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  1. Article ; Online: Uncertainty in magnetic resonance imaging-based prostate postimplant dosimetry: Results of a 10-person human observer study, and comparisons with automatic postimplant dosimetry.

    Sanders, Jeremiah W / Tang, Chad / Kudchadker, Rajat J / Venkatesan, Aradhana M / Mok, Henry / Hanania, Alexander N / Thames, Howard D / Bruno, Teresa L / Starks, Christine / Santiago, Edwin / Cunningham, Mandy / Frank, Steven J

    Brachytherapy

    2023  Volume 22, Issue 6, Page(s) 822–832

    Abstract: Purpose: Uncertainties in postimplant quality assessment (QA) for low-dose-rate prostate brachytherapy (LDRPBT) are introduced at two steps: seed localization and contouring. We quantified how interobserver variability (IoV) introduced in both steps ... ...

    Abstract Purpose: Uncertainties in postimplant quality assessment (QA) for low-dose-rate prostate brachytherapy (LDRPBT) are introduced at two steps: seed localization and contouring. We quantified how interobserver variability (IoV) introduced in both steps impacts dose-volume-histogram (DVH) parameters for MRI-based LDRPBT, and compared it with automatically derived DVH parameters.
    Methods and materials: Twenty-five patients received MRI-based LDRPBT. Seven clinical observers contoured the prostate and four organs at risk, and 4 dosimetrists performed seed localization, on each MRI. Twenty-eight unique manual postimplant QAs were created for each patient from unique observer pairs. Reference QA and automatic QA were also performed for each patient. IoV of prostate, rectum, and external urinary sphincter (EUS) DVH parameters owing to seed localization and contouring was quantified with coefficients of variation. Automatically derived DVH parameters were compared with those of the reference plans.
    Results: Coefficients of variation (CoVs) owing to contouring variability (CoV
    Conclusions: Seed localization introduces substantially less variability in postimplant QA than does contouring for MRI-based LDRPBT. While automatic seed localization may potentially help improve workflow efficiency, it has limited potential for improving the consistency and quality of postimplant dosimetry.
    MeSH term(s) Male ; Humans ; Prostate/diagnostic imaging ; Prostate/pathology ; Prostatic Neoplasms/diagnostic imaging ; Prostatic Neoplasms/radiotherapy ; Prostatic Neoplasms/pathology ; Uncertainty ; Brachytherapy/methods ; Radiotherapy Dosage ; Tomography, X-Ray Computed/methods ; Magnetic Resonance Imaging/methods
    Language English
    Publishing date 2023-09-15
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2098608-7
    ISSN 1873-1449 ; 1538-4721
    ISSN (online) 1873-1449
    ISSN 1538-4721
    DOI 10.1016/j.brachy.2023.08.001
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Fully Balanced SSFP Without an Endorectal Coil for Postimplant QA of MRI-Assisted Radiosurgery (MARS) of Prostate Cancer: A Prospective Study.

    Sanders, Jeremiah W / Venkatesan, Aradhana M / Levitt, Chad A / Bathala, Tharakeswara / Kudchadker, Rajat J / Tang, Chad / Bruno, Teresa L / Starks, Christine / Santiago, Edwin / Wells, Michelle / Weaver, Carl P / Ma, Jingfei / Frank, Steven J

    International journal of radiation oncology, biology, physics

    2020  Volume 109, Issue 2, Page(s) 614–625

    Abstract: Purpose: To investigate fully balanced steady-state free precession (bSSFP) with optimized acquisition protocols for magnetic resonance imaging (MRI)-based postimplant quality assessment of low-dose-rate (LDR) prostate brachytherapy without an ... ...

    Abstract Purpose: To investigate fully balanced steady-state free precession (bSSFP) with optimized acquisition protocols for magnetic resonance imaging (MRI)-based postimplant quality assessment of low-dose-rate (LDR) prostate brachytherapy without an endorectal coil (ERC).
    Methods and materials: Seventeen patients at a major academic cancer center who underwent MRI-assisted radiosurgery (MARS) LDR prostate cancer brachytherapy were imaged with moderate, high, or very high spatial resolution fully bSSFP MRIs without using an ERC. Between 1 and 3 signal averages (NEX) were acquired with acceleration factors (R) between 1 and 2, with the goal of keeping scan times between 4 and 6 minutes. Acquisitions with R >1 were reconstructed with parallel imaging and compressed sensing (PICS) algorithms. Radioactive seeds were identified by 3 medical dosimetrists. Additionally, some of the MRI techniques were implemented and tested at a community hospital; 3 patients underwent MARS LDR prostate brachytherapy and were imaged without an ERC.
    Results: Increasing the in-plane spatial resolution mitigated partial volume artifacts and improved overall seed and seed marker visualization at the expense of reduced signal-to-noise ratio (SNR). The reduced SNR as a result of imaging at higher spatial resolution and without an ERC was partially compensated for by the multi-NEX acquisitions enabled by PICS. Resultant image quality was superior to the current clinical standard. All 3 dosimetrists achieved near-perfect precision and recall for seed identification in the 17 patients. The 3 postimplant MRIs acquired at the community hospital were sufficient to identify 208 out of 211 seeds implanted without reference to computed tomography (CT).
    Conclusions: Acquiring postimplant prostate brachytherapy MRI without an ERC has several advantages including better patient tolerance, lower costs, higher clinical throughput, and widespread access to precision LDR prostate brachytherapy. This prospective study confirms that the use of an ERC can be circumvented with fully bSSFP and advanced MRI scan techniques in a major academic cancer center and community hospital, potentially enabling postimplant assessment of MARS LDR prostate brachytherapy without CT.
    MeSH term(s) Brachytherapy/instrumentation ; Humans ; Magnetic Resonance Imaging ; Male ; Prospective Studies ; Prostatic Neoplasms/diagnostic imaging ; Prostatic Neoplasms/radiotherapy ; Radiosurgery/instrumentation ; Radiotherapy Dosage ; Radiotherapy, Image-Guided/instrumentation ; Rectum ; Signal-To-Noise Ratio
    Language English
    Publishing date 2020-09-24
    Publishing country United States
    Document type Clinical Trial ; Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 197614-x
    ISSN 1879-355X ; 0360-3016
    ISSN (online) 1879-355X
    ISSN 0360-3016
    DOI 10.1016/j.ijrobp.2020.09.040
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 1218: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  3. Article ; Online: Can cost make a difference dosimetrically? Volumetric modulated arc therapy study for multileaf collimators of various widths for head and neck and prostate cancers.

    Ho, Jong-Han / Hagler, Shane / Lujano, Carrie / Seng, Sopaul / Starks, Christine / Perrin, Kelly / Turner, Lehendrick / Court, Laurence

    Medical dosimetry : official journal of the American Association of Medical Dosimetrists

    2017  Volume 42, Issue 1, Page(s) 12–17

    Abstract: Cancer is a global health issue that disproportionately kills based on stage of disease, cellular pathology, and genetics, to name a few. Another variable to consider in this ongoing fight is treatment machine complexity that leads to elevated ... ...

    Abstract Cancer is a global health issue that disproportionately kills based on stage of disease, cellular pathology, and genetics, to name a few. Another variable to consider in this ongoing fight is treatment machine complexity that leads to elevated development and purchasing cost, leading to a reduced use. Reducing the complexity (in hopes of lowering costs) would benefit underdeveloped, low- and middle-income countries by introducing newer treatment technology, as their currently accepted standards do not meet standards of more advanced, developed countries. In this study, unilateral head and neck (H&N), and prostate cases using volumetric modulated arc therapy (VMAT) were tested with multiple segment widths of 5, 10, 15, and 20mm to create treatable plans. Pinnacle 9.10v was used for planning purposes. A total of 12 cases were planned with varying multileaf collimator (MLC) widths. Treatment plans were evaluated retrospectively. Results show that altering the MLC widths from 5 through 20mm produces both comparable and treatable plans up to 99% and 98% target coverage for H&N and prostate, respectively, albeit clinically significant hot spots were shown to increase with increasing segment width. Furthermore, the results show that increasing widths can produce comparable treatment plans as measured against our current Food and Drug Administration (FDA)-approved treatment devices-leading to an increase in treatment efficacy in economically underdeveloped countries.
    MeSH term(s) Head and Neck Neoplasms/radiotherapy ; Humans ; Male ; Organ Sparing Treatments ; Prostatic Neoplasms/radiotherapy ; Radiation Injuries/prevention & control ; Radiotherapy, Intensity-Modulated/economics ; Radiotherapy, Intensity-Modulated/instrumentation ; Retrospective Studies
    Language English
    Publishing date 2017
    Publishing country United States
    Document type Comparative Study ; Journal Article
    ZDB-ID 645065-9
    ISSN 1873-4022 ; 0958-3947 ; 0739-0211
    ISSN (online) 1873-4022
    ISSN 0958-3947 ; 0739-0211
    DOI 10.1016/j.meddos.2016.10.001
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 2448: Show issues Location:
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    Jg. 1995 - 2021: Lesesall (2.OG)
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  4. Article ; Online: Clinical utility and value contribution of an MRI-positive line marker for image-guided brachytherapy in gynecologic malignancies.

    Ning, Matthew S / Vedam, Sastry / Ma, Jingfei / Stafford, R Jason / Bruno, Teresa L / Cunningham, Mandy / Starks, Christine / Lawyer, Ann / Venkatesan, Aradhana M / Wang, Li / Wang, Jihong / Olivieri, Nicholas D / Guzman, Alexis B / Incalcaterra, James R / Thaker, Nikhil G / Joyner, Melissa M / Lin, Lilie L / Jhingran, Anuja / Eifel, Patricia J /
    Klopp, Ann H

    Brachytherapy

    2020  Volume 19, Issue 3, Page(s) 305–315

    Abstract: Purpose: The purpose of this study was to investigate the utility of a novel MRI-positive line marker, composed of C4:S (cobalt chloride-based contrast agent) encapsulated in high-density polyethylene tubing, in permitting dosimetry and treatment ... ...

    Abstract Purpose: The purpose of this study was to investigate the utility of a novel MRI-positive line marker, composed of C4:S (cobalt chloride-based contrast agent) encapsulated in high-density polyethylene tubing, in permitting dosimetry and treatment planning directly on MRI.
    Methods and materials: We evaluated the clinical feasibility of the C4:S line markers in nine sequential brachytherapy procedures for gynecologic malignancies, including six tandem-and-ovoid and three interstitial cases. We then quantified the internal resource utilization of an intraoperative MRI-guided procedural episode via time-driven activity-based costing, identifying opportunities for cost-containment with use of the C4:S line markers.
    Results: The C4:S line markers demonstrated the strongest positive signal visibility on 3D constructive interference in steady state (CISS)/FIESTA-C followed by T1-weighted sequences, permitting accurate delineation of the applicator lumen and thus the source path. These images may be fused along with traditional T2-weighted sequences for optimal tumor and anatomy contouring, followed by treatment planning directly on MRI. By eliminating postoperative CT for fusion and applicator registration from the procedural episode, use of the C4:S line markers could decrease workflow time and lower total delivery costs per procedure.
    Conclusions: This analysis supports the clinical utility and value contribution of the C4:S line markers, which permit accurate MRI-based dosimetry and treatment planning, thereby eliminating the need for postoperative CT for fusion and applicator registration.
    MeSH term(s) Brachytherapy/economics ; Cobalt ; Contrast Media ; Cost Control ; Female ; Genital Neoplasms, Female/diagnostic imaging ; Genital Neoplasms, Female/radiotherapy ; Humans ; Magnetic Resonance Imaging ; Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted/economics ; Radiotherapy Planning, Computer-Assisted/methods
    Chemical Substances Contrast Media ; Cobalt (3G0H8C9362) ; cobaltous chloride (EVS87XF13W)
    Language English
    Publishing date 2020-04-04
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 2098608-7
    ISSN 1873-1449 ; 1538-4721
    ISSN (online) 1873-1449
    ISSN 1538-4721
    DOI 10.1016/j.brachy.2019.12.005
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 6116: Show issues Location:
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