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Article ; Online: Dosimetric variation in preoperative partial breast radiosurgery assessed by deformable image registrations.

Yoo, Sua / Blitzblau, Rachel / McDuff, Susan / Yin, Fang-Fang / Cui, Yunfeng

Journal of radiosurgery and SBRT

2023 Volume 8, Issue 3, Page(s) 227–235

Abstract: Objective: To assess dosimetric variation caused by breast deformation in breast radiosurgery based on deformable image registration.: Methods: This study included 30 patients who were treated in the prone position for preoperative partial breast ... ...

Abstract	Objective: To assess dosimetric variation caused by breast deformation in breast radiosurgery based on deformable image registration. Methods: This study included 30 patients who were treated in the prone position for preoperative partial breast radiosurgery. The biopsy clip in CBCT was aligned to the one from the planning CT. Deformable image registration (DIR) was performed to deform the planning CT into the CBCT, focusing on the breast shape. The treated plan (P Results: The mean differences of target volumes covered by 95% and 100% of the prescribed dose between P Conclusion: The treated plan was accurately recalculated based on the deformed CT. Despite slight variance in breast deformation, the dosimetric variation was very small, ensuring that adequate target coverage and skin dose were maintained during treatment as planned originally.
Language	English
Publishing date	2023-02-13
Publishing country	United States
Document type	Journal Article
ISSN	2156-4647
ISSN (online)	2156-4647
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Beyond Acceptable: The Vital Role of Medical Physicists in Ensuring High-Quality Treatment Plans.

Lin, Mu-Han / Olsen, Lindsey / Kavanaugh, James A / Jacqmin, Dustin / Lobb, Eric / Yoo, Sua / Berry, Sean L / Pichardo, Jose C / Cardenas, Carlos E / Roper, Justin / Kirk, Maura / Cheung, Joey P / Solberg, Timothy D / Moore, Kevin L / Kim, Minsun

Practical radiation oncology

2024 Volume 14, Issue 1, Page(s) 6–9

Language	English
Publishing date	2024-01-05
Publishing country	United States
Document type	Editorial
ZDB-ID	2655748-4
ISSN	1879-8519 ; 1879-8500
ISSN (online)	1879-8519
ISSN	1879-8500
DOI	10.1016/j.prro.2023.08.014
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Article ; Online: Accuracy and efficiency of image-guided radiation therapy (IGRT) for preoperative partial breast radiosurgery.

Yoo, Sua / O'Daniel, Jennifer / Blitzblau, Rachel / Yin, Fang-Fang / Horton, Janet K

Journal of radiosurgery and SBRT

2020 Volume 6, Issue 4, Page(s) 295–301

Abstract: Objective: To analyze and evaluate accuracy and efficiency of IGRT process for preoperative partial breast radiosurgery.: Methods: Patients were initially setup with skin marks and 5 steps were performed: (1) Initial orthogonal 2D kV images, (2) pre- ... ...

Abstract	Objective: To analyze and evaluate accuracy and efficiency of IGRT process for preoperative partial breast radiosurgery. Methods: Patients were initially setup with skin marks and 5 steps were performed: (1) Initial orthogonal 2D kV images, (2) pre-treatment 3D CBCT images, (3) verification orthogonal 2D kV images, (4) treatment including mid-treatment 2D kV images (for the final 15 patients only), and (5) post-treatment orthogonal 2D kV or 3D CBCT images. Patient position was corrected at each step to align the biopsy clip and to verify surrounding soft tissue positioning. Results: The mean combined vector magnitude shifts and standard deviations at the 5 imaging steps were (1) 0.96 ± 0.69, (2) 0.33 ± 0.40, (3) 0.05 ± 0.12, (4) 0.15 ± 0.17, and (5) 0.27 ± 0.24 in cm. The mean total IGRT time was 40.2 ± 13.2 minutes. Each step was shortened by 2 to 5 minutes with improvements implemented. Overall, improvements in the IGRT process reduced the mean total IGRT time by approximately 20 minutes. Clip visibility was improved by implementing oblique orthogonal images. Conclusion: Multiple imaging steps confirmed accurate patient positioning. Appropriate planning and imaging strategies improved the effectiveness and efficiency of the IGRT process for preoperative partial breast radiosurgery.
Language	English
Publishing date	2020-02-24
Publishing country	United States
Document type	Journal Article
ISSN	2156-4647
ISSN (online)	2156-4647
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Goal-Driven Beam Setting Optimization for Whole-Breast Radiation Therapy.

Wang, Wentao / Sheng, Yang / Yoo, Sua / Blitzblau, Rachel C / Yin, Fang-Fang / Wu, Q Jackie

Technology in cancer research & treatment

2019 Volume 18, Page(s) 1533033819858661

Abstract: Purpose: To develop an automated optimization program to generate optimal beam settings for whole-breast radiation therapy driven by clinically oriented goals.: Materials and methods: Forty patients were retrospectively included in this study. Each ... ...

Abstract	Purpose: To develop an automated optimization program to generate optimal beam settings for whole-breast radiation therapy driven by clinically oriented goals. Materials and methods: Forty patients were retrospectively included in this study. Each patient's planning images, contoured structures of planning target volumes, organs-at-risk, and breast wires were used to optimize for patient-specific-beam settings. Two beam geometries were available tangential beams only and tangential plus supraclavicular beams. Beam parameters included isocenter position, gantry, collimator, couch angles, and multileaf collimator shape. A geometry-based goal function was defined to determine such beam parameters to minimize out-of-field target volume and in-field ipsilateral lung volume. For each geometry, the weighting in the goal function was trained with 10 plans and tested on 10 additional plans. For each query patient, the optimal beam setting was searched for different gantry-isocenter pairs. Optimal fluence maps were generated by an in-house automatic fluence optimization program for target coverage and homogeneous dose distribution, and dose calculation was performed in Eclipse. Automatically generated plans were compared with manually generated plans for target coverage and lung and heart sparing. Results: The program successfully produced a set of beam parameters for every patient. Beam optimization time ranged from 10 to 120 s. The automatic plans had overall comparable plan quality to manually generated plans. For all testing cases, the mean target V Conclusion: We developed an automated goal-driven beam setting optimization program for whole-breast radiation therapy. It provides clinically relevant solutions based on previous clinical practice as well as patient specific anatomy on a substantially faster time frame.
MeSH term(s)	Algorithms ; Breast Neoplasms/diagnosis ; Breast Neoplasms/radiotherapy ; Female ; Humans ; Organs at Risk ; Radiometry ; Radiotherapy/methods ; Radiotherapy/standards ; Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted/methods ; Radiotherapy, Image-Guided ; Workflow
Language	English
Publishing date	2019-06-26
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	2146365-7
ISSN	1533-0338 ; 1533-0346
ISSN (online)	1533-0338
ISSN	1533-0346
DOI	10.1177/1533033819858661
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Zs.A 5871: Show issues

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bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
Jg. 1995 - 2021: Lesesall (2.OG)
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Article ; Online: Dosimetric comparison of preoperative single-fraction partial breast radiotherapy techniques: 3D CRT, noncoplanar IMRT, coplanar IMRT, and VMAT.

Yoo, Sua / Blitzblau, Rachel / Yin, Fang-Fang / Horton, Janet K

Journal of applied clinical medical physics

2015 Volume 16, Issue 1, Page(s) 5126

Abstract: The purpose of this study was to compare dosimetric parameters of treatment plans among four techniques for preoperative single-fraction partial breast radiotherapy in order to select an optimal treatment technique. The techniques evaluated were ... ...

Abstract	The purpose of this study was to compare dosimetric parameters of treatment plans among four techniques for preoperative single-fraction partial breast radiotherapy in order to select an optimal treatment technique. The techniques evaluated were noncoplanar 3D conformal radiation therapy (3D CRT), noncoplanar intensity-modulated radiation therapy (IMRTNC), coplanar IMRT (IMRTCO), and volumetric-modulated arc therapy (VMAT). The planning CT scans of 16 patients in the prone position were used in this study, with the single-fraction prescription doses of 15 Gy for the first eight patients and 18 Gy for the remaining eight patients. Six (6) MV photon beams were designed to avoid the heart and contralateral breast. Optimization for IMRT and VMAT was performed to reduce the dose to the skin and normal breast. All plans were normalized such that 100% of the prescribed dose covered greater than 95% of the clinical target volume (CTV) consisting of gross tumor volume (GTV) plus 1.5 cm margin. Mean homogeneity index (HI) was the lowest (1.05 ± 0.02) for 3D CRT and the highest (1.11 ± 0.04) for VMAT. Mean conformity index (CI) was the lowest (1.42 ± 0.32) for IMRTNC and the highest (1.60 ± 0.32) for VMAT. Mean of the maximum point dose to skin was the lowest (73.7 ± 11.5%) for IMRTNC and the highest (86.5 ± 6.68%) for 3D CRT. IMRTCO showed very similar HI, CI, and maximum skin dose to IMRTNC (differences <1%). The estimated mean treatment delivery time, excluding the time spent for patient positioning and imaging, was 7.0 ± 1.0, 8.3 ± 1.1, 9.7 ± 1.0, and 11.0 ± 1.5min for VMAT, IMRTCO, IMRTNC and 3D CRT, respectively. In comparison of all four techniques for preoperative single-fraction partial breast radiotherapy, we can conclude that noncoplanar or coplanar IMRT were optimal in this study as IMRT plans provided homogeneous and conformal target coverage, skin sparing, and relatively short treatment delivery time.
MeSH term(s)	Breast Neoplasms/radiotherapy ; Female ; Humans ; Organs at Risk ; Preoperative Care ; Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted/methods ; Radiotherapy, Intensity-Modulated/methods ; Tomography, X-Ray Computed/methods
Language	English
Publishing date	2015-01-08
Publishing country	United States
Document type	Comparative Study ; Journal Article
ZDB-ID	2010347-5
ISSN	1526-9914 ; 1526-9914
ISSN (online)	1526-9914
ISSN	1526-9914
DOI	10.1120/jacmp.v16i1.5126
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Article: Automatic Planning of Whole Breast Radiation Therapy Using Machine Learning Models.

Sheng, Yang / Li, Taoran / Yoo, Sua / Yin, Fang-Fang / Blitzblau, Rachel / Horton, Janet K / Ge, Yaorong / Wu, Q Jackie

Frontiers in oncology

2019 Volume 9, Page(s) 750

Abstract: Purpose: ...

Abstract	Purpose:
Language	English
Publishing date	2019-08-07
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2649216-7
ISSN	2234-943X
ISSN	2234-943X
DOI	10.3389/fonc.2019.00750
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Article: Clinical Experience With Machine Learning-Based Automated Treatment Planning for Whole Breast Radiation Therapy.

Yoo, Sua / Sheng, Yang / Blitzblau, Rachel / McDuff, Susan / Champ, Colin / Morrison, Jay / O'Neill, Leigh / Catalano, Suzanne / Yin, Fang-Fang / Wu, Q Jackie

Advances in radiation oncology

2021 Volume 6, Issue 2, Page(s) 100656

Abstract: Purpose: The machine learning-based automated treatment planning (MLAP) tool has been developed and evaluated for breast radiation therapy planning at our institution. We implemented MLAP for patient treatment and assessed our clinical experience for ... ...

Abstract	Purpose: The machine learning-based automated treatment planning (MLAP) tool has been developed and evaluated for breast radiation therapy planning at our institution. We implemented MLAP for patient treatment and assessed our clinical experience for its performance. Methods and materials: A total of 102 patients of breast or chest wall treatment plans were prospectively evaluated with institutional review board approval. A human planner executed MLAP to create an auto-plan via automation of fluence maps generation. If judged necessary, a planner further fine-tuned the fluence maps to reach a final plan. Planners recorded the time required for auto-planning and manual modification. Target (ie, breast or chest wall and nodes) coverage and dose homogeneity were compared between the auto-plan and final plan. Results: Cases without nodes (n = 71) showed negligible (<1%) differences for target coverage and dose homogeneity between the auto-plan and final plan. Cases with nodes (n = 31) also showed negligible difference for target coverage. However, mean ± standard deviation of volume receiving 105% of the prescribed dose and maximum dose were reduced from 43.0% ± 26.3% to 39.4% ± 23.7% and 119.7% ± 9.5% to 114.4% ± 8.8% from auto-plan to final plan, respectively, all with Conclusions: The MLAP tool has been successfully implemented for routine clinical practice and has significantly improved planning efficiency. Clinical experience indicates that auto-plans are sufficient for target coverage, but improvement is warranted to reduce high dose volume for cases with nodal irradiation. This study demonstrates the clinical implementation of auto-planning for patient treatment and the significant importance of integrating human experience and feedback to improve MLAP for better clinical translation.
Language	English
Publishing date	2021-01-22
Publishing country	United States
Document type	Journal Article
ISSN	2452-1094
ISSN	2452-1094
DOI	10.1016/j.adro.2021.100656
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Article: Dosimetric feasibility of cone-beam CT-based treatment planning compared to CT-based treatment planning.

Yoo, Sua / Yin, Fang-Fang

International journal of radiation oncology, biology, physics

2006 Volume 66, Issue 5, Page(s) 1553–1561

Abstract: Purpose: Cone-beam computed tomography (CBCT) images are currently used for positioning verification. However, it is yet unknown whether CBCT could be used in dose calculation for replanning in adaptive radiation therapy. This study investigates the ... ...

Abstract	Purpose: Cone-beam computed tomography (CBCT) images are currently used for positioning verification. However, it is yet unknown whether CBCT could be used in dose calculation for replanning in adaptive radiation therapy. This study investigates the dosimetric feasibility of CBCT-based treatment planning. Methods and materials: Hounsfield unit (HU) values and profiles of Catphan, homogeneous/inhomogeneous phantoms, and various tissue regions of patients in CBCT images were compared to those in CT. The dosimetric consequence of the HU variation was investigated by comparing CBCT-based treatment plans to conventional CT-based plans for both phantoms and patients. Results: The maximum HU difference between CBCT and CT of Catphan was 34 HU in the Teflon. The differences in other materials were less than 10 HU. The profiles for the homogeneous phantoms in CBCT displayed reduced HU values up to 150 HU in the peripheral regions compared to those in CT. The scatter and artifacts in CBCT became severe surrounding inhomogeneous tissues with reduced HU values up to 200 HU. The MU/cGy differences were less than 1% for most phantom cases. The isodose distributions between CBCT-based and CT-based plans agreed very well. However, the discrepancy was larger when CBCT was scanned without a bowtie filter than with bowtie filter. Also, up to 3% dosimetric error was observed in the plans for the inhomogeneous phantom. In the patient studies, the discrepancies of isodose lines between CT-based and CBCT-based plans, both 3D and IMRT, were less than 2 mm. Again, larger discrepancy occurred for the lung cancer patients. Conclusion: This study demonstrated the feasibility of CBCT-based treatment planning. CBCT-based treatment plans were dosimetrically comparable to CT-based treatment plans. Dosimetric data in the inhomogeneous tissue regions should be carefully validated.
MeSH term(s)	Brain Neoplasms/diagnostic imaging ; Brain Neoplasms/radiotherapy ; Feasibility Studies ; Humans ; Lung Neoplasms/diagnostic imaging ; Lung Neoplasms/radiotherapy ; Male ; Neoplasms/diagnostic imaging ; Neoplasms/radiotherapy ; Phantoms, Imaging ; Prostatic Neoplasms/diagnostic imaging ; Prostatic Neoplasms/radiotherapy ; Radiometry/instrumentation ; Radiometry/methods ; Radiotherapy Dosage ; Radiotherapy, Computer-Assisted/methods ; Tomography, X-Ray Computed/methods
Language	English
Publishing date	2006-12-01
Publishing country	United States
Document type	Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	197614-x
ISSN	1879-355X ; 0360-3016
ISSN (online)	1879-355X
ISSN	0360-3016
DOI	10.1016/j.ijrobp.2006.08.031
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Zs.A 1218: Show issues

Location:
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Jg. 1995 - 2021: Lesesall (1.OG)
ab Jg. 2022: Lesesaal (EG)

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Article ; Online: Treatment constraints for single dose external beam preoperative partial breast irradiation in early-stage breast cancer.

Charaghvandi, Ramona K / Yoo, Sua / van Asselen, Bram / Rodrigues, Anna / van den Bongard, Desirée H J G / Horton, Janet K

Clinical and translational radiation oncology

2017 Volume 6, Page(s) 7–14

Abstract: Background: Following breast-conserving surgery and post-operative 3D-conformal accelerated partial breast irradiation (APBI), suboptimal cosmetic results have been reported. Preoperative radiation delivery to the intact tumor enables better target ... ...

Abstract	Background: Following breast-conserving surgery and post-operative 3D-conformal accelerated partial breast irradiation (APBI), suboptimal cosmetic results have been reported. Preoperative radiation delivery to the intact tumor enables better target visualization and treatment volume reduction. Single dose preoperative APBI has the potential to improve toxicity profiles, reduce treatment burden and enable in vivo exploration of breast cancer radiogenomics. Purpose: Develop practical guidelines for single dose external beam preoperative APBI. Methods: Recommended dose constraints were derived from pooled dosimetry estimates from 2 clinical trials. In an American dose escalation trial, a uniform 15, 18 or 21 Gy dose has previously been evaluated for non-lobular cT1N0 or low/intermediate grade DCIS <2 cm in prone position ( Results: Dosimetric data pooling enabled the development of practical guidelines for single dose preoperative APBI. Conclusion: The developed guidelines will allow further explorations in the promising field of single dose preoperative external beam APBI for breast cancer treatment.
Language	English
Publishing date	2017-09-08
Publishing country	Ireland
Document type	Journal Article
ISSN	2405-6308
ISSN (online)	2405-6308
DOI	10.1016/j.ctro.2017.06.003
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Article ; Online: Radiotherapy treatment plans with RapidArc for prostate cancer involving seminal vesicles and lymph nodes.

Yoo, Sua / Wu, Q Jackie / Lee, W Robert / Yin, Fang-Fang

International journal of radiation oncology, biology, physics

2010 Volume 76, Issue 3, Page(s) 935–942

Abstract: Purpose: Dosimetric results and treatment delivery efficiency of RapidArc plans to those of conventional intensity-modulated radiotherapy (IMRT) plans were compared using the Eclipse treatment planning system for high-risk prostate cancer.: Materials ... ...

Abstract	Purpose: Dosimetric results and treatment delivery efficiency of RapidArc plans to those of conventional intensity-modulated radiotherapy (IMRT) plans were compared using the Eclipse treatment planning system for high-risk prostate cancer. Materials and methods: This study included 10 patients. The primary planning target volume (PTV(P)) contained prostate, seminal vesicles, and pelvic lymph nodes with a margin. The boost PTV (PTV(B)) contained prostate and seminal vesicles with a margin. The total prescription dose was 75.6 Gy (46.8 Gy to PTV(P) and an additional 28.8 Gy to PTV(B); 1.8 Gy/fraction). Three plans were generated for each PTV: Multiple-field IMRT, one-arc RapidArc (1ARC), and two-arc RapidArc (2ARC). Results: In the primary IMRT with PTV(P), average mean doses to bladder, rectum and small bowel were lower by 5.9%, 7.7% and 4.3%, respectively, than in the primary 1ARC and by 3.6%, 4.8% and 3.1%, respectively, than in the primary 2ARC. In the boost IMRT with PTV(B), average mean doses to bladder and rectum were lower by 2.6% and 4.8% than with the boost 1ARC and were higher by 0.6% and 0.2% than with the boost 2ARC. Integral doses were 7% to 9% higher with RapidArc than with IMRT for both primary and boost plans. Treatment delivery time was reduced by 2-7 minutes using RapidArc. Conclusion: For PTVs including prostate, seminal vesicles, and lymph nodes, IMRT performed better in dose sparing for bladder, rectum, and small bowel than did RapidArc. For PTVs including prostate and seminal vesicles, RapidArc with two arcs provided plans comparable to those for IMRT. The treatment delivery is more efficient with RapidArc.
MeSH term(s)	Algorithms ; Humans ; Intestine, Small/diagnostic imaging ; Lymph Nodes/diagnostic imaging ; Male ; Pelvis ; Prostate/diagnostic imaging ; Prostatic Neoplasms/diagnostic imaging ; Prostatic Neoplasms/radiotherapy ; Radiation Injuries/prevention & control ; Radiography ; Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted/methods ; Radiotherapy, Intensity-Modulated/methods ; Rectum/diagnostic imaging ; Seminal Vesicles/diagnostic imaging ; Urinary Bladder/diagnostic imaging
Language	English
Publishing date	2010-03-01
Publishing country	United States
Document type	Comparative Study ; Journal Article
ZDB-ID	197614-x
ISSN	1879-355X ; 0360-3016
ISSN (online)	1879-355X
ISSN	0360-3016
DOI	10.1016/j.ijrobp.2009.07.1677
Database	MEDical Literature Analysis and Retrieval System OnLINE

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ab Jg. 2022: Lesesaal (EG)

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