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Killen JP, Yong K, Luxton G, Endre Z. Life-threatening hypocalcaemia associated with denosumab in advanced chronic kidney disease. Intern Med J 2017; 46:746-7. [PMID: 27257154 DOI: 10.1111/imj.13097] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2015] [Revised: 01/30/2016] [Accepted: 02/01/2016] [Indexed: 12/01/2022]
Affiliation(s)
- J P Killen
- Department of Renal Medicine, Prince of Wales Hospital, Sydney, New South Wales, Australia
| | - K Yong
- Department of Renal Medicine, Prince of Wales Hospital, Sydney, New South Wales, Australia
| | - G Luxton
- Department of Renal Medicine, Prince of Wales Hospital, Sydney, New South Wales, Australia
| | - Z Endre
- Department of Renal Medicine, Prince of Wales Hospital, Sydney, New South Wales, Australia
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Chen X, Xing L, Azcona J, Luxton G, Bush K. SU-E-T-69: Cloud-Based Monte Carlo Patient-Specific Quality Assurance (QA) Method for Volumetric Modulated Arc Therapy (VMAT). Med Phys 2014. [DOI: 10.1118/1.4888399] [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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Han B, Luxton G, Lu M, Bush K, Wang L, Mok E, Xing L. Meeting the Challenge of SBRT QA: Development of a High-Resolution and High-Speed Dosimetry Strategy. Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.312] [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: 11/15/2022]
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Han B, Luxton G, Yu S, Lu M, Wang L, Mok E, Xing L. SU-C-105-06: Development of a High Resolution EPID Solution for Small Field Dosimetry. Med Phys 2013. [DOI: 10.1118/1.4813930] [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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Chen X, Xing L, Mok E, Luxton G, Bush K. MO-D-108-01: Cloud-Based Monte Carlo Patient-Specific Quality Assurance (QA) Method for Volumetric-Modulated Arc Therapy (VMAT): Clinical and Educational Impacts. Med Phys 2013. [DOI: 10.1118/1.4815235] [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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Liu W, Xie Y, Lin W, Luxton G, Nath R. Feature-based Automatic Real-time Tumor Motion Monitoring With or Without Fiducial Markers. Int J Radiat Oncol Biol Phys 2012. [DOI: 10.1016/j.ijrobp.2012.07.1940] [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: 11/30/2022]
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Bazan J, Luxton G, Kozak M, Anderson E, Hancock S, Kapp D, Kidd E, Hara W, Koong A, Chang D. Normal Tissue Complication Probability Modeling of Acute Hematologic Toxicity in Patients Receiving Pelvic IMRT and Concurrent Chemotherapy. Int J Radiat Oncol Biol Phys 2012. [DOI: 10.1016/j.ijrobp.2012.07.924] [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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Han B, Phillips T, Luxton G. SU-E-T-355: Volumetric Modulated Arc Therapy Treatment Quality Assurance Using an Ion Chamber Array and a Software-Modified Phantom. Med Phys 2012. [DOI: 10.1118/1.4735442] [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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Kalantzis G, Qian J, Han B, Luxton G. SU-E-T-338: Investigations of Fidelity of Dose Delivery at High Dose Rate of Flattening Filter Free (FFF) Beams in VMAT on TrueBeam™. Med Phys 2012. [DOI: 10.1118/1.4735425] [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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Han B, Luxton G, Bush K, Mok E, Lu M, Xing L. TU-E-BRB-07: An EPID Based Dosimetric Verification Tool for SBRT with High Dose Rate FFF Beams. Med Phys 2012; 39:3909. [DOI: 10.1118/1.4735956] [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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Bazan J, Luxton G, Mok E, Kunz P, Fisher G, Koong A, Chang D. Normal Tissue Complication Probability Modeling of Acute Hematologic Toxicity in Patients with Squamous Cell Carcinoma of the Anal Canal Treated with Definitive Chemoradiotherapy. Int J Radiat Oncol Biol Phys 2011. [DOI: 10.1016/j.ijrobp.2011.06.260] [Citation(s) in RCA: 3] [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: 11/30/2022]
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Liu W, Yan H, Lin W, Ahmad M, Cho B, Keall P, Luxton G, Xing L, Nath R. Optimizing Imaging Dose and Targeting Accuracy in IGRT for Real-time Radiographic Motion Tracking. Int J Radiat Oncol Biol Phys 2011. [DOI: 10.1016/j.ijrobp.2011.06.064] [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: 11/15/2022]
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Luxton G, Mok E, Qian J, Fahimian B, Kielar K, Hsu A, Xing L. SU-E-T-483: Investigations of Dose Delivery Accuracy of High Dose Rate Flattening Filter Free (FFF) Beams in RapidArc™ and IMRT Deliveries on TrueBeam™. Med Phys 2011. [DOI: 10.1118/1.3612436] [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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Kielar K, Mok E, Wang L, Luxton G, Maxim P, Hsu A, Xing L. SU-E-T-540: Verification of Dosimetric Accuracy on the TrueBeam STx: Rounded Leaf Effect of the High Definition MLC. Med Phys 2011. [DOI: 10.1118/1.3612502] [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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Qian J, Luxton G, Xing L. MO-D-BRB-01: Stereotactic Body Radiation Therapy (SBRT) Using Respiratory-Gated Volumetric Modulated Arc Therapy (VMAT) with Flattening Filter Free (FFF). Med Phys 2011. [DOI: 10.1118/1.3612906] [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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Tachibana H, Luxton G, Xing L. SU-E-T-260: Daily Quality Assurance of Volumetric Modulated Arc Therapy and Intensity Modulated Radiotherapy Using Dynamic Log Files: Retrospective Study. Med Phys 2011. [DOI: 10.1118/1.3612211] [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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Qian J, Xing L, Luxton G. SU-E-T-443: Dosimetric Verification for Volumetric Modulated Arc Therapy (VMAT) with Gating. Med Phys 2011. [DOI: 10.1118/1.3612397] [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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Liu W, Cho B, Keall P, Luxton G, Xing L. TU-E-204B-04: DMLC Implementation of a Prostate Intrafraction Motion Correction Strategy Based on Failure Detection Concept. Med Phys 2010. [DOI: 10.1118/1.3469295] [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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Liu W, Xing L, Qian J, Luxton G. TU-C-204B-05: First Clinical Development of a Failure Detection-Based Online Repositioning Strategy for Prostate IMRT - Experiments, Simulation, and Dosimetry Study. Med Phys 2010. [DOI: 10.1118/1.3469228] [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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Mastoridis T, Liu W, Mok E, Luxton G, Xing L. WE-B-BRA-05: Minimizing Radiation Dose in Stereoscopic X-Ray-Based Monitoring of Tumor Motion with the Effective Use of Partial Information. Med Phys 2010. [DOI: 10.1118/1.3469345] [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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Sachdev S, Dodd R, Chang S, Soltys S, Adler J, Luxton G, Choi C, Tupper L, Gibbs I. Stereotactic Radiosurgery Yields Long-term Control for Benign Intradural, Extramedullary Spine Tumors. Int J Radiat Oncol Biol Phys 2009. [DOI: 10.1016/j.ijrobp.2009.07.247] [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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Liu W, Luxton G, Xing L. Optimized Hybrid MV-kV Imaging Protocol for Volumetric Prostate Arc Therapy. Int J Radiat Oncol Biol Phys 2009. [DOI: 10.1016/j.ijrobp.2009.07.1305] [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: 10/20/2022]
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Liu W, Wiersma R, Luxton G, Xing L. TH-C-303A-03: Real-Time Motion Detection of Prostate Target During Volumetric Arc Therapy Using Onboard Imaging Devices. Med Phys 2009. [DOI: 10.1118/1.3182627] [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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Luxton G. SU-FF-T-487: Saturation of Repair Model for Cell Survival Applied to X-Ray and Carbon-Ion Irradiation. Med Phys 2009. [DOI: 10.1118/1.3181985] [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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Liu W, Xie Y, Luxton G, Wiersma R, Xing L. TU-C-303A-02: Intrafraction Prostate Motion Monitoring with Cine-MV and Minimal As-Needed Onboard KV Imaging. Med Phys 2009. [DOI: 10.1118/1.3182339] [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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Liu W, Wiersma RD, Mao W, Luxton G, Xing L. Real-time 3D internal marker tracking during arc radiotherapy by the use of combined MV-kV imaging. Phys Med Biol 2008; 53:7197-213. [PMID: 19043177 DOI: 10.1088/0031-9155/53/24/013] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
To minimize the adverse dosimetric effect caused by tumor motion, it is desirable to have real-time knowledge of the tumor position throughout the beam delivery process. A promising technique to realize the real-time image guided scheme in external beam radiation therapy is through the combined use of MV and onboard kV beam imaging. The success of this MV-kV triangulation approach for fixed-gantry radiation therapy has been demonstrated. With the increasing acceptance of modern arc radiotherapy in the clinics, a timely and clinically important question is whether the image guidance strategy can be extended to arc therapy to provide the urgently needed real-time tumor motion information. While conceptually feasible, there are a number of theoretical and practical issues specific to the arc delivery that need to be resolved before clinical implementation. The purpose of this work is to establish a robust procedure of system calibration for combined MV and kV imaging for internal marker tracking during arc delivery and to demonstrate the feasibility and accuracy of the technique. A commercially available LINAC equipped with an onboard kV imager and electronic portal imaging device (EPID) was used for the study. A custom built phantom with multiple ball bearings was used to calibrate the stereoscopic MV-kV imaging system to provide the transformation parameters from imaging pixels to 3D world coordinates. The accuracy of the fiducial tracking system was examined using a 4D motion phantom capable of moving in accordance with a pre-programmed trajectory. Overall, spatial accuracy of MV-kV fiducial tracking during the arc delivery process for normal adult breathing amplitude and period was found to be better than 1 mm. For fast motion, the results depended on the imaging frame rates. The RMS error ranged from approximately 0.5 mm for the normal adult breathing pattern to approximately 1.5 mm for more extreme cases with a low imaging frame rate of 3.4 Hz. In general, highly accurate real-time tracking of implanted markers using hybrid MV-kV imaging is achievable and the technique should be useful to improve the beam targeting accuracy of arc therapy.
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Affiliation(s)
- W Liu
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA 94305-5847, USA.
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Dua N, Mao W, Lee L, Riaz N, Wiersma R, Hsu A, Luxton G, King C, Xing L. Using MV Treatment Beam Imaging to Monitor Prostate Motion in Near Real-time on a Conventional LINAC. Int J Radiat Oncol Biol Phys 2008. [DOI: 10.1016/j.ijrobp.2008.06.128] [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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Luxton G, Antony J, Loo B, Carlson D, Maxim P, Xing L. Dose Escalation Feasible Due to Gating in Lung Cancer Patients. Int J Radiat Oncol Biol Phys 2008. [DOI: 10.1016/j.ijrobp.2008.06.272] [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: 11/16/2022]
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Antony J, Luxton G, Lee L, Chao M, Carlson D, Xing L. Biological Modeling Indices for 4D Radiation Therapy. Int J Radiat Oncol Biol Phys 2008. [DOI: 10.1016/j.ijrobp.2008.06.281] [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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Mao W, Riaz N, Lee K, Wiersma R, King C, Hsu A, Luxton G, Xing L. SU-DD-A3-03: Using Treatment Beam Imaging to Monitor Prostate Motion In Near Real-Time On a Conventional LINAC. Med Phys 2008. [DOI: 10.1118/1.2961364] [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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Teo BK, Hristov D, Mok E, Luxton G. SU-GG-T-225: Correction for Directional Response of a 2D Ion Chamber Array for Quality Assurance of Arc Radiotherapy and IMRT. Med Phys 2008. [DOI: 10.1118/1.2961977] [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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Ahn K, Dieterich S, Luxton G, Horst K, Hristov D. SU-DD-A1-05: Treatment Planning of Prone Position Accelerated Partial Breast Irradiation Customized for Magnetic Resonance Imaging Guidance. Med Phys 2008. [DOI: 10.1118/1.2961354] [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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Liu W, Mao W, Wiersma R, Luxton G, Riaz N, Xing L. TH-C-AUD C-06: Nearly Real-Time Tumor-Position Monitoring During Arc Therapy with Combined MV and KV Imaging. Med Phys 2008. [DOI: 10.1118/1.2962852] [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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Antony J, Loo B, Carlson D, Maxim P, Luxton G, Xing L. SU-GG-T-509: Impact of Gating On Dose Escalation in Lung Cancer Patients. Med Phys 2008. [DOI: 10.1118/1.2962258] [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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Antony J, Luxton G, Xing L. SU-GG-T-402: Model to Account for Organ Deformation During Respiration Using the Power Law Dependence of Biological Outcome On Volume (mass). Med Phys 2008. [DOI: 10.1118/1.2962152] [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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Isbister GK, Little M, Cull G, McCoubrie D, Lawton P, Szabo F, Kennedy J, Trethewy C, Luxton G, Brown SGA, Currie BJ. Thrombotic microangiopathy from Australian brown snake (Pseudonaja) envenoming. Intern Med J 2007; 37:523-8. [PMID: 17640187 DOI: 10.1111/j.1445-5994.2007.01407.x] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Australian brown snake (genus Pseudonaja) envenoming causes a venom-induced consumptive coagulopathy (VICC). A proportion of cases go on to develop thrombotic microangiopathy characterized by thrombocytopenia, microangiopathic haemolytic anaemia (MAHA) and acute renal failure (ARF). AIM The aim of the study was to define better the natural history and empirical treatments for thrombotic microangiopathy in brown snake envenoming. METHODS A review of brown snake bites recruited to the Australian Snakebite Project (ASP), a national multicentre study of snake envenoming was undertaken. Serial data are recorded on clinical effects and laboratory results, including measurement of venom concentrations. We describe cases of thrombotic microangiopathy and compare these to cases without thrombotic microangiopathy. RESULTS From 32 cases of brown snake envenoming with severe VICC, four (13%) developed thrombotic microangiopathy, we also included two cases of thrombotic microangiopathy from prior to ASP. All six developed severe thrombocytopenia (<20 x 10(-9)/L), worst 3 days after the bite and resolving over a week, MAHA with fragmented red blood cells on the blood film and five developed anuric ARF requiring dialysis and lasting 2-8 weeks. All six received antivenom, which was delayed compared with other brown snake-envenoming cases. Four were treated with plasmapheresis. The severity and recovery of the thrombocytopenia, anaemia and renal function were similar with and without plasmapheresis. The median length of stay for MAHA cases was 14 days (interquartile range (IQR) 12-14) compared to 1.8 days (IQR 1.3-2) for all other cases. CONCLUSION Thrombotic microangiopathy resulting from brown snake bite appears to have a good prognosis and management should focus on early antivenom therapy and supportive care including dialysis. The role of plasmapheresis is yet to be defined.
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Affiliation(s)
- G K Isbister
- Tropical Toxinology Unit, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.
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Hsu A, Mok E, Findley D, Luxton G. TH-D-M100E-01: An Electronic Compensator for Total Body Irradiation. Med Phys 2007. [DOI: 10.1118/1.2761728] [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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Langan LL, Park LP, Hughes TL, Irish A, Luxton G, Witt CS, Christiansen FT. Post-transplant HLA class II antibodies and high soluble CD30 levels are independently associated with poor kidney graft survival. Am J Transplant 2007; 7:847-56. [PMID: 17391128 DOI: 10.1111/j.1600-6143.2006.01691.x] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
HLA-specific antibodies (HSA) and soluble CD30 (sCD30) were measured in 208 renal transplant recipients with functioning grafts at least 1 year after transplantation (median 8.2 years) to investigate the predictive value of HSA and sCD30 on subsequent graft outcome. HSA (class I and class II) were detected by both ELISA LAT-M and Luminex LabScreen assays. Data on graft outcome was collected with a median follow-up time of 3.5 years after antibody and sCD30 measurement. Recipients with post-transplant HLA class II antibodies had particularly poor graft outcome with a hazard ratio (HR) of 7.8 (p < 0.0001) when detected by ELISA, and a HR of 6.0 (p < 0.0001) when detected by Luminex. A high post-transplant sCD30 level >or=100 U/mL was associated with increased risk of subsequent graft failure (HR 2.7, p = 0.03). sCD30 and HSA had an independent and additive association with graft outcome. Recipients with HLA class II antibody and high sCD30 had the highest risk of subsequent graft failure (HR 43.4, p < 0.0001 and HR 18.1, p = 0.0008 for ELISA and Luminex, respectively). These data show that detection of HSA and serum sCD30 measured at least 1-year post-transplant provides valuable and predictive information regarding subsequent graft outcome.
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Affiliation(s)
- L L Langan
- Department of Clinical Immunology and Biochemical Genetics, PathWest, Royal Perth Hospital, Western Australia, Australia
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Shirazi H, Thorndyke B, Maxim P, Loo B, Luxton G, Le Q. 2480. Int J Radiat Oncol Biol Phys 2006. [DOI: 10.1016/j.ijrobp.2006.07.891] [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: 10/24/2022]
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Hsu A, Pawlicki T, King C, Hancock S, Luxton G. TU-E-ValB-04: Impact On Nodal Dose Distribution From Daily Fiducial Tracking for IMRT Prostate and Pelvic Node Treatments. Med Phys 2006. [DOI: 10.1118/1.2241632] [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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Yoo S, Kim G, Hammoud R, Elder E, Pawlicki T, Guan H, Fox T, Luxton G, Yin F, Munro P. SU-FF-T-374: Quality Assurance of the On-Board Imager and Cone-Beam Computed Tomography Systems. Med Phys 2006. [DOI: 10.1118/1.2241291] [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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Luxton G. SU-FF-T-33: A New Formula for Normal Tissue Complication (NTCP) as a Function of Equivalent Uniform Dose (EUD) in the Lyman-Kutcher-Burman (LKB) Model. Med Phys 2006. [DOI: 10.1118/1.2240935] [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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Kim G, Horst K, Maxim P, Luxton G, Xing L, Boyer A, Pawlicki T. Investigation of Cone-beam CT for Breast Cancer Treatment Planning. Int J Radiat Oncol Biol Phys 2005. [DOI: 10.1016/j.ijrobp.2005.07.932] [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: 10/25/2022]
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Pawlicki T, Kim G, King C, Xing L, Boyer A, Luxton G. Investigation of Linac-based Image-guided Hypofractionated Prostate Treatment. Int J Radiat Oncol Biol Phys 2005. [DOI: 10.1016/j.ijrobp.2005.07.876] [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: 10/25/2022]
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Pawlicki T, Luxton G, Maxim P, Mistry V, Bourland P, Boyer A. SU-FF-T-200: Image-Guided IMRT Dose Verification with a Plastic Photosensitive Dosimeter. Med Phys 2005. [DOI: 10.1118/1.1997928] [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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Lim W, Luxton G, Hutchison B. Acute thyroiditis following parathyroidectomy for secondary hyperparathyroidism in a chronic renal failure patient. Intern Med J 2003; 33:131-3. [PMID: 12603588 DOI: 10.1046/j.1445-5994.2003.00306.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Murphy MJ, Adler JR, Bodduluri M, Dooley J, Forster K, Hai J, Le Q, Luxton G, Martin D, Poen J. Image-guided radiosurgery for the spine and pancreas. Comput Aided Surg 2001; 5:278-88. [PMID: 11029160 DOI: 10.1002/1097-0150(2000)5:4<278::aid-igs6>3.0.co;2-k] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
A robotic image-guided radiosurgical system has been modified to treat extra-cranial sites using implanted fiducials and skeletal landmarks to locate the treatment targets. The system has been used to treat an artero-venous malformation in the cervical spine, a recurrent schwannoma of the thoracic spine, a metastatic adenocarcinoma of the lumbar spine, and three pancreatic cancers. During each treatment, the image guidance system monitored the position of the target site and relayed the target coordinates to the beam-pointing system at discrete intervals. The pointing system then dynamically aligned the therapy beam with the lesion, automatically compensating for shifts in target position. Breathing-related motion of the pancreas lesions was managed by coordinating beam gating with breath-holding by the patient. The system maintained alignment with the spine lesions to within +/- 0.2 mm on average, and to within +/- 1 mm for the pancreatic tumors. This experience has demonstrated the feasibility of using image-guided robotic radiosurgery outside the cranium.
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Affiliation(s)
- M J Murphy
- Department of Radiation Oncology, Stanford University School of Medicine, CA 94305, USA.
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Abstract
PURPOSE To investigate the technical and physical feasibility of using a radiosurgery-like technique to irradiate a small target within the breast with a single fraction. MATERIAL AND METHODS During diagnostic biopsy, a tantalum surgical clip is placed in the lesion identified at mammography. Transverse CT scans over the entire breast are obtained, as the patient lies prone on a special table that allows the breast to hang down. The clip is used as a reference point to define the isocenter of the radiation treatment. RESULTS The clip is visible on port films taken with a 4 MV beam, allowing the isocenter to be set to its planned location. No movement of the hanging breast is visually detected. The possible beam directions are enclosed by a 220 degrees horizontal x 180 degrees vertical angular interval. Dosimetry of two "radiosurgical" examples, (A) seven fixed horizontal beams and (B) six 45 degrees arcs and a 90 degrees sagittal arc using a 4 MV x-ray beam with a 32 mm diameter collimator, are discussed. Both field arrangements produce adequate tumor coverage: the minimum target dose is 83% of the dose maximum in the fixed beam arrangement and 86% in the multiarc setup. In arrangement A the lung and other tissues external to the breast receive dose only from scattered radiation. In arrangement B the maximum lung dose is less than 5% of the dose to isocenter. CONCLUSION From a dosimetric point of view both described techniques are feasible, and the radiosurgery-like treatment is executable.
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Affiliation(s)
- G Jozsef
- Department of Radiation Oncology, School of Medicine, University of Southern California, Los Angeles 90033, USA.
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