12,080 research outputs found
Optimization of treatment planning workflow and tumor coverage during daily adaptive magnetic resonance image guided radiation therapy (MR-IGRT) of pancreatic cancer
Abstract Background To simplify the adaptive treatment planning workflow while achieving the optimal tumor-dose coverage in pancreatic cancer patients undergoing daily adaptive magnetic resonance image guided radiation therapy (MR-IGRT). Methods In daily adaptive MR-IGRT, the plan objective function constructed during simulation is used for plan re-optimization throughout the course of treatment. In this study, we have constructed the initial objective functions using two methods for 16 pancreatic cancer patients treated with the ViewRay™ MR-IGRT system: 1) the conventional method that handles the stomach, duodenum, small bowel, and large bowel as separate organs at risk (OARs) and 2) the OAR grouping method. Using OAR grouping, a combined OAR structure that encompasses the portions of these four primary OARs within 3 cm of the planning target volume (PTV) is created. OAR grouping simulation plans were optimized such that the target coverage was comparable to the clinical simulation plan constructed in the conventional manner. In both cases, the initial objective function was then applied to each successive treatment fraction and the plan was re-optimized based on the patient’s daily anatomy. OAR grouping plans were compared to conventional plans at each fraction in terms of coverage of the PTV and the optimized PTV (PTV OPT), which is the result of the subtraction of overlapping OAR volumes with an additional margin from the PTV. Results Plan performance was enhanced across a majority of fractions using OAR grouping. The percentage of the volume of the PTV covered by 95% of the prescribed dose (D95) was improved by an average of 3.87 ± 4.29% while D95 coverage of the PTV OPT increased by 3.98 ± 4.97%. Finally, D100 coverage of the PTV demonstrated an average increase of 6.47 ± 7.16% and a maximum improvement of 20.19%. Conclusions In this study, our proposed OAR grouping plans generally outperformed conventional plans, especially when the conventional simulation plan favored or disregarded an OAR through the assignment of distinct weighting parameters relative to the other critical structures. OAR grouping simplifies the MR-IGRT adaptive treatment planning workflow at simulation while demonstrating improved coverage compared to delivered pancreatic cancer treatment plans in daily adaptive radiation therapy
Focal Spot, Fall/Winter 1996
https://digitalcommons.wustl.edu/focal_spot_archives/1071/thumbnail.jp
Advanced Magnetic Resonance Imaging in Glioblastoma: A Review
INTRODUCTION
In 2017, it is estimated that 26,070 patients will be diagnosed with a malignant primary brain tumor in the United States, with more than half having the diagnosis of glioblas- toma (GBM).1 Magnetic resonance imaging (MRI) is a widely utilized examination in the diagnosis and post-treatment management of patients with glioblastoma; standard modalities available from any clinical MRI scanner, including T1, T2, T2-FLAIR, and T1-contrast-enhanced (T1CE) sequences, provide critical clinical information. In the last decade, advanced imaging modalities are increasingly utilized to further charac- terize glioblastomas. These include multi-parametric MRI sequences, such as dynamic contrast enhancement (DCE), dynamic susceptibility contrast (DSC), diffusion tensor imaging (DTI), functional imaging, and spectroscopy (MRS), to further characterize glioblastomas, and significant efforts are ongoing to implement these advanced imaging modalities into improved clinical workflows and personalized therapy approaches. A contemporary review of standard and advanced MR imaging in clinical neuro-oncologic practice is presented
Dosimetric evidence confirms computational model for magnetic field induced dose distortions of therapeutic proton beams
Given the sensitivity of proton therapy to anatomical variations, this cancer
treatment modality is expected to benefit greatly from integration with
magnetic resonance (MR) imaging. One of the obstacles hindering such an
integration are strong magnetic field induced dose distortions. These have been
predicted in simulation studies, but no experimental validation has been
performed so far. Here we show the first measurement of planar distributions of
dose deposited by therapeutic proton pencil beams traversing a one-Tesla
transversal magnetic field while depositing energy in a tissue-like phantom
using film dosimetry. The lateral beam deflection ranges from one millimeter to
one centimeter for 80 to 180 MeV beams. Simulated and measured deflection agree
within one millimeter for all studied energies. These results proof that the
magnetic field induced proton beam deflection is both measurable and accurately
predictable. This demonstrates the feasibility of accurate dose measurement and
hence validates dose predictions for the framework of MR-integrated proton
therapy
Focal Spot, Summer 1998
https://digitalcommons.wustl.edu/focal_spot_archives/1079/thumbnail.jp
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