Phase I/II study of resection and intraoperative cesium-131 radioisotope brachytherapy in patients with newly diagnosed brain metastases.

OBJECT: Resected brain metastases have a high rate of local recurrence without adjuvant therapy. Adjuvant whole-brain radiotherapy (WBRT) remains the standard of care with a local control rate \u3e 90%. However, WBRT is delivered over 10-15 days, which can delay other therapy and is associated with acute and long-term toxicities. Permanent cesium-131 ((131)Cs) implants can be used at the time of metastatic resection, thereby avoiding the need for any additional therapy. The authors evaluated the safety, feasibility, and efficacy of a novel therapeutic approach with permanent (131)Cs brachytherapy at the resection for brain metastases. METHODS: After institutional review board approval was obtained, 24 patients with a newly diagnosed metastasis to the brain were accrued to a prospective protocol between 2010 and 2012. There were 10 frontal, 7 parietal, 4 cerebellar, 2 occipital, and 1 temporal metastases. Histology included lung cancer (16), breast cancer (2), kidney cancer (2), melanoma (2), colon cancer (1), and cervical cancer (1). Stranded (131)Cs seeds were placed as permanent volume implants. The prescription dose was 80 Gy at a 5-mm depth from the resection cavity surface. Distant metastases were treated with stereotactic radiosurgery (SRS) or WBRT, depending on the number of lesions. The primary end point was local (resection cavity) freedom from progression (FFP). Secondary end points included regional FFP, distant FFP, median survival, overall survival (OS), and toxicity. RESULTS: The median follow-up was 19.3 months (range 12.89-29.57 months). The median age was 65 years (range 45-84 years). The median size of resected tumor was 2.7 cm (range 1.5-5.5 cm), and the median volume of resected tumor was 10.31 cm(3) (range 1.77-87.11 cm(3)). The median number of seeds used was 12 (range 4-35), with a median activity of 3.82 mCi per seed (range 3.31-4.83 mCi) and total activity of 46.91 mCi (range 15.31-130.70 mCi). Local FFP was 100%. There was 1 adjacent leptomeningeal recurrence, resulting in a 1-year regional FFP of 93.8% (95% CI 63.2%-99.1%). One-year distant FFP was 48.4% (95% CI 26.3%-67.4%). Median OS was 9.9 months (95% CI 4.8 months, upper limit not estimated) and 1-year OS was 50.0% (95% CI 29.1%-67.8%). Complications included CSF leak (1), seizure (1), and infection (1). There was no radiation necrosis. CONCLUSIONS: The use of postresection permanent (131)Cs brachytherapy implants resulted in no local recurrences and no radiation necrosis. This treatment was safe, well tolerated, and convenient for patients, resulting in a short radiation treatment course, high response rate, and minimal toxicity. These findings merit further study with a multicenter trial

Mixed-reality systems for enhancing stereotactic radiosurgery case planning

Embodiments of the present disclosure relate to methods, systems, and computer program products for rendering a three-dimensional anatoruical model in a virtual or augmented reality device. In various embodiments, a method includes reading at a remote seiver, a three-dimensional imaging study from a data store, where the three-dimensional imaging study includes a plurality of two-dimensional slices of at least one anatoruical strncture, optionally performing segmentation, at the remote seiver, on each of the plurality of two-dimensional slices, generating, at the remote seiver, a volumetlic model of the at least one anatoruical strncture based on the plurality of two-dimensional slices, scaling, at the remote seiver, the volumetrie model according to one or more display parameters of a virtual or augmented reality device, receiving, at the virtual or augmented reality device, the scaled volumetrie model; and rendering, at the virtual or augmented reality device, the scaled volumetrie model

Creazione di un sistema informativo territorialeper le occupazioni di Suolo Pubbliconella Municipalità 1 del Comune di Napoli

Il progetto è realizzato nell’ambito di un tirocinio formativo post– laurea tra il Dipartimento di Costruzioni e Metodi Matematici in Architettura dell’Università degli Studi di Napoli Federico II e la Municipalità 1 del Comune di Napoli. Esso prevede la realizzazione di un Sistema InformativoTerritoriale basato sull’acquisizione e gestione informatizzata delle pratiche di occupazione di suolo pubblico. Grazie a questo strumento, utilizzabile sia in locale che in rete mediante tecnologia GIS, è possibile reperire le singole informazioni in maniera immediata, avendo sempre un collegamento diretto tra la cartografia di base e la banca dati delle pratiche di occupazione di suolo pubblico, residente presso la Municipalità 1, in formato Microsoft Access

Creazione di un Sistema Informativo Territoriale per le occupazioni di suolo pubblico nella Municipalità 1 del Comune di Napoli

Si prevede la realizzazione di un Sistema Informativo Territoriale basato sull’acquisizione e gestione informatizzata delle pratiche di occupazione di suolo pubblico. Grazie a questo strumento, utilizzabile sia in locale che in rete mediante tecnologia GIS, è possibile reperire le singole informazioni in maniera immediata, avendo sempre un collegamento diretto tra la cartografia di base e la banca dati delle pratiche di occupazione di suolo pubblico, residente presso la Municipalità 1, in formato Microsoft Access