3 research outputs found
Total Skin Electron Therapy Stanford Technique Evolution With Monte Carlo Simulation Toward Personalized Treatments For Cutaneous Lymphoma
Current Total Skin Electron Therapy (TSET) Stanford technique for cutaneous
lymphoma, established in the 70's, involves a unique irradiation setup, i.e.
patient's position and beam arrangement, for all patients with ensuing great
variability in dose distribution and difficult dose optimization. A
Geant4-based simulation has been developed to explore the possibility of
personalizing the dose to each patient's anatomy. To achieve this optimization
of the treatment method, this project enrolls different aspects of the clinical
and computational techniques: starting with the knowledge of the experimental
parameters involving TSET practice, passing through an innovative approach to
model the patient's anatomy, a precise description of the electron beam and a
validated configuration of the physics models handling the interactions of the
electrons and of secondary particles. The Geant4-based simulation models the
patient as a tessellated solid derived from the optical scan of her/his body,
realistically reproduces the irradiation environment in detail and calculates
the energy deposition corresponding to each facet of the patient's scanned
surface. The resulting three-dimensional dose distribution constitutes the
basis for the personalization of the medical treatement as appropriate to each
patient's specific characteristics.Comment: Presented at the 2022 IEEE Nuclear Science Symposiu
Diagnostic Value of MRI Proton Density Fat Fraction for Assessing Liver Steatosis in Chronic Viral C Hepatitis
Objective. To assess the diagnostic performance of a T1-independent, T2*-corrected multiecho magnetic resonance imaging (MRI) technique for the quantification of hepatic steatosis in a cohort of patients affected by chronic viral C hepatitis, using liver biopsy as gold standard. Methods. Eighty-one untreated patients with chronic viral C hepatitis were prospectively enrolled. All included patients underwent MRI, transient elastography, and liver biopsy within a time interval <10 days. Results. Our cohort of 77 patients included 43/77 (55.8%) males and 34/77 (44.2%) females with a mean age of 51.31 ± 11.27 (18–81) years. The median MRI PDFF showed a strong correlation with the histological fat fraction (FF) (r=0.754, 95% CI 0.637 to 0.836, P<0.0001), and the correlation was influenced by neither the liver stiffness nor the T2* decay. The median MRI PDFF result was significantly lower in the F4 subgroup (P<0.05). The diagnostic accuracy of MRI PDFF evaluated by AUC-ROC analysis was 0.926 (95% CI 0.843 to 0.973) for S≥1 and 0.929 (95% CI 0.847 to 0.975) for S=2. Conclusions. Our MRI technique of PDFF estimation allowed discriminating with a good diagnostic accuracy between different grades of hepatic steatosis