scholarly journals Incorporating Clinical Imaging into the Delivery of Microbeam Radiation Therapy

2021 ◽  
Vol 11 (19) ◽  
pp. 9101
Author(s):  
Jason Paino ◽  
Micah Barnes ◽  
Elette Engels ◽  
Jeremy Davis ◽  
Susanna Guatelli ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Image Guidance ◽  
Radiation Treatment ◽  
Small Animal ◽  
Conventional Radiography ◽  
Patient Specific ◽  
Microbeam Radiation Therapy ◽  
Tumour Bearing ◽  
Treatment Margins

Synchrotron microbeam radiation therapy is a promising pre-clinical radiation treatment modality; however, it comes with many technical challenges. This study describes the image guidance protocol used for Australia’s first long-term pre-clinical MRT treatment of rats bearing 9L gliosarcoma tumours. The protocol utilises existing infrastructure available at the Australian Synchrotron and the adjoining Monash Biomedical Imaging facility. The protocol is designed and optimised to treat small animals utilising high-resolution clinical CT for patient specific tumour identification, coupled with conventional radiography, using the recently developed SyncMRT program for image guidance. Dosimetry performed in small animal phantoms shows patient dose is comparable to standard clinical doses, with a CT associated dose of less than 1.39cGy and a planar radiograh dose of less than 0.03cGy. Experimental validation of alignment accuracy with radiographic film demonstrates end to end accuracy of less than ±0.34mm in anatomical phantoms. Histological analysis of tumour-bearing rats treated with microbeam radiation therapy verifies that tumours are targeted well within applied treatment margins. To date, this technique has been used to treat 35 tumour-bearing rats.

Film dosimetry studies for patient specific quality assurance in microbeam radiation therapy

2019 ◽  
Vol 65 ◽  
pp. 227-237
Author(s):  
Alexandre Ocadiz ◽  
Jayde Livingstone ◽  
Mattia Donzelli ◽  
Stefan Bartzsch ◽  
Christian Nemoz ◽  
...  
Keyword(s):  
Quality Assurance ◽  
Radiation Therapy ◽  
Patient Specific ◽  
Film Dosimetry ◽  
Microbeam Radiation Therapy

Image-guided radiation therapy using computed tomography in radiotherapy

2010 ◽  
Vol 10 (2) ◽  
pp. 121-136 ◽  
Author(s):  
Winky Wing Ki Fung ◽  
Vincent Wing Cheung Wu
Keyword(s):  
Computed Tomography ◽  
Radiation Therapy ◽  
Soft Tissue ◽  
Image Guidance ◽  
Cone Beam ◽  
Patient Specific ◽  
Image Guided Radiotherapy ◽  
Soft Tissue Contrast ◽  
Image Guided ◽  
Tissue Contrast

AbstractThe sharp dose gradients in intensity-modulated radiation therapy increase the treatment sensitivity to various inter- and intra-fractional uncertainties, in which a slight anatomical change may greatly alter the actual dose delivered. Image-guided radiotherapy refers to the use of advanced imaging techniques to precisely track and correct these patient-specific variations in routine treatment. It can also monitor organ changes during a radiotherapy course. Currently, image-guided radiotherapy using computed tomography has gained much popularity in radiotherapy verification as it provides volumetric images with soft-tissue contrast for on-line tracking of tumour. This article reviews four types of computed tomography-based image guidance systems and their working principles. The system characteristics and clinical applications of the helical, megavoltage, computed tomography, and kilovoltage, cone-beam, computed tomography systems are discussed, given that they are currently the most commonly used systems for radiotherapy verification. This article also focuses on the recent techniques of soft-tissue contrast enhancement, digital tomosynthesis, four-dimensional fluoroscopic image guidance, and kilovoltage/megavoltage, in-line cone-beam imaging. These evolving systems are expected to take over the conventional two-dimensional verification system in the near future and provide the basis for implementing adaptive radiotherapy.

scholarly journals Establishment of Microbeam Radiation Therapy at a Small-Animal Irradiator

2021 ◽  
Vol 109 (2) ◽  
pp. 626-636
Author(s):  
Franziska Treibel ◽  
Mai Nguyen ◽  
Mabroor Ahmed ◽  
Annique Dombrowsky ◽  
Jan J. Wilkens ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Small Animal ◽  
Microbeam Radiation Therapy

End of Treatment Cone-Beam Computed Tomography (CBCT) is Predictive of Radiation Response and Overall Survival in Head and Neck Cancer

2021 ◽  
Author(s):  
Whitney Sumner ◽  
Sangwoo S. Kim ◽  
Lucas Vitzthum ◽  
Kevin Moore ◽  
Todd Atwood ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Overall Survival ◽  
Radiation Therapy ◽  
Lymph Nodes ◽  
Head And Neck ◽  
Cone Beam Computed Tomography ◽  
Image Guidance ◽  
Radiation Treatment ◽  
Cone Beam ◽  
Primary Tumors

Abstract Background: Image guidance in radiation oncology has resulted in significant improvements in the accuracy and precision of radiation therapy (RT). Recently, the resolution and quality of cone beam computed tomography (CBCT) for image guidance has increased so that tumor masses and lymph nodes are readily detectable and measurable. During treatment of head and neck squamous cell carcinoma (HNSCC), on-board CBCT setup imaging is routinely obtained; however, this CBCT imaging data has not been utilized to predict patient outcomes. Here, we analyzed whether changes in CBCT measurements obtained during a course of radiation therapy correlate with responses on routine 3-month follow-up diagnostic imaging and overall survival (OS). Materials/Methods: Patients with oropharyngeal primary tumors who received radiation therapy between 2015 and 2018 were included. Anatomical measurements were collected of the primary tumor and largest nodal conglomerate (LNC) at CT simulation, end of radiation treatment (EOT CBCT), and routine 3-month post-RT imaging. At each timepoint anteroposterior (AP), mediolateral (ML) and craniocaudal (CC) measurements were obtained and used to create a 2-dimensional (2D) maximum. Results: CBCT data from 64 node positive patients were analyzed. The largest nodal 2D maximum and CC measurements on EOT CBCT showed a statistically significant correlation with complete response on 3-month post-RT imaging (r=0.313, p=0.02 and r=0.318, p=0.02, respectively). Furthermore, patients who experienced a 30% or greater reduction in the CC dimension had improved OS (continuous HR 1.07, 95% CI 1.02-1.15, p=0.045). Conclusion: Decreased size of pathologic lymph nodes measured using CBCT setup imaging during a radiation course correlates with long term therapeutic response and overall survival of HNSCC patients. These results indicate that CBCT setup imaging may have utility as an early predictor of treatment response in oropharyngeal HNSCC and could ultimately help guide management.

scholarly journals Low-dose Radiation Treatment for Painful Heel Spur: a Highly Effective Therapy With Little Side Effects

2021 ◽  
Author(s):  
Freddy-Joel Djiepmo Njanang ◽  
Balint Tamaskovics ◽  
Edwin Boelke ◽  
Matthias Peiper ◽  
Jan Haussmann ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Side Effects ◽  
Pain Score ◽  
Severe Pain ◽  
Radiation Treatment ◽  
Pain Reduction ◽  
Effective Therapy ◽  
Response To Treatment ◽  
Painful Heel

Abstract Aim: Evaluation of pain reduction using orthovolt or cobalt-based radiation treatment for painful heel spurs and determination of long-term response as well as prognostic parameters.Methods: We identified a total of 102 consecutive patients treated for a total of 117 symptomatic heel spurs. 59 patients were treated with cobalt radiation, 31 patients with orthovolt therapy and 12 patients with both radiation systems. Pain reduction was scored using the modified Rowe-Score prior therapy, at the end of each treatment series as well as after 6 weeks and at the time of data collection. Long-term outcome was evaluated in patients with a follow-up period of longer than three years. Results: Before radiation therapy, 61 patients (60.4%) had a score of 0, significant strong pain. At the time of completion of radiation treatment, 3 patients (2.7%) were pain free (score of 30), whereas 8 patients (7.9%) had still severe pain (score 0). 6 weeks after radiation therapy, 33 patients (32.7%) were pain-free and 8 patients (7.9%) had severe pain (score 0), while at the time data of collection, 74 patients (73%) were free of pain and 1 patient (1%) had strong pain (score 0). Duration of pain before the start of radiation treatment was a significant prognostic factor (p=0.012) for response to treatment. Hier noch etwas über die Nebenwirkungen schreiben? Darauf gehen wir in der Conclusion ja ein.Conclusion: Radiotherapy of painful heel spurs is a highly effective therapy with little side effects providing long-term therapeutic response. The only significant prognostic parameter for response to treatment is the duration of pre-radiation therapy pain. Early integration of radiation therapy in the treatment seems to result in superior pain reduction.

Persistence of circulating t(14;18)-positive cells in long-term remission after radiation therapy for localized-stage follicular lymphoma.

1993 ◽  
Vol 11 (9) ◽  
pp. 1668-1673 ◽  
Author(s):  
J Finke ◽  
J Slanina ◽  
W Lange ◽  
G Dölken
Keyword(s):  
Radiation Therapy ◽  
Follicular Lymphoma ◽  
Mononuclear Cells ◽  
Radiation Treatment ◽  
Stage I ◽  
Peripheral Blood Mononuclear ◽  
Negative Results ◽  
Polymerase Chain

PURPOSE To determine the prevalence of circulating t(14;18)-positive cells in patients with long-term remission after radiation therapy for stage I and II follicular lymphoma. PATIENTS AND METHODS Peripheral-blood mononuclear cells from 21 patients in continuous remission were examined by a two-step polymerase chain reaction (PCR) assay for the detection of cells carrying a t(14;18) translocation with a breakpoint within the major breakpoint region (MBR) or minor cluster region (mcr). RESULTS Follow-up duration was between 25 and 160 months, with a median of 6.5 years. Thirteen patients (62%) showed negative results on repetitive testing. Cells that were t(14;18)-positive were found in eight patients (38%), all carrying a breakpoint in the MBR. One patient relapsed in each group. CONCLUSION Circulating t(14;18)-positive cells can persist in a high percentage of follicular lymphoma patients in long-term complete remission (CR) after radiation treatment for stage I and II disease. The significance of minimal residual t(14;18)-positive cells with regard to the risk of relapse needs to be investigated in further prospective long-term studies.

Second malignancy after Hodgkin disease treated with radiation therapy with or without chemotherapy: long-term risks and risk factors

Blood ◽  
2002 ◽  
Vol 100 (6) ◽  
pp. 1989-1996 ◽  
Author(s):  
Andrea K. Ng ◽  
M. V. Patricia Bernardo ◽  
Edie Weller ◽  
Kendall Backstrand ◽  
Barbara Silver ◽  
...  
Keyword(s):  
Risk Factors ◽  
Radiation Therapy ◽  
Radiation Treatment ◽  
Temporal Trends ◽  
Excess Risk ◽  
Hodgkin Disease ◽  
Field Size ◽  
Second Malignancy

Abstract The excess risk of second malignancy after Hodgkin disease is an increasing problem. In light of the long-term data, guidelines for follow-up of survivors of Hodgkin disease need to be redefined. In this study we attempt to analyze the long-term risks and temporal trends, identify patient- and treatment-related risk factors, and determine the prognosis of patients who develop a second malignancy after radiation treatment with or without chemotherapy for Hodgkin disease. Among 1319 patients with clinical stage I-IV Hodgkin disease, 181 second malignancies and 18 third malignancies were observed. With a median follow-up of 12 years, the relative risk (RR) and absolute excess risk of second malignancy were 4.6 and 89.3/10 000 person-years. The RR was significantly higher with combined chemotherapy and radiation therapy (6.1) than with radiation therapy alone (4.0, P = .015). The risk increased with increasing radiation field size (P = .03) in patients who received combined modality therapy, and with time after Hodgkin disease. After 15 and 20 years, there was a 2.3% and 4.0% excess risk of second malignancy per person per year. The 5-year survival after development of a second malignancy was 38.1%, with the worst prognosis seen after acute leukemia and lung cancer. The excess risk of second malignancy after Hodgkin disease continues to be increased after 15 to 20 years, and there does not appear to be a plateau. Our analysis suggests that the risk may be reduced with smaller radiation fields, as are used in current trials of abbreviated chemotherapy and limited-field radiation therapy.

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