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Liu Y, Venkatesulu BP, Sharma A, Pollard-Larkin JM, Sadagopan R, Symons J, Neri S, Singh P, Tailor R, Lin S, Krishnan S. High Dose Rate Radiation does not Protect Normal Tissue in Mice Cardiac and Splenic Models of Lymphopenia and Gastrointestinal Mucosal Injury. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.02.518] [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: 10/23/2022]
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Abstract
Advances in image-guided radiotherapy (RT) have allowed for dose escalation and more precise radiation treatment delivery. Each decade brings new imaging technologies to help improve RT patient setup. Currently, the most frequently used method of three-dimensional pre-treatment image verification is performed with cone beam CT. However, more recent developments have provided RT with the ability to have on-board MRI coupled to the teleradiotherapy unit. This latest tool for treating cancer is known as MR-guided RT. Several varieties of these units have been designed and installed in centres across the globe. Their prevalence, history, advantages and disadvantages are discussed in this review article. In preparation for the next generation of image-guided RT, this review also covers where MR-guided RT might be heading in the near future.
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Affiliation(s)
| | - Zhifei Wen
- UT MD Anderson Cancer Center, Houston, TX, USA
| | | | - Jihong Wang
- UT MD Anderson Cancer Center, Houston, TX, USA
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Pollard J, Prajapati S, Gao S, Nitsch P, Sadagopan R, Wang X, Balter P. SU-G-JeP3-15: Is the Reproducibility with Respect to Bone of Tumor Position at Simulation for Breath Hold CT Scans Correlated to the Reproducibility for Multiple Breath Hold CBCTs at Treatment in SBRT Thoracic Patients? Med Phys 2016. [DOI: 10.1118/1.4957080] [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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Gao S, Balter P, Wang X, Sadagopan R, Pollard J. SU-E-T-245: Detection of the Photon Target Damage in Varian Linac Based On Periodical Quality Assurance Measurements. Med Phys 2015. [DOI: 10.1118/1.4924607] [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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Lewis D, Wang X, Gao S, Nitsch P, Pollard J, Sadagopan R, Balter P. SU-E-T-26: A Dosimetric Comparison of Two Treatment Setups for Lung Stereotactic Body Radiation Therapy (SBRT) Patients. Med Phys 2015. [DOI: 10.1118/1.4924387] [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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Sadagopan R, Yang J, Li H. SU-E-J-256: Dual Energy Planar Image Based Localization in the Absence of On-Board CT Images. Med Phys 2014. [DOI: 10.1118/1.4888310] [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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Sadagopan R, Balter P. SU-E-T-715: Evaluation of Off-Target Isocenter Placement On TArget Coverage and Critical Structure Dose. Med Phys 2013. [DOI: 10.1118/1.4815142] [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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Sadagopan R, Kerns J. SU-E-T-64: Is Correction for the Sag of EPID Panel Necessary for Proper Evaluation of Picket Fence Test in Dynamic Mode? Med Phys 2012. [DOI: 10.1118/1.4735120] [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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Sadagopan R, Wang L. SU-E-T-468: A Novel Complexity Index to Evaluate IMRT QA. Med Phys 2011. [DOI: 10.1118/1.3612422] [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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Melancon A, Sadagopan R. SU-E-T-581: Correction Factors for Secondary Monitor Unit Calculation in Stereotactic Lung Radiotherapy. Med Phys 2011. [DOI: 10.1118/1.3612543] [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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Peng Y, Vedam S, Chang JY, Gao S, Sadagopan R, Bues M, Balter P. Implementation of feedback-guided voluntary breath-hold gating for cone beam CT-based stereotactic body radiotherapy. Int J Radiat Oncol Biol Phys 2011; 80:909-17. [PMID: 21470784 DOI: 10.1016/j.ijrobp.2010.08.011] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2010] [Revised: 07/28/2010] [Accepted: 08/07/2010] [Indexed: 11/30/2022]
Abstract
PURPOSE To analyze tumor position reproducibility of feedback-guided voluntary deep inspiration breath-hold (FGBH) gating for cone beam computed tomography (CBCT)-based stereotactic body radiotherapy (SBRT). METHODS AND MATERIALS Thirteen early-stage lung cancer patients eligible for SBRT with tumor motion of >1cm were evaluated for FGBH-gated treatment. Multiple FGBH CTs were acquired at simulation, and single FGBH CBCTs were also acquired prior to each treatment. Simulation CTs and treatment CBCTs were analyzed to quantify reproducibility of tumor positions during FGBH. Benefits of FGBH gating compared to treatment during free breathing, as well treatment with gating at exhalation, were examined for lung sparing, motion margins, and reproducibility of gross tumor volume (GTV) position relative to nonmoving anatomy. RESULTS FGBH increased total lung volumes by 1.5 times compared to free breathing, resulting in a proportional drop in total lung volume receiving 10 Gy or more. Intra- and inter-FGBH reproducibility of GTV centroid positions at simulation were 1.0 ± 0.5 mm, 1.3 ± 1.0 mm, and 0.6 ± 0.4 mm in the anterior-posterior (AP), superior-inferior (SI), and left-right lateral (LR) directions, respectively, compared to more than 1 cm of tumor motion at free breathing. During treatment, inter-FGBH reproducibility of the GTV centroid with respect to bony anatomy was 1.2 ± 0.7 mm, 1.5 ± 0.8 mm, and 1.0 ± 0.4 mm in the AP, SI, and LR directions. In addition, the quality of CBCTs was improved due to elimination of motion artifacts, making this technique attractive for poorly visualized tumors, even with small motion. CONCLUSIONS The extent of tumor motion at normal respiration does not influence the reproducibility of the tumor position under breath hold conditions. FGBH-gated SBRT with CBCT can improve the reproducibility of GTV centroids, reduce required margins, and minimize dose to normal tissues in the treatment of mobile tumors.
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Affiliation(s)
- Yong Peng
- Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA
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Benedict SH, Yenice KM, Followill D, Galvin JM, Hinson W, Kavanagh B, Keall P, Lovelock M, Meeks S, Papiez L, Purdie T, Sadagopan R, Schell MC, Salter B, Schlesinger DJ, Shiu AS, Solberg T, Song DY, Stieber V, Timmerman R, Tomé WA, Verellen D, Wang L, Yin FF. Stereotactic body radiation therapy: the report of AAPM Task Group 101. Med Phys 2010; 37:4078-101. [PMID: 20879569 DOI: 10.1118/1.3438081] [Citation(s) in RCA: 1334] [Impact Index Per Article: 95.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Task Group 101 of the AAPM has prepared this report for medical physicists, clinicians, and therapists in order to outline the best practice guidelines for the external-beam radiation therapy technique referred to as stereotactic body radiation therapy (SBRT). The task group report includes a review of the literature to identify reported clinical findings and expected outcomes for this treatment modality. Information is provided for establishing a SBRT program, including protocols, equipment, resources, and QA procedures. Additionally, suggestions for developing consistent documentation for prescribing, reporting, and recording SBRT treatment delivery is provided.
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Affiliation(s)
- Stanley H Benedict
- University of Virginia Health System, Charlottesville, Virginia 22908, USA.
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Peng Y, Vedam S, Gao S, Polf J, Sadagopan R, Balter P. SU-FF-T-565: Implementation of Feedback Guided Voluntary Breath Hold Gating for CBCT Based Stereotactic Body Radiotherapy. Med Phys 2009. [DOI: 10.1118/1.3182063] [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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Sadagopan R, Bencomo JA, Martin RL, Nilsson G, Matzen T, Balter PA. Characterization and clinical evaluation of a novel IMRT quality assurance system. J Appl Clin Med Phys 2009; 10:104-119. [PMID: 19458595 PMCID: PMC5720456 DOI: 10.1120/jacmp.v10i2.2928] [Citation(s) in RCA: 78] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2008] [Accepted: 12/10/2008] [Indexed: 11/23/2022] Open
Abstract
Intensity-modulated radiation therapy (IMRT) is a complex procedure that involves the delivery of complex intensity patterns from various gantry angles. Due to the complexity of the treatment plans, the standard-of-care is to perform measurement based patient-specific quality assurance (QA). IMRT QA is traditionally done with film for relative dose in a plane and an ion chamber for absolute dose. This is a laborious and time-consuming process. In this work, we characterized, commissioned, and evaluated the QA capabilities of a novel commercial IMRT device Delta4, (Scandidos, Uppsala, Sweden). This device consists of diode matrices in 2 orthogonal planes inserted in a cylindrical acrylic phantom that is 22 cm in diameter. Although the system has detectors in only 2 planes, it provides a novel interpolation algorithm that is capable of estimating doses at points where no detectors are present. Each diode is sampled per beam pulse so that the dose distribution can be evaluated on segment-by-segment, beam-by-beam, or as a composite plan from a single set of measurements. The end user can calibrate the system to perform absolute dosimetry eliminating the need for additional ion chamber measurements. The patient's IMRT plan is imported into the device over the hospital LAN and the results of measurements can be displayed as gamma profiles, distance-to-agreement maps, dose difference maps, or the measured dose distribution can be superimposed of the patient's anatomy to display an as-delivered plan. We evaluated the system's reproducibility, stability, pulse-rate dependence, dose-rate dependence, angular dependence, linearity of dose response and energy response using carefully planned measurements. We also validated the system's interpolation algorithm by measuring a complex dose distribution from an IMRT treatment. Several simple and complex isodose distributions planned using a treatment planning system were delivered to the QA device; the planned and measured dose distributions were then compared and analyzed. In addition, the dose distributions measured by conventional IMRT QA, which uses an ion chamber and film, were compared. We found that this device is accurate and reproducible and that its interpolation algorithm is valid. In addition the supplied software and network interface allow a streamlined IMRT QA process.
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Affiliation(s)
- Ramaswamy Sadagopan
- Department of Radiation Physics, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, U.S.A
| | - Jose A Bencomo
- Department of Radiation Physics, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, U.S.A
| | - Rafael L Martin
- Department of Physics, Universidad Central de Venezuela, Caracas, Venezuela
| | | | | | - Peter A Balter
- Department of Radiation Physics, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, U.S.A
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Martin R, BenComo J, Heard M, Martin M, Kaluarachchi K, Wells N, Sadagopan R. SU-GG-T-308: Polymer Cross-Linking and Sensitivity Enhancement in Normoxic Polymer Gels Used for Three-Dimensional Dosimetry. Med Phys 2008. [DOI: 10.1118/1.2962060] [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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Ikushima H, Balter P, Chang J, Hunjan S, Sadagopan R, Yu Z, Zhang Y, Dong L. TU-C-351-05: Daily Alignment Results for In-Room CT-Guided Stereotactic Body Radiation Therapy for Lung Cancer. Med Phys 2008. [DOI: 10.1118/1.2962468] [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: 11/07/2022] Open
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Sadagopan R, BenComo J, Martin R, Balter P, Vedam S, Nilsson G. TU-D-M100F-04: Characterisation, Commissioning and Evaluation of DELTA4 IMRT QA System. Med Phys 2007. [DOI: 10.1118/1.2761392] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [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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Sadagopan R, Balter P, Hunjan S. SU-FF-T-353: Prediction of Patient Treatment (couch) Coordinate Based On Treatment Planning CT Image. Med Phys 2007. [DOI: 10.1118/1.2761017] [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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Lindsay P, Briere T, Balter P, Sadagopan R, Starkschall G, Zhu X, Beddar S. SU-FF-T-195: Effect of Respiratory Gating On the Dose Distributions of Dynamic Wedge and IMRT Treatment Fields. Med Phys 2007. [DOI: 10.1118/1.2760855] [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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Sahoo N, Kazi A, Cho S, Sadagopan R, Wang C, Shiu A. SU-FF-T-45: A Procedure for Correcting the Effect of Detector Properties On Measured Profiles of Small Field MV X-Ray Beams. Med Phys 2006. [DOI: 10.1118/1.2240946] [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: 11/07/2022] Open
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Sadagopan R, Titt U, Tailor R. TH-D-224C-08: Dose Variation Within Lung Tumor and in Its Fingerlike Extension as a Function of Incident Photon Angle. Med Phys 2006. [DOI: 10.1118/1.2241920] [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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Shiu A, Wang C, Sadagopan R, Cho S, Lii M, Chang E, Woo S, Mahajan A, Sahoo N. Implementation of a 6D Robotic Couch-Top for the Automation of Image-Guided Brain SRS and Spinal SRT. Int J Radiat Oncol Biol Phys 2005. [DOI: 10.1016/j.ijrobp.2005.07.871] [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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Krempf M, Peltier P, Murat A, Sadagopan R, Guillon J, Charbonnel B. [Microalbuminuria is not a marker of diabetic retinopathy]. Presse Med 1987; 16:1191-3. [PMID: 2955362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Microalbuminuria is considered a good predictor of diabetic nephropathy. In this study over 50% of patients with retinopathy, whatever its severity, did not show microalbuminuria. However, among patients with microalbuminuria, the percentage of retinopathy was significantly increased (75%). It is concluded that with the exception of nephropathy, microalbuminuria is not a good parameter for the detection of other microangiopathic complications of diabetes.
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