Dynamic reconstruction for radiotherapy planning

Purpose: to determine preoperative SPECT-CT localization of sentinel lymph nodes (SLN) in women with cervical cancer. Materials and methods: SPECT-CT visualization of SLN was performed in 44 women with clinical stage IB-IIB cervical cancer. SPECT-CT examinations started 120-240 min after peritumoural injections of 99mTc-radiocolloids (200-300MBq in 0.4-1ml). All visualized LNs with uptake of radiocolloids were regarded as SLN. In all women we determined topography of SLN and lymph-flow patterns. Results: SLN were successfully visualized in 93.1% cases (41/44 women). The bilateral pattern of lymph flow was mentioned in 26 (63.4%), monolateral - in 15 (36.5%) cases. SLN localized in external iliac region in 25 (60.9%), internal iliac - in 14 (34.1%), obturator - in 22 (53.6%), presacral - in 1 (2.4%), common iliac region - in 21 (53,8%) cases. Uptake of radiocolloids in paraaortal lymph nodes was mentioned in 14 (34.1%) women Conclusion: SPECT-CT visualization of SLN can give important information for surgery and radiotherapy planning.

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Surgical Clips in Breast-conserving Surgery: Do they Represent the Tumour Bed Accurately?

Current Medical Imaging Formerly Current Medical Imaging Reviews ◽

10.2174/1573405614666180821121254 ◽

2019 ◽

Vol 15 (6) ◽

pp. 573-577

Author(s):

Ozlem Demircioglu ◽

Erkin Aribal ◽

Meral Uluer ◽

Zerrin Ozgen ◽

Fatih Demircioglu

Keyword(s):

Breast Cancer ◽

Standard Treatment ◽

Breast Conserving Surgery ◽

Radiotherapy Planning ◽

Surgical Scar ◽

Surgical Clips ◽

End Of Treatment

Introduction: Radiotherapy after Breast-Conserving Surgery (BCS) is a standard treatment for breast cancer. Currently, surgical clips are used to determine the tumour bed before radiotherapy planning. This study aimed to evaluate the migration of these clips on mammograms. Methods: The study was conducted on 121 females who were treated with radiotherapy after BCS at their first radiologic control examination 6 months after the end of treatment. MLO and CC views of all cases were evaluated regarding the clips. The distance between the surgical scar centre and the centre of the area covered by the clips was measured on both MLO and CC projections and recorded separately. This distance was determined as the clip displacement. A displacement ≤10 mm was recorded as no displacement. Results: The clips were out of the images and were not evaluated in 45 cases (37.2%) on CC and in 9 cases (7.4%) on MLO projections. There were no clip displacements in 37 (30.6%) cases on CC and in 43 (35.5%) cases on MLO views. The amount of displacement ranged from 11 to 56 mm with a mean of 24.38 mm on CC views, while on MLO projections, displacement ranged from 11 to 66 mm with a mean of 24.42 mm. Conclusion: A clip displacement of greater than 10 mm was found in 64.5% of cases on MLO views. Therefore, we believe that the reliability of these clips for accurate delineation of the tumour bed in radiotherapy planning is controversial and other methods must be added.

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Contribution of Magnetic Resonance Imaging in Determining Lumpectomy Cavity in Breast Radiotherapy

Current Medical Imaging Formerly Current Medical Imaging Reviews ◽

10.2174/1573405615666191008162447 ◽

2020 ◽

Vol 16 (8) ◽

pp. 997-1003

Author(s):

Ozlem Demircioglu ◽

Huseyin Tepetam ◽

Ayfer Ay Eren ◽

Zerrin Ozgen ◽

Fatih Demircioglu ◽

...

Keyword(s):

Breast Cancer ◽

Supine Position ◽

Radiotherapy Planning ◽

Breast Cancer Patients ◽

Breast Radiotherapy ◽

Lumpectomy Cavity ◽

Breast Cancer Radiotherapy ◽

Significant Difference ◽

Mean Diameter ◽

Ct And Mri

Background: Accurate localization of the lumpectomy cavity is important for breast cancer radiotherapy after breast-conserving surgery (BCS), but the LC localization based on CT is often difficult to delineate accurately. The study aimed to compare CT-defined LC planning to MRI-defined findings in the supine position for higher soft-tissue resolution of MRI. Methods: Fifty-nine breast cancer patients underwent radiotherapy CT planning in supine position followed by MR imaging on the same day. LC was contoured by the radiologist and radiation oncologist together by CT and MRI separately. T2 weighted MR images and tomography findings were combined and the LC volume, mean diameter and the longest axis length were measured after contouring. Subsequently, patients were divided into two groups according to seroma in LC and the above-mentioned parameters were compared. Results: We did not find any statistically significant difference in the LC volume, mean diameter and length at the longest axis between CT and MRI but based on the presence or absence of seroma, statistically significant differences were found in the LC volumes and the length at the longest axis of LC volumes. Conclusion: We believe that the supine MRI in the same position with CT will be more effective for radiotherapy planning, particularly in patients without a seroma in the surgical cavity.

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Threshold Based Segmentation in Positron Emission Tomography for Radiotherapy Planning and Treatment Assessment

Current Molecular Imaginge ◽

10.2174/2211555211201010063 ◽

2012 ◽

Vol 1 (1) ◽

pp. 63-68 ◽

Cited By ~ 1

Author(s):

Mahbubunnabi Tamal

Keyword(s):

Positron Emission Tomography ◽

Emission Tomography ◽

Radiotherapy Planning ◽

Treatment Assessment ◽

Positron Emission

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Toward PET/MRI as one-stop shop for radiotherapy planning in cervical cancer patients

Acta Oncologica ◽

10.1080/0284186x.2021.1936164 ◽

2021 ◽

pp. 1-9

Author(s):

Sahar Ahangari ◽

Naja Liv Hansen ◽

Anders Beck Olin ◽

Trine Jakobi Nøttrup ◽

Heidi Ryssel ◽

...

Keyword(s):

Cervical Cancer ◽

Cancer Patients ◽

Radiotherapy Planning ◽

One Stop

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Advanced Imaging Techniques for Radiotherapy Planning of Gliomas

Cancers ◽

10.3390/cancers13051063 ◽

2021 ◽

Vol 13 (5) ◽

pp. 1063

Author(s):

Antonella Castellano ◽

Michele Bailo ◽

Francesco Cicone ◽

Luciano Carideo ◽

Natale Quartuccio ◽

...

Keyword(s):

Radiation Treatment ◽

Imaging Modality ◽

Imaging Techniques ◽

Clinical Results ◽

Target Volume ◽

Radiotherapy Planning ◽

Tumor Control ◽

Current Standard ◽

Volume Delineation ◽

Hemodynamic Information

The accuracy of target delineation in radiation treatment (RT) planning of cerebral gliomas is crucial to achieve high tumor control, while minimizing treatment-related toxicity. Conventional magnetic resonance imaging (MRI), including contrast-enhanced T1-weighted and fluid-attenuated inversion recovery (FLAIR) sequences, represents the current standard imaging modality for target volume delineation of gliomas. However, conventional sequences have limited capability to discriminate treatment-related changes from viable tumors, owing to the low specificity of increased blood-brain barrier permeability and peritumoral edema. Advanced physiology-based MRI techniques, such as MR spectroscopy, diffusion MRI and perfusion MRI, have been developed for the biological characterization of gliomas and may circumvent these limitations, providing additional metabolic, structural, and hemodynamic information for treatment planning and monitoring. Radionuclide imaging techniques, such as positron emission tomography (PET) with amino acid radiopharmaceuticals, are also increasingly used in the workup of primary brain tumors, and their integration in RT planning is being evaluated in specialized centers. This review focuses on the basic principles and clinical results of advanced MRI and PET imaging techniques that have promise as a complement to RT planning of gliomas.

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Technical illustration of Volumetric arc conformal radiotherapy planning in a case of paratesticular sarcoma

Journal of Radiotherapy in Practice ◽

10.1017/s1460396920001211 ◽

2021 ◽

pp. 1-6

Author(s):

Anil Gupta ◽

Rambha Pandey ◽

Seema Sharma ◽

Vivek Ghosh ◽

Ekta Dhamija ◽

...

Keyword(s):

Organs At Risk ◽

Target Volume ◽

Radiotherapy Planning ◽

Current Evidence ◽

Lower Grade ◽

Malignant Tumours ◽

Target Volume Delineation ◽

Volume Delineation ◽

Delivery Technique ◽

Technical Illustration

Abstract Introduction: Paratesticular sarcoma are extremely rare malignant tumours. Unlike other sites, they tend to be lower grade and have higher propensity of lymphatic spread. They tend to fail locally and occasionally in the regional lymph nodes. In the absence of target volume delineation guidelines and technical illustration of conformal planning, we have made an attempt to illustrate conformal planning methodology and define target volume based on current evidence in a case of paratesticular sarcoma. Methods: We are presenting a case of 62-year-old male who presented with 15-cm scrotal swelling and underwent high inguinal orchidectomy with ligation of spermatic cord. Histopathology presented a well-differentiated leiomyosarcoma of epididymis. Post-operative radiotherapy target volume included the tumour bed, ipsilateral inguinal nodes and lower pelvic nodes as the clinical target volume. Conclusion: Adjuvant radiotherapy using advanced delivery technique such as volumetric arc technique can provide good dose distribution with good sparing of organs at risk. The downside of conformal radiation delivery is that it is a resource-intensive and has no established target volume delineation guidelines.

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