The University of Washington (UW) Clinical Neutron Therapy System (CNTS) has been used to treat over 3300 patients. Treatment planning for these patients is currently performed using an MV x-ray model in Pinnacle® adapted to fit measurements of fast neutron output factors, wedge factors, depth-dose and lateral profiles. While this model has provided an adequate representation of the CNTS for 3D conformal treatment planning, later versions of Pinnacle did not allow for isocentric gantry rotation machines with a source-to-axis distance of 150 cm. This restriction limited the neutron model to version 9.0 while the photon and electron treatment planning at the UW had moved on to newer versions. Also, intensity modulated neutron therapy (IMNT) is underdevelopment at the UW, and the Pinnacle neutron model developed cannot be used for inverse treatment planning. We have used the MCNP6 Monte Carlo code system to develop Collapsed Cone (CC) and Singular Value Decomposition (SVD) neutron scattering kernels suitable for integration into the RayStation treatment planning system. Kernels were generated for monoenergetic neutrons with energies ranging from 1 keV to 51 MeV, i.e. the energy range most relevant to the CNTS. Percent depth dose (PDD) profiles computed in RayStation for the CC and SVD kernels are in excellent agreement with each other for depths beyond the beam's dose build-up region (depths greater than about 1.7 cm) for open 2.8 × 2.8 cm, 10.3 × 10.3 cm, and 28.8 × 32.8 cm fields. Lateral profiles at several depths, as well as the PDD, calculated using the CC kernels in RayStation for the full CNTS energy spectrum pass a 3%/3 mm gamma test for field sizes of 2.8 × 2.8 cm, 10.0 × 10.3 cm, and 28.8 × 32.8 cm.
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http://dx.doi.org/10.1088/1361-6560/ab9a85 | DOI Listing |
Zhonghua Xue Ye Xue Za Zhi
December 2024
State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China Tianjin Institutes of Health Science, Tianjin 301600, China.
Smoldering multiple myeloma (SMM) patients are a heterogeneous group with variable prognosis. A subset of SMM patients have a higher risk of progressing to multiple myeloma (MM) within 2 years. The definition of high-risk patients is not consistent among different risk models, and the combination of various biomarkers and new technologies improves the predictive performance of risk models.
View Article and Find Full Text PDFJ Pediatr Surg
December 2024
Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.
Background And Aim: In this retrospective single center cohort study, we report the surgical outcomes of nephron-sparing surgery (NSS) for Wilms' tumor (WT) patients since centralization of pediatric oncology care in the Netherlands, and implementation of technological advancements. Therewith we describe the influence of experience and innovations for this type of surgery.
Methods: We retrospectively assessed all NSS procedures from January 1st 2015 until January 1st 2024 for patients who underwent surgery for a renal tumor at the Princess Máxima Center for Pediatric Oncology.
Best Pract Res Clin Anaesthesiol
March 2024
Department of Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, Department of Anesthesia and Critical Care Medicine, 1275 York Avenue, New York, NY, 10028, USA. Electronic address:
The objectives of this minireview are two-fold. The first is to discuss the evolution of opioid analgesia in perioperative medicine in the context of thoracic non-cardiac surgery. Current standard-of-care, aiming to optimize analgesia and limit undesirable side effects, is discussed in the context of multimodal analgesia, specifically enhanced recovery after thoracic surgery pathways.
View Article and Find Full Text PDFBest Pract Res Clin Anaesthesiol
September 2024
Joan Kirner Women's and Children's Sunshine Hospital, Western Health, St Albans, Australia. Electronic address:
Cardiovascular disease is a leading cause of morbidity and mortality for pregnant patients. A significant portion of cardiac morbidity and mortality is preventable and related to poor or delayed recognition of clinical warning signs and oversights in management. The establishment of pregnancy heart teams facilitates multidisciplinary planning to improve management of people with cardiovascular disease.
View Article and Find Full Text PDFDiabetes Obes Metab
January 2025
Endocrinologie, Diabétologie Et Gynécologie Pédiatrique, Hopital Necker-Enfants Malades, Université Paris Cité, AP-HP centre, Paris, France.
Background: Transition from paediatric to adult healthcare is a turning point for patients with Type 1 diabetes (T1D). A gradual coordinated process connecting paediatric and adult healthcare providers may improve adherence to adult follow-up.
Aims: To describe a transition process developed jointly by paediatric and adult diabetology units and compare patients progressing or not to follow-up in adult care setting.
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