Radiology Commons^™

Intrahepatic Cholangiocarcinoma Presenting As Li-Rads 5 "Hcc", Raja K. Dhanekula, Md, Donald Mitchell, Md, John Farber, Md, Ashwin R. Sama, Md, Jesse M. Civan, Md

Division of Gastroenterology and Hepatology Posters

Background

• Hepatocellular Carcinoma (HCC), if within Milan Criteria, is an indication for liver transplantation.

• In contrast, intrahepatic cholangiocarcinoma (IHCC) is a contra-indication to liver transplantation due to high rates of recurrence.

• LI-RADS 5 classification (synonymous with OPTN-5) carries a near 100% positive predictive value for HCC, allowing prioritization of patients for liver transplantation without histological confirmation.

• The “LI-RADS M” classification indicates the presence of malignancy not meeting diagnostic criteria for HCC. In theory, IHCC lesions should be identified as LI-RADS M and not LI-RADS 5.

Proceedings Of 2016 Aurora Scientific Day

Journal of Patient-Centered Research and Reviews

This supplement includes select abstracts presented at the 42nd annual Aurora Scientific Day research symposium, held May 25, 2016, in Milwaukee, Wisconsin. Aurora Scientific Day provides a forum for original research conducted by faculty, fellows, residents, students and other allied health professionals affiliated with Aurora Health Care, a not-for-profit health system comprised of integrated hospitals and clinics across eastern Wisconsin and northeastern Illinois.

Numerical Investigation Of Novel Microwave Applicators Based On Zero-Order Mode Resonance For Hyperthermia Treatment Of Cancer, David Vrba, Jan Vrba, Dario B. Rodrigues, Paul R. Stauffer

Department of Radiation Oncology Faculty Papers

This paper characterizes three novel microwave applicators based on zero-order mode resonators for use in hyperthermia treatment of cancer. The radiation patterns are studied with numerical simulations in muscle tissue-equivalent model at 434 MHz. The relative performance of the applicators is compared in terms of reflection coefficient, current distribution, power deposition (SAR) pattern, effective field size in 2D and 3D tissue volumes, and penetration depth. One particular configuration generated the most uniform SAR pattern, with 25% SAR covering 84 % of the treatment volume extending to 1 cm depth under the aperture, while remaining above 58% coverage as deep as …

Establishment Of Site Specific Multi Disciplinary Tumour Boards In Pakistan -Is It Really Necessary To Discuss All Cancer Cases In Multidisciplinary Tumour Board Meetings?, Ahmed Nadeem Abbasi

Department of Radiation Oncology

No abstract provided.

Establishment And Maintenance Of Quality Of Site-Specific Multidisciplinary Tumor Boards In Pakistan, Ahmed Nadeem Abbasi

Department of Radiation Oncology

No abstract provided.

Four-Dimensional (4d) Subharmonic Aided Pressure Estimation For Monitoring Neoadjuvant Chemotherapy Response Of Breast Cancer, Kibo Nam, Maria Stanczak, Anush Sridharan, Adam C. Berger, Tiffany Avery, John R. Eisenbrey, Flemming Forsberg

Department of Radiology Posters

Introduction

Neoadjuvant chemotherapy is a well-established treatment option for patients with non-metastatic breast cancer. The patient response is correlated with survival. However, the optimal method for monitoring neoadjuvant therapy response has not been established. One factor that may affect the response of neoadjuvant therapy is the interstitial fluid pressure (IFP). Increased IFP prevents an effective delivery of therapeutic agents and reduces the efficacy of the therapy. Recently, subharmonic-aided pressure estimation (SHAPE) using contrast-enhanced ultrasound (CEUS) has been developed and its potential was demonstrated in animals as a non-invasive technique for IFP measurements. The SHAPE method estimates IFP based on the …

Assessment Of Post-Treatment Imaging Changes Following Radiotherapy Using Magnetic Susceptibility Techniques, Jean-Guy Belliveau

Electronic Thesis and Dissertation Repository

Radiation therapy (RT) is a common treatment for brain neoplasms and is used alone or in combination with other therapies. The use of RT has been found to be successful in controlling tumors and extending the overall survival of patients; however, there are many unanswered questions regarding radiotherapy effects in the normal brain surrounding or infiltrated by tumor. Changes to the vascular and parenchyma have been documented, and more recently inflammatory mechanisms have been postulated to play a role in radiation injury. Traditional imaging techniques used within the clinic (CT and MRI) are often lacking in their ability to differentiate …

Optimizing Respiratory Gated Intensity Modulated Radiation Therapy Planning And Delivery Of Early-Stage Non-Small Cell Lung Cancer, Ilma Xhaferllari

Electronic Thesis and Dissertation Repository

Stereotactic ablative body radiotherapy (SABR) is the standard of care for inoperable early-stage non-small cell lung cancer (NSCLC) patients. However, thoracic tumours are susceptible to respiratory motion and, if unaccounted for, can potentially lead to dosimetric uncertainties. Respiratory gating is one method that limits treatment delivery to portions of the respiratory cycle, but when combined with intensity-modulated radiotherapy (IMRT), requires rigorous verification. The goal of this thesis is to optimize respiratory gated IMRT treatment planning and develop image-guided strategies to verify the dose delivery for future early-stage NSCLC patients.

Retrospective treatment plans were generated for various IMRT delivery techniques, including …

Predictive Biomarkers Of Cellular Radiosensitivity For Clinical Radiotherapy Treatment, Lisa White

Doctoral

Radiotherapy is prescribed to more than 50% of cancer patients during their treatment schedule. Due to intrinsic factors, individual variation in response exists, which will result in side effects or toxicity in a number of patients. Therefore, development of an assay or biomarker for the prediction and assessment of radiosensitivity among cancer patients undergoing radiotherapy would be beneficial. Such an assay would limit toxicities and facilitate dose-escalation for those patients who require it. Assays for predicting intrinsic cellular radiosensitivity remains as the established G2 chromosomal radiosensitivity and most promising, γH2AX foci assay. They can be applied to blood samples from …

Non-Invasive Imaging For The Assessment Of Cardiac Dose And Function Following Focused External Beam Irradiation, Omar El-Sherif

Electronic Thesis and Dissertation Repository

Technological advances in imaging and radiotherapy have led to significant improvement in the survival rate of breast cancer patients. However, a larger proportion of patients are now exhibiting the less understood, latent effects of incidental cardiac irradiation that occurs during left-sided breast radiotherapy. Here, we examine the utility of four-dimensional computed tomography (4D-CT) for the accurate assessment of cardiac dose; and a hybrid positron emission tomography (PET) magnetic resonance imaging (MRI) system to longitudinally study radiation-induced cardiac effects in a canine model.

Using 4D-CT and deformable dose accumulation, we assessed the variation caused by breathing motion in the estimated dose …

Safety Of Lobar Hepatic Arterial Embolization In Metastatic Uveal Melanoma Patients With Underlying Gilbert's Disease, David C. Feldstein, Md, Robert D. Adamo, Md, Carin F. Gonsalves, Md, Fsir, David J. Eschelman, Ms, Fsir, Medical Oncology, Thomas Jefferson University Hospital, Philadelphia, Pa, Takami Sato, Md, Phd

Department of Medical Oncology Posters

Introduction

❖ Uveal melanoma is the most common primary intraocular malignant tumor in adults.

❖ Up to half of all patients develop systemic metastases, with liver involvement in >90% of patients.¹

❖ Various liver-directed, locoregional therapies (i.e. chemoembolization, immunoembolization, radioembolization, and ablation) have played a significant role in prolonging the lives of patients with metastatic uveal melanoma.²

❖ Elevated bilirubin levels are typically considered a relative contraindication for lobar hepatic arterial embolization treatment, given mainly the increased risk of precipitating hepatic failure.

❖ Gilbert's syndrome, also known as benign unconjugated hyperbilirubinemia, is a hereditary disorder of bilirubin conjugation. …

Bh3 Mimetic Abt-737 Sensitizes Colorectal Cancer Cells To Ixazomib Through Mcl-1 Downregulation And Autophagy Inhibition., Lifeng Yang, Juefeng Wan, Sheng Xiao, Darryll Barkhouse, Ji Zhu, Guichao Li, Bo Lu, Zhen Zhang

Department of Radiation Oncology Faculty Papers

The proteasome inhibitor MLN9708 is an orally administered drug that is hydrolyzed into its active form, MLN2238 (ixazomib). Compared with Bortezomib, MLN2238 has a shorter proteasome dissociation half-life and a lower incidence and severity of peripheral neuropathy, which makes it an attractive candidate for colorectal cancer treatment. In the present study, we observed that MLN2238 induced autophagy, as evidenced by conversion of the autophagosomal marker LC3 from LC3I to LC3II, in colorectal cancer cell lines. Mcl-1, an anti-apoptotic Bcl-2 family protein, was markedly elevated after treating a colorectal cancer cell line with MLN2238. We proved that inhibiting Mcl-1 expression enhances …

Radiation-Enhanced Therapeutic Targeting Of Galectin-1 Enriched Malignant Stroma In Triple Negative Breast Cancer, Meenakshi Upreti, Amar Jyoti, Sara E. Johnson, Elden P. Swindell, Dana L. Napier, Pallavi Sethi, Ryan Chan, Jonathan M. Feddock, Heidi L. Weiss, Thomas V. O'Halloran, B. Mark Evers

Pharmaceutical Sciences Faculty Publications

Currently there are no FDA approved targeted therapies for Triple Negative Breast Cancer (TNBC). Ongoing clinical trials for TNBC have focused primarily on targeting the epithelial cancer cells. However, targeted delivery of cytotoxic payloads to the non-transformed tumor associated-endothelium can prove to be an alternate approach that is currently unexplored. The present study is supported by recent findings on elevated expression of stromal galectin-1 in clinical samples of TNBC and our ongoing findings on stromal targeting of radiation induced galectin-1 by the anginex-conjugated arsenic-cisplatin loaded liposomes using a novel murine tumor model. We demonstrate inhibition of tumor growth and metastasis …

Establishing The Feasibility Of The Dosimetric Compliance Criteria Of Rtog 1308: Phase Iii Randomized Trial Comparing Overall Survival After Photon Versus Proton Radiochemotherapy For Inoperable Stage Ii-Iiib Nsclc., Tawfik Giaddui, Wenzhou Chen, Jialu Yu, Liyong Lin, Charles B. Simone, Lulin Yuan, Yutao U.T. Gong, Q. Jackie Wu, Radhe Mohan, Xiaodong Zhang, Jaques B. Bluett, Michael Gillin, Kevin Moore, Elizabeth O'Meara, Jennifer Presley, Jeffrey D Bradley, Zhongxing Liao, James Galvin, Ying Xiao

Department of Radiation Oncology Faculty Papers

BACKGROUND: To establish the feasibility of the dosimetric compliance criteria of the RTOG 1308 trial through testing against Intensity Modulation Radiation Therapy (IMRT) and Passive Scattering Proton Therapy (PSPT) plans.

METHODS: Twenty-six lung IMRT and 26 proton PSPT plans were included in the study. Dose Volume Histograms (DVHs) for targets and normal structures were analyzed. The quality of IMRT plans was assessed using a knowledge-based engineering tool.

RESULTS: Most of the RTOG 1308 dosimetric criteria were achieved. The deviation unacceptable rates were less than 10 % for most criteria; however, a deviation unacceptable rate of more than 20 % was …

Biodistribution And Pharmacokinetics Study Of Sirna-Loaded Anti-Ntsr1-Mab-Functionalized Novel Hybrid Nanoparticles In A Metastatic Orthotopic Murine Lung Cancer Model., Maryna Perepelyuk, Chellappagounder Thangavel, Yi Liu, Robert B. Den, Bo Lu, Adam E. Snook, Sunday A. Shoyele

Department of Radiation Oncology Faculty Papers

Small interfering RNA (siRNA) is effective in silencing critical molecular pathways in cancer. The use of this tool as a treatment modality is limited by lack of an intelligent carrier system to enhance the preferential delivery of this molecule to specific targets in vivo. In the present study, the in vivo behavior of novel anti-NTSR1-mAb-functionalized antimutant K-ras siRNA-loaded hybrid nanoparticles, delivered by i.p. injection to non-small-cell lung cancer in mice models, was investigated and compared to that of a naked siRNA formulation. The siRNA in anti-NTSR1-mAb-functionalized hybrid nanoparticles was preferentially accumulated in tumor-bearing lungs and metastasized tumor for at least …

Cogstate Computerized Memory Tests In Patients With Brain Metastases: Secondary Endpoint Results Of Nrg Oncology Rtog 0933., Chip Caine, Snehal Deshmukh, Vinai Gondi, Minesh Mehta, Wolfgang Tomé, Benjamin W. Corn, Andrew Kanner, Howard Rowley, Vijayananda Kundapur, Albert Denittis, Jeffrey Noah Greenspoon, Andre A. Konski, Glenn S. Bauman, Adam Raben, Wenyin Shi, Merideth Wendland, Lisa Kachnic

Department of Radiation Oncology Faculty Papers

Whole brain radiotherapy (WBRT) is associated with memory dysfunction. As part of NRG Oncology RTOG 0933, a phase II study of WBRT for brain metastases that conformally avoided the hippocampal stem cell compartment (HA-WBRT), memory was assessed pre- and post-HA-WBRT using both traditional and computerized memory tests. We examined whether the computerized tests yielded similar findings and might serve as possible alternatives for assessment of memory in multi-institution clinical trials. Adult patients with brain metastases received HA-WBRT to 30 Gy in ten fractions and completed Hopkins Verbal Learning Test-Revised (HVLT-R), CogState International Shopping List Test (ISLT) and One Card Learning …