The Experts below are selected from a list of 3879 Experts worldwide ranked by ideXlab platform
Jan-jakob Sonke - One of the best experts on this subject based on the ideXlab platform.
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LDeform: Longitudinal deformation analysis for Adaptive Radiotherapy of lung cancer
Medical physics, 2019Co-Authors: Saad Nadeem, Jan-jakob Sonke, Joseph O Deasy, Pengpeng Zhang, Andreas Rimner, Allen TannenbaumAbstract:Purpose Conventional Radiotherapy for large lung tumors is given over several weeks, during which the tumor typically regresses in a highly nonuniform and variable manner. Adaptive Radiotherapy would ideally follow these shape changes, but we need an accurate method to extrapolate tumor shape changes. We propose a computationally efficient algorithm to quantitate tumor surface shape changes that makes minimal assumptions, identifies fixed points, and can be used to predict future tumor geometrical response. Methods A novel combination of nonrigid iterative closest point (ICP) and local shape-preserving map algorithms, LDeform, is developed to enable visualization, prediction, and categorization of both diffeomorphic and nondiffeomorphic tumor deformations during an extended course of Radiotherapy. Results We tested and validated our technique on 31 longitudinal CT/MRI subjects, with five to nine time points each. Based on this tumor deformation analysis, regions of local growth, shrinkage, and anchoring are identified and tracked across multiple time points. This categorization in turn represents a rational biomarker of local response. Results demonstrate useful predictive power, with an averaged Dice coefficient and surface mean-squared error of 0.85 and 2.8 mm, respectively, over all images. Conclusions We conclude that the LDeform algorithm can facilitate the Adaptive decision-making process during lung cancer Radiotherapy.
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Adaptive Radiotherapy for anatomical changes
Seminars in radiation oncology, 2019Co-Authors: Jan-jakob Sonke, Marianne C. Aznar, Coen R. N. RaschAbstract:The anatomy of cancer patients changes between radiation treatment planning and delivery as well as over the course of Radiotherapy. Adaptive Radiotherapy (ART) aims to deliver radiation accurately and precisely in the presence of such changes. To that end, ART uses an imaging feedback loop to quantify these changes and modify the treatment plan accordingly. This paper provides an overview of anatomical changes occurring over the course of therapy and various Adaptive strategies developed to account for those. Moreover, residual uncertainties present in Adaptive Radiotherapy are discussed as well as required tools, potential pitfalls and remaining challenges.
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magnetic resonance guided Adaptive Radiotherapy a solution to the future
Seminars in Radiation Oncology, 2014Co-Authors: Patrick A Kupelian, Jan-jakob SonkeAbstract:Magnetic resonance imaging–guided Adaptive Radiotherapy would make available the best in anatomical and functional imaging during the course of radiation therapy. The possible methodology of magnetic resonance imaging–guided adapted Radiotherapy and possible clinical applications are discussed.
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Magnetic Resonance–Guided Adaptive Radiotherapy: A Solution to the Future
Seminars in radiation oncology, 2014Co-Authors: Patrick A Kupelian, Jan-jakob SonkeAbstract:Magnetic resonance imaging–guided Adaptive Radiotherapy would make available the best in anatomical and functional imaging during the course of radiation therapy. The possible methodology of magnetic resonance imaging–guided adapted Radiotherapy and possible clinical applications are discussed.
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TU‐A‐BRCD‐01: Image Acquisition and Processing for Adaptive Radiotherapy
Medical Physics, 2012Co-Authors: Marc L. Kessler, Jeffrey H. Siewerdsen, Jan-jakob SonkeAbstract:Adaptive Radiotherapy involves acquisition and processing of image data from numerous devices at various time scales. In contrast to conventional Radiotherapy which mainly involves unidirectional flow of image data in fairly large steps ‐ from the scanners to the planners to the treatment machines ‐ Adaptive Radiotherapy involves a bidirectional and iterative flow of image data. Acquisition and processing of multimodality imaging data for the initial planning step is now common place: x‐ray CT provides accurate geometric and density information; MR provides exquisite soft tissue contrast; and nuclear medicine imaging provides unique metabolic information. Data from these modalities are registered and integrated to help define the tumor volume(s) and surrounding healthy tissues. These modalities along with ultrasound and optical imaging can also provide 4D and time series image data to help model moment‐to‐moment physiologic motion and day‐to‐day functional and anatomic changes. Tracking these changes between and during treatment fractions is a key aspect of the Adaptive Radiotherapy process. Image processing steps required to support this tracking and adaptation of treatments include deformable image registration, contour propagation, and dose accumulation. The outputs of these steps are used to support decisions about maintaining or adapting the current treatment plan. This course will provide an overview of the different imaging devices used to support Adaptive Radiotherapy and highlight the benefits and challenges of each. The details of the various image processing tools used to extract, combine, and analyze the information from the various imaging data will also be presented. Finally, the effective use of these devices and tools for the Adaptive Radiotherapy process will be described and elucidated using several clinical examples. Learning Objectives: 1. Understand the basic principles of image acquisition used in Adaptive Radiotherapy 2. Understand the basic principles of image processing used in Adaptive Radiotherapy 3. Understand how imaging and image processing are used in the Adaptive Radiotherapy process
Hans Theodor Eich - One of the best experts on this subject based on the ideXlab platform.
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Primary Cardiac Angiosarcoma Treated With Positron Emission Tomography/Magnetic Resonance Imaging-Guided Adaptive Radiotherapy.
The Canadian journal of cardiology, 2015Co-Authors: Khaled Elsayad, Philipp Lehrich, Heidi Yppaerilae-wolters, Chantal Dieckmann, Jan Kriz, Uwe Haverkamp, Hans Theodor EichAbstract:Radiotherapy (RT) for inoperable patients with primary cardiac sarcomas or residual tumor is often limited by the sensitivity of the heart and lung to radiation injury. We describe a novel treatment modality with Adaptive Radiotherapy (ART) using tumor volume tracking in a 37-year-old woman who presented with unresectable primary cardiac angiosarcoma. The patient was treated using positron emission tomography/magnetic resonance imaging-guided ART with 55.8 Gy concomitant with paclitaxel chemotherapy. In conclusion, the treatment was well tolerated, and a significant tumor volume reduction of ∼ 57% was achieved during Radiotherapy, suggesting the effectiveness and tolerability of ART in combination with paclitaxel-based chemotherapy.
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Primary Cardiac Angiosarcoma Treated With Positron Emission Tomography/Magnetic Resonance Imaging–Guided Adaptive Radiotherapy
Canadian Journal of Cardiology, 2015Co-Authors: Khaled Elsayad, Philipp Lehrich, Heidi Yppaerilae-wolters, Chantal Dieckmann, Jan Kriz, Uwe Haverkamp, Hans Theodor EichAbstract:Radiotherapy (RT) for inoperable patients with primary cardiac sarcomas or residual tumor is often limited by the sensitivity of the heart and lung to radiation injury. We describe a novel treatment modality with Adaptive Radiotherapy (ART) using tumor volume tracking in a 37-year-old woman who presented with unresectable primary cardiac angiosarcoma. The patient was treated using positron emission tomography/magnetic resonance imaging-guided ART with 55.8 Gy concomitant with paclitaxel chemotherapy. In conclusion, the treatment was well tolerated, and a significant tumor volume reduction of ∼ 57% was achieved during Radiotherapy, suggesting the effectiveness and tolerability of ART in combination with paclitaxel-based chemotherapy.
D Yang - One of the best experts on this subject based on the ideXlab platform.
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A practical implementation of physics quality assurance for photon Adaptive Radiotherapy.
Zeitschrift fur medizinische Physik, 2018Co-Authors: Bin Cai, S Mutic, Olga Green, Rojano Kashani, Vivian Rodriguez, D YangAbstract:Abstract The fast evolution of technology in Radiotherapy (RT) enabled the realization of Adaptive Radiotherapy (ART). However, the new characteristics of ART pose unique challenges for efficiencies and effectiveness of quality assurance (QA) strategies. In this paper, we discuss the necessary QAs for ART and introduce a practical implementation. A previously published work on failure modes and effects analysis (FMEA) of ART is introduced first to explain the risks associated with ART sub-processes. After a brief discussion of QA challenges, we review the existing QA strategies and tools that might be suitable for each ART step. By introducing the MR-guided online ART QA processes developed at our institute, we demonstrate a practical implementation. The limitations and future works to develop more robust and efficient QA strategies are discussed at the end.
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technical note dirart a software suite for deformable image registration and Adaptive Radiotherapy research
Medical Physics, 2010Co-Authors: D Yang, Issam El Naqa, S Brame, Apte Aditya, Murty S Goddu, S Mutic, Joseph O Deasy, D LowAbstract:Purpose: Recent years have witnessed tremendous progress in image guide Radiotherapy technology and a growing interest in the possibilities for adapting treatment planning and delivery over the course of treatment. One obstacle faced by the research community has been the lack of a comprehensive open-source software toolkit dedicated for Adaptive Radiotherapy (ART). To address this need, the authors have developed a software suite called the Deformable Image Registration and Adaptive Radiotherapy Toolkit (DIRART). Methods: DIRART is an open-source toolkit developed in MATLAB. It is designed in an object-oriented style with focus on user-friendliness, features, and flexibility. It contains four classes of DIR algorithms, including the newer inverse consistency algorithms to provide consistent displacement vector field in both directions. It also contains common ART functions, an integrated graphical user interface, a variety of visualization and image-processing features, dose metric analysis functions, and interface routines. These interface routines make DIRART a powerful complement to the Computational Environment for Radiotherapy Research (CERR) and popular image-processing toolkits such as ITK. Results :DIRART provides a set of image processing/registration algorithms and postprocessing functions to facilitate the development and testing of DIR algorithms. It also offers a good amount of options for DIR results visualization, evaluation, and validation. Conclusions : By exchanging data with treatment planning systems via DICOM-RT files andCERR, and by bringing image registration algorithms closer to Radiotherapy applications, DIRART is potentially a convenient and flexible platform that may facilitate ART and DIR research.
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Technical Note: DIRART – A software suite for deformable image registration and Adaptive Radiotherapy research
Medical physics, 2010Co-Authors: D Yang, Issam El Naqa, S Brame, Apte Aditya, S Mutic, Joseph O Deasy, S. Murty Goddu, Daniel A. LowAbstract:Purpose: Recent years have witnessed tremendous progress in image guide Radiotherapy technology and a growing interest in the possibilities for adapting treatment planning and delivery over the course of treatment. One obstacle faced by the research community has been the lack of a comprehensive open-source software toolkit dedicated for Adaptive Radiotherapy (ART). To address this need, the authors have developed a software suite called the Deformable Image Registration and Adaptive Radiotherapy Toolkit (DIRART). Methods: DIRART is an open-source toolkit developed in MATLAB. It is designed in an object-oriented style with focus on user-friendliness, features, and flexibility. It contains four classes of DIR algorithms, including the newer inverse consistency algorithms to provide consistent displacement vector field in both directions. It also contains common ART functions, an integrated graphical user interface, a variety of visualization and image-processing features, dose metric analysis functions, and interface routines. These interface routines make DIRART a powerful complement to the Computational Environment for Radiotherapy Research (CERR) and popular image-processing toolkits such as ITK. Results :DIRART provides a set of image processing/registration algorithms and postprocessing functions to facilitate the development and testing of DIR algorithms. It also offers a good amount of options for DIR results visualization, evaluation, and validation. Conclusions : By exchanging data with treatment planning systems via DICOM-RT files andCERR, and by bringing image registration algorithms closer to Radiotherapy applications, DIRART is potentially a convenient and flexible platform that may facilitate ART and DIR research.
Patrick A Kupelian - One of the best experts on this subject based on the ideXlab platform.
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magnetic resonance guided Adaptive Radiotherapy a solution to the future
Seminars in Radiation Oncology, 2014Co-Authors: Patrick A Kupelian, Jan-jakob SonkeAbstract:Magnetic resonance imaging–guided Adaptive Radiotherapy would make available the best in anatomical and functional imaging during the course of radiation therapy. The possible methodology of magnetic resonance imaging–guided adapted Radiotherapy and possible clinical applications are discussed.
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Magnetic Resonance–Guided Adaptive Radiotherapy: A Solution to the Future
Seminars in radiation oncology, 2014Co-Authors: Patrick A Kupelian, Jan-jakob SonkeAbstract:Magnetic resonance imaging–guided Adaptive Radiotherapy would make available the best in anatomical and functional imaging during the course of radiation therapy. The possible methodology of magnetic resonance imaging–guided adapted Radiotherapy and possible clinical applications are discussed.
Jeremy T. Booth - One of the best experts on this subject based on the ideXlab platform.
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See, Think, and Act: Real-Time Adaptive Radiotherapy.
Seminars in radiation oncology, 2019Co-Authors: Paul J. Keall, Per Rugaard Poulsen, Jeremy T. BoothAbstract:The world is embracing the information age, with real-time data at hand to assist with many decisions. Similarly, in cancer Radiotherapy we are inexorably moving toward using information in a smarter and faster fashion, to usher in the age of real-time Adaptive Radiotherapy. The three critical steps of real-time Adaptive Radiotherapy, aligned with driverless vehicle technology are a continuous see, think, and act loop. See: use imaging systems to probe the patient anatomy or physiology as it evolves with time. Think: use current and prior information to optimize the treatment using the available Adaptive degrees of freedom. Act: deliver the real-time adapted treatment. This paper expands upon these three critical steps for real-time Adaptive Radiotherapy, provides a historical context, reviews the clinical rationale, and gives a future outlook for real-time Adaptive Radiotherapy.
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Kilovoltage intrafraction monitoring for real-time image guided Adaptive Radiotherapy reduces total dose for lung SABR
Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, 2016Co-Authors: Prabhjot Juneja, Vincent Caillet, Tom Shaw, Judith Martland, Jeremy T. BoothAbstract:Abstract This study presents estimation of typical kV fluoroscopic imaging doses for image-guided real-time Adaptive Radiotherapy. For a cohort of 10 lung SABR patients the estimated imaging dose to ipsi-lateral lung with real-time adaptation is 9.9–15.1cGy, which is less than the extra lung dose from treatment with potentially larger ITV-based PTV approach.
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The first patient treatment of electromagnetic-guided real time Adaptive Radiotherapy using MLC tracking for lung SABR
Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, 2016Co-Authors: Jeremy T. Booth, Vincent Caillet, Nicholas Hardcastle, Ricky O'brien, Kathryn Szymura, Charlene Crasta, Benjamin Harris, Carol Haddad, Thomas Eade, Paul J. KeallAbstract:Abstract Background and purpose Real time Adaptive Radiotherapy that enables smaller irradiated volumes may reduce pulmonary toxicity. We report on the first patient treatment of electromagnetic-guided real time Adaptive Radiotherapy delivered with MLC tracking for lung stereotactic ablative body Radiotherapy. Materials and methods A clinical trial was developed to investigate the safety and feasibility of MLC tracking in lung. The first patient was an 80-year old man with a single left lower lobe lung metastasis to be treated with SABR to 48Gy in 4 fractions. In–house software was integrated with a standard linear accelerator to adapt the treatment beam shape and position based on electromagnetic transponders implanted in the lung. MLC tracking plans were compared against standard ITV-based treatment planning. MLC tracking plan delivery was reconstructed in the patient to confirm safe delivery. Results Real time Adaptive Radiotherapy delivered with MLC tracking compared to standard ITV-based planning reduced the PTV by 41% (18.7–11cm 3 ) and the mean lung dose by 30% (202–140cGy), V20 by 35% (2.6–1.5%) and V5 by 9% (8.9–8%). Conclusion An emerging technology, MLC tracking, has been translated into the clinic and used to treat lung SABR patients for the first time. This milestone represents an important first step for clinical real-time Adaptive Radiotherapy that could reduce pulmonary toxicity in lung Radiotherapy.
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A dosimetric comparison of real-time Adaptive and non-Adaptive Radiotherapy: A multi-institutional study encompassing robotic, gimbaled, multileaf collimator and couch tracking
Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, 2016Co-Authors: E. Colvill, Per Rugaard Poulsen, Jeremy T. Booth, Simeon Nill, M.f. Fast, James L. Bedford, Uwe Oelfke, Mitsuhiro Nakamura, Esben S. Worm, Rune HansenAbstract:Purpose A study of real-time Adaptive Radiotherapy systems was performed to test the hypothesis that, across delivery systems and institutions, the dosimetric accuracy is improved with Adaptive treatments over non-Adaptive Radiotherapy in the presence of patient-measured tumor motion.
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TH-AB-303-01: Benchmarking Real-Time Adaptive Radiotherapy Systems: A Multi- Platform Multi-Institutional Study
Medical Physics, 2015Co-Authors: E. Colvill, Per Rugaard Poulsen, Jeremy T. Booth, Simeon Nill, M.f. Fast, James L. Bedford, Uwe Oelfke, Mitsuhiro Nakamura, Rune Hansen, Esben S. WormAbstract:Purpose: The era of real-time Adaptive Radiotherapy is here: patients are being treated by CyberKnife (since 2004), Vero (2011) and MLC tracking (2013) technology, with couch tracking planned to be clinical in 2015. We have developed a common set of tools for benchmarking real-time Adaptive Radiotherapy systems and to test the hypothesis that, across delivery systems and institutions, real-time Adaptive Radiotherapy improves the dosimetric accuracy over non-Adaptive Radiotherapy in the presence of realistic tumor motion. Methods: Ten institutions with CyberKnife, Vero, MLC or couch tracking technology were involved in the study. Common materials were anonymized lung and prostate CT and structure sets, patient-measured motion traces (four lung, four prostate) and SBRT planning protocols (lung: RTOG1021, prostate: RTOG0938). The institutions delivered lung and prostate plans to a moving dosimeter programmed with tumor motion. For each trace the plan was delivered twice; with and without motion adaptation, each measurement was compared to the static dosimeter dose and the percentage of failed points for γ-tests recorded. Results: Eleven measurement sets were obtained for this study; two CyberKnife, two Vero, five MLC and two couch tracking sets. For all lung traces all sets show improved dose accuracy from a mean 2%/2mm γ-failrate of 1.6% with adaptation and 14.7% with no motion correction(p
