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Article: Imaging Strategies in Proton Therapy for Thoracic Tumors: A Mini Review.

Algranati, Carlo / Strigari, Lidia

2022 Volume 12, Page(s) 833364

Abstract: Proton beam therapy (PBT) is often more attractive for its high gradient dose distributions than other treatment modalities with external photon beams. However, in thoracic lesions treated particularly with pencil beam scanning (PBS) proton beams, ... ...

Abstract	Proton beam therapy (PBT) is often more attractive for its high gradient dose distributions than other treatment modalities with external photon beams. However, in thoracic lesions treated particularly with pencil beam scanning (PBS) proton beams, several dosimetric issues are addressed. The PBS approach may lead to large hot or cold spots in dose distributions delivered to the patients, potentially affecting the tumor control and/or increasing normal tissue side effects. This delivery method particularly benefits image-guided approaches. Our paper aims at reviewing imaging strategies and their technological trends for PBT in thoracic lesions. The focus is on the use of imaging strategies in simulation, planning, positioning, adaptation, monitoring, and delivery of treatment and how changes in the anatomy of thoracic tumors are handled with the available tools and devices in PBT. Starting from bibliographic research over the past 5 years, retrieving 174 papers, major key questions, and implemented solutions were identified and discussed; the results aggregated and presented following the methodology of analysis of expert interviews.
Language	English
Publishing date	2022-04-14
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2649216-7
ISSN	2234-943X
ISSN	2234-943X
DOI	10.3389/fonc.2022.833364
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Article ; Online: Evolution of Portable Sensors for In-Vivo Dose and Time-Activity Curve Monitoring as Tools for Personalized Dosimetry in Molecular Radiotherapy.

Strigari, Lidia / Marconi, Raffaella / Solfaroli-Camillocci, Elena

Sensors (Basel, Switzerland)

2023 Volume 23, Issue 5

Abstract: Treatment personalization in Molecular Radiotherapy (MRT) relies on pre- and post-treatment SPECT/ PET-based images and measurements to obtain a patient-specific absorbed dose-rate distribution map and its evolution over time. Unfortunately, the number ... ...

Abstract	Treatment personalization in Molecular Radiotherapy (MRT) relies on pre- and post-treatment SPECT/ PET-based images and measurements to obtain a patient-specific absorbed dose-rate distribution map and its evolution over time. Unfortunately, the number of time points that are available per patient to investigate individual pharmacokinetics is often reduced by limited patient compliance or SPECT or PET/CT scanner availability for dosimetry in busy departments. The adoption of portable sensors for in-vivo dose monitoring during the entire treatment could improve the assessment of individual biokinetics in MRT and, thus, the treatment personalization. The evolution of portable devices, non-SPECT/PET-based options, already used for monitoring radionuclide activity transit and accumulation during therapy with radionuclides (i.e., MRT or brachytherapy), is presented to identify valuable ones, which combined with conventional nuclear medicine imaging systems could be effective in MRT. External probes, integration dosimeters and active detecting systems were included in the study. The devices and their technology, the range of applications, the features and limitations are discussed. Our overview of the available technologies encourages research and development of portable devices and dedicated algorithms for MRT patient-specific biokinetics study. This would represent a crucial advancement towards personalized treatment in MRT.
MeSH term(s)	Humans ; Positron Emission Tomography Computed Tomography ; Radiotherapy Dosage ; Radiometry/methods ; Tomography, Emission-Computed, Single-Photon/methods ; Phantoms, Imaging
Language	English
Publishing date	2023-02-26
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2052857-7
ISSN	1424-8220 ; 1424-8220
ISSN (online)	1424-8220
ISSN	1424-8220
DOI	10.3390/s23052599
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Article ; Online: A CT deep learning reconstruction algorithm: Image quality evaluation for brain protocol at decreasing dose indexes in comparison with FBP and statistical iterative reconstruction algorithms.

Tomasi, Silvia / Szilagyi, Klarisa Elena / Barca, Patrizio / Bisello, Francesca / Spagnoli, Lorenzo / Domenichelli, Sara / Strigari, Lidia

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) 103319

Abstract: Purpose: To characterise the impact of Precise Image (PI) deep learning reconstruction algorithm on image quality, compared to filtered back-projection (FBP) and iDose: Methods: Catphan-600 phantom was acquired with an Incisive CT scanner using a ... ...

Abstract	Purpose: To characterise the impact of Precise Image (PI) deep learning reconstruction algorithm on image quality, compared to filtered back-projection (FBP) and iDose Methods: Catphan-600 phantom was acquired with an Incisive CT scanner using a dedicated brain protocol, at six different dose levels (volume computed tomography dose index (CTDI Results: The five PI levels did not significantly affect the mean CT number. For a given CTDI Conclusions: The improved performances of intermediate PI levels in brain protocols compared to conventional algorithms seem to suggest a potential reduction of CTDI
MeSH term(s)	Radiation Dosage ; Deep Learning ; Tomography, X-Ray Computed/methods ; Brain/diagnostic imaging ; Algorithms ; Phantoms, Imaging ; Radiographic Image Interpretation, Computer-Assisted/methods
Language	English
Publishing date	2024-02-28
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.2024.103319
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Article ; Online: "Image quality evaluation of the Precise image CT deep learning reconstruction algorithm compared to Filtered Back-projection and iDose

Barca, Patrizio / Domenichelli, Sara / Golfieri, Rita / Pierotti, Luisa / Spagnoli, Lorenzo / Tomasi, Silvia / Strigari, Lidia

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)

2023 Volume 106, Page(s) 102517

Abstract: Purpose: To characterize the performance of the Precise Image (PI) deep learning reconstruction (DLR) algorithm for abdominal Computed Tomography (CT) imaging.: Methods: CT images of the Catphan-600 phantom (equipped with an external annulus) were ... ...

Abstract	Purpose: To characterize the performance of the Precise Image (PI) deep learning reconstruction (DLR) algorithm for abdominal Computed Tomography (CT) imaging. Methods: CT images of the Catphan-600 phantom (equipped with an external annulus) were acquired using an abdominal protocol at four dose levels and reconstructed using FBP, iDose Results: The behavior of the PI algorithm depended strongly on the selected level of reconstruction. The phantom analysis suggested that the PI image noise decreased linearly by varying the level of reconstruction from Sharper to Smoother, expressing a noise reduction up to 80% with respect to FBP. Additionally, the non-uniformity decreased, the histograms became narrower, and d' values increased as PI reconstruction levels changed from Sharper to Smoother. PI had no significant impact on the average CT number of different contrast objects. The conventional FBP NPS was deeply altered only by Smooth and Smoother levels of reconstruction. Furthermore, spatial resolution was found to be dose- and contrast-dependent, but in each analyzed condition it was greater than or comparable to FBP and iDose Conclusions: The PI algorithm can reduce image noise with respect to FBP and iDose
MeSH term(s)	Deep Learning ; Radiation Dosage ; Tomography, X-Ray Computed/methods ; Phantoms, Imaging ; Algorithms ; Radiographic Image Interpretation, Computer-Assisted/methods ; Image Processing, Computer-Assisted/methods
Chemical Substances	idose (2152-76-3)
Language	English
Publishing date	2023-01-18
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.2022.102517
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Article ; Online: A single centre intercomparison between commercial treatment planning systems for

Della Gala, Giuseppe / Santoro, Miriam / Rasoatsaratanany, Garoson Albertine / Paolani, Giulia / Strolin, Silvia / Strigari, Lidia

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)

2023 Volume 116, Page(s) 103172

Abstract: Introduction: Dedicated Treatment Planning Systems (TPSs) were developed to personalize : Methods: A homogeneous (EH) and an anthropomorphic phantom with hot and cold inserts (EA) filled with : Results: Small (<2.1 %) and large (up to 42.4 %) ... ...

Abstract	Introduction: Dedicated Treatment Planning Systems (TPSs) were developed to personalize Methods: A homogeneous (EH) and an anthropomorphic phantom with hot and cold inserts (EA) filled with Results: Small (<2.1 %) and large (up to 42.4 %) relative volume differences were observed on large (>500 ml) and small VOIs, respectively. Mean absorbed doses relative differences were < 3 % except for small VOIs with steep dose gradients (up to 89.1 % in the VA Cold Sphere VOI). Within the same TPS, LDC negligibly affected the mean absorbed dose, while DKC and LDM showed differences up to 63 %. DHVs were mostly overlapped in experimental phantoms, with some differences in the virtual versions. Dose profiles agreed within 1 %. Conclusion: TPSs showed an overall good agreement except for small VOI volumes and mean absorbed doses of VOIs with steep dose gradients. These discrepancies should be considered in the dosimetry uncertainty assessment, thus requiring an appropriate harmonization.
MeSH term(s)	Humans ; Tomography, Emission-Computed, Single-Photon/methods ; Single Photon Emission Computed Tomography Computed Tomography ; Radiometry/methods ; Brachytherapy ; Phantoms, Imaging ; Yttrium Radioisotopes/therapeutic use ; Liver Neoplasms
Chemical Substances	Yttrium Radioisotopes
Language	English
Publishing date	2023-11-24
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.2023.103172
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Article ; Online: Efficient quality assurance for isocentric stability in stereotactic body radiation therapy using machine learning.

Salahuddin, Sana / Buzdar, Saeed Ahmad / Iqbal, Khalid / Azam, Muhammad Adeel / Strigari, Lidia

Radiological physics and technology

2023 Volume 17, Issue 1, Page(s) 219–229

Abstract: This study aims to predict isocentric stability for stereotactic body radiation therapy (SBRT) treatments using machine learning (ML), covers the challenges of manual assessment and computational time for quality assurance (QA), and supports medical ... ...

Abstract	This study aims to predict isocentric stability for stereotactic body radiation therapy (SBRT) treatments using machine learning (ML), covers the challenges of manual assessment and computational time for quality assurance (QA), and supports medical physicists to enhance accuracy. The isocentric parameters for collimator (C), gantry (G), and table (T) tests were conducted with the RUBY phantom during QA using TrueBeam linac for SBRT. This analysis combined statistical features from the IsoCheck EPID software. Five ML models, including logistic regression (LR), decision tree (DT), random forest (RF), naive Bayes (NB), and support vector machines (SVM), were used to predict the outcome of the QA procedure. 247 Winston-Lutz (WL) tests were collected from 2020 to 2022. In our study, both DT and RF achieved the highest score on test accuracy (Acc. test) ranging from 93.5% to 99.4%, and area under curve (AUC) values from 90 to 100% on three modes (C, G, and T). The precision, recall, and F1 scores indicate the DT model consistently outperforms other ML models in predicting isocenter stability deviation in QA. The QA assessment using ML models can assist error prediction early to avoid potential harm during SBRT and ensure safe and effective patient treatments.
MeSH term(s)	Humans ; Radiosurgery/methods ; Bayes Theorem ; Particle Accelerators ; Software ; Machine Learning
Language	English
Publishing date	2023-12-31
Publishing country	Japan
Document type	Journal Article
ZDB-ID	2433581-2
ISSN	1865-0341 ; 1865-0333
ISSN (online)	1865-0341
ISSN	1865-0333
DOI	10.1007/s12194-023-00768-5
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Article ; Online: Dose-Effects Models for Space Radiobiology: An Overview on Dose-Effect Relationships.

Strigari, Lidia / Strolin, Silvia / Morganti, Alessio Giuseppe / Bartoloni, Alessandro

Frontiers in public health

2021 Volume 9, Page(s) 733337

Abstract: Space radiobiology is an interdisciplinary science that examines the biological effects of ionizing radiation on humans involved in aerospace missions. The dose-effect models are one of the relevant topics of space radiobiology. Their knowledge is ... ...

Abstract	Space radiobiology is an interdisciplinary science that examines the biological effects of ionizing radiation on humans involved in aerospace missions. The dose-effect models are one of the relevant topics of space radiobiology. Their knowledge is crucial for optimizing radioprotection strategies (e.g., spaceship and lunar space station-shielding and lunar/Mars village design), the risk assessment of the health hazard related to human space exploration, and reducing damages induced to astronauts from galactic cosmic radiation. Dose-effect relationships describe the observed damages to normal tissues or cancer induction during and after space flights. They are developed for the various dose ranges and radiation qualities characterizing the actual and the forecast space missions [International Space Station (ISS) and solar system exploration]. Based on a Pubmed search including 53 papers reporting the collected dose-effect relationships after space missions or in ground simulations, 7 significant dose-effect relationships (e.g., eye flashes, cataract, central nervous systems, cardiovascular disease, cancer, chromosomal aberrations, and biomarkers) have been identified. For each considered effect, the absorbed dose thresholds and the uncertainties/limitations of the developed relationships are summarized and discussed. The current knowledge on this topic can benefit from further
MeSH term(s)	Astronauts ; Cosmic Radiation/adverse effects ; Humans ; Radiation Dosage ; Radiobiology
Language	English
Publishing date	2021-11-08
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2711781-9
ISSN	2296-2565 ; 2296-2565
ISSN (online)	2296-2565
ISSN	2296-2565
DOI	10.3389/fpubh.2021.733337
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Article ; Online: A scoping review on the "burned out" or "burnt out" testicular cancer: When a rare phenomenon deserves more attention.

Iannantuono, Giovanni Maria / Strigari, Lidia / Roselli, Mario / Torino, Francesco

Critical reviews in oncology/hematology

2021 Volume 165, Page(s) 103452

Abstract: The "burned out" or "burnt out" testicular cancer (BTC) indicates the spontaneous and complete regression of a testicular germ cell tumor in the presence of distant metastases at the diagnosis. As this condition was never reviewed systematically, a ... ...

Abstract	The "burned out" or "burnt out" testicular cancer (BTC) indicates the spontaneous and complete regression of a testicular germ cell tumor in the presence of distant metastases at the diagnosis. As this condition was never reviewed systematically, a scoping review was conducted to scrutinize the available literature on clinical and histological features of BTC patients. Medline was searched from inception to 19 April 2020. A virtual cohort of 68 BTC patients was generated. Our findings highlighted some inconsistencies: BTC was diagnosed in 5,9% of patients not showing distant metastases and in 2,9% of patients who did not undergo an orchiectomy. Besides, evidence of residual tumor was found in 22,7% of testis specimens, recognized as seminoma in 40% of cases. The emerged inconsistencies may derive from the lack of an unequivocal definition of BTC. Larger collaborative studies are needed to define the best diagnostic workup and treatment for BTC patients.
MeSH term(s)	Humans ; Male ; Neoplasms, Germ Cell and Embryonal/diagnosis ; Neoplasms, Germ Cell and Embryonal/epidemiology ; Neoplasms, Germ Cell and Embryonal/therapy ; Retroperitoneal Neoplasms ; Seminoma/diagnosis ; Seminoma/epidemiology ; Testicular Neoplasms/diagnosis ; Testicular Neoplasms/epidemiology ; Testicular Neoplasms/therapy
Language	English
Publishing date	2021-08-09
Publishing country	Netherlands
Document type	Journal Article ; Review
ZDB-ID	605680-5
ISSN	1879-0461 ; 0737-9587 ; 1040-8428
ISSN (online)	1879-0461
ISSN	0737-9587 ; 1040-8428
DOI	10.1016/j.critrevonc.2021.103452
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Article ; Online: Overview of commercial treatment planning systems for targeted radionuclide therapy.

Della Gala, Giuseppe / Bardiès, Manuel / Tipping, Jill / Strigari, Lidia

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)

2021 Volume 92, Page(s) 52–61

Abstract: Introduction: Targeted Radionuclide Therapy (TRT) is a branch of cancer medicine dealing with the therapeutic use of radioisotopes associated with biological vectors accumulating in the tumors/targets, indicated as Molecular Radiotherapy (MRT), or ... ...

Abstract	Introduction: Targeted Radionuclide Therapy (TRT) is a branch of cancer medicine dealing with the therapeutic use of radioisotopes associated with biological vectors accumulating in the tumors/targets, indicated as Molecular Radiotherapy (MRT), or directly injected into the arteries that supply blood to liver tumour vasculature, indicated as Selective RT (SRT). The aim of this work is to offer a panoramic view on the increasing number of commercially-available TRT treatment planning systems (TPSs). Materials and methods: A questionnaire was sent to manufacturers' representatives. Academic software were not considered. Questions were grouped as follows: general information, clinical workflow, calibration procedure, image processing/reconstruction, image registration and segmentation tools, time-activity curve (TAC) fitting and absorbed dose calculation. Results: All software reported have CE-marking. TPSs were divided between SRT-dedicated software [4] and MRT [5] dosimetry software. In SRT, since no kinetic process is involved, absorbed dose calculation does not require TAC fitting, and image registration is not fully developed in all TPS. All software requires a radionuclide-specific calibration. In SRT, a relative image calibration can be obtained by scaling the counts to a known activity. Automated VOI contouring and rigid/deformable propagation between different acquisitions time-points is implemented in most TPSs, although DICOM export is rare. Different TAC fits are available depending on the number of time-points. Voxel S-value and Local deposition methods are the most frequent dosimetric approaches; dose-voxel kernel convolution and semi-Monte Carlo method are also available. Conclusions: Available TPSs allows performing personalized dosimetry in clinical practice. Individual variations in methodology/algorithms must be considered in the standardisation/harmonization processes.
Language	English
Publishing date	2021-12-02
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.2021.11.001
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Article: Alpha-Emitter Radiopharmaceuticals and External Beam Radiotherapy: A Radiobiological Model for the Combined Treatment.

Sarnelli, Anna / Belli, Maria Luisa / Azzali, Irene / Loi, Emiliano / Severi, Stefano / Strigari, Lidia

Cancers

2022 Volume 14, Issue 4

Abstract: Previously published studies combined external beam radiotherapy (EBRT) treatments with different activities ... ...

Abstract	Previously published studies combined external beam radiotherapy (EBRT) treatments with different activities of
Language	English
Publishing date	2022-02-21
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2527080-1
ISSN	2072-6694
ISSN	2072-6694
DOI	10.3390/cancers14041077
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