Radiation Medicine Commons^™

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 …

Comparison Of Pulmonary Function Changes Between Patients Receiving Neoadjuvant Chemotherapy And Chemoradiotherapy Prior To Minimally Invasive Esophagectomy: A Randomized And Controlled Trial, Xiaosang Chen, Mingjun Du, Han Tang, Hao Wang, Yong Fang, Miao Lin, Jun Yin, Lijie Tan, Yaxing Shen

Faculty, Staff and Student Publications

PURPOSE: Adequate pulmonary function is important for patients undergoing surgical resection of esophageal cancer, especially those that received neoadjuvant therapy. However, it is unknown if pre-operative radiation affects pulmonary function differently compared to chemotherapy. The purpose of this study was to compare changes in pulmonary function between patients undergoing minimally invasive esophagectomy (MIE) who received neoadjuvant chemotherapy or chemoradiotherapy.

METHODS: Between March 2017 and March 2018, esophageal cancer patients requiring neoadjuvant therapy were prospectively enrolled and randomly assigned to receive chemotherapy (CT) or chemoradiotherapy (CRT) before MIE. All patients received pulmonary function testing before and after the neoadjuvant therapy. Changes …

Radiation Exposure Determination In A Secure, Cloud-Based Online Environment, Ben C. Shirley, Eliseos J. Mucaki, Peter Rogan

Biochemistry Publications

Rapid sample processing and interpretation of estimated exposures will be critical for triaging exposed individuals after a major radiation incident. The dicentric chromosome (DC) assay assesses absorbed radiation using metaphase cells from blood. The Automated Dicentric Chromosome Identifier and Dose Estimator System (ADCI) identifies DCs and determines radiation doses. This study aimed to broaden accessibility and speed of this system, while protecting data and software integrity. ADCI Online is a secure web-streaming platform accessible worldwide from local servers. Cloud-based systems containing data and software are separated until they are linked for radiation exposure estimation. Dose estimates are identical to ADCI …

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 …

Artificial Intelligence For Radiation Oncology Applications Using Public Datasets, Kareem A Wahid, Enrico Glerean, Jaakko Sahlsten, Joel Jaskari, Kimmo Kaski, Mohamed A Naser, Renjie He, Abdallah S R Mohamed, Clifton D Fuller

Faculty, Staff and Student Publications

Artificial intelligence (AI) has exceptional potential to positively impact the field of radiation oncology. However, large curated datasets - often involving imaging data and corresponding annotations - are required to develop radiation oncology AI models. Importantly, the recent establishment of Findable, Accessible, Interoperable, Reusable (FAIR) principles for scientific data management have enabled an increasing number of radiation oncology related datasets to be disseminated through data repositories, thereby acting as a rich source of data for AI model building. This manuscript reviews the current and future state of radiation oncology data dissemination, with a particular emphasis on published imaging datasets, AI …

Tumor Treating Fields With Radiation For Glioblastoma: A Narrative Review, Ryan C. Miller, Muneeb Khan Niazi, Olga Russial, Spencer Poiset, Wenyin Shi

Department of Radiation Oncology Faculty Papers

Background and objective: With a phase 3 clinical trial (EF-32, ClinicalTrials.gov: NCT04471844) currently underway examining the potential benefit of concurrent chemoradiation and tumor treating fields (TTFields) for patients with glioblastoma (GBM), we present the following narrative review to highlight the current evidence that supports this approach. The current management paradigm for GBM includes maximal safe surgical resection followed by concurrent chemoradiation with further temozolomide (TMZ) and TTFields used as maintenance therapy. Despite several treatment advances over the past few decades, the overall prognosis remains poor and new strategies are currently under investigation, including the use of chemoradiation concurrently with …

Diffusing Alpha-Emitters Radiation Therapy In Combination With Temozolomide Or Bevacizumab In Human Glioblastoma Multiforme Xenografts, Yossi Nishri, Maayan Vatarescu, Ishai Luz, Lior Epstein, Mirta Dumančić, Sara Del Mare, Amit Shai, Michael Schmidt, Lisa Deutsch, Robert Den, Itzhak Kelson, Yona Keisari, Lior Arazi, Tomer Cooks, Vered Domankevich

Department of Radiation Oncology Faculty Papers

Glioblastoma multiforme (GBM) is at present an incurable disease with a 5-year survival rate of 5.5%, despite improvements in treatment modalities such as surgery, radiation therapy, chemotherapy [e.g., temozolomide (TMZ)], and targeted therapy [e.g., the antiangiogenic agent bevacizumab (BEV)]. Diffusing alpha-emitters radiation therapy (DaRT) is a new modality that employs radium-224-loaded seeds that disperse alpha-emitting atoms inside the tumor. This treatment was shown to be effective in mice bearing human-derived GBM tumors. Here, the effect of DaRT in combination with standard-of-care therapies such as TMZ or BEV was investigated. In a viability assay, the combination of alpha radiation with TMZ …

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) …

A Quantitative Investigation Of Treating Lung Tumors With Dynamic Conformal Arcs Vs. Vmat For Lung Sbrt Plans, Shawn Loutos

Masters Projects

Introduction

This study aims to investigate the comparisons in dynamic conformal arc, VMAT (no ASC), forced MU limitations (ASC), or a 50/50 hybrid arc (ASC) in how they can improve a lung SBRT case where the tumor is abutting a dose critical structure. The goal of this research is to investigate multiple treatment techniques in an attempt to increase the dose constraint pass rate. The variables in comparison are how well different plan iterations can successfully meet constraints as well as pass a 0.5 modulation complexity score (MCS).

Methods

10 previously treated patients were used in this study who exhibited …

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

Masters Projects

Introduction

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

Methods

Five patients that had been …

Effects Of Ezfluence Planning Software On Dosimetric Parameter Compliance For Early-Stage Breast Cancer, Jackie Loomis

Masters Projects

Each year over 2 million women are given a breast cancer diagnosis and over half a million women succumb to the disease yearly. As technology advances in the world of radiation oncology, automated planning softwares, such as Radformation’s EZFluence, are being utilized to streamline the treatment planning process. This study was designed to investigate whether the automated plans are dosimetrically equivalent to traditionally planned 3D field in field tangential plans. Is there a disadvantage to using these automated softwares? Three different dosimetrists with varying backgrounds replanned 27 previously treated breast cancer patients and an assortment of comparisons were ran between …

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

Masters Projects

Introduction

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

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

Dissertations and Theses (Open Access)

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

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

Masters Projects

Introduction

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

Methods

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

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

Medical Student Research Symposium

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

Mri-Based Synthetic Ct Images Generated Using 3d Conditional Gan For Impt Treatment Planning, Shupeng Chen, An Qin, Rohan Deraniyagala, Xuanfeng Ding, Y Peng, Y Liu, C Zhao, X Deng

Conference Presentation Abstracts

Purpose: To develop an advanced deep convolutional neural network architecture to generate synthetic CT (SCT) images from MR images for intensity-modulated proton therapy (IMPT) treatment planning of head and neck cancer patients. Methods: T1-weighted MR images and paired CT (PCT) images were obtained from 189 nasopharyngeal cancer (NPC) patients under radiotherapy immobilization. Deformable image registration was performed between MR and PCT images for each patient to create an MR-CT image pair. Thirteen pairs were randomly chosen as independent test sets and the remaining 176 pairs (14 for validation and 162 for training) were used to build two conditional generative adversarial …

Development Of A Collision Model For Advanced Proton Treatment Planning And Delivery, Shupeng Chen, Lewei Zhao, Weili Zheng, An Qin, Rohan Deraniyagala, Xuanfeng Ding

Conference Presentation Abstracts

Purpose: A major barrier to implementing advanced proton therapy delivery techniques, such as proton arc/4pi delivery is the unknown characteristics of the collision zones, i.e., the combinations of couch and gantry angles that result in a mechanical collision between the gantry and couch or patient. This study aims to develop a collision model for the determination of patient-specific collision zones to enable safe and deliverable noncoplanar proton therapy treatment planning. Methods: The detailed geometric parameters of the treatment machine including the nozzle, the snout, and the size and the location of the range shifter were measured from an IBA Proteus …

An Evolutionary Algorithm Of The Spot Sparsity Optimization In Proton Arc Therapy, Lewei Zhao, Gang Liu, Xiaoqiang Li, Xuanfeng Ding

Conference Presentation Abstracts

Purpose: Spot-scanning Proton Arc (SPArc) plan normally contains thousands of spot numbers in which is the delivery time is proportional to the number of spots. It is critical to find an optimal SPArc with a fast delivery speed while maintaining a good plan quality. Thus, we developed a novel evolutionary algorithm to directly search the optimal spot sparsity solution in the balance of plan quality and beam delivery time (BDT). Methods: The planning platform included a plan quality objective, a selector and a generator. A selector was designed to filter or add the spot according to the expected spot number, …

Evaluation Of Variables Predicting Pulmonary Function Test (Pft) Changes For Lung Cancer Patients Treated On A Prospective 4dct-Ventilation Functional Avoidance Clinical Trial, Nader Ghassemi, Richard Castillo, Edward Castillo, Bernard L. Jones, Moyed Miften, Brian Kavanaugh, Maria Werner Werner-Wasik, Ryan Miller, Julie Barta, Inga Grills, Thomas Guerrero

Conference Presentation Abstracts

Purpose: Functional avoidance radiotherapy uses functional imaging to reduce pulmonary toxicity by designing radiotherapy plans that reduce doses to the functional lung. A novel form of lung functional imaging uses 4DCT imaging to calculate 4DCT-based lung ventilation (4DCT-ventilation) maps. A phase-II, multi-center, prospective study of 4DCT-ventilation functional avoidance was completed. Pre and post-treatment pulmonary function tests (PFTs) were acquired in order to quantitatively assess pulmonary function change. The purpose of this study is to evaluate which factors predict for PFT changes for patients treated with 4DCT-ventilation functional avoidance radiotherapy. Methods: 56 patients with locally advanced lung cancer receiving radiotherapy were …