SPECT/CT image-based dosimetry for Yttrium-90 radionuclide therapy: Application to treatment response.

This work demonstrates the efficacy of voxel-based Y microsphere dosimetry utilizing post-therapy SPECT/CT imaging and applies it to the prediction of treatment response for the management of patients with hepatocellular carcinoma (HCC). A Y microsphere dosimetry navigator (RapidSphere) within a commercial platform (Velocity, Varian Medical Systems) was demonstrated for three microsphere cases that were imaged using optimized bremsstrahlung SPECT/CT. For each case, the Y SPECT/CT was registered to follow-up diagnostic MR/CT using deformable image registration.

Treatment efficiency of volumetric modulated arc therapy in comparison with intensity-modulated radiotherapy in the treatment of prostate cancer.

Purpose: Treatment with intensity-modulated radiation therapy (IMRT) is increasingly standard for prostate cancer. Volume-modulated arc therapy (VMAT) to deliver IMRT potentially enables shorter treatment time. The aim of this study was to test this hypothesis by measuring the average patient in-room time with VMAT versus dynamic multileaf collimator (DMLC) IMRT.

Quantitative analysis of pre- and post-treatment PET-CT scans using deformable image registration methods.

Background And Purpose: To investigate the utility of quantitative PET analysis for early prediction of local control following stereotactic body radiation therapy (SBRT).

Material And Methods: An initial test cohort of fourteen cases and a validation cohort of twenty-three cases were analyzed. All patients had metastatic or recurrent cancer and underwent PET-CTs pre- and post- SBRT to a variety of sites.

In vivo assay of folate receptors in nonfunctional pituitary adenomas with 99mTc-folate SPECT/CT.

Unlabelled: The objective of this study was to evaluate the in vivo assay of folate receptors in nonfunctional pituitary adenomas using preoperative (99m)Tc-folate SPECT/CT and Western blot analysis (WBA) of surgical specimens as the standard.

Methods: Fifty-six patients (29 men, 27 women; age range, 29-82 y) with clinically nonfunctional pituitary adenomas on MRI underwent preoperative imaging using 666 MBq (18 mCi) of (99m)Tc-folate. SPECT/CT images and whole-body and lateral head planar images were acquired approximately 2 h after injection.

PET lesion segmentation using automated iso-intensity contouring in head and neck cancer.

To improve the objectivity of the integration of positron emission tomography (PET), we used the conformality index (CI) to measure the goodness of fit of a given PET iso-SUV (standardized uptake value) level with the GTV defined on PET (GTV(PET)) and CT (GTV(CT)). Twenty-two datasets involving 20 head and neck cancer patients were identified. GTV(PET) and GTV(CT) were delineated manually.

Pelvic shape and prostate motion: implications for target volume design and analysis of acute toxicity.

Objectives: To study the impact of pelvic shape on prostate motion and the implications for radiotherapy target design and treatment outcomes.

Methods: A total of 3741 measurements (daily shift moves in the 3 principal directions) on 29 consecutive prostate cancer patients were reviewed. All patients had 3 prostatic fiducials placed and were tracked using kilovoltage on-board imaging.

Case study of anti-1-amino-3-F-18 fluorocyclobutane-1-carboxylic acid (anti-[F-18] FACBC) to guide prostate cancer radiotherapy target design.

Purpose Of The Report: Anti-1-amino-3-F-18 fluorocyclobutane-1-carboxylic acid (FACBC) is a novel radiotracer, which has shown some promise for use with positron emission tomography (PET)/computed tomography (CT) for visualizing prostate cancer. Here we describe a case of a prostate cancer patient who underwent radiation treatment and had an FACBC scan obtained as part of a pilot study.

Methods: We explored the potential impact of FACBC on treatment planning.

Automated data mining of a proprietary database system for physician quality improvement.

Purpose: Physician practice quality improvement is a subject of intense national debate. This report describes using a software data acquisition program to mine an existing, commonly used proprietary radiation oncology database to assess physician performance.

Methods And Materials: Between 2003 and 2004, a manual analysis was performed of electronic portal image (EPI) review records.

Integration of databases for radiotherapy outcomes analyses.

The technical nature of radiotherapy requires different data collection strategies for outcomes reporting than those required for most other disciplines in clinical medicine. To correlate advances in radiotherapy technology with treatment outcomes, it is necessary to integrate a given radiotherapy outcomes-study database with the record-and-verify database and with the global hospital database. The authors review the recent development of each of these categories of databases from the vantage point of radiotherapy.

Clinical implementation and efficiency of kilovoltage image-guided radiation therapy.

This paper describes measurements of clinical efficiency and time requirements associated with image-guided radiation therapy (IGRT). In June 2004, the authors' institution installed an integrated kilovoltage (kV) imaging system attached to a medical linear accelerator for radiographic target localization. Over the past year, 242 patients have been localized with the kV radiographic imaging system for a total of 2,700 fractions.

The electronification of the radiation oncology treatment cycle: the promises and pitfalls of a digital department.

Radiation oncology departments are becoming more complex in terms of documentation, calculation, and delivery of therapy. Automation of such processes minimizes the likelihood of human error in each, and is clearly the direction in which the discipline is heading. The patient treatment cycle should be seamlessly integrated; unfortunately this is seldom the case given the different systems involved.