Esophageal Motion Characteristics and Determination of Setup Errors in Esophageal Cancer

In this review, we outline the potential benefits and the future role of MRI and MR-guided radiotherapy (MRgRT) in the management of esophageal cancer. Although not currently used in most clinical practice settings, MRI is a useful non-invasive imaging modality that provides excellent soft tissue contrast and the ability to visualize cancer physiology. Chemoradiation therapy with or without surgery is essential for the management of locally advanced esophageal cancer. MRI can help stage esophageal cancer, delineate the gross tumor volume (GTV), and assess the response to chemoradiotherapy. Integrated MRgRT systems can help overcome the challenge of esophageal motion due to respiratory motion by using real-time imaging and tumor tracking with respiratory gating. With daily on-table MRI, shifts in tumor position and tumor regression can be taken into account for online-adaptation. The combination of accurate GTV visualization, respiratory gating, and online adaptive planning, allows for tighter treatment volumes and improved sparing of the surrounding normal organs. This could lead to a reduction in radiotherapy induced cardiac toxicity, pneumonitis and post-operative complications. Tumor physiology as seen on diffusion weighted imaging or dynamic contrast enhancement can help individualize treatments based on the response to chemoradiotherapy. Patients with a complete response on MRI can be considered for organ preservation while patients with no response can be offered an earlier resection. In patients with a partial response to chemoradiotherapy, areas of residual cancer can be targeted for dose escalation. The tighter and more accurate targeting enabled with MRgRT may enable hypofractionated treatment schedules.

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Determination of the resection line in early esophageal cancer using intraoperative endoscopic examination with lugol staining

Journal of Surgical Oncology ◽

10.1002/jso.2930500304 ◽

1992 ◽

Vol 50 (3) ◽

pp. 149-152 ◽

Cited By ~ 8

Author(s):

Hiroyuki Kuwano ◽

Kaoru Kitamura ◽

Kinya Baba ◽

Masaru Morita ◽

Hiroyuki Matsuda ◽

...

Keyword(s):

Esophageal Cancer ◽

Endoscopic Examination ◽

Early Esophageal Cancer ◽

Resection Line

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Abstract 789: Determination of MAPK and Wnt pathway activity in esophageal cancer

10.1158/1538-7445.am10-789 ◽

2010 ◽

Author(s):

Nicholas B. Shannon ◽

Christopher J. Peters ◽

Jonathan R. Rees ◽

James S. Hardwick ◽

Chunsheng Zhang ◽

...

Keyword(s):

Esophageal Cancer ◽

Wnt Pathway ◽

Pathway Activity

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Prediction of Green Water Events on FPSO Vessels

Volume 2: Safety and Reliability; Pipeline Technology ◽

10.1115/omae2003-37452 ◽

2003 ◽

Cited By ~ 3

Author(s):

Alexander Fyfe ◽

Edward Ballard

Keyword(s):

Probability Distributions ◽

Green Water ◽

Design Stage ◽

Wave Crest ◽

Peak Period ◽

Wave Conditions ◽

Motion Characteristics ◽

Central North Sea

Most floating vessels experience some sea states, not necessarily extreme storms, which cause large volumes of green water to flow across the deck. Due to the location of safety critical equipment on the deck of FPSOs, the determination of the likely occurrences and the magnitudes of such events are critical to safe design and operation. A method for the determination of green water heights on the deck of an FPSO has been presented in references 1–5. This paper examines the long-term distributions of heights implied by these references and the identification of sea states in which extreme events are likely to occur. The method is based upon the long term distribution of sea states at the intended location, combined with the motion characteristics of the vessel. Freeboard exceedance at the bow and at a point along the side is considered for two typical FPSO configurations. The methodology presented is widely applicable to many locations but wave conditions typical of the Central North Sea are used by way of illustration. The results presented include long term probability distributions of green water height on deck at locations of interest. Relative contributions of each combination of significant wave height and peak period to the probability of the largest single event in a defined return period are determined and discussed. It is shown that the wave conditions most likely to give rise to the most severe green water events are seldom those characterized by the largest wave crest heights. Instead, there exists a complex dependence on characteristic periods associated with vessel motions and on the long-term occurrences of particular sea states. The ability to predict conditions in which the largest green water events are most likely to occur offers the possibility of providing improved operational guidelines for FPSOs, allowing action to be taken to avoid unfavourable loading conditions and/or vessel headings in certain sea conditions. However, it is also shown that it may be difficult to identify some severe green water sea states from normally available forecast data and hence it is important that appropriate provision is made at the design stage.

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SU-F-BRD-03: Determination of Plan Robustness for Systematic Setup Errors Using Trilinear Interpolation

Medical Physics ◽

10.1118/1.4889057 ◽

2014 ◽

Vol 41 (6Part23) ◽

pp. 395-395

Author(s):

MK Fix ◽

W Volken ◽

D Frei ◽

D Terribilini ◽

A Dal Pra ◽

...

Keyword(s):

Setup Errors ◽

Trilinear Interpolation

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Intrafraction Esophageal Motion for Clinically T1 Esophageal Cancer

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/j.ijrobp.2014.05.1094 ◽

2014 ◽

Vol 90 (1) ◽

pp. S332-S333

Author(s):

S. Sekii ◽

Y. Ito ◽

K. Inaba ◽

K. Kobayashi ◽

K. Harada ◽

...

Keyword(s):

Esophageal Cancer ◽

Esophageal Motion

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Determination of microvessel density by real-time PCR in esophageal cancer: Correlation with histological methods, angiogenic growth factor expression and lymph node metastasis

Journal of Clinical Oncology ◽

10.1200/jco.2006.24.18_suppl.10053 ◽

2006 ◽

Vol 24 (18_suppl) ◽

pp. 10053-10053

Author(s):

S. Loges ◽

H. Claussen ◽

U. Reichelt ◽

M. Bubenheim ◽

A. Erbersdobler ◽

...

Keyword(s):

Esophageal Cancer ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Esophageal Carcinoma ◽

Real Time ◽

Microvessel Density ◽

Real Time Pcr ◽

Angiogenic Growth Factors ◽

Node Metastasis

10053 Background: Neoangiogenesis and lymphangiogenesis represent prognostic factors in human malignancies. Determination of microvessel density (MVD) by immunohistology is labor-intensive and subject to interobserver variability. We evaluated real time PCR to quantify MVD in primary tumor samples from patients with esophageal cancer. Methods: We performed real-time PCR analyzes of endothel-specific (VE-Cadherin, P1H12, VEGFR-2, tie-2), lymphendothel-specific (Prox, LYVE, VEGFR-3) antigens and of angiogenic growth factors (VEGF-A, VEGF-C, VEGF-D, Ang-1, Ang-2) in primary esophageal carcinoma tissue of 54 patients. These results were compared to MVD determined immunohistochemically by CD31 staining. Results: For validation, MNC samples spiked with HUVECs were analyzed by qPCR for VE-CAD and P1H12 yielding a linear correlation (r=0.99 and 0.96 respectively). Expression of endothelial markers was highly correlated in tumor samples, e.g. CD144 with CD146 τb=0.451, CD144 with VEGFR-2 τb =0.744 and CD144 with tie-2 τb=0.684 (p for all comparisons < 0.0001). QPCR results were compared to MVD determination by CD31 staining in a subgroup of 33 patients. The highest association between both methods was found for CD144 (τb=0.258, p=0.0379) and VEGFR-2 (τb=0.222, p=0.0745) indicating that immunohistology and qPCR yield comparable results. MVD was significantly linked to the expression of VEGF-A, -C,-D and Ang1 and Ang2 (p for all comparisons <0.0001). We analyzed expression of lymphendothelial cell antigens Prox, LYVE and VEGFR-3 for quantification of lymphatic vessels. A close association between the expression of different lymphendothelial factors was seen (LYVE with Prox τb=0.334, p=0.0021, LYVE with VEGFR-3 τb=0.450, p=0.0150). MVD and lymphvessel density was not linked. Lymph node metastases detected on surgical specimen were associated with MVD determined immunohistologically (p=0.003)or by qPCR (p=0.048) and to VEGF-C expression (p=0.04). Conclusions: QPCR analysis of CD144 and VEGFR2 represents a novel tool for quantification of MVD in tumor samples. Expression of VEGFR2 and VEGF-C is associated with lymph node metastasis in patients with esophageal carcinoma. No significant financial relationships to disclose.

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