One-class Gaussian process regressor for quality assessment of transperineal ultrasound images

The use of ultrasound guidance in prostate cancer radiotherapy workflows is not widespread. This can be partially attributed to the need for image interpretation by a trained operator during ultrasound image acquisition. In this work, a one-class regressor, based on DenseNet and Gaussian processes, was implemented to assess automatically the quality of transperineal ultrasound images of the male pelvic region. The implemented deep learning approach achieved a scoring accuracy of 94%, a specificity of 95% and a sensitivity of 93% with respect to the majority vote of three experts, which was comparable with the results of these experts. This is the first step towards a fully automatic workflow, which could potentially remove the need for image interpretation and thereby make the use of ultrasound imaging, which allows real-time volumetric organ tracking in the RT environment, more appealing for hospitals

Depression in Heart Failure with Reduced Ejection Fraction, an Undervalued Comorbidity: An Up-To-Date Review

Introduction: Depression is a common and severe comorbidity among individuals with heart failure (HF). Up to a third of all HF patients are depressed, and an even higher proportion have symptoms of depression. Aim: In this review, we evaluate the relationship between HF and depression, explain the pathophysiology and epidemiology of both diseases and their relationship, and highlight novel diagnostic and therapeutic options for HF patients with depression. Materials and Methods: This narrative review involved keyword searches of PubMed and Web of Science. Review search terms included ["Depression" OR "Depres*" OR "major depr*"] AND ["Heart Failure" OR "HF" OR "HFrEF" OR "HFmrEF" OR "HFpEF" OR "HFimpEF"] in all fields. Studies included in the review met the following criteria: (A) published in a peer-reviewed journal; (B) described the impact of depression on HF and vice versa; and (C) were opinion papers, guidelines, case studies, descriptive studies, randomized control trials, prospective studies, retrospective studies, narrative reviews, and systematic reviews. Results: Depression is an emergent HF risk factor and strongly relates with worse clinical outcomes. HF and depression share multiple pathways, including platelet dis-reactivity, neuroendocrine malfunction, inappropriate inflammation, tachi-arrhythmias, and frailty in the social and community setting. Existing HF guidelines urge evaluation of depression in all HF patients, and numerous screening tools are available. Depression is ultimately diagnosed based on DSM-5 criteria. There are both non-pharmaceutical and pharmaceutical treatments for depression. Regarding depressed symptoms, non-pharmaceutical treatments, such as cognitive-behavioral therapy and physical exercise, have shown therapeutic results, under medical supervision and with an effort level adapted to the patient's physical resources, together with optimal HF treatment. In randomized clinical studies, selective serotonin reuptake inhibitors, the backbone of antidepressant treatment, did not demonstrate advantage over the placebo in patients with HF. New antidepressant medications are currently being studied and could provide a chance to enhance management, treatment, and control of depression in patients with HF. Conclusions: Despite the substantial link between depression and HF, their combination is underdiagnosed and undertreated. Considering the hopeful yet unclear findings of antidepressant trials, further research is required to identify people who may benefit from antidepressant medication. The goal of future research should be a complete approach to the care of these patients, who are anticipated to become a significant medical burden in the future

Measurements corrections in quantitative ultrasound-aided image guided radiotherapy: Speed of sound aberration correction

To correct speed of sound (SOS) aberrations in ultrasound (US) imaging systems for quantitative image guided radiotherapy (IGRT) applications. US waves travel at different speeds in different human tissues. Conventional qualitative US-based imaging systems assume instead that the SOS is constant in all tissues; 1540 m/s, which is an accepted average value for soft tissues. This assumption is a systematic source of errors and image distortion in quantitative US imaging, whereas in qualitative diagnostic imaging it is usually unimportant

Introduction

Chapter 1 is an introduction to the topics covered in the book, describing image guided and adaptive radiotherapy, and the rationale for its use. It also contains a history of ultrasound in radiotherapy

Misure di fascio in Tomoterapia con Tomodose in una gestione del reparto di Oncologia Radioterapica via web

This paper is free to read on the publishers website SUMMARY: The presence, inside the hospital facility, of a LAN (Local Area Network) is sufficient in order to arrange a web-based system for the management of processes and resources inside a Radiotherapy Department in an integrated, expandable and scalable way. The many benefits in this kind of management are here exposed, in particular if a connection to a WAN (Internet) is available. For construction, the system allows to operate in conformity with the ISO 9000 standard. The constitution of a central database is the fundamental aspect: daily data collection is concentrated and made accessible to all the clients, thus reducing redundancies and increasing efficiency. This is particularly evident when a cross-check among measurements performed with different methods is necessary, as in the reported example on beam measurements on a Tomotherapy® device. A procedure is introduced to correctly read the discrepancies, from a web-management point of view, among measurements performed with Tomotherapy® Xe on-board detectors, Tomodose® and ion chambers. Data collected with different measurement methods are analyzed and compared in real time. The database remains available in order to build time trends that can be useful for forecasts

Collimator design and simulation for preclinical radiotherapy applications using a clinical cell irradiator

The use of preclinical studies with animal models in biomedical research provides a critical step in the assessment of novel therapeutic approaches. In vivo studies using small animals play a pivotal role in generating and improving methods for therapeutic treatment of cancer including radiotherapy (RT). Rodents, and in particular mice, have led to extensive development in cancer research. Currently, there are two commercially available radiation devices for small animal irradiation: The Small Animal Radiation Research Platform. Both deliver targeted radiation to preclinical animal models with an accuracy equivalent to clinical RT using a rotating gantry and implement high-resolution cone beam-CT and 3D bioluminescent tomographic imaging. However, the complexity of these systems makes them rather expensive, which is often a hindering factor for hospitals or research institutions to acquire them..