Use of in vivo transit portal images to detect gross inter-fraction patient geometry changes on an O-ring type linear accelerator for pelvis and head/neck patients

Author(s):  
Trent Aland ◽  
Talia Jarema ◽  
Myles Spalding ◽  
Tanya Kairn ◽  
Jamie V Trapp
2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Sarah O. S. Osman ◽  
Emily Russell ◽  
Raymond B. King ◽  
Karen Crowther ◽  
Suneil Jain ◽  
...  

Abstract Background In this study, a novel pelvic phantom was developed and used to assess the visibility and presence of artefacts from different types of commercial fiducial markers (FMs) on multi-modality imaging relevant to prostate cancer. Methods and materials The phantom was designed with 3D printed hollow cubes in the centre. These cubes were filled with gel to mimic the prostate gland and two parallel PVC rods were used to mimic bones in the pelvic region. Each cube was filled with gelatine and three unique FMs were positioned with a clinically-relevant spatial distribution. The FMs investigated were; Gold Marker (GM) CIVCO, GM RiverPoint, GM Gold Anchor (GA) line and ball shape, and polymer marker (PM) from CIVCO. The phantom was scanned using several imaging modalities typically used to image prostate cancer patients; MRI, CT, CBCT, planar kV-pair, ExacTrac, 6MV, 2.5MV and integrated EPID imaging. The visibility of the markers and any observed artefacts in the phantom were compared to in-vivo scans of prostate cancer patients with FMs. Results All GMs were visible in volumetric scans, however, they also had the most visible artefacts on CT and CBCT scans, with the magnitude of artefacts increasing with FM size. PM FMs had the least visible artefacts in volumetric scans but they were not visible on portal images and had poor visibility on lateral kV images. The smallest diameter GMs (GA) were the most difficult GMs to identify on lateral kV images. Conclusion The choice between different FMs is also dependent on the adopted IGRT strategy. PM was found to be superior to investigated gold markers in the most commonly used modalities in the management of prostate cancer; CT, CBCT and MRI imaging.


2013 ◽  
Vol 29 (5) ◽  
pp. 569
Author(s):  
Andrew Reilly ◽  
Eva Rutkowska ◽  
Martyn Gilmore ◽  
Alan Gately ◽  
Carolyn Furlong

2019 ◽  
Vol 2019 ◽  
pp. 1-9
Author(s):  
Carolin Reimann ◽  
Julia Brangsch ◽  
Lisa Christine Adams ◽  
Christa Thöne-Reineke ◽  
Bernd Hamm ◽  
...  

Background. Magnetic resonance angiography (MRA) represents a clinical reference standard for the in vivo assessment of the vasculature. In this study, the potential of non-contrast-enhanced and contrast-enhanced angiography of the head/neck vasculature in mice on a clinical MR imaging system was tested. Methods. All in vivo magnetic resonance imaging was performed with a 3T clinical system (Siemens). Non-contrast-enhanced (time-of-flight, TOF) and contrast-enhanced angiography (gadofosveset-trisodium, GdT) were performed in C57BL/6J mouse strain. Lumen-to-muscle ratios (LMRs) and area measurements were assessed. Histology was performed as reference standard of all relevant vascular structures. Results. A close correlation between TOF (R2 = 0.79; p<0.05) and contrast-enhanced (GdT) angiography (R2 = 0.92; p<0.05) with histological area measurements was found. LMRs were comparable between both sequences. Regarding interobserver reproducibility, contrast-enhanced (GdT) angiography yielded a smaller 95% confidence interval and a closer interreader correlation compared to non-contrast-enhanced (TOF) measurements (−0.73–0.89; R2 = 0.81 vs. −0.55–0.56; R2 = 0.94). Conclusion. This study demonstrates that non-contrast-enhanced and contrast-enhanced angiographies of the head/neck vasculature of small animals can reliably performed on a clinical 3T MR scanner. Contrast-enhanced angiography enables the visualization of vascular structures with higher intravascular contrast and higher reproducibility.


2010 ◽  
Vol 68 (4-5) ◽  
pp. 795-798 ◽  
Author(s):  
Marcela A. Leal ◽  
Claudio Viegas ◽  
Alfredo Viamonte ◽  
Anna Campos ◽  
Delson Braz ◽  
...  

mBio ◽  
2016 ◽  
Vol 7 (3) ◽  
Author(s):  
Louis Cicchini ◽  
Joseph A. Westrich ◽  
Tao Xu ◽  
Daniel W. Vermeer ◽  
Jennifer N. Berger ◽  
...  

ABSTRACT High-risk human papillomaviruses (HPVs) are causally associated with multiple human cancers. Previous studies have shown that the HPV oncoprotein E7 induces immune suppression; however, the underlying mechanisms remain unknown. To understand the mechanisms by which HPV deregulates host immune responses in the tumor microenvironment, we analyzed gene expression changes of all known chemokines and their receptors using our global gene expression data sets from human HPV-positive and -negative head/neck cancer and cervical tissue specimens in different disease stages. We report that, while many proinflammatory chemokines increase expression throughout cancer progression, CXCL14 is dramatically downregulated in HPV-positive cancers. HPV suppression of CXCL14 is dependent on E7 and associated with DNA hypermethylation in the CXCL14 promoter. Using in vivo mouse models, we revealed that restoration of Cxcl14 expression in HPV-positive mouse oropharyngeal carcinoma cells clears tumors in immunocompetent syngeneic mice, but not in Rag1 -deficient mice. Further, Cxcl14 reexpression significantly increases natural killer (NK), CD4 + T, and CD8 + T cell infiltration into the tumor-draining lymph nodes in vivo . In vitro transwell migration assays show that Cxcl14 reexpression induces chemotaxis of NK, CD4 + T, and CD8 + T cells. These results suggest that CXCL14 downregulation by HPV plays an important role in suppression of antitumor immune responses. Our findings provide a new mechanistic understanding of virus-induced immune evasion that contributes to cancer progression. IMPORTANCE Human papillomaviruses (HPVs) are causally associated with more than 5% of all human cancers. During decades of cancer progression, HPV persists, evading host surveillance. However, little is known about the immune evasion mechanisms driven by HPV. Here we report that the chemokine CXCL14 is significantly downregulated in HPV-positive head/neck and cervical cancers. Using patient tissue specimens and cultured keratinocytes, we found that CXCL14 downregulation is linked to CXCL14 promoter hypermethylation induced by the HPV oncoprotein E7. Restoration of Cxcl14 expression in HPV-positive cancer cells clears tumors in immunocompetent syngeneic mice, but not in immunodeficient mice. Mice with Cxcl14 reexpression show dramatically increased natural killer and T cells in the tumor-draining lymph nodes. These results suggest that epigenetic downregulation of CXCL14 by HPV plays an important role in suppressing antitumor immune responses. Our findings may offer novel insights to develop preventive and therapeutic tools for restoring antitumor immune responses in HPV-infected individuals.


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