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Vens C, van Luijk P, Vogelius RI, El Naqa I, Humbert-Vidan L, von Neubeck C, Gomez-Roman N, Bahn E, Brualla L, Böhlen TT, Ecker S, Koch R, Handeland A, Pereira S, Possenti L, Rancati T, Todor D, Vanderstraeten B, Van Heerden M, Ullrich W, Jackson M, Alber M, Marignol L. A joint physics and radiobiology DREAM team vision - Towards better response prediction models to advance radiotherapy. Radiother Oncol 2024; 196:110277. [PMID: 38670264 DOI: 10.1016/j.radonc.2024.110277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 03/21/2024] [Accepted: 04/11/2024] [Indexed: 04/28/2024]
Abstract
Radiotherapy developed empirically through experience balancing tumour control and normal tissue toxicities. Early simple mathematical models formalized this practical knowledge and enabled effective cancer treatment to date. Remarkable advances in technology, computing, and experimental biology now create opportunities to incorporate this knowledge into enhanced computational models. The ESTRO DREAM (Dose Response, Experiment, Analysis, Modelling) workshop brought together experts across disciplines to pursue the vision of personalized radiotherapy for optimal outcomes through advanced modelling. The ultimate vision is leveraging quantitative models dynamically during therapy to ultimately achieve truly adaptive and biologically guided radiotherapy at the population as well as individual patient-based levels. This requires the generation of models that inform response-based adaptations, individually optimized delivery and enable biological monitoring to provide decision support to clinicians. The goal is expanding to models that can drive the realization of personalized therapy for optimal outcomes. This position paper provides their propositions that describe how innovations in biology, physics, mathematics, and data science including AI could inform models and improve predictions. It consolidates the DREAM team's consensus on scientific priorities and organizational requirements. Scientifically, it stresses the need for rigorous, multifaceted model development, comprehensive validation and clinical applicability and significance. Organizationally, it reinforces the prerequisites of interdisciplinary research and collaboration between physicians, medical physicists, radiobiologists, and computational scientists throughout model development. Solely by a shared understanding of clinical needs, biological mechanisms, and computational methods, more informed models can be created. Future research environment and support must facilitate this integrative method of operation across multiple disciplines.
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Affiliation(s)
- C Vens
- School of Cancer Science, University of Glasgow, Glasgow, UK; Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
| | - P van Luijk
- Department of Biomedical Sciences of Cells and Systems, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; Department of Radiation Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
| | - R I Vogelius
- Department of Oncology, Rigshospitalet, Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Denmark.
| | - I El Naqa
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI 48103, United States.
| | - L Humbert-Vidan
- University of Texas MD Anderson Cancer Centre, Houston, TX, United States; Department of MedicalPhysics, Guy's and St Thomas' NHS Foundation Trust, London, UK; School of Cancer and Pharmaceutical Sciences, Comprehensive Cancer Centre, King's College London, London, UK
| | - C von Neubeck
- Department of Particle Therapy, University Hospital Essen, University of Duisburg-Essen, Essen 45147, Germany
| | - N Gomez-Roman
- Strathclyde Institute of Phrmacy and Biomedical Sciences, University of Strathclyde, Glasgow, UK
| | - E Bahn
- Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany; Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany; National Center for Tumor Diseases (NCT), Heidelberg, Germany; Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - L Brualla
- West German Proton Therapy Centre Essen (WPE), Essen, Germany; Faculty of Medicine, University of Duisburg-Essen, Germany
| | - T T Böhlen
- Institute of Radiation Physics, Lausanne University Hospital and Lausanne University, Lausanne, Switzerland
| | - S Ecker
- Department of Radiation Oncology, Medical University of Wien, Austria
| | - R Koch
- Department of Particle Therapy, University Hospital Essen, University of Duisburg-Essen, Essen 45147, Germany
| | - A Handeland
- Department of Oncology and Medical Physics, Haukeland University Hospital, Bergen, Norway; Department of Physics and Technology, University of Bergen, Bergen, Norway
| | - S Pereira
- Neolys Diagnostics, 7 Allée de l'Europe, 67960 Entzheim, France
| | - L Possenti
- Data Science Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - T Rancati
- Data Science Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - D Todor
- Department of Radiation Oncology, Virginia Commonwealth University, United States
| | - B Vanderstraeten
- Department of Radiotherapy-Oncology, Ghent University Hospital, Gent, Belgium; Department of Human Structure and Repair, Ghent University, Gent, Belgium
| | - M Van Heerden
- Center for Proton Therapy, Paul Scherrer Institute, Villigen, Switzerland
| | | | - M Jackson
- School of Cancer Science, University of Glasgow, Glasgow, UK
| | - M Alber
- Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany; Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany
| | - L Marignol
- Applied Radiation Therapy Trinity (ARTT), Discipline of Radiation Therapy, School of Medicine, Trinity St. James's Cancer Institute, Trinity College Dublin, University of Dublin, Dublin, Ireland
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Francis L, Urdaneta A, Todor D. PO-1515: A tale of two image-based treatment workflows for prostate HDR: can dosimetry alone tell the story? Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01533-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Todor D, Fields E, Allen A, Batchelar D, Brouillard E, Ding J, Kudla M, Bachand F, Hajdok G, D'Souza D. PD-0659: Looking Beyond D90: Correlating EUBED, gBEUD with Outcome in Cervical Cancer Brachytherapy. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00681-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Urdaneta A, Todor D. PO-1548: Can the tumorlet model explain why 2 x 13.5Gy is not the equivalent of 1 x 19.5Gy? Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01566-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Todor D. SP-0234 Inverse treatment planning in clinical practice, one click and done? Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30654-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Liang J, Todor D. SU-G-201-15: Nomogram as an Efficient Dosimetric Verification Tool in HDR Prostate Brachytherapy. Med Phys 2016. [DOI: 10.1118/1.4956888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Todor D. MO-E-BRD-02: Accelerated Partial Breast Irradiation in Brachytherapy: Is Shorter Better? Med Phys 2015. [DOI: 10.1118/1.4925371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Craciunescu O, Todor D, de Leeuw A. WE-F-BRD-01: HDR Brachytherapy II: Integrating Imaging with HDR. Med Phys 2014. [DOI: 10.1118/1.4889467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Sharma M, Fields E, Todor D. SU-E-T-23: A Novel Two-Step Optimization Scheme for Tandem and Ovoid (T&O) HDR Brachytherapy Treatment for Locally Advanced Cervical Cancer. Med Phys 2014. [DOI: 10.1118/1.4888353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Siebert F, Anscher M, Hagan M, Kaden S, Todor D. PD-0188: Validation of the prostate tumorlet model based on multi-institution clinical data. Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)30293-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Ververs J, Anscher M, Rivard M, Todor D. SU-E-T-455: A Treatment Planning Feasibility Study for Prostate LDR Brachytherapy Treatments Using the New 103-Pd CivaString Source. Comparison with Clinical Cases Using the TheraSeed Model 200 103-Pd Source. Med Phys 2013. [DOI: 10.1118/1.4814888] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Todor D, Hagan M, Horn J. SU-D-105-07: Validation and Pitfalls of Strength-Based Medical Event Definition in Prostate Seed Brachytherapy: An Evidence-Based Critical Analysis. Med Phys 2013. [DOI: 10.1118/1.4814003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Todor D, Becker S. TU-F-500-01: Point and Counter Point Debate: Brachytherapy Is Better Than External Beam Therapy for Partial Breast Irradiation. Med Phys 2013. [DOI: 10.1118/1.4815446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Karlin J, Horn J, Todor D, Hagan M. An Exploratory Analysis of Prostate Brachytherapy Cases Using the Proposed Activity-based Medical Event Definition. Int J Radiat Oncol Biol Phys 2012. [DOI: 10.1016/j.ijrobp.2012.07.968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Todor D, Horn J, Karlin J, Hagan M. WE-A-BRB-07: Critical Analysis of Strength-Based Medical Event Definition in Prostate Seed Brachytherapy Based on a Comparative Retrospective Pre- and Post-Implant Analysis. Med Phys 2012. [DOI: 10.1118/1.4736048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Todor D, Lin P, Barani I, Axente M, Hagan M, Anscher M. OC-37 THE PROSTATE TUMORLET PROJECT. CRITICAL ANALYSIS OF D90: TILTING AT WINDMILLS? Radiother Oncol 2012. [DOI: 10.1016/s0167-8140(12)72004-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Vera R, Todor D, Bennion N, Mukhopadyay N, Arthur D. OC-132 EXCELLENT COSMESIS AFTER APBI: DOES DOSE TO THE DERMAL VOLUME PROVIDE A BETTER PREDICTIVE CONSTRAINT THAN SKIN DMAX? Radiother Oncol 2012. [DOI: 10.1016/s0167-8140(12)72099-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Al Sulaimani E, Arthur D, Todor D. SU-E-T-271: A Variable Target Comparison of Whole Breast and Partial Breast Irradiation Fractionation Regimens. Do the Current Margins Make Sense? Med Phys 2011. [DOI: 10.1118/1.3612222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Khan A, Vicini F, Dale R, Haffty B, Todor D, Moore D, Arthur D. 628 poster SHORT-COURSE ACCELERATED PARTIAL BREAST IRRADIATION (OVER 2 DAYS) IS FEASIBLE WITH THE CONTURA(r) MULTI-LUMEN BRACHYTHERAPY DEVICE. Radiother Oncol 2011. [DOI: 10.1016/s0167-8140(11)70750-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Zheng D, Gilbert V, Todor D. MO-FF-A1-04: An Innovative Needle Tip Detection Method for TRUS-Guided Prostate HDR Brachytherapy. Med Phys 2010. [DOI: 10.1118/1.3469140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Pokhrel D, Murphy M, Todor D, Weiss E, Williamson J. TU-D-BRB-06: Localizing Intracavitary Brachytherapy Applicators from Conebeam CT X-Ray Projections Via a Novel Iterative Forward Projection Matching (IFPM) Algorithm. Med Phys 2010. [DOI: 10.1118/1.3469255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Pokhrel D, Murphy M, Todor D, Weiss E, Williamson J. TU-D-BRB-04: Reconstruction of Brachytherapy Seed Positions and Orientations from Conebeam CT X-Ray Projections: A Novel Iterative Forward Projection Matching Algorithm. Med Phys 2010. [DOI: 10.1118/1.3469253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Liang X, Arthur D, Todor D. SU-GG-T-66: Dosimetric Comparison between Contura MLB and MammoSite ML. Med Phys 2010. [DOI: 10.1118/1.3468452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Todor D. TU-SAM-BRB-02: HDR Intra-Cavitary Approaches to APBI: Basic Physics and Limitations. Med Phys 2010. [DOI: 10.1118/1.3469205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Fatyga M, Williamson JF, Dogan N, Todor D, Siebers JV, George R, Barani I, Hagan M. A comparison of HDR brachytherapy and IMRT techniques for dose escalation in prostate cancer: a radiobiological modeling study. Med Phys 2009; 36:3995-4006. [PMID: 19810472 PMCID: PMC2738740 DOI: 10.1118/1.3187224] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2009] [Revised: 07/06/2009] [Accepted: 07/06/2009] [Indexed: 01/02/2023] Open
Abstract
A course of one to three large fractions of high dose rate (HDR) interstitial brachytherapy is an attractive alternative to intensity modulated radiation therapy (IMRT) for delivering boost doses to the prostate in combination with additional external beam irradiation for intermediate risk disease. The purpose of this work is to quantitatively compare single-fraction HDR boosts to biologically equivalent fractionated IMRT boosts, assuming idealized image guided delivery (igIMRT) and conventional delivery (cIMRT). For nine prostate patients, both seven-field IMRT and HDR boosts were planned. The linear-quadratic model was used to compute biologically equivalent dose prescriptions. The cIMRT plan was evaluated as a static plan and with simulated random and setup errors. The authors conclude that HDR delivery produces a therapeutic ratio which is significantly better than the conventional IMRT and comparable to or better than the igIMRT delivery. For the HDR, the rectal gBEUD analysis is strongly influenced by high dose DVH tails. A saturation BED, beyond which no further injury can occur, must be assumed. Modeling of organ motion uncertainties yields mean outcomes similar to static plan outcomes.
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Affiliation(s)
- M Fatyga
- Department of Radiation Oncology, Virginia Commonwealth University Medical Center, 401 College Street, Richmond, Virginia 23298, USA.
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Bondal A, Altunbas C, Ivanova T, Gilbert V, Todor D. SU-GG-BRC-03: Real Time 3D Tracking of the HDR Source Using Flat Panel Detector. Med Phys 2009. [DOI: 10.1118/1.3182179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Pokhrel D, Murphy M, Todor D, Lazos D, Weiss E, Motai Y, Williamson J. SU-FF-T-04: Permanent Brachytherapy Seed Localization Via Iterative Forward Projection Matching (IFPM) Algorithm Using Intraoperative Cone-Beam CT Sinogram Projections. Med Phys 2009. [DOI: 10.1118/1.3181474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Ivanova T, Gilbert L, Lazos D, Todor D. SU-FF-T-64: Characterization of MOSFET Dosimetry System for Source Position Verification in HDR Brachytherapy. Med Phys 2009. [DOI: 10.1118/1.3181536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Todor D, Vicini F, Arthur D, Julian T, Lyden M. SU-FF-T-37: Contura Multilumen Balloon (MLB) Registry Trial: Initial Dosimetric Experience. Med Phys 2009. [DOI: 10.1118/1.3181509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Cuttino L, Stojadinovic S, Shumadine J, Rosu M, Todor D, Arthur D. Potential Effect of Inherent Treatment Planning Uncertainties on Expected Vs. Actual Dose to Skin and Chest Wall with the Mammosite (MS) for Accelerated Partial Breast Irradiation. Int J Radiat Oncol Biol Phys 2008. [DOI: 10.1016/j.ijrobp.2008.06.758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Stojadinovic S, Todor D, Cuttino L, Arthur D. TH-C-AUD A-01: A Systematic Analysis of Errors and Uncertainties in Partial Breast Irradiation Using the MammoSite Balloon Catheter. Med Phys 2008. [DOI: 10.1118/1.2962836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Bondal A, Barani I, Lin P, Cuttino L, Arthur D, Todor D. SU-GG-T-412: Modeling the Dose Rate Effect On High Dose Rate (HDR) Accelerated Partial Breast Irradiation (APBI) Treatment. Med Phys 2008. [DOI: 10.1118/1.2962160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Pokhrel D, Murphy M, Todor D, Williamson J. TH-C-AUD A-05: Experimental Validation of An Iterative Forward Projection Matching Algorithm for Seeds Center Localization Using Conebeam-CT X-Ray Projections. Med Phys 2008. [DOI: 10.1118/1.2962840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Fatyga M, Williamson J, Dogan N, Todor D, Siebers J, George R, Hagan M, Barani I. TH-C-M100F-08: HDR Brachytherapy and Online Image-Guided Adaptive IMRT for Dose Escalation in Prostate Cancer: Comparison of Brachytherapy and IMRT Boosts. Med Phys 2007. [DOI: 10.1118/1.2761686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Le Y, Todor D, Williamson J. WE-C-224C-04: Correlated Sampling for Accelerating CT-Based Monte Carlo Dose Calculations for Brachytherapy Treatment Planning. Med Phys 2006. [DOI: 10.1118/1.2241709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Le Y, Chibani O, Todor D, Siebers J, Williamson J. MO-E-T-618-01: An Integrated CT-Based Monte Carlo Dose-Evaluation System for Brachytherapy and Its Application to Permanent Prostate Implant Postprocedure Dosimetric Analysis. Med Phys 2005. [DOI: 10.1118/1.1998298] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Sillanpaa J, Chang J, Mageras G, Riem H, Ford E, Todor D, Ling CC, Amols H. Developments in megavoltage cone beam CT with an amorphous silicon EPID: Reduction of exposure and synchronization with respiratory gating. Med Phys 2005; 32:819-29. [PMID: 15839355 DOI: 10.1118/1.1861522] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
We have studied the feasibility of a low-dose megavoltage cone beam computed tomography (MV CBCT) system for visualizing the gross tumor volume in respiratory gated radiation treatments of nonsmall-cell lung cancer. The system consists of a commercially available linear accelerator (LINAC), an amorphous silicon electronic portal imaging device, and a respiratory gating system. The gantry movement and beam delivery are controlled using dynamic beam delivery toolbox, a commercial software package for executing scripts to control the LINAC. A specially designed interface box synchronizes the LINAC, image acquisition electronics, and the respiratory gating system. Images are preprocessed to remove artifacts due to detector sag and LINAC output fluctuations. We report on the output, flatness, and symmetry of the images acquired using different imaging parameters. We also examine the quality of three-dimensional (3D) tomographic reconstruction with projection images of anthropomorphic thorax, contrast detail, and motion phantoms. The results show that, with the proper choice of imaging parameters, the flatness and symmetry are reasonably good with as low as three beam pulses per projection image. Resolution of 5% electron density differences is possible in a contrast detail phantom using 100 projections and 30 MU. Synchronization of image acquisition with simulated respiration also eliminated motion artifacts in a moving phantom, demonstrating the system's capability for imaging patients undergoing gated radiation therapy. The acquisition time is limited by the patient's respiration (only one image per breathing cycle) and is under 10 min for a scan of 100 projections. In conclusion, we have developed a MV CBCT system using commercially available components to produce 3D reconstructions, with sufficient contrast resolution for localizing a simulated lung tumor, using a dose comparable to portal imaging.
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Affiliation(s)
- J Sillanpaa
- Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, New York 10021, USA
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Cuttino L, Todor D, Arthur D, George R, Pacyna L. 3D conformal external beam radiotherapy (3D-CRT) for accelerated partial breast irradiation (APBI): What is the correct prescription dose. Int J Radiat Oncol Biol Phys 2004. [DOI: 10.1016/j.ijrobp.2004.07.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Keall P, Wijesooriya K, Vedam S, George R, Todor D, Murphy M, Siebers J, Williamson J, Mohan R. A four-dimensional controller for DMLC-based tumor tracking. Int J Radiat Oncol Biol Phys 2004. [DOI: 10.1016/j.ijrobp.2004.07.163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Arthur D, Wazer D, Koo D, Shah N, Berle L, Cuttino L, Yunes M, Rivard M, Todor D, Tong S, Tenenholz T, DiPetrillo T. The importance of dose volume histogram evaluation in partial breast brachytherapy: a study of dosimetric parameters. Int J Radiat Oncol Biol Phys 2003. [DOI: 10.1016/s0360-3016(03)01265-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Ford EC, Chang J, Mueller K, Sidhu K, Todor D, Mageras G, Yorke E, Ling CC, Amols H. Cone-beam CT with megavoltage beams and an amorphous silicon electronic portal imaging device: potential for verification of radiotherapy of lung cancer. Med Phys 2002; 29:2913-24. [PMID: 12512728 DOI: 10.1118/1.1517614] [Citation(s) in RCA: 73] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
We investigate the potential of megavoltage (MV) cone-beam CT with an amorphous silicon electronic portal imaging device (EPID) as a tool for patient position verification and tumor/organ motion studies in radiation treatment of lung tumors. We acquire 25 to 200 projection images using a 22 x 29 cm EPID. The acquisition is automatic and requires 7 minutes for 100 projections; it can be synchronized with respiratory gating. From these images, volumetric reconstruction is accomplished with a filtered backprojection in the cone-beam geometry. Several important prereconstruction image corrections, such as detector sag, must be applied. Tests with a contrast phantom indicate that differences in electron density of 2% can be detected with 100 projections, 200 cGy total dose. The contrast-to-noise ratio improves as the number of projections is increased. With 50 projections (100 cGy), high contrast objects are visible, and as few as 25 projections yield images with discernible features. We identify a technique of acquiring projection images with conformal beam apertures, shaped by a multileaf collimator, to reduce the dose to surrounding normal tissue. Tests of this technique on an anthropomorphic phantom demonstrate that a gross tumor volume in the lung can be accurately localized in three dimensions with scans using 88 monitor units. As such, conformal megavoltage cone-beam CT can provide three-dimensional imaging of lung tumors and may be used, for example, in verifying respiratory gated treatments.
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Affiliation(s)
- E C Ford
- Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA
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Constantinescu E, Cristea E, Albulescu D, Todor D. [Allantoin, a plant constituent with diuretic effect]. Pharmazie 1967; 22:601-2. [PMID: 5602425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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