Increased Dose to Organs in Urinary Tract Associates With Measures of Genitourinary Toxicity in Pooled Voxel-Based Analysis of 3 Randomized Phase III Trials.

Dose information from organ sub-regions has been shown to be more predictive of genitourinary toxicity than whole organ dose volume histogram information. This study aimed to identify anatomically-localized regions where 3D dose is associated with genitourinary toxicities in healthy tissues throughout the pelvic anatomy. Dose distributions for up to 656 patients of the Trans-Tasman Radiation Oncology Group 03.

Relationships between rectal and perirectal doses and rectal bleeding or tenesmus in pooled voxel-based analysis of 3 randomised phase III trials.

Background And Purpose: This study aimed to identify anatomically-localised regions where planned radiotherapy dose is associated with gastrointestinal toxicities in healthy tissues throughout the pelvic anatomy.

Materials And Methods: Planned dose distributions for up to 657 patients of the Trans Tasman Radiation Oncology Group 03.04 RADAR trial were deformably registered onto a single exemplar computed tomography dataset.

Reduced Dose Posterior to Prostate Correlates With Increased PSA Progression in Voxel-Based Analysis of 3 Randomized Phase 3 Trials.

Purpose: Reducing margins during treatment planning to decrease dose to healthy organs surrounding the prostate can risk inadequate treatment of subclinical disease. This study aimed to investigate whether lack of dose to subclinical disease is associated with increased disease progression by using high-quality prostate radiation therapy clinical trial data to identify anatomically localized regions where dose variation is associated with prostate-specific antigen progression (PSAP).

Methods And Materials: Planned dose distributions for 683 patients of the Trans-Tasman Radiation Oncology Group 03.

Rationale for Modernising Imaging in Advanced Prostate Cancer.

Context: To effectively manage patients with advanced prostate cancer (APC), it is essential to have accurate, reproducible, and validated methods for detecting and quantifying the burden of bone and soft tissue metastases and for assessing their response to therapy. Current standard of care imaging with bone and computed tomography (CT) scans have significant limitations for the assessment of bone metastases in particular.

Objective: We aimed to undertake a critical comparative review of imaging methods used for diagnosis and disease monitoring of metastatic APC from the perspective of their availability and ability to assess disease presence, extent, and response of bone and soft tissue disease.

METastasis Reporting and Data System for Prostate Cancer: Practical Guidelines for Acquisition, Interpretation, and Reporting of Whole-body Magnetic Resonance Imaging-based Evaluations of Multiorgan Involvement in Advanced Prostate Cancer.

Context: Comparative reviews of whole-body magnetic resonance imaging (WB-MRI) and positron emission tomography/computed tomography (CT; with different radiotracers) have shown that metastasis detection in advanced cancers is more accurate than with currently used CT and bone scans. However, the ability of WB-MRI and positron emission tomography/CT to assess therapeutic benefits has not been comprehensively evaluated. There is also considerable variability in the availability and quality of WB-MRI, which is an impediment to clinical development.

An evaluation and replication of miRNAs with disease stage and colorectal cancer-specific mortality.

MicroRNAs (miRNAs) have been implicated in colorectal cancer (CRC) development and associated with prognostic indicators such as disease stage and survival. Prognostic associations are often based on few individuals and imprecise. In this study, we utilize population-based data from 1,141 CRC cases to replicate previously reported associations between 121 miRNAs and disease stage and survival.

Second cancer risk and mortality in men treated with radiotherapy for stage I seminoma.

Background: Patients with stage I testicular seminoma are typically diagnosed at a young age and treatment is associated with low relapse and mortality rates. The long-term risks of adjuvant radiotherapy in this patient group are therefore particularly relevant.

Methods: We identified patients and obtained treatment details from 12 cancer centres (11 United Kingdom, 1 Norway) and ascertained second cancers and mortality through national registries.

Rituximab with pentostatin or cladribine: an effective combination treatment for hairy cell leukemia after disease recurrence.

The purine analogs pentostatin and cladribine are effective treatments for hairy cell leukemia (HCL). However, alternative treatments are needed for patients with recurrent disease. We reviewed retrospectively data from 18 patients who were retreated with either pentostatin (n = 12) or cladribine (n = 6) in combination with rituximab, after 1-6 (median 2) previous treatments with either purine analog as a single agent.

Long-term follow-up of 233 patients with hairy cell leukaemia, treated initially with pentostatin or cladribine, at a median of 16 years from diagnosis.

Hairy cell leukaemia (HCL) was first described 50 years ago. Median survival was then 4 years. The purine analogues, introduced in the 1980s, transformed this prognosis.

Evaluation of 31P high-resolution magic angle spinning of intact tissue samples.

The first detailed evaluation is presented of high-resolution (31)P MRS using magic angle spinning (MAS) of intact tissue samples and comparison with the conventional method of studying tissue extracts. The main motivation is that MAS leaves the sample intact at the end of the study for histopathological evaluation. While MAS of tissue samples has previously been demonstrated for (1)H MRS, (31)P MRS is better suited to study of the phospholipid metabolites of importance in cancer.

Prediction of clinicopathologic response of breast cancer to primary chemotherapy at contrast-enhanced MR imaging: initial clinical results.

Purpose: To prospectively document changes in contrast agent kinetics in patients with primary breast cancer treated with systemic chemotherapy after one or two cycles and to determine whether kinetic measures can be used to predict final clinicopathologic response.

Materials And Methods: Institutional committees on clinical research and ethics approval and patient consent were obtained. Dynamic magnetic resonance (MR) examinations were performed in 25 women with primary breast cancer before treatment and after the first (n = 21) and second (n = 15) cycle of neoadjuvant chemotherapy.

Preliminary dose response study of a gel dosimeter using 2-Hydroxyethyl Methacrylate (HEMA).

In this work we present a gel dosimeter based on 2-Hydroxyethyl Methacrylate (HEMA). The gel dosimeter is manufactured in normal atmospheric oxygen (normoxic) and undergoes a measurable change after irradiation. The gel is shown to provide a signal to noise ratio of up to at least 35 and have a linear change in transverse relaxation rate up to 70 Gy when measured with magnetic resonance imaging.

Stereotactic linear accelerator radiotherapy for pituitary tumors.

Last decade has seen important advances in radiotherapy technology which combine precise tumor localization with accurate targeted delivery of radiation. This technique of high precision conformal radiotherapy, described as stereotactic radiotherapy or radiosurgery, uses modern linear accelerators available in most radiation oncology departments. The article describes the new technique as applied to the treatment of pituitary adenoma and reviews published clinical results.

Commissioning and implementation of a stereotactic conformal radiotherapy technique using a general-purpose planning system.

The purpose of this paper is to report on commissioning and clinical implementation of a customized system for pediatric stereotactic conformal radiotherapy (SCRT). The system is based on the Pinnacle treatment-planning system and its interfaces with other equipment: (1) Beam models were optimized for our compact blocking system and a new LINAC. (2) Three CT-to-density conversion tables were evaluated, one using tabulated data for a commercial phantom, the second including additional points from the manufacturer's data for the inserts in an in-house phantom, and the third using measured densities for the in-house phantom materials combined with tabulated data for the commercial phantom.

The dose distribution of low dose rate Cs-137 in intracavitary brachytherapy: comparison of Monte Carlo simulation, treatment planning calculation and polymer gel measurement.

In this study, the dose distribution delivered by low dose rate Cs-137 brachytherapy sources was investigated using Monte Carlo (MC) techniques and polymer gel dosimetry. The results obtained were compared with a commercial treatment planning system (TPS). The 20 mm and the 30 mm diameter Selectron vaginal applicator set (Nucletron) were used for this study.

The use of gel dosimetry for verification of electron and photon treatment plans in carcinoma of the scalp.

In recent years there has been a large amount of research into the potential use of radiation sensitive gels for three-dimensional verification of clinical radiotherapy doses. In this paper we report the use of a MAGIC gel dosimeter (Fong et al 2001 Phys. Med.

The development and application of functional nuclear magnetic resonance to in vivo therapeutic anticancer research: 2002 Sir Godfrey Hounsfield lecture delivered at the President's Day, Manchester.

A little over 30 years ago, Sir Godfrey Hounsfield and his colleagues revolutionized medical imaging by developing CT scanning. In recent years a combination of improved technology and a deeper understanding of tumour biology have led to the development of imaging based strategies aimed at interrogating tissue structure and function. The prospects of this new technology include the prediction of tumour response and the non-invasive study of conventionally inaccessible yet important pharmacological compartments.

Ductal approaches to assessment and management of women at high risk for developing breast cancer.

The ductal approach to breast cancer, encompassing nipple aspiration, ductal lavage and duct endoscopy, allows assessment of breast ductal epithelial cells and their local microenvironment in a graded process of increasing invasiveness. Samples of ductal epithelial cells sufficient for cytological diagnosis may be safely collected, titres of individual proteins showing variation with breast cancer status may be measured, and abnormal pathology within the breast ducts may be directly visualized. Identification of surrogate molecular markers may facilitate early breast cancer detection, in conjunction with cytological assessment, and be useful for individual prediction of breast cancer risk and assessment of treatment response.

Monitoring temozolomide treatment of low-grade glioma with proton magnetic resonance spectroscopy.

Assessment of low-grade glioma treatment response remains as much of a challenge as the treatment itself. Proton magnetic resonance spectroscopy ((1)H-MRS) and imaging were incorporated into a study of patients receiving temozolomide therapy for low-grade glioma in order to evaluate and monitor tumour metabolite and volume changes during treatment. Patients (n=12) received oral temozolomide (200 mg m(-2) day(-1)) over 5 days on a 28-day cycle for 12 cycles.

Radiotherapy for malignant gliomas in the elderly.

While fractionated external beam radiotherapy remains the principal treatment in patients with histologically verified malignant glioma, its use in older patients and in patients with adverse prognostic features has not been subject to randomized studies. Hypofractionated partial brain irradiation offers a short, well-tolerated treatment with a palliative benefit for patients with a predicted median survival of less than 6 months. To assess its true efficacy in terms of survival and quality-of-life gain requires a formal randomized comparison with supportive care either alone or in combination with palliative chemotherapy and with radical radiotherapy.

Effects of residual single-quantum coherences in intermolecular multiple-quantum coherence studies.

Intermolecular multiple-quantum coherences (iMQCs) have been reported to offer a sensitivity to sample structure at a specific user-defined length scale down to the order of 10 microm. When assessing this novel contrast mechanism in controlled phantom experiments, we have observed three different mechanisms whereby residual single-quantum coherences (SQCs) arising from intense high spatial frequencies, stimulated echoes and strong spatially encoding gradients can produce significant changes in signal contrast at particular length scales. These changes which only appear when components arising from SQCs and iMQCs are both present in the detected signal, are similar to changes previously attributed to iMQCs alone.

The role of hemoglobin concentration in clinically localized prostate cancer treated with radical radiotherapy +/- neoadjuvant androgen deprivation.

Purpose: Serum hemoglobin level (Hb) is a significant determinant of treatment outcome after radical radiotherapy (RT) for several cancer types, but its importance in prostate cancer is not well established.

Methods And Materials: Two treatment-specific cohorts of men with localized prostate cancer (T1-4, Nx/N0, M0) were analyzed. Seven hundred six men who received radical RT at Princess Margaret Hospital between 1987 and 2000 comprise the RT-alone cohort, of whom 536 had a pre-RT Hb.

A systematic study of techniques for elective cervical nodal irradiation with anterior or opposed anterior and posterior beams.

Purpose: To assess target coverage and dose homogeneity using conventional radiotherapy (RT) and intensity-modulated RT (IMRT) with anterior and posterior beams for elective irradiation of the cervical lymph nodes in patients with head and neck cancer.

Materials And Methods: A planning study was performed in six patients who had undergone radical RT for head and neck cancer. RT plans to irradiate the cervical lymph nodes using a single anterior field, or opposed anterior and posterior fields, with 6 or 10 MV photons were compared.