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  1. Article ; Online: A sub-analysis of multi-center planning radiosurgery for intracranial metastases through automation (MC-PRIMA) comparing UK and international centers.

    Chan, Mark K H

    Medical engineering & physics

    2023  Volume 117, Page(s) 103996

    Abstract: Objectives: A sub-analysis of the MC-PRIMA study was performed to compare the plan quality of stereotactic radiosurgery (SRS) to multiple brain metastases (MBM) between UK and other international centres.: Methods and materials: Six centres from the ... ...

    Abstract Objectives: A sub-analysis of the MC-PRIMA study was performed to compare the plan quality of stereotactic radiosurgery (SRS) to multiple brain metastases (MBM) between UK and other international centres.
    Methods and materials: Six centres from the UK and nineteen from other international centres autoplanned using Multiple Brain Mets™ (AutoMBM; Brainlab, Munich, Germany) software for a five MBM study case from a prior planning competition that was originally organized by the Trans-Tasmania Radiation Oncology Group (TROG). Twenty-three dosimetric metrics and the resulting composite plan score per the TROG planning competition were compared between the UK and other international centres. Planning experience and planning time from each planner were recorded and statistically compared.
    Results: Planning experiences between two groups are equal. Except for mean dose to the hippocampus, all other 22 dosimetric metrics were comparable between two groups. The inter-planner variations in these 23 dosimetric metrics and the composite plan score were also statistically equivalent. Planning time is slightly longer in the UK group (mean = 86.8 min) with a mean difference of 50.3 min.
    Conclusions: AutoMBM effectively achieves standardization of the plan quality of SRS to MBM within UK and further against the other international centres. Significant planning efficiency gain by AutoMBM both among the UK and other international centres may help to increase the capacity of SRS service by alleviating the clinical and technical loadings.
    MeSH term(s) Radiosurgery/methods ; Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted/methods ; Automation ; United Kingdom
    Language English
    Publishing date 2023-05-18
    Publishing country England
    Document type Journal Article
    ZDB-ID 1181080-4
    ISSN 1873-4030 ; 1350-4533
    ISSN (online) 1873-4030
    ISSN 1350-4533
    DOI 10.1016/j.medengphy.2023.103996
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  2. Article ; Online: Correction to: Comparison of 3D and 4D Monte Carlo optimization in robotic tracking stereotactic body radiotherapy of lung cancer.

    Chan, Mark K H / Werner, Rene / Ayadi, Miriam / Blanck, Oliver

    Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al

    2022  Volume 198, Issue 10, Page(s) 958

    Language English
    Publishing date 2022-06-27
    Publishing country Germany
    Document type Published Erratum
    ZDB-ID 84983-2
    ISSN 1439-099X ; 0179-7158 ; 0039-2073
    ISSN (online) 1439-099X
    ISSN 0179-7158 ; 0039-2073
    DOI 10.1007/s00066-022-01967-6
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  3. Article ; Online: In Reply to Oskan.

    Moustakis, Christos / Eich, Hans Theodor / Blanck, Oliver / Chan, Mark K H / Boda-Heggemann, Judit / Andratschke, Nicolaus / Schmitt, Daniela

    International journal of radiation oncology, biology, physics

    2022  Volume 114, Issue 2, Page(s) 374–375

    Language English
    Publishing date 2022-08-12
    Publishing country United States
    Document type Letter
    ZDB-ID 197614-x
    ISSN 1879-355X ; 0360-3016
    ISSN (online) 1879-355X
    ISSN 0360-3016
    DOI 10.1016/j.ijrobp.2022.06.061
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  4. Article ; Online: Investigation of four-dimensional (4D) Monte Carlo dose calculation in real-time tumor tracking stereotatic body radiotherapy for lung cancers.

    Chan, Mark K H / Kwong, Dora L W / Ng, Sherry C Y / Tam, Eric K W / Tong, Anthony S M

    Medical physics

    2022  

    Abstract: Purpose: To investigate the dosimetric variations and radiobiological impacts as a consequence of delivering treatment plans of 3D nature in 4D manner based on the 4D Monte Carlo treatment planning framework implemented on Cyberknife.: Methods and ... ...

    Abstract Purpose: To investigate the dosimetric variations and radiobiological impacts as a consequence of delivering treatment plans of 3D nature in 4D manner based on the 4D Monte Carlo treatment planning framework implemented on Cyberknife.
    Methods and materials: Dose distributions were optimized on reference 3D images at end of exhale phase of a 4DCT dataset for twenty-five lung cancer patients treated with 60 Gy / 3Fx or 48 Gy / 4Fx. Deformable image registrations (DIR) between individual 3DCT images to the reference 3DCT image in the 4DCT study were performed to interpolate doses calculated on multiple anatomical geometries back on to the reference geometry to compose a 4D dose distribution that included the tracking beam motion and organ deformation. The 3D and 4D dose distributions that were initially calculated with the equivalent path-length (EPL) algorithm (3D
    Results: Comparing 4D
    Conclusion: The large discrepancy between original 3D
    Language English
    Publishing date 2022-09-15
    Publishing country United States
    Document type Journal Article
    ZDB-ID 188780-4
    ISSN 2473-4209 ; 0094-2405
    ISSN (online) 2473-4209
    ISSN 0094-2405
    DOI 10.1002/mp.15815
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  5. Article ; Online: Linking dose delivery accuracy and planning target margin in radiosurgery based on dose-volume histograms derived from measurement-guided dose reconstruction.

    Chan, Mark K H / Leung, Ronnie W K / Lee, Venus W Y / Wong, Matthew Y P / Chiang, Chi-Leung / Law, Gilbert M L / Blanck, Oliver

    Physics in medicine and biology

    2019  Volume 64, Issue 4, Page(s) 45009

    Abstract: In radiosurgery (SRS), the geometric uncertainties of machine-related delivery including image-guidance and hence the planning target volume (PTV) are often evaluated by the end-to-end gamma (γ) comparison that carries no information about the clinical ... ...

    Abstract In radiosurgery (SRS), the geometric uncertainties of machine-related delivery including image-guidance and hence the planning target volume (PTV) are often evaluated by the end-to-end gamma (γ) comparison that carries no information about the clinical relevance of deviations of individual SRS plans during delivery quality assurance (DQA). A proof-of-concept method was proposed to derive the PTV against both the plan- and the machine-specific delivery errors directly from the clinically relevant dose-volume histograms (DVHs) using measured-guided dose reconstruction (MGDR) during DQA. A liquid-filled detector array and a rotating phantom were used to measure sixteen arc-based radiosurgery treatments with 1 and 2 mm gross tumor volume (GTV)-to-PTV margins, producing MGDR-3D dose distribution on both the phantom and the patient CT for γ index and clinical DVH evaluations, respectively. The PTV was considered optimal when the MGDR showed the desired prescription dose coverage (V
    MeSH term(s) Arteriovenous Malformations/pathology ; Arteriovenous Malformations/surgery ; Humans ; Meningeal Neoplasms/pathology ; Meningeal Neoplasms/surgery ; Meningioma/pathology ; Meningioma/surgery ; Neuroma, Acoustic/pathology ; Neuroma, Acoustic/surgery ; Phantoms, Imaging ; Radiosurgery/methods ; Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted/methods ; Radiotherapy, Intensity-Modulated/methods ; Surgery, Computer-Assisted/methods
    Language English
    Publishing date 2019-02-11
    Publishing country England
    Document type Journal Article
    ZDB-ID 208857-5
    ISSN 1361-6560 ; 0031-9155
    ISSN (online) 1361-6560
    ISSN 0031-9155
    DOI 10.1088/1361-6560/aafd47
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    Zs.A 199: Show issues Location:
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  6. Article ; Online: Comparison of 3D and 4D Monte Carlo optimization in robotic tracking stereotactic body radiotherapy of lung cancer.

    Chan, Mark K H / Werner, Rene / Ayadi, Miriam / Blanck, Oliver

    Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al

    2014  Volume 191, Issue 2, Page(s) 161–171

    Abstract: Purpose: To investigate the adequacy of three-dimensional (3D) Monte Carlo (MC) optimization (3DMCO) and the potential of four-dimensional (4D) dose renormalization (4DMCrenorm) and optimization (4DMCO) for CyberKnife (Accuray Inc., Sunnyvale, CA) ... ...

    Abstract Purpose: To investigate the adequacy of three-dimensional (3D) Monte Carlo (MC) optimization (3DMCO) and the potential of four-dimensional (4D) dose renormalization (4DMCrenorm) and optimization (4DMCO) for CyberKnife (Accuray Inc., Sunnyvale, CA) radiotherapy planning in lung cancer.
    Materials and methods: For 20 lung tumors, 3DMCO and 4DMCO plans were generated with planning target volume (PTV5 mm) = gross tumor volume (GTV) plus 5 mm, assuming 3 mm for tracking errors (PTV3 mm) and 2 mm for residual organ deformations. Three fractions of 60 Gy were prescribed to ≥ 95 % of the PTV5 mm. Each 3DMCO plan was recalculated by 4D MC dose calculation (4DMCrecal) to assess the dosimetric impact of organ deformations. The 4DMCrecal plans were renormalized (4DMCrenorm) to 95 % dose coverage of the PTV5 mm for comparisons with the 4DMCO plans. A 3DMCO plan was considered adequate if the 4DMCrecal plan showed ≥ 95 % of the PTV3 mm receiving 60 Gy and doses to other organs at risk (OARs) were below the limits.
    Results: In seven lesions, 3DMCO was inadequate, providing < 95 % dose coverage to the PTV3 mm. Comparison of 4DMCrecal and 3DMCO plans showed that organ deformations resulted in lower OAR doses. Renormalizing the 4DMCrecal plans could produce OAR doses higher than the tolerances in some 4DMCrenorm plans. Dose conformity of the 4DMCrenorm plans was inferior to that of the 3DMCO and 4DMCO plans. The 4DMCO plans did not always achieve OAR dose reductions compared to 3DMCO and 4DMCrenorm plans.
    Conclusion: This study indicates that 3DMCO with 2 mm margins for organ deformations may be inadequate for Cyberknife-based lung stereotactic body radiotherapy (SBRT). Renormalizing the 4DMCrecal plans could produce degraded dose conformity and increased OAR doses; 4DMCO can resolve this problem.
    MeSH term(s) Four-Dimensional Computed Tomography/methods ; Humans ; Imaging, Three-Dimensional/methods ; Lung Neoplasms/pathology ; Lung Neoplasms/surgery ; Monte Carlo Method ; Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted/methods ; Radiotherapy, Conformal/methods ; Robotics ; Tumor Burden
    Language English
    Publishing date 2014-09-20
    Publishing country Germany
    Document type Comparative Study ; Journal Article
    ZDB-ID 84983-2
    ISSN 1439-099X ; 0179-7158 ; 0039-2073
    ISSN (online) 1439-099X
    ISSN 0179-7158 ; 0039-2073
    DOI 10.1007/s00066-014-0747-5
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  7. Article ; Online: Palliative Liver Radiotherapy (RT) for Symptomatic Hepatocellular Carcinoma (HCC).

    Yeung, Cynthia S Y / Chiang, C L / Wong, Natalie S M / Ha, S K / Tsang, K S / Ho, Connie H M / Wang, B / Lee, Venus W Y / Chan, Mark K H / Lee, Francis A S

    Scientific reports

    2020  Volume 10, Issue 1, Page(s) 1254

    Abstract: This study aims at evaluating the symptom response, response duration, and toxicity of single dose palliative liver radiotherapy (RT) for symptomatic HCC patients. We reviewed unresectable HCC patients treated with palliative RT in our institution. ... ...

    Abstract This study aims at evaluating the symptom response, response duration, and toxicity of single dose palliative liver radiotherapy (RT) for symptomatic HCC patients. We reviewed unresectable HCC patients treated with palliative RT in our institution. Eligible patients were unsuitable or refractory to trans-arterial chemoembolization (TACE) and stereotactic body radiotherapy (SBRT), with an index symptom of pain or abdominal discomfort. The primary outcome was the percentage of patients with clinical improvement of index symptom at 1 month. Secondary outcomes were response duration, toxicities, alpha-feto protein (AFP) response, and radiological response. Fifty-two patients were included in the study. The index symptom was pain in 34 patients (65.4%), and abdominal discomfort (34.6%) in 18 patients. At 1 month, 51.9% of patients had improvement of symptoms. Median time to symptom progression was 89 days (range: 12-392 days). Treatment was well tolerated with only 2 patients (3.8%) developing grade 3 GI toxicities. AFP response, radiological response rate, and disease control rate at 3 months were 48.6%, 15.1%, and 54.5% respectively. Half of the patients had improvement of index symptoms after receiving palliative liver RT with median response duration of 3 months. The treatment was well tolerated with minimal toxicities.
    MeSH term(s) Aged ; Carcinoma, Hepatocellular/pathology ; Carcinoma, Hepatocellular/radiotherapy ; Female ; Humans ; Liver Neoplasms/pathology ; Liver Neoplasms/radiotherapy ; Male ; Middle Aged ; Palliative Care/methods ; Radiotherapy/methods ; Radiotherapy Dosage ; Severity of Illness Index ; Survival Analysis ; Treatment Outcome
    Language English
    Publishing date 2020-01-27
    Publishing country England
    Document type Journal Article
    ZDB-ID 2615211-3
    ISSN 2045-2322 ; 2045-2322
    ISSN (online) 2045-2322
    ISSN 2045-2322
    DOI 10.1038/s41598-020-58108-1
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  8. Article ; Online: Tumor-dose-rate variations during robotic radiosurgery of oligo and multiple brain metastases.

    Wilhelm, Maria-Lisa / Chan, Mark K H / Abel, Benedikt / Cremers, Florian / Siebert, Frank-Andre / Wurster, Stefan / Krug, David / Wolff, Robert / Dunst, Jürgen / Hildebrandt, Guido / Schweikard, Achim / Rades, Dirk / Ernst, Floris / Blanck, Oliver

    Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al

    2020  Volume 197, Issue 7, Page(s) 581–591

    Abstract: Purpose: For step-and-shoot robotic stereotactic radiosurgery (SRS) the dose delivered over time, called local tumor-dose-rate (TDR), may strongly vary during treatment of multiple lesions. The authors sought to evaluate technical parameters influencing ...

    Abstract Purpose: For step-and-shoot robotic stereotactic radiosurgery (SRS) the dose delivered over time, called local tumor-dose-rate (TDR), may strongly vary during treatment of multiple lesions. The authors sought to evaluate technical parameters influencing TDR and correlate TDR to clinical outcome.
    Material and methods: A total of 23 patients with 162 oligo (1-3) and multiple (>3) brain metastases (OBM/MBM) treated in 33 SRS sessions were retrospectively analyzed. Median PTV were 0.11 cc (0.01-6.36 cc) and 0.50 cc (0.12-3.68 cc) for OBM and MBM, respectively. Prescription dose ranged from 16 to 20 Gy prescribed to the median 70% isodose line. The maximum dose-rate for planning target volume (PTV) percentage p in time span s during treatment (TDR
    Results: TDR
    Conclusions: Large TDR variations are noted during MBM-SRS which mainly arise from prolonged treatment times. Clinically, low TDR corresponded with decreased local tumor responses, although the main influencing factor was concomitant medication.
    MeSH term(s) Brain Neoplasms/radiotherapy ; Brain Neoplasms/surgery ; Humans ; Radiation Dosage ; Radiosurgery/methods ; Retrospective Studies ; Robotic Surgical Procedures/methods ; Treatment Outcome ; Tumor Burden/radiation effects
    Language English
    Publishing date 2020-06-25
    Publishing country Germany
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 84983-2
    ISSN 1439-099X ; 0179-7158 ; 0039-2073
    ISSN (online) 1439-099X
    ISSN 0179-7158 ; 0039-2073
    DOI 10.1007/s00066-020-01652-6
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  9. Article ; Online: Quantifying variability of intrafractional target motion in stereotactic body radiotherapy for lung cancers.

    Chan, Mark K H / Kwong, Dora L W / Tam, Eric / Tong, Anthony / Ng, Sherry C Y

    Journal of applied clinical medical physics

    2013  Volume 14, Issue 5, Page(s) 140–152

    Abstract: In lung stereotactic body radiotherapy (SBRT), variability of intrafractional target motion can negate the potential benefits of four-dimensional (4D) treatment planning that aims to account for the dosimetric impacts of organ motion. This study used ... ...

    Abstract In lung stereotactic body radiotherapy (SBRT), variability of intrafractional target motion can negate the potential benefits of four-dimensional (4D) treatment planning that aims to account for the dosimetric impacts of organ motion. This study used tumor motion data obtained from CyberKnife SBRT treatments to quantify the reproducibility of probability motion function (pmf) of 37 lung tumors. The reproducibility of pmf was analyzed with and without subtracting the intrafractional baseline drift from the original motion data. Statistics of intrafractional tumor motion including baseline drift, target motion amplitude and period, were also calculated. The target motion amplitude significantly correlates with variations (1SD) of motion amplitude and baseline drift. Significant correlation between treatment time and variations (1 SD) of motion amplitude was observed in anterior-posterior (AP) motion, but not in craniocaudal (CC) and left-right (LR) motion. The magnitude of AP and LR baseline drifts significantly depend on the treatment time, while the CC baseline drift does not. The reproducibility of pmf as a function of time can be well described by a two-exponential function with a fast and slow component. The reproducibility of pmf is over 60% for the CC motion and over 50% for the AP and LR motions when baseline variations were subtracted from the original motion data. It decreases to just over 30% for the CC motion and about 20% for the AP and LR motion, otherwise. 4D planning has obvious limitations due to variability of intrafractional target motion. To account for potential risks of overdosing critical organs, it is important to simulate the dosimetric impacts of intra- and interfractional baseline drift using population statistics obtained from SBRT treatments.
    MeSH term(s) Algorithms ; Four-Dimensional Computed Tomography ; Humans ; Lung Neoplasms/diagnostic imaging ; Lung Neoplasms/surgery ; Movement ; Organs at Risk/radiation effects ; Radiosurgery ; Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted ; Tumor Burden
    Language English
    Publishing date 2013-09-06
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2010347-5
    ISSN 1526-9914 ; 1526-9914
    ISSN (online) 1526-9914
    ISSN 1526-9914
    DOI 10.1120/jacmp.v14i5.4319
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  10. Article ; Online: Evaluation of dose prediction error and optimization convergence error in four-dimensional inverse planning of robotic stereotactic lung radiotherapy.

    Chan, Mark K H / Kwong, Dora L W / Tong, Anthony / Tam, Eric / Ng, Sherry C Y

    Journal of applied clinical medical physics

    2013  Volume 14, Issue 4, Page(s) 4270

    Abstract: Inverse optimization of robotic stereotactic lung radiotherapy is typically performed using relatively simple dose calculation algorithm on a single instance of breathing geometry. Variations of patient geometry and tissue density during respiration ... ...

    Abstract Inverse optimization of robotic stereotactic lung radiotherapy is typically performed using relatively simple dose calculation algorithm on a single instance of breathing geometry. Variations of patient geometry and tissue density during respiration could reduce the dose accuracy of these 3D optimized plans. To quantify the potential benefits of direct four-dimensional (4D) optimization in robotic lung radiosurgery, 4D optimizations using 1) ray-tracing algorithm with equivalent path-length heterogeneity correction (4EPL(opt)), and 2) Monte Carlo (MC) algorithm (4MC(opt)), were performed in 25 patients. The 4EPL(opt) plans were recalculated using MC algorithm (4MC(recal)) to quantify the dose prediction errors (DPEs). Optimization convergence errors (OCEs) were evaluated by comparing the 4MC(recal) and 4MC(opt) dose results. The results were analyzed by dose-volume histogram indices for selected organs. Statistical equivalence tests were performed to determine the clinical significance of the DPEs and OCEs, compared with a 3% tolerance. Statistical equivalence tests indicated that the DPE and the OCE are significant predominately in GTV D98%. The DPEs in V20 of lung, and D2% of cord, trachea, and esophagus are within 1.2%, while the OCEs are within 10.4% in lung V20 and within 3.5% in trachea D2%. The marked DPE and OCE suggest that 4D MC optimization is important to improve the dosimetric accuracy in robotic-based stereotactic body radiotherapy, despite the longer computation time.
    MeSH term(s) Algorithms ; Four-Dimensional Computed Tomography ; Humans ; Lung Neoplasms/diagnostic imaging ; Lung Neoplasms/radiotherapy ; Lung Neoplasms/surgery ; Monte Carlo Method ; Radiosurgery/statistics & numerical data ; Radiotherapy Planning, Computer-Assisted/statistics & numerical data ; Radiotherapy, Intensity-Modulated/statistics & numerical data ; Robotics
    Language English
    Publishing date 2013-07-08
    Publishing country United States
    Document type Evaluation Study ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2010347-5
    ISSN 1526-9914 ; 1526-9914
    ISSN (online) 1526-9914
    ISSN 1526-9914
    DOI 10.1120/jacmp.v14i4.4270
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