Publications by authors named "Fukunaga J"

This study examined the characteristics of the broad model (KBP) through a complete open-loop evaluation of volumetric modulated arc therapy (VMAT) plans for prostate cancer in 30 patients at two institutions. KBP, trained using 561 prostate cancer VMAT plans from five institutions with different treatment protocols, was shared with two institutions. The institutions were not involved in the creation of KBP.

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  • The study focuses on measuring beam alignment in medical linear accelerators, emphasizing the importance of analyzing focal spot positions to ensure accurate radiation delivery.
  • The newly developed Quality Control Tool (QCT) device facilitates simultaneous tests of light/radiation field coincidence and isocenter testing, enabling effective analysis of focal spots with specific software.
  • Results show that focal spot position varies with gantry angle, showcasing the QCT's capacity to accurately measure displacements and assess beam alignment without interference from the jaw collimator.
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  • * Five healthcare institutions tested this model on prostate cancer treatments, comparing how well each model could estimate dosimetric parameters and plan quality.
  • * Results showed the Multi-coll. model was more accurate in its estimates and provided better plan quality, particularly in reducing radiation exposure to the rectum and bladder.
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In this study, we aimed to conduct a survey on the current clinical practice of, staffing for, commissioning of, and staff training for online adaptive radiotherapy (oART) in the institutions that installed commercial oART systems in Japan, and to share the information with institutions that will implement oART systems in future. A web-based questionnaire, containing 107 questions, was distributed to nine institutions in Japan. Data were collected from November to December 2023.

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The aim of this study was to investigate planning target volume (PTV) margin in online adaptive radiation therapy (oART) for gastric mucosa-associated lymphoid tissue (MALT) lymphomas. Four consecutive patients with gastric MALT lymphoma who received oART (30 Gy in 15 fractions) on the oART system were included in this study. One hundred and twenty cone-beam computed tomography (CBCT) scans acquired pre- and post-treatment of 60 fractions for all patients were used to evaluate intra- and interfractional motions.

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  • - The study developed a deep learning model to predict the volume of lung tissue receiving at least 20 Gy during radiation therapy, using 91 chest X-ray images from lung cancer patients treated between 2018-2022.
  • - A convolutional neural network was employed to create the model, which was evaluated using statistical measures like RMSE and MAE, resulting in a median prediction error of -1.8% and a Pearson correlation coefficient of 0.40 between actual and predicted values.
  • - The model showed strong performance as a binary classifier for V <20% with a sensitivity of 75.0% and an accuracy of 80.6%, indicating its potential for assisting in patient treatment strategies.
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Objectives: The objective of the study is to analyze the difference in target dose distributions between Acuros XB (AXB) and collapsed cone convolution (CCC)/superposition and the impact of the tumor locations in clinical cases of stereotactic ablative body radiotherapy (SABR) for lung cancer.

Materials And Methods: Ninety-six patients underwent SABR for lung cancers Kyushu University Hospital from 2014 to 2017. We recalculated clinical plans originally calculated by AXB using CCC with the identical monitor units (MUs) and beam arrangements.

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This study evaluated the validity of internal target volumes (ITVs) defined by three- (3DCT) and four-dimensional computed tomography (4DCT), and subsequently compared them with actual movements during treatment. Five patients with upper lobe lung tumors were treated with stereotactic body radiotherapy (SBRT) at 48 Gy in four fractions. Planning 3DCT images were acquired with peak-exhale and peak-inhale breath-holds, and 4DCT images were acquired in the cine mode under free breathing.

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Purpose: To evaluate whether knowledge-based volumetric modulated arc therapy plans for prostate cancer with a multi-institution model (broad model) are clinically useful and effective as a standardization method.

Methods: A knowledge-based planning (KBP) model was trained with 561 prostate VMAT plans from five institutions with different contouring and planning policies. Five clinical plans at each institution were reoptimized with the broad and single institution model, and the dosimetric parameters and relationship between D and the overlapping volume (rectum or bladder and target) were compared.

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Purpose: To investigate fundamental dosimetric properties of surface dose, exit dose, and beam profile of the brass mesh bolus for 4, 6, and 10 MV high-energy photon beams in radiation therapy.

Methods: Surface dose and exit dose in the water-equivalent phantom were measured, and percent depth doses (PDDs) were calculated with no bolus, one layer of brass mesh, two layers of brass mesh bolus, three layers of brass mesh bolus, and 0.5 cm tissue-equivalent (TE) bolus.

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Background/aim: This study evaluated the impact of knowledge-based plan (KBP) model improvement on plan complexity and delivery accuracy in volumetric modulated arc therapy (VMAT) for prostate cancer at multiple institutions.

Materials And Methods: Five institutions created the first KBP model before April 2017 and subsequently devised a new model (second model) based on feedback from the first KBP and the efforts of planners after April 2019. The dose-volume histogram (DVH) parameters were validated for two prostate cancer cases between the first and second KBPs.

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We established a multi-institution model (big model) of knowledge-based treatment planning with over 500 treatment plans from five institutions in volumetric modulated arc therapy (VMAT) for prostate cancer. This study aimed to clarify the efficacy of using a large number of registered treatment plans for sharing the big model. The big model was created with 561 clinically approved VMAT plans for prostate cancer from five institutions (A: 150, B: 153, C: 49, D: 60, and E: 149) with different planning strategies.

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Background/aim: The aim of this study was to evaluate the mechanical performance and the effect on dose distribution and deliverability of volumetric modulated arc therapy (VMAT) plans for prostate cancer created with the commercial knowledge-based planning (KBP) system (RapidPlan™).

Materials And Methods: Three institutions, A, B, and C were enrolled in this study. Each institution established and trained a KBP model with their own cases.

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Background: The aim of this study was to investigate the performance of the RapidPlan (RP ) using models registered pseudostructures, and to determine how many structures are required for automatic optimization of volumetric modulated arc therapy (VMAT) for postoperative uterine cervical cancer.

Materials And Methods: Pseudo-structures around the PTV were retrospectively contoured for patients who had completed treatment at five institutions. For 22 common patients, plans were generated with a single optimization for models with two (RP_2), four (RP_4), and five (RP_5) registered structures, and the dosimetric parameters of these models were compared with a clinical plan with several optimizations.

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In the present study, by using double self-activated CsI detectors, the development of a neutron dosemeter system whose response indicates better agreement with the International Commission on Radiological Protection-74 rem-response was carried out to simply evaluate the neutron dose with high accuracy. The present double neutron dosemeter system, using a slow-neutron dosemeter (thermal to 10 keV) and a fast-neutron dosemeter (above 10 keV), consists of CsI scintillators wrapped with two types of neutron energy filtering materials: polyethylene and B4C silicon rubber. After optimization of each filter thickness, to confirm the validity of our method, the neutron ambient dose equivalents under several operating conditions of medical linear accelerators (Linacs) were evaluated using a Monte Carlo simulation and an experiment with the present dosemeter.

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Background: The aim of this study was to clarify factors predicting the performance of knowledge-based planning (KBP) models in volume modulated arc therapy for prostate cancer in terms of sparing the organ at risk (OAR).

Materials And Methods: In three institutions, each KBP model was trained by more than 20 library plans (LP) per model. To validate the characterization of each KBP model, 45 validation plans (VP) were calculated by the KBP system.

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Purpose: To evaluate the postural balance of type 2 diabetics with vertigo, dizziness, and/or unsteadiness.

Methods: limit of stability, pressure center displacement area, and sway velocity of 20 patients with type 2 diabetes were compared with 22 controls using the Balance Rehabilitation Unit (BRUTM, Medicaa) posturography.

Results: Compared to the control group, patients with type 2 diabetes showed a significantly lower limit of stability and a significantly higher-pressure center displacement area on a firm surface with eyes open, eyes closed, and horizontal vestibular-visual interaction; and higher sway velocity on a firm surface with eyes open and with eyes closed.

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This study developed a radiomics-based predictive model for radiation-induced pneumonitis (RP) after lung cancer stereotactic body radiation therapy (SBRT) on pretreatment planning computed tomography (CT) images. For the RP prediction models, 275 non-small-cell lung cancer patients consisted of 245 training (22 with grade ≥ 2 RP) and 30 test cases (8 with grade ≥ 2 RP) were selected. A total of 486 radiomic features were calculated to quantify the RP texture patterns reflecting radiation-induced tissue reaction within lung volumes irradiated with more than x Gy, which were defined as LVx.

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Dosimetric evaluation and variation assessment were performed with two knowledge-based planning (KBP) models created at different periods for volumetric-modulated arc therapy (VMAT) for prostate cancer at five institutes. The first and second models (F- and S-models) for KBP were created before April 2017 and April 2019, respectively. The S-model was created using feedback plans from the F-model.

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MTG8 (RUNX1T1) is a fusion partner of AML1 (RUNX1) in the leukemic chromosome translocation t(8;21). The AML1-MTG8 fusion gene encodes a chimeric transcription factor. One of the highly conserved domains of MTG8 is TAFH which possesses homology with human TAF4 [TATA-box binding protein-associated factor].

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Purpose: There remain uncertainties due to inter- and intraobserver variability in soft-tissue-based patient positioning even with the use of image-guided radiation therapy (IGRT). This study aimed to reveal observer uncertainties of soft-tissue-based patient positioning on cone-beam computed tomography (CBCT) images for prostate cancer IGRT.

Methods: Twenty-six patients (7-8 fractions/patient, total number of 204 fractions) who underwent IGRT for prostate cancer were selected.

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Purpose: The aim of this study was to investigate whether additional manual objectives are necessary for the RapidPlan (RP) with a single optimization. We conducted multi-institutional comparisons of plan quality for head and neck cancer (HNC) using the models created at each institute.

Methods: The ability of RP to produce acceptable plans for dose requirements was evaluated in two types of oropharynx cancers at five institutes in Japan.

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Background: Insulin-derived amyloidosis is a skin-related complication of insulin therapy that interferes with insulin therapy. Although toxicities of in vitro-formed insulin amyloid fibrils have been well studied, the toxicity of insulin-derived amyloidosis remains to be clarified.

Case Presentation: A 58-year-old man with type 2 diabetes mellitus underwent a lower limb amputation due to diabetic gangrene.

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This study aimed to evaluate the performance of a single-energy metal artifact reduction (SEMAR) algorithm for radiation therapy treatment using phantom cases with metal inserts, assess improvements in computed tomography (CT) number accuracy, and investigate its effects on treatment planning dosimetry. A standard electron density phantom was scanned with and without metal inserts. The numbers of tissue-equivalent materials on both uncorrected and SEMAR-corrected CT images were compared.

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Purpose: To examine the anatomical position of point B and the relationship between the dose at point B and the dose delivered to the pelvic lymph nodes in computed tomography (CT)-based brachytherapy for cervical cancer.

Material And Methods: Forty-nine cervical cancer patients were treated at Kyushu University Hospital. For all cases, planning CT images obtained after the applicator insertion were imported to an Oncentra Brachy (Elekta AB, Stockholm, Sweden), and points A (dose prescription, 6 Gy) and points B were set according to the Manchester method.

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