A deep image-to-image network organ segmentation algorithm for radiation treatment planning: principles and evaluation.

Background: We describe and evaluate a deep network algorithm which automatically contours organs at risk in the thorax and pelvis on computed tomography (CT) images for radiation treatment planning.

Methods: The algorithm identifies the region of interest (ROI) automatically by detecting anatomical landmarks around the specific organs using a deep reinforcement learning technique. The segmentation is restricted to this ROI and performed by a deep image-to-image network (DI2IN) based on a convolutional encoder-decoder architecture combined with multi-level feature concatenation.

Club Fit: Development of a Physical Activity and Healthy Eating Intervention at a Boys & Girls Club After School Program.

Children and adolescents from minority and low income backgrounds face social and environmental challenges to engaging in physical activity and healthy eating to maintain a healthy weight. In this study, we present pilot work to develop and implement a multi-component physical activity and healthy eating intervention at a Boys & Girls Club (BGC) afterschool program. Using a community-based participatory approach, BGC staff and academic researchers developed intervention components informed by formative studies and based on a Social Ecological Theory framework.

Planting a Problem: Examining the Spread of Seed-Borne Potato Virus Y.

Potato virus Y (PVY) is among the most economically impactful potato pathogens, yet the spread of PVY from infected seed potatoes within commercial potato fields has not been adequately studied. Test lots containing various seed-borne PVY levels were created by mixing different proportions of seed pieces from healthy and infected tubers drawn from the same seed source. These seed lots were planted in commercial potato fields near the Teton Seed Potato Management Area from 2010 to 2012.

Heart dosimetric analysis of three types of cardiac toxicity in patients treated on dose-escalation trials for Stage III non-small-cell lung cancer.

Background And Purpose: To assess associations between radiation dose/volume parameters for cardiac subvolumes and different types of cardiac events in patients treated on radiation dose-escalation trials.

Material And Methods: Patients with Stage III non-small-cell lung cancer received dose-escalated radiation (median 74 Gy) using 3D-conformal radiotherapy on six prospective trials from 1996 to 2009. Volumes analyzed included whole heart, left ventricle (LV), right atrium (RA), and left atrium (LA).

Local Radiotherapy Intensification for Locally Advanced Non-small-cell Lung Cancer - A Call to Arms.

Chemoradiotherapy, the standard of care for locally advanced non-small-cell lung cancer (NSCLC), often fails to eradicate all known disease. Despite advances in chemotherapeutic regimens, locally advanced NSCLC remains a difficult disease to treat, and locoregional failure remains common. Improved radiographic detection can identify patients at significant risk of locoregional failure after definitive treatment, and newer methods of escalating locoregional treatment may allow for improvements in locoregional control with acceptable toxicity.

Cardiac Toxicity After Radiotherapy for Stage III Non-Small-Cell Lung Cancer: Pooled Analysis of Dose-Escalation Trials Delivering 70 to 90 Gy.

Purpose The significance of radiotherapy (RT) -associated cardiac injury for stage III non-small-cell lung cancer (NSCLC) is unclear, but higher heart doses were associated with worse overall survival in the Radiation Therapy Oncology Group (RTOG) 0617 study. We assessed the impact of heart dose in patients treated at our institution on several prospective dose-escalation trials. Patients and Methods From 1996 to 2009, 127 patients with stage III NSCLC (Eastern Cooperative Oncology Group performance status, 0 to 1) received dose-escalated RT to 70 to 90 Gy (median, 74 Gy) in six trials.

Global Health Simulation During Residency.

Resident participation in international health electives (IHEs) has been shown to be beneficial, yet not all residents have the opportunity to participate. We sought to determine whether participating in simulated global health cases, via the standardized Simulation Use for Global Away Rotations (SUGAR) curriculum, was useful for all pediatric residents, not merely those planning to go on an IHE. Pediatric residents in our program took part in 2 SUGAR cases and provided feedback via an online survey.

Race, insurance type, and stage of presentation among lung cancer patients.

The purpose of this study was to determine whether African-American lung cancer patients are diagnosed at a later stage than white patients, regardless of insurance type. The relationship between race and stage at diagnosis by insurance type was assessed using a Poisson regression model, with relative risk as the measure of association. The setting of the study was a large tertiary care cancer center located in the southeastern United States.

Geometric-feature-based spectral graph matching in pharyngeal surface registration.

Fusion between an endoscopic movie and a CT can aid specifying the tumor target volume for radiotherapy. That requires a deformable pharyngeal surface registration between a 3D endoscope reconstruction and a CT segmentation. In this paper, we propose to use local geometric features for deriving a set of initial correspondences between two surfaces, with which an association graph can be constructed for registration by spectral graph matching.

Patterns of local failure for sinonasal malignancies.

Purpose: To identify the patterns of local failure for sinonasal malignancies treated with radiation therapy (RT).

Methods And Materials: We retrospectively identified 79 patients with sinonasal malignancies treated between 2000 and 2011. The median follow-up was 34 months (7-137).

Important prognostic factors for lung cancer in tobacco predominant Eastern North Carolina: study based on a single cancer registry.

Background: It is known that lung cancer incidence and mortality rate are higher in African Americans (AA) than whites. In Eastern North Carolina, there is a higher percentage of AA population than the national average (30.2% vs.

Dosimetric evaluation of an ipsilateral intensity modulated radiotherapy beam arrangement for parotid malignancies.

Background: We conducted a dosimetric comparison of an ipsilateral beam arrangement for intensity modulated radiotherapy (IMRT) with off-axis beams.

Patients And Methods: Six patients who received post-operative radiotherapy (RT) for parotid malignancies were used in this dosimetric study. Four treatment plans were created for each CT data set (24 plans): 1) ipsilateral 4-field off-axis IMRT (4fld-OA), 2) conventional wedge pair (WP), 3) 7 field co-planar IMRT (7fld), and 4) ipsilateral co-planar 4-field quartet IMRT (4fld-CP).

Phase I study of concurrent weekly docetaxel, high-dose intensity-modulated radiation therapy (IMRT) and androgen-deprivation therapy (ADT) for high-risk prostate cancer.

Unlabelled: Study Type - Therapy (phase 1) Level of Evidence 2a What's known on the subject? and What does the study add? High-risk and locally advanced prostate cancers are difficult to cure with the standard regimen of radiation therapy (RT) with concurrent androgen-deprivation therapy (ADT). Multiple studies have explored the addition of docetaxel chemotherapy in attempt to improve patient outcomes. Prior Phase I studies have shown that docetaxel 20 mg/m(2) is a safe dose, when given concurrently with 70 Gy of radiation.

Management of nonesthesioneuroblastoma sinonasal malignancies with neuroendocrine differentiation.

Objectives/hypothesis: Report the outcomes of patients with nonesthesioneuroblastoma (non-ENB) sinonasal malignancies with neuroendocrine differentiation.

Study Design: Single Institution Retrospective Case Series.

Methods: We conducted a retrospective chart review of 19 biopsy-proven non-ENB sinonasal neuroendocrine carcinomas diagnosed between 1997 and 2010 and treated with multimodality therapy.

The impact of local and regional disease extent on overall survival in patients with advanced stage IIIB/IV non-small cell lung carcinoma.

Purpose: Patients with advanced stage IIIB or stage IV non-small cell lung carcinoma are typically treated with initial platinum-based chemotherapy. A variety of factors (eg, performance status, gender, age, histology, weight loss, and smoking history) are generally accepted as predictors of overall survival. Because uncontrolled pulmonary disease constitutes a major cause of death in these patients, we hypothesized that clinical and radiographic factors related to intrathoracic disease at diagnosis may be prognostically significant in addition to conventional factors.

Incidence of subclinical nodal disease at the time of salvage surgery for locally recurrent head and neck cancer initially treated with definitive radiation therapy.

Objectives/hypothesis: To estimate the incidence of subclinical nodal disease at the time of isolated local recurrence (LR) after chemoradiotherapy for an initially staged N0 head and neck squamous cell carcinoma.

Methods: We retrospectively reviewed 44 patients who underwent salvage surgery with or without elective neck dissection (END) for an isolated LR between 1997 and 2010. The incidence of subclinical nodal disease was determined from the pathology reports and from clinical neck failures.

SU-E-T-623: Utilizing a Hybrid Optimizer to Improve Dose Conformity during IMRT Planning.

Purpose: For IMRT treatment planning, an index-dose based algorithm features a fast approach in optimizing beam shapes and weights, and the quasi-Newton method is adopted in segment weight optimization by many commercial products. By combining these two optimizers, we aim to improve IMRT plan quality by achieving better normal tissue sparing.

Methods: An IMRT plan was generated using an in-house treatment planning system in three steps: 1) optimize fluence using beamlet intensity modulation, 2) generate Multi-collimator leaf sequence and segment weights, 3) tune the segment shapes and weights as each segment treated as a single beam.

SU-E-T-422: Lung SBRT Using Cyberknife: Technique and Treatment Outcome.

Purpose: At East Carolina University, we have been treating primary and secondary lung cancers with Cyberknife stereotactic body radiotherapy (CK- SBRT) since February 2009. Till October 2011, we have treated a total of 79 patients (83 sites). In this study, we present our experience in CK-SBRT and clinical outcome of the treated patients.

SU-E-T-412: Can Cyberknife SBRT Be an Alternative to Brachytherapy for Cervical Cancer Treatment?

Purpose: To investigate the effectiveness of stereotactic body radiation therapy (SBRT) with Cyberknife for treatment of squamous cell carcinoma (SCCa) of cervix that are commonly treated with brachytherapy.

Methods: SCCa of cervix is routinely treated with external beam radiation therapy (EBRT) followed by brachytherapy. Common practice is to use high-dose- rate (HDR) brachytherapy, mainly with Ir-192; however, low-dose-rate (LDR) brachytherapy with Cs-137 is also used.

Is image registration of fluorodeoxyglucose-positron emission tomography/computed tomography for head-and-neck cancer treatment planning necessary?

Purpose: To evaluate dosimetry and patterns of failure related to fluorodeoxyglucose-positron emission tomography (FDG-PET)-defined biological tumor volumes (BTVs) for head-and-neck squamous cell carcinoma (HNSCC) treated with definitive radiotherapy (RT).

Methods And Materials: We conducted a retrospective study of 91 HNSCC patients who received pretreatment PET/CT scans that were not formally used for target delineation. The median follow-up was 34.

Concomitant radiotherapy and chemotherapy for high-risk nonmelanoma skin carcinomas of the head and neck.

Background. To report on the use and feasibility of a multimodality approach using concomitant radiotherapy and chemotherapy in patients with high-risk nonmelanoma skin carcinoma (NMSC) of the head and neck. Methods.

Is primary prostate cancer treatment influenced by likelihood of extraprostatic disease? A surveillance, epidemiology and end results patterns of care study.

Purpose: To examine the patterns of primary treatment in a recent population-based cohort of prostate cancer patients, stratified by the likelihood of extraprostatic cancer as predicted by disease characteristics available at diagnosis.

Methods And Materials: A total of 157,371 patients diagnosed from 2004 to 2008 with clinically localized and potentially curable (node-negative, nonmetastatic) prostate cancer, who have complete information on prostate-specific antigen, Gleason score, and clinical stage, were included. Patients with clinical T1/T2 disease were grouped into categories of <25%, 25%-50%, and >50% likelihood of having extraprostatic disease using the Partin nomogram.