Curvilinear catheter implantation in HDR prostate brachytherapy: feasibility study.

Background: High-dose-rate (HDR) brachytherapy (BT) has been acknowledged as a widely utilized treatment for patients with intermediate- and high-risk prostate cancer, despite its side effects such as edema, incontinence, and impotence. Nevertheless, the treatment is consistently limited by the potential danger of excessive irradiation to organs-at-risk (OARs) like the urethra, bladder, and rectum.

Purpose: This study aims to introduce curvilinear catheter implantation in the prostate gland for HDR treatment.

Invasive Nodal Staging via Endobronchial Ultrasound and Outcome in Patients Treated with Stereotactic Body Radiation Therapy for Early-Stage Non-Small Cell Lung Cancer - Results from a Single Institution Study.

Introduction: Stereotactic body radiation therapy (SBRT) is an effective treatment for medically inoperable early-stage non-small cell lung cancer (NSCLC). The prognostic value of invasive nodal staging (INS) for patients undergoing SRBT has not been studied extensively. Herein, we report the impact of INS in addition to 18F-FDG-PET on treatment outcome for patients with NSCLC undergoing SBRT.

Pretreatment and Posttreatment Tumor Metabolic Activity Assessed by FDG-PET/CT as Predictors of Tumor Recurrence and Survival Outcomes in Early-Stage Non-Small Cell Lung Cancer Treated With Stereotactic Body Radiation Therapy.

Purpose: Stereotactic body radiation therapy (SBRT) is considered the standard of care for medically inoperable early-stage non-small cell lung cancer. There is mixed evidence on the prognostic significance of tumor metabolic activity assessed by positron emission tomography combined with computed tomography (PET/CT) using F-18 fluorodeoxyglucose (FDG). The objectives of this study were to evaluate the maximum standardized uptake value (SUV) pretreatment and at 3 and 6 months after SBRT for prediction of tumor control and survival outcomes.

A feature boosted deep learning method for automatic facial expression recognition.

Automatic facial expression recognition (FER) plays a crucial role in human-computer based applications such as psychiatric treatment, classroom assessment, surveillance systems, and many others. However, automatic FER is challenging in real-time environment. The traditional methods used handcrafted methods for FER but mostly failed to produce superior results in the wild environment.

First report on ecotoxicological QSTR and i-QSTR modeling for the prediction of acute ecotoxicity of diverse organic chemicals against three protozoan species.

The recent years have witnessed an upsurge of interest to assess the toxicity of organic chemicals exhibiting harmful impacts on the environment. In this investigation, we have developed regression-based quantitative structure-toxicity relationship (QSTR) models against three protozoan species (Entosiphon sulcantum, Uronema parduczi, and Chilomonas paramecium) using three sets of descriptor combinations such as ETA indices only, non-ETA descriptors only, and both ETA and non-ETA descriptors to examine the key structural features that determine the toxic properties of protozoa. The interspecies QSTR models (i-QSTRs) were also generated for efficient data gap-filling of toxicity databases.

Using a deep learning approach for implanted seed detection on fluoroscopy images in prostate brachytherapy.

Purpose: To apply a deep learning approach to automatically detect implanted seeds on a fluoroscopy image in prostate brachytherapy.

Material And Methods: Forty-eight fluoroscopy images of patients, who underwent permanent seed implant (PSI) were used for this study after our Institutional Review Boards approval. Pre-processing procedures that were used to prepare for the training data, included encapsulating each seed in a bounding box, re-normalizing seed dimension, cropping to a region of prostate, and converting fluoroscopy image to PNG format.

Dose uncertainty due to needle-tip localization error in prostate seed implantation.

Purpose: This study quantified the dosimetric uncertainty caused by needle-tip detection errors in ultrasound images due to bevel-tip orientation differences, with respect to the location on template grid.

Material And Methods: Trans-rectal ultrasound (TRUS) system with physical template grid and 18-gauge bevel-tip brachytherapy needles were used. TRUS was set at 6.

HDR Brachytherapy Planning using Active Needles - Preliminary Investigation on Dose Planning.

In this study we present a new approach to plan a high-dose-rate (HDR) prostate brachytherapy (BT) using active needles recently developed by our group. The active needles realize bi-directional bending inside the tissue, and thereby more compliant with the patient's anatomy compared with conventional straight needles. A computational method is presented to first generate a needle arrangement configuration based on the patient's prostate anatomy.

Pattern of Radiotherapy Treatment in Low-Risk, Intermediate-Risk, and High-Risk Prostate Cancer Patients: Analysis of National Cancer Database.

Background: In this study, the utilization rates and survival outcomes of different radiotherapy techniques are compared in prostate cancer (PCa) patients stratified by risk group. Methods: We analyzed an extensive data set of N0, M0, non-surgical PCa patients diagnosed between 2004 and 2015 from the National Cancer Database (NCDB). Patients were grouped into six categories based on RT modality: an intensity-modulated radiation therapy (IMRT) group with brachytherapy (BT) boost, IMRT with/without IMRT boost, proton therapy, stereotactic body radiation therapy (SBRT), low-dose-rate brachytherapy (BT LDR), and high-dose-rate brachytherapy (BT HDR).

Effect of applicator removal from target volume for cervical cancer patients treated with Venezia high-dose-rate brachytherapy applicator.

Purpose: The volume of Venezia applicator with vaginal caps can be relatively large compared to target volumes. This study investigated the dosimetric and radiobiological effects of applicator volume removal for cervical cancer patients treated with Venezia (VZ) and tandem and split-ring (TSR) applicators used in the clinic.

Material And Methods: A total of 40 patients (101 plans) with stage IIA-IIIC cervical cancer were retrospectively reviewed.

A Comparative Study of Patients With Early-Stage Non-Small Cell Lung Cancer Treated With Stereotactic Body Radiation Therapy Using CyberKnife and Linear Accelerator-Based Volumetric Modulated Arc Therapy.

Purpose: Stereotactic body radiation therapy (SBRT) has become the standard of care for medically inoperable early-stage non-small cell lung cancer. We investigated 2 modalities of lung SBRT, CyberKnife (CK) and volumetric modulated arc therapy (VMAT), for differences in dosimetric parameters, tumor control, and clinical outcomes.

Methods And Materials: Patients who underwent SBRT for T1-2N0M0 non-small cell lung cancer from 2012 to 2018 were included.

Treating Recurrent Brain Metastases Using GammaTile Brachytherapy: A Case Report and Dosimetric Modeling Method.

One of the treatment options for recurrent brain metastases is surgical resection combined with intracranial brachytherapy. GammaTile® (GT) (GT Medical Technologies, Tempe, Arizona) is a tile-shaped permanent brachytherapy device with cesium 131 (Cs) seeds embedded within a collagen carrier. We report a case of treating a patient with recurrent brain metastases with GT and demonstrate a dosimetric modeling method.

Focal Prostate Stereotactic Body Radiation Therapy With Correlative Pathological and Radiographic-Based Treatment Planning.

Introduction: Advances in multiparametric MRI (mpMRI) combining anatomic and functional imaging can accurately identify foci of adenocarcinoma within the prostate, offering the possibility of partial gland therapy. We performed tandem prospective pilot trials to investigate the feasibility of focal prostate SBRT (f-SBRT) based on correlating diagnostic mpMRI and biopsies with confirmatory pathology in treatment planning.

Materials And Methods: Patients with pathologic focal Gleason 6-7 disease and a corresponding PIRADS 4-5 lesion on mpMRI underwent targeted and comprehensive biopsies using MRI/ultrasound fusion under electromagnetic sensor navigation.

Role of radiation in extensive stage small cell lung cancer: a National Cancer Database registry analysis.

The role of prophylactic cranial irradiation (PCI) and thoracic radiation therapy (TRT) in extensive-stage small cell lung cancer remains controversial. The authors examined the National Cancer Database and identified patients with extensive-stage small cell lung cancer with no brain metastasis. Patients were excluded if they died 30 days from diagnosis, did not receive polychemotherapy, had other palliative radiation or had missing information.

Permanent Interstitial Cesium-131 Brachytherapy in Treating High-Risk Recurrent Head and Neck Cancer: A Prospective Pilot Study.

Purpose/objectives: To establish the feasibility and safety of intraoperative placement of cesium-131 (Cs-131) seeds for re-irradiation in recurrent head and neck cancer (HNC).

Methods: Patients with resectable recurrent HNC who were deemed to have a high risk of second recurrence were eligible. Immediately after tumor extirpation, seeds were implanted in the surgical bed based on the preoperative treatment plan with intraoperative adjustment.

A Pilot Study Examining the Prognostic Utility of Tumor Shrinkage on Cone-Beam Computed Tomography (CBCT) for Stage III Locally Advanced Non-Small Cell Lung Cancer Patients Treated with Definitive Chemoradiation.

There has been growing interest in utilizing information from cone-beam computed tomography (CBCT) to help guide both treatment delivery and prognosis. In this assessment of locally advanced unresectable stage III non-small cell lung cancer (NSCLC) treated with definitive chemoradiation, we aimed to determine the survival advantage associated with using CBCT to measure tumor regression. Patient, tumor, and treatment characteristics were collected.

Synthetic CT Generation of the Pelvis in Patients With Cervical Cancer: A Single Input Approach Using Generative Adversarial Network.

Multi-modality imaging constitutes a foundation of precision medicine, especially in oncology where reliable and rapid imaging techniques are needed in order to insure adequate diagnosis and treatment. In cervical cancer, precision oncology requires the acquisition of F-labeled 2-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET), magnetic resonance (MR), and computed tomography (CT) images. Thereafter, images are co-registered to derive electron density attributes required for FDG-PET attenuation correction and radiation therapy planning.

Feasibility of improving patient's safety with in vivo dose tracking in intracavitary and interstitial HDR brachytherapy.

Purpose: The in vivo dosimetric monitoring in HDR brachytherapy is important for improving patient safety. However, there are very limited options available for clinical application. In this study, we present a new in vivo dose measurement system with a plastic scintillating detector (PSD) for GYN HDR brachytherapy.

Appropriate Methodology for EBRT and HDR Intracavitary/Interstitial Brachytherapy Dose Composite and Clinical Plan Evaluation for Patients With Cervical Cancer.

Purpose: This study assessed the appropriateness of full parameter addition (FPA) methods with respect to the 3-dimensional deformable dose composite method for evaluating combined external beam radiation therapy (EBRT) and intracavitary brachytherapy (ICBT).

Methods And Materials: A total of 22 patients who received EBRT and high-dose-rate ICBT were retrospectively evaluated. Split-ring and tandem applicators were used for all patients.

Tumor localization accuracy for high-precision radiotherapy during active breath-hold.

Background: Conventionally fractionated and stereotactic body radiation therapy (SBRT) for thoracoabdominal tumors may utilize breath-hold techniques. However, there are concerns that differential amounts of inspired airflow may result in unplanned tumor dislocation and underdosing. Thus, we investigated tumor localization accuracy associated with lung volume variations during breath-hold treatment via an automated-gating interface.

Evaluating radiotherapy treatment delay using Failure Mode and Effects Analysis (FMEA).

Purpose: This study identified and evaluated the factors that are responsible for delay in the clinical workflow of radiation therapy, starting from the CT simulation (CT-Sim) to the first fraction of treatment delivery using the Failure Mode and Effects Analysis (FMEA) methodology.

Materials And Methods: A total of 1106 patient cases were retrospectively analyzed using FMEA methodology. For each failure mode (FM), the following factors were rated and discussed by the group: occurrence (O), severity (S), detectability (D), and methods of improvement or mitigation.

Comparison of multiparametric MRI-based and transrectal ultrasound-based preplans with intraoperative ultrasound-based planning for low dose rate interstitial prostate seed implantation.

Purpose: Transrectal ultrasound images are routinely acquired for low dose rate (LDR) prostate brachytherapy dosimetric preplanning (pTRUS), although diagnostic multiparametric magnetic resonance imaging (mpMRI) may serve this purpose as well. We compared the predictive abilities of TRUS vs MRI relative to intraoperative TRUS (iTRUS) to assess the role of mpMRI in brachytherapy preplanning.

Materials And Methods: Retrospective analysis was performed on 32 patients who underwent iTRUS-guided prostate LDR brachytherapy as either mono- or combination therapy.

Assessment of beam-matched linacs quality/accuracy for interchanging SBRT or SRT patient using VMAT without replanning.

Purpose: Dosimetric accuracy is critical when switching a patient treated with stereotactic body radiation therapy (SBRT) or stereotactic fractionated radiotherapy (SRT) among beam-matched linacs. In this study, the dose delivery accuracy of volumetric modulated arc therapy (VMAT) plans for SBRT/SRT patients were evaluated on three beam-matched linacs.

Method: Beam data measurements such as percentage depth dose (PDD ), beam profiles, output factors, and multi-leaf collimator (MLC) leaf transmission factor for 6 MV photon beam were performed on three beam-matched linacs.