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Article ; Online: Rectal Cancer MRI Guided Radiotherapy: A Practical Review for the Physician.

Chiloiro, Giuditta / Gani, Cihan / Boldrini, Luca

2023 Volume 34, Issue 1, Page(s) 64–68

Abstract: MR-guided radiotherapy is a treatment approach that combines the advantages of magnetic resonance imaging (MRI) with the precision of radiation therapy. This practical review provides an overview of the current state-of-the-art of MR-guided radiotherapy ... ...

Abstract	MR-guided radiotherapy is a treatment approach that combines the advantages of magnetic resonance imaging (MRI) with the precision of radiation therapy. This practical review provides an overview of the current state-of-the-art of MR-guided radiotherapy for rectal cancer, including its technical aspects, clinical outcomes, and existing limitations. Even though some studies have demonstrated the feasibility and safety of this treatment modality, challenges remain in terms of patient selection, treatment planning optimization, and long-term follow-up. Despite these issues, MR-guided radiotherapy shows promise as a potentially valuable rectal cancer treatment approach.
MeSH term(s)	Humans ; Radiotherapy Planning, Computer-Assisted/methods ; Rectal Neoplasms/diagnostic imaging ; Rectal Neoplasms/radiotherapy ; Radiotherapy, Image-Guided/methods ; Magnetic Resonance Imaging ; Physicians
Language	English
Publishing date	2023-12-15
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1146999-7
ISSN	1532-9461 ; 1053-4296
ISSN (online)	1532-9461
ISSN	1053-4296
DOI	10.1016/j.semradonc.2023.10.004
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Article ; Online: Auto-segmentation of pelvic organs at risk on 0.35T MRI using 2D and 3D Generative Adversarial Network models.

Vagni, Marica / Tran, Huong Elena / Romano, Angela / Chiloiro, Giuditta / Boldrini, Luca / Zormpas-Petridis, Konstantinos / Kawula, Maria / Landry, Guillaume / Kurz, Christopher / Corradini, Stefanie / Belka, Claus / Indovina, Luca / Gambacorta, Maria Antonietta / Placidi, Lorenzo / Cusumano, Davide

Physica medica : PM : an international journal devoted to the applications of physics to medicine and biology : official journal of the Italian Association of Biomedical Physics (AIFB)

2024 Volume 119, Page(s) 103297

Abstract: Purpose: Manual recontouring of targets and Organs At Risk (OARs) is a time-consuming and operator-dependent task. We explored the potential of Generative Adversarial Networks (GAN) to auto-segment the rectum, bladder and femoral heads on 0.35T MRIs to ... ...

Abstract	Purpose: Manual recontouring of targets and Organs At Risk (OARs) is a time-consuming and operator-dependent task. We explored the potential of Generative Adversarial Networks (GAN) to auto-segment the rectum, bladder and femoral heads on 0.35T MRIs to accelerate the online MRI-guided-Radiotherapy (MRIgRT) workflow. Methods: 3D planning MRIs from 60 prostate cancer patients treated with 0.35T MR-Linac were collected. A 3D GAN architecture and its equivalent 2D version were trained, validated and tested on 40, 10 and 10 patients respectively. The volumetric Dice Similarity Coefficient (DSC) and 95th percentile Hausdorff Distance (HD95 Results: In the internal test set, the 3D and 2D GANs showed DSC/HD95 Conclusions: The proposed 3D GAN auto-segments pelvic OARs with high accuracy on 0.35T, in both the internal and the external test sets, outperforming its 2D equivalent in both segmentation robustness and volume generation time.
MeSH term(s)	Male ; Humans ; Organs at Risk/diagnostic imaging ; Image Processing, Computer-Assisted ; Tomography, X-Ray Computed ; Pelvis/diagnostic imaging ; Magnetic Resonance Imaging
Language	English
Publishing date	2024-02-03
Publishing country	Italy
Document type	Journal Article
ZDB-ID	1122650-x
ISSN	1724-191X ; 1120-1797
ISSN (online)	1724-191X
ISSN	1120-1797
DOI	10.1016/j.ejmp.2024.103297
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Article ; Online: Radiotherapy imaging: An unexpected ally in fighting COVID 19 pandemic.

Boldrini, Luca / Dinapoli, Nicola / Valentini, Vincenzo

Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology

2020 Volume 148, Page(s) 223–224

Keywords	covid19
Language	English
Publishing date	2020-04-25
Publishing country	Ireland
Document type	Letter
ZDB-ID	605646-5
ISSN	1879-0887 ; 0167-8140
ISSN (online)	1879-0887
ISSN	0167-8140
DOI	10.1016/j.radonc.2020.04.036
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Article ; Online: Impact of data transfer between treatment planning systems on dosimetric parameters.

Meffe, Guenda / Votta, Claudio / Turco, Gabriele / Chillè, Elena / Nardini, Matteo / Romano, Angela / Chiloiro, Giuditta / Panza, Giulia / Galetto, Matteo / Capotosti, Amedeo / Moretti, Roberto / Gambacorta, Maria Antonietta / Boldrini, Luca / Indovina, Luca / Placidi, Lorenzo

Physica medica : PM : an international journal devoted to the applications of physics to medicine and biology : official journal of the Italian Association of Biomedical Physics (AIFB)

2024 Volume 121, Page(s) 103369

Abstract: Purpose: In radiotherapy it is often necessary to transfer a patient's DICOM (Digital Imaging and COmmunications in Medicine) dataset from one system to another for re-treatment, plan-summation or registration purposes. The aim of the study is to ... ...

Abstract	Purpose: In radiotherapy it is often necessary to transfer a patient's DICOM (Digital Imaging and COmmunications in Medicine) dataset from one system to another for re-treatment, plan-summation or registration purposes. The aim of the study is to evaluate effects of dataset transfer between treatment planning systems. Materials and methods: Twenty-five patients treated in a 0.35T MR-Linac (MRidian, ViewRay) for locally-advanced pancreatic cancer were enrolled. For each patient, a nominal dose distribution was optimized on the planning MRI. Each plan was daily re-optimized if needed to match the anatomy and exported from MRIdian-TPS (ViewRay Inc.) to Eclipse-TPS (Siemens-Varian). A comparison between the two TPSs was performed considering the PTV and OARs volumes (cc), as well as dose coverages and clinical constraints. Results: From the twenty-five enrolled patients, 139 plans were included in the data comparison. The median values of percentage PTV volume variation are 10.8 % for each fraction, while percentage differences of PTV coverage have a mean value of -1.4 %. The median values of the percentage OARs volume variation are 16.0 %, 7.0 %, 10.4 % and 8.5 % for duodenum, stomach, small and large bowel, respectively. The percentage variations of the dose constraints are 41.0 %, 52.7 % and 49.8 % for duodenum, stomach and small bowel, respectively. Conclusions: This study has demonstrated a non-negligible variation in size and dosimetric parameters when datasets are transferred between TPSs. Such variations should be clinically considered. Investigations are focused on DICOM structure algorithm employed by the TPSs during the transfer to understand the cause of such variations.
Language	English
Publishing date	2024-04-24
Publishing country	Italy
Document type	Journal Article
ZDB-ID	1122650-x
ISSN	1724-191X ; 1120-1797
ISSN (online)	1724-191X
ISSN	1120-1797
DOI	10.1016/j.ejmp.2024.103369
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Article: Nutritional counselling for head and neck cancer patients treated with (chemo)radiation therapy: why, how, when, and what?

Santo, Bianca / Bertini, Niccolò / Cattaneo, Carlo Guglielmo / De Matteis, Sara / De Franco, Paola / Grassi, Roberta / Iorio, Giuseppe Carlo / Longo, Silvia / Boldrini, Luca / Piras, Antonio / Desideri, Isacco / De Felice, Francesca / Salvestrini, Viola

Frontiers in oncology

2024 Volume 13, Page(s) 1240913

Language	English
Publishing date	2024-01-09
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2649216-7
ISSN	2234-943X
ISSN	2234-943X
DOI	10.3389/fonc.2023.1240913
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Article: MR-Guided Radiotherapy for Rectal Cancer: Current Perspective on Organ Preservation.

Boldrini, Luca / Intven, Martijn / Bassetti, Michael / Valentini, Vincenzo / Gani, Cihan

Frontiers in oncology

2021 Volume 11, Page(s) 619852

Abstract: Online MRI-guided radiotherapy (MRgRT) is one of the most recent technological advances in radiotherapy. MRgRT permits the visualization of tumorous and healthy tissue while the patient is on the treatment table and online daily plan adaptations ... ...

Abstract	Online MRI-guided radiotherapy (MRgRT) is one of the most recent technological advances in radiotherapy. MRgRT permits the visualization of tumorous and healthy tissue while the patient is on the treatment table and online daily plan adaptations following the observed anatomical changes. In the context of rectal cancer, online MRgRT is a very promising modality due to the pronounced geographical variability of tumor tissues and the surrounding healthy tissues. This current paper will discuss the possible applications of online MRgRT, in particular, in terms of radiotherapy dose escalation and response prediction in organ preservation approaches for rectal cancer.
Language	English
Publishing date	2021-03-30
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2649216-7
ISSN	2234-943X
ISSN	2234-943X
DOI	10.3389/fonc.2021.619852
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Article ; Online: Role of radiation oncology in modern multidisciplinary cancer treatment.

Valentini, Vincenzo / Boldrini, Luca / Mariani, Silvia / Massaccesi, Mariangela

Molecular oncology

2020 Volume 14, Issue 7, Page(s) 1431–1441

Abstract: Cancer care is moving from a disease-focused management toward a patient-centered tailored approach. Multidisciplinary management that aims to define individual, optimal treatment strategies through shared decision making between healthcare professionals ...

Abstract	Cancer care is moving from a disease-focused management toward a patient-centered tailored approach. Multidisciplinary management that aims to define individual, optimal treatment strategies through shared decision making between healthcare professionals and patient is a fundamental aspect of high-quality cancer care and often includes radiation oncology. Advances in technology and radiobiological research allow to deliver ever more tailored radiation treatments in an ever easier and faster way, thus improving the efficacy, safety, and accessibility of radiation therapy. While these changes are improving quality of cancer care, they are also enormously increasing complexity of decision making, thus challenging the ability to deliver quality affordable cancer care. In this review, we provide an updated outline of the role of radiation oncology in the modern multidisciplinary treatment of cancer. Particularly, we focus on the way some developments in key areas of cancer management are challenging multidisciplinary cancer care in the different clinical settings of early, locally advanced, and metastatic disease, thus highlighting some priority areas of research.
MeSH term(s)	Big Data ; Humans ; Immunotherapy ; Interdisciplinary Research ; Neoplasms/pathology ; Neoplasms/therapy ; Radiation Oncology ; Radiotherapy Planning, Computer-Assisted
Language	English
Publishing date	2020-06-22
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2415106-3
ISSN	1878-0261 ; 1574-7891
ISSN (online)	1878-0261
ISSN	1574-7891
DOI	10.1002/1878-0261.12712
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Article: Management of Esophago-Gastric Junction Carcinoma: A Narrative Multidisciplinary Review.

Tondolo, Vincenzo / Casà, Calogero / Rizzo, Gianluca / Leone, Mariavittoria / Quero, Giuseppe / Alfieri, Virginia / Boldrini, Luca / Bulajic, Milutin / Corsi, Domenico / Micciché, Francesco

Cancers

2023 Volume 15, Issue 9

Abstract: Esophagogastric junction (EGJ) carcinoma represents a specific site of disease, given the opportunities for multimodal clinical care and management and the possibilities of combined treatments. It encompasses various clinical subgroups of disease that ... ...

Abstract	Esophagogastric junction (EGJ) carcinoma represents a specific site of disease, given the opportunities for multimodal clinical care and management and the possibilities of combined treatments. It encompasses various clinical subgroups of disease that are heterogeneous and deserve different treatments; therefore, the guidelines have progressively evolved over time, considering the evidence provided by clinical trials. The aim of this narrative review was to summarize the main evidence, which orientates the current guidelines, and to collect the main ongoing studies to address existing gray areas.
Language	English
Publishing date	2023-05-03
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2527080-1
ISSN	2072-6694
ISSN	2072-6694
DOI	10.3390/cancers15092597
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Article ; Online: Radiomics-enhanced early regression index for predicting treatment response in rectal cancer: a multi-institutional 0.35 T MRI-guided radiotherapy study.

Boldrini, Luca / Chiloiro, Giuditta / Cusumano, Davide / Yadav, Poonam / Yu, Gao / Romano, Angela / Piras, Antonio / Votta, Claudio / Placidi, Lorenzo / Broggi, Sara / Catucci, Francesco / Lenkowicz, Jacopo / Indovina, Luca / Bassetti, Michael F / Yang, Yingli / Fiorino, Claudio / Valentini, Vincenzo / Gambacorta, Maria Antonietta

La Radiologia medica

2024 Volume 129, Issue 4, Page(s) 615–622

Abstract: Purpose: The accurate prediction of treatment response in locally advanced rectal cancer (LARC) patients undergoing MRI-guided radiotherapy (MRIgRT) is essential for optimising treatment strategies. This multi-institutional study aimed to investigate ... ...

Abstract	Purpose: The accurate prediction of treatment response in locally advanced rectal cancer (LARC) patients undergoing MRI-guided radiotherapy (MRIgRT) is essential for optimising treatment strategies. This multi-institutional study aimed to investigate the potential of radiomics in enhancing the predictive power of a known radiobiological parameter (Early Regression Index, ERI Methods: Patients from three international sites were included and divided into training and validation sets. 0.35 T T2/T1-weighted MR images were acquired during simulation and at each treatment fraction. The biologically effective dose (BED) conversion was used to account for different radiotherapy schemes: gross tumour volume was delineated on the MR images corresponding to specific BED levels and radiomic features were then extracted. Multiple logistic regression models were calculated, combining ERI Results:* A total of 91 patients was enrolled: 58 were used as training, 33 as validation. Overall, pCR was observed in 25 cases. The model showing the highest performance was obtained combining ERI Conclusion: The integration of the radiomic analysis with ERI
MeSH term(s)	Humans ; Radiomics ; Rectal Neoplasms/diagnostic imaging ; Rectal Neoplasms/radiotherapy ; Rectal Neoplasms/pathology ; Magnetic Resonance Imaging/methods ; Rectum ; Neoadjuvant Therapy/methods ; Retrospective Studies
Language	English
Publishing date	2024-03-21
Publishing country	Italy
Document type	Multicenter Study ; Journal Article
ZDB-ID	205751-7
ISSN	1826-6983 ; 0033-8362
ISSN (online)	1826-6983
ISSN	0033-8362
DOI	10.1007/s11547-024-01761-7
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Article: Impact of bias field correction on 0.35 T pelvic MR images: evaluation on generative adversarial network-based OARs' auto-segmentation and visual grading assessment.

Vagni, Marica / Tran, Huong Elena / Catucci, Francesco / Chiloiro, Giuditta / D'Aviero, Andrea / Re, Alessia / Romano, Angela / Boldrini, Luca / Kawula, Maria / Lombardo, Elia / Kurz, Christopher / Landry, Guillaume / Belka, Claus / Indovina, Luca / Gambacorta, Maria Antonietta / Cusumano, Davide / Placidi, Lorenzo

Frontiers in oncology

2024 Volume 14, Page(s) 1294252

Abstract: Purpose: Magnetic resonance imaging (MRI)-guided radiotherapy enables adaptive treatment plans based on daily anatomical changes and accurate organ visualization. However, the bias field artifact can compromise image quality, affecting diagnostic ... ...

Abstract	Purpose: Magnetic resonance imaging (MRI)-guided radiotherapy enables adaptive treatment plans based on daily anatomical changes and accurate organ visualization. However, the bias field artifact can compromise image quality, affecting diagnostic accuracy and quantitative analyses. This study aims to assess the impact of bias field correction on 0.35 T pelvis MRIs by evaluating clinical anatomy visualization and generative adversarial network (GAN) auto-segmentation performance. Materials and methods: 3D simulation MRIs from 60 prostate cancer patients treated on MR-Linac (0.35 T) were collected and preprocessed with the N4ITK algorithm for bias field correction. A 3D GAN architecture was trained, validated, and tested on 40, 10, and 10 patients, respectively, to auto-segment the organs at risk (OARs) rectum and bladder. The GAN was trained and evaluated either with the original or the bias-corrected MRIs. The Dice similarity coefficient (DSC) and 95th percentile Hausdorff distance (HD95 Results: In the test set, the GAN trained and evaluated on original and bias-corrected MRIs showed DSC/HD95 Conclusion: The bias field correction did not improve the anatomy visualization from a clinical point of view and the OARs' auto-segmentation outputs generated by the GAN.
Language	English
Publishing date	2024-03-28
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2649216-7
ISSN	2234-943X
ISSN	2234-943X
DOI	10.3389/fonc.2024.1294252
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