement, and washout percentages between the phases were evaluated.

RESULTS: Regardless of size, all ITPAs (22/22) showed peak enhancement in the arterial phase, which was significantly greater than both colloid nodules (15/22) …