Use of surface-guided radiation therapy in combination with IGRT for setup and intrafraction motion monitoring during stereotactic body radiation therapy treatments of the lung and abdomen.

This study analyzes the accuracy of 3D surface mapping with Surface-guided radiation therapy (SGRT) in detecting interfraction setup error and intrafraction motion during SBRT treatments of the lung and abdomen. MATERIALS AND METHODS: Seventy-one patients with 85 malignant thoracic or abdominal tumors treated with SBRT were analyzed. For initial patient setup, an alternating scheme of kV/kV imaging or SGRT was followed by cone beam computed tomography (CBCT) for more accurate tumor volumetric localization. The CBCT six degree shifts after initial setup with each method were recorded to assess interfraction setup error. Patients were then monitored continuously with SGRT during treatment. If an intrafractional shift in any direction>2 mm for longer than 2 sec was detected by SGRT, then CBCT was repeated and the recorded deltas were compared to those detected by SGRT. RESULTS: Interfractional shifts after SGRT setup and CBCT were small in all directions with mean values of
Source: Journal of Applied Clinical Medical Physics - Category: Physics Authors: Tags: J Appl Clin Med Phys Source Type: research

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Elevated LDH, B symptoms, advanced stage and failure to achieve complete response after initial treatment are clinical variables associated with shorter progression ‐free survival (PFS) in pulmonary marginal zone lymphoma (PMZL). Multifocal lung disease, extrapulmonary MZL and cavitary lesions on computed tomography scans have been identified as radiologic features associated with shorter PFS. Radiation therapy and surgery are potentially curative strategies in PMZL. AbstractPulmonary marginal zone lymphoma (PMZL) is the most common non ‐Hodgkin lymphoma affecting the lung. PMZL is usually an indolent disease. Clinical...
Source: Cancer Medicine - Category: Cancer & Oncology Authors: Tags: ORIGINAL RESEARCH Source Type: research
Authors: Lachkar S, Guisier F, Roger M, Bota S, Lerouge D, Piton N, Thiberville L, Salaün M Abstract Background: Fiducial markers (FMs) are useful for tracking small peripheral lung nodules (PLN) before stereotactic radiotherapy, but migration over the course of treatment may result in inaccurate dosing to the tumor. To minimize FM migration, coil-tailed FMs have been designed. Our objective was to assess both the feasibility of radial endobronchial ultrasonography (r-EBUS) placement and the migration rate of coil-tailed FMs. Methods: In this retrospective study, we included patients who received r-EBUS gu...
Source: Journal of Thoracic Disease - Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research
Case Summary: A 28-year-old nulliparous woman presented with rectal bleeding. Colonoscopy revealed a 4-cm malignant-appearing mass in the proximal rectum, and biopsies confirmed invasive adenocarcinoma of the rectum. Computed tomography scan showed no evidence of metastatic disease. Staging MRI found transmural extension with minimal stranding in the adjacent fat, as well as no evidence of pathological pelvic adenopathy, consistent with a T3N0 lesion. The proposed treatment plan involved neoadjuvant chemotherapy and radiation therapy before primary surgical resection. The patient desired fertility preservation and was re...
Source: Diseases of the Colon and Rectum - Category: Gastroenterology Tags: Resident’s Corner Source Type: research
ConclusionsThis study demonstrates differences between ce-CT and FDG-PET/CT for initial staging of IBC and how these differences potentially affect patient management. Preliminary data suggest that FDG-PET/CT may be the imaging modality of choice for initial staging of IBC. Prospective trials testing initial staging with FDG-PET/CT versus important clinical end-points in IBC are warranted.
Source: Breast Cancer Research and Treatment - Category: Cancer & Oncology Source Type: research
An 85-year-old asymptomatic man with suspected biochemical recurrence of prostate cancer underwent an 18F-fluciclovine PET/CT scan, which revealed a solitary suspicious tracer uptake in the dorsal right corporal body of the proximal pendulous penis. The patient underwent ultrasound-guided fine-needle aspiration of the penile lesion, which revealed metastatic prostate cancer. The patient had definitive external beam radiation therapy 3 years before the examination. At the time of scan, the prostatic-specific antigen (PSA) was only 1.0 ng/mL, although the PSA doubling time was 2.6 months. It is unusual to detect a solitary p...
Source: Clinical Nuclear Medicine - Category: Nuclear Medicine Tags: Interesting Images Source Type: research
AbstractObjectiveTo explore standardized relative thresholds of volume-based parameters on FDG PET/CT, and define the optimal prognosticator among the relative thresholds for patients with locally advanced pancreatic head cancer (LAPHC) treated by stereotactic body radiation therapy (SBRT).MethodsThirty-five patients with LAPHC were enrolled, and all underwent SBRT and baseline FDG PET/CT scan. Maximum standardized uptake value (SUVmax) was measured, and metabolic tumor volume (MTV) and total lesion glycolysis (TLG) were calculated under the relative (30%, 40%, and 50%) thresholds of SUVmax. Survival analysis was performed...
Source: Annals of Nuclear Medicine - Category: Nuclear Medicine Source Type: research
Purpose: We demonstrate proof of principle that normal tissue doses can be greatly reduced in lung stereotactic body radiation therapy (SBRT) for mobile tumors, if the delivered dose is split between opposite respiratory states. Methods: Patients that underwent 5 fraction lung SBRT at our institution and had deep inspiration breath hold (DIBH) and free breathing 4D computed tomography scans were included. Volumetric modulated arc therapy plans were generated on both respiratory phases and a third composite plan was generated delivering half the dose using the DIBH plan and the other half using the expiratory phase plan for each fraction.
Source: Medical Dosimetry - Category: Radiology Authors: Source Type: research
Conclusion: The clinical symptoms of atypical/malignant SFT of the pancreas with spleen vein invasion are not atypical, and imaging feature is lack of specificity. Preoperative diagnosis is difficult, and there is a potential for malignancy. However, due to the paucity of randomized control trials, there is no established, globally accepted treatment strategy, radiation therapy and chemotherapy regimens have not demonstrated global effectiveness, and no standardized treatments have been identified. Therefore, we recommend complete surgical resection and close clinical follow-up.
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
eau S Abstract Computed tomography (CT) in the treatment position is currently indispensable for planning radiation therapy. Other imaging modalities, such as magnetic resonance imaging (MRI) and positron emission-tomography (PET), can be used to improve the definition of the tumour and/or healthy tissue but also to provide functional data of the target volume. Accurate image registration is essential for treatment planning, so MRI and PET scans should be registered at the planning CT scan. Hybrid PET/MRI scans with a hard plane can be used but pose the problem of the absence of CT scans. Finally, techniques for m...
Source: Cancer Radiotherapie - Category: Cancer & Oncology Authors: Tags: Cancer Radiother Source Type: research
The epidemiology of oropharyngeal cancer is evolving. Previously, this disease was frequently observed in patients with substantial tobacco and alcohol use[1]. More recently, human papillomavirus (HPV) related oropharyngeal cancer is increasing in incidence, particularly in young and non-smoking patients.[2,3]. The prevalence of HPV related oropharynx cancer has increased from 40% of all cases in Radiation Therapy Oncology Group (RTOG) 9003 to 68% on RTOG 0129 and 73% on RTOG 0522[4,5].p16 immunohistochemistry is a reliable surrogate for determining HPV status[6].
Source: Radiotherapy and Oncology - Category: Radiology Authors: Tags: Original Article Source Type: research
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