Radiation Medicine Commons^™

Mepilex Use In Breast Cancer Radiotherapy Patients, Yeuying Qiu, Sean Quinlan-Davidson Md

Research Scholars

No abstract provided.

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

Dissertations and 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 …

Advancement Of A 3d Computational Phantom And Its Age Scaling Methodologies For Retrospective Dose Reconstruction Studies, Aashish Gupta

Dissertations and Theses (Open Access)

We have used a 3D age-scalable computational phantom for over two decades for retrospective dose reconstruction studies of childhood cancer survivors (CCS) treated with 2D historic radiotherapy (RT). However, our phantom and its age scaling functions (ASF) must be updated so that it can be used in studies that include survivors treated with contemporary RT. We aimed to implement our phantom and its age scaling functions in DICOM format and determine the feasibility of applying our ASFs to accurately scale the whole-body CT-based anatomies.

In the implementation study, we developed Python scripts that model the phantom and ASFs in a …

Monte Carlo (Gate/Geant4) Estimation Of Clinician Hand Dose From Radionuclide Injection, H Edelman, Brian Loughery

Conference Presentation Abstracts

No abstract provided.

Modeling Of Island Block Scatter For Intensity Modulated Bolus Electron Conformal Therapy, Joseph G. Scotto

LSU Master's Theses

Purpose: Bolus electron conformal therapy (BECT) benefits treatment of the post-mastectomy chest wall, head and neck, paraspinal muscles, and extremities. Patient dose heterogeneities caused by bolus can be reduced through intensity modulation (IM) across the incident electron beam. This requires passive radiotherapy intensity modulation for electrons (PRIME) devices, which utilize tungsten pins (island blocks) imbedded in machinable foam. IM-BECT treatment planning requires accurate dose calculation using the pencil beam redefinition dose algorithm (PBRA). Currently, the PBRA models island blocks as perfect collimators. This work explores models to account for electrons scattering into and out of the sides of island blocks. …

Structural Shielding Considerations For Vmat, Ana Lucia Dieguez

LSU Master's Theses

Introduction: As noted in National Council on Radiation Protection and Measurements (NCRP) Report 151, the medical physicist or other qualified expert has the responsibility to keep abreast of any new technology or treatment method that could potentially impact structural shielding design. Volumetric arc therapy (VMAT) became prevalent after the publication of Report 151 and thus was not explicitly addressed in Report 151. If the shielding-related characteristics of VMAT differ enough from the expectations of Report 151, especially in the circumstance of a vault utilized exclusively for VMAT, a shielding design based on Report 151 could potentially be inadequate. The …

Estimating The Tolerance Of Brachial Plexus To Hypofractionated Stereotactic Body Radiotherapy: A Modelling-Based Approach From Clinical Experience., Irina Kapitanova, Sharmi Biswas, Sabrina Divekar, Eric J. Kemmerer, Robert A. Rostock, Kenneth M Forster, Rachel J. Grimm, Carla J Scofield, Jimm Grimm, Bahman Emami, Anand Mahadevan

Department of Radiation Oncology Faculty Papers

BACKGROUND: Brachial plexopathy is a potentially serious complication from stereotactic body radiation therapy (SBRT) that has not been widely studied. Therefore, we compared datasets from two different institutions and generated a brachial plexus dose-response model, to quantify what dose constraints would be needed to minimize the effect on normal tissue while still enabling potent therapy for the tumor.

METHODS: Two published SBRT datasets were pooled and modeled from patients at Indiana University and the Richard L. Roudebush Veterans Administration Medical Center from 1998 to 2007, as well as the Karolinska Institute from 2008 to 2013. All patients in both studies …

Flash Radiotherapy: Skin Pigmentation As A Non-Invasive Indicator For Radiation-Induced Damage, Brady Mccallister

ENGS 88 Honors Thesis (AB Students)

FLASH ultra-high dose rate radiotherapy (RT) is one of the most rapidly growing subfields of radiation oncology today due to its potential to increase the limits of the therapeutic ratio. The FLASH effect, which includes heightened normal tissue sparing paired with iso-effective tumor cell killing, has been literature documented, in a limited manner, in rodent models, a few large animals, and one clinical patients.

A porcine-based experiment was conducted to test the effects of FLASH RT on normal tissue compared to conventional (CONV) RT. A clinical linear accelerator (LINAC) was reversibly converted to be capable of FLASH RT. A female …

Pembrolizumab Plus Concurrent Chemoradiation Therapy In Patients With Unresectable, Locally Advanced, Stage Iii Non-Small Cell Lung Cancer: The Phase 2 Keynote-799 Nonrandomized Trial, Salma K. Jabbour, Ki Hyeong Lee, Nikolaj Frost, Valeriy Breder, Dariusz M. Kowalski, Theodore Pollock, Evgeny Levchenko, Noemi Reguart, Alex Martinez-Marti, Baerin Houghton, Jean-Baptiste Paoli, Sufia Safina, Keunchil Park, Takefumi Komiya Md, Amy Sanford, Vishal Boolell, Hong Liu, Ayman Samkari, Steven M. Keller, Martin Reck

PCI Publications and Projects

Importance: Administration of pembrolizumab plus concurrent chemoradiation therapy (cCRT) may provide treatment benefit to patients with locally advanced, stage III non-small cell lung cancer (NSCLC).

Objective: To evaluate treatment outcomes and safety of pembrolizumab plus cCRT in stage III NSCLC.

Design, setting, and participants: The phase 2, nonrandomized, 2-cohort, open-label KEYNOTE-799 study enrolled patients between November 5, 2018, and July 31, 2020, from 52 academic facilities and community-based institutions across 10 countries. As of October 28, 2020, median (range) follow-up was 18.5 (13.6-23.8) months in cohort A and 13.7 (2.9-23.5) months in cohort B. Of 301 patients screened, 216 eligible …

Comparative Analysis Of 1152 African-American And European-American Men With Prostate Cancer Identifies Distinct Genomic And Immunological Differences., Walter Rayford, Alp Tuna Beksac, Jordan Alger, Mohammed Alshalalfa, Mohsen Ahmed, Irtaza Khan, Ugo G. Falagario, Yang Liu, Elai Davicioni, Daniel E. Spratt, Edward M. Schaeffer, Felix Y. Feng, Brandon Mahal, Paul L Nguyen, Robert B. Den, Mark D. Greenberger, Randy Bradley, Justin M. Watson, Matthew Beamer, Lambros Stamatakis, Darrell J. Carmen, Shivanshu Awasthi, Jonathan Hwang, Rachel Weil, Harri Merisaari, Nihal Mohamed, Leslie A. Deane, Dimple Chakravarty, Kamlesh K. Yadav, Kosj Yamoah, Sujit S. Nair, Ashutosh K. Tewari

Department of Radiation Oncology Faculty Papers

Racial disparities in prostate cancer have not been well characterized on a genomic level. Here we show the results of a multi-institutional retrospective analysis of 1,152 patients (596 African-American men (AAM) and 556 European-American men (EAM)) who underwent radical prostatectomy. Comparative analyses between the race groups were conducted at the clinical, genomic, pathway, molecular subtype, and prognostic levels. The EAM group had increased ERG (P < 0.001) and ETS (P = 0.02) expression, decreased SPINK1 expression (P < 0.001), and basal-like (P < 0.001) molecular subtypes. After adjusting for confounders, the AAM group was associated with higher expression of CRYBB2, GSTM3, and inflammation genes (IL33, IFNG, CCL4, CD3, ICOSLG), and lower expression of mismatch repair genes (MSH2, MSH6) (p < 0.001 for all). At the pathway level, the AAM group had higher expression of genes sets related to the immune response, apoptosis, hypoxia, and reactive oxygen species. EAM group was associated with higher levels of fatty acid metabolism, DNA repair, and WNT/beta-catenin signaling. Based on cell lines data, AAM were predicted to have higher potential response to DNA damage. In conclusion, biological characteristics of prostate tumor were substantially different in AAM when compared to EAM.

Investigate The Delivery Efficiency And Accuracy Of Spot-Scanning Proton Arc (Sparc) In Comparison With Conventional Impt, Automatic Step-And-Shoot Multifield Impt, Lewei Zhao, Gang Liu, Di Yan, Xiaoqiang Li, Xuanfeng Ding

Conference Presentation Abstracts

No abstract provided.

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

Conference Presentation Abstracts

No abstract provided.

Assess The Interplay Effect Based On The Cyclotron Accelerator Proton Therapy System Machine-Specific Delivery Sequence Model, Lewei Zhao, Gang Liu, J Shen, A Lee, Di Yan, Rohan Deraniyagala, Craig Stevens, Weili Zheng, Xiaoqiang Li, S Tang, Xuanfeng Ding

Conference Presentation Abstracts

No abstract provided.

Current State Of Lgbtqia+ Healthcare, Jessica Vadas

Conference Presentation Abstracts

No abstract provided.

Develop A Rotational Robust Optimized Spot-Scanning Proton Arc (Sparc) Algorithm, Shupeng Chang, Gang Liu, Lewei Zhao, Weili Zheng, An Qin, Di Yan, Xiaoqiang Li, Xuanfeng Ding

Conference Presentation Abstracts

No abstract provided.

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

No abstract provided.

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.

Toward Online Adaptive Proton Therapy Of Sinonasal Cancer: The Dosimetric Accuracy Of Utilizing Deep-Learning Synthetic Ct From Cbct For Daily Treatment Dose Verification, An Qin, Lewei Zhao, Shupeng Chen, Xiaoqiang Li, Weili Zheng, Di Yan, Rohan Deraniyagala, Xuanfeng Ding

Conference Presentation Abstracts

No abstract provided.

Changes In Post-Treatment Cardiac Pet Avidity Predict Overall Survival In Lung Cancer Patients Treated With Chemoradiation, T Santangelo, F Forghani, C Rusthoven, R Castillo, E Castillo, B Jones, T Guerrero, Y Vinogradskiy

Conference Presentation Abstracts

No abstract provided.

External Beam Radiation Therapy Carries Lower Risk Of Sexual Dysfunction As Compared To Radical Prostatectomy In Treatment Of Patients With Localized Prostate Cancer, Aamod S. Dekhne

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report appraising:

Donovan JL, Hamdy FC, Lane JA, et al. Patient-Reported Outcomes after Monitoring, Surgery, or Radiotherapy for Prostate Cancer. N Engl J Med. 2016;375(15):1425-1437. https://doi.org/10.1056/NEJMoa1606221

for a patient with localized prostate cancer and concerns regarding future sexual dysfunction.

Guided Imagery And Sentinel Lymph Node Biopsy Pain, Brandy Alicia Kirk

Evidence-Based Practice Project Reports

The standard of care in the treatment for women diagnosed with breast cancer includes identification and biopsy of the sentinel lymph nodes (SLN) of the breast (Chaterjee et al., 2017; Kneece, 2017). The process of identifying the SLNs involves radioisotope injections into or near the areola. Because this area is highly sensitive, women report this procedure to be considerably painful. The purpose of this evidence-based practice (EBP) project was to determine if the provision of a 5-minute session of guided imagery (GI), as a complementary alternative medicine, prior to SLN injections was effective in mitigating reports of procedural pain. A …

Structure Sparsity Of The Spot Optimization In Proton Arc Therapy, Lewei Zhao

Conference Presentation Abstracts

Radiation therapy is one of the main cancer treatments that uses radiation to kill cancer cells. Proton therapy, or proton radiotherapy, is a type of particle therapy that uses a beam of protons to irradiate tumor volume. Beaumont proton therapy center research group invented the first robust and delivery-efficient spot-scanning proton arc (SPArc) therapy in 2016. Based on our beam modeling platform, we have found that the spot switching time (SSWT) is proportional to spot numbers. We aim to develop a direct mathematical optimization method to reduce the spot numbers for SPArc based on an independent optimization method to reduce …

Conditional Survival Among Patients With Oropharyngeal Cancer Treated With Radiation Therapy And Alive Without Recurrence 5 Years After Diagnosis, Kristina R Dahlstrom, Juhee Song, Peter F Thall, Clifton D Fuller, Katherine A Hutcheson, Faye M Johnson, G Brandon Gunn, Jack Phan, Steven J Frank, William H Morrison, Renata Ferrarotto, David I Rosenthal, Erich M Sturgis, Adam S Garden

Faculty, Staff and Students Publications

BACKGROUND: Risk of recurrence among patients with oropharyngeal cancer (OPC) who survive 5 years is low. The goal of this study was to assess long-term survival of patients with OPC alive without recurrence 5 years after diagnosis.

METHODS: This study included newly diagnosed patients with OPC, who had been treated with radiation and were alive without recurrence 5 years after diagnosis. Overall survival (OS) probabilities beyond 5 years were estimated using the Kaplan-Meier method. Factors associated with OS were determined using Bayesian piecewise exponential survival regression. Standardized mortality ratios for all-cause death were estimated controlling for study year, age, and …

Nbtxr3 Radiotherapy-Activated Functionalized Hafnium Oxide Nanoparticles Show Efficient Antitumor Effects Across A Large Panel Of Human Cancer Models., Ping Zhang, Julie Marill, Audrey Darmon, Naeemunnisa Mohamed Anesary, Bo Lu, Md, Sébastien Paris

Department of Radiation Oncology Faculty Papers

Purpose: The side effects of radiotherapy induced on healthy tissue limit its use. To overcome this issue and fully exploit the potential of radiotherapy to treat cancers, the first-in-class radioenhancer NBTXR3 (functionalized hafnium oxide nanoparticles) has been designed to amplify the effects of radiotherapy.

Patients and Methods: Thanks to its physical mode of action, NBTXR3 has the potential to be used to treat any type of solid tumor. Here we demonstrate that NBTXR3 can be used to treat a wide variety of solid cancers. For this, we evaluated different parameters on a large panel of human cancer models, such as …

Targeting Resistance To Radiation-Immunotherapy In Cold Hnsccs By Modulating The Treg-Dendritic Cell Axis., Michael W. Knitz, Thomas E. Bickett, Laurel B. Darragh, Ayman J. Oweida, Shilpa Bhatia, Benjamin Van Court, Shiv Bhuvane, Miles Piper, Jacob Gadwa, Adam C. Mueller, Diemmy Nguyen, Varuna Nangia, Douglas G. Osborne, Xiyuan Bai, Sarah E. Ferrara, Mary-Keara Boss, Andrew Goodspeed, Matthew A. Burchill, Beth A. Jirón Tamburini, Edward D. Chan, Curtis R. Pickering, Eric T. Clambey, Sana D. Karam

Department of Radiation Oncology Faculty Papers

BACKGROUND: Numerous trials combining radiation therapy (RT) and immunotherapy in head and neck squamous cell carcinoma (HNSCC) are failing. Using preclinical immune cold models of HNSCC resistant to RT-immune checkpoint inhibitors, we investigate therapeutic approaches of overcoming such resistance by examining the differential microenvironmental response to RT.

METHODS: We subjected two HPV-negative orthotopic mouse models of HNSCC to combination RT, regulatory T cells (Treg) depletion, and/or CD137 agonism. Tumor growth was measured and intratumorous and lymph node immune populations were compared among treatment groups. Human gene sets, genetically engineered mouse models DEREG and BATF3-/-, flow and time-of-flight cytometry, RNA-Seq, …

Initial Clinical Experience Of Mr-Guided Radiotherapy For Non-Small Cell Lung Cancer., Cathryn B. Crockett, Pamela Samson, Robert Chuter, Michael Dubec, Corinne Faivre-Finn, Olga L. Green, Sara L. Hackett, Fiona Mcdonald, Clifford Robinson, Anna-Maria Shiarli, Michael W Straza, Joost J.C. Verhoeff, Maria Werner-Wasik, Gregory Vlacich, David Cobben

Department of Radiation Oncology Faculty Papers

Curative-intent radiotherapy plays an integral role in the treatment of lung cancer and therefore improving its therapeutic index is vital. MR guided radiotherapy (MRgRT) systems are the latest technological advance which may help with achieving this aim. The majority of MRgRT treatments delivered to date have been stereotactic body radiation therapy (SBRT) based and include the treatment of (ultra-) central tumors. However, there is a move to also implement MRgRT as curative-intent treatment for patients with inoperable locally advanced NSCLC. This paper presents the initial clinical experience of using the two commercially available systems to date: the ViewRay MRIdian and …

Radiopharmaceutical Validation For Clinical Use, Charles A. Kunos, Rodney Howells, Aman Chauhan, Zin W. Myint, Mark E. Bernard, Riham H. El Khouli, Jacek Capala

Internal Medicine Faculty Publications

Radiopharmaceuticals are reemerging as attractive anticancer agents, but there are no universally adopted guidelines or standardized procedures for evaluating agent validity before early-phase trial implementation. To validate a radiopharmaceutical, it is desirous for the radiopharmaceutical to be specific, selective, and deliverable against tumors of a given, molecularly defined cancer for which it is intended to treat. In this article, we discuss four levels of evidence—target antigen immunohistochemistry, in vitro and in vivo preclinical experiments, animal biodistribution and dosimetry studies, and first-in-human microdose biodistribution studies—that might be used to justify oncology therapeutic radiopharmaceuticals in a drug-development sequence involving early-phase trials. We …

Stereotactic Body Radiation Therapy (Sbrt) For Patients With Stage I Non-Small Cell Lung Cancer Is Applicable To More Tumors Than Sublobar Resection, Andrew Song, Nathaniel R. Evans Iii, Scott W. Cowan, Jenny Guo, Tingting Zhan, Bo Lu, Maria Werner-Wasik

Department of Radiation Oncology Faculty Papers

Background: Virtually all patients with medically inoperable stage I non-small cell lung cancer (NSCLC) can receive stereotactic body radiation therapy. However, the percentage of such patients in whom sublobar resection is technically feasible is unknown. This discrepancy can confound clinical trial eligibility and designs comparing stereotactic body radiation therapy vs. sublobar resection.

Methods: A total of 137 patients treated with stereotactic body radiation therapy for lung lesions (3/2013-11/2017) underwent retrospective review. Diagnostic CT chest and PET/CT images, stereotactic body radiation therapy dates, and demographic data were collected on 100 of 137 patients. Two experienced board-certified thoracic surgeons independently reviewed anonymized …

High-Dose-Rate Brachytherapy For The Treatment Of Basal And Squamous Cell Carcinomas On Sensitive Areas Of The Face: A Report Of Clinical Outcomes And Acute And Subacute Toxicities, James M. Taylor, Bahar Dasgeb, Spencer Liem, Ayesha Ali, Amy Harrison, Mitchell Finkelstein, Jisun Cha, Rani Anne, Steven Greenbaum, William Sherwin, Wenyin Shi

Department of Radiation Oncology Faculty Papers

Purpose Basal cell and cutaneous squamous cell carcinoma are common malignancies (keratinocyte carcinomas [KCs]). Surgical resection is the standard of care. Radiation using high-dose rate brachytherapy (HDR-BT) may serve as a superior alternative where surgical scars may be of cosmetic concern or in elderly patients with significant comorbidity. We aim to describe the clinical and cosmetic outcomes as well as posttreatment radiation toxicities associated with HDR-BT in patients who were treated for KCs of the face.

Methods and Materials Patients with KCs treated with HDR-BT from 2015 to 2018 were included in the study. Patient medical records and clinical photos …

Mir-21 Plays A Dual Role In Tumor Formation And Cytotoxic Response In Breast Tumors, Tu Dan, Anuradha A. Shastri, Ajay Palagani, Simone Buraschi, Thomas Neill, Jason E Savage, Aastha Kapoor, Tiziana Deangelis, Sankar Addya, Kevin Camphausen, Renato V. Iozzo, Nicole L Simone

Department of Radiation Oncology Faculty Papers

Breast cancer (BrCa) relies on specific microRNAs to drive disease progression. Oncogenic miR-21 is upregulated in many cancers, including BrCa, and is associated with poor survival and treatment resistance. We sought to determine the role of miR-21 in BrCa tumor initiation, progression and treatment response. In a triple-negative BrCa model, radiation exposure increased miR-21 in both primary tumor and metastases. In vitro, miR-21 knockdown decreased survival in all BrCa subtypes in the presence of radiation. The role of miR-21 in BrCa initiation was evaluated by implanting wild-type miR-21 BrCa cells into genetically engineered mouse models where miR-21 was intact, heterozygous …