scholarly journals Impact of prescription isodose level and collimator selection on dose homogeneity and plan quality in robotic radiosurgery

2021 ◽  
Author(s):  
Alexandra Hellerbach ◽  
Markus Eichner ◽  
Daniel Rueß ◽  
Klaus Luyken ◽  
Mauritius Hoevels ◽  
...  
Keyword(s):  
Treatment Time ◽  
Target Dose ◽  
Dose Distributions ◽  
Robotic Radiosurgery ◽  
Treatment Plans ◽  
Dose Homogeneity ◽  
Physical Limitations ◽  
The Impact ◽  
Prescription Isodose ◽  
Selection Of

Abstract Purpose In stereotactic radiosurgery (SRS), prescription isodoses and resulting dose homogeneities vary widely across different platforms and clinical entities. Our goal was to investigate the physical limitations of generating dose distributions with an intended level of homogeneity in robotic SRS. Methods Treatment plans for non-isocentric irradiation of 4 spherical phantom targets (volume 0.27–7.70 ml) and 4 clinical targets (volume 0.50–5.70 ml) were calculated using Sequential (phantom) or VOLOTM (clinical) optimizers (Accuray, Sunnyvale, CA, USA). Dose conformity, volume of 12 Gy isodose (V12Gy) as a measure for dose gradient, and treatment time were recorded for different prescribed isodose levels (PILs) and collimator settings. In addition, isocentric irradiation of phantom targets was examined, with dose homogeneity modified by using different collimator sizes. Results Dose conformity was generally high (nCI ≤ 1.25) and varied little with PIL. For all targets and collimator sets, V12Gy was highest for PIL ≥ 80% and lowest for PIL ≤ 65%. The impact of PIL on V12Gy was highest for isocentric irradiation and lowest for clinical targets (VOLOTM optimization). The variability of V12Gy as a function of collimator selection was significantly higher than that of PIL. V12Gy and treatment time were negatively correlated. Plans utilizing a single collimator with a diameter in the range of 70–80% of the target diameter were fastest, but showed the strongest dependence on PIL. Conclusion Inhomogeneous dose distributions with PIL ≤ 70% can be used to minimize dose to normal tissue. PIL ≥ 90% is associated with a marked and significant increase in off-target dose exposure. Careful selection of collimators during planning is even more important.

scholarly journals Impact of intra-fractional motion on dose distributions in lung IMRT

2020 ◽  
pp. 1-5
Author(s):  
Mikhail A. Chetvertkov ◽  
Oleg N. Vassiliev ◽  
Jinzhong Yang ◽  
He C. Wang ◽  
Amy Y. Liu ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Organs At Risk ◽  
Intensity Modulated Radiotherapy ◽  
Median Number ◽  
Clinical Treatment ◽  
Dose Distributions ◽  
Median Reduction ◽  
Treatment Plans ◽  
The Mean ◽  
The Impact

Abstract Aim: To investigate the impact of intra-fractional motion on dose distribution in patients treated with intensity-modulated radiotherapy (IMRT) for lung cancer. Materials and methods: Twenty patients who had undergone IMRT for non-small cell lung cancer were selected for this retrospective study. For each patient, a four-dimensional computed tomography (CT) image set was acquired and clinical treatment plans were developed using the average CT. Dose distributions were then recalculated for each of the 10 phases of respiratory cycle and combined using deformable image registration to produce cumulative dose distributions that were compared with the clinical treatment plans. Results: Intra-fractional motion reduced planning target volume (PTV) coverage in all patients. The median reduction of PTV covered by the prescription isodose was 3·4%; D98 was reduced by 3·1 Gy. Changes in the mean lung dose were within ±0·7 Gy. V20 for the lung increased in most patients; the median increase was 1·6%. The dose to the spinal cord was unaffected by intra-fractional motion. The dose to the heart was slightly reduced in most patients. The median reduction in the mean heart dose was 0·22 Gy, and V30 was reduced by 2·5%. The maximum dose to the oesophagus was also reduced in most patients, by 0·74 Gy, whereas V50 did not change significantly. The median number of points in which dose differences exceeded 3%/3 mm was 6·2%. Findings: Intra-fractional anatomical changes reduce PTV coverage compared to the coverage predicted by clinical treatment planning systems that use the average CT for dose calculation. Doses to organs at risk were mostly over-predicted.

CTNI-44. DOSIMETRIC IMPACT OF TUMOR TREATING FIELDS ON CONCURRENT RADIATION THERAPY FOR PEDIATRIC BRAIN TUMORS

2021 ◽  
Vol 23 (Supplement_6) ◽  
pp. vi69-vi70
Author(s):  
Enzhuo Quan ◽  
Eun Han ◽  
Christine Chung ◽  
Tina Briere ◽  
Zsila Sadighi ◽  
...  
Keyword(s):  
Brain Tumors ◽  
Tumor Volume ◽  
Volumetric Modulated Arc Therapy ◽  
Skin Dose ◽  
Target Coverage ◽  
Dose Distributions ◽  
Tumor Treating Fields ◽  
Early Results ◽  
Treatment Plans ◽  
The Impact

Abstract INTRODUCTION Early results suggest that tumor treating fields (TTF) concurrent with radiotherapy (RT) for glioblastoma yields acceptable dosimetry in adults; the impact on RT dose distribution in children is unknown. This study was undertaken to evaluate the dosimetric impact of TTF on concurrent photon RT for children with brain tumors. METHODS CT scans of an anthropomorphic pediatric head phantom (approximately 15-year-old) and an infant-head-sized spherical phantom were acquired with and without TTF attached. For each phantom, simulated supratentorial tumor targets were initially contoured on CT datasets acquired without TTF attached. Treatment plans using volumetric modulated arc therapy were created to deliver 60Gy and 50Gy to the gross tumor volume (GTV) and clinical tumor volume (CTV), respectively, in 30 fractions. The dose distributions of the same treatment plans were then re-computed with TTF attached. Target coverage metrics were compared between dose distributions with and without TTF. To measure skin dose, treatment plans were delivered with thermoluminescent dosimeters placed on the phantoms at various locations, with and without TTF attached. RESULTS The presence of TTF slightly reduced target coverage. For the two phantoms studied, D95 of the CTV was reduced by 0.65% and 1.03%, and D95 of the GTV was reduced by 0.7% and 1.05%, respectively. Electrodes under the direct beam path increased skin dose by an average of 43.3% (0.3Gy – 20.7Gy), but all skin dose measurements stayed within tolerances. TTF electrodes out of the RT field did not cause an increase in measured dose. CONCLUSIONS The dosimetric impact of TTF on pediatric head phantoms receiving concurrent RT resembles that reported in adult studies. Although the tumor dose is not significantly affected, the skin dose notably increases due to the bolus effect from the TTF electrodes, which may be mitigated by skin-sparing planning and shifting of the device during RT.

Methods for Restricting Maximum Exposure Rate in Computerized Adaptative Testing

Methodology ◽  
2007 ◽  
Vol 3 (1) ◽  
pp. 14-23 ◽  
Author(s):  
Juan Ramon Barrada ◽  
Julio Olea ◽  
Vicente Ponsoda
Keyword(s):  
Measurement Accuracy ◽  
Computerized Adaptive Testing ◽  
Computation Time ◽  
Adaptive Testing ◽  
Exposure Rate ◽  
Control Parameters ◽  
The Impact ◽  
Two Alternatives ◽  
Selection Of ◽  
Maximum Exposure

Abstract. The Sympson-Hetter (1985) method provides a means of controlling maximum exposure rate of items in Computerized Adaptive Testing. Through a series of simulations, control parameters are set that mark the probability of administration of an item on being selected. This method presents two main problems: it requires a long computation time for calculating the parameters and the maximum exposure rate is slightly above the fixed limit. Van der Linden (2003) presented two alternatives which appear to solve both of the problems. The impact of these methods in the measurement accuracy has not been tested yet. We show how these methods over-restrict the exposure of some highly discriminating items and, thus, the accuracy is decreased. It also shown that, when the desired maximum exposure rate is near the minimum possible value, these methods offer an empirical maximum exposure rate clearly above the goal. A new method, based on the initial estimation of the probability of administration and the probability of selection of the items with the restricted method ( Revuelta & Ponsoda, 1998 ), is presented in this paper. It can be used with the Sympson-Hetter method and with the two van der Linden's methods. This option, when used with Sympson-Hetter, speeds the convergence of the control parameters without decreasing the accuracy.

Study on the Chemical Modification Process of Jute Fiber

TAPPI Journal ◽  
2010 ◽  
Vol 9 (2) ◽  
pp. 23-29 ◽  
Author(s):  
Wei-ming Wang ◽  
Zai-sheng Cai ◽  
Jian-yong Yu
Keyword(s):  
Sodium Hydroxide ◽  
Sodium Silicate ◽  
Treatment Time ◽  
Jute Fiber ◽  
Process Conditions ◽  
Silicate Concentration ◽  
Sodium Hydroxide Concentration ◽  
Liquor Ratio ◽  
Degumming Process ◽  
Selection Of

Degumming of pre-chlorite treated jute fiber was studied in this paper. The effects of sodium hydroxide concentration, treatment time, temperature, sodium silicate concentration, fiber-to-liquor ratio, penetrating agent TF-107B concentration, and degumming agent TF-125A concentration were the process conditions examined. With respect to gum decomposition, fineness and mechanical properties, sodium hydroxide concentration, sodium silicate concentration, and treatment time were found to be the most important parameters. An orthogonal L9(34) experiment designed to optimize the conditions for degumming resulted in the selection of the following procedure: sodium hydroxide of 12g/L, sodium silicate of 3g/L, TF-107B of 2g/L, TF-125A of 2g/L, treatment time of 105 min, temperature of 100°C and fiber to liquor ratio of 1:20. The effect of the above degumming process on the removal of impurities was also examined and the results showed that degumming was an effective method for removing impurities, especially hemicellulose.

Prognostic value of absolute monocyte count in chronic lymphocytic leukaemia

2015 ◽  
Vol 156 (15) ◽  
pp. 592-597
Author(s):  
László Szerafin ◽  
János Jakó ◽  
Ferenc Riskó
Keyword(s):  
Chronic Lymphocytic Leukaemia ◽  
Prognostic Value ◽  
Lymphocytic Leukaemia ◽  
Treatment Time ◽  
Monocyte Count ◽  
Time To Treatment ◽  
Causes Of Mortality ◽  
The Absolute ◽  
The Impact ◽  
Overal Survival

Introduction: The low peripheral absolute lymphocyte and high monocyte count have been reported to correlate with poor clinical outcome in various lymphomas and other cancers. However, a few data known about the prognostic value of absolute monocyte count in chronic lymphocytic leukaemia. Aim: The aim of the authors was to investigate the impact of absolute monocyte count measured at the time of diagnosis in patients with chronic lymphocytic leukaemia on the time to treatment and overal survival. Method: Between January 1, 2005 and December 31, 2012, 223 patients with newly-diagnosed chronic lymphocytic leukaemia were included. The rate of patients needing treatment, time to treatment, overal survival and causes of mortality based on Rai stages, CD38, ZAP-70 positivity and absolute monocyte count were analyzed. Results: Therapy was necessary in 21.1%, 57.4%, 88.9%, 88.9% and 100% of patients in Rai stage 0, I, II, III an IV, respectively; in 61.9% and 60.8% of patients exhibiting CD38 and ZAP-70 positivity, respectively; and in 76.9%, 21.2% and 66.2% of patients if the absolute monocyte count was <0.25 G/l, between 0.25–0.75 G/l and >0.75 G/l, respectively. The median time to treatment and the median overal survival were 19.5, 65, and 35.5 months; and 41.5, 65, and 49.5 months according to the three groups of monocyte counts. The relative risk of beginning the therapy was 1.62 (p<0.01) in patients with absolute monocyte count <0.25 G/l or >0.75 G/l, as compared to those with 0.25–0.75 G/l, and the risk of overal survival was 2.41 (p<0.01) in patients with absolute monocyte count lower than 0.25 G/l as compared to those with higher than 0.25 G/l. The relative risks remained significant in Rai 0 patients, too. The leading causes of mortality were infections (41.7%) and the chronic lymphocytic leukaemia (58.3%) in patients with low monocyte count, while tumours (25.9–35.3%) and other events (48.1 and11.8%) occurred in patients with medium or high monocyte counts. Conclusions: Patients with low and high monocyte counts had a shorter time to treatment compared to patients who belonged to the intermediate monocyte count group. The low absolute monocyte count was associated with increased mortality caused by infectious complications and chronic lymphocytic leukaemia. The absolute monocyte count may give additional prognostic information in Rai stage 0, too. Orv. Hetil., 2015, 156(15), 592–597.

Impact of removing ESBL designation from culture reports on the selection of antibiotics for the treatment of infections associated with ESBL-producing organisms

2020 ◽  
Vol 41 (5) ◽  
pp. 604-607 ◽  
Author(s):  
Mark D. Lesher ◽  
Cory M. Hale ◽  
Dona S. S. Wijetunge ◽  
Matt R. England ◽  
Debra S. Myers ◽  
...  
Keyword(s):  
Antimicrobial Stewardship ◽  
Antibiotic Prescribing ◽  
The Impact ◽  
Inhibitor Combination ◽  
Lactamase Inhibitor ◽  
Selection Of

AbstractWe characterized the impact of removal of the ESBL designation from microbiology reports on inpatient antibiotic prescribing. Definitive prescribing of carbapenems decreased from 48.4% to 16.1% (P = .01) and β-lactam–β-lactamase inhibitor combination increased from 19.4% to 61.3% (P = .002). Our findings confirm the importance of collaboration between microbiology and antimicrobial stewardship programs.

scholarly journals Evaluating the impact of prescription isodose line on plan quality using Gamma Knife inverse planning

2021 ◽  
Author(s):  
Qianyi Xu ◽  
Gregory Kubicek ◽  
David Mulvihill ◽  
Warren Goldman ◽  
Gary Eastwick ◽  
...  
Keyword(s):  
Gamma Knife ◽  
Plan Quality ◽  
Inverse Planning ◽  
The Impact ◽  
Prescription Isodose

scholarly journals The Impact of Alkaloid-Producing Epichloë Endophyte on Forage Ryegrass Breeding: A New Zealand Perspective

Toxins ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 158
Author(s):  
Colin Eady
Keyword(s):  
Seed Production ◽  
Health Issues ◽  
Abiotic Stressors ◽  
Livestock Health ◽  
The Right ◽  
The Impact ◽  
The Relationship ◽  
And Storage ◽  
Selection Of ◽  
Epichloë Endophyte

For 30 years, forage ryegrass breeding has known that the germplasm may contain a maternally inherited symbiotic Epichloë endophyte. These endophytes produce a suite of secondary alkaloid compounds, dependent upon strain. Many produce ergot and other alkaloids, which are associated with both insect deterrence and livestock health issues. The levels of alkaloids and other endophyte characteristics are influenced by strain, host germplasm, and environmental conditions. Some strains in the right host germplasm can confer an advantage over biotic and abiotic stressors, thus acting as a maternally inherited desirable ‘trait’. Through seed production, these mutualistic endophytes do not transmit into 100% of the crop seed and are less vigorous than the grass seed itself. This causes stability and longevity issues for seed production and storage should the ‘trait’ be desired in the germplasm. This makes understanding the precise nature of the relationship vitally important to the plant breeder. These Epichloë endophytes cannot be ‘bred’ in the conventional sense, as they are asexual. Instead, the breeder may modulate endophyte characteristics through selection of host germplasm, a sort of breeding by proxy. This article explores, from a forage seed company perspective, the issues that endophyte characteristics and breeding them by proxy have on ryegrass breeding, and outlines the methods used to assess the ‘trait’, and the application of these through the breeding, production, and deployment processes. Finally, this article investigates opportunities for enhancing the utilisation of alkaloid-producing endophytes within pastures, with a focus on balancing alkaloid levels to further enhance pest deterrence and improving livestock outcomes.

scholarly journals An IoT-Based Participatory Antitheft System for Public Safety Enhancement in Smart Cities

Smart Cities ◽  
2021 ◽  
Vol 4 (2) ◽  
pp. 919-937
Author(s):  
Nikos Papadakis ◽  
Nikos Koukoulas ◽  
Ioannis Christakis ◽  
Ilias Stavrakas ◽  
Dionisis Kandris
Keyword(s):  
Smart Cities ◽  
Low Cost ◽  
Negative Influence ◽  
Asset Tracking ◽  
Tracking Tasks ◽  
Tracking Process ◽  
The Impact ◽  
Operation Center ◽  
Safety Enhancement ◽  
Selection Of

The risk of theft of goods is certainly an important source of negative influence in human psychology. This article focuses on the development of a scheme that, despite its low cost, acts as a smart antitheft system that achieves small property detection. Specifically, an Internet of Things (IoT)-based participatory platform was developed in order to allow asset-tracking tasks to be crowd-sourced to a community. Stolen objects are traced by using a prototype Bluetooth Low Energy (BLE)-based system, which sends signals, thus becoming a beacon. Once such an item (e.g., a bicycle) is stolen, the owner informs the authorities, which, in turn, broadcast an alert signal to activate the BLE sensor. To trace the asset with the antitheft tag, participants use their GPS-enabled smart phones to scan BLE tags through a specific smartphone client application and report the location of the asset to an operation center so that owners can locate their assets. A stolen item tracking simulator was created to support and optimize the aforementioned tracking process and to produce the best possible outcome, evaluating the impact of different parameters and strategies regarding the selection of how many and which users to activate when searching for a stolen item within a given area.

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