HDR brachytherapy well chamber calibration and stability evaluated over twenty years of clinical use

Abstract BACKGROUND This report describes a process for designing a 3D printed patient-specific applicator for HDR brachytherapy of the orbit. CASE PRESENTATION A 34-year-old man with recurrent melanoma of the orbit was referred for consideration of re-irradiation. An applicator for HDR brachytherapy was designed based on the computed tomography (CT) of patient anatomy. The body contour was used to generate an applicator with a flush fit against the patient’s skin while the planning target volume (PTV) was used to devise channels that allow for access and coverage of the tumor bed. An end-to-end quality assurance test was devised to determine feasibility for clinical use. The applicator was designed to conform to the volume and contours inside the orbital cavity. Support wings placed flush with the patient skin provided stability and reproducibility, while 16 source channels of varying length were needed for sufficient access to the target. A solid sheath, printed as an outer support-wall for each channel, prevented bending or accidental puncturing of the surface of the applicator. CONCLUSIONS Quality assurance tests demonstrated feasibility for clinical use. Our experience with available 3D printing technology used to generate an applicator for the orbit may provide guidance for how materials of suitable biomechanical and radiation properties can be used in brachytherapy.

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A Design Process for a 3D Printed Patient-Specific Applicator for HDR Brachytherapy of the Orbit

10.21203/rs.3.rs-17333/v2 ◽

2020 ◽

Author(s):

Ergys David Subashi ◽

Corbin Jacobs ◽

Rodney Hood ◽

David Kirsch ◽

Oana Craciunescu

Keyword(s):

Target Volume ◽

The Body ◽

Patient Specific ◽

Clinical Use ◽

Hdr Brachytherapy ◽

Orbital Cavity ◽

Body Contour ◽

Tumor Bed ◽

Varying Length ◽

3D Printed

Abstract BACKGROUND: This report describes a process for designing a 3D printed patient-specific applicator for HDR brachytherapy of the orbit. CASE PRESENTATION: A 34-year-old man with recurrent melanoma of the orbit was referred for consideration of re-irradiation. An applicator for HDR brachytherapy was designed based on the computed tomography (CT) of patient anatomy. The body contour was used to generate an applicator with a flush fit against the patient’s skin while the planning target volume (PTV) was used to devise channels that allow for access and coverage of the tumor bed. An end-to-end dosimetric test was devised to determine feasibility for clinical use. The applicator was designed to conform to the volume and contours inside the orbital cavity. Support wings placed flush with the patient skin provided stability and reproducibility, while 16 source channels of varying length were needed for sufficient access to the target. A solid sheath, printed as an outer support-wall for each channel, prevented bending or accidental puncturing of the surface of the applicator. CONCLUSIONS: Quality assurance tests demonstrated feasibility for clinical use. Our experience with available 3D printing technology used to generate an applicator for the orbit may provide guidance for how materials of suitable biomechanical and radiation properties can be used in brachytherapy.

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Lessons learned from a HDR brachytherapy well ionisation chamber calibration error

Australasian Physical & Engineering Sciences in Medicine ◽

10.1007/s13246-011-0095-z ◽

2011 ◽

Vol 34 (4) ◽

pp. 529-533 ◽

Cited By ~ 3

Author(s):

Claire Dempsey

Keyword(s):

Lessons Learned ◽

Calibration Error ◽

Hdr Brachytherapy ◽

Ionisation Chamber ◽

Chamber Calibration

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Assessing Functional Language in School-Aged Children Using Language Sample Analysis

Perspectives of the ASHA Special Interest Groups ◽

10.1044/2020_persp-19-00079 ◽

2020 ◽

Vol 5 (3) ◽

pp. 622-636

Author(s):

John Heilmann ◽

Alexander Tucci ◽

Elena Plante ◽

Jon F. Miller

Keyword(s):

Computer Hardware ◽

School Age Children ◽

Functional Language ◽

School Age ◽

Clinical Use ◽

Sample Analysis ◽

Validity And Reliability ◽

Language Sample Analysis ◽

Accuracy And Repeatability ◽

Language Sample

Purpose The goal of this clinical focus article is to illustrate how speech-language pathologists can document the functional language of school-age children using language sample analysis (LSA). Advances in computer hardware and software are detailed making LSA more accessible for clinical use. Method This clinical focus article illustrates how documenting school-age student's communicative functioning is central to comprehensive assessment and how using LSA can meet multiple needs within this assessment. LSA can document students' meaningful participation in their daily life through assessment of their language used during everyday tasks. The many advances in computerized LSA are detailed with a primary focus on the Systematic Analysis of Language Transcripts (Miller & Iglesias, 2019). The LSA process is reviewed detailing the steps necessary for computers to calculate word, morpheme, utterance, and discourse features of functional language. Conclusion These advances in computer technology and software development have made LSA clinically feasible through standardized elicitation and transcription methods that improve accuracy and repeatability. In addition to improved accuracy, validity, and reliability of LSA, databases of typical speakers to document status and automated report writing more than justify the time required. Software now provides many innovations that make LSA simpler and more accessible for clinical use. Supplemental Material https://doi.org/10.23641/asha.12456719

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Translation Research for the Rehabilitation of Left Spatial Neglect and Associated Disorders of Attention in Stroke Patients

Perspectives on Neurophysiology and Neurogenic Speech and Language Disorders ◽

10.1044/nnsld18.2.55 ◽

2008 ◽

Vol 18 (2) ◽

pp. 55-65 ◽

Cited By ~ 2

Author(s):

Nkiruka Arene ◽

Argye E. Hillis

Keyword(s):

Theoretical Basis ◽

Attention Bias ◽

Spatial Neglect ◽

Clinical Use ◽

Stroke Patients ◽

Translation Research ◽

Unilateral Neglect ◽

Assessment And Treatment ◽

Sound Theoretical Basis ◽

Review Current

Abstract The syndrome of unilateral neglect, typified by a lateralized attention bias and neglect of contralateral space, is an important cause of morbidity and disability after a stroke. In this review, we discuss the challenges that face researchers attempting to elucidate the mechanisms and effectiveness of rehabilitation treatments. The neglect syndrome is a heterogeneous disorder, and it is not clear which of its symptoms cause ongoing disability. We review current methods of neglect assessment and propose logical approaches to selecting treatments, while acknowledging that further study is still needed before some of these approaches can be translated into routine clinical use. We conclude with systems-level suggestions for hypothesis development that would hopefully form a sound theoretical basis for future approaches to the assessment and treatment of neglect.

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