Proton stereotactic body radiation therapy for liver metastases-results of 5-year experience for 81 hepatic lesions.

Background: To report on our institutional experience using Proton stereotactic body radiation therapy (SBRT) for patients with liver metastases.

Methods: All patients with liver metastases treated with Proton SBRT between September 2012 and December 2017 were retrospectively analyzed. Local control (LC) and overall survival (OS) were estimated using the Kaplan-Meier method calculated from the time of completion of Proton SBRT.

A phase I trial of Proton stereotactic body radiation therapy for liver metastases.

Background: A phase I trial to determine the maximum tolerated dose (MTD) of Proton stereotactic body radiation therapy (SBRT) for liver metastases in anticipation of a subsequent phase II study.

Methods: An institutional IRB approved phase I clinical trial was conducted. Eligible patients had 1-3 liver metastases measuring less than 5 cm, and no metastases location within 2 cm of the GI tract.

Passive proton therapy vs. IMRT planning study with focal boost for prostate cancer.

Background: Exploiting biologic imaging, studies have been performed to boost dose to gross intraprostatic tumor volumes (GTV) while reducing dose elsewhere in the prostate. Interest in proton beams has increased due to superior normal-tissue sparing they afford. Our goal was to dosimetrically compare 3D conformal proton boost plans with intensity-modulated radiation therapy (IMRT) plans with respect to target coverage and avoiding organs at risk.

Commissioning of a proton gantry equipped with dual x-ray imagers and a robotic patient positioner, and evaluation of the accuracy of single-beam image registration for this system.

Purpose: To check the accuracy of a gantry equipped with dual x-ray imagers and a robotic patient positioner for proton radiotherapy, and to evaluate the accuracy and feasibility of single-beam registration using the robotic positioner.

Methods: One of the proton treatment rooms at their institution was upgraded to include a robotic patient positioner (couch) with 6 degrees of freedom and dual orthogonal kilovoltage x-ray imaging panels. The wander of the proton beam central axis, the wander of the beamline, and the orthogonal image panel crosswires from the gantry isocenter were measured for different gantry angles.

Radiographic film dosimetry of proton beams for depth-dose constancy check and beam profile measurement.

Radiographic film dosimetry suffers from its energy dependence in proton dosimetry. This study sought to develop a method of measuring proton beams by the film and to evaluate film response to proton beams for the constancy check of depth dose (DD). It also evaluated the film for profile measurements.

Evaluation of normal tissue exposure in patients receiving radiotherapy for pancreatic cancer based on RTOG 0848.

Background: Pancreatic cancer is a highly aggressive malignancy. Chemoradiotherapy (CRT) is utilized in many cases to improve locoregional control; however, toxicities associated with radiation can be significant given the location of the pancreas. RTOG 0848 seeks to evaluate chemoradiation using either intensity-modulated radiation therapy (IMRT) or 3D conformal photon radiotherapy (3DCRT) modalities as an adjuvant treatment.

Analysis of Intensity-Modulated Radiation Therapy (IMRT), Proton and 3D Conformal Radiotherapy (3D-CRT) for Reducing Perioperative Cardiopulmonary Complications in Esophageal Cancer Patients.

Background. While neoadjuvant concurrent chemoradiotherapy has improved outcomes for esophageal cancer patients, surgical complication rates remain high. The most frequent perioperative complications after trimodality therapy were cardiopulmonary in nature.

Partial breast radiation therapy with proton beam: 5-year results with cosmetic outcomes.

Purpose: We updated our previous report of a phase 2 trial using proton beam radiation therapy to deliver partial breast irradiation (PBI) in patients with early stage breast cancer.

Methods And Materials: Eligible subjects had invasive nonlobular carcinoma with a maximal dimension of 3 cm. Patients underwent partial mastectomy with negative margins; axillary lymph nodes were negative on sampling.

Evaluation of the dosimetric properties of a synthetic single crystal diamond detector in high energy clinical proton beams.

Purpose: To investigate the dosimetric properties of a synthetic single crystal diamond Schottky diode for accurate relative dose measurements in large and small field high-energy clinical proton beams.

Methods: The dosimetric properties of a synthetic single crystal diamond detector were assessed by comparison with a reference Markus parallel plate ionization chamber, an Exradin A16 microionization chamber, and Exradin T1a ion chamber. The diamond detector was operated at zero bias voltage at all times.

Conditions for reliable time-resolved dosimetry of electronic portal imaging devices for fixed-gantry IMRT and VMAT.

Purpose: The continuous scanning mode of electronic portal imaging devices (EPID) that offers time-resolved information has been newly explored for verifying dynamic radiation deliveries. This study seeks to determine operating conditions (dose rate stability and time resolution) under which that mode can be used accurately for the time-resolved dosimetry of intensity-modulated radiation therapy (IMRT) beams.

Methods: The authors have designed the following test beams with variable beam holdoffs and dose rate regulations: a 10 × 10 cm open beam to serve as a reference beam; a sliding window (SW) beam utilizing the motion of a pair of multileaf collimator (MLC) leaves outside the 10 × 10 cm jaw; a step and shoot (SS) beam to move the pair in step; a volumetric modulated arc therapy (VMAT) beam.

Evaluation and comparison of New 4DCT based strategies for proton treatment planning for lung tumors.

Purpose: To evaluate different strategies for proton lung treatment planning based on four-dimensional CT (4DCT) scans.

Methods And Materials: Twelve cases, involving only gross tumor volumes (GTV), were evaluated. Single image sets of (1) maximum intensity projection (MIP3) of end inhale (EI), middle exhale (ME) and end exhale (EE) images; (2) average intensity projection (AVG) of all phase images; and (3) EE images from 4DCT scans were selected as primary images for proton treatment planning.

Fractionated proton radiotherapy for benign cavernous sinus meningiomas.

Purpose: To evaluate the efficacy of fractionated proton radiotherapy for a population of patients with benign cavernous sinus meningiomas.

Methods And Materials: Between 1991 and 2002, 72 patients were treated at Loma Linda University Medical Center with proton therapy for cavernous sinus meningiomas. Fifty-one patients had biopsy or subtotal resection; 47 had World Health Organization grade 1 pathology.

SU-E-T-167: Comprehensive Evaluation of EPID Image Acquisition for Integrating and Temporal Dosimetry of Fixed-Gantry IMRT and ArcIMRT.

Purpose: To evaluate EPID for dosimetry applications of arc and static-gantry IMRT with sliding window (SW) and/or step-and-shoot (SS) deliveries Methods: IMRT beams (SW & SS) were designed that generate beam hold-offs and dose rate modulation due to MLC motion under 10 × 10 cm jaw. An arcIMRT beam was designed by adding gantry movement to the SW field. A 10 cm × 10 cm open beam was also used.

SU-E-T-238: Annual QA of Proton Gantry with Robotic Table.

Purpose: To perform the annual QA of proton gantry with a robotic table.

Methods: A new proton gantry with robotic table has been commissioned and is being used in clinic for patient treatment. The gantry is equipped with a robotic table with 6-degrees of freedom and dual cardinal angle KV imagers for patient registration.

SU-E-T-100: How to Improve the Dose Accuracy for Gantry Angle Dependent Patient Specific IMRT QA Using 2D Ion Chamber Array with Octavius Phantom.

Purpose: To determine the cross calibration factors which can predict more accurate dose distribution for fixed beam IMRT QA using Octavius phantom.

Methods: The ion chamber based Octavius 2D-array detector (PTW, Freiburg, Germany) is a step in the right direction to measure the absolute dose and dose distribution for patient specific IMRT QA. However, the directional dependency of this detector made it less than desirable for angle dependent IMRT QA.

Water-equivalent path length calibration of a prototype proton CT scanner.

Purpose: The authors present a calibration method for a prototype proton computed tomography (pCT) scanner. The accuracy of these measurements depends upon careful calibration of the energy detector used to measure the residual energy of the protons that passed through the object.

Methods: A prototype pCT scanner with a cesium iodide (CsI(Tl)) crystal calorimeter was calibrated by measuring the calorimeter response for protons of 200 and 100 MeV initial energies undergoing degradation in polystyrene plates of known thickness and relative stopping power (RSP) with respect to water.

A practical approach for electron monitor unit calculation.

Electron monitor unit (MU) calculation requires measured beam data such as the relative output factor (ROF) of a cone, insert correction factor (ICF) and effective source-to-surface distance (ESD). Measuring the beam data to cover all possible clinical cases is not practical for a busy clinic because it takes tremendous time and labor. In this study, we propose a practical approach to reduce the number of data measurements without affecting accuracy.

Dosimetry aspects of proton therapy.

High-energy photons and high-energy protons are very different in the ways they interact with matter. These differences lead to distinct advantages of protons over photons for treatment of cancer. Some aspects of proton interactions with tissue that make this modality superior for treating cancer are: (i) Initially, the protons lose energy very slowly as they enter the body; this results in a low entrance dose and low doses to the normal tissues proximal to the tumor.

Lipid-gramicidin interactions using two-dimensional Fourier-transform electron spin resonance.

The application of two-dimensional Fourier-transform electron-spin-resonance (2D-FT-ESR) to the study of lipid/gramicidin A (GA) interactions is reported. It is shown that 2D-FT-ESR spectra provide substantially enhanced spectral resolution to changes in the dynamics and ordering of the bulk lipids (as compared with cw-ESR spectra), that result from addition of GA to membrane vesicles of dipalmitoylphosphatidylcholine (DPPC) in excess water containing 16-PC as the lipid spin label. The agreement between the theory of Lee, Budil, and Freed and experimental results is very good in the liquid crystalline phase.

Longitudinal relaxation and diffusion measurements using magnetic resonance signals from laser-hyperpolarized 129Xe nuclei.

Methods for T1 relaxation and diffusion measurements based on magnetic resonance signals from laser-hyperpolarized 129Xe nuclei are introduced. The methods involve optimum use of the perishable hyperpolarized magnetization of 129Xe. The necessary theoretical framework for the methods is developed, and then the methods are applied to measure the longitudinal relaxation constant, T1, and the self-diffusion constant, D, of hyperpolarized 129Xe.

Magnetization and diffusion effects in NMR imaging of hyperpolarized substances.

The special magnetization characteristics of hyperpolarized noble gases have led to an interest in using these agents for new MRI applications. In this note, the magnetization effects and NMR signal dependence of two noble gases, 3He and l29Xe, are modeled across a range of gradient-echo imaging parameters. Pulse-sequence analysis shows a wide variation in optimum flip angles between imaging of gas (e.

Studies on lipid membranes by two-dimensional Fourier transform ESR: Enhancement of resolution to ordering and dynamics.

The first two-dimensional Fourier-transform electron spin resonance (2D-FT-ESR) studies of nitroxide-labeled lipids in membrane vesicles are reported. The considerable enhancement this experiment provides for extracting rotational and translational diffusion rates, as well as orientational ordering parameters by means of ESR spectroscopy, is demonstrated. The 2D spectral analysis is achieved using theoretical simulations that are fit to experiments by an efficient and automated nonlinear least squares approach.