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Sample records for guided stereotactic high

  1. CT and Ultrasound Guided Stereotactic High Intensity Focused Ultrasound (HIFU)

    SciTech Connect

    Wood, Bradford J.; Frenkel, V.; Viswanathan, A.; Dromi, S.; Oh, K.; Kam, A.; Li, K. C. P.; Yanof, J.; Bauer, C.; Kruecker, J.; Seip, R.

    2006-05-08

    To demonstrate the feasibility of CT and B-mode Ultrasound (US) targeted HIFU, a prototype coaxial focused ultrasound transducer was registered and integrated to a CT scanner. CT and diagnostic ultrasound were used for HIFU targeting and monitoring, with the goals of both thermal ablation and non-thermal enhanced drug delivery. A 1 megahertz coaxial ultrasound transducer was custom fabricated and attached to a passive position-sensing arm and an active six degree-of-freedom robotic arm via a CT stereotactic frame. The outer therapeutic transducer with a 10 cm fixed focal zone was coaxially mounted to an inner diagnostic US transducer (2-4 megahertz, Philips Medical Systems). This coaxial US transducer was connected to a modified commercial focused ultrasound generator (Focus Surgery, Indianapolis, IN) with a maximum total acoustic power of 100 watts. This pre-clinical paradigm was tested for ability to heat tissue in phantoms with monitoring and navigation from CT and live US. The feasibility of navigation via image fusion of CT with other modalities such as PET and MRI was demonstrated. Heated water phantoms were tested for correlation between CT numbers and temperature (for ablation monitoring). The prototype transducer and integrated CT/US imaging system enabled simultaneous multimodality imaging and therapy. Pre-clinical phantom models validated the treatment paradigm and demonstrated integrated multimodality guidance and treatment monitoring. Temperature changes during phantom cooling corresponded to CT number changes. Contrast enhanced or non-enhanced CT numbers may potentially be used to monitor thermal ablation with HIFU. Integrated CT, diagnostic US, and therapeutic focused ultrasound bridges a gap between diagnosis and therapy. Preliminary results show that the multimodality system may represent a relatively inexpensive, accessible, and simple method of both targeting and monitoring HIFU effects. Small animal pre-clinical models may be translated to large

  2. CT and Ultrasound Guided Stereotactic High Intensity Focused Ultrasound (HIFU)

    NASA Astrophysics Data System (ADS)

    Wood, Bradford J.; Yanof, J.; Frenkel, V.; Viswanathan, A.; Dromi, S.; Oh, K.; Kruecker, J.; Bauer, C.; Seip, R.; Kam, A.; Li, K. C. P.

    2006-05-01

    To demonstrate the feasibility of CT and B-mode Ultrasound (US) targeted HIFU, a prototype coaxial focused ultrasound transducer was registered and integrated to a CT scanner. CT and diagnostic ultrasound were used for HIFU targeting and monitoring, with the goals of both thermal ablation and non-thermal enhanced drug delivery. A 1 megahertz coaxial ultrasound transducer was custom fabricated and attached to a passive position-sensing arm and an active six degree-of-freedom robotic arm via a CT stereotactic frame. The outer therapeutic transducer with a 10 cm fixed focal zone was coaxially mounted to an inner diagnostic US transducer (2-4 megahertz, Philips Medical Systems). This coaxial US transducer was connected to a modified commercial focused ultrasound generator (Focus Surgery, Indianapolis, IN) with a maximum total acoustic power of 100 watts. This pre-clinical paradigm was tested for ability to heat tissue in phantoms with monitoring and navigation from CT and live US. The feasibility of navigation via image fusion of CT with other modalities such as PET and MRI was demonstrated. Heated water phantoms were tested for correlation between CT numbers and temperature (for ablation monitoring). The prototype transducer and integrated CT/US imaging system enabled simultaneous multimodality imaging and therapy. Pre-clinical phantom models validated the treatment paradigm and demonstrated integrated multimodality guidance and treatment monitoring. Temperature changes during phantom cooling corresponded to CT number changes. Contrast enhanced or non-enhanced CT numbers may potentially be used to monitor thermal ablation with HIFU. Integrated CT, diagnostic US, and therapeutic focused ultrasound bridges a gap between diagnosis and therapy. Preliminary results show that the multimodality system may represent a relatively inexpensive, accessible, and simple method of both targeting and monitoring HIFU effects. Small animal pre-clinical models may be translated to large

  3. Stereotactic (Mammographically Guided) Breast Biopsy

    MedlinePlus

    ... Z Stereotactic Breast Biopsy Stereotactic breast biopsy uses mammography – a specific type of breast imaging that uses ... the breast are often detected by physical examination, mammography, or other imaging studies. However, it is not ...

  4. Stereotactic Image-Guided Intensity Modulated Radiotherapy Using the HI-ART II Helical Tomotherapy System

    SciTech Connect

    Holmes, Timothy W. Hudes, Richard; Dziuba, Sylwester; Kazi, Abdul; Hall, Mark; Dawson, Dana

    2008-07-01

    The highly integrated adaptive radiation therapy (HI-ART II) helical tomotherapy unit is a new radiotherapy machine designed to achieve highly precise and accurate treatments at all body sites. The precision and accuracy of the HI-ART II is similar to that provided by stereotactic radiosurgery systems, hence the historical distinction between external beam radiotherapy and stereotactic procedures based on differing precision requirements is removed for this device. The objectives of this work are: (1) to describe stereotactic helical tomotherapy processes (SRS, SBRT); (2) to show that the precision and accuracy of the HI-ART meet the requirements defined for SRS and SBRT; and (3) to describe the clinical implementation of a stereotactic image-guided intensity modulated radiation therapy (IG-IMRT) system that incorporates optical motion management.

  5. An image guided small animal stereotactic radiotherapy system.

    PubMed

    Sha, Hao; Udayakumar, Thirupandiyur S; Johnson, Perry B; Dogan, Nesrin; Pollack, Alan; Yang, Yidong

    2016-04-01

    Small animal radiotherapy studies should be performed preferably on irradiators capable of focal tumor irradiation and healthy tissue sparing. In this study, an image guided small animal arc radiation treatment system (iSMAART) was developed which can achieve highly precise radiation targeting through the utilization of onboard cone beam computed tomography (CBCT) guidance. The iSMAART employs a unique imaging and radiation geometry where animals are positioned upright. It consists of a stationary x-ray tube, a stationary flat panel detector, and a rotatable and translational animal stage. System performance was evaluated in regards to imaging, image guidance, animal positioning, and radiation targeting using phantoms and tumor bearing animals. The onboard CBCT achieved good signal, contrast, and sub-millimeter spatial resolution. The iodine contrast CBCT accurately delineated orthotopic prostate tumors. Animal positioning was evaluated with ~0.3 mm vertical displacement along superior-inferior direction. The overall targeting precision was within 0.4 mm. Stereotactic radiation beams conformal to tumor targets can be precisely delivered from multiple angles surrounding the animal. The iSMAART allows radiobiology labs to utilize an image guided precision radiation technique that can focally irradiate tumors while sparing healthy tissues at an affordable cost. PMID:26958942

  6. An image guided small animal stereotactic radiotherapy system

    PubMed Central

    Sha, Hao; Udayakumar, Thirupandiyur S.; Johnson, Perry B.; Dogan, Nesrin; Pollack, Alan; Yang, Yidong

    2016-01-01

    Small animal radiotherapy studies should be performed preferably on irradiators capable of focal tumor irradiation and healthy tissue sparing. In this study, an image guided small animal arc radiation treatment system (iSMAART) was developed which can achieve highly precise radiation targeting through the utilization of onboard cone beam computed tomography (CBCT) guidance. The iSMAART employs a unique imaging and radiation geometry where animals are positioned upright. It consists of a stationary x-ray tube, a stationary flat panel detector, and a rotatable and translational animal stage. System performance was evaluated in regards to imaging, image guidance, animal positioning, and radiation targeting using phantoms and tumor bearing animals. The onboard CBCT achieved good signal, contrast, and sub-millimeter spatial resolution. The iodine contrast CBCT accurately delineated orthotopic prostate tumors. Animal positioning was evaluated with ∼0.3 mm vertical displacement along superior-inferior direction. The overall targeting precision was within 0.4 mm. Stereotactic radiation beams conformal to tumor targets can be precisely delivered from multiple angles surrounding the animal. The iSMAART allows radiobiology labs to utilize an image guided precision radiation technique that can focally irradiate tumors while sparing healthy tissues at an affordable cost. PMID:26958942

  7. CT-guided stereotactic neurosurgery: experience in 24 cases with a new stereotactic system.

    PubMed Central

    Thomas, D G; Anderson, R E; du Boulay, G H

    1984-01-01

    Twenty-four cases have been operated upon using a prototype Brown-Roberts-Wells, CT-guided stereotactic neurosurgical system. This device has proved to be practical and flexible in clinical use. No CT scanner modifications were required, a fact which simplified its use in more than one hospital. Multiple targets can be biopsied with ease and relative safety. Drainage and other therapeutic procedures can be carried out with minimal hazard. Future applications of this system may include its use with NMR and PET images. Images PMID:6363629

  8. High Dose-Per-Fraction Irradiation of Limited Lung Volumes Using an Image-Guided, Highly Focused Irradiator: Simulating Stereotactic Body Radiotherapy Regimens in a Small-Animal Model

    SciTech Connect

    Cho, Jaeho; Kodym, Reinhard; Seliounine, Serguei

    2010-07-01

    Purpose: To investigate the underlying biology associated with stereotactic body radiotherapy (SBRT), both in vivo models and image-guided, highly focal irradiation systems are necessary. Here, we describe such an irradiation system and use it to examine normal tissue toxicity in a small-animal model at lung volumes similar to those associated with human therapy. Methods and Materials: High-dose radiation was delivered to a small volume of the left lung of C3H/HeJCr mice using a small-animal stereotactic irradiator. The irradiator has a collimation mechanism to produce focal radiation beams, an imaging subsystem consisting of a fluorescent screen coupled to a charge-coupled device camera, and a manual positioning stage. Histopathologic examination and micro-CT were used to evaluate the radiation response. Results: Focal obliteration of the alveoli by fibrous connective tissue, hyperplasia of the bronchiolar epithelium, and presence of a small number of inflammatory cells are the main reactions to low-volume/high-dose irradiation of the mouse lung. The tissue response suggested a radiation dose threshold for early phase fibrosis lying between 40 and 100 Gy. The irradiation system satisfied our requirements of high-dose-rate, small beam diameter, and precise localization and verification. Conclusions: We have established an experimental model and image-guided animal irradiation system for the study of high dose per fraction irradiations such as those used with SBRT at volumes analogous to those used in human beings. It will also allow the targeting of specific anatomical structures of the thorax or ultimately, orthotopic tumors of the lung.

  9. High Retention and Safety of Percutaneously Implanted Endovascular Embolization Coils as Fiducial Markers for Image-Guided Stereotactic Ablative Radiotherapy of Pulmonary Tumors

    SciTech Connect

    Hong, Julian C.; Yu Yao; Rao, Aarti K.; Dieterich, Sonja; Maxim, Peter G.; Le, Quynh-Thu; Diehn, Maximilian; Sze, Daniel Y.; Kothary, Nishita; Loo, Billy W.

    2011-09-01

    Purpose: To compare the retention rates of two types of implanted fiducial markers for stereotactic ablative radiotherapy (SABR) of pulmonary tumors, smooth cylindrical gold 'seed' markers ('seeds') and platinum endovascular embolization coils ('coils'), and to compare the complication rates associated with the respective implantation procedures. Methods and Materials: We retrospectively analyzed the retention of percutaneously implanted markers in 54 consecutive patients between January 2004 and June 2009. A total of 270 markers (129 seeds, 141 coils) were implanted in or around 60 pulmonary tumors over 59 procedures. Markers were implanted using a percutaneous approach under computed tomography (CT) guidance. Postimplantation and follow-up imaging studies were analyzed to score marker retention relative to the number of markers implanted. Markers remaining near the tumor were scored as retained. Markers in a distant location (e.g., pleural space) were scored as lost. CT imaging artifacts near markers were quantified on radiation therapy planning scans. Results: Immediately after implantation, 140 of 141 coils (99.3%) were retained, compared to 110 of 129 seeds (85.3%); the difference was highly significant (p < 0.0001). Of the total number of lost markers, 45% were reported lost during implantation, but 55% were lost immediately afterwards. No additional markers were lost on longer-term follow-up. Implanted lesions were peripherally located for both seeds (mean distance, 0.33 cm from pleural surface) and coils (0.34 cm) (p = 0.96). Incidences of all pneumothorax (including asymptomatic) and pneumothorax requiring chest tube placement were lower in implantation of coils (23% and 3%, respectively) vs. seeds (54% and 29%, respectively; p = 0.02 and 0.01). The degree of CT artifact was similar between marker types. Conclusions: Retention of CT-guided percutaneously implanted coils is significantly better than that of seed markers. Furthermore, implanting coils is at

  10. MRI-guided stereotactic radiofrequency thermocoagulation for 100 hypothalamic hamartomas.

    PubMed

    Kameyama, Shigeki; Shirozu, Hiroshi; Masuda, Hiroshi; Ito, Yosuke; Sonoda, Masaki; Akazawa, Kohei

    2016-05-01

    OBJECT The aim of this study was to elucidate the invasiveness, effectiveness, and feasibility of MRI-guided stereotactic radiofrequency thermocoagulation (SRT) for hypothalamic hamartoma (HH). METHODS The authors examined the clinical records of 100 consecutive patients (66 male and 34 female) with intractable gelastic seizures (GS) caused by HH, who underwent SRT as a sole surgical treatment between 1997 and 2013. The median duration of follow-up was 3 years (range 1-17 years). Seventy cases involved pediatric patients. Ninety percent of patients also had other types of seizures (non-GS). The maximum diameter of the HHs ranged from 5 to 80 mm (median 15 mm), and 15 of the tumors were giant HHs with a diameter of 30 mm or more. Comorbidities included precocious puberty (33.0%), behavioral disorder (49.0%), and mental retardation (50.0%). RESULTS A total of 140 SRT procedures were performed. There was no adaptive restriction for the giant or the subtype of HH, regardless of any prior history of surgical treatment or comorbidities. Patients in this case series exhibited delayed precocious puberty (9.0%), pituitary dysfunction (2.0%), and weight gain (7.0%), besides the transient hypothalamic symptoms after SRT. Freedom from GS was achieved in 86.0% of patients, freedom from other types of seizures in 78.9%, and freedom from all seizures in 71.0%. Repeat surgeries were not effective for non-GS. Seizure freedom led to disappearance of behavioral disorders and to intellectual improvement. CONCLUSIONS The present SRT procedure is a minimally invasive and highly effective surgical procedure without adaptive limitations. SRT involves only a single surgical procedure appropriate for all forms of epileptogenic HH and should be considered in patients with an early history of GS. PMID:26587652

  11. Robotic System for MRI-Guided Stereotactic Neurosurgery

    PubMed Central

    Li, Gang; Cole, Gregory A.; Shang, Weijian; Harrington, Kevin; Camilo, Alex; Pilitsis, Julie G.; Fischer, Gregory S.

    2015-01-01

    Stereotaxy is a neurosurgical technique that can take several hours to reach a specific target, typically utilizing a mechanical frame and guided by preoperative imaging. An error in any one of the numerous steps or deviations of the target anatomy from the preoperative plan such as brain shift (up to 20 mm), may affect the targeting accuracy and thus the treatment effectiveness. Moreover, because the procedure is typically performed through a small burr hole opening in the skull that prevents tissue visualization, the intervention is basically “blind” for the operator with limited means of intraoperative confirmation that may result in reduced accuracy and safety. The presented system is intended to address the clinical needs for enhanced efficiency, accuracy, and safety of image-guided stereotactic neurosurgery for Deep Brain Stimulation (DBS) lead placement. The work describes a magnetic resonance imaging (MRI)-guided, robotically actuated stereotactic neural intervention system for deep brain stimulation procedure, which offers the potential of reducing procedure duration while improving targeting accuracy and enhancing safety. This is achieved through simultaneous robotic manipulation of the instrument and interactively updated in situ MRI guidance that enables visualization of the anatomy and interventional instrument. During simultaneous actuation and imaging, the system has demonstrated less than 15% signal-to-noise ratio (SNR) variation and less than 0.20% geometric distortion artifact without affecting the imaging usability to visualize and guide the procedure. Optical tracking and MRI phantom experiments streamline the clinical workflow of the prototype system, corroborating targeting accuracy with 3-axis root mean square error 1.38 ± 0.45 mm in tip position and 2.03 ± 0.58° in insertion angle. PMID:25376035

  12. Reliability of the Bony Anatomy in Image-Guided Stereotactic Radiotherapy of Brain Metastases

    SciTech Connect

    Guckenberger, Matthias Baier, Kurt; Guenther, Iris; Richter, Anne; Wilbert, Juergen; Sauer, Otto; Vordermark, Dirk; Flentje, Michael

    2007-09-01

    Purpose: To evaluate whether the position of brain metastases remains stable between planning and treatment in cranial stereotactic radiotherapy (SRT). Methods and Materials: Eighteen patients with 20 brain metastases were treated with single-fraction (17 lesions) or hypofractionated (3 lesions) image-guided SRT. Median time interval between planning and treatment was 8 days. Before treatment a cone-beam CT (CBCT) and a conventional CT after application of i.v. contrast were acquired. Setup errors using automatic bone registration (CBCT) and manual soft-tissue registration of the brain metastases (conventional CT) were compared. Results: Tumor size was not significantly different between planning and treatment. The three-dimensional setup error (mean {+-} SD) was 4.0 {+-} 2.1 mm and 3.5 {+-} 2.2 mm according to the bony anatomy and the lesion itself, respectively. A highly significant correlation between automatic bone match and soft-tissue registration was seen in all three directions (r {>=} 0.88). The three-dimensional distance between the isocenter according to bone match and soft-tissue registration was 1.7 {+-} 0.7 mm, maximum 2.8 mm. Treatment of intracranial pressure with steroids did not influence the position of the lesion relative to the bony anatomy. Conclusion: With a time interval of approximately 1 week between planning and treatment, the bony anatomy of the skull proved to be an excellent surrogate for the target position in image-guided SRT.

  13. Intraoperative real-time MRI-guided stereotactic biopsy followed by laser thermal ablation for progressive brain metastases after radiosurgery.

    PubMed

    Torcuator, Roy G; Hulou, M Maher; Chavakula, Vamsidhar; Jolesz, Ferenc A; Golby, Alexandra J

    2016-02-01

    Stereotactic radiosurgery is one of the treatment options for brain metastases. However, there are patients who will progress after radiosurgery. One of the potential treatments for this subset of patients is laser ablation. Image-guided stereotactic biopsy is important to determine the histopathological nature of the lesion. However, this is usually based on preoperative, static images, which may affect the target accuracy during the actual procedure as a result of brain shift. We therefore performed real-time intraoperative MRI-guided stereotactic aspiration and biopsies on two patients with symptomatic, progressive lesions after radiosurgery followed immediately by laser ablation. The patients tolerated the procedure well with no new neurologic deficits. Intraoperative MRI-guided stereotactic biopsy followed by laser ablation is safe and accurate, providing real-time updates and feedback during the procedure. PMID:26596402

  14. MRI-guided stereotactic amygdalohippocampectomy: a single center experience

    PubMed Central

    Vojtěch, Zdeněk; Malíková, Hana; Krámská, Lenka; Liščák, Roman; Vladyka, Vilibald

    2015-01-01

    Background This paper presents our experience of stereotactic radiofrequency amygdalohippocampectomy performed for intractable mesial temporal lobe epilepsy. Methods The article describes the cases of 61 patients who were treated during the period from 2004 to 2010. Mean postoperative follow-up was 5.3 years. Neuropsychological results were obtained for a subset of 31 patients. Results At their last postsurgical visit, 43 (70.5%) patients were Engel class I, six (9.8%) class II, nine (14.8%) class III, and three (4.9%) class IV. The surgery was complicated by four intracranial hematomas. One of them caused acute hydrocephalus and was treated by shunting and resolved without sequelae, while another caused transitory aphasia. The remaining hematomas were asymptomatic. There were two cases of meningitis which required antibiotic treatment. One patient committed suicide due to postoperative depression. After the procedure, we performed open epilepsy surgery and rethermolesions in three and two patients, respectively (8.2%). Patients showed increases in their mean full scale, verbal, and performance intelligence quotient (IQ) scores of 4, 3, and 4 IQ points, respectively (P<0.05). Five (17.2%), four (13.8%), and four (13.3%) patients improved their full scale, verbal, and performance IQ scores, respectively. No significant changes were found in memory performance, with a mean increase of 1, 3, and 0 memory quotient points in global, verbal, and visual memory, respectively (P<0.05). Global memory improved in three (10.3%) patients, verbal memory in one (3.4%), and one patient (3.3%) showed deterioration in visual memory. Conclusion Stereotactic radiofrequency amygdalohippocampectomy offers a safe, effective, and less aggressive treatment modality in cases of well-defined mesial temporal lobe epilepsy. Seizure outcome is comparable with the results of conventional epilepsy surgery and cognitive results could be even better. PMID:25709460

  15. [The development of a guide device for stereotactic core-needle biopsy of the breast].

    PubMed

    Kong, Longyang; Wu, Jian; Gao, Peng; Wu, Guohui; Li, Xiuwang

    2013-11-01

    To meet the need of accurate positioning for biopsy gun in the breast biopsy operation, a new stereotactic biopsy guide device have been developed to adapt to the domestic mammary machine, which can help physician to carry out biopsy operation more accurately and effectively. The guide device has the motion model, measurement model and display model and can realize linear motion and display real-time displacement values in X, Y and Z direction. The experimental results showed that the guide device could be well fixed in the domestic mammary machine, and achieved good accuracy and repeatability in each direction. Depending on the displacement values, physician can change the space of biopsy gun accurately. PMID:24617213

  16. Image-Guided Stereotactic Spine Radiosurgery on a Conventional Linear Accelerator

    SciTech Connect

    Wang Jiazhu Rice, Roger; Mundt, Arno; Sandhu, Ajay; Murphy, Kevin

    2010-04-01

    Stereotactic radiosurgery for spinal metastasis consists of a high radiation dose delivered to the tumor in 1 to 5 fractions. Due to the high radiation dose in a single or fewer treatments, the precision of tumor localization and dose delivery is of great concern. Many groups have published their experiences of spinal radiosurgery with the use of CyberKnife System (Accuray Inc.). In this study, we report in detail our approach to stereotactic spine radiosurgery (SSRS) using a conventional linear accelerator (Varian Trilogy), utilizing the features of kilovolt on-board imaging (kV-OBI) and cone beam computed tomography (CBCT) for image guidance. We present our experience in various aspects of the SSRS procedure, including patient simulation and immobilization, intensity-modulated radiation treatment (IMRT) planning and beam selection, portal dosimetry for patient planning quality assurance (QA), and the use of image guidance in tumor localization prior to and during treatment delivery.

  17. Non-stereotactic method involving combination of ultrasound-guided wire localization and vacuum-assisted breast biopsy for microcalcification

    PubMed Central

    Lee, Jeeyeon; Park, Ho Yong; Jung, Jin Hyang; Kim, Wan Wook; Hwang, Seung Ook; Kwon, Taek Ju; Chung, Jin Ho

    2016-01-01

    Background Stereotactic breast biopsy is a standard intervention for evaluation of “microcalcification-only” lesions. However, an expensive stereotactic device and radiologic expertise are necessary for this procedure. We herein report a non-stereotactic technique involving the combination of wire localization and vacuum-assisted breast biopsy (VABB) under ultrasound (US) guidance. Methods Twenty-two consecutive patients with category 3 or 4a microcalcification only as shown by mammography underwent the above-mentioned non-stereotactic combination method involving US-guided wire localization and VABB. The location of the microcalcification was measured by manual stereotaxis, and the microcalcification was confirmed by specimen mammography after the procedure. Results The mean number ± standard deviation of removed cores and calcified cores was 28.4±13.4 and 2.2±0.9, respectively. In one case, the procedure was repeated 3 times. The histologic diagnoses were fibrocystic change (n=14), fibroadenoma (n=4), sclerosing adenosis (n=1), usual ductal hyperplasia (n=2), and atypical ductal hyperplasia (n=1). Conclusions “Microcalcification-only” breast lesions can be easily evaluated with the combination of non-stereotactic US-guided wire localization and VABB. This would be an effective diagnostic technique for breast lesion which reveals only microcalcification. PMID:27294037

  18. Real-Time Magnetic Resonance-Guided Stereotactic Laser Amygdalohippocampotomy for Mesial Temporal Lobe Epilepsy

    PubMed Central

    Willie, Jon T.; Laxpati, Nealen G.; Drane, Daniel L.; Gowda, Ashok; Appin, Christina; Hao, Chunhai; Brat, Daniel J.; Helmers, Sandra L.; Saindane, Amit; Nour, Sherif G.; Gross, Robert E.

    2014-01-01

    Background Open surgery effectively treats mesial temporal lobe epilepsy (MTLE), but carries risks of neurocognitive deficits, which may be reduced with minimally invasive alternatives. Objective To describe technical and clinical outcomes of stereotactic laser amygdalohippocampotomy (SLAH) with real-time magnetic resonance thermal imaging (MRTI) guidance. Methods Under general anesthesia and utilizing standard stereotactic methods, 13 adult patients with intractable MTLE (with and without mesial temporal sclerosis, MTS) prospectively underwent insertion of a saline-cooled fiber-optic laser applicator into amygdalohippocampal structures from an occipital trajectory. Computer-controlled laser ablation was performed during continuous MRTI followed by confirmatory contrast-enhanced anatomic imaging and volumetric reconstruction. Clinical outcomes were determined from seizure diaries. Results A mean 60% volume of the amygdalohippocampal complex was ablated in 13 patients (9 with MTS) undergoing 15 procedures. Median hospitalization was one day. With follow-up ranging from 5-26 (median 14) months, 77% (10/13) of patients achieved meaningful seizure reduction, of which 54% (7/13) were free of disabling seizures. Of patients with preoperative MTS, 67% (6/9) achieved seizure freedom. All recurrences were observed by<6 months. Variances in ablation volume and length did not account for individual clinical outcomes. Whereas no complications of laser therapy itself were observed, one significant complication, a visual field defect, resulted from deviated insertion of a stereotactic aligning rod, which was corrected prior to ablation. Conclusion Real-time MR-guided SLAH is a technically novel, safe, and effective alternative to open surgery. Further evaluation with larger cohorts over time is warranted. PMID:24618797

  19. Frameless Image-Guided Intracranial Stereotactic Radiosurgery: Clinical Outcomes for Brain Metastases

    SciTech Connect

    Breneman, John C. Steinmetz, Ryan; Smith, Aaron; Lamba, Michael; Warnick, Ronald E.

    2009-07-01

    Purpose: After preclinical investigations confirming the accuracy of target localization by frameless image-guided radiosurgery, we report the clinical outcomes of patients with brain metastases who underwent frameless radiosurgery. Methods and Materials: Between 2005 and 2006, 53 patients underwent frameless stereotactic radiosurgery using a linear accelerator equipped with on-board image guidance for the treatment of 158 brain metastases. The radiation doses were delivered in a single fraction (dose range, 12-22 Gy; median, 18). Patients were followed with magnetic resonance imaging scans at 2-3-month intervals. Progression-free survival was the primary study endpoint. Results: With a median follow-up of 38 weeks (range, 14-112), the overall survival rate was 70% at 6 months, 44% at 1 year, 29% at 18 months, and 16% at 24 months. Local control was achieved in 90% of 168 treated lesions at 6 months, 80% at 12 months, 78% at 18 months, and 78% at 24 months. Local control tended to be improved in lesions treated with {>=}18 Gy and for lesions <0.2 cm{sup 3}. Adverse events occurred in 5 patients (9.6%). No evidence of imaging changes on post-stereotactic radiosurgery scans was found to suggest mistargeting of a radiation isocenter. Conclusion: The clinical outcomes after frameless stereotactic radiosurgery were comparable to those after frame-based radiosurgery techniques. Given its significant advantages in terms of patient comfort, ability to use fractionated treatment regimens, and convenience in scheduling of personnel and equipment resources, frameless radiosurgery will likely become a common technique for intracranial radiosurgery.

  20. Benefit of three-dimensional image-guided stereotactic localization in the hypofractionated treatment of lung cancer

    SciTech Connect

    Wang Lu . E-mail: lu.wang@fccc.edu; Feigenberg, Steve; Chen Lili; Pasklev, Kamen M.S.; Ma, Charlie C.-M.

    2006-11-01

    Purpose: The aim of this study was to investigate the benefit of image-guided stereotactic localization in the hypofractionated treatment for medically inoperable non-small-cell lung cancer. Methods and Materials: A stereotactic body localizer (SBL) system was used for patient immobilization, reliable image registration among multiphase computed tomography (CT) scanning, and image-guided stereotactic localization. Three sets of CT scans were taken (free breathing, and breath holding at the end-tidal inspiration and expiration, respectively) to contrast target motion. Target delineation was performed on all 3 sets of images and the combination of the targets forms an internal target volume (ITV). In this retrospective study of treatment dose verification, we performed image fusion between the simulation CT scan and each pretreatment CT scan to obtain the same target and critical structure information. The same treatment plans were reloaded onto each pretreatment CT scan with their respective stereotactic coordinate system. The changes in dose distributions were assessed by dose-volume histograms of the planning target volume (PTV) and the critical structures before and after isocenter corrections which were prompted by image-guided stereotactic localization. We compared D{sub 95}, D{sub 99}, and V{sub 95} for the PTV and internal target volume, and V{sub 2} and V{sub 3} for the ipsilateral lung. Results: Our retrospective study for 10 patients with 40 dose reconstructions showed that the average D{sub 95}, D{sub 99}, and V{sub 95} of the PTVs are 92.1%, 88.1%, and 95.8% of the planned values before isocenter corrections. With the corrections, all of these values are improved to 100% of the planned values. Conclusions: Three-dimensional image guidance is crucial for stereotactic radiotherapy of lung tumors.

  1. Effect of image-guided hypofractionated stereotactic radiotherapy on peripheral non-small-cell lung cancer

    PubMed Central

    Wang, Shu-wen; Ren, Juan; Yan, Yan-li; Xue, Chao-fan; Tan, Li; Ma, Xiao-wei

    2016-01-01

    The objective of this study was to compare the effects of image-guided hypofractionated radiotherapy and conventional fractionated radiotherapy on non-small-cell lung cancer (NSCLC). Fifty stage- and age-matched cases with NSCLC were randomly divided into two groups (A and B). There were 23 cases in group A and 27 cases in group B. Image-guided radiotherapy (IGRT) and stereotactic radiotherapy were conjugately applied to the patients in group A. Group A patients underwent hypofractionated radiotherapy (6–8 Gy/time) three times per week, with a total dose of 64–66 Gy; group B received conventional fractionated radiotherapy, with a total dose of 68–70 Gy five times per week. In group A, 1-year and 2-year local failure survival rate and 1-year local failure-free survival rate were significantly higher than in group B (P<0.05). The local failure rate (P<0.05) and distant metastasis rate (P>0.05) were lower in group A than in group B. The overall survival rate of group A was significantly higher than that of group B (P=0.03), and the survival rate at 1 year was 87% vs 63%, (P<0.05). The median survival time of group A was longer than that of group B. There was no significant difference in the incidence of complications between the two groups (P>0.05). Compared with conventional fractionated radiation therapy, image-guided hypofractionated stereotactic radiotherapy in NSCLC received better treatment efficacy and showed good tolerability. PMID:27574441

  2. Clinical Results of a Pilot Study on Stereovision-Guided Stereotactic Radiotherapy and Intensity Modulated Radiotherapy

    PubMed Central

    Li, Shidong; Kleinberg, Lawrence R.; Rigamonti, Daniele; Wharam, Moody D.; Rashid, Abdul; Jackson, Juan; Djajaputra, David; He, Shenjen; Creasey, Tunisia; DeWeese, Theodore L.

    2011-01-01

    Real-time stereovision-guidance has been introduced for efficient and convenient fractionated stereotactic radiotherapy (FSR) and image-guided intensity-modulated radiation therapy (IMRT). This first pilot study is to clinically evaluate its accuracy and precision as well as impact on treatment doses. Sixty-one FSR patients wearing stereotactic masks (SMs) and nine IMRT patients wearing flexible masks (FMs), were accrued. Daily target reposition was initially based-on biplane-radiographs and then adjusted in six degrees of freedom under real-time stereovision guidance. Mean and standard deviation of the head displacements measured the accuracy and precision. Head positions during beam-on times were measured with real-time stereovisions and used for determination of delivered doses. Accuracy ± precision in direction with the largest errors shows improvement from 0.4 ± 2.3 mm to 0.0 ± 1.0 mm in the inferior-to-superior direction for patients wearing SM or from 0.8 ± 4.3 mm to 0.4 ± 1.7 mm in the posterior-to-anterior direction for patients wearing FM. The image-guidance increases target volume coverage by >30% for small lesions. Over half of head position errors could be removed from the stereovision-guidance. Importantly, the technique allows us to check head position during beam-on time and makes it possible for having frameless head refixation without tight masks. PMID:21070083

  3. Stereotactic mammography imaging combined with 3D US imaging for image guided breast biopsy

    SciTech Connect

    Surry, K. J. M.; Mills, G. R.; Bevan, K.; Downey, D. B.; Fenster, A.

    2007-11-15

    Stereotactic X-ray mammography (SM) and ultrasound (US) guidance are both commonly used for breast biopsy. While SM provides three-dimensional (3D) targeting information and US provides real-time guidance, both have limitations. SM is a long and uncomfortable procedure and the US guided procedure is inherently two dimensional (2D), requiring a skilled physician for both safety and accuracy. The authors developed a 3D US-guided biopsy system to be integrated with, and to supplement SM imaging. Their goal is to be able to biopsy a larger percentage of suspicious masses using US, by clarifying ambiguous structures with SM imaging. Features from SM and US guided biopsy were combined, including breast stabilization, a confined needle trajectory, and dual modality imaging. The 3D US guided biopsy system uses a 7.5 MHz breast probe and is mounted on an upright SM machine for preprocedural imaging. Intraprocedural targeting and guidance was achieved with real-time 2D and near real-time 3D US imaging. Postbiopsy 3D US imaging allowed for confirmation that the needle was penetrating the target. The authors evaluated 3D US-guided biopsy accuracy of their system using test phantoms. To use mammographic imaging information, they registered the SM and 3D US coordinate systems. The 3D positions of targets identified in the SM images were determined with a target localization error (TLE) of 0.49 mm. The z component (x-ray tube to image) of the TLE dominated with a TLE{sub z} of 0.47 mm. The SM system was then registered to 3D US, with a fiducial registration error (FRE) and target registration error (TRE) of 0.82 and 0.92 mm, respectively. Analysis of the FRE and TRE components showed that these errors were dominated by inaccuracies in the z component with a FRE{sub z} of 0.76 mm and a TRE{sub z} of 0.85 mm. A stereotactic mammography and 3D US guided breast biopsy system should include breast compression for stability and safety and dual modality imaging for target localization

  4. Target Coverage in Image-Guided Stereotactic Body Radiotherapy of Liver Tumors

    SciTech Connect

    Wunderink, Wouter . E-mail: w.wunderink@erasmusmc.nl; Romero, Alejandra Mendez; Osorio, Eliana M. Vasquez; Boer, Hans C.J. de; Brandwijk, Rene P.; Levendag, Peter C.; Heijmen, Ben

    2007-05-01

    Purpose: To determine the effect of image-guided procedures (with computed tomography [CT] and electronic portal images before each treatment fraction) on target coverage in stereotactic body radiotherapy for liver patients using a stereotactic body frame (SBF) and abdominal compression. CT guidance was used to correct for day-to-day variations in the tumor's mean position in the SBF. Methods and Materials: By retrospectively evaluating 57 treatment sessions, tumor coverage, as obtained with the clinically applied CT-guided protocol, was compared with that of alternative procedures. The internal target volume-plus (ITV{sup +}) was introduced to explicitly include uncertainties in tumor delineations resulting from CT-imaging artifacts caused by residual respiratory motion. Tumor coverage was defined as the volume overlap of the ITV{sup +}, derived from a tumor delineated in a treatment CT scan, and the planning target volume. Patient stability in the SBF, after acquisition of the treatment CT scan, was evaluated by measuring the displacement of the bony anatomy in the electronic portal images relative to CT. Results: Application of our clinical protocol (with setup corrections following from manual measurements of the distances between the contours of the planning target volume and the daily clinical target volume in three orthogonal planes, multiple two-dimensional) increased the frequency of nearly full ({>=}99%) ITV{sup +} coverage to 77% compared with 63% without setup correction. An automated three-dimensional method further improved the frequency to 96%. Patient displacements in the SBF were generally small ({<=}2 mm, 1 standard deviation), but large craniocaudal displacements (maximal 7.2 mm) were occasionally observed. Conclusion: Daily, CT-assisted patient setup may substantially improve tumor coverage, especially with the automated three-dimensional procedure. In the present treatment design, patient stability in the SBF should be verified with portal

  5. Real-time magnetic resonance imaging-guided frameless stereotactic brain biopsy: technical note.

    PubMed

    Mohyeldin, Ahmed; Lonser, Russell R; Elder, J Bradley

    2016-04-01

    OBJECT The object of this study was to assess the feasibility, accuracy, and safety of real-time MRI-compatible frameless stereotactic brain biopsy. METHODS Clinical, imaging, and histological data in consecutive patients who underwent stereotactic brain biopsy using a frameless real-time MRI system were analyzed. RESULTS Five consecutive patients (4 males, 1 female) were included in this study. The mean age at biopsy was 45.8 years (range 29-60 years). Real-time MRI permitted concurrent display of the biopsy cannula trajectory and tip during placement at the target. The mean target depth of biopsied lesions was 71.3 mm (range 60.4-80.4 mm). Targeting accuracy analysis revealed a mean radial error of 1.3 ± 1.1 mm (mean ± standard deviation), mean depth error of 0.7 ± 0.3 mm, and a mean absolute tip error of 1.5 ± 1.1 mm. There was no correlation between target depth and absolute tip error (Pearson product-moment correlation coefficient, r = 0.22). All biopsy cannulae were placed at the target with a single penetration and resulted in a diagnostic specimen in all cases. Histopathological evaluation of biopsy samples revealed dysembryoplastic neuroepithelial tumor (1 case), breast carcinoma (1 case), and glioblastoma multiforme (3 cases). CONCLUSIONS The ability to place a biopsy cannula under real-time imaging guidance permits on-the-fly alterations in the cannula trajectory and/or tip placement. Real-time imaging during MRI-guided brain biopsy provides precise safe targeting of brain lesions. PMID:26495951

  6. Breast biopsy - stereotactic

    MedlinePlus

    ... several types of breast biopsies, including open, ultrasound-guided , and lumpectomy . This article focuses on stereotactic breast ... a special machine, a needle or sheath is guided to the exact location of the abnormal area. ...

  7. CT-Guided Fiducial Placement for CyberKnife Stereotactic Radiosurgery: An Initial Experience

    SciTech Connect

    Sotiropoulou, Evangelia; Stathochristopoulou, Irene; Stathopoulos, Konstantinos; Verigos, Kosmas; Salvaras, Nikolaos; Thanos, Loukas

    2010-06-15

    CyberKnife frameless image-guided radiosurgery has become a widely used system for parenchymal extracranial lesions. Gold fiducials are required for the planning and aiming of CyberKnife therapy. We report our initial experience and describe the technique of positioning tumor markers, under CT guidance. We conducted a retrospective review of 105 patients who were referred for CyberKnife stereotactic radiosurgery at Iatropolis CyberKnife Center in Athens. All patients underwent percutaneous fiducial placement via CT guidance. At the desired location, the 18-G needle was advanced into or near the tumor. Data collected included number and locations of fiducials placed and complications experienced to date. One hundred five patients underwent fiducial placement under CT guidance and a total number of 319 gold seeds were implanted. We experienced one episode of pneumothorax that required drainage, one mild pneumothorax, and three episodes of perifocal pulmonary hemorrhage. In conclusion, fiducial implantation under CT guidance appears to be a safe and efficient procedure, as long as it is performed by an experienced interventional radiologist.

  8. Real-time 3D-surface-guided head refixation useful for fractionated stereotactic radiotherapy

    SciTech Connect

    Li Shidong; Liu Dezhi; Yin Gongjie; Zhuang Ping; Geng, Jason

    2006-02-15

    Accurate and precise head refixation in fractionated stereotactic radiotherapy has been achieved through alignment of real-time 3D-surface images with a reference surface image. The reference surface image is either a 3D optical surface image taken at simulation with the desired treatment position, or a CT/MRI-surface rendering in the treatment plan with corrections for patient motion during CT/MRI scans and partial volume effects. The real-time 3D surface images are rapidly captured by using a 3D video camera mounted on the ceiling of the treatment vault. Any facial expression such as mouth opening that affects surface shape and location can be avoided using a new facial monitoring technique. The image artifacts on the real-time surface can generally be removed by setting a threshold of jumps at the neighboring points while preserving detailed features of the surface of interest. Such a real-time surface image, registered in the treatment machine coordinate system, provides a reliable representation of the patient head position during the treatment. A fast automatic alignment between the real-time surface and the reference surface using a modified iterative-closest-point method leads to an efficient and robust surface-guided target refixation. Experimental and clinical results demonstrate the excellent efficacy of <2 min set-up time, the desired accuracy and precision of <1 mm in isocenter shifts, and <1 deg. in rotation.

  9. Cone-beam Computed Tomography-guided Stereotactic Liver Punctures: A Phantom Study

    SciTech Connect

    Toporek, Grzegorz Wallach, Daphne Weber, Stefan; Bale, Reto; Widmann, Gerlig

    2013-12-15

    Purpose: Images from computed tomography (CT), combined with navigation systems, improve the outcomes of local thermal therapies that are dependent on accurate probe placement. Although the usage of CT is desired, its availability for time-consuming radiological interventions is limited. Alternatively, three-dimensional images from C-arm cone-beam CT (CBCT) can be used. The goal of this study was to evaluate the accuracy of navigated CBCT-guided needle punctures, controlled with CT scans. Methods: Five series of five navigated punctures were performed on a nonrigid phantom using a liver specific navigation system and CBCT volumetric dataset for planning and navigation. To mimic targets, five titanium screws were fixed to the phantom. Target positioning accuracy (TPE{sub CBCT}) was computed from control CT scans and divided into lateral and longitudinal components. Additionally, CBCT-CT guidance accuracy was deducted by performing CBCT-to-CT image coregistration and measuring TPE{sub CBCT-CT} from fused datasets. Image coregistration was evaluated using fiducial registration error (FRE{sub CBCT-CT}) and target registration error (TRE{sub CBCT-CT}). Results: Positioning accuracies in lateral directions pertaining to CBCT (TPE{sub CBCT} = 2.1 {+-} 1.0 mm) were found to be better to those achieved from previous study using CT (TPE{sub CT} = 2.3 {+-} 1.3 mm). Image coregistration error was 0.3 {+-} 0.1 mm, resulting in an average TRE of 2.1 {+-} 0.7 mm (N = 5 targets) and average Euclidean TPE{sub CBCT-CT} of 3.1 {+-} 1.3 mm. Conclusions: Stereotactic needle punctures might be planned and performed on volumetric CBCT images and controlled with multidetector CT with positioning accuracy higher or similar to those performed using CT scanners.

  10. Computer assisted CT-guided stereotactic transplantation of foetal ventral mesencephalon to the caudate nucleus and putamen in Parkinson's disease.

    PubMed

    Molina, H; Quiñones, R; Ortega, I; Alvarez, L; Muñoz, J; Gonzalez, C; Suárez, C

    1993-01-01

    We report our preliminary results related to CT-guided stereotactic transplantation of foetal ventral mesencephalic cell suspension into the striatum of five patients with idiopathic Parkinson's disease. The mean age was 51 years, the evolution time of the disease ranged from 7 to 14 years, and all of them had motor complications associated with chronic L-dopa therapy. The patients were evaluated according to the Core Assessment Program for Intracerebral Transplantations (CAPIT) for one year before and three months after surgery. The postoperative clinical assessment demonstrated significant improvement of neurological symptoms and reduction of daily L-dopa dosage. PMID:8109284

  11. Stereotactic Body Radiotherapy for Oligometastasis: Opportunities for Biology to Guide Clinical Management.

    PubMed

    Correa, Rohann J M; Salama, Joseph K; Milano, Michael T; Palma, David A

    2016-01-01

    Oligometastasis refers to a state of limited metastatic disease burden, in which surgical or ablative treatment to all known visible metastases holds promise to extend survival or even effect cure. Stereotactic body radiotherapy is a form of radiation treatment capable of delivering a high biologically effective dose of radiation in a highly conformal manner, with a favorable toxicity profile. Enthusiasm for oligometastasis ablation, however, should be counterbalanced against the limited supporting evidence. It remains unknown to what extent (if any) ablation influences survival or quality of life. Rising clinical equipoise necessitates the completion of randomized controlled trials to assess this, several of which are underway. However, a lack of clear identification criteria or biomarkers to define the oligometastatic state hampers optimal patient selection.This narrative review explores the evolutionary origins of oligometastasis, the steps of the metastatic process at which oligometastases may arise, and the biomolecular mediators of this state. It discusses clinical outcomes with treatment of oligometastases, ongoing trials, and areas of basic and translational research that may lead to novel biomarkers. These efforts should provide a clearer, biomolecular definition of oligometastatic disease and aid in the accurate selection of patients for ablative therapies. PMID:27441744

  12. Cone Beam CT Image Guidance for Intracranial Stereotactic Treatments: Comparison With a Frame Guided Set-Up

    SciTech Connect

    Masi, Laura Casamassima, Franco; Polli, Caterina; Menichelli, Claudia; Bonucci, Ivano; Cavedon, Carlo

    2008-07-01

    Purpose: An analysis is performed of the setup errors measured by a kV cone beam computed tomography (CBCT) for intracranial stereotactic radiotherapy (SRT) patients immobilized by a thermoplastic mask and a bite-block and positioned using stereotactic coordinates. We evaluated the overall positioning precision and accuracy of the immobilizing and localizing systems. The potential of image-guided radiotherapy to replace stereotactic methods is discussed. Methods and Materials: Fifty-seven patients received brain SRT. After a frame-guided setup, before each fraction (131 fractions), a CBCT was acquired and the detected displacements corrected online. Translational and rotational errors were analyzed calculating overall mean and standard deviation. A separate analysis was performed for bite-block (in conjunction with mask) and for simple thermoplastic mask. Interobserver variability for CBCT three-dimensional registration was assessed. The residual error after correction and intrafractional motion were calculated. Results: The mean module of the three-dimensional displacement vector was 3.0 {+-} 1.4 mm. Setup errors for bite block and mask were smaller (2.9 {+-} 1.3 mm) than those for thermoplastic mask alone (3.2 {+-} 1.5 mm), but statistical significance was not reached (p = 0.15). Interobserver variability was negligible. The maximum margin calculated for residual errors and intra fraction motion was small but not negligible (1.57 mm). Conclusions: Considering the detected setup errors, daily image guidance is essential for the efficacy of SRT treatments when mask immobilization is used, and even when a bite-block is used in conjunction. The frame setup is still used as a starting point for the opportunity of rotational corrections. Residual margins after on-line corrections must be evaluated.

  13. Image-Guided Robotic Stereotactic Body Radiation Therapy for Liver Metastases: Is There a Dose Response Relationship?

    SciTech Connect

    Vautravers-Dewas, Claire; Dewas, Sylvain; Bonodeau, Francois; Adenis, Antoine; Lacornerie, Thomas; Penel, Nicolas; Lartigau, Eric; Mirabel, Xavier

    2011-11-01

    Purpose: To evaluate the outcome, tolerance, and toxicity of stereotactic body radiotherapy, using image-guided robotic radiation delivery, for the treatment of patients with unresectable liver metastases. Methods and Material: Patients were treated with real-time respiratory tracking between July 2007 and April 2009. Their records were retrospectively reviewed. Metastases from colorectal carcinoma and other primaries were not necessarily confined to liver. Toxicity was evaluated using National Cancer Institute Common Criteria for Adverse Events version 3.0. Results: Forty-two patients with 62 metastases were treated with two dose levels of 40 Gy in four Dose per Fraction (23) and 45 Gy in three Dose per Fraction (13). Median follow-up was 14.3 months (range, 3-23 months). Actuarial local control for 1 and 2 years was 90% and 86%, respectively. At last follow-up, 41 (66%) complete responses and eight (13%) partial responses were observed. Five lesions were stable. Nine lesions (13%) were locally progressed. Overall survival was 94% at 1 year and 48% at 2 years. The most common toxicity was Grade 1 or 2 nausea. One patient experienced Grade 3 epidermitis. The dose level did not significantly contribute to the outcome, toxicity, or survival. Conclusion: Image-guided robotic stereotactic body radiation therapy is feasible, safe, and effective, with encouraging local control. It provides a strong alternative for patients who cannot undergo surgery.

  14. Image-guided stereotactic radiotherapy in 4 dogs with intracranial neoplasia.

    PubMed

    Moon, Alaina Burkard; Heller, Heidi Barnes; Forrest, Lisa

    2016-05-01

    The purpose of this study was to describe the use, and side effects, of a novel stereotactic radiotherapy protocol using TomoTherapy(®) in 4 dogs with confirmed or suspected primary extra-axial intracranial neoplasia. Three fractions of 8 Gy were prescribed. Acute side effects were noted in 1 dog; no late effects were noted. PMID:27152041

  15. Image-Guided Localization Accuracy of Stereoscopic Planar and Volumetric Imaging Methods for Stereotactic Radiation Surgery and Stereotactic Body Radiation Therapy: A Phantom Study

    SciTech Connect

    Kim, Jinkoo; Jin, Jian-Yue; Walls, Nicole; Nurushev, Teamour; Movsas, Benjamin; Chetty, Indrin J.; Ryu, Samuel

    2011-04-01

    Purpose: To evaluate the positioning accuracies of two image-guided localization systems, ExacTrac and On-Board Imager (OBI), in a stereotactic treatment unit. Methods and Materials: An anthropomorphic pelvis phantom with eight internal metal markers (BBs) was used. The center of one BB was set as plan isocenter. The phantom was set up on a treatment table with various initial setup errors. Then, the errors were corrected using each of the investigated systems. The residual errors were measured with respect to the radiation isocenter using orthogonal portal images with field size 3 x 3 cm{sup 2}. The angular localization discrepancies of the two systems and the correction accuracy of the robotic couch were also studied. A pair of pre- and post-cone beam computed tomography (CBCT) images was acquired for each angular correction. Then, the correction errors were estimated by using the internal BBs through fiducial marker-based registrations. Results: The isocenter localization errors ({mu} {+-}{sigma}) in the left/right, posterior/anterior, and superior/inferior directions were, respectively, -0.2 {+-} 0.2 mm, -0.8 {+-} 0.2 mm, and -0.8 {+-} 0.4 mm for ExacTrac, and 0.5 {+-} 0.7 mm, 0.6 {+-} 0.5 mm, and 0.0 {+-} 0.5 mm for OBI CBCT. The registration angular discrepancy was 0.1 {+-} 0.2{sup o} between the two systems, and the maximum angle correction error of the robotic couch was 0.2{sup o} about all axes. Conclusion: Both the ExacTrac and the OBI CBCT systems showed approximately 1 mm isocenter localization accuracies. The angular discrepancy of two systems was minimal, and the robotic couch angle correction was accurate. These positioning uncertainties should be taken as a lower bound because the results were based on a rigid dosimetry phantom.

  16. Touch Imprint Cytology and Stereotactically-Guided Core Needle Biopsy of Suspicious Breast Lesions: 15-Year Follow-up

    PubMed Central

    Schulz-Wendtland, R.; Fasching, P. A.; Bani, M. R.; Lux, M. P.; Jud, S.; Rauh, C.; Bayer, C.; Wachter, D. L.; Hartmann, A.; Beckmann, M. W.; Uder, M.; Loehberg, C. R.

    2016-01-01

    Introduction: Stereotactically-guided core needle biopsies (CNB) of breast tumours allow histological examination of the tumour without surgery. Touch imprint cytology (TIC) of CNB promises to be useful in providing same-day diagnosis for counselling purposes and for planning future surgery. Having addressed the issue of accuracy of immediate microscopic evaluation of TIC, we wanted to re-examine the usefulness of this procedure in light of the present health care climate of cost containment by incorporating the surgical 15-year follow-up data and outcome. Patients and Methods: From January until December 1996 we performed TIC in core needle biopsies of 173 breast tumours in 169 patients, consisting of 122 malignant and 51 benign tumours. Histology of core needle biopsies was proven by surgical histology in all malignant and in 5 benign tumours. Surgical breast biopsy was not performed in 46 patients with 46 benign lesions, as the histological result from the core needle biopsy and the result of the TIC were in agreement with the suspected diagnosis from the complementary breast diagnostics. A 15-year follow-up of these patients followed in 2013 and follow-up data was collected from 40 women. Results: In the 15-year follow-up of the 40 benign lesions primarily confirmed using CNB and TIC, a diagnostic sensitivity, specificity, positive and negative predictive value and accuracy of 100 % was found. Conclusion: TIC and stereotactically guided CNB showed excellent long-term follow-up in patients with benign breast lesions. The use of TIC to complement CNB can therefore provide immediate cytological diagnosis of breast lesions. PMID:26855442

  17. Outcomes and Toxicity for Hypofractionated and Single-Fraction Image-Guided Stereotactic Radiosurgery for Sarcomas Metastasizing to the Spine

    SciTech Connect

    Folkert, Michael R.; Bilsky, Mark H.; Tom, Ashlyn K.; Oh, Jung Hun; Alektiar, Kaled M.; Laufer, Ilya; Tap, William D.; Yamada, Yoshiya

    2014-04-01

    Purpose: Conventional radiation treatment (20-40 Gy in 5-20 fractions, 2-5 Gy per fraction) for sarcoma metastatic to the spine provides subtherapeutic doses, resulting in poor durable local control (LC) (50%-77% at 1 year). Hypofractionated (HF) and/or single-fraction (SF) image-guided stereotactic radiosurgery (IG-SRS) may provide a more effective means of managing these lesions. Methods and Materials: Patients with pathologically proven high-grade sarcoma metastatic to the spine treated with HF and SF IG-SRS were included. LC and overall survival (OS) were analyzed by the use of Kaplan-Meier statistics. Univariate and multivariate analyses were performed by the use of Cox regression with competing-risks analysis; all confidence intervals are 95%. Toxicities were assessed according to Common Terminology Criteria for Adverse Events, version 4.0. Results: From May 2005 to November 11, 2012, 88 patients with 120 discrete metastases received HF (3-6 fractions; median dose, 28.5 Gy; n=52, 43.3%) or SF IG-SRS (median dose, 24 Gy; n=68, 56.7%). The median follow-up time was 12.3 months. At 12 months, LC was 87.9% (confidence interval [CI], 81.3%-94.5%), OS was 60.6% (CI, 49.6%-71.6%), and median survival was 16.9 months. SF IG-SRS demonstrated superior LC to HF IG-SRS (12-month LC of 90.8% [CI, 83%-98.6%] vs 84.1% [CI, 72.9%-95.3%] P=.007) and retained significance on multivariate analysis (P=.030, hazard ratio 0.345; CI, 0.132-0.901]. Treatment was well tolerated, with 1% acute grade 3 toxicity, 4.5% chronic grade 3 toxicity, and no grade >3 toxicities. Conclusions: In the largest series of metastatic sarcoma to the spine to date, IG-SRS provides excellent LC in the setting of an aggressive disease with low radiation sensitivity and poor prognosis. Single-fraction IG-SRS is associated with the highest rates of LC with minimal toxicity.

  18. Design and simulation of an articulated surgical arm for guiding stereotactic neurosurgery

    NASA Astrophysics Data System (ADS)

    Kadi, A. Majeed; Zamorano, Lucia J.; Frazer, Matthew P.; Lu, Yi

    1992-03-01

    In stereotactic surgery, the need exists for means of relating intraoperatively the position and orientation of the surgical instrument used by the neurosurgeon to a known frame of reference. An articulated arm is proposed which would provide the neurosurgeon with on-line information for position, and orientation of the surgical tools being moved by the neurosurgeon. The articulated arm has six degrees of freedom, with five revolute and one prismatic joints. The design features include no obstruction to the field of view, lightweight, good balance against gravity, an accuracy of 1 mm spherical error probability (SEP), and a solvable kinematic structure making it capable of fitting the operating room environment. The arm can be mounted on either the surgical table or the stereotactic frame. A graphical simulation of the arm was created using the IGRIP simulation package created by Deneb Robotics. The simulation demonstrates the use of the arm, mounted on several positions of the ring reaching various target points within the cranium.

  19. A new device for stereotactic CT-guided biopsy of the canine brain: design, construction, and needle placement accuracy.

    PubMed

    Giroux, Alain; Jones, Jeryl C; Bøhn, Jan Helge; Duncan, Robert B; Waldron, Don R; Inzana, Karen R

    2002-01-01

    An inexpensive device was created for computed tomographic (CT)-guided stereotactic biopsy of the canine brain. The accuracy of the device was tested using 16, formalin-perfused, canine head specimens. For each dog, a 6-inch biopsy needle was guided into pituitary gland and caudate nucleus targets. Needle tracks were measured using the CT computer and infused with tissue staining solution. Hit success and actual needle track lengths were determined from sliced brain specimens. The device enabled accurate orientation and placement of the canine head in the slice plane, such that progressive penetration of the biopsy needle could be monitored. The caudate nucleus was hit 12/16 times (75% accuracy) and the pituitary gland 15.5/16 times (98.6% accuracy). Hit proportions for the two targets did not differ (P < 0.05). A significant difference was found between CT and actual track length for both targets (P < 0.01). This was attributed to incomplete staining of the bevel portion of the needle track. PMID:12088316

  20. High Technology Internship. Curriculum Guide.

    ERIC Educational Resources Information Center

    Judson Independent School District, Converse, TX.

    This guide was developed to help teachers conduct a cooperative work experience internship program in high technology and related industry for high school students. The curriculum guide provides an overview of the high-technology internship program, lists goals and objectives of the program, and provides a course outline containing 13 units. Each…

  1. Five-Year Outcomes of High-Dose Single-Fraction Spinal Stereotactic Radiosurgery

    SciTech Connect

    Moussazadeh, Nelson; Lis, Eric; Katsoulakis, Evangelia; Kahn, Sweena; Svoboda, Marek; DiStefano, Natalie M.; McLaughlin, Lily; Bilsky, Mark H.; Yamada, Yoshiya; Laufer, Ilya

    2015-10-01

    Purpose: To characterize local tumor control and toxicity risk in very long-term survivors (>5 years) after high-dose spinal image guided, intensity modulated radiation therapy delivered as single-dose stereotactic radiosurgery (SRS). Previously published spinal SRS outcome analyses have included a heterogeneous population of cancer patients, mostly with short survival. This is the first study reporting the long-term tumor control and toxicity profiles after high-dose single-fraction spinal SRS. Methods and Materials: The study population included all patients treated from June 2004 to July 2009 with single-fraction spinal SRS (dose 24 Gy) who had survived at least 5 years after treatment. The endpoints examined included disease progression, surgical or radiation retreatment, in-field fracture development, and radiation-associated toxicity, scored using the Radiation Therapy Oncology Group radiation morbidity scoring criteria and the Common Terminology Criteria for Adverse Events, version 4.0. Local control and fracture development were assessed using Kaplan-Meier analysis. Results: Of 278 patients, 31 (11.1%), with 36 segments treated for spinal tumors, survived at least 5 years after treatment and were followed up radiographically and clinically for a median of 6.1 years (maximum 102 months). The histopathologic findings for the 5-year survivors included radiation-resistant metastases in 58%, radiation-sensitive metastases in 22%, and primary bone tumors in 19%. In this selected cohort, 3 treatment failures occurred at a median of 48.6 months, including 2 recurrences in the radiation field and 1 patient with demonstrated progression at the treatment margins. Ten lesions (27.8%) were associated with acute grade 1 cutaneous or gastrointestinal toxicity. Delayed toxicity ≥3 months after treatment included 8 cases (22.2%) of mild neuropathy, 2 (5.6%) of gastrointestinal discomfort, 8 (22.2%) of dermatitides, and 3 (8.3%) of myalgias/myositis. Thirteen

  2. Robotic Image-Guided Stereotactic Radiotherapy, for Isolated Recurrent Primary, Lymph Node or Metastatic Prostate Cancer

    SciTech Connect

    Jereczek-Fossa, Barbara Alicja; Beltramo, Giancarlo; Fariselli, Laura; Fodor, Cristiana; Santoro, Luigi; Vavassori, Andrea; Zerini, Dario; Gherardi, Federica; Ascione, Carmen; Bossi-Zanetti, Isa; Mauro, Roberta; Bregantin, Achille; Bianchi, Livia Corinna; De Cobelli, Ottavio; Orecchia, Roberto

    2012-02-01

    Purpose: To evaluate the outcome of robotic CyberKnife (Accuray, Sunnyvale, CA)-based stereotactic radiotherapy (CBK-SRT) for isolated recurrent primary, lymph node, or metastatic prostate cancer. Methods and Materials: Between May 2007 and December 2009, 34 consecutive patients/38 lesions were treated (15 patients reirradiated for local recurrence [P], 4 patients reirradiated for anastomosis recurrence [A], 16 patients treated for single lymph node recurrence [LN], and 3 patients treated for single metastasis [M]). In all but 4 patients, [{sup 11}C]choline positron emission tomography/computed tomography was performed. CBK-SRT consisted of reirradiation and first radiotherapy in 27 and 11 lesions, respectively. The median CBK-SRT dose was 30 Gy in 4.5 fractions (P, 30 Gy in 5 fractions; A, 30 Gy in 5 fractions; LN, 33 Gy in 3 fractions; and M, 36 Gy in 3 fractions). In 18 patients (21 lesions) androgen deprivation was added to CBK-SRT (median duration, 16.6 months). Results: The median follow-up was 16.9 months. Acute toxicity included urinary events (3 Grade 1, 2 Grade 2, and 2 Grade 3 events) and rectal events (1 Grade 1 event). Late toxicity included urinary events (3 Grade 1, 2 Grade 2, and 2 Grade 3 events) and rectal events (1 Grade 1 event and 1 Grade 2 event). Biochemical response was observed in 32 of 38 evaluable lesions. Prostate-specific antigen stabilization was seen for 4 lesions, and in 2 cases prostate-specific antigen progression was reported. The 30-month progression-free survival rate was 42.6%. Disease progression was observed for 14 lesions (5, 2, 5, and 2 in Groups P, A, LN, and M respectively). In only 3 cases, in-field progression was seen. At the time of analysis (May 2010), 19 patients are alive with no evidence of disease and 15 are alive with disease. Conclusions: CyberKnife-based stereotactic radiotherapy is a feasible approach for isolated recurrent primary, lymph node, or metastatic prostate cancer, offering excellent in-field tumor

  3. Percutaneous Access of the Petrous Apex In Vitro Using Customized Micro-stereotactic Frames based on Image Guided Surgical Technology

    PubMed Central

    Wanna, George B; Balachandran, Ramya; Majdani, Omid; Mitchell, Jason; Labadie, Robert F.

    2015-01-01

    Conclusion Our study demonstrates - in cadavers - the ability to obtain a minimally-invasive approach to access the petrous apex using patient-customized microstereotactic frames based on pre-intervention radiographic studies. Objectives To conduct in vitro studies to demonstrate the feasibility of percutaneous petrous apex access using customized, bone-mounted, micro-stereotactic frames. Methods Cadaveric temporal bone specimens (n = 10) were affixed with three bone-implanted fiducial markers. CT scans were obtained and used in planning, in reference to the fiducial markers, a straight transmastoid infralabyrinthine trajectory from the mastoid surface to the petrous apex without violating the basal turn of the cochlea or the carotid artery. A drill press was mounted on the customized-frame and used to guide a 2 mm drill bit on the desired trajectory. The course of the drill bit and its relationship to surrounding vital anatomy (cochlea, carotid artery, facial nerve and internal jugular vein) were determined by repeat CT scanning. Results In 10 of 10 specimens, the drill bit trajectory was accurate with clearance (mean ± standard deviation in mm) from the cochlea, facial nerve, carotid artery, and jugular vein of 3.43 ± 1.57, 3.14 ± 1.15, 4.57 ± 1.52, and 6.05 ± 2.98, respectively. PMID:19707904

  4. Fiducial migration following small peripheral lung tumor image-guided CyberKnife stereotactic radiosurgery

    NASA Astrophysics Data System (ADS)

    Strulik, Konrad L.; Cho, Min H.; Collins, Brian T.; Khan, Noureen; Banovac, Filip; Slack, Rebecca; Cleary, Kevin

    2008-03-01

    To track respiratory motion during CyberKnife stereotactic radiosurgery in the lung, several (three to five) cylindrical gold fiducials are implanted near the planned target volume (PTV). Since these fiducials remain in the human body after treatment, we hypothesize that tracking fiducial movement over time may correlate with the tumor response to treatment and pulmonary fibrosis, thereby serving as an indicator of treatment success. In this paper, we investigate fiducial migration in 24 patients through examination of computed tomography (CT) volume images at four time points: pre-treatment, three, six, and twelve month post-treatment. We developed a MATLAB based GUI environment to display the images, identify the fiducials, and compute our performance measure. After we semi-automatically segmented and detected fiducial locations in CT images of the same patient over time, we identified them according to their configuration and introduced a relative performance measure (ACD: average center distance) to detect their migration. We found that the migration tended to result in a movement towards the fiducial center of the radiated tissue area (indicating tumor regression) and may potentially be linked to the patient prognosis.

  5. Reirradiation using robotic image-guided stereotactic radiotherapy of recurrent head and neck cancer

    PubMed Central

    Yamazaki, Hideya; Ogita, Mikio; Himei, Kengo; Nakamura, Satoaki; Suzuki, Gen; Yoshida, Ken; Kotsuma, Tadayuki; Yoshioka, Yasuo

    2016-01-01

    The purpose of this study was to examine the prognosis for patients with head and neck cancer after reirradiation using Cyberknife stereotactic body irradiation with special focus on mucosal ulceration. We conducted a retrospective multi-institutional review of 107 patients with previously irradiated head and neck cancer. The median follow-up time for all patients was 15 months, and the 2-year overall survival rate was 35%. Significant prognostic factors for overall survival were primary site (nasopharynx versus other sites), presence of ulceration, and PTV volume. Detailed analysis of ulceration showed a lower response rate (28%) in the ulceration (+) group than the ulceration (−) group (63%; P = 0.0045). The 2-year overall survival rates were 8% in the ulceration (+) group and 42.7% (P = 0.0001) in the ulceration (−) group, respectively. We recorded 22 severe toxicities, including 11 patients with carotid blow-out syndrome (CBOS), which was fatal in 9 patients. CBOS occurred in 6 patients with ulceration (6/25; 24%), and 5 patients experienced CBOS without ulceration (5/82; 6%; P=0.027). In conclusion, ulceration is an important prognostic factor, not only for adverse events but also for survival after reirradiation using CyberKnife. PMID:26983982

  6. Intrafraction Variation of Mean Tumor Position During Image-Guided Hypofractionated Stereotactic Body Radiotherapy for Lung Cancer

    SciTech Connect

    Shah, Chirag; Grills, Inga S.; Kestin, Larry L.; McGrath, Samuel; Ye Hong; Martin, Shannon K.; Yan Di

    2012-04-01

    Purpose: Prolonged delivery times during daily cone-beam computed tomography (CBCT)-guided lung stereotactic body radiotherapy (SBRT) introduce concerns regarding intrafraction variation (IFV) of the mean target position (MTP). The purpose of this study was to evaluate the magnitude of the IFV-MTP and to assess target margins required to compensate for IFV and postonline CBCT correction residuals. Patient, treatment, and tumor characteristics were analyzed with respect to their impact on IFV-MTP. Methods and Materials: A total of 126 patients with 140 tumors underwent 659 fractions of lung SBRT. Dose prescribed was 48 or 60 Gy in 12 Gy fractions. Translational target position correction of the MTP was performed via onboard CBCT. IFV-MTP was measured as the difference in MTP between the postcorrection CBCT and the posttreatment CBCT excluding residual error. Results: IFV-MTP was 0.2 {+-} 1.8 mm, 0.1 {+-} 1.9 mm, and 0.01 {+-} 1.5 mm in the craniocaudal, anteroposterior, and mediolateral dimensions and the IFV-MTP vector was 2.3 {+-} 2.1 mm. Treatment time and excursion were found to be significant predictors of IFV-MTP. An IFV-MTP vector greater than 2 and 5 mm was seen in 40.8% and 7.2% of fractions, respectively. IFV-MTP greater than 2 mm was seen in heavier patients with larger excursions and longer treatment times. Significant differences in IFV-MTP were seen between immobilization devices. The stereotactic frame immobilization device was found to be significantly less likely to have an IFV-MTP vector greater than 2 mm compared with the alpha cradle, BodyFIX, and hybrid immobilization devices. Conclusions: Treatment time and respiratory excursion are significantly associated with IFV-MTP. Significant differences in IFV-MTP were found between immobilization devices. Target margins for IFV-MTP plus post-correction residuals are dependent on immobilization device with 5-mm uniform margins being acceptable for the frame immobilization device.

  7. Salvage image-guided intensity modulated or stereotactic body reirradiation of local recurrence of prostate cancer

    PubMed Central

    Jereczek-Fossa, B A; Fodor, C; Bazzani, F; Maucieri, A; Ronchi, S; Ferrario, S; Colangione, S P; Gerardi, M A; Caputo, M; Cecconi, A; Gherardi, F; Vavassori, A; Comi, S; Cambria, R; Garibaldi, C; Cattani, F; De Cobelli, O; Orecchia, R

    2015-01-01

    Objective: To retrospectively evaluate external beam reirradiation (re-EBRT) delivered to the prostate/prostatic bed for local recurrence, after radical or adjuvant/salvage radiotherapy (RT). Methods: 32 patients received re-EBRT between February 2008 and October 2013. All patients had clinical/radiological local relapse in the prostate or prostatic bed and no distant metastasis. re-EBRT was delivered with selective RT technologies [stereotactic RT including CyberKnifeTM (Accuray, Sunnyvale, CA); image-guidance and intensity-modulated RT etc.]. Toxicity was evaluated using the Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer criteria. Biochemical control was assessed according to the Phoenix definition (NADIR + 2 ng ml−1). Results: Acute urinary toxicity: G0, 24 patients; G1, 6 patients; G2, 2 patients. Acute rectal toxicity: G0, 28 patients; G1, 2 patients; and G2, 1 patient. Late urinary toxicity (evaluated in 30 cases): G0, 23 patients; G1, 6 patients; G2, 1 patient. Late renal toxicity: G0, 25 patients; G1, 5 patients. A mean follow-up of 21.3 months after re-EBRT showed that 13 patients were free of cancer, 3 were alive with biochemical relapse and 12 patients were alive with clinically evident disease. Four patients had died: two of disease progression and two of other causes. Conclusion: re-EBRT using modern technology is a feasible approach for local prostate cancer recurrence offering 2-year tumour control in about half of the patients. Toxicity of re-EBRT is low. Future studies are needed to identify the patients who would benefit most from this treatment. Advances in knowledge: Our series, based on experience in one hospital alone, shows that re-EBRT for local relapse of prostate cancer is feasible and offers a 2-year cure in about half of the patients. PMID:26055506

  8. Probabilities of Radiation Myelopathy Specific to Stereotactic Body Radiation Therapy to Guide Safe Practice

    SciTech Connect

    Sahgal, Arjun; Weinberg, Vivian; Ma, Lijun; Chang, Eric; Chao, Sam; Muacevic, Alexander; Gorgulho, Alessandra; Soltys, Scott; Gerszten, Peter C.; Ryu, Sam; Angelov, Lilyana; Gibbs, Iris; Wong, C. Shun; Larson, David A.

    2013-02-01

    Purpose: Dose-volume histogram (DVH) results for 9 cases of post spine stereotactic body radiation therapy (SBRT) radiation myelopathy (RM) are reported and compared with a cohort of 66 spine SBRT patients without RM. Methods and Materials: DVH data were centrally analyzed according to the thecal sac point maximum (Pmax) volume, 0.1- to 1-cc volumes in increments of 0.1 cc, and to the 2 cc volume. 2-Gy biologically equivalent doses (nBED) were calculated using an {alpha}/{beta} = 2 Gy (units = Gy{sub 2/2}). For the 2 cohorts, the nBED means and distributions were compared using the t test and Mann-Whitney test, respectively. Significance (P<.05) was defined as concordance of both tests at each specified volume. A logistic regression model was developed to estimate the probability of RM using the dose distribution for a given volume. Results: Significant differences in both the means and distributions at the Pmax and up to the 0.8-cc volume were observed. Concordant significance was greatest for the Pmax volume. At the Pmax volume the fit of the logistic regression model, summarized by the area under the curve, was 0.87. A risk of RM of 5% or less was observed when limiting the thecal sac Pmax volume doses to 12.4 Gy in a single fraction, 17.0 Gy in 2 fractions, 20.3 Gy in 3 fractions, 23.0 Gy in 4 fractions, and 25.3 Gy in 5 fractions. Conclusion: We report the first logistic regression model yielding estimates for the probability of human RM specific to SBRT.

  9. Daily Alignment Results of In-Room Computed Tomography-Guided Stereotactic Body Radiation Therapy for Lung Cancer

    SciTech Connect

    Ikushima, Hitoshi; Balter, Peter; Komaki, Ritsuko; Hunjun, Sandeep; Bucci, M. Kara; Liao Zhongxing; McAleer, Mary F.; Yu, Zhiqian H.; Zhang, Yongbin; Chang, Joe Y.; Dong, Lei

    2011-02-01

    Purpose: To determine the extent of interfractional setup errors and day-to-day organ motion errors by assessing daily bone alignment results and changes in soft tissue tumor position during hypofractionated, in-room computed tomography (CT)-guided stereotactic body radiation therapy (SBRT) of lung cancer. Methods and Materials: Daily alignment results during SBRT were analyzed for 117 tumors in 112 patients. Patients received 40-50 Gy of SBRT in four to five fractions using an integrated CT-LINAC system. The free-breathing CT scans acquired during treatment setup were retrospectively realigned to match with each of the bony references and the gross tumor volume (GTV) defined on the reference CT by rigid-body registration, and the daily deviations were calculated. Results: The mean magnitude ({+-} SD) three-dimensional shift from the initial skin marks to the final bone-aligned positions was 9.4 {+-} 5.7 mm. The mean daily GTV deviation from the bone position was 0.1 {+-} 3.8 mm in the anterior-posterior direction, -0.01 {+-} 4.2 mm in the superior-inferior direction, and 0.2 {+-} 2.5 mm in the lateral direction. A clinically noteworthy trend (net change >5 mm in any direction) in GTV position relative to the bone was observed in 23 cases (20%). Conclusions: Soft tissue target position can change significantly beyond the motion envelope defined in the original internal target volume in four-dimensional CT-based treatment planning for SBRT of lung cancer. Additional margin should be considered for adequate coverage of interfractional changes.

  10. Dose-Response Relationship for Image-Guided Stereotactic Body Radiotherapy of Pulmonary Tumors: Relevance of 4D Dose Calculation

    SciTech Connect

    Guckenberger, Matthias Wulf, Joern; Mueller, Gerd; Krieger, Thomas; Baier, Kurt; Gabor, Manuela; Richter, Anne; Wilbert, Juergen; Flentje, Michael

    2009-05-01

    Purpose: To evaluate outcome after image-guided stereotactic body radiotherapy (SBRT) for early-stage non-small-cell lung cancer (NSCLC) and pulmonary metastases. Methods and Materials: A total of 124 patients with 159 pulmonary lesions (metastases n = 118; NSCLC, n = 41; Stage IA, n = 13; Stage IB, n = 19; T3N0, n = 9) were treated with SBRT. Patients were treated with hypofractionated schemata (one to eight fractions of 6-26 Gy); biologic effective doses (BED) to the clinical target volume (CTV) were calculated based on four-dimensional (4D) dose calculation. The position of the pulmonary target was verified using volume imaging before all treatments. Results: With mean/median follow-up of 18/14 months, actuarial local control was 83% at 36 months with no difference between NSCLC and metastases. The dose to the CTV based on 4D dose calculation was closely correlated with local control: local control rates were 89% and 62% at 36 months for >100 Gy and <100 Gy BED (p = 0.0001), respectively. Actuarial freedom from regional and systemic progression was 34% at 36 months for primary NSCLC group; crude rate of regional failure was 15%. Three-year overall survival was 37% for primary NSCLC and 16% for metastases; no dose-response relationship for survival was observed. Exacerbation of comorbidities was the most frequent cause of death for primary NSCLC. Conclusions: Doses of >100 Gy BED to the CTV based on 4D dose calculation resulted in excellent local control rates. This cutoff dose is not specific to the treatment technique and protocol of our study and may serve as a general recommendation.

  11. Use of a frameless computed tomography-guided stereotactic biopsy system for nasal biopsy in five dogs.

    PubMed

    Kuhlman, Gregory M; Taylor, Amanda R; Thieman-Mankin, Kelley M; Griffin, Jay; Cook, Audrey K; Levine, Jonathan M

    2016-04-15

    CASE DESCRIPTION 5 dogs (median age, 9 years; median body weight, 31 kg [68.2 lb]) with undefined nasal masses were examined after undergoing CT of the head and nasal biopsy via a rostral rhinoscopic or unaided (blind) approach because histologic results for collected biopsy specimens (inflammatory, necrotic, or hemorrhagic disease) suggested the specimens were nonrepresentative of the underlying disease process identified via CT (aggressive or malignant disease). CLINICAL FINDINGS Clinical signs at the time dogs were evaluated included open-mouth breathing, sneezing, or unilateral epistaxis. Histologic findings pertaining to the original biopsy specimens were suggestive of benign processes such as inflammation. In an attempt to obtain better representative specimens, a frameless CT-guided stereotactic biopsy system (CTSBS) was used to collect additional biopsy specimens from masses within the nasal and sinus passages of the dogs. The second set of biopsy specimens was histologically evaluated. TREATMENT AND OUTCOME Histologic evaluation of biopsy specimens collected via the CTSBS revealed results suggestive of malignant neoplasia (specifically, chondrosarcoma, hemangiopericytoma, or undifferentiated sarcoma) for 3 dogs, mild mixed-cell inflammation for 1 dog, and hamartoma for 1 dog. No complications were reported. These findings resulted in a change in treatment recommendations for 3 dogs and confirmed that no additional treatment was required for 1 dog (with hamartoma). For the remaining dog, in which CT findings and clinical history were strongly suggestive of neoplasia, the final diagnosis was rhinitis. CLINICAL RELEVANCE Biopsy specimens were safely collected from masses within the nasal and sinus passages of dogs by use of a frameless CTSBS, allowing a definitive diagnosis that was unachievable with other biopsy approaches. PMID:27031420

  12. A robust MRI-compatible system to facilitate highly accurate stereotactic administration of therapeutic agents to targets within the brain of a large animal model

    PubMed Central

    White, E.; Woolley, M.; Bienemann, A.; Johnson, D.E.; Wyatt, M.; Murray, G.; Taylor, H.; Gill, S.S.

    2011-01-01

    Achieving accurate intracranial electrode or catheter placement is critical in clinical practice in order to maximise the efficacy of deep brain stimulation and drug delivery respectively as well as to minimise side-effects. We have developed a highly accurate and robust method for MRI-guided, stereotactic delivery of catheters and electrodes to deep target structures in the brain of pigs. This study outlines the development of this equipment and animal model. Specifically this system enables reliable head immobilisation, acquisition of high-resolution MR images, precise co-registration of MRI and stereotactic spaces and overall rigidity to facilitate accurate burr hole-generation and catheter implantation. To demonstrate the utility of this system, in this study a total of twelve catheters were implanted into the putamen of six Large White Landrace pigs. All implants were accurately placed into the putamen. Target accuracy had a mean Euclidean distance of 0.623 mm (standard deviation of 0.33 mm). This method has allowed us to accurately insert fine cannulae, suitable for the administration of therapeutic agents by convection-enhanced delivery (CED), into the brain of pigs. This study provides summary evidence of a robust system for catheter implantation into the brain of a large animal model. We are currently using this stereotactic system, implantation procedure and animal model to develop catheter-based drug delivery systems that will be translated into human clinical trials, as well as to model the distribution of therapeutic agents administered by CED over large volumes of brain. PMID:21074564

  13. Liver motion during cone beam computed tomography guided stereotactic body radiation therapy

    SciTech Connect

    Park, Justin C.; Park, Sung Ho; Kim, Jong Hoon; Yoon, Sang Min; Song, Si Yeol; Liu Zhaowei; Song Bongyong; Kauweloa, Kevin; Webster, Matthew J.; Sandhu, Ajay; Mell, Loren K.; Jiang, Steve B.; Mundt, Arno J.; Song, William Y.

    2012-10-15

    Purpose: Understanding motion characteristics of liver such as, interfractional and intrafractional motion variability, difference in motion within different locations in the organ, and their complex relationship with the breathing cycles are particularly important for image-guided liver SBRT. The purpose of this study was to investigate such motion characteristics based on fiducial markers tracked with the x-ray projections of the CBCT scans, taken immediately prior to the treatments. Methods: Twenty liver SBRT patients were analyzed. Each patient had three fiducial markers (2 Multiplication-Sign 5-mm gold) percutaneously implanted around the gross tumor. The prescription ranged from 2 to 8 fractions per patient. The CBCT projections data for each fraction ({approx}650 projections/scan), for each patient, were analyzed and the 2D positions of the markers were extracted using an in-house algorithm. In total, >55 000 x-ray projections were analyzed from 85 CBCT scans. From the 2D extracted positions, a 3D motion trajectory of the markers was constructed, from each CBCT scans, resulting in left-right (LR), anterior-posterior (AP), and cranio-caudal (CC) location information of the markers with >55 000 data points. The authors then analyzed the interfraction and intrafraction liver motion variability, within different locations in the organ, and as a function of the breathing cycle. The authors also compared the motion characteristics against the planning 4DCT and the RPM Trade-Mark-Sign (Varian Medical Systems, Palo Alto, CA) breathing traces. Variations in the appropriate gating window (defined as the percent of the maximum range at which 50% of the marker positions are contained), between fractions were calculated as well. Results: The range of motion for the 20 patients were 3.0 {+-} 2.0 mm, 5.1 {+-} 3.1 mm, and 17.9 {+-} 5.1 mm in the planning 4DCT, and 2.8 {+-} 1.6 mm, 5.3 {+-} 3.1 mm, and 16.5 {+-} 5.7 mm in the treatment CBCT, for LR, AP, and CC directions

  14. Integral test phantom for dosimetric quality assurance of image guided and intensity modulated stereotactic radiotherapy

    SciTech Connect

    Letourneau, Daniel; Keller, Harald; Sharpe, Michael B.; Jaffray, David A.

    2007-05-15

    The objective of this work is to develop a dosimetric phantom quality assurance (QA) of linear accelerators capable of cone-beam CT (CBCT) image guided and intensity-modulated radiotherapy (IG-IMRT). This phantom is to be used in an integral test to quantify in real-time both the performance of the image guidance and the dose delivery systems in terms of dose localization. The prototype IG-IMRT QA phantom consisted of a cylindrical imaging phantom (CatPhan) combined with an array of 11 radiation diodes mounted on a 10 cm diameter disk, oriented perpendicular to the phantom axis. Basic diode response characterization was performed for 6 and 18 MV photons. The diode response was compared to planning system calculations in the open and penumbrae regions of simple and complex beam arrangements. The clinical use of the QA phantom was illustrated in an integral test of an IG-IMRT treatment designed for a clinical spinal radiosurgery case. The sensitivity of the phantom to multileaf collimator (MLC) calibration and setup errors in the clinical setting was assessed by introducing errors in the IMRT plan or by displacing the phantom. The diodes offered good response linearity and long-term reproducibility for both 6 and 18 MV. Axial dosimetry of coplanar beams (in a plane containing the beam axes) was made possible with the nearly isoplanatic response of the diodes over 360 deg. of gantry (usually within {+-}1%). For single beam geometry, errors in phantom placement as small as 0.5 mm could be accurately detected (in gradient {>=}1%/mm). In clinical setting, MLC systematic errors of 1 mm on a single MLC bank introduced in the IMRT plan were easily detectable with the QA phantom. The QA phantom demonstrated also sufficient sensitivity for the detection of setup errors as small as 1 mm for the IMRT delivery. These results demonstrated that the prototype can accurately and efficiently verify the entire IG-IMRT process. This tool, in conjunction with image guidance capabilities

  15. Targeting accuracy of an image guided gating system for stereotactic body radiotherapy

    NASA Astrophysics Data System (ADS)

    Tenn, Stephen E.; Solberg, Timothy D.; Medin, Paul M.

    2005-12-01

    Recently, a commercial system capable of x-ray image guided patient positioning and respiratory gated delivery has become available. Here we describe the operational principles of this system and investigate its geometric targeting accuracy under controlled conditions. The system tracks breathing via infrared (IR) detection of reflective markers located on the patient's abdomen. Localization kilovoltage (kV) x-rays are triggered from within the gated delivery window portion of the breathing trace and after positioning, the tumour will cross the linac isocentre during gated delivery. We tested geometric accuracy of this system by localizing and delivering gated fields to a moving phantom. Effects of phantom speed, gating window location, timing errors and phantom rotations on positioning and gating accuracy were investigated. The system delivered gated fields to both a moving and static phantom with equal accuracy. The position of the gating window affects accuracy only to the extent that an asymmetric breathing motion could affect dose distribution within its boundaries. Positioning errors were found to be less then 0.5 ± 0.2 mm for phantom rotations up to 5°. We found and corrected a synchronization error caused by a faulty x-ray duration setting and detected a 60 ± 20 ms time delay in our linear accelerator.

  16. Implementation of Feedback-Guided Voluntary Breath-Hold Gating for Cone Beam CT-Based Stereotactic Body Radiotherapy

    SciTech Connect

    Peng Yong; Vedam, Sastry; Chang, Joe Y.; Gao Song; Sadagopan, Ramaswamy; Bues, Martin; Balter, Peter

    2011-07-01

    Purpose: To analyze tumor position reproducibility of feedback-guided voluntary deep inspiration breath-hold (FGBH) gating for cone beam computed tomography (CBCT)-based stereotactic body radiotherapy (SBRT). Methods and materials: Thirteen early-stage lung cancer patients eligible for SBRT with tumor motion of >1cm were evaluated for FGBH-gated treatment. Multiple FGBH CTs were acquired at simulation, and single FGBH CBCTs were also acquired prior to each treatment. Simulation CTs and treatment CBCTs were analyzed to quantify reproducibility of tumor positions during FGBH. Benefits of FGBH gating compared to treatment during free breathing, as well treatment with gating at exhalation, were examined for lung sparing, motion margins, and reproducibility of gross tumor volume (GTV) position relative to nonmoving anatomy. Results: FGBH increased total lung volumes by 1.5 times compared to free breathing, resulting in a proportional drop in total lung volume receiving 10 Gy or more. Intra- and inter-FGBH reproducibility of GTV centroid positions at simulation were 1.0 {+-} 0.5 mm, 1.3 {+-} 1.0 mm, and 0.6 {+-} 0.4 mm in the anterior-posterior (AP), superior-inferior (SI), and left-right lateral (LR) directions, respectively, compared to more than 1 cm of tumor motion at free breathing. During treatment, inter-FGBH reproducibility of the GTV centroid with respect to bony anatomy was 1.2 {+-} 0.7 mm, 1.5 {+-} 0.8 mm, and 1.0 {+-} 0.4 mm in the AP, SI, and LR directions. In addition, the quality of CBCTs was improved due to elimination of motion artifacts, making this technique attractive for poorly visualized tumors, even with small motion. Conclusions: The extent of tumor motion at normal respiration does not influence the reproducibility of the tumor position under breath hold conditions. FGBH-gated SBRT with CBCT can improve the reproducibility of GTV centroids, reduce required margins, and minimize dose to normal tissues in the treatment of mobile tumors.

  17. Defining the Optimal Planning Target Volume in Image-Guided Stereotactic Radiosurgery of Brain Metastases: Results of a Randomized Trial

    SciTech Connect

    Kirkpatrick, John P.; Wang, Zhiheng; Sampson, John H.; McSherry, Frances; Herndon, James E.; Allen, Karen J.; Duffy, Eileen; Hoang, Jenny K.; Chang, Zheng; Yoo, David S.; Kelsey, Chris R.; Yin, Fang-Fang

    2015-01-01

    Purpose: To identify an optimal margin about the gross target volume (GTV) for stereotactic radiosurgery (SRS) of brain metastases, minimizing toxicity and local recurrence. Methods and Materials: Adult patients with 1 to 3 brain metastases less than 4 cm in greatest dimension, no previous brain radiation therapy, and Karnofsky performance status (KPS) above 70 were eligible for this institutional review board–approved trial. Individual lesions were randomized to 1- or 3- mm uniform expansion of the GTV defined on contrast-enhanced magnetic resonance imaging (MRI). The resulting planning target volume (PTV) was treated to 24, 18, or 15 Gy marginal dose for maximum PTV diameters less than 2, 2 to 2.9, and 3 to 3.9 cm, respectively, using a linear accelerator–based image-guided system. The primary endpoint was local recurrence (LR). Secondary endpoints included neurocognition Mini-Mental State Examination, Trail Making Test Parts A and B, quality of life (Functional Assessment of Cancer Therapy-Brain), radionecrosis (RN), need for salvage radiation therapy, distant failure (DF) in the brain, and overall survival (OS). Results: Between February 2010 and November 2012, 49 patients with 80 brain metastases were treated. The median age was 61 years, the median KPS was 90, and the predominant histologies were non–small cell lung cancer (25 patients) and melanoma (8). Fifty-five, 19, and 6 lesions were treated to 24, 18, and 15 Gy, respectively. The PTV/GTV ratio, volume receiving 12 Gy or more, and minimum dose to PTV were significantly higher in the 3-mm group (all P<.01), and GTV was similar (P=.76). At a median follow-up time of 32.2 months, 11 patients were alive, with median OS 10.6 months. LR was observed in only 3 lesions (2 in the 1 mm group, P=.51), with 6.7% LR 12 months after SRS. Biopsy-proven RN alone was observed in 6 lesions (5 in the 3-mm group, P=.10). The 12-month DF rate was 45.7%. Three months after SRS, no significant change in

  18. Technical note: gold marker implants and high-frequency jet ventilation for stereotactic, single-dose irradiation of liver tumors.

    PubMed

    Fritz, P; Kraus, H-J; Dölken, W; Mühlnickel, W; Müller-Nolte, F; Hering, W

    2006-02-01

    With reference to radiosurgery of the liver, we describe techniques designed to solve the methodological problem of striking targets subject to respiratory motion with the necessary precision. Implanting a gold marker in the vicinity of the liver tumor was the first step in ensuring the reproducibility of the isocenter's position. An 18-karat gold rod measuring 1.9 x 3 mm was implanted approximately 2 cm from the edge of the tumor as this was displayed in the spiral, thin-slice CT with contrast media. Both the implantation of the marker and the required, CT-controlled biopsy of the liver tumor can be achieved simultaneously with the same puncture needle. The efficiency of high-frequency jet ventilation (HFJV) in neutralizing the targeted organ's respiratory motion during stereotactic single-dose irradiation was evaluated. The procedure was carried out on ten patients without any complications. In the time between treatment planning and irradiation (3 days), no significant marker migration was observable. In all cases, the gold marker (volume: 7.5 mm(3)) was readily observable in the treatment beam using portal imaging. HFJV provided reliable immobilization. The liver motion in each anesthetized patient was limited to under 3.0 mm in all directions. Thus, the correct field settings and target reproducibility were able to be analyzed and documented during the irradiation. The combination of marker and HFJV enables the determination of stereotactic coordinates directly related to the liver itself and, in this way, stereotactic radiation treatment of liver tumors is freed from the uncertainties involved in orientation to bony landmarks, in respiratory motion, and in changes of position in the stereotactic body frame. The method is feasible and can improve the accuracy of stereotactic body radiation therapy. PMID:16417397

  19. Performance of a Novel Repositioning Head Frame for Gamma Knife Perfexion and Image-Guided Linac-Based Intracranial Stereotactic Radiotherapy

    SciTech Connect

    Ruschin, Mark; Nayebi, Nazanin; Carlsson, Per; Brown, Kevin

    2010-09-01

    Purpose: To evaluate the geometric positioning and immobilization performance of a vacuum bite-block repositioning head frame (RHF) system for Perfexion (PFX-SRT) and linac-based intracranial image-guided stereotactic radiotherapy (SRT). Methods and Materials: Patients with intracranial tumors received linac-based image-guided SRT using the RHF for setup and immobilization. Three hundred thirty-three fractions of radiation were delivered in 12 patients. The accuracy of the RHF was estimated for linac-based SRT with online cone-beam CT (CBCT) and for PFX-SRT with a repositioning check tool (RCT) and offline CBCT. The RCT's ability to act as a surrogate for anatomic position was estimated through comparison to CBCT image matching. Immobilization performance was evaluated daily with pre- and postdose delivery CBCT scans and RCT measurements. Results: The correlation coefficient between RCT- and CBCT-reported displacements was 0.59, 0.75, 0.79 (Right, Superior, and Anterior, respectively). For image-guided linac-based SRT, the mean three-dimensional (3D) setup error was 0.8 mm with interpatient ({Sigma}) and interfraction ({sigma}) variations of 0.1 and 0.4 mm, respectively. For PFX-SRT, the initial, uncorrected mean 3D positioning displacement in stereotactic coordinates was 2.0 mm, with {Sigma} = 1.1 mm and {sigma} = 0.8 mm. Considering only RCT setups <1mm (PFX action level) the mean 3D positioning displacement reduced to 1.3 mm, with {Sigma} = 0.9 mm and {sigma} = 0.4 mm. The largest contributing systematic uncertainty was in the superior-inferior direction (mean displacement = -0.5 mm; {Sigma} = 0.9 mm). The largest mean rotation was 0.6{sup o} in pitch. The mean 3D intrafraction motion was 0.4 {+-} 0.3 mm. Conclusion: The RHF provides excellent immobilization for intracranial SRT and PFX-SRT. Some small systematic uncertainties in stereotactic positioning exist and must be considered when generating PFX-SRT treatment plans. The RCT provides reasonable surrogacy

  20. Planned Two-Fraction Proton Beam Stereotactic Radiosurgery for High-Risk Inoperable Cerebral Arteriovenous Malformations

    SciTech Connect

    Hattangadi, Jona A.; Chapman, Paul H.; Bussiere, Marc R.; Niemierko, Andrzej; Ogilvy, Christopher S.; Rowell, Alison; Daartz, Juliane; Loeffler, Jay S.; Shih, Helen A.

    2012-06-01

    Purpose: To evaluate patients with high-risk cerebral arteriovenous malformations (AVMs), based on eloquent brain location or large size, who underwent planned two-fraction proton stereotactic radiosurgery (PSRS). Methods and Materials: From 1991 to 2009, 59 patients with high-risk cerebral AVMs received two-fraction PSRS. Median nidus volume was 23 cc (range, 1.4-58.1 cc), 70% of cases had nidus volume {>=}14 cc, and 34% were in critical locations (brainstem, basal ganglia). Median AVM score based on age, AVM size, and location was 3.19 (range, 0.9-6.9). Many patients had prior surgery or embolization (40%) or prior PSRS (12%). The most common prescription was 16 Gy radiobiologic equivalent (RBE) in two fractions, prescribed to the 90% isodose. Results: At a median follow-up of 56.1 months, 9 patients (15%) had total and 20 patients (34%) had partial obliteration. Patients with total obliteration received higher total dose than those with partial or no obliteration (mean dose, 17.6 vs. 15.5 Gy (RBE), p = 0.01). Median time to total obliteration was 62 months (range, 23-109 months), and 5-year actuarial rate of partial or total obliteration was 33%. Five-year actuarial rate of hemorrhage was 22% (95% confidence interval, 12.5%-36.8%) and 14% (n = 8) suffered fatal hemorrhage. Lesions with higher AVM scores were more likely to hemorrhage (p = 0.024) and less responsive to radiation (p = 0.026). The most common complication was Grade 1 headache acutely (14%) and long term (12%). One patient developed a Grade 2 generalized seizure disorder, and two had mild neurologic deficits. Conclusions: High-risk AVMs can be safely treated with two-fraction PSRS, although total obliteration rate is low and patients remain at risk for future hemorrhage. Future studies should include higher doses or a multistaged PSRS approach for lesions more resistant to obliteration with radiation.

  1. Hypofractionated Stereotactic Radiation Therapy in Recurrent High-Grade Glioma: A New Challenge

    PubMed Central

    Navarria, Pierina; Ascolese, Anna Maria; Tomatis, Stefano; Reggiori, Giacomo; Clerici, Elena; Villa, Elisa; Maggi, Giulia; Bello, Lorenzo; Pessina, Federico; Cozzi, Luca; Scorsetti, Marta

    2016-01-01

    Purpose The aim of this study was to evaluate outcomes of hypofractionated stereotactic radiation therapy (HSRT) in patients re-treated for recurrent high-grade glioma. Materials and Methods From January 2006 to September 2013, 25 patients were treated. Six patients underwent radiation therapy alone, while 19 underwent combined treatment with surgery and/or chemotherapy. Only patients with Karnofsky Performance Status (KPS) > 70 and time from previous radiotherapy greater than 6 months were re-irradiated. The mean recurrent tumor volume was 35 cm3 (range, 2.46 to 116.7 cm3), and most of the patients (84%) were treated with a total dose of 25 Gy in five fractions (range, 20 to 50 Gy in 5-10 fractions). Results The median follow-up was 18 months (range, 4 to 36 months). The progression-free survival (PFS) at 1 and 2 years was 72% and 34% and the overall survival (OS) 76% and 50%, respectively. No severe toxicity was recorded. In univariate and multivariate analysis extent of resection at diagnosis significantly influenced PFS and OS (p < 0.01). Patients with smaller recurren tumor volume treated had better local control and survival. Indeed, the 2-year PFS was 40% (≤ 50 cm3) versus 11% (p=0.1) and the 2-year OS 56% versus 33% (> 50 cm3), respectively (p=0.26). Conclusion In our experience, HSRT could be a safe and feasible therapeutic option for recurrent high grade glioma even in patients with larger tumors. We believe that a multidisciplinary evaluation is mandatory to assure the best treatment for selected patients. Local treatment should also be considered as part of an integrated approach. PMID:25761491

  2. High-dose MVCT image guidance for stereotactic body radiation therapy

    SciTech Connect

    Westerly, David C.; Schefter, Tracey E.; Kavanagh, Brian D.; Chao, Edward; Lucas, Dan; Flynn, Ryan T.; Miften, Moyed

    2012-08-15

    Purpose: Stereotactic body radiation therapy (SBRT) is a potent treatment for early stage primary and limited metastatic disease. Accurate tumor localization is essential to administer SBRT safely and effectively. Tomotherapy combines helical IMRT with onboard megavoltage CT (MVCT) imaging and is well suited for SBRT; however, MVCT results in reduced soft tissue contrast and increased image noise compared with kilovoltage CT. The goal of this work was to investigate the use of increased imaging doses on a clinical tomotherapy machine to improve image quality for SBRT image guidance. Methods: Two nonstandard, high-dose imaging modes were created on a tomotherapy machine by increasing the linear accelerator (LINAC) pulse rate from the nominal setting of 80 Hz, to 160 Hz and 300 Hz, respectively. Weighted CT dose indexes (wCTDIs) were measured for the standard, medium, and high-dose modes in a 30 cm solid water phantom using a calibrated A1SL ion chamber. Image quality was assessed from scans of a customized image quality phantom. Metrics evaluated include: contrast-to-noise ratios (CNRs), high-contrast spatial resolution, image uniformity, and percent image noise. In addition, two patients receiving SBRT were localized using high-dose MVCT scans. Raw detector data collected after each scan were used to reconstruct standard-dose images for comparison. Results: MVCT scans acquired using a pitch of 1.0 resulted in wCTDI values of 2.2, 4.7, and 8.5 cGy for the standard, medium, and high-dose modes respectively. CNR values for both low and high-contrast materials were found to increase with the square root of dose. Axial high-contrast spatial resolution was comparable for all imaging modes at 0.5 lp/mm. Image uniformity was improved and percent noise decreased as the imaging dose increased. Similar improvements in image quality were observed in patient images, with decreases in image noise being the most notable. Conclusions: High-dose imaging modes are made possible on a

  3. On-Board Imaging Validation of Optically Guided Stereotactic Radiosurgery Positioning System for Conventionally Fractionated Radiotherapy for Paranasal Sinus and Skull Base Cancer

    SciTech Connect

    Maxim, Peter G.; Loo, Billy W.; Murphy, James D.; Chu, Karen P.M.; Hsu, Annie; Le, Quynh-Thu

    2011-11-15

    Purpose: To evaluate the positioning accuracy of an optical positioning system for stereotactic radiosurgery in a pilot experience of optically guided, conventionally fractionated, radiotherapy for paranasal sinus and skull base tumors. Methods and Materials: Before each daily radiotherapy session, the positioning of 28 patients was set up using an optical positioning system. After this initial setup, the patients underwent standard on-board imaging that included daily orthogonal kilovoltage images and weekly cone beam computed tomography scans. Daily translational shifts were made after comparing the on-board images with the treatment planning computed tomography scans. These daily translational shifts represented the daily positional error in the optical tracking system and were recorded during the treatment course. For 13 patients treated with smaller fields, a three-degree of freedom (3DOF) head positioner was used for more accurate setup. Results: The mean positional error for the optically guided system in patients with and without the 3DOF head positioner was 1.4 {+-} 1.1 mm and 3.9 {+-} 1.6 mm, respectively (p <.0001). The mean positional error drifted 0.11 mm/wk upward during the treatment course for patients using the 3DOF head positioner (p = .057). No positional drift was observed in the patients without the 3DOF head positioner. Conclusion: Our initial clinical experience with optically guided head-and-neck fractionated radiotherapy was promising and demonstrated clinical feasibility. The optically guided setup was especially useful when used in conjunction with the 3DOF head positioner and when it was recalibrated to the shifts using the weekly portal images.

  4. A Study on Target Positioning Error and Its Impact on Dose Variation in Image-Guided Stereotactic Body Radiotherapy for the Spine

    SciTech Connect

    Kim, Siyong Jin, Hosang; Yang, Huey; Amdur, Robert J.

    2009-04-01

    Purpose: To investigate the amount of target positioning error and evaluate its dosimetric impact during image-guided stereotactic body radiotherapy for single-fraction spine treatment. Methods and Materials: A prescription dose of 15 Gy and five to nine coplanar intensity-modulated beams were used. The patient was immobilized with a custom-fit vacuum mold, and the target was localized with a volumetric cone-beam CT image. A robotic couch with six degrees of freedom was used for target adjustment. For evaluation a cone-beam CT image was obtained at the end of treatment. Both target positioning error and its dosimetric impact were investigated for the first 9 cases. Results: For cases studied, translational errors were 0.9 {+-} 0.5 mm (lateral), 1.2 {+-} 0.9 mm (longitudinal), 0.7 {+-} 0.6 mm (vertical), and 1.8 {+-} 1.0 mm (vector), and rotational errors were 1.6 deg. {+-} 1.3 deg. (pitch), 0.8 deg. {+-} 0.9 deg. (roll), and 0.8 deg. {+-} 0.4{sup o} (yaw). For the clinical target volume, D{sub 95} (dose to 95% of target volume), D{sub 90}, D{sub max}, and D{sub mean} were evaluated. Only 1 case showed significant dose variations, reaching up to 18% in D{sub 95}. The spinal cord dose was evaluated by observing D{sub 0.1} (dose to 0.1 cm{sup 3}), D{sub 0.5}, D{sub 1.0}, and D{sub max}. Although 1 case showed a dose change reaching up to 30% in D{sub max}, cord dose was within the planning tolerance limit in all but 2 cases (3% higher in one and 0.4% higher in the other). Conclusion: The implemented image-guided stereotactic body radiotherapy provides precise target localization. However, despite reasonably precise spatial precision, dosimetric perturbation can be significant because of both extremely steep dose gradients and close distances between the target and the spinal cord.

  5. Predictors of Local Control After Single-Dose Stereotactic Image-Guided Intensity-Modulated Radiotherapy for Extracranial Metastases

    SciTech Connect

    Greco, Carlo; Zelefsky, Michael J.; Lovelock, Michael; Fuks, Zvi; Hunt, Margie; Rosenzweig, Kenneth; Zatcky, Joan; Kim, Balem; Yamada, Yoshiya

    2011-03-15

    Purpose: To report tumor local control after treatment with single-dose image-guided intensity-modulated radiotherapy (SD-IGRT) to extracranial metastatic sites. Methods and Materials: A total of 126 metastases in 103 patients were treated with SD-IGRT to prescription doses of 18-24 Gy (median, 24 Gy) between 2004 and 2007. Results: The overall actuarial local relapse-free survival (LRFS) rate was 64% at a median follow-up of 18 months (range, 2-45 months). The median time to failure was 9.6 months (range, 1-23 months). On univariate analysis, LRFS was significantly correlated with prescription dose (p = 0.029). Stratification by dose into high (23 to 24 Gy), intermediate (21 to 22 Gy), and low (18 to 20 Gy) dose levels revealed highly significant differences in LRFS between high (82%) and low doses (25%) (p < 0.0001). Overall, histology had no significant effect on LRFS (p = 0.16). Renal cell histology displayed a profound dose-response effect, with 80% LRFS at the high dose level (23 to 24 Gy) vs. 37% with low doses ({<=}22 Gy) (p = 0.04). However, for patients who received the high dose level, histology was not a statistically significant predictor of LRFS (p = 0.90). Target organ (bone vs. lymph node vs. soft tissues) (p = 0.5) and planning target volume size (p = 0.55) were not found to be associated with long-term LRFS probability. Multivariate Cox regression analysis confirmed prescription dose to be a significant predictor of LRFS (p = 0.003). Conclusion: High-dose SD-IGRT is a noninvasive procedure resulting in high probability of local tumor control. Single-dose IGRT may be effectively used to locally control metastatic deposits regardless of histology and target organ, provided sufficiently high doses (> 22 Gy) of radiation are delivered.

  6. Esophageal Toxicity From High-Dose, Single-Fraction Paraspinal Stereotactic Radiosurgery

    SciTech Connect

    Cox, Brett W.; Jackson, Andrew; Hunt, Margie; Bilsky, Mark; Yamada, Yoshiya

    2012-08-01

    Purpose: To report the esophageal toxicity from single-fraction paraspinal stereotactic radiosurgery (SRS) and identify dosimetric and clinical risk factors for toxicity. Methods and Materials: A total of 204 spinal metastases abutting the esophagus (182 patients) were treated with high-dose single-fraction SRS during 2003-2010. Toxicity was scored using the National Cancer Institute Common Toxicity Criteria for Adverse Events, version 4.0. Dose-volume histograms were combined to generate a comprehensive atlas of complication incidence that identifies risk factors for toxicity. Correlation of dose-volume factors with esophageal toxicity was assessed using Fisher's exact test and logistic regression. Clinical factors were correlated with toxicity. Results: The median dose to the planning treatment volume was 24 Gy. Median follow-up was 12 months (range, 3-81). There were 31 (15%) acute and 24 (12%) late esophageal toxicities. The rate of grade {>=}3 acute or late toxicity was 6.8% (14 patients). Fisher's exact test resulted in significant median splits for grade {>=}3 toxicity at V12 = 3.78 cm{sup 3} (relative risk [RR] 3.7, P=.05), V15 = 1.87 cm{sup 3} (RR 13, P=.0013), V20 = 0.11 cm{sup 3} (RR 6, P=0.01), and V22 = 0.0 cm{sup 3} (RR 13, P=.0013). The median split for D2.5 cm{sup 3} (14.02 Gy) was also a significant predictor of toxicity (RR 6; P=.01). A highly significant logistic regression model was generated on the basis of D2.5 cm{sup 3}. One hundred percent (n = 7) of grade {>=}4 toxicities were associated with radiation recall reactions after doxorubicin or gemcitabine chemotherapy or iatrogenic manipulation of the irradiated esophagus. Conclusions: High-dose, single-fraction paraspinal SRS has a low rate of grade {>=}3 esophageal toxicity. Severe esophageal toxicity is minimized with careful attention to esophageal doses during treatment planning. Iatrogenic manipulation of the irradiated esophagus and systemic agents classically associated with radiation

  7. Outcome of Elderly Patients with Meningioma after Image-Guided Stereotactic Radiotherapy: A Study of 100 Cases

    PubMed Central

    Budach, Volker; Graaf, Lukas; Gollrad, Johannes; Badakhshi, Harun

    2015-01-01

    Introduction. Incidence of meningioma increases with age. Surgery has been the mainstay treatment. Elderly patients, however, are at risk of severe morbidity. Therefore, we conducted this study to analyze long-term outcomes of linac-based fractionated stereotactic radiotherapy (FSRT) for older adults (aged ≥65 years) with meningioma and determine prognostic factors. Materials and Methods. Between October 1998 and March 2009, 100 patients (≥65, median age, 71 years) were treated with FSRT for meningioma. Two patients were lost to follow-up. Eight patients each had grade I and grade II meningiomas, and five patients had grade III meningiomas. The histology was unknown in 77 cases (grade 0). Results. The median follow-up was 37 months, and 3-year, 5-year, and 10-year progression-free survival (PFS) rates were 93.7%, 91.1%, and 82%. Patients with grade 0/I meningioma showed 3- and 5-year PFS rates of 98.4% and 95.6%. Patients with grade II or III meningiomas showed 3-year PFS rates of 36%. 93.8% of patients showed local tumor control. Multivariate analysis did not indicate any significant prognostic factors. Conclusion. FSRT may play an important role as a noninvasive and safe method in the clinical management of older patients with meningioma. PMID:26101778

  8. Clinical Feasibility of Using an EPID in cine Mode for Image-Guided Verification of Stereotactic Body Radiotherapy

    SciTech Connect

    Berbeco, Ross I.

    2007-09-01

    Purpose: To introduce a novel method for monitoring tumor location during stereotactic body radiotherapy (SBRT) while the treatment beam is on by using a conventional electronic portal imaging device (EPID). Methods and Materials: In our clinic, selected patients were treated under a phase I institutional review board-approved SBRT protocol for limited hepatic metastases from solid tumors. Before treatment planning multiple gold fiducial markers were implanted on the periphery of the tumor. During treatment the EPID was used in cine mode to collect the exit radiation and produce a sequence of images for each field. An in-house program was developed for calculating the location of the fiducials and their relative distance to the planned locations. Results: Three case studies illustrate the utility of the technique. Patient A exhibited a systematic shift of 4 mm during one of the treatment beams. Patient B showed an inferior drift of the target of approximately 1 cm from the time of setup to the end of the fraction. Patient C had a poor setup on the first day of treatment that was quantified and accounted for on subsequent treatment days. Conclusions: Target localization throughout each treatment beam can be quickly assessed with the presented technique. Treatment monitoring with an EPID in cine mode is shown to be a clinically feasible and useful tool.

  9. English Curriculum Guide: Senior High Program.

    ERIC Educational Resources Information Center

    Mehlville R-9 School District, St. Louis, MO.

    Prepared by the teaching staff and curriculum office of the Mehlville (Missouri) School District, this curriculum guide for senior high school English presents a dual focus on language (grammar, usage, composition) and literature (fiction, nonfiction, poetry, drama, media). Following a statement of the philosophy of the program, the guide outlines…

  10. Image-guided robotic stereotactic body radiotherapy for benign spinal tumors: theUniversity of California San Francisco preliminary experience.

    PubMed

    Sahgal, A; Chou, D; Ames, C; Ma, L; Lamborn, K; Huang, K; Chuang, C; Aiken, A; Petti, P; Weinstein, P; Larson, D

    2007-12-01

    We evaluate our preliminary experience using the Cyberknife Radiosurgery System in treating benign spinal tumors. A retrospective review of 16 consecutively treated patients, comprising 19 benign spinal tumors, was performed. Histologic types included neurofibroma [11], chordoma [4], hemangioma [2], and meningioma [2]. Three patients had Neurofibromatosis Type 1 (NF1). Only one tumor, recurrent chordoma, had been previously irradiated, and as such not considered in the local failure analysis. Local failure, for the remaining 18 tumors, was based clinically on symptom progression and/or tumor enlargement based on imaging. Indications for spine stereotactic body radiotherapy (SBRT) consisted of either adjuvant to subtotal resection (5/19), primary treatment alone (12/19), boost following external beam radiotherapy (1/19), and salvage following previous radiation (1/19). Median tumor follow-up is 25 months (2-37), and one patient (with NF1) died at 12 months from a stroke. The median total dose, number of fractions, and prescription isodose was 21 Gy (10-30 Gy), 3 fx (1-5 fx), 80% (42-87%). The median tumor volume was 7.6 cc (0.2-274.1 cc). The median V100 (volume V receiving 100% of the prescribed dose) and maximum tumor dose was 95% (77-100%) and 26.7 Gy (15.4-59.7 Gy), respectively. Three tumors progressed at 2, 4, and 36 months post-SR (n=18). Two tumors were neurofibromas (both in NF1 patients), and the third was an intramedullary hemangioblastoma. Based on imaging, two tumors had MRI documented progression, three had regressed, and 13 were unchanged (n=18). With short follow-up, local control following Cyberknife spine SBRT for benign spinal tumors appear acceptable. PMID:17994789

  11. [Stereotactic radiotherapy in brain metastases].

    PubMed

    Dhermain, F; Reyns, N; Colin, P; Métellus, P; Mornex, F; Noël, G

    2015-02-01

    Stereotactic radiotherapy of brain metastases is increasingly proposed after polydisciplinary debates among experts. Its definition and modalities of prescription, indications and clinical interest regarding the balance between efficacy versus toxicity need to be discussed. Stereotactic radiotherapy is a 'high precision' irradiation technique (within 1mm), using different machines (with invasive contention or frameless, photons X or gamma) delivering high doses (4 to 25Gy) in a limited number of fractions (usually 1 to 5, ten maximum) with a high dose gradient. Dose prescription will depend on materials, dose constraints to organs at risk varying with fractionation. Stereotactic radiotherapy may be proposed: (1) in combination with whole brain radiotherapy with the goal of increasing (modestly) overall survival of patients with a good performance status, 1 to 3 brain metastases and a controlled extracranial disease; (2) for recurrence of 1-3 brain metastases after whole brain radiotherapy; (3) after complete resection of a large and/or symptomatic brain metastases; (4) after diagnosis of 3-5 asymptomatic new or progressing brain metastases during systemic therapy, with the aim of delaying whole brain radiotherapy (avoiding its potential neurotoxicity) and maintaining a high focal control rate. Only a strict follow-up with clinical and MRI every 3 months will permit to deliver iterative stereotactic radiotherapies without jeopardizing survival. Simultaneous delivering of stereotactic radiotherapy with targeted medicines should be carefully discussed. PMID:25640215

  12. GammaPod-A new device dedicated for stereotactic radiotherapy of breast cancer

    SciTech Connect

    Yu, Cedric X.; Shao Xinyu; Deng Jianchun; Duan Zhengcheng; Zhang Jin; Zheng, Mike; Yu, Ying S.; Regine, William

    2013-05-15

    Purpose: This paper introduces a new external beam radiotherapy device named GammaPod that is dedicated for stereotactic radiotherapy of breast cancer. Methods: The design goal of the GammaPod as a dedicated system for treating breast cancer is the ability to deliver ablative doses with sharp gradients under stereotactic image guidance. Stereotactic localization of the breast is achieved by a vacuum-assisted breast immobilization cup with built-in stereotactic frame. Highly focused radiation is achieved at the isocenter due to the cross-firing from 36 radiation arcs generated by rotating 36 individual Cobalt-60 beams. The dedicated treatment planning system optimizes an optimal path of the focal spot using an optimization algorithm borrowed from computational geometry such that the target can be covered by 90%-95% of the prescription dose and the doses to surrounding tissues are minimized. The treatment plan is intended to be delivered with continuous motion of the treatment couch. In this paper the authors described in detail the gamma radiation unit, stereotactic localization of the breast, and the treatment planning system of the GammaPod system. Results: A prototype GammaPod system was installed at University of Maryland Medical Center and has gone through a thorough functional, geometric, and dosimetric testing. The mechanical and functional performances of the system all meet the functional specifications. Conclusions: An image-guided breast stereotactic radiotherapy device, named GammaPod, has been developed to deliver highly focused and localized doses to a target in the breast under stereotactic image guidance. It is envisioned that the GammaPod technology has the potential to significantly shorten radiation treatments and even eliminate surgery by ablating the tumor and sterilizing the tumor bed simultaneously.

  13. Available evidence on re-irradiation with stereotactic ablative radiotherapy following high-dose previous thoracic radiotherapy for lung malignancies.

    PubMed

    De Bari, Berardino; Filippi, Andrea Riccardo; Mazzola, Rosario; Bonomo, Pierluigi; Trovò, Marco; Livi, Lorenzo; Alongi, Filippo

    2015-06-01

    Patients affected with intra-thoracic recurrences of primary or secondary lung malignancies after a first course of definitive radiotherapy have limited therapeutic options, and they are often treated with a palliative intent. Re-irradiation with stereotactic ablative radiotherapy (SABR) represents an appealing approach, due to the optimized dose distribution that allows for high-dose delivery with better sparing of organs at risk. This strategy has the goal of long-term control and even cure. Aim of this review is to report and discuss published data on re-irradiation with SABR in terms of efficacy and toxicity. Results indicate that thoracic re-irradiation may offer satisfactory disease control, however the data on outcome and toxicity are derived from low quality retrospective studies, and results should be cautiously interpreted. As SABR may be associated with serious toxicity, attention should be paid for an accurate patients' selection. PMID:25913714

  14. A Pilot Study of Hypofractionated Stereotactic Radiation Therapy and Sunitinib in Previously Irradiated Patients With Recurrent High-Grade Glioma

    SciTech Connect

    Wuthrick, Evan J.; Curran, Walter J.; Camphausen, Kevin; Lin, Alexander; Glass, Jon; Evans, James; Andrews, David W.; Axelrod, Rita; Shi, Wenyin; Werner-Wasik, Maria; Haacke, E. Mark; Hillman, Gilda G.; Dicker, Adam P.

    2014-10-01

    Purpose/Objective(s): Angiogenic blockade with irradiation may enhance the therapeutic ratio of radiation therapy (RT) through vascular normalization. We sought to determine the safety and toxicity profile of continuous daily-dosed sunitinib when combined with hypofractionated stereotactic RT (fSRT) for recurrent high-grade gliomas (rHGG). Methods and Materials: Eligible patients had malignant high-grade glioma that recurred or progressed after primary surgery and RT. All patients received a minimum of a 10-day course of fSRT, had World Health Organization performance status of 0 to 1, and a life expectancy of >3 months. During fSRT, sunitinib was administered at 37.5 mg daily. The primary endpoint was acute toxicity, and response was assessed via serial magnetic resonance imaging. Results: Eleven patients with rHGG were enrolled. The fSRT doses delivered ranged from 30 to 42 Gy in 2.5- to 3.75-Gy fractions. The median follow-up time was 40 months. Common acute toxicities included hematologic disorders, fatigue, hypertension, and elevated liver transaminases. Sunitinib and fSRT were well tolerated. One grade 4 mucositis toxicity occurred, and no grade 4 or 5 hypertensive events or intracerebral hemorrhages occurred. One patient had a nearly complete response, and 4 patients had stable disease for >9 months. Two patients (18%) remain alive and progression-free >3 years from enrollment. The 6-month progression-free survival was 45%. Conclusions: Sunitinib at a daily dose of 37.5 mg given concurrently with hypofractionated stereotactic reirradiation for rHGG yields acceptable toxicities and an encouraging 6-month progression-free survival.

  15. Results for local control and functional outcome after linac-based image-guided stereotactic radiosurgery in 190 patients with vestibular schwannoma

    PubMed Central

    Badakhshi, Harun; Graf, Reinhold; Böhmer, Dirk; Synowitz, Michael; Wiener, Edzard; Budach, Volker

    2014-01-01

    Background We assessed local control (LC) and functional outcome after linac-based stereotactic radiosurgery (SRS) for vestibular schwannoma (VS). Methods Between 1998 and 2008, 190 patients with VS were treated with SRS. All patients had tumors <2 cm diameter. Patients received 13.5 Gy prescribed to the 80th isodose at the tumor margin. The primary endpoint was LC. Secondary endpoints were symptomatic control and morbidity. Results Median follow-up was 40 months. LC was achieved in 88% of patients. There were no acute reactions exceeding Grade I. Trigeminal nerve dysfunction was present in 21.6% (n = 41) prior to SRS. After treatment, 85% (n = 155) had no change, 4.4,% (n = 8) had a relief of symptoms, 10.4% (n = 19) had new symptoms. Facial nerve dysfunction was present in some patients prior to treatment, e.g. paresis (12.6%; n = 24) and dysgeusia (0.5%; n = 1). After treatment 1.1% (n = 2) reported improvement and 6.1% (n = 11) experienced new symptoms. Hearing problems before SRS were present in 69.5% of patients (n = 132). After treatment, 62.6% (n = 144) had no change, 10.4% (n = 19) experienced improvement and 26.9% (n = 49) became hearing impaired. Conclusion This series of SRS for small VS provided similar LC rates to microsurgery; thus, it is effective as a non-invasive, image-guided procedure. The functional outcomes observed indicate the safety and effectiveness of linac-based SRS. Patients may now be informed of the clinical equivalence of SRS to microsurgery. PMID:23979079

  16. Indirect Tumor Cell Death After High-Dose Hypofractionated Irradiation: Implications for Stereotactic Body Radiation Therapy and Stereotactic Radiation Surgery

    SciTech Connect

    Song, Chang W.; Lee, Yoon-Jin; Griffin, Robert J.; Park, Inhwan; Koonce, Nathan A.; Hui, Susanta; Kim, Mi-Sook; Dusenbery, Kathryn E.; Sperduto, Paul W.; Cho, L. Chinsoo

    2015-09-01

    Purpose: The purpose of this study was to reveal the biological mechanisms underlying stereotactic body radiation therapy (SBRT) and stereotactic radiation surgery (SRS). Methods and Materials: FSaII fibrosarcomas grown subcutaneously in the hind limbs of C3H mice were irradiated with 10 to 30 Gy of X rays in a single fraction, and the clonogenic cell survival was determined with in vivo–in vitro excision assay immediately or 2 to 5 days after irradiation. The effects of radiation on the intratumor microenvironment were studied using immunohistochemical methods. Results: After cells were irradiated with 15 or 20 Gy, cell survival in FSaII tumors declined for 2 to 3 days and began to recover thereafter in some but not all tumors. After irradiation with 30 Gy, cell survival declined continuously for 5 days. Cell survival in some tumors 5 days after 20 to 30 Gy irradiation was 2 to 3 logs less than that immediately after irradiation. Irradiation with 20 Gy markedly reduced blood perfusion, upregulated HIF-1α, and increased carbonic anhydrase-9 expression, indicating that irradiation increased tumor hypoxia. In addition, expression of VEGF also increased in the tumor tissue after 20 Gy irradiation, probably due to the increase in HIF-1α activity. Conclusions: Irradiation of FSaII tumors with 15 to 30 Gy in a single dose caused dose-dependent secondary cell death, most likely by causing vascular damage accompanied by deterioration of intratumor microenvironment. Such indirect tumor cell death may play a crucial role in the control of human tumors with SBRT and SRS.

  17. High Power Disk Loaded Guide Load

    SciTech Connect

    Farkas, Z.D.; /SLAC

    2006-02-22

    A method to design a matching section from a smooth guide to a disk-loaded guide, using a variation of broadband matching, [1, 2] is described. Using this method, we show how to design high power loads. The load consists of a disk-loaded coaxial guide operating in the TE{sub 01}-mode. We use this mode because it has no electric field terminating on a conductor, has no axial currents, and has no current at the cylinder-disk interface. A high power load design that has -35 dB reflection and a 200 MHz, -20 dB bandwidth, is presented. It is expected that it will carry the 600 MW output peak power of the pulse compression network. We use coaxial geometry and stainless steel material to increase the attenuation per cell.

  18. Art. Junior High Curriculum Guide.

    ERIC Educational Resources Information Center

    Gailus, Ann; And Others

    The course on art education, intended for the junior high school art teacher, outlines an art program based on concepts and performance objectives. The major objective is to promote each child's development so that he is not only proficient in measurable skills and knowledge but also a resourceful and creative individual. Suggested teaching…

  19. TEACHER'S GUIDE TO HIGH SCHOOL SPEECH.

    ERIC Educational Resources Information Center

    JENKINSON, EDWARD B., ED.

    THIS GUIDE TO HIGH SCHOOL SPEECH FOCUSES ON SPEECH AS ORAL COMPOSITION, STRESSING THE IMPORTANCE OF CLEAR THINKING AND COMMUNICATION. THE PROPOSED 1-SEMESTER BASIC COURSE IN SPEECH ATTEMPTS TO IMPROVE THE STUDENT'S ABILITY TO COMPOSE AND DELIVER SPEECHES, TO THINK AND LISTEN CRITICALLY, AND TO UNDERSTAND THE SOCIAL FUNCTION OF SPEECH. IN ADDITION…

  20. Phase I trial of panobinostat and fractionated stereotactic re-irradiation therapy for recurrent high grade gliomas.

    PubMed

    Shi, Wenyin; Palmer, Joshua D; Werner-Wasik, Maria; Andrews, David W; Evans, James J; Glass, Jon; Kim, Lyndon; Bar-Ad, Voichita; Judy, Kevin; Farrell, Christopher; Simone, Nicole; Liu, Haisong; Dicker, Adam P; Lawrence, Yaacov R

    2016-05-01

    Panobinostat is an oral HDAC inhibitor with radiosensitizing activity. We investigated the safety, tolerability and preliminary efficacy of panobinostat combined with fractionated stereotactic re-irradiation therapy (FSRT) for recurrent high grade gliomas. Patients with recurrent high grade gliomas were enrolled in a 3 + 3 dose escalation study to determine dose limiting toxicities (DLTs), maximum tolerated dose (MTD), safety, tolerability, and preliminary efficacy. FSRT was prescribed to 30-35 Gy delivered in 10 fractions. Panobinostat was administrated concurrently with radiotherapy. Of 12 evaluable patients, 8 had recurrent GBM, and 4 had recurrent anaplastic astrocytoma. There were three grade 3 or higher toxicities in each the 10 and 30 mg cohorts. In the 30 mg cohort, there was one DLT; grade 4 neutropenia. One patient developed late grade 3 radionecrosis. The median follow up was 18.8 months. The PFS6 was 67, 33, and 83 % for 10, 20, and 30 mg cohorts, respectively. The median OS was 7.8, 6.1 and 16.1 months for the 10, 20 and 30 mg cohorts, respectively. Panobinostat administrated with FSRT is well tolerated at 30 mg. A phase II trial is warranted to assess the efficacy of panobinostat plus FSRT for recurrent glioma. PMID:26821711

  1. High resolution guided wave pipe inspection

    NASA Astrophysics Data System (ADS)

    Velichko, Alexander; Wilcox, Paul D.

    2009-03-01

    Commercial guided wave inspection systems provide rapid screening of pipes, but limited sizing capability for small defects. However, accurate detection and sizing of small defects is essential for assessing the integrity of inaccessible pipe regions where guided waves provide the only possible inspection mechanism. In this paper an array-based approach is presented that allows guided waves to be focused on both transmission and reception to produce a high resolution image of a length of pipe. In the image, it is shown that a signal to coherent noise ratio of over 40 dB with respect to the reflected signal from a free end of pipe can be obtained, even taking into account typical levels of experimental uncertainty in terms of transducer positioning, wave velocity etc. The combination of an image with high resolution and a 40 dB dynamic range enables the detection of very small defects. It also allows the in-plane shape of defects over a certain size to be observed directly. Simulations are used to estimate the detection and sizing capability of the system for crack-like defects. Results are presented from a prototype system that uses EMATs to fully focus pipe guided wave modes on both transmission and reception in a 12 inch diameter stainless steel pipe. The 40 dB signal to coherent noise ratio is obtained experimentally and a 2 mm diameter (0.08 wavelengths) half-thickness hole is shown to be detectable.

  2. Safety and Efficacy of Stereotactic Body Radiation Therapy in the Treatment of Pulmonary Metastases from High Grade Sarcoma

    PubMed Central

    Mehta, Niraj; Selch, Michael; Lee, Jay M.; Eilber, Fritz C.; Chmielowski, Bartosz; Agazaryan, Nzhde; Steinberg, Michael

    2013-01-01

    Introduction. Patients with high-grade sarcoma (HGS) frequently develop metastatic disease thus limiting their long-term survival. Lung metastases (LM) have historically been treated with surgical resection (metastasectomy). A potential alternative for controlling LM could be stereotactic body radiation therapy (SBRT). We evaluated the outcomes from our institutional experience utilizing SBRT. Methods. Sixteen consecutive patients with LM from HGS were treated with SBRT between 2009 and 2011. Routine radiographic and clinical follow-up was performed. Local failure was defined as CT progression on 2 consecutive scans or growth after initial shrinkage. Radiation pneumonitis and radiation esophagitis were scored using Common Toxicity Criteria (CTC) version 3.0. Results. All 16 patients received chemotherapy, and a subset (38%) also underwent prior pulmonary metastasectomy. Median patient age was 56 (12–85), and median follow-up time was 20 months (range 3–43). A total of 25 lesions were treated and evaluable for this analysis. Most common histologies were leiomyosarcoma (28%), synovial sarcoma (20%), and osteosarcoma (16%). Median SBRT prescription dose was 54 Gy (36–54) in 3-4 fractions. At 43 months, local control was 94%. No patient experienced G2-4 radiation pneumonitis, and no patient experienced radiation esophagitis. Conclusions. Our retrospective experience suggests that SBRT for LM from HGS provides excellent local control and minimal toxicity. PMID:24198717

  3. Tumor Control Outcomes After Hypofractionated and Single-Dose Stereotactic Image-Guided Intensity-Modulated Radiotherapy for Extracranial Metastases From Renal Cell Carcinoma

    SciTech Connect

    Zelefsky, Michael J.; Greco, Carlo; Motzer, Robert; Magsanoc, Juan Martin; Pei Xin; Lovelock, Michael; Mechalakos, Jim; Zatcky, Joan; Fuks, Zvi; Yamada, Yoshiya

    2012-04-01

    Purpose: To report tumor local progression-free outcomes after treatment with single-dose, image-guided, intensity-modulated radiotherapy and hypofractionated regimens for extracranial metastases from renal cell primary tumors. Patients and Methods: Between 2004 and 2010, 105 lesions from renal cell carcinoma were treated with either single-dose, image-guided, intensity-modulated radiotherapy to a prescription dose of 18-24 Gy (median, 24) or hypofractionation (three or five fractions) with a prescription dose of 20-30 Gy. The median follow-up was 12 months (range, 1-48). Results: The overall 3-year actuarial local progression-free survival for all lesions was 44%. The 3-year local progression-free survival for those who received a high single-dose (24 Gy; n = 45), a low single-dose (<24 Gy; n = 14), or hypofractionation regimens (n = 46) was 88%, 21%, and 17%, respectively (high single dose vs. low single dose, p = .001; high single dose vs. hypofractionation, p < .001). Multivariate analysis revealed the following variables were significant predictors of improved local progression-free survival: 24 Gy dose compared with a lower dose (p = .009) and a single dose vs. hypofractionation (p = .008). Conclusion: High single-dose, image-guided, intensity-modulated radiotherapy is a noninvasive procedure resulting in high probability of local tumor control for metastatic renal cell cancer generally considered radioresistant according to the classic radiobiologic ranking.

  4. Guiding Center Equations of High Accuracy

    SciTech Connect

    R.B. White, G. Spizzo and M. Gobbin

    2013-03-29

    Guiding center simulations are an important means of predicting the effect of resistive and ideal magnetohydrodynamic instabilities on particle distributions in toroidal magnetically confined thermonuclear fusion research devices. Because saturated instabilities typically have amplitudes of δ B/B of a few times 10-4 numerical accuracy is of concern in discovering the effect of mode particle resonances. We develop a means of following guiding center orbits which is greatly superior to the methods currently in use. In the presence of ripple or time dependent magnetic perturbations both energy and canonical momentum are conserved to better than one part in 1014, and the relation between changes in canonical momentum and energy is also conserved to very high order.

  5. Dosimetric and deformation effects of image-guided interventions during stereotactic body radiation therapy of the prostate using an endorectal balloon

    SciTech Connect

    Jones, Bernard L.; Gan, Gregory; Diot, Quentin; Kavanagh, Brian; Timmerman, Robert D.; Miften, Moyed

    2012-06-15

    Purpose: During stereotactic body radiation therapy (SBRT) for the treatment of prostate cancer, an inflatable endorectal balloon (ERB) may be used to reduce motion of the target and reduce the dose to the posterior rectal wall. This work assessed the dosimetric impact of manual interventions on ERB position in patients receiving prostate SBRT and investigated the impact of ERB interventions on prostate shape. Methods: The data of seven consecutive patients receiving SBRT for the treatment of clinical stage T1cN0M0 prostate cancer enrolled in a multi-institutional, IRB-approved trial were analyzed. The SBRT dose was 50 Gy in five fractions to a planning target volume (PTV) that included the prostate (implanted with three fiducial markers) with a 3-5 mm margin. All plans were based on simulation images that included an ERB inflated with 60 cm{sup 3} of air. Daily kilovoltage cone-beam computed tomography (CBCT) imaging was performed to localize the PTV, and an automated fusion with the planning images yielded displacements required for PTV relocalization. When the ERB volume and/or position were judged to yield inaccurate repositioning, manual adjustment (ERB reinflation and/or repositioning) was performed. Based on all 59 CBCT image sets acquired, a deformable registration algorithm was used to determine the dose received by, displacement of, and deformation of the prostate, bladder (BLA), and anterior rectal wall (ARW). This dose tracking methodology was applied to images taken before and after manual adjustment of the ERB (intervention), and the delivered dose was compared to that which would have been delivered in the absence of intervention. Results: Interventions occurred in 24 out of 35 (69%) of the treated fractions. The direct effect of these interventions was an increase in the prostate radiation dose that included 95% of the PTV (D95) from 9.6 {+-} 1.0 to 10.0 {+-} 0.2 Gy (p = 0.06) and an increase in prostate coverage from 94.0% {+-} 8.5% to 97.8% {+-} 1

  6. Fractionated stereotactic radiotherapy plus bevacizumab after response to bevacizumab plus irinotecan as a rescue treatment for high-grade gliomas

    PubMed Central

    Conde-Moreno, Antonio José; García-Gómez, Raquel; Albert-Antequera, María; Almendros-Blanco, Piedad; De Las Peñas-Bataller, Ramón; González-Vidal, Verónica; López-Torrecilla, José Luis; Ferrer-Albiach, Carlos

    2015-01-01

    Aim To evaluate the possibility of implementing a new scheme of rescue treatment after relapse or progression of high-grade glioma (HGG) treated at the first-line with bevacizumab and irinotecan (BVZ+CPT11), evaluating the response and toxicity of associating BVZ and fractionated stereotactic radiotherapy (BVZ+FSRT). Materials and methods We retrospectively analysed data from 59 patients with relapse of HGG. Nine patients with HGG relapse after treatment using the Stupp protocol that were treated with BVZ+CPT11 for progression between July 2007 and August 2012, after which the response was assessed according to the Revised Assessment in Neuro-Oncology (RANO) criteria. BVZ was administered at a dose of 10 mg/kg and FSRT up to a prescribed dose of 30 Gy, 500 cGy per fraction, three days a week. The median follow-up was 38 months. Results The treatment was well-tolerated by all patients. The response after nuclear magnetic resonance imaging (MRI) at 3–6 months was progression in two patients, stable disease in four, and three patients had a partial response. The median overall survival (OS) from diagnosis until death or the last control was 36.8 months. The median progression-free survival (PFS) was 10.8 months. The results from tumour sub-group analysis indicated that the PFS was not statistically significant although it seemed that it was higher in grade-III. The OS was higher in grade-III gliomas. Conclusions The combination of BVZ+FSRT as a second-line HGG relapse rescue treatment is well-tolerated and seems to offer promising results. We believe that multi-centre prospective studies are needed to determine the long-term efficacy and toxicity of this therapeutic approach. PMID:25949228

  7. Patterns of Failure After Concurrent Bevacizumab and Hypofractionated Stereotactic Radiation Therapy for Recurrent High-Grade Glioma

    SciTech Connect

    Shapiro, Lauren Q.; Beal, Kathryn; Goenka, Anuj; Karimi, Sasan; Iwamoto, Fabio M.; Yamada, Yoshiya; Zhang, Zhigang; Lassman, Andrew B.; Abrey, Lauren E.; Gutin, Philip H.

    2013-03-01

    Purpose: Concurrent bevacizumab with hypofractionated stereotactic radiation therapy (HSRT) is safe and effective for the treatment of recurrent high-grade gliomas (HGG). The objective of this study was to characterize the patterns of failure after this treatment regimen. Methods and Materials: Twenty-four patients with recurrent enhancing HGG were previously treated on an institutional review board-approved protocol of concurrent bevacizumab and reirradiation. Patients received 30 Gy in 5 fractions to the recurrent tumor with HSRT. Brain magnetic resonance imaging (MRI) was performed every 2 cycles, and bevacizumab was continued until clinical or radiographic tumor progression according to the criteria of Macdonald et al. MRI at the time of progression was fused to the HSRT treatment plan, and the location of recurrence was classified on the basis of volume within the 95% isodose line. Outcomes based on patient characteristics, tumor grade, recurrence pattern, and best response to treatment were analyzed by the Kaplan-Meier method. Results: Twenty-two patients experienced either clinical or radiographic progression. Recurrent tumor was enhancing in 15 (71.4%) and nonenhancing in 6 (28.6%) patients. Eleven patients (52.4%) had recurrence within the radiation field, 5 patients (23.8%) had marginal recurrence, and 5 patients had recurrence outside the radiation field. Pattern of enhancement and location of failure did not correlate with overall survival or progression-free survival. Radiographic response was the only variable to significantly correlate with progression-free survival. Conclusions: Despite the promising initial response seen with the addition of HSRT to bevacizumab as salvage treatment for recurrent HGG, approximately half of patients ultimately still experience failure within the radiation field. The rate of local failure with the addition of HSRT seems to be lower than that seen with bevacizumab alone in the salvage setting. Our data underscore the

  8. Stereotactic body radiotherapy: current strategies and future development

    PubMed Central

    2016-01-01

    Stereotactic body radiotherapy (SBRT) has emerged as the standard treatment for medically inoperable early-staged non-small cell lung cancer (NSCLC). The local control rate after SBRT is over 90%. Some forms of tumour motion management and image-guided radiation delivery techniques are the prerequisites for fulfilment of its goal to deliver a high radiation dose to the tumour target without overdosing surrounding normal tissues. In this review, the current strategies of tumour motion management will be discussed, followed by an overview of various image-guided radiotherapy (RT) systems and devices available for clinical practice. Besides medically inoperable stage I NSCLC, SBRT has also been widely adopted for treatment of oligometastasis involving the lungs. Its possible applications in various other cancer illnesses are under extensive exploration. The progress of SBRT is critically technology-dependent. With advancement of technology, the ideal of personalised, effective and yet safe SBRT is already on the horizon. PMID:27606082

  9. Stereotactic body radiotherapy: current strategies and future development.

    PubMed

    Tsang, Maverick W K

    2016-07-01

    Stereotactic body radiotherapy (SBRT) has emerged as the standard treatment for medically inoperable early-staged non-small cell lung cancer (NSCLC). The local control rate after SBRT is over 90%. Some forms of tumour motion management and image-guided radiation delivery techniques are the prerequisites for fulfilment of its goal to deliver a high radiation dose to the tumour target without overdosing surrounding normal tissues. In this review, the current strategies of tumour motion management will be discussed, followed by an overview of various image-guided radiotherapy (RT) systems and devices available for clinical practice. Besides medically inoperable stage I NSCLC, SBRT has also been widely adopted for treatment of oligometastasis involving the lungs. Its possible applications in various other cancer illnesses are under extensive exploration. The progress of SBRT is critically technology-dependent. With advancement of technology, the ideal of personalised, effective and yet safe SBRT is already on the horizon. PMID:27606082

  10. Parent and Student Guide to High School Superintendent Suspension Hearings.

    ERIC Educational Resources Information Center

    Advocates for Children of New York, Inc., Long Island City.

    This guide has been written to help parents represent their children at New York City Board of Education hearings. The guide explains the rights of parents and children and explains the steps a parent should take in representing the child. It only applies to regular education high school suspensions. Sections of the guide explain: (1) reasons a…

  11. Stereotactic radiosurgery of brain metastases.

    PubMed

    Specht, Hanno M; Combs, Stephanie E

    2016-09-01

    Brain metastases are a common problem in solid malignancies and still represent a major cause of morbidity and mortality. With the ongoing improvement in systemic therapies, the expectations on the efficacy of brain metastases directed treatment options are growing. As local therapies against brain metastases continue to evolve, treatment patterns have shifted from a palliative "one-treatment-fits-all" towards an individualized, patient adapted approach. In this article we review the evidence for stereotactic radiation treatment based on the current literature. Stereotactic radiosurgery (SRS) as a local high precision approach for the primary treatment of asymptomatic brain metastases has gained wide acceptance. It leads to lasting tumor control with only minor side effects compared to whole brain radiotherapy, since there is only little dose delivered to the healthy brain. The same holds true for hypofractionated stereotactic radiotherapy (HFSRT) for large metastases or for lesions close to organs at risk (e.g. the brainstem). New treatment indications such as neoadjuvant SRS followed by surgical resection or postoperative local therapy to the resection cavity show promising data and are also highlighted in this manuscript. With the evolution of local treatment options, optimal patient selection becomes more and more crucial. This article aims to aid decision making by outlining prognostic factors, treatment techniques and indications and common dose prescriptions. PMID:27071010

  12. Minimal Inter-Fractional Fiducial Migration during Image-Guided Lung Stereotactic Body Radiotherapy Using SuperLock Nitinol Coil Fiducial Markers

    PubMed Central

    Rong, Yi; Bazan, Jose G.; Sekhon, Ashley; Haglund, Karl; Xu-Welliver, Meng; Williams, Terence

    2015-01-01

    Objectives Stereotactic body radiotherapy (SBRT) is being increasingly used for the treatment of patients with lung cancer or lung metastasis who are medically unfit to undergo resection. In order to improve accuracy and confidence in targeting tumors, many centers rely on fiducial implantation. We evaluated the migration of a novel fiducial marker specifically designed for lung tissue implanted via electromagnetic navigation bronchoscopy (ENB). Methods We retrospectively quantified the individual and group migrations of SuperLock nitinol coil fiducials for 15 patients receiving lung stereotactic body radiotherapy (SBRT), in order to evaluate the reliability of using these fiducials as a target surrogate for cases where tumors cannot be clearly delineated on cone beam CTs (CBCTs). For each fraction, we compared the individual and group migrations of the fiducials between the planning CT and the acquired CBCT. The group migration was defined as the distance between the centroids of the fiducial group and GTV. Results A total of 16 lung targets were included in our study for these 15 patients (one patient with two targets). Of 55 fiducials placed, we observed a 100% retention rate. The mean individual migration was 1.87 mm (range, 0.63–5.25 mm) with a standard deviation of 1.26 mm. The mean group migration was 1.94 mm (range, 0.03–6.19 mm) with a standard deviation of 1.45 mm. Overall, there was minimal change in the relative locations of the markers with respect to each other, as well as to the target. Conclusions We found that the SuperLock nitinol coil fiducial marker positions are stable throughout the radiation treatment, and can be used as a reliable surrogate to target, and to avoid geometric misses during gated treatments. PMID:26158847

  13. Dynamics of laser-guided alternating current high voltage discharges

    NASA Astrophysics Data System (ADS)

    Daigle, J.-F.; Théberge, F.; Lassonde, P.; Kieffer, J.-C.; Fujii, T.; Fortin, J.; Châteauneuf, M.; Dubois, J.

    2013-10-01

    The dynamics of laser-guided alternating current high voltage discharges are characterized using a streak camera. Laser filaments were used to trigger and guide the discharges produced by a commercial Tesla coil. The streaking images revealed that the dynamics of the guided alternating current high voltage corona are different from that of a direct current source. The measured effective corona velocity and the absence of leader streamers confirmed that it evolves in a pure leader regime.

  14. Stereotactic Radiosurgery for Glioblastoma.

    PubMed

    Redmond, Kristin J; Mehta, Minesh

    2015-01-01

    Glioblastoma (GBM) is the most common primary malignant brain tumor in adults and one of the most aggressive of all human cancers. GBM tumors are highly infiltrative and relatively resistant to conventional therapies. Aggressive management of GBM using a combination of surgical resection, followed by fractionated radiotherapy and chemotherapy has been shown to improve overall survival; however, GBM tumors recur in the majority of patients and the disease is most often fatal. There is a need to develop new treatment regimens and technological innovations to improve the overall survival of GBM patients. The role of stereotactic radiosurgery (SRS) for the treatment of GBM has been explored and is controversial. SRS utilizes highly precise radiation techniques to allow dose escalation and delivery of ablative radiation doses to the tumor while minimizing dose to the adjacent normal structures. In some studies, SRS with concurrent chemotherapy has shown improved local control with acceptable toxicities in select GBM patients. However, because GBM is a highly infiltrative disease, skeptics argue that local therapies, such as SRS, do not improve overall survival. The purpose of this article is to review the literature regarding SRS in both newly diagnosed and recurrent GBM, to describe SRS techniques, potential eligible SRS candidates, and treatment-related toxicities. In addition, this article will propose promising areas for future research for SRS in the treatment of GBM. PMID:26848407

  15. Lifework Planning Guide: A Student Guide to High School Planning.

    ERIC Educational Resources Information Center

    Wisconsin State Dept. of Public Instruction, Madison.

    This document is designed to help Wisconsin eighth grade students, their parents, and their teachers plan an individualized course of study in high school that will help these students research their post-high school goals. The document begins by describing the process of lifework planning, which is intended to equip students with the research…

  16. Prognostic factors in patients treated with stereotactic image-guided robotic radiosurgery for brain metastases: a single-center retrospective analysis of 223 patients.

    PubMed

    Pontoriero, Antonio; Conti, Alfredo; Iatì, Giuseppe; Mondello, Stefania; Aiello, Dario; Rifatto, Carmen; Risoleti, Edoarda; Mazzei, Micol; Tomasello, Francesco; Pergolizzi, Stefano; De Renzis, Costantino

    2016-07-01

    In this retrospective study, we evaluated the overall survival (OS) and local control (LC) of brain metastases (BM) in patients treated with stereotactic radiosurgery (SRS). The scope was to identify host, tumor, and treatment factors predictive of LC and survival and define implications for clinical decisions. A total of 223 patients with 360 BM from various histologies treated with SRS alone or associated with whole brain radiotherapy (WBRT) in our institution between July 1, 2008 and August 31, 2013 were retrospectively reviewed. Among other prognostic factors, we had also evaluated retrospectively Karnofsky performance status scores (KPS) and graded prognostic assessment (GPA). Overall survival (OS) and local control (LC) were the primary endpoints. Kaplan-Meier and Cox proportional hazards models were used to estimate OS and LC and identify factors predictive of survival and local control. The median duration of follow-up time was 9 months (range 0.4-51 months). Median overall survival of all patients was 11 months. The median local control was 38 months. No statistical difference in terms of survival or LC between patients treated with SRS alone or associated with WBRT was found. On multivariate analysis, KPS was the only statistically significant predictor of OS (hazard ratio [HR] 2.53, p = 0.006). On univariate analysis, KPS and GPA were significantly prognostic for survival. None of the host, tumor, or treatment factors analyzed in the univariate model factors were significantly associated with local failure. PMID:27106896

  17. High Performance Home Building Guide for Habitat for Humanity Affiliates

    SciTech Connect

    Lindsey Marburger

    2010-10-01

    This guide covers basic principles of high performance Habitat construction, steps to achieving high performance Habitat construction, resources to help improve building practices, materials, etc., and affiliate profiles and recommendations.

  18. Automated stereotactic positioning system.

    PubMed

    Goerss, S J; Kelly, P J; Kall, B A

    1987-01-01

    An automated stereotactic machine has been interfaced to a surgical computer to complete a totally interactive surgical system capable of locating tumor volumes. Stepper motors, activated by the host computer, drive a three-dimensional slide to position the patient's head with respect to a fixed arc, locating the surgical target. Linear encoders on each axis create a closed-loop positioning system and a digital display for visual inspection of the slide's position. The 160-mm arc directs all instrumentation to its isocenter, regardless of the two angular settings, providing maximum freedom in selecting a safe trajectory to the target. Phantom test points compatible with computerized tomographic and magnetic resonance imaging were repeatedly scanned to determine the overall system accuracy, which approached 0.6 mm, depending on the spatial resolution of the image. This stereotactic device may be used to perform stereotactic laser craniotomies, biopsies, 192Ir implants for interstitial radiation, third ventriculostomies and functional procedures. PMID:3329830

  19. The Curriculum Guide: High School Psychology.

    ERIC Educational Resources Information Center

    Greenstone, James L.

    Designed for the secondary level, this curriculum guide suggests concepts and teaching strategies for ten areas of psychology. The content areas of instruction include learning and study skills, behavior patterns, adjustment to the social environment, development of critical thinking, sensitivity to needs and feelings of others, physiological…

  20. Health Education Resource Guide, Junior High.

    ERIC Educational Resources Information Center

    Federal Way School District 210, WA.

    As part of a health education program for K-12, this curriculum guide for grade eight provides: (1) a short overview of health education; (2) a scope and sequence chart which lists specific topics to teach on mental health, physical health, community health, and safety that are appropriate at different grade levels; (3) a list of objectives; and…

  1. A novel compound 6D-offset simulating phantom and quality assurance program for stereotactic image-guided radiation therapy system.

    PubMed

    Yuen Kan Ngar, Dennis; Lok-Man Cheung, Michael; Koon-Ming Kam, Michael; Poon, Wai-Sang; Tak-Cheung Chan, Anthony

    2013-01-01

    A comprehensive quality assurance (QA) device cum program was developed for the commissioning and routine testing of the 6D IGRT systems. In this article, both the new QA system and the BrainLAB IGRT system which was added onto a Varian Clinac were evaluated. A novel compound 6D-offset simulating phantom was designed and fabricated in the Prince of Wales Hospital (PWH), Hong Kong. The QA program generated random compound 6D-offset values. The 6D phantom was simply set up and shifted accordingly. The BrainLAB ExacTrac X-ray IGRT system detected the offsets and then corrected the phantom position automatically through the robotic couch. Routine QA works facilitated data analyses of the detection errors, the correction errors, and the correlations. Fifty sets of data acquired in 2011 in PWH were thoroughly analyzed. The 6D component detection errors and correction errors of the IGRT system were all within ± 1 mm and ± 1° individually. Translational and rotational scalar resultant errors were found to be 0.50 ± 0.27 mm and 0.54 ± 0.23°, respectively. Most individual component errors were shown to be independent of their original offset values. The system characteristics were locally established. The BrainLAB 6D IGRT system added onto a regular linac is sufficiently precise for stereotactic RT. This new QA methodology is competent to assure the IGRT system overall integrity. Annual grand analyses are recommended to check local system consistency and for external cross comparison. The target expansion policy of 1.5 mm 3D margin from CTV to PTV is confirmed for this IGRT system currently in PWH. PMID:24257294

  2. Image-Guided Stereotactic Body Radiation Therapy in Patients With Isolated Para-Aortic Lymph Node Metastases From Uterine Cervical and Corpus Cancer

    SciTech Connect

    Choi, Chul Won; Cho, Chul Koo Yoo, Seong Yul; Kim, Mi Sook; Yang, Kwang Mo; Yoo, Hyung Jun; Seo, Young Seok; Kang, Jin Kyu; Lee, Dong Han; Lee, Kyung Hee; Lee, Eui Don; Rhu, Sang Young; Choi, Suck Chul; Kim, Moon Hong; Kim, Beob Jong

    2009-05-01

    Purpose: The aims of this study were to evaluate the role of stereotactic body radiation therapy (SBRT) as a local treatment for isolated para-aortic lymph node (PALN) metastases originating from uterine cervical and corpus cancer. Methods and Materials: We retrospectively enrolled 30 patients with isolated PALN metastases originating from uterine cervical and corpus cancer who had received SBRT using the CyberKnife (CK). All patients were shown to have isolated PALN metastases by computed tomography (CT) and/or positron emission tomography (PET)-CT. The overall survival (OS), local control (LC) rate, and disease progression-free survival (DPFS) rate were calculated according to the Kaplan-Meier method. Comparison between prognosis groups was performed using log-rank analysis. Toxicities were also evaluated. Results: The 4-year OS rate was 50.1%, and the median survival time was not reached. The OS rate among symptomatic patients was significantly lower than that among asymptomatic patients (p = 0.002). The 4-year actuarial LC rate was 67.4%. Patients with a planning target volume of {<=}17 ml had significantly higher LC rates (p = 0.009). The 4-year DPFS rate was 45.0%, and the median time to disease progression was 32 months. Small planning target volume was a favorable prognostic factor (p = 0.043). Grade 3 or 4 complications requiring hospitalization were reported in 1 patient at 20 months after SBRT. Conclusion: The OS and LS rates were promising, and the incidence of toxicities was low. Use of SBRT with the CyberKnife is an effective modality for treating isolated PALN metastases in patients with uterine cervical and corpus cancer.

  3. Use of Image-Guided Stereotactic Body Radiation Therapy in Lieu of Intracavitary Brachytherapy for the Treatment of Inoperable Endometrial Neoplasia

    SciTech Connect

    Kemmerer, Eric; Hernandez, Enrique; Ferriss, James S.; Valakh, Vladimir; Miyamoto, Curtis; Li, Shidong; Micaily, Bizhan

    2013-01-01

    Purpose: Retrospective analysis of patients with invasive endometrial neoplasia who were treated with external beam radiation therapy followed by stereotactic body radiation therapy (SBRT) boost because of the inability to undergo surgery or brachytherapy. Methods and Materials: We identified 11 women with stage I-III endometrial cancer with a median age of 78 years that were not candidates for hysterectomy or intracavitary brachytherapy secondary to comorbidities (91%) or refusal (9%). Eight patients were American Joint Committee on Cancer (AJCC) stage I (3 stage IA, 5 stage IB), and 3 patients were AJCC stage III. Patients were treated to a median of 4500 cGy at 180 cGy per fraction followed by SBRT boost (600 cGy per fraction Multiplication-Sign 5). Results: The most common side effect was acute grade 1 gastrointestinal toxicity in 73% of patients, with no late toxicities observed. With a median follow-up of 10 months since SBRT, 5 patients (45%) experienced locoregional disease progression, with 3 patients (27%) succumbing to their malignancy. At 12 and 18 months from SBRT, the overall freedom from progression was 68% and 41%, respectively. Overall freedom from progression (FFP) was 100% for all patients with AJCC stage IA endometrial carcinoma, whereas it was 33% for stage IB at 18 months. The overall FFP was 100% for International Federation of Obstetrics and Gynecology grade 1 disease. The estimated overall survival was 57% at 18 months from diagnosis. Conclusion: In this study, SBRT boost to the intact uterus was feasible, with encouragingly low rates of acute and late toxicity, and favorable disease control in patients with early-stage disease. Additional studies are needed to provide better insight into the best management of these clinically challenging cases.

  4. Imaging for Stereotactic Spine Radiotherapy: Clinical Considerations

    SciTech Connect

    Dahele, Max; Zindler, Jaap D.; Sanchez, Esther; Verbakel, Wilko F.; Kuijer, Joost P.A.; Slotman, Ben J.; Senan, Suresh

    2011-10-01

    There is growing interest in the use of stereotactic body radiation therapy (SBRT) for spinal metastases. With the need for accurate target definition and conformal avoidance of critical normal structures, high-quality multimodal imaging has emerged as a key component at each stage of the treatment process. Multidisciplinary collaboration is necessary to optimize imaging protocols and implement imaging advances into routine patient care.

  5. SU-E-J-269: Assessing the Precision of Dose Delivery in CBCT-Guided Stereotactic Body Radiation Therapy for Lung and Soft Tissue Metastatic Lesions

    SciTech Connect

    Parsai, S; Dalhart, A; Chen, C; Parsai, E; Pearson, D; Sperling, N; Reddy, K

    2014-06-01

    Purpose: Ensuring reproducibility of target localization is critical to accurate stereotactic body radiation treatment (SBRT) for lung and soft tissue metastatic lesions. To characterize interfraction variability in set-up and evaluate PTV margins utilized for SBRT, daily CBCTs were used to calculate delivered target and OAR doses compared to those expected from planning. Methods: CBCT images obtained prior to each fraction of SBRT for a lung and thyroid metastatic lesion were evaluated. The target CTV/ITV and OARs on each of 8 CBCT data sets were contoured. Using MIM fusion software and Pinnacle{sup 3} RTP system, delivered dose distribution was reconstructed on each CBCT, utilizing translational shifts performed prior to treatment. Actual delivered vs. expected doses received by target CTV/ITV and adjacent critical structures were compared to characterize accuracy of pre-treatment translational shifts and PTV margins. Results: The planned CTV/ITV D95% and V100% were 4595cGy and 91.47% for the lung lesion, and 3010cGy and 96.34% for the thyroid lesion. Based on CBCT analysis, actual mean D95% and V100% for lung ITV were 4542±344.4cGy and 91.54±3.45%; actual mean D95% and V100% for thyroid metastasis CTV were 3005±25.98cGy and 95.20±2.522%. For the lung lesion, ipsilateral lung V20, heart V32 (cc) and spinal cord (.03 cc) max were 110.15cc, 3.33cc, and 1680cGy vs. 110.27±14.79cc, 6.74±3.76cc, and 1711±46.56cGy for planned vs. delivered doses, respectively. For the thyroid metastatic lesion, esophagus V18, trachea (.03 cc) max, and spinal cord (.03 cc) max were 0.35cc, 2555cGy, and 850cGy vs. 0.16±0.13cc, 2147±367cGy, and 838±45cGy for planned vs. delivered treatments, respectively. Conclusion: Minimal variability in SBRT target lesion dose delivered based on pre-treatment CBCT-based translational shifts suggests tighter PTV margins may be considered to further decrease dose to surrounding critical structures. Guidelines for optimal target alignment during

  6. Stereotactic Body Radiotherapy and Ablative Therapies for Lung Cancer.

    PubMed

    Abbas, Ghulam; Danish, Adnan; Krasna, Mark J

    2016-07-01

    The treatment paradigm for early stage lung cancer and oligometastatic disease to the lung is rapidly changing. Ablative therapies, especially stereotactic body radiation therapy, are challenging the surgical gold standard and have the potential to be the standard for operable patients with early stage lung cancer who are high risk due to co- morbidities. The most commonly used ablative modalities include stereotactic body radiation therapy, microwave ablation, and radiofrequency ablation. PMID:27261915

  7. The use of high field strength and parallel imaging techniques for MRI-based gel dosimetry in stereotactic radiosurgery

    NASA Astrophysics Data System (ADS)

    Seimenis, I.; Moutsatsos, A.; Petrokokkinos, L.; Kantemiris, I.; Benekos, O.; Efstathopoulos, E.; Papagiannis, P.; Spevacek, V.; Semnicka, J.; Dvorak, P.

    2009-07-01

    The poor clinical acceptance of polymer gel dosimetry for dose verification in stereotactic radio-surgery applications stems, inter alia, from the increased MRI acquisition times needed to meet the associated spatial resolution demands. To examine whether this could be partly alleviated by the employment of 3 Tesla imagers and parallel imaging techniques, a PolyAcrylamide Gel filled tube was irradiated in a Leksell Gamma Knife unit with two single irradiation shots (4 mm and 8 mm) and underwent four different scanning sessions using an optimised, volume selective, 32 echo CPMG pulse sequence: One performed on a 1.5 T imager with 0.5 × 0.5 mm2 in-plane spatial resolution and 0.75 mm slice thickness (scan A), while the rest three on a 3.0 T imager; one with the same spatial resolution as in scan A (scan B) and two with finer in-plane resolution (scans C and D). In scans B and C the sensitivity encoding (SENSE) parallel imaging technique was employed. Relative dose distributions derived by scan A were benchmarked against Monte Carlo and treatment planning system calculations, and then used as the reference for the comparison of 2D relative dose distributions derived by each scan in terms of dose difference and distance-to-agreement criteria (γ index tool). Findings suggest that careful MRI planning based on a figure of merit accounting for scanning time and precision for a given increase in spatial resolution, could facilitate the introduction of polymer gel dosimetry into the clinical setting as a practical quality assurance tool for complex radio-surgery techniques.

  8. Stereotactic radiosurgery and stereotactic radiotherapy for brain metastases.

    PubMed

    Halasz, Lia M; Rockhill, Jason K

    2013-01-01

    Stereotactic radiosurgery (SRS) and hypofractionated stereotactic radiotherapy (HFSRT) have become important treatment modalities for brain metastases. While effective, there are still areas of extensive debate on its appropriate use in patients with life-limiting diseases. This review provides an overview of the indications and challenges of SRS and HFSRT in the management of brain metastases. PMID:23717789

  9. Stereotactic radiosurgery for gynecologic cancer.

    PubMed

    Kunos, Charles; Brindle, James M; Debernardo, Robert

    2012-01-01

    Stereotactic body radiotherapy (SBRT) distinguishes itself by necessitating more rigid patient immobilization, accounting for respiratory motion, intricate treatment planning, on-board imaging, and reduced number of ablative radiation doses to cancer targets usually refractory to chemotherapy and conventional radiation. Steep SBRT radiation dose drop-off permits narrow 'pencil beam' treatment fields to be used for ablative radiation treatment condensed into 1 to 3 treatments. Treating physicians must appreciate that SBRT comes at a bigger danger of normal tissue injury and chance of geographic tumor miss. Both must be tackled by immobilization of cancer targets and by high-precision treatment delivery. Cancer target immobilization has been achieved through use of indexed customized Styrofoam casts, evacuated bean bags, or body-fix molds with patient-independent abdominal compression.(1-3) Intrafraction motion of cancer targets due to breathing now can be reduced by patient-responsive breath hold techniques,(4) patient mouthpiece active breathing coordination,(5) respiration-correlated computed tomography,(6) or image-guided tracking of fiducials implanted within and around a moving tumor.(7-9) The Cyberknife system (Accuray [Sunnyvale, CA]) utilizes a radiation linear accelerator mounted on a industrial robotic arm that accurately follows patient respiratory motion by a camera-tracked set of light-emitting diodes (LED) impregnated on a vest fitted to a patient.(10) Substantial reductions in radiation therapy margins can be achieved by motion tracking, ultimately rendering a smaller planning target volumes that are irradiated with submillimeter accuracy.(11-13) Cancer targets treated by SBRT are irradiated by converging, tightly collimated beams. Resultant radiation dose to cancer target volume histograms have a more pronounced radiation "shoulder" indicating high percentage target coverage and a small high-dose radiation "tail." Thus, increased target conformality

  10. Guide to NYC Small High Schools, 2005-2006

    ERIC Educational Resources Information Center

    New Visions for Public Schools, 2005

    2005-01-01

    New Visions for Public Schools has put together "The New York City Guide to Small High Schools" to describe new opportunities in the public high school system: over 200 small secondary schools created over the last five years. These small schools are part of the Department of Education's efforts to create more choices for thousands of students…

  11. Junior High English Language Arts Curriculum and Program Guide.

    ERIC Educational Resources Information Center

    Northwest Territories Dept. of Education, Yellowknife.

    Noting that both first and second language students of English need teacher help in linking their experiences and language to new situations and structures presented in the junior high classroom, this curriculum and program guide (for the English language curriculum for all students at the junior high level in Canada's Northwest Territories)…

  12. The Black Student's Guide to High School Success.

    ERIC Educational Resources Information Center

    Ekeler, William J., Ed.

    The selections in this book offer advice on how to get the most out of a high school education by making intelligent and informed decisions in and out of the classroom. The guide features 15 essays geared to the student, each written by a professional or educator. Each is followed by a short essay by a black high school student about his or her…

  13. Making Sense of Integrated Science: A Guide for High Schools.

    ERIC Educational Resources Information Center

    Biological Sciences Curriculum Study, Colorado Springs.

    This guide outlines the initial work and includes recommendations for schools and districts on how to implement an integrated science program. Chapters include: (1) "What Is Integrated Science and What Does It Look Like at the High School Level?"; (2) "Coherence in High School Science" (F. James Rutherford); (3) "Thinking about Change: What Will…

  14. Users guide to high altitude imagery of Michigan

    NASA Technical Reports Server (NTRS)

    1973-01-01

    A guide to the high altitude imagery of Michigan outlines the areas of the state covered by selected recent high altitude aircraft and Earth Resources Technology Satellite flights. The types of remote sensing used are described. Maps of the flight coverage areas are included along with price lists of available imagery.

  15. Is robotic arm stereotactic body radiation therapy “virtual high dose ratebrachytherapy” for prostate cancer? An analysis of comparative effectiveness using published data [corrected].

    PubMed

    Zaorsky, Nicholas George; Hurwitz, Mark D; Dicker, Adam P; Showalter, Timothy N; Den, Robert B

    2015-05-01

    High-dose rate brachytherapy (HDR-BT) monotherapy and robotic arm (i.e., CyberKnife) stereotactic body radiation therapy (SBRT) are emerging technologies that have become popular treatment options for prostate cancer. Proponents of both HDR-BT monotherapy and robotic arm SBRT claim that these modalities are as efficacious as intensity-modulated radiation therapy in treating prostate cancer. Moreover, proponents of robotic arm SBRT believe it is more effective than HDR-BT monotherapy because SBRT is non-invasive, touting it as 'virtual HDR-BT.' We perform a comparative effective analysis of the two technologies. The tumor control rates and toxicities of HDR-BT monotherapy and robotic arm SBRT are promising. However, at present, it would be inappropriate to state that HDR-BT monotherapy and robotic arm SBRT are as efficacious or effective as other treatment modalities for prostate cancer, which have stronger foundations of evidence. Studies reporting on these technologies have relatively short follow-up time, few patients and are largely retrospective. PMID:25540018

  16. High-gain reverse guide field free electron lasers

    SciTech Connect

    Tsui, K.H.

    1995-10-01

    Electron beam trajectories under circularly polarized external wigglers in free electron laser devices with axial guide fields are reconsidered by introducing the self-fields of the electron beam. The competition between the self-fields and the wiggler field plus the action of the guide field are not only responsible for the known positive guide field singularity, but also the new reverse guide field singularity. The physics of the new reverse field singularity relies on the fact that an azimuthal magnetic field uniform in {ital z} is able to generate steady-state helical beam orbits just as if it were a transverse wiggler. According to this theory, the handness of the circularly polarized microwave should depend on the guide field configuration. High-gain strong pump equations coupled to these trajectories are used to account for the Massachusetts Institute of Technology reverse guide field results [Phys. Rev. Lett. {bold 67}, 3082 (1991)]. {copyright} {ital 1995} {ital American} {ital Institute} {ital of} {ital Physics}.

  17. Stereotactic surgery for eating disorders.

    PubMed

    Sun, Bomin; Liu, Wei

    2013-01-01

    EATING DISORDERS (EDS) ARE A GROUP OF SEVERELY IMPAIRED EATING BEHAVIORS, WHICH INCLUDE THREE SUBGROUPS: anorexia nervosa (AN), bulimia nervosa (BN), and ED not otherwise specified (EDNOS). The precise mechanism of EDs is still unclear and the disorders cause remarkable agony for the patients and their families. Although there are many available treatment methods for EDs today, such as family therapy, cognitive behavioral therapy, medication, psychotherapy, and so on, almost half of the patients are refractory to all current medical treatment and never fully recover. For treatment-refractory EDs, stereotactic surgery may be an alternative therapy. This review discusses the history of stereotactic surgery, the modern procedures, and the mostly used targets of stereotactic surgery in EDs. In spite of the limited application of stereotactic surgery in ED nowadays, stereotactic lesion and deep brain stimulation (DBS) are promising treatments with the development of modern functional imaging techniques and the increasing understanding of its mechanism in the future. PMID:23682343

  18. Stereotactic surgery for eating disorders

    PubMed Central

    Sun, Bomin; Liu, Wei

    2013-01-01

    Eating disorders (EDs) are a group of severely impaired eating behaviors, which include three subgroups: anorexia nervosa (AN), bulimia nervosa (BN), and ED not otherwise specified (EDNOS). The precise mechanism of EDs is still unclear and the disorders cause remarkable agony for the patients and their families. Although there are many available treatment methods for EDs today, such as family therapy, cognitive behavioral therapy, medication, psychotherapy, and so on, almost half of the patients are refractory to all current medical treatment and never fully recover. For treatment-refractory EDs, stereotactic surgery may be an alternative therapy. This review discusses the history of stereotactic surgery, the modern procedures, and the mostly used targets of stereotactic surgery in EDs. In spite of the limited application of stereotactic surgery in ED nowadays, stereotactic lesion and deep brain stimulation (DBS) are promising treatments with the development of modern functional imaging techniques and the increasing understanding of its mechanism in the future. PMID:23682343

  19. Engineer's guide to high-temperature superconductivity

    NASA Astrophysics Data System (ADS)

    Doss, James D.

    The physics, properties, preparation, and applications of high-Tc superconductors are described. Chapters are devoted to the history of superconductivity, fundamental considerations, superconductor applications, the processing of high-Tc superconductors, measurement techniques, and safety problems. Also provided are a review of basic electrical and magnetic theory; a table of units and conversions; a glossary of terms and symbols; and lists of superconductor-related products, services, publications, and associations.

  20. TE_01 High Power Disk Loaded Guide Load

    SciTech Connect

    Farkas, Z.D.; /SLAC

    2005-06-01

    A method to design a matching section from a smooth guide to a disk-loaded guide, using a variation of broadband matching, [1, 2] is described. Using this method, we show how to design high power loads, attenuators and filters. The load consists of a disk-loaded coaxial guide operating in the TE{sub 01}-mode. We use this mode because it has no electric field terminating on a conductor, has no axial currents, and has no current at the cylinder-disk interface. A high power load design that has -35 dB reflection and a 200 MHz, -20 dB bandwidth, is presented. It is expected that it will carry the 600 MW output peak power of the pulse compression network. We use coaxial geometry and stainless steel material to increase the attenuation per cell.

  1. High Temperature Calibration Furnace System user's guide

    NASA Technical Reports Server (NTRS)

    1994-01-01

    The High Temperature Calibration Furnace System (HTCFS) was developed by Summitec Corporation. It is a high precision instrument providing a constant temperature which can be used to calibrate high temperature thermocouples. Incorporating the many recent technological advances from the fields of optical fiber thermometry, material science, computer systems interfacing, and process control, the engineers at Summitec Corporation have been able to create a system that can reach a steady operating temperature of 1700 C. The precision for the system requires the measurement of temperature to be within 1 C in two hours and within 2 C in 24 hours. As documented, the experimental result shows that this system has been able to stay within .5 C in 5 hours. No other systems commercially available have been able to achieve such high temperature precision. This manual provides an overview of the system design, instructions for instrument setup, and operation procedures. Also included are a vendor list and the source codes for the custom-designed software.

  2. High School Law Awareness Curriculum Guide, 1980.

    ERIC Educational Resources Information Center

    Seminole County Board of Public Instruction, Sanford, FL.

    Instructional materials, activities, and lesson plans used to teach high school students about the law, the legal process, and the legal system are presented. The materials are intended to be incorporated into the U.S. history curriculum. The following topics are covered: procedure for trial simulation; the Boston Massacre; the debate over…

  3. Stereotactic PET atlas of the human brain: Aid for visual interpretation of functional brain images

    SciTech Connect

    Minoshima, S.; Koeppe, R.A.; Frey, A.; Ishihara, M.; Kuhl, D.E.

    1994-06-01

    In the routine analysis of functional brain images obtained by PET, subjective visual interpretation is often used for anatomic localization. To enhance the accuracy and consistency of the anatomic interpretation, a PET stereotactic atlas and localization approach was designed for functional brain images. The PET atlas was constructed from a high-resolution [{sup 18}F]fluorodeoxyglucose (FDG) image set of a normal volunteer (a 41-yr-ld woman). The image set was reoriented stereotactically, according to the intercommissural (anterior and posterior commissures) line and transformed to the standard stereotactic atlas coordinates. Cerebral structures were annotated on the transaxial planes using a proportional grid system and surface-rendered images. The stereotactic localization technique was applied to image sets from patients with Alzheimer`s disease, and areas of functional alteration were localized visually by referring to the PET atlas. Major brain structures were identified on both transaxial planes and surface-rendered images. In the stereotactic system, anatomic correspondence between the PET atlas and stereotactically reoriented individual image sets of patients with Alzheimer`s disease facilitated both indirect and direct localization of the cerebral structures. Because rapid stereotactic alignment methods for PET images are now available for routine use, the PET atlas will serve as an aid for visual interpretation of functional brain images in the stereotactic system. Widespread application of stereotactic localization may be used in functional brain images, not only in the research setting, but also in routine clinical situations. 41 refs., 3 figs.

  4. Design guide for high pressure oxygen systems

    NASA Technical Reports Server (NTRS)

    Bond, A. C.; Pohl, H. O.; Chaffee, N. H.; Guy, W. W.; Allton, C. S.; Johnston, R. L.; Castner, W. L.; Stradling, J. S.

    1983-01-01

    A repository for critical and important detailed design data and information, hitherto unpublished, along with significant data on oxygen reactivity phenomena with metallic and nonmetallic materials in moderate to very high pressure environments is documented. This data and information provide a ready and easy to use reference for the guidance of designers of propulsion, power, and life support systems for use in space flight. The document is also applicable to designs for industrial and civilian uses of high pressure oxygen systems. The information presented herein are derived from data and design practices involving oxygen usage at pressures ranging from about 20 psia to 8000 psia equal with thermal conditions ranging from room temperatures up to 500 F.

  5. Tomotherapy and stereotactic radiosurgery

    NASA Astrophysics Data System (ADS)

    Soisson, Emilie T.

    Currently, at the University of Wisconsin-Madison, a linear accelerator equipped with circular collimators and a floor stand is used for stereotactic radiosurgery (SRS) delivery. In the interest of providing a more efficient delivery option for patients with multiple brain metastases, a Tomotherapy-based radiosurgery program was developed to serve as an intensity modulated compliment to our existing delivery method. The unique advantage of Tomotherapy over other radiotherapy delivery units is the on board megavoltage CT that can be used for both stereotactic localization and treatment planning. As such, a workflow was designed in which the planning image is acquired on the treatment unit itself and, instead using a patient-frame based coordinate system for stereotactic localization, volumetric imaging is used to precisely locate the target at the time of treatment. Localization and delivery accuracy was found to be comparable to conventional approaches and well within stated tolerances. A Tomotherapy-specific treatment planning technique was also developed using the Tomotherapy treatment planning system that reliably produces plans that achieve both conformal target coverage and sufficiently steep dose falloff into surrounding normal brain. Tomotherapy plans have been compared to conventional circular collimator based plans for both the treatment of brain metastases and arteriovenous malformations in terms of both target conformity and dose to normal brain. To determine the effect of plan differences on patient outcome, clinical data was used to predict the resulting risk of treatment induced symptomatic brain necrosis for both conventional and Tomotherapy based plans. Overall, it was determined that plans generated using the described planning technique are acceptable for radiosurgery. In addition, delivery time for complex cases is comparable to or improved over conventional isocentric approaches. Finally, this work explores the impact of future product

  6. High-dose-rate Three-dimensional Conformal Radiotherapy Combined with Active Breathing Control for Stereotactic Body Radiotherapy of Early-stage Non-small-cell Lung Cancer.

    PubMed

    Wang, Ruozheng; Yin, Yong; Qin, Yonghui; Yu, Jinming

    2015-12-01

    The purpose of this study was to evaluate the feasibility and benefits of using high-dose-rate three-dimensional conformal radiotherapy (3D-CRT) combined with active breathing control (ABC) for stereotactic body radiotherapy (SBRT) of patients with early-stage non-small-cell lung cancer (NSCLC). Eight patients with early-stage NSCLC underwent CT scans under standard free-breathing (FB) and moderately deep inspiration breath-hold (mDIBH) with ABC. Two high-dose-rate 3D-CRT plans (1000 Mu/min) were designed based on the CT scans with FB and mDIBH. The maximal dose (D1%), minimal dose (D99%), conformity index (CI), and homogeneity index (HI) of the planning target volume (PTV), and dose-volume indices of the organs at risk between each plan were compared. The mean PTV volume decreased from 158.04 cm(3) with FB to 76.90 cm(3) with mDIBH (p < 0.05). When mDIBH was used, increases in the affected lung volume (by 47%), contralateral lung volume (by 55%), and total lung volume (by 50%) were observed compared to FB (p < 0.05). The V5-V40 of the affected lung (Vx represented the percentage volume of organs receiving at least the x Gy), V5-V40 and the mean dose for the total lung, V5-V40 and mean dose of the chest wall, and the maximum dose of the spinal cord were less for mDIBH than FB (p < 0.05). There were no significant differences in CI, HI, D1%, or D99% for the PTV between the plans. In conclusion, high-dose-rate 3D-CRT combined with ABC reduced the radiation dose to the lungs and chest wall without affecting the dose distribution in SBRT of early-stage NSCLC patients. PMID:24988055

  7. Teachers Guide to Social Studies in the Senior High School.

    ERIC Educational Resources Information Center

    Cason, Constance; And Others

    This guide to the social studies was developed for use in the senior high schools of Duval County, Jacksonville, Florida. Topics covered are United States government, United States history, anthropology, bible history, comparative institutions, European history, Florida history, human relations, political science, economics, psychology, sociology,…

  8. High School Industrial Arts. A Guide for Teachers.

    ERIC Educational Resources Information Center

    Oregon State Dept. of Education, Salem.

    This teacher's guide is designed to help high school industrial arts teachers plan activities to develop their students' awareness of technology in our culture and the variety of related careers available to them. Discussed first are the objectives, scope, and sequence of industrial arts. Next, the special characteristics and needs of adolescents,…

  9. High School Art Education Guide. Competency-Based Education.

    ERIC Educational Resources Information Center

    Frederick County Public Schools, MD.

    Arranged into 26 sections, this curriculum guide provides high school teachers with a competency based approach to teaching art education. Following a statement of appreciation, the philosophy and goals for art education in Maryland are presented. An excerpt from Edmund Feldman's "Varieties of Visual Experience" discusses aesthetic expression.…

  10. Heads Up: Concussion in High School Sports. Guide for Coaches

    ERIC Educational Resources Information Center

    Centers for Disease Control and Prevention, 2005

    2005-01-01

    This guide provides general information to high school sports coaches about concussions. It focuses on the fact that coaches can play a key role in preventing concussions and managing them properly when they occur. The following sections are included: (1) The Facts; (2) Signs and Symptoms; (3) Prevention and Preparation; (4) When a Concussion…

  11. Law and the Family: A High School Curriculum Guide.

    ERIC Educational Resources Information Center

    Khanlian, John F., Ed.; And Others

    This curriculum guide is designed to assist high school classroom teachers in developing and implementing a program on family law. The major objective of the document is to help students understand how profoundly the law is associated with their private lives. The document is presented in four chapters. Key areas in this frequently ignored area of…

  12. Investigating Safely: A Guide for High School Teachers

    ERIC Educational Resources Information Center

    Texley, Juliana; Kwan, Terry; Summers, John

    2004-01-01

    Just as high school science is more complex than it is at lower grade levels, so are the safety issues teachers face in their classes and labs. Reduce the risks to people and place with Investigating Safely, the third and most advanced and detailed volume in NSTA's unique series of safety guidebooks for science teachers. Some of the guides 11…

  13. The Estuary Guide. Level 3: High School. Draft.

    ERIC Educational Resources Information Center

    Alexander, Glen; And Others

    Estuaries are marine systems that serve as nurseries for animals, links in the migratory pathways, and habitat for a complex community of organisms. This curriculum guide intended for use at the high school level seeks to teach what estuaries are; provide opportunities to practice decision-making that affects estuaries; and encourage students to…

  14. Failure Mode and Effect Analysis for Delivery of Lung Stereotactic Body Radiation Therapy

    SciTech Connect

    Perks, Julian R.; Stanic, Sinisa; Stern, Robin L.; Henk, Barbara; Nelson, Marsha S.; Harse, Rick D.; Mathai, Mathew; Purdy, James A.; Valicenti, Richard K.; Siefkin, Allan D.; Chen, Allen M.

    2012-07-15

    Purpose: To improve the quality and safety of our practice of stereotactic body radiation therapy (SBRT), we analyzed the process following the failure mode and effects analysis (FMEA) method. Methods: The FMEA was performed by a multidisciplinary team. For each step in the SBRT delivery process, a potential failure occurrence was derived and three factors were assessed: the probability of each occurrence, the severity if the event occurs, and the probability of detection by the treatment team. A rank of 1 to 10 was assigned to each factor, and then the multiplied ranks yielded the relative risks (risk priority numbers). The failure modes with the highest risk priority numbers were then considered to implement process improvement measures. Results: A total of 28 occurrences were derived, of which nine events scored with significantly high risk priority numbers. The risk priority numbers of the highest ranked events ranged from 20 to 80. These included transcription errors of the stereotactic coordinates and machine failures. Conclusion: Several areas of our SBRT delivery were reconsidered in terms of process improvement, and safety measures, including treatment checklists and a surgical time-out, were added for our practice of gantry-based image-guided SBRT. This study serves as a guide for other users of SBRT to perform FMEA of their own practice.

  15. A novel, integrated PET-guided MRS technique resulting in more accurate initial diagnosis of high-grade glioma.

    PubMed

    Kim, Ellen S; Satter, Martin; Reed, Marilyn; Fadell, Ronald; Kardan, Arash

    2016-06-01

    Glioblastoma multiforme (GBM) is the most common and lethal malignant glioma in adults. Currently, the modality of choice for diagnosing brain tumor is high-resolution magnetic resonance imaging (MRI) with contrast, which provides anatomic detail and localization. Studies have demonstrated, however, that MRI may have limited utility in delineating the full tumor extent precisely. Studies suggest that MR spectroscopy (MRS) can also be used to distinguish high-grade from low-grade gliomas. However, due to operator dependent variables and the heterogeneous nature of gliomas, the potential for error in diagnostic accuracy with MRS is a concern. Positron emission tomography (PET) imaging with (11)C-methionine (MET) and (18)F-fluorodeoxyglucose (FDG) has been shown to add additional information with respect to tumor grade, extent, and prognosis based on the premise of biochemical changes preceding anatomic changes. Combined PET/MRS is a technique that integrates information from PET in guiding the location for the most accurate metabolic characterization of a lesion via MRS. We describe a case of glioblastoma multiforme in which MRS was initially non-diagnostic for malignancy, but when MRS was repeated with PET guidance, demonstrated elevated choline/N-acetylaspartate (Cho/NAA) ratio in the right parietal mass consistent with a high-grade malignancy. Stereotactic biopsy, followed by PET image-guided resection, confirmed the diagnosis of grade IV GBM. To our knowledge, this is the first reported case of an integrated PET/MRS technique for the voxel placement of MRS. Our findings suggest that integrated PET/MRS may potentially improve diagnostic accuracy in high-grade gliomas. PMID:27122050

  16. Corrosion monitoring using high-frequency guided ultrasonic waves

    NASA Astrophysics Data System (ADS)

    Fromme, Paul

    2014-02-01

    Corrosion develops due to adverse environmental conditions during the life cycle of a range of industrial structures, e.g., offshore oil platforms, ships, and desalination plants. Both pitting corrosion and generalized corrosion leading to wall thickness loss can cause the degradation of the structural integrity. The nondestructive detection and monitoring of corrosion damage in difficult to access areas can be achieved using high frequency guided waves propagating along the structure from accessible areas. Using standard ultrasonic transducers with single sided access to the structure, guided wave modes were generated that penetrate through the complete thickness of the structure. The wave propagation and interference of the different guided wave modes depends on the thickness of the structure. Laboratory experiments were conducted and the wall thickness reduced by consecutive milling of the steel structure. Further measurements were conducted using accelerated corrosion in a salt water bath and the damage severity monitored. From the measured signal change due to the wave mode interference the wall thickness reduction was monitored. The high frequency guided waves have the potential for corrosion damage monitoring at critical and difficult to access locations from a stand-off distance.

  17. Corrosion monitoring using high-frequency guided waves

    NASA Astrophysics Data System (ADS)

    Fromme, P.

    2016-04-01

    Corrosion can develop due to adverse environmental conditions during the life cycle of a range of industrial structures, e.g., offshore oil platforms, ships, and desalination plants. Generalized corrosion leading to wall thickness loss can cause the reduction of the strength and thus degradation of the structural integrity. The monitoring of corrosion damage in difficult to access areas can be achieved using high frequency guided waves propagating along the structure from accessible areas. Using standard ultrasonic wedge transducers with single sided access to the structure, guided wave modes were selectively generated that penetrate through the complete thickness of the structure. The wave propagation and interference of the different guided wave modes depends on the thickness of the structure. Laboratory experiments were conducted for wall thickness reduction due to milling of the steel structure. From the measured signal changes due to the wave mode interference the reduced wall thickness was monitored. Good agreement with theoretical predictions was achieved. The high frequency guided waves have the potential for corrosion damage monitoring at critical and difficult to access locations from a stand-off distance.

  18. Dosimetry analyses comparing high-dose-rate brachytherapy, administered as monotherapy for localized prostate cancer, with stereotactic body radiation therapy simulated using CyberKnife.

    PubMed

    Fukuda, Shoichi; Seo, Yuji; Shiomi, Hiroya; Yamada, Yuji; Ogata, Toshiyuki; Morimoto, Masahiro; Konishi, Koji; Yoshioka, Yasuo; Ogawa, Kazuhiko

    2014-11-01

    The purpose of this study was to perform dosimetry analyses comparing high-dose-rate brachytherapy (HDR-BT) with simulated stereotactic body radiotherapy (SBRT). We selected six consecutive patients treated with HDR-BT monotherapy in 2010, and a CyberKnife SBRT plan was simulated for each patient using computed tomography images and the contouring set used in the HDR-BT plan for the actual treatment, but adding appropriate planning target volume (PTV) margins for SBRT. Then, dosimetric profiles for PTVs of the rectum, bladder and urethra were compared between the two modalities. The SBRT plan was more homogenous and provided lower dose concentration but better coverage for the PTV. The maximum doses in the rectum were higher in the HDR-BT plans. However, the HDR-BT plan provided a sharper dose fall-off around the PTV, resulting in a significant and considerable difference in volume sparing of the rectum with the appropriate PTV margins added for SBRT. While the rectum D5cm(3) for HDR-BT and SBRT was 30.7 and 38.3 Gy (P < 0.01) and V40 was 16.3 and 20.8 cm(3) (P < 0.01), respectively, SBRT was significantly superior in almost all dosimetric profiles for the bladder and urethra. These results suggest that SBRT as an alternative to HDR-BT in hypofractionated radiotherapy for prostate cancer might have an advantage for bladder and urethra dose sparing, but for the rectum only when proper PTV margins for SBRT are adopted. PMID:24957754

  19. Stereotactic Mesencephalotomy for Cancer - Related Facial Pain

    PubMed Central

    Kim, Deok-ryeong; Lee, Sang-won

    2014-01-01

    Cancer-related facial pain refractory to pharmacologic management or nondestructive means is a major indication for destructive pain surgery. Stereotactic mesencephalotomy can be a valuable procedure in the management of cancer pain involving the upper extremities or the face, with the assistance of magnetic resonance imaging (MRI) and electrophysiologic mapping. A 72-year-old man presented with a 3-year history of intractable left-sided facial pain. When pharmacologic and nondestructive measures failed to provide pain alleviation, he was reexamined and diagnosed with inoperable hard palate cancer with intracranial extension. During the concurrent chemoradiation treatment, his cancer-related facial pain was aggravated and became medically intractable. After careful consideration, MRI-based stereotactic mesencephalotomy was performed at a point 5 mm behind the posterior commissure, 6 mm lateral to and 5 mm below the intercommissural plane using a 2-mm electrode, with the temperature of the electrode raised to 80℃ for 60 seconds. Up until now, the pain has been relatively well-controlled by intermittent intraventricular morphine injection and oral opioids, with the pain level remaining at visual analogue scale 4 or 5. Stereotactic mesencephalotomy with the use of high-resolution MRI and electrophysiologic localization is a valuable procedure in patients with cancer-related facial pain. PMID:25289131

  20. High Five: A Nutrition Program for High School Youth. Teacher Guide.

    ERIC Educational Resources Information Center

    James, Delores C. S.; Rienzo, Barbara A.

    This teacher's guide is part of a multiculturally sensitive teaching package to promote health-enhancing nutrition concepts for Florida public high school students. These nutrition promotion materials are intended to be incorporated into life skills management, home economics, physical education, or life science classes. The guide includes…

  1. SU-E-T-620: Dosimetric Compliance Study for a New Prostate Protocol of Combined High Dose Rate Brachytherapy and Stereotactic Body Radiotherapy

    SciTech Connect

    Peng, C; Giaddui, T; Den, R; Harrison, A; Yu, Y

    2014-06-15

    Purpose: To investigate the adherence of treatment plans of prostate cancer patients with the dosimetric compliance criteria of the new in house phase I trial of high dose rate (HDR) brachytherapy combined with stereotactic body radiotherapy (SBRT) for intermediate risk prostate cancer patients. Methods: Ten prostate cancer patients were treated using this trial. They received one fraction of HDR to 15Gy, followed by external beam(EB) boost of 3.2Gy(Level 1, five patients) or 3.94Gy(level 2, five patients) per fraction for 10 or 7 fractions, respectively, both equivalent to EB treatments of 113.5Gy in 2Gy fractions. The EB plans were either IMRT or VMAT plans. DVH analysis was performed to verify the adherence of treatment plans to the dosimetric criteria of the trial. Results: For Level 1 patients, target coverage were adequate, with CTV V32Gy(%) of 99.0±1.0 (mean ± 1 standard deviation), and PTV V31Gy(%) of 99.6±0.3. PTV V32.9Gy(%) is 1.4±3.1 and PTVmax is 32.9±0.2Gy. Rectum, bladder and femoral heads sparing were well within protocol criteria. For Level 2 patients, CTV V27.6Gy(%) is 98.7±1.8; PTV V26.7Gy(%) is 99.0±1.4. PTV V28.4Gy(%) is 1.3±1.4, with three patients having minor deviation from protocol. Again critical structures were spared compliant to the protocol. The analysis of HDR plans show similar results, with adequate dose coverage to the prostate and sparing of critical structures including urethra and rectum. V100(%) and V90(%) of prostate are 96.0±1.1 and 98.9±0.5. Urethra D10(%) is 113.1±2.9. Rectum V80(cc) is 1.4±0.5. Hotspot in prostate is substantially higher than what the protocol specifies. But the criteria for hotspot are only guidelines, serving to lower the dose to urethra . Conclusion: This new high biological equivalent dose prostate trial has been carried out successfully for ten patients. Based on dosimetric analysis, all HDR and external plans were compliant to the protocol criteria, with only minor deviations.

  2. SU-E-T-383: Can Stereotactic Body Radiotherapy Mimic the Dose Distribution of High-Dose-Rate Tandem and Ovoids/ring Brachytherapy?

    SciTech Connect

    Park, S; Demanes, J; Kamrava, M; Scanderbeg, D

    2014-06-01

    Purpose: To investigate whether stereotactic body radiotherapy (SBRT) using volumetric modulated arc therapy (VMAT) can mimic the dosimetry of tandem and ovoids/ring brachytherapy. Methods: We selected 5 patients treated with 3D-CT based high-dose rate (HDR) brachytherapy using 4 tandem and ovoid and 1 tandem and ring case. Manual optimization based on the Manchester system followed by graphical optimization (Nucletron Oncentra MasterPlan or Varian BrachyVision) was performed to deliver 6.0 Gy per fraction to a high-risk CTV while maintaining dose to organs at risk (OAR) below the ABS recommendations. For theoretical SBRT plans, CT images and OAR contours from the HDR plans were imported into Eclipse (Varian). The SBRT plan was created to mimic the heterogeneity of HDR plans by using a simultaneous integrated boost technique to match the V100, V150, and V200 isodose volumes from HDR. The OAR Dmax from HDR was used to define the OAR dose constraints for SBRT. Target coverage, dose spill-out, and OAR doses (D0.1cc, D1cc, and D2cc) between the HDR and SBRT plans were compared for significance using a two-tail paired ttest. Results: The mean isodose volumes for HDR vs. SBRT were 29.4 cc vs. 29.0 cc (V200, p = 0.674), 49.2 cc vs. 56.3 cc (V150, p = 0.017), 95.4 cc vs. 127.7 cc (V100, p = 0.001), and 271.9 cc vs. 581.6 cc (V50, p = 0.001). The D2cc to OAR for HDR vs. SBRT was 71.6% vs. 96.2% (bladder, p = 0.002), 69.2% vs. 101.7% (rectum, p = 0.0003), and 56.9% vs. 68.6% (sigmoid, p = 0.004). Conclusion: SBRT with VMAT can provide similar dose target coverage (V200), but dose spill-out and doses to OAR were statistically significantly higher than HDR. This study clearly demonstrated that brachytherapy can not be substituted with SBRT in gynecologic cervical cancer treatment.

  3. Stereotactic radiosurgery for functional disorders.

    PubMed

    Friehs, Gerhard M; Park, Michael C; Goldman, Marc A; Zerris, Vasilios A; Norén, Georg; Sampath, Prakash

    2007-01-01

    Stereotactic radiosurgery (SRS) with the Gamma Knife and linear accelerator has revolutionized neurosurgery over the past 20 years. The most common indications for radiosurgery today are tumors and arteriovenous malformations of the brain. Functional indications such as treatment of movement disorders or intractable pain only contribute a small percentage of treated patients. Although SRS is the only noninvasive form of treatment for functional disorders, it also has some limitations: neurophysiological confirmation of the target structure is not possible, and one therefore must rely exclusively on anatomical targeting. Furthermore, lesion sizes may vary, and shielding adjacent radiosensitive neural structures may be difficult or impossible. The most common indication for functional SRS is the treatment of trigeminal neuralgia. Radiosurgical treatment for epilepsy and certain psychiatric illnesses is performed in several centers as part of strict research protocols, and radiosurgical pallidotomy or medial thalamotomy is no longer recommended due to the high risk of complications. Radiosurgical ventrolateral thalamotomy for the treatment of tremor in patients with Parkinson disease or multiple sclerosis, as well as in the treatment of essential tremor, may be indicated for a select group of patients with advanced age, significant medical conditions that preclude treatment with open surgery, or patients who must receive anticoagulation therapy. A promising new application of SRS is high-dose radiosurgery delivered to the pituitary stalk. This treatment has already been successfully performed in several centers around the world to treat severe pain in patients with end-stage cancer. PMID:18081480

  4. Pelvic Nodal Dosing With Registration to the Prostate: Implications for High-Risk Prostate Cancer Patients Receiving Stereotactic Body Radiation Therapy

    SciTech Connect

    Kishan, Amar U. Lamb, James M.; Jani, Shyam S.; Kang, Jung J.; Steinberg, Michael L.; King, Christopher R.

    2015-03-15

    Purpose: To determine whether image guidance with rigid registration (RR) to intraprostatic markers (IPMs) yields acceptable coverage of the pelvic lymph nodes in the context of a stereotactic body radiation therapy (SBRT) regimen. Methods and Materials: Four to seven kilovoltage cone-beam CTs (CBCTs) from 12 patients with high-risk prostate cancer were analyzed, allowing approximation of an SBRT regimen. The nodal clinical target volume (CTV{sub N}) and bladder were contoured on all kilovoltage CBCTs. The V{sub 100} CTV{sub N}, expressed as a ratio to the same parameter on the initial plan, and the magnitude of translational shift between RR to the IPMs versus RR to the pelvic bones, were computed. The ability of a multimodality bladder filling protocol to minimize bladder height variation was assessed in a separate cohort of 4 patients. Results: Sixty-five CBCTs were assessed. The average V{sub 100} CTV{sub N} was 92.6%, but for a subset of 3 patients the average was 80.0%, compared with 97.8% for the others (P<.0001). The average overall and superior–inferior axis magnitudes of the bony-to-fiducial translations were significantly larger in the subgroup with suboptimal nodal coverage (8.1 vs 3.9 mm and 5.8 vs 2.4 mm, respectively; P<.0001). Relative bladder height changes were also significantly larger in the subgroup with suboptimal nodal coverage (42.9% vs 18.5%; P<.05). Use of a multimodality bladder-filling protocol minimized bladder height variation (P<.001). Conclusion: A majority of patients had acceptable nodal coverage after RR to IPMs, even when approximating SBRT. However, a subset of patients had suboptimal nodal coverage. These patients had large bony-to-fiducial translations and large variations in bladder height. Nodal coverage should be excellent if the superior–inferior axis bony-to-fiducial translation and the relative bladder height change (both easily measured on CBCT) are kept to a minimum. Implementation of a strict bladder filling

  5. Multicentimeter long high density magnetic plasmas for optical guiding.

    PubMed

    Pollock, B B; Froula, D H; Tynan, G R; Divol, L; Price, D; Costa, R; Yepiz, F; Fulkerson, S; Mangini, F; Glenzer, S H

    2008-10-01

    We present a platform for producing long plasma channels suitable for guiding lasers over several centimeters by applying magnetic fields to limit the radial heat flux from a preforming laser beam. The resulting density gradient will be used as an optical plasma waveguide. The plasma conditions have been chosen to be consistent with the requirements for laser wakefield acceleration where multi-GeV electrons are predicted. A detailed description of the system used to produce the high (5 T) magnetic fields and initial results that show a 5 cm long plasma column are discussed. PMID:19044692

  6. Stereotactic radiosurgery and immunotherapy for metastatic spinal melanoma.

    PubMed

    Caruso, James P; Cohen-Inbar, Or; Bilsky, Mark H; Gerszten, Peter C; Sheehan, Jason P

    2015-03-01

    The management of metastatic spinal melanoma involves maximizing local control, preventing recurrence, and minimizing treatment-associated toxicity and spinal cord damage. Additionally, therapeutic measures should promote mechanical stability, facilitate rehabilitation, and promote quality of life. These objectives prove difficult to achieve given melanoma's elusive nature, radioresistant and chemoresistant histology, vascular character, and tendency for rapid and early metastasis. Different therapeutic modalities exist for metastatic spinal melanoma treatment, including resection (definitive, debulking, or stabilization procedures), stereotactic radiosurgery, and immunotherapeutic techniques, but no single treatment modality has proven fully effective. The authors present a conceptual overview and critique of these techniques, assessing their effectiveness, separately and combined, in the treatment of metastatic spinal melanoma. They provide an up-to-date guide for multidisciplinary treatment strategies. Protocols that incorporate specific, goal-defined surgery, immunotherapy, and stereotactic radiosurgery would be beneficial in efforts to maximize local control and minimize toxicity. PMID:25727228

  7. Cranial stereotactic radiosurgery: current status of the initial paradigm shifter.

    PubMed

    Sheehan, Jason P; Yen, Chun-Po; Lee, Cheng-Chia; Loeffler, Jay S

    2014-09-10

    The concept of stereotactic radiosurgery (SRS) was first described by Lars Leksell in 1951. It was proposed as a noninvasive alternative to open neurosurgical approaches to manage a variety of conditions. In the following decades, SRS emerged as a unique discipline involving a collegial partnership among neurosurgeons, radiation oncologists, and medical physicists. SRS relies on the precisely guided delivery of high-dose ionizing radiation to an intracranial target. The focused convergence of multiple beams yields a potent therapeutic effect on the target and a steep dose fall-off to surrounding structures, thereby minimizing the risk of collateral damage. SRS is typically administered in a single session but can be given in as many as five sessions or fractions. By providing an ablative effect noninvasively, SRS has altered the treatment paradigms for benign and malignant intracranial tumors, functional disorders, and vascular malformations. Literature on extensive intracranial radiosurgery has unequivocally demonstrated the favorable benefit-to-risk profile that SRS affords for appropriately selected patients. In a departure from conventional radiotherapeutic strategies, radiosurgical principles have recently been extended to extracranial indications such as lung, spine, and liver tumors. The paradigm shift resulting from radiosurgery continues to alter the landscape of related fields. PMID:25113762

  8. 1-D profiling using highly dispersive guided waves

    NASA Astrophysics Data System (ADS)

    Volker, Arno; van Zon, Tim

    2014-02-01

    Corrosion is one of the industries major issues regarding the integrity of assets. Currently, inspections are conducted at regular intervals to ensure a sufficient integrity level of these assets. Cost reduction while maintaining a high level of reliability and safety of installations is a major challenge. There are many situations where the actual defect location is not accessible, e.g., a pipe support or a partially buried pipe. Guided wave tomography has been developed to reconstruct the wall thickness of steel pipes. In case of bottom of the line corrosion, i.e., a single corrosion pit, a simpler approach may be followed. Data is collected in a pitch-catch configuration at the 12 o'clock position using highly dispersive guided waves. After dispersion correction the data collapses to a short pulse, any residual dispersion indicates wall loss. The phase spectrum is used to invert for the wall thickness profile in the circumferential direction, assuming a Gaussian defect profile. The approach is evaluated on numerically simulated and on measured data. The method is intended for rapid, semi-quantitative screening of pipes.

  9. 1D profiling using highly dispersive guided waves

    NASA Astrophysics Data System (ADS)

    Volker, Arno; van Zon, Tim; Hsu, Mick; Boogert, Lennart

    2016-02-01

    Corrosion is one of the industries major issues regarding the integrity of assets. Currently inspections are conducted at regular intervals to ensure a sufficient integrity level of these assets. Cost reduction while maintaining a high level of reliability and safety of installations is a major challenge. There are many situations where the actual defect location is not accessible, e.g., a pipe support or a partially buried pipe. In case of bottom of the line corrosion, i.e., a single corrosion pit, a simpler approach may be followed. Guided waves are propagated around the circumference of a pipe. In case of wall loss, the phase of the signal changes which is used to estimate the local wall thickness profile. A special EMAT sensor has been developed, which works in a pit-catch configuration at the 12 o'clock position using highly dispersive guided waves. In order to improve the sensitivity, an inversion in performed on multiple orders of circumferential passes. Experimental results are presented on different pipes containing artificial and real defects.

  10. 1-D profiling using highly dispersive guided waves

    SciTech Connect

    Volker, Arno; Zon, Tim van

    2014-02-18

    Corrosion is one of the industries major issues regarding the integrity of assets. Currently, inspections are conducted at regular intervals to ensure a sufficient integrity level of these assets. Cost reduction while maintaining a high level of reliability and safety of installations is a major challenge. There are many situations where the actual defect location is not accessible, e.g., a pipe support or a partially buried pipe. Guided wave tomography has been developed to reconstruct the wall thickness of steel pipes. In case of bottom of the line corrosion, i.e., a single corrosion pit, a simpler approach may be followed. Data is collected in a pitch-catch configuration at the 12 o'clock position using highly dispersive guided waves. After dispersion correction the data collapses to a short pulse, any residual dispersion indicates wall loss. The phase spectrum is used to invert for the wall thickness profile in the circumferential direction, assuming a Gaussian defect profile. The approach is evaluated on numerically simulated and on measured data. The method is intended for rapid, semi-quantitative screening of pipes.

  11. 1D profiling using highly dispersive guided waves

    SciTech Connect

    Volker, Arno; Zon, Tim van; Enthoven, Daniel; Verburg, Wesley

    2015-03-31

    Corrosion is one of the industries major issues regarding the integrity of assets. Currently inspections are conducted at regular intervals to ensure a sufficient integrity level of these assets. Cost reduction while maintaining a high level of reliability and safety of installations is a major challenge. There are many situations where the actual defect location is not accessible, e.g., a pipe support or a partially buried pipe. Guided wave tomography has been developed to reconstruct the wall thickness. In case of bottom of the line corrosion, i.e., a single corrosion pit, a simpler approach may be followed. Data is collected in a pit-catch configuration at the 12 o'clock position using highly dispersive guided waves. The phase spectrum is used to invert for a wall thickness profile in the circumferential direction, assuming a Gaussian defect profile. An EMAT sensor design has been made to measure at the 12 o'clock position of a pipe. The concept is evaluated on measured data, showing good sizing capabilities on a variety simple defect profiles.

  12. Junior High Business Education. Arkansas Public School Course Content Guide.

    ERIC Educational Resources Information Center

    Arkansas State Dept. of Education, Little Rock.

    This course content guide was developed in accordance with the Standards for Accreditation of Public Schools adopted by the Arkansas State Board of Education. The guide is offered as a framework upon which a curriculum can be built. Within the subject area and at each grade level, the content guide identifies skills at three instructional levels:…

  13. The Mathematics of Three N-Localizers Used Together for Stereotactic Neurosurgery

    PubMed Central

    2015-01-01

    The N-localizer enjoys widespread use in image-guided stereotactic neurosurgery and radiosurgery. This article derives the mathematical equations that are used with three N-localizers and provides analogies, explanations, and appendices in order to promote a deeper understanding of the mathematical principles that govern the N-localizer. PMID:26594605

  14. Stereotactic Radiosurgery and Stereotactic Body Radiotherapy (SBRT)

    MedlinePlus

    ... deliver high-energy x-rays, also known as photons. The linear accelerator can perform SRS on larger ... A neurosurgeon will use local anesthesia to numb two spots on your forehead and two spots on ...

  15. Image Guided Endoscopic Evacuation of Spontaneous Intracerebral Hemorrhage

    PubMed Central

    Miller, Chad M; Vespa, Paul; Saver, Jeffrey L; Kidwell, Chelsea S; Carmichael, Stanley T.; Alger, Jeffry; Frazee, John; Starkman, Sid; Liebeskind, David; Nenov, Valeriy; Elashoff, Robert; Martin, Neil

    2014-01-01

    Background Spontaneous intracerebral hemorrhage (ICH) is a devastating disease with high morbidity and mortality. ICH lacks an effective medical or surgical treatment despite the acknowledged pathophysiological benefits of achieved hemostasis and clot removal. Image guided stereotactic endoscopic hematoma evacuation is a promising minimally invasive approach designed to limit operative injury and maximize hematoma removal. Methods A single center randomized controlled trial was designed to assess the safety and efficacy of stereotactic hematoma evacuation compared to best medical management. Patients were randomized within 24 hours of hemorrhage in a 3:2 fashion to best medical management plus endoscopic hematoma evacuation or best medical management alone. Data was collected to assess efficacy and safety of hematoma evacuation and to identify procedural components requiring technical improvement. Results 10 patients have been enrolled and randomized to treatment. Six patients underwent endoscopic evacuation with a hematoma volume reduction of 80% +/−13 at 24 hours post procedure. The medical arm demonstrated a hematoma enlargement of 78% +/−142 during this same period. Rehemorrhage rates and deterioration rates were similar in the two groups. Mortality was 20% in the endoscopic group and 50% in the medical treatment cohort. The endoscopic technique was shown to be effective in identification and evacuation of hematomas while reduction in the number of endoscopic passes and maintenance of hemostasis require further study. Conclusion Image guided stereotactic endoscopic hematoma removal is a promising minimally invasive technique that is effective in immediate hematoma evacuation. This technique deserves further investigation to determine its role in ICH management. PMID:18424298

  16. Junior High Computer Literacy. Curriculum Guide=L'Informatique au Secondaire 7-8-9. Guide Pedagogique.

    ERIC Educational Resources Information Center

    Alberta Dept. of Education, Edmonton. Curriculum Branch.

    This curriculum guide provides information in both English and French for the teaching of computer literacy in junior high schools in the Canadian province of Alberta. A basic introductory course developed in response to the need to acquaint junior high school students with a general understanding of computers and their use, the program for grades…

  17. Stereotactic radiosurgery for WHO grade I meningiomas.

    PubMed

    Sheehan, Jason P; Williams, Brian J; Yen, Chun Po

    2010-09-01

    Meningiomas represent a common intracranial tumor in the adult population. Although extirpation to achieve a gross total resection or at least decrease mass effect has been the mainstay of treatment, stereotactic radiosurgery has come to play an increasingly important role in the management of patients with meningiomas. Radiosurgery utilizes highly focused, beams of ionizing radiation to inactivate tumor cells. Image guidance and a steep dose fall off are critical features of this approach. The radiobiology of radiosurgery differs in certain advantageous ways from conventional radiotherapy. Radiosurgery initially was utilized to treat recurrent or residual skull base meningiomas. As success was observed in this setting, radiosurgery has gradually expanded its role so as to treat convexity meningiomas; it is also used as an upfront treatment for patients for whom clinical and neuro-imaging findings are consistent with a meningioma. Most large series demonstrate tumor control rates for patients with grade I meningiomas in excess of 85%. Neurological function is generally preserved or improved for patients with meningiomas. However, complications can occur. Longitudinal follow-up including neurologic and radiologic assessment is required. Single and multisession stereotactic radiosurgery will likely play an expanded role in the treatment of patients with meningiomas. PMID:20734218

  18. Multimedia educational services in stereotactic radiotherapy.

    PubMed

    Bazioglou, M; Theodorou, K; Kappas, C

    1999-01-01

    The computer-based learning methods in medicine have been well established as stand-alone learning systems. Recently, these systems were enriched with the use of telematics technology to provide distance learning capabilities. Stereotactic radiotherapy is one of the most representative advanced radiotherapy techniques. Due to the multidisciplinary character of the technique and the rapid evolution of technology implemented, the demands in training have increased. The potential of interactive multimedia and Internet technologies for the achievement of distance learning capabilities in this domain are investigated. The realization of a computer-based educational program in stereotactic radiotherapy in a multimedia format is a new application in the computer-aided distance learning field. The system is built according to a client and server architecture, based on the Internet infrastructure, and composed of server nodes. The impact of the system may be described in terms of: time and transportation costs saving, flexibility in training (scheduling, rate and subject selection), online communication and interaction with experts, cost effective access to material (delivery or access by a large number of users and revision of the material by avoiding high costs of computer-based training systems and database development). PMID:10394345

  19. Plans, Patterns, and Move Categories Guiding a Highly Selective Search

    NASA Astrophysics Data System (ADS)

    Trippen, Gerhard

    In this paper we present our ideas for an Arimaa-playing program (also called a bot) that uses plans and pattern matching to guide a highly selective search. We restrict move generation to moves in certain move categories to reduce the number of moves considered by the bot significantly. Arimaa is a modern board game that can be played with a standard Chess set. However, the rules of the game are not at all like those of Chess. Furthermore, Arimaa was designed to be as simple and intuitive as possible for humans, yet challenging for computers. While all established Arimaa bots use alpha-beta search with a variety of pruning techniques and other heuristics ending in an extensive positional leaf node evaluation, our new bot, Rat, starts with a positional evaluation of the current position. Based on features found in the current position - supported by pattern matching using a directed position graph - our bot Rat decides which of a given set of plans to follow. The plan then dictates what types of moves can be chosen. This is another major difference from bots that generate "all" possible moves for a particular position. Rat is only allowed to generate moves that belong to certain categories. Leaf nodes are evaluated only by a straightforward material evaluation to help avoid moves that lose material. This highly selective search looks, on average, at only 5 moves out of 5,000 to over 40,000 possible moves in a middle game position.

  20. MR-Guided Ultrasonic Brain Therapy: High Frequency Approach

    NASA Astrophysics Data System (ADS)

    Aubry, J. F.; Marsac, L.; Pernot, M.; Tanter, M.; Robert, B.; Brentnall, M.; Annic, P.; La Greca, R.; de Charentenay, A.; Pomatta, F.; Martin, Y.; Cohen-Bacrie, C.; Souquet, J.; Fink, M.

    2010-03-01

    A novel MR-guided brain therapy device operating at 1 MHz has been designed and constructed. The system has been installed and tested in a clinical 1.5 T Philips Achieva MRI. Three dimensional time domain finite differences simulations were used to compute the propagation of the wave field through three human skulls. The simulated phase distortions were used as inputs for transcranial correction and the corresponding pressure fields were scanned in the focal plane. At half of the maximum power (10 W/cm2 on the surface of the transducers), necroses were induced 2 cm deep in turkey breasts placed behind a human skull. In vitro experiments on human skulls show that simulations restore more than 85% of the pressure level through the skull bone when compared to a control correction performed with an implanted hydrophone. Finally, high power experiments are performed though the skull bone and a MR-Thermometry sequence is used to map the temperature rise in a brain phantom every 3 s in two orthogonal planes (focal plane and along the axis of the probe).

  1. Alaska's Living Tundra. Alaska Wildlife Week, 25-29 April 1988. Unit 6: Primary Teacher's Guide; Upper Elementary Teacher's Guide; Junior/Senior High School Teacher's Guide; Supplement.

    ERIC Educational Resources Information Center

    Quinlan, Susan E.

    Despite its cold and barren appearance, Alaska's tundra supports a surprising variety of insects, birds, and mammals. In this document, three teacher's guides (for primary, upper elementary, and junior and senior high schools) and a supplementary resource packet present a comprehensive unit of study on Alaska's living tundra. The five lessons in…

  2. High-Frequency Jet Ventilation for Complete Target Immobilization and Reduction of Planning Target Volume in Stereotactic High Single-Dose Irradiation of Stage I Non-Small Cell Lung Cancer and Lung Metastases

    SciTech Connect

    Fritz, Peter; Kraus, Hans-Joerg; Muehlnickel, Werner; Sassmann, Volker; Hering, Werner; Strauch, Konstantin

    2010-09-01

    Purpose: To demonstrate the feasibility of complete target immobilization by means of high-frequency jet ventilation (HFJV); and to show that the saving of planning target volume (PTV) on the stereotactic body radiation therapy (SBRT) under HFJV, compared with SBRT with respiratory motion, can be predicted with reliable accuracy by computed tomography (CT) scans at peak inspiration phase. Methods and Materials: A comparison regarding different methods for defining the PTV was carried out in 22 patients with tumors that clearly moved with respiration. A movement span of the gross tumor volume (GTV) was defined by fusing respiration-correlated CT scans. The PTV enclosed the GTV positions with a safety margin throughout the breathing cycle. To create a PTV from CT scans acquired under HFJV, the same margins were drawn around the immobilized target. In addition, peak inspiration phase CT images (PIP-CTs) were used to approximate a target immobilized by HFJV. Results: The resulting HFJV-PTVs were between 11.6% and 45.4% smaller than the baseline values calculated as respiration-correlated CT-PTVs (median volume reduction, 25.4%). Tentative planning by means of PIP-CT PTVs predicted that in 19 of 22 patients, use of HFJV would lead to a reduction in volume of {>=}20%. Using this threshold yielded a positive predictive value of 0.89, as well as a sensitivity of 0.94 and a specificity of 0.5. Conclusions: In all patients, SBRT under HFJV provided a reliable immobilization of the GTVs and achieved a reduction in PTVs, regardless of patient compliance. Tentative planning facilitated the selection of patients who could better undergo radiation in respiratory standstill, both with greater accuracy and lung protection.

  3. Science Fair. It's a Blast! A Guide for Junior High Students. Teacher's Guide.

    ERIC Educational Resources Information Center

    Riggins, Patricia C., Ed.

    Science fairs have the potential to help students develop new ways of solving problems using a scientific approach. This supplemental guide was developed for those teachers involved with science fairs as well as others who work with students in developing a project. Several reasons for holding a science fair are listed, along with some…

  4. High School/High Tech Program Guide: An Implementation Guide for High School/High Tech Program Coordinators. Promoting Careers in Science and Technology for High School Students with Disabilities.

    ERIC Educational Resources Information Center

    Office of Disability Employment Policy (DOL), Washington, DC.

    This implementation guide is intended to assist educators in planning, establishing, building, and managing a High School/High Tech project for high school students with disabilities. The program is designed to develop career opportunities, provide activities that will spark an interest in high technology fields, and encourage students to pursue…

  5. Road to High-Performance Workplaces. A Guide to Better Jobs and Better Business Results.

    ERIC Educational Resources Information Center

    Department of Labor, Washington, DC. Office of the American Workplace.

    This guide identifies selected workplace practices that individual businesses have used to become high performance work organizations. The guide, which is intended for managers, directors, labor leaders, workers, investors, and other individuals interesting in adopting high performance work practices, lays out the basic steps involved in…

  6. Characteristics Data Base: Programmer's guide to the High-Level Waste Data Base

    SciTech Connect

    Jones, K.E. ); Salmon, R. )

    1990-08-01

    The High-Level Waste Data Base is a menu-driven PC data base developed as part of OCRWM's technical data base on the characteristics of potential repository wastes, which also includes spent fuel and other materials. This programmer's guide completes the documentation for the High-Level Waste Data Base, the user's guide having been published previously. 3 figs.

  7. Radiobiological mechanisms of stereotactic body radiation therapy and stereotactic radiation surgery

    PubMed Central

    Kim, Mi-Sook; Kim, Wonwoo; Park, In Hwan; Kim, Hee Jong; Lee, Eunjin; Jung, Jae-Hoon; Cho, Lawrence Chinsoo

    2015-01-01

    Despite the increasing use of stereotactic body radiation therapy (SBRT) and stereotactic radiation surgery (SRS) in recent years, the biological base of these high-dose hypo-fractionated radiotherapy modalities has been elusive. Given that most human tumors contain radioresistant hypoxic tumor cells, the radiobiological principles for the conventional multiple-fractionated radiotherapy cannot account for the high efficacy of SBRT and SRS. Recent emerging evidence strongly indicates that SBRT and SRS not only directly kill tumor cells, but also destroy the tumor vascular beds, thereby deteriorating intratumor microenvironment leading to indirect tumor cell death. Furthermore, indications are that the massive release of tumor antigens from the tumor cells directly and indirectly killed by SBRT and SRS stimulate anti-tumor immunity, thereby suppressing recurrence and metastatic tumor growth. The reoxygenation, repair, repopulation, and redistribution, which are important components in the response of tumors to conventional fractionated radiotherapy, play relatively little role in SBRT and SRS. The linear-quadratic model, which accounts for only direct cell death has been suggested to overestimate the cell death by high dose per fraction irradiation. However, the model may in some clinical cases incidentally do not overestimate total cell death because high-dose irradiation causes additional cell death through indirect mechanisms. For the improvement of the efficacy of SBRT and SRS, further investigation is warranted to gain detailed insights into the mechanisms underlying the SBRT and SRS. PMID:26756026

  8. Proposal to develop guides for high school teachers on Global Systems Science. [Final project report

    SciTech Connect

    Sneider, C.I.; Golden, R. )

    1993-02-16

    The Lawrence Hall of Science requests funding for development of trial versions of five guides for high school teachers on the topic of Global Systems Science. The guides will reflect the guided-discovery approach for which the Lawrence Hall of Science has gained an international reputation. They will include a wealth of materials already developed as well as new materials, organized as a comprehensive program on global change. The guides could be used together for an entire one-semester course, or integrated individually into existing high school courses in the sciences and social studies.

  9. Proposal to develop guides for high school teachers on Global Systems Science. Final project report

    SciTech Connect

    Sneider, C.I.; Golden, R.

    1993-02-16

    The Lawrence Hall of Science requests funding for development of trial versions of five guides for high school teachers on the topic of Global Systems Science. The guides will reflect the guided-discovery approach for which the Lawrence Hall of Science has gained an international reputation. They will include a wealth of materials already developed as well as new materials, organized as a comprehensive program on global change. The guides could be used together for an entire one-semester course, or integrated individually into existing high school courses in the sciences and social studies.

  10. Salvage Reirradiaton With Stereotactic Body Radiotherapy for Locally Recurrent Head-and-Neck Tumors

    SciTech Connect

    Cengiz, Mustafa; Ozyigit, Goekhan; Yazici, Goezde; Dogan, Ali; Yildiz, Ferah; Zorlu, Faruk; Guerkaynak, Murat; Gullu, Ibrahim H.; Hosal, Sefik; Akyol, Fadil

    2011-09-01

    Purpose: In this study, we present our results of reirradiation of locally recurrent head-and-neck cancer with image-guided, fractionated, frameless stereotactic body radiotherapy technique. Methods and Materials: From July 2007 to February 2009, 46 patients were treated using the CyberKnife (Accuray, Sunnyvale, CA) at the Department of Radiation Oncology, Hacettepe University, Ankara, Turkey. All patients had recurrent, unresectable, and previously irradiated head-and-neck cancer. The most prominent site was the nasopharynx (32.6%), and the most common histopathology was epidermoid carcinoma. The planning target volume was defined as the gross tumor volume identified on magnetic resonance imaging and computed tomography. There were 22 female and 24 male patients. Median age was 53 years (range, 19-87 years). The median tumor dose with stereotactic body radiotherapy was 30 Gy (range, 18-35 Gy) in a median of five (range, one to five) fractions. Results: Of 37 patients whose response to therapy was evaluated, 10 patients (27%) had complete tumor regression, 11 (29.8%) had partial response, and 10 (27%) had stable disease. Ultimate local disease control was achieved in 31 patients (83.8%). The overall survival was 11.93 months in median (ranged, 11.4 - 17.4 months), and the median progression free survival was 10.5 months. One-year progression-free survival and overall survival were 41% and 46%, respectively. Grade II or greater long-term complications were observed in 6 (13.3%) patients. On follow-up, 8 (17.3%) patients had carotid blow-out syndrome, and 7 (15.2%) patients died of bleeding from carotid arteries. We discovered that this fatal syndrome occurred only in patients with tumor surrounding carotid arteries and carotid arteries receiving all prescribed dose. Conclusions: Stereotactic body radiotherapy is an appealing treatment option for patients with recurrent head-and-neck cancer previously treated with radiation to high doses. Good local control with

  11. Patient Guide to the Assessment and Treatment of Hypertriglyceridemia (High Triglycerides)

    MedlinePlus

    Assessment and Treatment of Hypertriglyceridemia (High Triglycerides) A Patient’s Guide Having high levels of triglycerides, or hypertriglyceridemia , is a common problem. Triglycerides are fats in the blood (also called ...

  12. Dynamic Lung Tumor Tracking for Stereotactic Ablative Body Radiation Therapy

    PubMed Central

    Kunos, Charles A.; Fabien, Jeffrey M.; Shanahan, John P.; Collen, Christine; Gevaert, Thierry; Poels, Kenneth; Van den Begin, Robbe; Engels, Benedikt; De Ridder, Mark

    2015-01-01

    Physicians considering stereotactic ablative body radiation therapy (SBRT) for the treatment of extracranial cancer targets must be aware of the sizeable risks for normal tissue injury and the hazards of physical tumor miss. A first-of-its-kind SBRT platform achieves high-precision ablative radiation treatment through a combination of versatile real-time imaging solutions and sophisticated tumor tracking capabilities. It uses dual-diagnostic kV x-ray units for stereoscopic open-loop feedback of cancer target intrafraction movement occurring as a consequence of respiratory motions and heartbeat. Image-guided feedback drives a gimbaled radiation accelerator (maximum 15 x 15 cm field size) capable of real-time ±4 cm pan-and-tilt action. Robot-driven ±60° pivots of an integrated ±185° rotational gantry allow for coplanar and non-coplanar accelerator beam set-up angles, ultimately permitting unique treatment degrees of freedom. State-of-the-art software aids real-time six dimensional positioning, ensuring irradiation of cancer targets with sub-millimeter accuracy (0.4 mm at isocenter). Use of these features enables treating physicians to steer radiation dose to cancer tumor targets while simultaneously reducing radiation dose to normal tissues. By adding respiration correlated computed tomography (CT) and 2-[18F] fluoro-2-deoxy-ᴅ-glucose (18F-FDG) positron emission tomography (PET) images into the planning system for enhanced tumor target contouring, the likelihood of physical tumor miss becomes substantially less1. In this article, we describe new radiation plans for the treatment of moving lung tumors. PMID:26131774

  13. Social Science Instructional Guides: High School (Grades 9-12).

    ERIC Educational Resources Information Center

    Hartman, Carl; And Others

    The guide, part of a social science learning continuum from first through twelfth grades, contains outlines for two-semester social studies courses for grades 9-12. Three components comprise each section: time allocations for units, instructional objectives, and a content outline. The Grade 9 course, Cultures of the Non-Western World, contains…

  14. Hospitality Education: A Guide for High School Teachers.

    ERIC Educational Resources Information Center

    Illinois State Office of Education, Springfield. Div. of Vocational and Technical Education.

    The guide presents key steps in establishing hospitality education curricula, based on recommendations of more than 300 surveyed educators and industry personnel and on information from over 60 proposed or existing curricula. The scope of the hospitality industries is described as including the categories of food service, lodging, tourism, and…

  15. Competency-Based Adult High School Completion Student Services Guide.

    ERIC Educational Resources Information Center

    Singer, Elizabeth; And Others

    Designed as part of a 310 Special Demonstration and Teacher Training Project undertaken at Brevard Community College, this student services guide contains information to assist adult education administrators, counselors, instructors, and office personnel in meeting the needs of students enrolled in adult/community education schools. Primary…

  16. Middle School/Junior High School Evaluative Criteria. A Guide for School Improvement. Revised Edition.

    ERIC Educational Resources Information Center

    Manlove, Donald C., Ed.

    Guidelines for self evaluation by middle schools and junior high schools and by visiting committees are outlined in this publication. The guide is divided into 12 sections. The first is the manual, which provides recommendations for implementation and follow-up of the evaluation procedure. The remaining parts consist of guiding principles, forms,…

  17. Nevada Competency-Based Adult High School Diploma Project. Teacher's Guide.

    ERIC Educational Resources Information Center

    Haynes, Melinda K.

    Developed by the Nevada Competency-Based Adult High School Diploma (CBAHSD) Project, this teacher's guide accompanies a student handbook and ten curriculum guides which cover the following subjects: consumer education; environmental education; health; language arts; citizenship; American Government; United States History; mathematics; earth and…

  18. Creating and Sustaining High-Quality Charter School Governing Boards. A Guide for State Policymakers

    ERIC Educational Resources Information Center

    Butler, Elizabeth A.

    2008-01-01

    This guide for state policymakers examines the laws, policies, and programs that states are using to create and sustain high-quality charter school governing boards. In particular, the guide focuses on the two aspects of governing boards that interviews with state administrators revealed are most critical for a board's success: board composition…

  19. Environmental Education Teacher's Guide, Junior High School. A Core Experience Study of the Natural Environment.

    ERIC Educational Resources Information Center

    Bennett, Dean B.; Willink, Wesley H.

    This Environmental Education Teacher's Guide, developed for use in the junior high school, is designed to familiarize teachers with how an environmental education program can help in their teaching and in achieving the goals of the school. The suggested core activities in this guide are designed to be a motivating way of introducting junior high…

  20. Guided Practice Software for Teaching DNA Replication to Senior High School Students

    ERIC Educational Resources Information Center

    Woods, Eric C.; McKinnon, Alan E.; Hickford, Jonathan G. H.; Abell, Walt A.

    2008-01-01

    The prototype of a guided practice application was developed to instruct year 13 biology students in the process of DNA replication. The application uses a high degree of interaction to engage the student in a guided exploration and problem solving exercise. An evaluation revealed that the students showed considerable enthusiasm and significant…

  1. Stereotactic hypothalamotomy for behaviour disorders

    PubMed Central

    Schvarcz, J. R.; Driollet, R.; Rios, E.; Betti, O.

    1972-01-01

    Posterior hypothalamotomy is a relatively simple stereotactic procedure. The radiological determination of the target and its physiological corroboration by electrical stimulation are accurate. The lesions have always been made in the site of maximum sympathetic response. In this respect, the cardiovascular changes (hypertension and tachycardia), which are always elicited from a more restricted area, are of particular importance. Depth recordings, however, have been less useful. Undesirable side-effects, if present, were mild and transitory. There was no postoperative intelligence deficit, at least with the standard tests. Images PMID:5035309

  2. Photography (Graphic Communications). Industrial Arts, Senior High--Level II. North Dakota Senior High Industrial Arts Curriculum Guides.

    ERIC Educational Resources Information Center

    Poehls, Eddie; And Others

    This course guide for a photography course is one of four developed for the graphic communications area in the North Dakota senior high industrial arts education program. (Eight other guides are available for two other areas of Industrial Arts--energy/power and production.) Part 1 provides such introductory information as a definition and…

  3. Plastic Technology (Production). Industrial Arts, Senior High--Level II. North Dakota Senior High Industrial Arts Curriculum Guides.

    ERIC Educational Resources Information Center

    Claus, Robert; And Others

    This course guide for a plastic technology course is one of four developed for the production area in the North Dakota senior high industrial arts education program. (Eight other guides are available for two other areas of Industrial Arts--energy/power and graphic communications.) Part 1 provides such introductory information as a definition and…

  4. Transportation (Energy/Power). Industrial Arts, Senior High--Level II. North Dakota Senior High Industrial Arts Curriculum Guides.

    ERIC Educational Resources Information Center

    Lawrence, Allen; And Others

    This course guide for a transportation course is one of four developed for the energy/power area in the North Dakota senior high industrial arts education program. (Eight other guides are available for two other areas of Industrial Arts--graphic communications and production.) Part 1 provides such introductory information as a definition and…

  5. Industrial Crafts (Production.) Industrial Arts, Senior High--Level II. North Dakota Senior High Industrial Arts Curriculum Guides.

    ERIC Educational Resources Information Center

    Claus, Robert; And Others

    This course guide for an industrial crafts course is one of four developed for the production area in the North Dakota senior high industrial arts education program. (Eight other guides are available for two other areas of Industrial Arts--energy/power and graphic communications.) Part 1 provides such introductory information as a definition and…

  6. Graphic Arts (Graphic Communications). Industrial Arts, Senior High--Level II. North Dakota Senior High Industrial Arts Curriculum Guides.

    ERIC Educational Resources Information Center

    Poehls, Eddie; And Others

    This course guide for a graphic arts course is one of four developed for the graphic communications area in the North Dakota senior high industrial arts education program. (Eight other guides are available for two other areas of Industrial Arts--energy/power and production.) Part 1 provides such introductory information as a definition and…

  7. Energy Sources (Energy/Power). Industrial Arts, Senior High--Level II. North Dakota Senior High Industrial Arts Curriculum Guides.

    ERIC Educational Resources Information Center

    Lawrence, Allen; And Others

    This course guide for an energy sources course is one of four developed for the energy/power area in the North Dakota senior high industrial arts education program. (Eight other guides are available for two other areas of Industrial Arts--graphic communications and production.) Part 1 provides such introductory information as a definition and…

  8. Wood Technology (Production). Industrial Arts, Senior High--Level II. North Dakota Senior High Industrial Arts Curriculum Guides.

    ERIC Educational Resources Information Center

    Claus, Robert; And Others

    This course guide for a wood technology course is one of four developed for the production area in the North Dakota senior high industrial arts education program. (Eight other guides are available for two other areas of Industrial Arts--energy/power and graphic communications.) Part 1 provides such introductory information as a definition and…

  9. Power Technology (Energy/Power). Industrial Arts, Senior High--Level II. North Dakota Senior High Industrial Arts Curriculum Guides.

    ERIC Educational Resources Information Center

    Lawrence, Allen; And Others

    This course guide for a power technology course is one of four developed for the energy/power area in the North Dakota senior high industrial arts education program. (Eight other guides are available for two other areas of Industrial Arts--graphic communications and production.) Part 1 provides such introductory information as a definition and…

  10. [Image-guided stereotaxic biopsy of central nervous system lesions].

    PubMed

    Nasser, J A; Confort, C I; Ferraz, A; Esperança, J C; Duarte, F

    1998-06-01

    In a series of 44 image guided stereotactic biopsy from August 1995 until March 1997, findings were as follows (frequency order). Tumors, glioblastoma was the most frequent. Primary lymphoma and other conditions associated to AIDS. Metastasis, three cases, Vasculites, two cases, Arachnoid cyst, Creutzfeldt-Jakob, cortical degeneration, inespecific calcification (one case each). The age varied from 1 to 83 years. Forty one lesions were supratentorial, two infratentorial, and one was outside the brain (dura and skull) and we used stereotaxy to localize it. There was no mortality and morbidity was 2.3%. The literature is reviewed. We conclude that this procedure is safe and highly diagnostic. PMID:9698729

  11. Guiding of low-energy electrons by highly ordered Al2O3 nanocapillaries

    NASA Astrophysics Data System (ADS)

    Milosavljević, A. R.; Víkor, Gy.; Pešić, Z. D.; Kolarž, P.; Šević, D.; Marinković, B. P.; Mátéfi-Tempfli, S.; Mátéfi-Tempfli, M.; Piraux, L.

    2007-03-01

    We report an experimental study of guided transmission of low-energy (200 350eV) electrons through highly ordered Al2O3 nanocapillaries with large aspect ratio ( 140nm diameter and 15μm length). The nanochannel array was prepared using self-ordering phenomena during a two-step anodization process of a high-purity aluminum foil. The experimental results clearly show the existence of the guiding effect, as found for highly charged ions. The guiding of the electron beam was observed for tilt angles up to 12° . As seen for highly charged ions, the guiding efficiency increases with decreasing electron incident energy. The transmission efficiency appeared to be significantly lower than observed for highly charged ions and, moreover, the intensity of transmitted electrons significantly decreases with decreasing impact energy.

  12. Stereotactic radiosurgery/stereotactic body radiation therapy-reflection on the last decade's achievements and future directions.

    PubMed

    Knisely, Jonathan; Sahgal, Arjun; Lo, Simon; Ma, Lijun; Chang, Eric

    2016-04-01

    Stereotactic radiosurgery (SRS) and its extracranial first cousin, stereotactic body radiation therapy (SBRT) have become increasingly important in the palliative treatment of cancer patients over the past decade. Appropriately designed and adequately powered clinical trials have in many clinical scenarios amply justified the time, effort, and expense associated with the development and delivery of these highly conformal and complex radiation treatment plans. Ongoing trials are anticipated to provide further confirmatory documentation of the benefits that have been readily observed by caregivers, patients, and their families. It may be predicted that future directions for palliative radiosurgery will include simplification, through greater automation, of the detailed steps that are still required for safe treatment, and thereby increase the chances for patients to receive these advanced palliative interventions at local institutions, from local caregivers. PMID:27121742

  13. Nelson's syndrome: single centre experience using the linear accelerator (LINAC) for stereotactic radiosurgery and fractionated stereotactic radiotherapy.

    PubMed

    Wilson, Peter J; Williams, Janet R; Smee, Robert I

    2014-09-01

    Nelson's syndrome is a unique clinical phenomenon of growth of a pituitary adenoma following bilateral adrenalectomies for the control of Cushing's disease. Primary management is surgical, with limited effective medical therapies available. We report our own institution's series of this pathology managed with radiation: prior to 1990, 12 patients were managed with conventional radiotherapy, and between 1990 and 2007, five patients underwent stereotactic radiosurgery (SRS) and two patients fractionated stereotactic radiotherapy (FSRT), both using the linear accelerator (LINAC). Tumour control was equivocal, with two of the five SRS patients having a reduction in tumour volume, one patient remaining unchanged, and two patients having an increase in volume. In the FSRT group, one patient had a decrease in tumour volume whilst the other had an increase in volume. Treatment related morbidity was low. Nelson's syndrome is a challenging clinical scenario, with a highly variable response to radiation in our series. PMID:24825407

  14. Magnetic resonance image-guided versus ultrasound-guided high-intensity focused ultrasound in the treatment of breast cancer.

    PubMed

    Li, Sheng; Wu, Pei-Hong

    2013-08-01

    Image-guided high-intensity focused ultrasound (HIFU) has been used for more than ten years, primarily in the treatment of liver and prostate cancers. HIFU has the advantages of precise cancer ablation and excellent protection of healthy tissue. Breast cancer is a common cancer in women. HIFU therapy, in combination with other therapies, has the potential to improve both oncologic and cosmetic outcomes for breast cancer patients by providing a curative therapy that conserves mammary shape. Currently, HIFU therapy is not commonly used in breast cancer treatment, and efforts to promote the application of HIFU is expected. In this article, we compare different image-guided models for HIFU and reviewed the status, drawbacks, and potential of HIFU therapy for breast cancer. PMID:23237221

  15. Magnetic resonance image-guided versus ultrasound-guided high-intensity focused ultrasound in the treatment of breast cancer

    PubMed Central

    Li, Sheng; Wu, Pei-Hong

    2013-01-01

    Image-guided high-intensity focused ultrasound (HIFU) has been used for more than ten years, primarily in the treatment of liver and prostate cancers. HIFU has the advantages of precise cancer ablation and excellent protection of healthy tissue. Breast cancer is a common cancer in women. HIFU therapy, in combination with other therapies, has the potential to improve both oncologic and cosmetic outcomes for breast cancer patients by providing a curative therapy that conserves mammary shape. Currently, HIFU therapy is not commonly used in breast cancer treatment, and efforts to promote the application of HIFU is expected. In this article, we compare different image-guided models for HIFU and reviewed the status, drawbacks, and potential of HIFU therapy for breast cancer. PMID:23237221

  16. Once-Weekly, High-Dose Stereotactic Body Radiotherapy for Lung Cancer: 6-Year Analysis of 60 Early-Stage, 42 Locally Advanced, and 7 Metastatic Lung Cancers

    SciTech Connect

    Salazar, Omar M. Sandhu, Taljit S.; Lattin, Paul B.; Chang, Jung H.; Lee, Choon K.; Groshko, Gayle A.; Lattin, Cheryl J.

    2008-11-01

    Purpose: To explore once-weekly stereotactic body radiotherapy (SBRT) in nonoperable patients with localized, locally advanced, or metastatic lung cancer. Methods and Materials: A total of 102 primary (89 untreated plus 13 recurrent) and 7 metastatic tumors were studied. The median follow-up was 38 months, the average patient age was 75 years. Of the 109 tumors studied, 60 were Stage I (45 IA and 15 IB), 9 were Stage II, 30 were Stage III, 3 were Stage IV, and 7 were metastases. SBRT only was given in 73% (40 Gy in four fractions to the planning target volume to a total dose of 53 Gy to the isocenter for a biologically effective dose of 120 Gy{sub 10}). SBRT was given as a boost in 27% (22.5 Gy in three fractions once weekly for a dose of 32 Gy at the isocenter) after 45 Gy in 25 fractions to the primary plus the mediastinum. The total biologically effective dose was 120 Gy{sub 10}. Respiration gating was used in 46%. Results: The overall response rate was 75%; 33% had a complete response. The overall response rate was 89% for Stage IA patients (40% had a complete response). The local control rate was 82%; it was 100% and 93% for Stage IA and IB patients, respectively. The failure rate was 37%, with 17% within the planning target volume. No Grade 3-4 acute toxicities developed in any patient; 12% and 7% of patients developed Grade 1 and 2 toxicities, respectively. Late toxicity, all Grade 2, developed in 3% of patients. The 5-year cause-specific survival rate for Stage I was 70% and was 74% and 64% for Stage IA and IB patients, respectively. The 3-year Stage III cause-specific survival rate was 30%. The patients with metastatic lung cancer had a 57% response rate, a 27% complete response rate, an 86% local control rate, a median survival time of 19 months, and 23% 3-year survival rate. Conclusions: SBRT is noninvasive, convenient, fast, and economically attractive; it achieves results similar to surgery for early or metastatic lung cancer patients who are older

  17. Optical spectroscopy for stereotactic biopsy of brain tumors

    NASA Astrophysics Data System (ADS)

    Markwardt, Niklas; von Berg, Anna; Fiedler, Sebastian; Goetz, Marcus; Haj-Hosseini, Neda; Polzer, Christoph; Stepp, Herbert; Zelenkov, Petr; Rühm, Adrian

    2015-07-01

    Stereotactic biopsy procedure is performed to obtain a tissue sample for diagnosis purposes. Currently, a fiber-based mechano-optical device for stereotactic biopsies of brain tumors is developed. Two different fluorophores are employed to improve the safety and reliability of this procedure: The fluorescence of intravenously applied indocyanine green (ICG) facilitates the recognition of blood vessels and thus helps minimize the risk of cerebral hemorrhages. 5- aminolevulinic-acid-induced protoporphyrin IX (PpIX) fluorescence is used to localize vital tumor tissue. ICG fluorescence detection using a 2-fiber probe turned out to be an applicable method to recognize blood vessels about 1.5 mm ahead of the fiber tip during a brain tumor biopsy. Moreover, the suitability of two different PpIX excitation wavelengths regarding practical aspects was investigated: While PpIX excitation in the violet region (at 405 nm) allows for higher sensitivity, red excitation (at 633 nm) is noticeably superior with regard to blood layers obscuring the fluorescence signal. Contact measurements on brain simulating agar phantoms demonstrated that a typical blood coverage of the tumor reduces the PpIX signal to about 75% and nearly 0% for 633 nm and 405 nm excitation, respectively. As a result, 633 nm seems to be the wavelength of choice for PpIX-assisted detection of high-grade gliomas in stereotactic biopsy.

  18. Transcranial MR-guided High Intensity Focused Ultrasound for Non-Invasive Functional Neurosurgery

    NASA Astrophysics Data System (ADS)

    Werner, Beat; Morel, Anne; Zadicario, Eyal; Jeanmonod, Daniel; Martin, Ernst

    2010-03-01

    While the development of transcranial MR-guided High Intensity Focused Ultrasound has been driven mainly by applications for tumor ablation this new intervention method is also very attractive for functional neurosurgery due to its non-invasiveness, the absence of ionizing radiation and the closed-loop intervention control by MRI. Here we provide preliminary data to demonstrate the clinical feasibility, safety and precision of non-invasive functional neurosurgery by transcranial MR-guided High Intensity Focused Ultrasound.

  19. Human pallidothalamic and cerebellothalamic tracts: anatomical basis for functional stereotactic neurosurgery

    PubMed Central

    Gallay, Marc N.; Jeanmonod, Daniel; Liu, Jian

    2008-01-01

    Anatomical knowledge of the structures to be targeted and of the circuitry involved is crucial in stereotactic functional neurosurgery. The present study was undertaken in the context of surgical treatment of motor disorders such as essential tremor (ET) and Parkinson’s disease (PD) to precisely determine the course and three-dimensional stereotactic localisation of the cerebellothalamic and pallidothalamic tracts in the human brain. The course of the fibre tracts to the thalamus was traced in the subthalamic region using multiple staining procedures and their entrance into the thalamus determined according to our atlas of the human thalamus and basal ganglia [Morel (2007) Stereotactic atlas of the human thalamus and basal ganglia. Informa Healthcare Inc., New York]. Stereotactic three-dimensional coordinates were determined by sectioning thalamic and basal ganglia blocks parallel to stereotactic planes and, in two cases, by correlation with magnetic resonance images (MRI) from the same brains prior to sectioning. The major contributions of this study are to provide: (1) evidence that the bulks of the cerebellothalamic and pallidothalamic tracts are clearly separated up to their thalamic entrance, (2) stereotactic maps of the two tracts in the subthalamic region, (3) the possibility to discriminate between different subthalamic fibre tracts on the basis of immunohistochemical stainings, (4) correlations of histologically identified fibre tracts with high-resolution MRI, and (5) evaluation of the interindividual variability of the fibre systems in the subthalamic region. This study should provide an important basis for accurate stereotactic neurosurgical targeting of the subthalamic region in motor disorders such as PD and ET. PMID:18193279

  20. Dosimetric Comparison of Intensity-Modulated Stereotactic Radiotherapy With Other Stereotactic Techniques for Locally Recurrent Nasopharyngeal Carcinoma

    SciTech Connect

    Kung, Shiris Wai Sum; Wu, Vincent Wing Cheung; Kam, Michael Koon Ming; Leung, Sing Fai; Yu, Brian Kwok Hung; Ngai, Dennis Yuen Kan; Wong, Simon Chun Fai; Chan, Anthony Tak Cheung

    2011-01-01

    Purpose: Locally recurrent nasopharyngeal carcinoma (NPC) patients can be salvaged by reirradiation with a substantial degree of radiation-related complications. Stereotactic radiotherapy (SRT) is widely used in this regard because of its rapid dose falloff and high geometric precision. The aim of this study was to examine whether the newly developed intensity-modulated stereotactic radiotherapy (IMSRT) has any dosimetric advantages over three other stereotactic techniques, including circular arc (CARC), static conformal beam (SmMLC), and dynamic conformal arc (mARC), in treating locally recurrent NPC. Methods and Materials: Computed tomography images of 32 patients with locally recurrent NPC, previously treated with SRT, were retrieved from the stereotactic planning system for contouring and computing treatment plans. Treatment planning of each patient was performed for the four treatment techniques: CARC, SmMLC, mARC, and IMSRT. The conformity index (CI) and homogeneity index (HI) of the planning target volume (PTV) and doses to the organs at risk (OARs) and normal tissue were compared. Results: All four techniques delivered adequate doses to the PTV. IMSRT, SmMLC, and mARC delivered reasonably conformal and homogenous dose to the PTV (CI <1.47, HI <0.53), but not for CARC (p < 0.05). IMSRT presented with the smallest CI (1.37) and HI (0.40). Among the four techniques, IMSRT spared the greatest number of OARs, namely brainstem, temporal lobes, optic chiasm, and optic nerve, and had the smallest normal tissue volume in the low-dose region. Conclusion: Based on the dosimetric comparison, IMSRT was optimal for locally recurrent NPC by delivering a conformal and homogenous dose to the PTV while sparing OARs.

  1. Scattering of high order guided wave modes around a through-thickness circular hole

    NASA Astrophysics Data System (ADS)

    Travaglini, Christophe; Bescond, Christophe; França, Demartonne Ramos; Kruger, Silvio E.; Viens, Martin; Bélanger, Pierre

    2016-02-01

    Ultrasonic guided waves have the ability to propagate long distances with minimal attenuation, which makes them particularly interesting in structural health monitoring (SHM) applications. Using the baseline subtraction approach, the signal from a defect-free structure is compared with the actual monitoring signal to detect and locate defects. There are many scientific publications on low-frequency guided waves for SHM purposes, and the interaction between guided wave fundamental modes and defects is also well documented. There is however a very limited number of studies on high order modes. High-frequency guided waves may enable the detection of smaller cracks related to conventional low-frequency guided wave SHM. The main difficulty at high frequency is the existence of several modes with different velocities. This study investigates the scattering of high order guided wave modes around a through-thickness hole with a view to developing a highly sensitive SHM method. A 3D finite element model of a 305 mm × 305 mm × 1.6 mm aluminium plate was used to determine the scattering of cracks on the circumference of a through-thickness hole in the middle of the plate. Crack properties such as orientation, length and depth were studied. A subset of the finite element simulations were validated against experimental results. The experimental setup comprised a film type PZT actuator bonded on the side of the plate and a laser interferometer detector. An input signal centered at 4 MHz was used in all simulations and experiments.

  2. Neutron Spectral Brightness of Cold Guide 4 at the High Flux Isotope Reactor

    SciTech Connect

    Winn, B. L.; Robertson, J. L.; Iverson, Erik B.; Selby, D. L.

    2009-05-03

    The High Flux Isotope Reactor resumed operation in June of 2007 with a super-critical hydrogen cold source in horizontal beam tube 4. Cold guide 4 is a guide system designed to deliver neutrons from this source at reasonable flux at wavelengths greater than 4 Å to several instruments, and includes a 15-m, 96-section, 4-channel bender. A time-of-flight spectrum with calibrated detector was recorded at port C of cold guide 4, and compared to McStas simulations, to generate a brightness spectrum.

  3. Sci—Sat AM: Stereo — 08: Stereotactic Ablative Radiotherapy (SABR) for low, intermediate and high risk prostate cancer using Volumetric Modulated Arc Therapy (VMAT) with a 10x Flattening Filter Free (FFF) beam

    SciTech Connect

    Mestrovic, A; Fortin, D; Alexander, A

    2014-08-15

    Purpose: To determine the feasibility of using Volumetric Modulated Arc Therapy (VMAT) with a 10x Flattening Filter Free (FFF) beam for Stereotactic Ablative Radiotherapy (SABR) for low, intermediate and high risk prostate cancer. Methods and Materials: Ten anonymized patient CT data sets were used in this planning study. For each patient CT data set, three sets of contours were generated: 1) low risk, 2) intermediate risk, and 3) high risk scenarios. For each scenario, a single-arc and a double-arc VMAT treatment plans were created. Plans were generated with the Varian Eclipse™ treatment planning system for a Varian TrueBeam™ linac equipped with Millenium 120 MLC. Plans were created using a 10x-FFF beam with a maximum dose rate of 2400 MU/min. Dose prescription was 36.25Gy/5 fractions with the planning objective of covering 99% of the Planning Target Volume with the 95% of the prescription dose. Normal tissue constraints were based on provincial prostate SABR planning guidelines, derived from national and international prostate SABR protocols. Plans were evaluated and compared in terms of: 1) dosimetric plan quality, and 2) treatment delivery efficiency. Results: Both single-arc and double-arc VMAT plans were able to meet the planning goals for low, intermediate and high risk scenarios. No significant dosimetric differences were observed between the plans. However, the treatment time was significantly lower for a single-arc VMAT plans. Conclusions: Prostate SABR treatments are feasible with 10x-FFF VMAT technique. A single-arc VMAT offers equivalent dosimetric plan quality and a superior treatment delivery efficiency, compared to a double-arc VMAT.

  4. 2D/3D Image fusion for accurate target localization and evaluation of a mask based stereotactic system in fractionated stereotactic radiotherapy of cranial lesions

    SciTech Connect

    Jin, J.-Y.; Ryu, Samuel; Faber, Kathleen; Mikkelsen, Tom; Chen Qing; Li Shidong; Movsas, Benjamin

    2006-12-15

    The purpose of this study was to evaluate the accuracy of a two-dimensional (2D) to three-dimensional (3D) image-fusion-guided target localization system and a mask based stereotactic system for fractionated stereotactic radiotherapy (FSRT) of cranial lesions. A commercial x-ray image guidance system originally developed for extracranial radiosurgery was used for FSRT of cranial lesions. The localization accuracy was quantitatively evaluated with an anthropomorphic head phantom implanted with eight small radiopaque markers (BBs) in different locations. The accuracy and its clinical reliability were also qualitatively evaluated for a total of 127 fractions in 12 patients with both kV x-ray images and MV portal films. The image-guided system was then used as a standard to evaluate the overall uncertainty and reproducibility of the head mask based stereotactic system in these patients. The phantom study demonstrated that the maximal random error of the image-guided target localization was {+-}0.6 mm in each direction in terms of the 95% confidence interval (CI). The systematic error varied with measurement methods. It was approximately 0.4 mm, mainly in the longitudinal direction, for the kV x-ray method. There was a 0.5 mm systematic difference, primarily in the lateral direction, between the kV x-ray and the MV portal methods. The patient study suggested that the accuracy of the image-guided system in patients was comparable to that in the phantom. The overall uncertainty of the mask system was {+-}4 mm, and the reproducibility was {+-}2.9 mm in terms of 95% CI. The study demonstrated that the image guidance system provides accurate and precise target positioning.

  5. Stereotactic radiotherapy for wet age-related macular degeneration: current perspectives.

    PubMed

    Neffendorf, James E; Jackson, Timothy L

    2015-01-01

    Neovascular age-related macular degeneration is a leading cause of blindness in the developed world. Currently, the treatment of choice is intravitreal injections of anti-VEGF medications. These require frequent dosing, up to monthly, and impose a substantial burden on patients and the health economy. Ionizing radiation was proposed as a possible treatment for age-related macular degeneration due to its anti-inflammatory and anti-fibrotic properties. Stereotactic radiotherapy is an outpatient-based radiotherapy platform that provides stereotactic application of low energy X-ray to the retina in three highly collimated beams that cross the inferior sclera to overlap at the macula. A randomized, double-masked, sham-controlled trial of 230 patients (INTREPID) showed that a single dose of stereotactic radiotherapy significantly reduces the number of intravitreal anti-VEGF injections needed over 2 years. A larger randomized controlled trial (STAR) is underway. PMID:26491243

  6. Stereotactic radiotherapy for wet age-related macular degeneration: current perspectives

    PubMed Central

    Neffendorf, James E; Jackson, Timothy L

    2015-01-01

    Neovascular age-related macular degeneration is a leading cause of blindness in the developed world. Currently, the treatment of choice is intravitreal injections of anti-VEGF medications. These require frequent dosing, up to monthly, and impose a substantial burden on patients and the health economy. Ionizing radiation was proposed as a possible treatment for age-related macular degeneration due to its anti-inflammatory and anti-fibrotic properties. Stereotactic radiotherapy is an outpatient-based radiotherapy platform that provides stereotactic application of low energy X-ray to the retina in three highly collimated beams that cross the inferior sclera to overlap at the macula. A randomized, double-masked, sham-controlled trial of 230 patients (INTREPID) showed that a single dose of stereotactic radiotherapy significantly reduces the number of intravitreal anti-VEGF injections needed over 2 years. A larger randomized controlled trial (STAR) is underway. PMID:26491243

  7. Rapid fabrication of custom patient biopsy guides.

    PubMed

    Rajon, Didier A; Bova, Frank J; Chi, Yueh-Yun; Friedman, William A

    2009-01-01

    Image guided surgery is currently performed using frame-based as well as frameless approaches. In order to reduce the invasive nature of stereotactic guidance as well as to reduce the cost in both equipment and time required within the operating room we investigated the use of rapid prototyping (RP) technology. In our approach we fabricated custom patient specific face-masks and guides that can be applied to the patient during surgery. These guides provide a stereotactic reference for the accurate placement of surgical tools to a pre-planned target along a pre-planned trajectory. While the use of RP machines has previously been shown to be satisfactory for the accuracy standpoint, one of our design criteria, completing the entire built and introduction into the sterile field in less than 120 minutes, was unobtainable. Our primary problems were the fabrication time and the non-resistance of the built material to high-temperature sterilization. In the current study, we have investigated the use of subtractive rapid prototyping (SRP) machines to perform the same quality of surgical guidance while improving the fabrication time and allowing for choosing materials suitable for sterilization. Because SRP technology does not offer the same flexibility as RP in term of prototype shape and complexity, our software program was adapted to provide new guide designs suitable for SRP fabrication. The biopsy guide was subdivided for a more efficient built with the parts being uniquely assembled to form the final guide. The accuracy of the assembly was then assessed using a modified Brown-Roberts-Wells phantom base that allows measuring the position of a biopsy needle introduced into the guide and comparing it with the actual planned target. These tests showed that 1) SRP machines provide an average accuracy of 0.77 mm with a standard deviation of 0.05 mm (plus or minus one image pixel) and 2) SRP allows for fabrication and sterilization within three and a half hours after

  8. An x-ray image guidance system for small animal stereotactic irradiation

    NASA Astrophysics Data System (ADS)

    Song, K. H.; Pidikiti, R.; Stojadinovic, S.; Speiser, M.; Seliounine, S.; Saha, D.; Solberg, T. D.

    2010-12-01

    An x-ray image-guided small animal stereotactic irradiator was developed and characterized to enable tumor visualization and accurate target localization for small field, high dose irradiation. The system utilizes a custom collimation system, a motorized positioning system (x, y, θ), a digital imaging panel and operating software, and is integrated with a commercial x-ray unit. The essential characteristics of the irradiator include small radiation fields (1-10 mm), high dose rate (>10 Gy min-1) and submillimeter target localization. The software enables computer-controlled image acquisition, stage motion and target localization providing simple and precise automated target localization. The imaging panel was characterized in terms of signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and spatial resolution. Overall localization accuracy and precision were assessed. SNR, CNR and spatial resolution are 24 dB, 21 dB and 2.8 lp mm-1, respectively, and localization accuracy is approximately 65 µm with 6 µm precision. With the aid of image guidance, system performance was subsequently used to evaluate radiation response in a rat orthotopic lung tumor effectively sparing normal tissues and in a mouse normal lung. The capabilities of 3D treatment and cone-beam computed tomography are presented for 3D localization and delivery as a work in progress.

  9. An x-ray image guidance system for small animal stereotactic irradiation.

    PubMed

    Song, K H; Pidikiti, R; Stojadinovic, S; Speiser, M; Seliounine, S; Saha, D; Solberg, T D

    2010-12-01

    An x-ray image-guided small animal stereotactic irradiator was developed and characterized to enable tumor visualization and accurate target localization for small field, high dose irradiation. The system utilizes a custom collimation system, a motorized positioning system (x, y, θ), a digital imaging panel and operating software, and is integrated with a commercial x-ray unit. The essential characteristics of the irradiator include small radiation fields (1-10 mm), high dose rate (>10 Gy min(-1)) and submillimeter target localization. The software enables computer-controlled image acquisition, stage motion and target localization providing simple and precise automated target localization. The imaging panel was characterized in terms of signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and spatial resolution. Overall localization accuracy and precision were assessed. SNR, CNR and spatial resolution are 24 dB, 21 dB and 2.8 lp mm(-1), respectively, and localization accuracy is approximately 65 µm with 6 µm precision. With the aid of image guidance, system performance was subsequently used to evaluate radiation response in a rat orthotopic lung tumor effectively sparing normal tissues and in a mouse normal lung. The capabilities of 3D treatment and cone-beam computed tomography are presented for 3D localization and delivery as a work in progress. PMID:21081818

  10. [Possibilities of stereotactic radiotherapy in the palliative treatment of patients with pancreatic cancer].

    PubMed

    Tkachev, S I; Medvedev, S V; Znatkova, Ya R; Romanov, D S; Nogovitsyn, E A; Bulychkin, P V; Yurieva, T V; Gutnik, R A; Yazhgunovich, I P; Berdnik, A V; Bykova, Yu B; Bazin, I S; Fedoseenko, D I

    2015-01-01

    Morbidity and mortality from pancreatic cancer is steadily increasing. Resectable cases are not more than 20%. Conventional schemes of chemoradiation and radiation therapy are durable over the time, have toxicity and low treatment outcomes. Many foreign authors consider as promising the technique of stereotactic radiotherapy, which is often used in pancreatic cancer and permit achieving high local control. At our institution there has been developed and introduced into clinical practice a method of stereotactic radiotherapy for the palliative treatment of patients with pancreatic cancer, which improved not only the duration but also the quality of life of patients. PMID:26016157

  11. The Effects of Guided Inquiry Instruction on Student Achievement in High School Biology

    ERIC Educational Resources Information Center

    Vass, Laszlo

    2010-01-01

    The purpose of this quantitative, quasi-experimental study was to measure the effect of a student-centered instructional method called guided inquiry on the achievement of students in a unit of study in high school biology. The study used a non-random sample of 109 students, the control group of 55 students enrolled in high school one, received…

  12. Which Type of Inquiry Project Do High School Biology Students Prefer: Open or Guided?

    ERIC Educational Resources Information Center

    Sadeh, Irit; Zion, Michal

    2012-01-01

    In teaching inquiry to high school students, educators differ on which method of teaching inquiry is more effective: Guided or open inquiry? This paper examines the influence of these two different inquiry learning approaches on the attitudes of Israeli high school biology students toward their inquiry project. The results showed significant…

  13. Which Type of Inquiry Project Do High School Biology Students Prefer: Open or Guided?

    NASA Astrophysics Data System (ADS)

    Sadeh, Irit; Zion, Michal

    2012-10-01

    In teaching inquiry to high school students, educators differ on which method of teaching inquiry is more effective: Guided or open inquiry? This paper examines the influence of these two different inquiry learning approaches on the attitudes of Israeli high school biology students toward their inquiry project. The results showed significant differences between the two groups: Open inquiry students were more satisfied and felt they gained benefits from implementing the project to a greater extent than guided inquiry students. On the other hand, regarding documentation throughout the project, guided inquiry students believed that they conducted more documentation, as compared to their open inquiry peers. No significant differences were found regarding `the investment of time', but significant differences were found in the time invested and difficulties which arose concerning the different stages of the inquiry process: Open inquiry students believed they spent more time in the first stages of the project, while guided inquiry students believed they spent more time in writing the final paper. In addition, other differences were found: Open inquiry students felt more involved in their project, and felt a greater sense of cooperation with others, in comparison to guided inquiry students. These findings may help teachers who hesitate to teach open inquiry to implement this method of inquiry; or at least provide their students with the opportunity to be more involved in inquiry projects, and ultimately provide their students with more autonomy, high-order thinking, and a deeper understanding in performing science.

  14. Noncontact monitoring of fatigue crack growth using high frequency guided waves

    NASA Astrophysics Data System (ADS)

    Masserey, B.; Fromme, P.

    2014-03-01

    The development of fatigue cracks at fastener holes due to stress concentration is a common problem in aircraft maintenance. This contribution investigates the use of high frequency guided waves for the non-contact monitoring of fatigue crack growth in tensile, aluminium specimens. High frequency guided ultrasonic waves have a good sensitivity for defect detection and can propagate along the structure, thus having the potential for the inspection of difficult to access parts by means of non-contact measurements. Experimentally the required guided wave modes are excited using standard wedge transducers and measured using a laser interferometer. The growth of fatigue cracks during cyclic loading was monitored optically and the resulting changes in the signal caused by crack growth are quantified. Full three-dimensional simulation of the scattering of the high frequency guided ultrasonic waves at the fastener hole and crack has been implemented using the Finite Difference (FD) method. The comparison of the results shows a good agreement of the measured and predicted scattered field of the guided wave at quarter-elliptical and through-thickness fatigue cracks. The measurements show a good sensitivity for the early detection of fatigue damage and for the monitoring of fatigue crack growth at a fastener hole. The sensitivity and repeatability are ascertained, and the robustness of the methodology for practical in-situ ultrasonic monitoring of fatigue crack growth is discussed.

  15. Stereotactic biopsy of brainstem lesions: 21 years experiences of a single center.

    PubMed

    Quick-Weller, Johanna; Lescher, Stephanie; Bruder, Markus; Dinc, Nazife; Behmanesh, Bedjan; Seifert, Volker; Weise, Lutz; Marquardt, Gerhard

    2016-09-01

    Stereotactic biopsies are procedures performed to obtain tumor tissue for diagnostic examinations. Cerebral lesions of unknown entities can safely be accessed and tissue can be examined, resulting in correct diagnosis and according treatment. Stereotactic procedures of lesions in highly eloquent regions such as the brainstem have been performed for more than two decades in our department. In this retrospective study we focus on results, approaches, modalities of anesthesia, and complications. We performed a retrospective analysis of our prospective database, including 26 patients who underwent stereotactic biopsy of the brainstem between April 1994 and June 2015. All of the patients underwent preoperative MRI. Riechert-Mundinger-frame was used before 2000, thereafter the Leksell stereotactic frame was used. After 2000 entry and target points were calculated by using BrainLab stereotactic system. We evaluated histopathological results as well as further treatment; additionally we compared complications of local versus general anesthesia and complications of a frontal versus a trans-cerebellar approach. Median age of all patients was 33 years, and median number of tissue samples taken was 12. In all patients a final histopathological diagnosis could be established. 5 patients underwent the procedure under local anesthesia, 21 patients in general anesthesia. In 19 patients a frontal approach was performed, while in 7 patients a trans-cerebellar approach was used. Complications occurred in five patients. Thereby no significant difference was found with regard to approach (frontal versus trans-cerebellar) or anesthesia (local versus general). Stereotactic biopsies even of lesions in the brainstem are a save way to obtain tumor tissue for final diagnosis, resulting in adequate treatment. Approach can be trans-cerebellar or frontal and procedure can be performed either under local or general anesthesia without significant differences concerning complication rate. PMID

  16. Adaptation of telecobalt unit for stereotactic irradiation

    SciTech Connect

    Singh, I. Rabi Raja . E-mail: rabiraja@cmcvellore.ac.in; Ravindran, B. Paul; Ayyangar, K.M.

    2007-04-01

    We investigated the feasibility of using an isocentric telecobalt unit for advanced treatment techniques, such as stereotactic radiotherapy. To adapt the telecobalt unit (Th780 C) for stereotactic irradiation, collimator inserts of various sizes, collimator mount, and a couch mount suitable for the telecobalt unit were developed, and the characteristics of the narrow beams of Cobalt-60 ({sup 60}Co) were studied. Comparative study was carried out between the stereotactic radiotherapy plans of 6 MV and {sup 60}Co beams using a 3-dimensional (3D) treatment planning system. The beam penumbra of {sup 60}Co beams was found to be larger than those of 6 MV beams. The dose-volume histograms (DVH) obtained from the {sup 60}Co beam plan were comparable to those obtained from the 6 MV plan. The DVH of nontarget tissue obtained from the plans of the 2 beams were found to be in good agreement to each other. The difference in equivalent fall-off distance (EFOD) for all 3 cases was found insignificant; hence, it can be concluded that the fall-off dose in the dose distribution of the {sup 60}Co stereotactic plan is as good as that of the 6 MV stereotactic plan. In all 3 cases for which the treatment plans were compared between {sup 60}Co and 6 MV beams, it was observed that the fall-off doses outside the target were similar; therefore, considering {sup 60}Co with 5-mm margin is a cost effective alternative for the linac-based stereotactic radiotherapy.

  17. An Educator's Guide to High-End Videoconferencing.

    ERIC Educational Resources Information Center

    Maring, Gerald H.; Schmid, Jason A.; Roark, Jeremy

    This document describes the origins of cybermentoring and focuses on projects with elementary and secondary schools throughout the state of Washington. It discusses use of telephone communication, email, web design, and low-end videoconferencing technologies in initial cyberprojects, and recent cyberprojects that have begun to make use of high-end…

  18. Curriculum Guide for Art Education in the Senior High School.

    ERIC Educational Resources Information Center

    Byar, Corinne L.; Dougherty, Marguerite D.

    This course outline for art education at the senior high school level aims to promote the development of each child so that he is not only proficient in measurable skills and knowledge but is also a resourceful and creative individual. The suggested teaching activities include classroom demonstrations and slide shows followed by student…

  19. Guide to School Design: Healthy + High Performance Schools

    ERIC Educational Resources Information Center

    Healthy Schools Network, Inc., 2007

    2007-01-01

    A "healthy and high performance school" uses a holistic design process to promote the health and comfort of children and school employees, as well as conserve resources. Children may spend over eight hours a day at school with little, if any, legal protection from environmental hazards. Schools are generally not well-maintained; asthma is a…

  20. Guide for Planning a High School Environmental Action Conference.

    ERIC Educational Resources Information Center

    Wanless, Angie, Comp.; And Others

    The purpose of this manual is to provide guidelines and suggestions for people organizing an environmental action conference for high school students. The format and planning suggestions are based on the methods used for a conference organized by the Wisconsin Center for Environmental Education in 1991. The bulk of the manual provides structure…

  1. Imaging of Radiation Dose for Stereotactic Radiosurgery.

    PubMed

    Guan, Timothy Y; Almond, Peter R; Park, Hwan C; Lindberg, Robert D; Shields, Christopher B

    2015-01-01

    The distributions of radiation dose for stereotactic radiosurgery, using a modified linear accelerator (Philips SL-25 and SRS-200), have been studied by using three different dosimeters: (1) ferrous-agarose-xylenol orange (FAX) gels, (2) TLD, and (3) thick-emulsion GafChromic dye film. These dosimeters were loaded into a small volume of defect in a phantom head. A regular linac stereotactic radiosurgery treatment was then given to the phantom head for each type of dosimeter. The measured radiation dose and its distributions were found to be in good agreement with those calculated by the treatment planning computer. PMID:27421869

  2. Guided-Mode-Leaky-Mode-Guided-Mode Fiber Interferometer and Its High Sensitivity Refractive Index Sensing Technology

    PubMed Central

    Wang, Qi; Li, Chunyue; Zhao, Chengwu; Li, Weizheng

    2016-01-01

    A cascaded symmetrical dual-taper Mach-Zehnder interferometer structure based on guided-mode and leaky-mode interference is proposed in this paper. Firstly, the interference spectrum characteristics of interferometer has been analyzed by the Finite Difference-Beam Propagation Method (FD-BPM). When the diameter of taper waist is 20 μm–30 μm, dual-taper length is 1 mm and taper distance is 4 cm–6 cm, the spectral contrast is higher, which is suitable for sensing. Secondly, experimental research on refractive index sensitivity is carried out. A refractive index sensitivity of 62.78 nm/RIU (refractive index unit) can achieved in the RI range of 1.3333–1.3792 (0%~25% NaCl solution), when the sensor structure parameters meet the following conditions: diameter of taper waist is 24 μm, dual-taper length is 837 μm and taper distance is 5.5 cm. The spectrum contrast is 0.8 and measurement resolution is 1.6 × 10−5 RIU. The simulation analysis is highly consistent with experimental results. Research shows that the sensor has promising application in low RI fields where high-precision measurement is required due to its high sensitivity and stability. PMID:27258281

  3. Guided-Mode-Leaky-Mode-Guided-Mode Fiber Interferometer and Its High Sensitivity Refractive Index Sensing Technology.

    PubMed

    Wang, Qi; Li, Chunyue; Zhao, Chengwu; Li, Weizheng

    2016-01-01

    A cascaded symmetrical dual-taper Mach-Zehnder interferometer structure based on guided-mode and leaky-mode interference is proposed in this paper. Firstly, the interference spectrum characteristics of interferometer has been analyzed by the Finite Difference-Beam Propagation Method (FD-BPM). When the diameter of taper waist is 20 μm-30 μm, dual-taper length is 1 mm and taper distance is 4 cm-6 cm, the spectral contrast is higher, which is suitable for sensing. Secondly, experimental research on refractive index sensitivity is carried out. A refractive index sensitivity of 62.78 nm/RIU (refractive index unit) can achieved in the RI range of 1.3333-1.3792 (0%~25% NaCl solution), when the sensor structure parameters meet the following conditions: diameter of taper waist is 24 μm, dual-taper length is 837 μm and taper distance is 5.5 cm. The spectrum contrast is 0.8 and measurement resolution is 1.6 × 10(-5) RIU. The simulation analysis is highly consistent with experimental results. Research shows that the sensor has promising application in low RI fields where high-precision measurement is required due to its high sensitivity and stability. PMID:27258281

  4. Natural Resources Technologies: A Suggested Post High School Program Development Guide.

    ERIC Educational Resources Information Center

    Soles, Robert L.

    This post high school program development guide considers the following natural resources technological areas: air pollution control, forest, rangeland, minerals and mineral fuels, geological, outdoor recreation, soil, urban-regional planning, landscape, water, wastewater, oceanography, wildlife, fish, and marine life. Within each area, the…

  5. An Incompressible Fluid Model for High-Speed Pellet Propagation in Guide-tubes

    NASA Astrophysics Data System (ADS)

    Perkins, F. W.

    2006-04-01

    This work reports theoretical models developed to support optimization of pellet-fueling. Experiments show pellet penetration will be optimized by high-field-side, high-speed launch. In present pellet systems, acceleration takes place outside the main tokamak chamber and pellets must propagate at high velocity through curved guide tubes to reach the desired HFS launch point. If the pellet velocity V exceeds a critical value Vc 300m/s, then centrifugal force will breakup the pellet in agreement with observations. In the limit V>>Vc, the pellet material can be modeled as an incompressible granular fluid of DT dust fragments and an equation is developed for its length l along the guide tube. The solution shows that l depends only on the angle the guide tube bends and not on the pellet speed. If a v-notch guide tube is used with a right-angle bend, the pellet as emerges as a highly elongated DT dust cloud, essentially a fluid jet. Further analysis shows this jet to be unstable and breakup into a series of droplets is expected. Ablation calculations based on droplet size result in poor penetration.

  6. Teachers' Guide to Music Appreciation III A and III B in the Senior High School.

    ERIC Educational Resources Information Center

    Scott, J. Mark; Dawkins, Barbara R.

    This guide to music appreciation courses was developed for use in senior high schools in Duval County, Jacksonville, Florida. Music Appreciation III A examines the development of music, from the Gothic period through the Classical period. Music Appreciation III B examines the development of music from the Romantic period through the 1970s.…

  7. Development of a Career Student Guide for the Tech Prep Program for Henry County High School.

    ERIC Educational Resources Information Center

    Winchester, Ruth Ann

    This practicum report describes the research conducted in preparation for developing a career student guide to acquaint students attending Henry County High School (HCHS) in McDonough, Georgia, with the school's new tech prep program. Chapters 1 and 2 contain background information about HCHS' tech prep program and a review of literature regarding…

  8. Middle/Junior High School Parenthood Education Curriculum Guide for Consumer and Homemaking Education.

    ERIC Educational Resources Information Center

    Hadley, Sharon; And Others

    Intended for use by teachers on the middle or junior high school level in Kentucky, this curriculum guide outlines a four-week course in parenthood education. The eight units included are as follow: (1) responsibilities of parenthood, including parental roles and financial responsibilities; (2) human reproduction; (3) family planning and birth…

  9. Makiko's New World: Activities for the High School Classroom. [Videotape with] Teacher's Guide.

    ERIC Educational Resources Information Center

    Stanford Univ., CA. Stanford Program on International and Cross Cultural Education.

    The film "Makiko's New World" offers U.S. high school students a unique glimpse into the latter part of the Meiji Period (1868-1912) in Japanese history. Students have the opportunity to experience the life of one Japanese woman, Makiko, during the Meiji Period through the "lens" of her diary. The teacher's guide was developed to provide suggested…

  10. Speech Courses in the Senior High School Program: A Guide for Teachers.

    ERIC Educational Resources Information Center

    Detroit Public Schools, MI.

    This teacher guide to senior high school speech programs includes philosophy, objectives, course outlines, numerous sample materials, suggestions for projects and procedures, bibliographies, listings of suggested films, and evaluation materials for courses in (1) basic speech (e.g., voice and diction; action; rhetoric; advertising psychology;…

  11. Conversation Compass: A Teacher's Guide to High-Quality Language Learning in Young Children

    ERIC Educational Resources Information Center

    Curenton, Stephanie M.

    2016-01-01

    Classroom conversation plays an important role in the development of children's language and reasoning. However, studies show that classroom talk relies too much on directives and close-ended questions. "Conversation Compass" provides the tools to strengthen your language-learning environment: (1) The Compass: guide high-quality…

  12. BO-CEC Business and Office Careers Course Guide; Junior High and Middle Schools.

    ERIC Educational Resources Information Center

    Colorado State Univ., Ft. Collins. Dept. of Vocational Education.

    The curriculum guide for middle and junior high school grades presents 15 resource units, designed to simulate business career situations, organized into five sections: clerical (receptionist, general office worker, cashier, typist, and accounting clerk), secretarial/stenographic (secretary, court reporter, executive secretary), accounting and…

  13. Nutrition Education: Choose Well, Be Well. A Curriculum Guide for High School.

    ERIC Educational Resources Information Center

    California State Dept. of Education, Sacramento.

    This curriculum guide for high school students contains 20 information acquisition lessons, 6 values awareness lessons, and 5 open-ended discussion lessons. Some lessons contain activities that extend over several days; other lessons contain one specific activity. The nutrition education goals are directed toward the attainment of nutrition…

  14. Nutrition Education: Choose Well, Be Well. A Curriculum Guide for Junior High School.

    ERIC Educational Resources Information Center

    California State Dept. of Education, Sacramento.

    This curriculum guide for junior high school students contains 17 information acquisition lessons, 5 values awareness lessons, and 6 open-ended discussion lessons. Some lessons contain activities that extend over several days; other lessons contain one specific activity. The nutrition education goals are directed toward the attainment of nutrition…

  15. The 2009 High School Transcript Study User's Guide. NCES 2011-465

    ERIC Educational Resources Information Center

    Nord, C.; Hicks, L.; Hoover, K.; Jones, M.; Lin, A.; Lyons, M.; Perkins, R.; Roey, S.; Rust, K.; Sickles, D.

    2011-01-01

    This user's guide documents the procedures used to collect, process, and summarize data from the 2009 High School Transcript Study (HSTS 2009). Chapters detail the sampling of schools and graduates (chapters 2 and 3), data collection procedures (chapter 4), data processing procedures (chapter 5), and weighting procedures (chapter 6). Chapter 7…

  16. The Negro in United States History. A Resource Guide (Tentative) for Senior High School.

    ERIC Educational Resources Information Center

    Boston Public Schools, MA.

    GRADES OR AGES: Senior high school (Grades 10-12). SUBJECT MATTER: The Negro in United States history. ORGANIZATION AND PHYSICAL APPEARANCE: The guide has 12 units: 1) African Background; 2) Exploration; 3) The Revolution; 4) The Constitution; 5) Westward Expansion; 6) Slavery; 7) Lincoln and Slavery; 8) The Civil War; 9) Reconstruction; 10)…

  17. Prospective Mathematics Teachers' Ways of Guiding High School Students in GeoGebra-Supported Inquiry Tasks

    ERIC Educational Resources Information Center

    Hahkioniemi, Markus; Leppaaho, Henry

    2012-01-01

    In this paper, we study how prospective teachers guide students' reasoning in GeoGebra-supported inquiry tasks. Twenty prospective mathematics teachers wrote about how they would react as a teacher in hypothetical situations where high school students present their GeoGebra-supported solutions to the teacher. Before writing their reactions, the…

  18. The 1998 High School Transcript Study User's Guide and Technical Report.

    ERIC Educational Resources Information Center

    Roey, Stephen; Caldwell, Nancy; Rust, Keith; Blumstein, Eyal; Krenzke, Tom; Legum, Stan; Kuhn, Judy; Waksberg, Mark; Haynes, Jacqueline

    The 1998 High School Transcript Study provides the U.S. Department of Education and other educational policymakers with information regarding current course offerings and students' course-taking patterns in U.S. secondary schools. Similar studies were conducted in 1982, 1987, 1990, and 1994. This guide documents the procedures used to collect and…

  19. Junior High Curriculum Guide to Language Arts of the Mehlville School District.

    ERIC Educational Resources Information Center

    Mehlville R-9 School District, St. Louis, MO.

    Based on the latest research and theories, this junior high school curriculum guide was prepared for teachers of language arts. Following a statement of the philosophy of the program, teaching objectives are stated for writing, literature, and related skill areas. Other sections include a scope and sequence chart, evaluation and testing…

  20. Coastal Awareness: A Resource Guide for Teachers in Junior High Science.

    ERIC Educational Resources Information Center

    Rasmussen, Frederick A.

    Background information, activity suggestions, and recommended resource materials comprise this guide for designing a week-long ecology unit for junior high school students on Coastal Awareness. Discussed is how various physical processes such as waves, currents, and tides affect rocky shores, marshes, sandy beaches, and estuaries. To encourage…

  1. Occupational Preparation in the Natural Resources: A Suggested High School Curriculum Guide.

    ERIC Educational Resources Information Center

    Mortensen, James H.

    This curriculum guide was developed to provide a model plan to help public high schools and area vocational-technical schools to initiate, or evaluate and improve, natural resource occupational preparation programs. It offers a curriculum plan which can be modified to meet particular needs and objectives which are career education oriented. This…

  2. Common Core Standards for High School Mathematics: A Quick-Start Guide

    ERIC Educational Resources Information Center

    Dempsey, Kathleen; Schwols, Armitra

    2012-01-01

    Shifting your high school's math program to new Common Core standards is much easier when teachers and leaders have this handy guide. Getting a copy for every staff member involved in the process ensures everyone knows: (1) How the six conceptual categories throughout the math standards are connected and reinforced; (2) How the modeling standards…

  3. Consumer Education: A Conceptual Structure and Planning Guide for Senior High Schools in Wisconsin.

    ERIC Educational Resources Information Center

    Appleton Public Schools, WI.

    Prepared by junior and senior high teachers, the curriculum guide is an interdisciplinary approach by the business education, home economics, and social studies departments to a consumer education course. The initial development of materials was field tested and revised; a second-year field testing of the revised curriculum and a final analysis…

  4. Common Core Standards for High School English Language Arts: A Quick-Start Guide

    ERIC Educational Resources Information Center

    Kendall, John; Frazee, Dana; Ryan, Susan

    2012-01-01

    High school teachers and leaders with responsibility for English language arts (ELA) need this handy guide to successfully implement the Common Core in their respective grade levels. Getting a copy for every staff member ensures they know: (1) How grades 11-12 ELA content differs from and builds upon 9-10 standards; (2) How the four strands…

  5. Social Studies: A Resource Guide for Hearing-Impaired High School Students.

    ERIC Educational Resources Information Center

    Jaggers, Robert A.; Jaggers, Barbara A.

    The guide was written to give secondary level hearing impaired students exposure to real life problems from a social studies perspective. Units are outlined for the three levels of the high school years and provide an overview, information on vocabulary, target competencies, suggested activities, sources, and a list of objectives. The units are…

  6. "Failure Is Not an Option": Struggling High School Uses Standards to Guide Reform

    ERIC Educational Resources Information Center

    Lambertson, Sherry

    2014-01-01

    This article describes the use of standards to guide the reform of a struggling high school in Grant Michigan. The author describes the challenges and obstacles that the school was facing, and admits that school reform was difficult. Turnaround seemed impossible, but it held the promise of something larger than life: successful students who become…

  7. Senior High School Parenthood Education Curriculum Guide for Consumer and Homemaking Education.

    ERIC Educational Resources Information Center

    Bohannon, Nancy; And Others

    Intended for use by teachers on the senior high school level in Kentucky, this curriculum guide outlines a semester course in parenthood education. The eleven instructional units include (1) the individual and his self-concept; (2) the family and its structure; (3) human reproduction, emphasizing heredity, biological systems, conception, and…

  8. Planting the seeds of success: CT-guided gold seed fiducial marker placement to guide robotic radiosurgery.

    PubMed

    Patel, Aashish; Khalsa, Bhavraj; Lord, Bryce; Sandrasegaran, Kumar; Lall, Chandana

    2013-04-01

    Fiducial marker (FM)-guided stereotactic body radiation therapy (SBRT) allows for precise targeting and delivery of radiation to a tumor site. In this article, we briefly discuss SBRT, provide examples to describe CT-guided FM placement to guide SBRT, and discuss some of the associated risks and benefits. This article serves as a pictorial review for body imagers and interventional radiologists who perform CT-guided procedures and interpret diagnostic studies for oncology patients. CT-guided FMs were placed in patients who were appropriate candidates for SBRT. One week following placement, patients underwent diagnostic CT and/or MR examinations in order to include the FM data in the development of a treatment plan. From October 2007-November 2009, a total of 89 patients were implanted with FMs. Sites of implantation included lung, liver, bone, chest and abdominal wall, and peritoneum/retroperitoneum. Complications included pneumothorax and FM migration. Twenty-one patients (33%) with lung FM placement experienced at least a small pneumothorax and 6 patients (9%) required thoracostomy tubes. FM migration occurred in 5 patients (8%) with lung placement. SBRT provides a safer and more effective alternative to conventional radiotherapy, and CT-guided FM implantation of tumor sites increases the precision of SBRT. Technical improvements in FM placement can limit the complications associated with the procedure and further enable highly localized tumor therapy. PMID:23551782

  9. Stellar Populations. A User Guide from Low to High Redshift

    NASA Astrophysics Data System (ADS)

    Greggio, Laura; Renzini, Alvio

    2011-09-01

    This textbook is meant to illustrate the specific role played by stellar population diagnostics in our attempt to understand galaxy formation and evolution. The book starts with a rather unconventional summary of the results of stellar evolution theory (Chapter 1), as they provide the basis for the construction of synthetic stellar populations. Current limitations of stellar models are highlighted, which arise from the necessity to parametrize all those physical processes that involve bulk mass motions, such as convection, mixing, mass loss, etc. Chapter 2 deals with the foundations of the theory of synthetic stellar populations, and illustrates their energetics and metabolic functions, providing basic tools that will be used in subsequent chapters. Chapters 3 and 4 deal with resolved stellar populations, first addressing some general problems encountered in photometric studies of stellar fields. Then some highlights are presented illustrating our current capacity of measuring stellar ages in Galactic globular clusters, in the Galactic bulge and in nearby galaxies. Chapter 5 is dedicated to the exemplification of synthetic spectra of simple as well as composite stellar populations, drawing attention to those spectral features that may depend on less secure results of stellar evolution models. Chapter 6 illustrates how synthetic stellar populations are used to derive basic galaxy properties, such as star formation rates, stellar masses, ages and metallicities, and does so for galaxies at low as well as at high redshifts. Chapter 7 is dedicated to supernovae, distinguishing them in core collapse and thermonuclear cases, describing the evolution of their rates for various star formation histories, and estimating the supernova productivity of stellar populations and their chemical yields. In Chapter 8 the stellar initial mass function (IMF) is discussed, first showing how even apparently small IMF variations may have large effects on the demo! graphy of stellar

  10. High-Intensity Focused Ultrasound: Current Status for Image-Guided Therapy.

    PubMed

    Copelan, Alexander; Hartman, Jason; Chehab, Monzer; Venkatesan, Aradhana M

    2015-12-01

    Image-guided high-intensity focused ultrasound (HIFU) is an innovative therapeutic technology, permitting extracorporeal or endocavitary delivery of targeted thermal ablation while minimizing injury to the surrounding structures. While ultrasound-guided HIFU was the original image-guided system, MR-guided HIFU has many inherent advantages, including superior depiction of anatomic detail and superb real-time thermometry during thermoablation sessions, and it has recently demonstrated promising results in the treatment of both benign and malignant tumors. HIFU has been employed in the management of prostate cancer, hepatocellular carcinoma, uterine leiomyomas, and breast tumors, and has been associated with success in limited studies for palliative pain management in pancreatic cancer and bone tumors. Nonthermal HIFU bioeffects, including immune system modulation and targeted drug/gene therapy, are currently being explored in the preclinical realm, with an emphasis on leveraging these therapeutic effects in the care of the oncology patient. Although still in its early stages, the wide spectrum of therapeutic capabilities of HIFU offers great potential in the field of image-guided oncologic therapy. PMID:26622104

  11. Relativistic electron motion in cylindrical waveguide with strong guiding magnetic field and high power microwave

    SciTech Connect

    Wu, Ping; Sun, Jun; Cao, Yibing

    2015-06-15

    In O-type high power microwave (HPM) devices, the annular relativistic electron beam is constrained by a strong guiding magnetic field and propagates through an interaction region to generate HPM. Some papers believe that the E × B drift of electrons may lead to beam breakup. This paper simplifies the interaction region with a smooth cylindrical waveguide to research the radial motion of electrons under conditions of strong guiding magnetic field and TM{sub 01} mode HPM. The single-particle trajectory shows that the radial electron motion presents the characteristic of radial guiding-center drift carrying cyclotron motion. The radial guiding-center drift is spatially periodic and is dominated by the polarization drift, not the E × B drift. Furthermore, the self fields of the beam space charge can provide a radial force which may pull electrons outward to some extent but will not affect the radial polarization drift. Despite the radial drift, the strong guiding magnetic field limits the drift amplitude to a small value and prevents beam breakup from happening due to this cause.

  12. High Voltage Power Supply Design Guide for Space

    NASA Technical Reports Server (NTRS)

    Bever, Renate S.; Ruitberg, Arthur P.; Kellenbenz, Carl W.; Irish, Sandra M.

    2006-01-01

    This book is written for newcomers to the topic of high voltage (HV) in space and is intended to replace an earlier (1970s) out-of-print document. It discusses the designs, problems, and their solutions for HV, mostly direct current, electric power, or bias supplies that are needed for space scientific instruments and devices, including stepping supplies. Output voltages up to 30kV are considered, but only very low output currents, on the order of microamperes. The book gives a brief review of the basic physics of electrical insulation and breakdown problems, especially in gases. It recites details about embedment and coating of the supplies with polymeric resins. Suggestions on HV circuit parts follow. Corona or partial discharge testing on the HV parts and assemblies is discussed both under AC and DC impressed test voltages. Electric field analysis by computer on an HV device is included in considerable detail. Finally, there are many examples given of HV power supplies, complete with some of the circuit diagrams and color photographs of the layouts.

  13. Do ultrasound-guided regional blocks signify a new paradigm in high-risk patients?

    PubMed

    Bendtsen, Thomas F; Haskins, Stephen; Kølsen Petersen, Jens Aage; Børglum, Jens

    2016-06-01

    It has been suggested for many years that regional anaesthesia is advantageous in high-risk patients, either as the sole anaesthetic or in combination with general anaesthesia. Regional techniques are safe and even more so when guided by ultrasound. In the high-risk patient population, ultrasound-guided regional anaesthesia (UGRA) can help decrease risk of perioperative morbidity and improve short-term as well as long-term outcomes, particularly in the orthopaedic, vascular, oncologic and chronic pain patient populations. Nevertheless, complications do still occur and benefits of a specific regional nerve blockade need to be weighed against potential risks on an individual basis. The emergence of reasonably priced, easy-to-use ultrasound machines facilitates regional anaesthesia, and this kind of anaesthesia may become the standard of care in high-risk patients. PMID:27396806

  14. Monitoring general corrosion of rebar embedded in mortar using high-frequency guided mechanical waves

    NASA Astrophysics Data System (ADS)

    Ervin, Benjamin L.; Bernhard, Jennifer T.; Kuchma, Daniel A.; Reis, Henrique

    2007-04-01

    High-frequency guided mechanical waves were used to ultrasonically monitor reinforced mortar specimens undergoing accelerated general corrosion damage. Waves were invoked, using both single-cycle and high-cycle tonebursts, at frequencies where the attenuation is at a local minimum. Results show that the high-frequency waves were sensitive to irregularities in the reinforcing rebar profile caused by corrosion. The sensitivity is thought to be due to scattering, reflections, and mode conversion at the irregularities. Certain frequencies show promise for being insensitive to the surrounding mortar, ingress of water, presence of additional rebar, stirrups, and rust product accumulation. This lack of sensitivity allows for changes in guided wave behavior from bar profile deterioration to be isolated from the effects of other surrounding interfaces.

  15. A Phase 1/2 Trial of Brief Androgen Suppression and Stereotactic Radiation Therapy (FASTR) for High-Risk Prostate Cancer

    SciTech Connect

    Bauman, Glenn; Ferguson, Michelle; Lock, Michael; Chen, Jeff; Ahmad, Belal; Venkatesan, V.M.; Sexton, Tracy; D'Souza, David; Loblaw, Andrew; Warner, Andrew; Rodrigues, George

    2015-07-15

    Purpose: To initiate a phase 1/2 trial to examine the tolerability of a condensed combined-modality protocol for high-risk prostate cancer. Methods and Materials: Men scoring ≥3 on the Vulnerable Elderly Scale (VES) or refusing conventionally fractionated treatment for high-risk prostate cancer were eligible to participate. Androgen suppression was delivered for 12 months, and radiation therapy was delivered using 25 Gy to pelvic nodes delivered synchronously with 40 Gy to the prostate given as 1 fraction per week over 5 weeks. The phase 1 component included predetermined stopping rules based on 6-month treatment-related toxicity, with trial suspension specified if there were ≥6 of 15 patients (40%) or ≥3 of 15 (20%) who experienced grade ≥2 or ≥3 gastrointestinal (GI) or genitourinary (GU) toxicity, respectively. Results: Sixteen men were enrolled, with 7 men meeting the criteria of VES ≥3 and 9 men having a VES <3 but choosing the condensed treatment. One man was not treated owing to discovery of a synchronous primary rectal cancer. Four patients (26%) experienced grade ≥2 toxicity at 6 weeks after treatment. There were 9 of 15 (60%) who experienced grade ≥2 GI or GU toxicity and 4 of 15 (26%) grade ≥3 GI or GU toxicity at 6 months, and 5 of 15 (30%) grade ≥2 GI and GU toxicity at 6 months. A review of the 15 cases did not identify any remedial changes, thus the phase 1 criteria were not met. Conclusion: This novel condensed treatment had higher than anticipated late toxicities and was terminated before phase 2 accrual. Treatment factors, such as inclusion of pelvic lymph node radiation therapy, planning constraints, and treatment margins, or patient factors related to the specific frail elderly population may be contributing.

  16. Stereotactically-navigated percutaneous Irreversible Electroporation (IRE) compared to conventional IRE: a prospective trial

    PubMed Central

    Pregler, Benedikt; Nießen, Christoph; Schicho, Andreas; Haimerl, Michael; Jung, Ernst Michael; Stroszczynski, Christian; Wiggermann, Philipp

    2016-01-01

    Purpose. The purpose of this study was to compare CT-navigated stereotactic IRE (SIRE) needle placement to non-navigated conventional IRE (CIRE) for percutaneous ablation of liver malignancies. Materials and Methods. A prospective trial including a total of 20 patients was conducted with 10 patients in each arm of the study. IRE procedures were guided using either CT fluoroscopy (CIRE) or a stereotactic planning and navigation system (SIRE). Primary endpoint was procedure time. Secondary endpoints were accuracy of needle placement, technical success rate, complication rate and dose-length product (DLP). Results. A total of 20 IRE procedures were performed to ablate hepatic malignancies (16 HCC, 4 liver metastases), 10 procedures in each arm. Mean time for placement of IRE electrodes in SIRE was significantly shorter with 27 ± 8 min compared to 87 ± 30 min for CIRE (p < 0.001). Accuracy of needle placement for SIRE was higher than CIRE (2.2 mm vs. 3.3 mm mean deviation, p < 0.001). The total DLP and the fluoroscopy DLP were significantly lower in SIRE compared to CIRE. Technical success rate and complication rates were equal in both arms. Conclusion. SIRE demonstrated a significant reduction of procedure length and higher accuracy compared to CIRE. Stereotactic navigation has the potential to reduce radiation dose for the patient and the radiologist without increasing the risk of complications or impaired technical success compared to CIRE. PMID:27602266

  17. Stereotactically-navigated percutaneous Irreversible Electroporation (IRE) compared to conventional IRE: a prospective trial.

    PubMed

    Beyer, Lukas P; Pregler, Benedikt; Nießen, Christoph; Schicho, Andreas; Haimerl, Michael; Jung, Ernst Michael; Stroszczynski, Christian; Wiggermann, Philipp

    2016-01-01

    Purpose. The purpose of this study was to compare CT-navigated stereotactic IRE (SIRE) needle placement to non-navigated conventional IRE (CIRE) for percutaneous ablation of liver malignancies. Materials and Methods. A prospective trial including a total of 20 patients was conducted with 10 patients in each arm of the study. IRE procedures were guided using either CT fluoroscopy (CIRE) or a stereotactic planning and navigation system (SIRE). Primary endpoint was procedure time. Secondary endpoints were accuracy of needle placement, technical success rate, complication rate and dose-length product (DLP). Results. A total of 20 IRE procedures were performed to ablate hepatic malignancies (16 HCC, 4 liver metastases), 10 procedures in each arm. Mean time for placement of IRE electrodes in SIRE was significantly shorter with 27 ± 8 min compared to 87 ± 30 min for CIRE (p < 0.001). Accuracy of needle placement for SIRE was higher than CIRE (2.2 mm vs. 3.3 mm mean deviation, p < 0.001). The total DLP and the fluoroscopy DLP were significantly lower in SIRE compared to CIRE. Technical success rate and complication rates were equal in both arms. Conclusion. SIRE demonstrated a significant reduction of procedure length and higher accuracy compared to CIRE. Stereotactic navigation has the potential to reduce radiation dose for the patient and the radiologist without increasing the risk of complications or impaired technical success compared to CIRE. PMID:27602266

  18. Robot Assisted Stereotactic Laser Ablation for a Radiosurgery Resistant Hypothalamic Hamartoma

    PubMed Central

    Acharya, Vinita; Sather, Michael

    2016-01-01

    Hypothalamic hamartomas (HH) are benign tumors that can cause significant morbidity in adults as a cause of epilepsy, particularly gelastic seizures. Open and endoscopic resections of HH offer good seizure control but have high rates of morbidity and are technically challenging. Stereotactic radiosurgery has been an alternative treatment; however, it results in comparably poor seizure control. Recently, in children, stereotactic laser ablation has shown promise as a surgical technique that can combine the best features of both of these approaches for the treatment of HH. Here we present the first reported use of a frameless robot-assisted stereotactic system to treat an HH. The patient had failed two previous Gamma Knife radiosurgery treatments. Post-procedure he had a stable, but unintentional weight loss of 20 kg and a transient episode of hemiparesis the night of the operation. At six months postoperatively the patient remained seizure free. Stereotactic laser ablation may represent a new standard in the treatment of HH in adults, especially in those who have failed radiosurgery. Further study is warranted in this population to determine efficacy and safety profiles. PMID:27217984

  19. Life Experience Unit Guide Developed for Junior High and High School Resource Room Programs.

    ERIC Educational Resources Information Center

    Dorhman, Mary H.; Riker, Jerry

    The life experience unit guide, which is intended to be used with emotionally unstable adolescents and which offers selected activities for an integrated language arts, science, and social studies curriculum, is described. Provided for the language arts strand are forms such as sentence completion forms, a feeling checklist, a self evaluation…

  20. Investigation of therapy improvement using real-time photoacoustic imaging guided high intensity focused ultrasound

    NASA Astrophysics Data System (ADS)

    Cui, Huizhong

    There are a lot of risks in cancer treatment by invasive surgery, such as bleeding, wound infection, and long recovery time, etc. Therefore, there is great need for minimally- or non-invasive treatment. High intensity focused ultrasound (HIFU) is a rapidly growing and truly non-invasive technology. It has been widely used in therapeutic applications, such as rapid tissue heating and tissue ablation. With proper imaging guidance, HIFU treatment can be performed totally noninvasively. Currently, ultrasound imaging-guided HIFU has been extensively studied. However, ultrasound imaging guidance is less precise because of the relatively low imaging contrast, sensitivity, and specificity for noninvasive detection. In this study, we employed photoacoustic imaging (PAI) technique, which has been developed a novel promising imaging technique for early cancer detection, to guide HIFU treatment. The goal of this study is to investigate the feasibility of PAI to guide, monitor in real time and enhance the HIFU therapy. In this dissertation, as the first step, the integrated PAI and HIFU system had been shown to have the feasibility to guide HIFU both ex vivo and in vivo. Then, the system was improved and developed to a real-time PAI-guided HIFU system. It is demonstrated that the sensitivity of PA detection for HIFU lesion is very high and the saturation of PA signals can be used as the indicator for tissue coagulation. During the temperature measurement using this system, laser-enhanced HIFU heating was found. Thus, we further investigated the laser enhanced technique in both HIFU heating and pulsed HIFU thrombolysis. In the HIFU therapy, laser light was employed to illuminate the sample concurrently with HIFU radiation. The resulting cavitation was detected with a passive cavitation detector. We demonstrated that concurrent light illumination during HIFU has the potential to significantly enhance HIFU by reducing cavitation threshold.

  1. Numerical study of energy conversion mechanism of magnetic reconnection in the presence of high guide field

    NASA Astrophysics Data System (ADS)

    Inoue, S.; Ono, Y.; Tanabe, H.; Horiuchi, R.; Cheng, C. Z.

    2015-08-01

    The first two-dimensional particle in cell simulation of the reconnection region of two merging torus plasmas lead us to quantitative studies on the energy conversion mechanism under a high out-of-plane (guide) magnetic field condition. Even with the existence of the strong guide field, magnetic reconnection causes the efficient conversion of in-plane (poloidal) magnetic field energy. The ratio of the plasma kinetic energy flux of ions to that of electrons is roughly two to one, in agreement with the recent experimental results. Due to the suppression of nonlinear dynamics of ions motions in the vicinity of the reconnection region with guide field, the major energy flux of ions is changed to the flow energy flux. For electrons, a field-aligned acceleration caused by parallel electric field generates the non-thermal electrons through trapping (bouncing) effect, which is exhausted as the anisotropic energy flux of electrons. The inventory of the converted magnetic energy in the case with the guide field is quantitatively revealed.

  2. A slanting light-guide analog decoding high resolution detector for positron emission tomography camera

    SciTech Connect

    Wong, W.H.; Jing, M.; Bendriem, B.; Hartz, R.; Mullani, N.; Gould, K.L.; Michel, C.

    1987-02-01

    Current high resolution PET cameras require the scintillation crystals to be much narrower than the smallest available photomultipliers. In addition, the large number of photomultiplier channels constitutes the major component cost in the camera. Recent new designs use the Anger camera type of analog decoding method to obtain higher resolution and lower cost by using the relatively large photomultipliers. An alternative approach to improve the resolution and cost factors has been proposed, with a system of slanting light-guides between the scintillators and the photomultipliers. In the Anger camera schemes, the scintillation light is distributed to several neighboring photomultipliers which then determine the scintillation location. In the slanting light-guide design, the scintillation is metered and channeled to only two photomultipliers for the decision making. This paper presents the feasibility and performance achievable with the slanting light-guide detectors. With a crystal/photomultiplier ratio of 6/1, the intrinsic resolution was found to be 4.0 mm using the first non-optimized prototype light-guides on BGO crystals. The axial resolution will be about 5-6 mm.

  3. A guide to the porcine anatomy for the interventional electrophysiologist. Fluoroscopy and high density electroanatomical mapping.

    PubMed

    Hilbert, Sebastian; Kosiuk, Jedrzej; John, Silke; Hindricks, Gerhard; Bollmann, Andreas

    2015-02-01

    Invasive electrophysiology is a rapidly developing field of cardiovascular science with a constant need for inventions and testing of new technologies and concepts. Despite the swine model being an established tool in biomedical research no comprehensive guide for interventional electrophysiologists exists. The aim of the current article is to provide a practical overview of the pig anatomy, fluoroscopic views, and corresponding high density electroanatomic maps using a novel mapping system and a practical guide for interventions and techniques. In 17 pigs, fluoroscopic images of the right atrium, coronary sinus (CS), left atrium, and pulmonary veins as well as the right and left ventricles were obtained and correlated with ultra-high density electroanatomic maps and gross anatomy. Pitfalls of the porcine anatomy are precisely addressed, and alternative access techniques to overcome those issues are suggested. Important differences to human electrophysiological studies are highlighted. Complementary models such as cardiac ischemia induction or renal and pulmonary artery denervation are discussed in detail. PMID:25630688

  4. Extracranial stereotactic body radiotherapy. Review of main SBRT features and indications in primary tumors

    PubMed Central

    Rubio, Carmen; Morera, Rosa; Hernando, Ovidio; Leroy, Thomas.; Lartigau, S. Eric

    2013-01-01

    Aim Review of main SBRT features and indications in primary tumors. Background Stereotactic body radiotherapy has been developed in the last few years. SBRT allows the hypofractionated treatment of extra cranial tumors, using either a single or limited number of dose fractions, and resulting in the delivery of a high biological effective dose with low toxicity. Material and methods SBRT requires a high level of accuracy for all phases of the treatment process: effective patient immobilization, precise target localization, highly conformed dosimetry and image guided systems for treatment verification. The implementation of SBRT in routine requires a careful considering of organ motion. Gating and tracking are effective ways to do so, and less invasive technologies “fiducials free” have been developed. Due to the hypofractionated scheme, the physician must pay attention to new dosimetric constraints in organ at risk and new radiobiological models are needed to assess the optimal fractionation and dose schemes. Results Currently, SBRT is safe and effective to treat primary tumors, which are otherwise untreatable with conventional radiotherapy or surgery. SBRT has quickly developed because of its excellent results in terms of tolerance and its high locoregional control rates. SBRT indications in primary tumors, such as lung primary tumors, have become a standard of care for inoperable patients. SBRT seems to be effective in many others indications in curative or palliative intent such as liver primary tumors, and novel indications and strategies are currently emerging in prostate cancer, head and neck tumor recurrences or pelvis reirradiations. Conclusion Currently, SBRT is mainly used when there is no other therapeutic alternative for the patient. This is due to the lack of randomized trials in these settings. However, the results shown in retrospective studies let us hope to impose SBRT as a new standard of care for many patients in the next few years. PMID

  5. Monitoring of corrosion damage using high-frequency guided ultrasonic waves

    NASA Astrophysics Data System (ADS)

    Chew, D.; Fromme, P.

    2014-03-01

    Due to adverse environmental conditions corrosion can develop during the life cycle of industrial structures, e.g., offshore oil platforms, ships, and desalination plants. Both pitting corrosion and generalized corrosion leading to wall thickness loss can cause the degradation of the integrity and load bearing capacity of the structure. Structural health monitoring of corrosion damage in difficult to access areas can in principle be achieved using high frequency guided waves propagating along the structure from accessible areas. Using standard ultrasonic transducers with single sided access to the structure, high frequency guided wave modes were generated that penetrate through the complete thickness of the structure. Wall thickness reduction was induced using accelerated corrosion in a salt water bath. The corrosion damage was monitored based on the effect on the wave propagation and interference of the different modes. The change in the wave interference was quantified based on an analysis in the frequency domain (Fourier transform) and was found to match well with theoretical predictions for the wall thickness loss. High frequency guided waves have the potential for corrosion damage monitoring at critical and difficult to access locations from a stand-off distance.

  6. Monitoring of corrosion damage using high-frequency guided ultrasonic waves

    NASA Astrophysics Data System (ADS)

    Chew, D.; Fromme, P.

    2015-03-01

    Due to adverse environmental conditions corrosion can develop during the life cycle of industrial structures, e.g., offshore oil platforms, ships, and desalination plants. Both pitting corrosion and generalized corrosion leading to wall thickness loss can cause the degradation of the integrity and load bearing capacity of the structure. Structural health monitoring of corrosion damage in difficult to access areas can in principle be achieved using high frequency guided waves propagating along the structure from accessible areas. Using standard ultrasonic transducers with single sided access to the structure, high frequency guided wave modes were generated that penetrate through the complete thickness of the structure. Wall thickness reduction was induced using accelerated corrosion in a salt water bath. The corrosion damage was monitored based on the effect on the wave propagation and interference of the different modes. The change in the wave interference was quantified based on an analysis in the frequency domain (Fourier transform) and was found to match well with theoretical predictions for the wall thickness loss. High frequency guided waves have the potential for corrosion damage monitoring at critical and difficult to access locations from a stand-off distance.

  7. Dimeric CRISPR RNA-guided FokI nucleases for highly specific genome editing.

    PubMed

    Tsai, Shengdar Q; Wyvekens, Nicolas; Khayter, Cyd; Foden, Jennifer A; Thapar, Vishal; Reyon, Deepak; Goodwin, Mathew J; Aryee, Martin J; Joung, J Keith

    2014-06-01

    Monomeric CRISPR-Cas9 nucleases are widely used for targeted genome editing but can induce unwanted off-target mutations with high frequencies. Here we describe dimeric RNA-guided FokI nucleases (RFNs) that can recognize extended sequences and edit endogenous genes with high efficiencies in human cells. RFN cleavage activity depends strictly on the binding of two guide RNAs (gRNAs) to DNA with a defined spacing and orientation substantially reducing the likelihood that a suitable target site will occur more than once in the genome and therefore improving specificities relative to wild-type Cas9 monomers. RFNs guided by a single gRNA generally induce lower levels of unwanted mutations than matched monomeric Cas9 nickases. In addition, we describe a simple method for expressing multiple gRNAs bearing any 5' end nucleotide, which gives dimeric RFNs a broad targeting range. RFNs combine the ease of RNA-based targeting with the specificity enhancement inherent to dimerization and are likely to be useful in applications that require highly precise genome editing. PMID:24770325

  8. High-frequency guided ultrasonic waves for hidden defect detection in multi-layered aircraft structures.

    PubMed

    Masserey, Bernard; Raemy, Christian; Fromme, Paul

    2014-09-01

    Aerospace structures often contain multi-layered metallic components where hidden defects such as fatigue cracks and localized disbonds can develop, necessitating non-destructive testing. Employing standard wedge transducers, high frequency guided ultrasonic waves that penetrate through the complete thickness were generated in a model structure consisting of two adhesively bonded aluminium plates. Interference occurs between the wave modes during propagation along the structure, resulting in a frequency dependent variation of the energy through the thickness with distance. The wave propagation along the specimen was measured experimentally using a laser interferometer. Good agreement with theoretical predictions and two-dimensional finite element simulations was found. Significant propagation distance with a strong, non-dispersive main wave pulse was achieved. The interaction of the high frequency guided ultrasonic waves with small notches in the aluminium layer facing the sealant and on the bottom surface of the multilayer structure was investigated. Standard pulse-echo measurements were conducted to verify the detection sensitivity and the influence of the stand-off distance predicted from the finite element simulations. The results demonstrated the potential of high frequency guided waves for hidden defect detection at critical and difficult to access locations in aerospace structures from a stand-off distance. PMID:24856653

  9. Guided Growth of Horizontal ZnSe Nanowires and their Integration into High-Performance Blue-UV Photodetectors.

    PubMed

    Oksenberg, Eitan; Popovitz-Biro, Ronit; Rechav, Katya; Joselevich, Ernesto

    2015-07-15

    Perfectly aligned horizontal ZnSe nano-wires are obtained by guided growth, and easily integrated into high-performance blue-UV photodetectors. Their crystal phase and crystallographic orientation are controlled by the epitaxial relations with six different sapphire planes. Guided growth paves the way for the large-scale integration of nanowires into optoelectronic devices. PMID:26011601

  10. 48 CFR 570.117-2 - Guiding principles for federal leadership in high performance and sustainable buildings.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 4 2011-10-01 2011-10-01 false Guiding principles for federal leadership in high performance and sustainable buildings. 570.117-2 Section 570.117-2 Federal... LEASEHOLD INTERESTS IN REAL PROPERTY General 570.117-2 Guiding principles for federal leadership in...

  11. 48 CFR 570.117-2 - Guiding principles for federal leadership in high performance and sustainable buildings.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 48 Federal Acquisition Regulations System 4 2012-10-01 2012-10-01 false Guiding principles for federal leadership in high performance and sustainable buildings. 570.117-2 Section 570.117-2 Federal... LEASEHOLD INTERESTS IN REAL PROPERTY General 570.117-2 Guiding principles for federal leadership in...

  12. 48 CFR 570.117-2 - Guiding principles for federal leadership in high performance and sustainable buildings.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 4 2014-10-01 2014-10-01 false Guiding principles for federal leadership in high performance and sustainable buildings. 570.117-2 Section 570.117-2 Federal... LEASEHOLD INTERESTS IN REAL PROPERTY General 570.117-2 Guiding principles for federal leadership in...

  13. 48 CFR 570.117-2 - Guiding principles for federal leadership in high performance and sustainable buildings.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 48 Federal Acquisition Regulations System 4 2013-10-01 2013-10-01 false Guiding principles for federal leadership in high performance and sustainable buildings. 570.117-2 Section 570.117-2 Federal... LEASEHOLD INTERESTS IN REAL PROPERTY General 570.117-2 Guiding principles for federal leadership in...

  14. Acceptance testing prone stereotactic breast biopsy units.

    PubMed

    Kimme-Smith, C; Solberg, T

    1994-07-01

    When the Mammography Quality Standards Act becomes law in October, 1994, stereotactic breast biopsy units may require yearly physicist calibration. Upright stereotactic units can be easily tested using conventional mammography procedures and a gelatin phantom containing simulated calcifications, but prone units are difficult to assess because of the under-table tube configuration. The two current manufacturers of these units have made different design decisions which affect each unit's calibration. There are a number of important distinctions between screening and prone biopsy units. For the two currently available prone units, a pronounced heel effect makes ion chamber position critical. Focal spot measurements are particularly difficult on one unit because there is no light field. The fixed grid on the other unit must be tested with a flood film. Physicists who inspect these units before their clinical use should be aware of variations needed by this equipment for specific acceptance tests. PMID:7968854

  15. Stereotactic catheter placement for Ommaya reservoirs.

    PubMed

    Kennedy, Benjamin C; Brown, Lauren T; Komotar, Ricardo J; McKhann, Guy M

    2016-05-01

    Ommaya reservoirs are an important surgical therapy for the chronic intrathecal administration of chemotherapy for patients with leptomeningeal carcinomatosis. Surgical accuracy is paramount in these patients with typically normal sized ventricles, and may be improved with stereotactic guidance. This paper aimed to review a large series of stereotactic Ommaya catheter placements, examining accuracy and complications. We conducted a retrospective review of 109 consecutive adult patients who underwent stereotactic Ommaya catheter placement for leptomeningeal carcinomatosis or central nervous system lymphoma at Columbia University Medical Center, USA, from 1998-2013. The rate of accurate placement in the ventricular system was 99%, with the only poor catheter position due to post-placement migration. The rate of peri-operative complications was 6.4%. Hemorrhagic complications occurred in patients with thrombocytopenia or therapeutic anti-coagulation pre-operatively or during the post-operative period. Use of stereotaxy for catheter placement of Ommaya reservoirs is safe and effective, and should be considered when placing a catheter into non-hydrocephalic ventricles. PMID:26778516

  16. Magnetic resonance-guided high-intensity focused ultrasound (MR-HIFU) ablation of liver tumours

    PubMed Central

    Bartels, L.W.; Deckers, R.; Ries, M.; Mali, W.P.Th.M.; Moonen, C.T.W.; van den Bosch, M.A.A.J.

    2012-01-01

    Abstract Recent decades have seen a paradigm shift in the treatment of liver tumours from invasive surgical procedures to minimally invasive image-guided ablation techniques. Magnetic resonance-guided high-intensity focused ultrasound (MR-HIFU) is a novel, completely non-invasive ablation technique that has the potential to change the field of liver tumour ablation. The image guidance, using MR imaging and MR temperature mapping, provides excellent planning images and real-time temperature information during the ablation procedure. However, before clinical implementation of MR-HIFU for liver tumour ablation is feasible, several organ-specific challenges have to be addressed. In this review we discuss the MR-HIFU ablation technique, the liver-specific challenges for MR-HIFU tumour ablation, and the proposed solutions for clinical translation. PMID:23022541

  17. Construction of a high-tech operating room for image-guided surgery using VR.

    PubMed

    Suzuki, Naoki; Hattori, Asaki; Suzuki, Shigeyuki; Otake, Yoshito; Hayashibe, Mitsuhiro; Kobayashi, Susumu; Nezu, Takehiko; Sakai, Haruo; Umezawa, Yuji

    2005-01-01

    This project aimed to construct an operating room to implement high dimensional (3D, 4D) medical imaging and medical virtual reality techniques that would enable clinical tests for new surgical procedures. We designed and constructed such an operating room at Dai-san Hospital, the Jikei Univ. School of Medicine, Tokyo, Japan. The room was equipped with various facilities for image-guided, robot and tele- surgery. In this report, we describe an outline of our "high-tech operating room" and future plans. PMID:15718793

  18. Problems Involved in an Emergency Method of Guiding a Gliding Vehicle from High Altitudes to a High Key Position

    NASA Technical Reports Server (NTRS)

    Jewel, Joseph W., Jr.; Whitten, James B.

    1960-01-01

    An investigation has been conducted to determine the problems involved in an emergency method of guiding a gliding vehicle from high altitudes to a high key position (initial position) above a landing field. A jet airplane in a simulated flameout condition, conventional ground-tracking radar, and a scaled wire for guidance programming on the radar plotting board were used in the tests. Starting test altitudes varied from 30,000 feet to 46,500 feet, and starting positions ranged 8.4 to 67 nautical miles from the high key. Specified altitudes of the high key were 12,000, 10,000 or 4,000 feet. Lift-drag ratios of the aircraft of either 17, 16, or 6 were held constant during any given flight; however, for a few flights the lift-drag ratio was varied from 11 to 6. Indicated airspeeds were held constant at either 160 or 250 knots. Results from these tests indicate that a gliding vehicle having a lift-drag ratio of 16 and an indicated approach speed of 160 knots can be guided to within 800 feet vertically and 2,400 feet laterally of a high key position. When the lift-drag ratio of the vehicle is reduced to 6 and the indicated approach speed is raised to 250 knots, the radar controller was able to guide the vehicle to within 2,400 feet vertically and au feet laterally of the high key. It was also found that radar stations which give only azimuth-distance information could control the glide path of a gliding vehicle as well as stations that receive azimuth-distance-altitude information, provided that altitude information is supplied by the pilot.

  19. Image guided surgery in the management of craniocerebral gunshot injuries

    PubMed Central

    Elserry, Tarek; Anwer, Hesham; Esene, Ignatius Ngene

    2013-01-01

    Background: A craniocerebral trauma caused by firearms is a complex injury with high morbidity and mortality. One of the most intriguing and controversial part in their management in salvageable patients is the decision to remove the bullet/pellet. A bullet is foreign to the brain and, in principle, should be removed. Surgical options for bullet extraction span from conventional craniotomy, through C-arm-guided surgery to minimally invasive frame or frameless stereotaxy. But what is the best surgical option? Methods: We prospectively followed up a cohort of 28 patients with cranio-cerebral gunshot injury (CCHSI) managed from January to December 2012 in our department of neurosurgery. The missiles were extracted via stereotaxy (frame or frameless), C-arm-guided, or free-hand-based surgery. Cases managed conservatively were excluded. The Glasgow Outcome Score was used to assess the functional outcome on discharge. Results: Five of the eight “stereotactic cases” had an excellent outcome after missile extraction while the initially planned stereotaxy missed locating the missile in three cases and were thus subjected to free hand craniotomy. Excellent outcome was obtained in five of the nine “neuronavigation cases, five of the eight cases for free hand surgery based on the bony landmarks, and five of the six C-arm-based surgery. Conclusion: Conventional craniotomy isn’t indicated in the extraction of isolated, retained, intracranial firearm missiles in civilian injury but could be useful when the missile is incorporated within a surgical lesion. Stereotactic surgery could be useful for bullet extraction, though with limited precision in identifying small pellets because of their small sizes, thus exposing patients to same risk of brain insult when retrieving a missile by conventional surgery. Because of its availability, C-arm-guided surgery continues to be of much benefit, especially in emergency situations. We recommend an extensive long-term study of these

  20. Toxicity and outcomes of thoracic re-irradiation using stereotactic body radiation therapy (SBRT)

    PubMed Central

    2013-01-01

    Background Patients treated for a thoracic malignancy carry a significant risk of developing other lung lesions. Locoregional control of intrathoracic recurrences is challenging due to the impact of prior therapies on normal tissues. We examined the safety and efficacy of thoracic re-irradiation using high-precision image-guided stereotactic body radiation therapy (SBRT). Methods Records of 39 patients with prior intra-thoracic conventionally fractionated radiation therapy (RT) who underwent SBRT for a subsequent primary, recurrent or metastatic lung tumor from 11/2004 to 7/2011 were retrospectively reviewed. Results Median dose of prior RT was 61 Gy (range 30–80 Gy). Median biologically effective prescription dose (α/β = 10) (BED10) of SBRT was 70.4 Gy (range 42.6-180 Gy). With a median followup of 12.6 months among survivors, 1- and 2-year actuarial local progression-free survival (LPFS) were 77% and 64%, respectively. Median recurrence-free (RFS) and overall survival (OS) were 13.8 and 22.0 months, respectively. Patients without overlap of high-dose regions of the primary and re-irradiation plans were more likely to receive a BED10 ≥100 Gy, which was associated with higher LPFS (hazard ratio, [HR] = 0.18, p = 0.04), RFS ([HR] = 0.31, p = 0.038) and OS ([HR] = 0.25, p = 0.014). Grade 2 and 3 pulmonary toxicity was observed in 18% and 5% of patients, respectively. Other grade 2–4 toxicities included chest wall pain in 18%, fatigue in 15% and skin toxicity in 5%. No grade 5 events occurred. Conclusions SBRT can be safely and successfully administered to patients with prior thoracic RT. Dose reduction for cases with direct overlap of successive radiation fields results in acceptable re-treatment toxicity profile. PMID:23617949

  1. Dosimetric verification of stereotactic radiosurgery/stereotactic radiotherapy dose distributions using Gafchromic EBT3

    SciTech Connect

    Cusumano, Davide; Fumagalli, Maria L.; Marchetti, Marcello; Fariselli, Laura; De Martin, Elena

    2015-10-01

    Aim of this study is to examine the feasibility of using the new Gafchromic EBT3 film in a high-dose stereotactic radiosurgery and radiotherapy quality assurance procedure. Owing to the reduced dimensions of the involved lesions, the feasibility of scanning plan verification films on the scanner plate area with the best uniformity rather than using a correction mask was evaluated. For this purpose, signal values dispersion and reproducibility of film scans were investigated. Uniformity was then quantified in the selected area and was found to be within 1.5% for doses up to 8 Gy. A high-dose threshold level for analyses using this procedure was established evaluating the sensitivity of the irradiated films. Sensitivity was found to be of the order of centiGray for doses up to 6.2 Gy and decreasing for higher doses. The obtained results were used to implement a procedure comparing dose distributions delivered with a CyberKnife system to planned ones. The procedure was validated through single beam irradiation on a Gafchromic film. The agreement between dose distributions was then evaluated for 13 patients (brain lesions, 5 Gy/die prescription isodose ~80%) using gamma analysis. Results obtained using Gamma test criteria of 5%/1 mm show a pass rate of 94.3%. Gamma frequency parameters calculation for EBT3 films showed to strongly depend on subtraction of unexposed film pixel values from irradiated ones. In the framework of the described dosimetric procedure, EBT3 films proved to be effective in the verification of high doses delivered to lesions with complex shapes and adjacent to organs at risk.

  2. Stereotactic radiotherapy for malignancies involving the trigeminal and facial nerves.

    PubMed

    Cuneo, K C; Zagar, T M; Brizel, D M; Yoo, D S; Hoang, J K; Chang, Z; Wang, Z; Yin, F F; Das, S K; Green, S; Ready, N; Bhatti, M T; Kaylie, D M; Becker, A; Sampson, J H; Kirkpatrick, J P

    2012-06-01

    Involvement of a cranial nerve caries a poor prognosis for many malignancies. Recurrent or residual disease in the trigeminal or facial nerve after primary therapy poses a challenge due to the location of the nerve in the skull base, the proximity to the brain, brainstem, cavernous sinus, and optic apparatus and the resulting complex geometry. Surgical resection caries a high risk of morbidity and is often not an option for these patients. Stereotactic radiosurgery and radiotherapy are potential treatment options for patients with cancer involving the trigeminal or facial nerve. These techniques can deliver high doses of radiation to complex volumes while sparing adjacent critical structures. In the current study, seven cases of cancer involving the trigeminal or facial nerve are presented. These patients had unresectable recurrent or residual disease after definitive local therapy. Each patient was treated with stereotactic radiation therapy using a linear accelerator based system. A multidisciplinary approach including neuroradiology and surgical oncology was used to delineate target volumes. Treatment was well tolerated with no acute grade 3 or higher toxicity. One patient who was reirradiated experienced cerebral radionecrosis with mild symptoms. Four of the seven patients treated had no evidence of disease after a median follow up of 12 months (range 2-24 months). A dosimetric analysis was performed to compare intensity modulated fractionated stereotactic radiation therapy (IM-FSRT) to a 3D conformal technique. The dose to 90% (D90) of the brainstem was lower with the IM-FSRT plan by a mean of 13.5 Gy. The D95 to the ipsilateral optic nerve was also reduced with IM-FSRT by 12.2 Gy and the D95 for the optic chiasm was lower with FSRT by 16.3 Gy. Treatment of malignancies involving a cranial nerve requires a multidisciplinary approach. Use of an IM-FSRT technique with a micro-multileaf collimator resulted in a lower dose to the brainstem, optic nerves and chiasm

  3. Robust frameless stereotactic localization in extra-cranial radiotherapy

    SciTech Connect

    Riboldi, Marco; Baroni, Guido; Spadea, Maria Francesca; Bassanini, Fabio; Tagaste, Barbara; Garibaldi, Cristina; Orecchia, Roberto; Pedotti, Antonio

    2006-04-15

    In the field of extra-cranial radiotherapy, several inaccuracies can make the application of frameless stereotactic localization techniques error-prone. When optical tracking systems based on surface fiducials are used, inter- and intra-fractional uncertainties in marker three-dimensional (3D) detection may lead to inexact tumor position estimation, resulting in erroneous patient setup. This is due to the fact that external fiducials misdetection results in deformation effects that are poorly handled in a rigid-body approach. In this work, the performance of two frameless stereotactic localization algorithms for 3D tumor position reconstruction in extra-cranial radiotherapy has been specifically tested. Two strategies, unweighted versus weighted, for stereotactic tumor localization were examined by exploiting data coming from 46 patients treated for extra-cranial lesions. Measured isocenter displacements and rotations were combined to define isocentric procedures, featuring 6 degrees of freedom, for correcting patient alignment (isocentric positioning correction). The sensitivity of the algorithms to uncertainties in the 3D localization of fiducials was investigated by means of 184 numerical simulations. The performance of the implemented isocentric positioning correction was compared to conventional point-based registration. The isocentric positioning correction algorithm was tested on a clinical dataset of inter-fractional and intra-fractional setup errors, which was collected by means of an optical tracker on the same group of patients. The weighted strategy exhibited a lower sensitivity to fiducial localization errors in simulated misalignments than those of the unweighted strategy. Isocenter 3D displacements provided by the weighted strategy were consistently smaller than those featured by the unweighted strategy. The peak decrease in median and quartile values of isocenter 3D displacements were 1.4 and 2.7 mm, respectively. Concerning clinical data, the

  4. Stereotactic radiotherapy of meningiomas compressing optical pathways

    SciTech Connect

    Hamm, Klaus-Detlef . E-mail: khamm@erfurt.helios-kliniken.de; Henzel, Martin; Gross, Markus W.; Surber, Gunnar; Kleinert, Gabriele; Engenhart-Cabillic, Rita

    2006-11-15

    Purpose: Microsurgical resection is usually the treatment of choice for meningiomas, especially for those that compress the optical pathways. However, in many cases of skull-base meningiomas a high risk of neurological deficits and recurrences exist in cases where the complete tumor removal was not possible. In such cases (fractionated) stereotactic radiotherapy (SRT) can offer an alternative treatment option. We evaluated the local control rate, symptomatology, and toxicity. Patients and Methods: Between 1997 and 2003, 183 patients with skull-base meningiomas were treated with SRT, among them were 65 patients with meningiomas that compressed optical pathways (64 benign, 1 atypical). Of these 65 cases, 20 were treated with SRT only, 27 were subtotally resected before SRT, and 18 underwent multiple tumor resections before SRT. We investigated the results until 2005, with a median follow-up of 45 months (range, 22-83 months). The tumor volume (TV = gross tumor volume) ranged from 0.61 to 90.20 cc (mean, 18.9 cc). Because of the risk of new visual disturbances, the dose per fraction was either 2 or 1.8 Gy for all patients, to a total dose of 50 to 60 Gy. Results: The overall survival and the progression-free survival rates for 5 years were assessed to 100% in this patient group. To date, no progression for these meningiomas have been observed. Quantitatively, tumor shrinkage of more than 20%, or more than 2 mm in diameter, was proved in 35 of the 65 cases after SRT. In 29 of the 65 patients, at least 1 of the symptoms improved. On application of the Common Toxicity Criteria (CTC), acute toxicity (Grade 3) was seen in 1 case (worsening of conjunctivitis). Another 2 patients developed late toxicity by LENT-SOMA score, 1 x Grade 1 and 1 x Grade 3 (field of vision loss). Conclusion: As a low-risk and effective treatment option for tumor control, SRT with 1.8 to 2.0 Gy per fraction can also be recommended in case of meningiomas that compress optical pathways. An

  5. Using problem based learning and guided inquiry in a high school acid-base chemistry unit

    NASA Astrophysics Data System (ADS)

    McKinley, Katie

    The purpose of this investigation was to determine if incorporating problem based learning and guided inquiry would improve student achievement in an acid base unit for high school chemistry. The activities and labs in the unit were modified to be centered around the problem of a fish kill that students investigated. Students also participated in guided inquiry labs to increase the amount of critical thinking and problem solving being done in the classroom. The hypothesis was that the implementation of problem based learning and guided inquiry would foster student learning. Students took a pre-test and post-test on questions covering the objectives of the acid base unit. These assessments were compared to determine the effectiveness of the unit. The results indicate that the unit was effective in increasing student performance on the unit test. This study also analyzed the process of problem based learning. Problem based learning can be an effective method of engaging students in inquiry. However, designing an effective problem based learning unit requires careful design of the problem and enough structure to assure students learn the intended content.

  6. Advances in MR image-guided high-intensity focused ultrasound therapy.

    PubMed

    Kim, Young-sun

    2015-05-01

    The clinical role of magnetic resonance image-guided high-intensity focused ultrasound (MR-HIFU) is rapidly expanding due to its merit of non-invasiveness. MR thermometry based on a proton resonance frequency shift technique is able to accurately measure HIFU-induced temperature changes, which provides considerable advantages over ultrasonography-guided HIFU in terms of safety and therapeutic efficacy. Recent studies and the resulting technological advances in MR-HIFU such as MR thermometry for moving organs, MR-acoustic radiation force imaging, and a volumetric mild hyperthermia technique further will expand its clinical roles from mere ablation therapy to targeted drug delivery and chemo- or radio-sensitisation for cancer treatment. In this article, MR-HIFU therapy is comprehensively reviewed with an emphasis on the roles of MR imaging in HIFU therapy, techniques of MR monitoring, recent advances in clinical MR-HIFU systems, and potential future applications of MR-HIFU therapy. In addition, the pros and cons of MR-HIFU when compared with ultrasonography-guided HIFU are discussed. PMID:25373687

  7. [Brain radiation necrosis after stereotactic radiotherapy of the resection cavity for intracranial metastases: analysis of the literature from four cases].

    PubMed

    Doré, M; Lefebvre, L; Delpon, G; Thillays, F

    2015-04-01

    Stereotactic hypofractionated radiotherapy after resection of brain metastasis is an alternative to whole brain radiotherapy. A high dose per fraction is associated with a risk of radiation necrosis. We present four cases of confirmed histological radiation necrosis. Differentiating recurrent tumour from radiation necrosis in this scenario is challenging. An enhancing area in magnetic resonance imaging (MRI) with a "cut bell pepper" appearance may suggest radiation necrosis. Advanced imaging modalities such as perfusion MR imaging and positron emission tomography can be useful. Dosimetric predictors of the occurrence of radiation necrosis after stereotactic hypofractionated radiotherapy are poorly understood and require prospective studies on larger cohorts. PMID:25573799

  8. Single fraction multimodal image guided focal salvage high-dose-rate brachytherapy for recurrent prostate cancer

    PubMed Central

    Rischke, Hans-Christian; Meyer, Philipp Tobias; Knobe, Sven; Volgeova-Neher, Natalja; Kollefrath, Michael; Jilg, Cordula Annette; Grosu, Anca Ligia; Baltas, Dimos; Kroenig, Malte

    2016-01-01

    Purpose We present a novel method for treatment of locally recurrent prostate cancer (PCa) following radiation therapy: focal, multimodal image guided high-dose-rate (HDR) brachytherapy. Material and methods We treated two patients with recurrent PCa after primary (#1) or adjuvant (#2) external beam radiation therapy. Multiparametric magnetic resonance imaging (mpMRI), choline, positron emission tomography combined with computed tomography (PET/CT), or prostate-specific membrane antigen (PSMA)-PET combined with CT identified a single intraprostatic lesion. Positron emission tomography or magnetic resonance imaging – transrectal ultrasound (MRI-TRUS) fusion guided transperineal biopsy confirmed PCa within each target lesion. We defined a PET and mpMRI based gross tumor volume (GTV). A 5 mm isotropic margin was applied additionally to each lesion to generate a planning target volume (PTV), which accounts for technical fusion inaccuracies. A D90 of 18 Gy was intended in one fraction to each PTV using ultrasound guided HDR brachytherapy. Results Six month follow-up showed adequate prostate specific antygen (PSA) decline in both patients (ΔPSA 83% in patient 1 and ΔPSA 59.3% in patient 2). Follow-up 3-tesla MRI revealed regressive disease in both patients and PSMA-PET/CT showed no evidence of active disease in patient #1. No acute or late toxicities occurred. Conclusions Single fraction, focal, multimodal image guided salvage HDR brachytherapy for recurrent prostate cancer is a feasible therapy for selected patients with single lesions. This approach has to be evaluated in larger clinical trials. PMID:27504134

  9. Femtosecond laser guiding of a high-voltage discharge and the restoration of dielectric strength in air and nitrogen

    SciTech Connect

    Leonov, S. B.; Firsov, A. A.; Shurupov, M. A.; Michael, J. B.; Shneider, M. N.; Miles, R. B.; Popov, N. A.

    2012-12-15

    The use of a low energy, high peak intensity (>100 TW/cm{sup 2}) femtosecond laser pulse is investigated for guiding and control of a sub-microsecond high voltage discharge. Study of the laser induced plasma channel and measurements of the field required for breakdown in air and nitrogen at atmospheric pressure are presented. Direct imaging of the dynamics of the discharge breakdown shows effective laser guiding. The effectiveness of laser guiding is shown to be critically dependent on the laser focusing geometry, timing, and location relative to the electrodes.

  10. Femtosecond laser guiding of a high-voltage discharge and the restoration of dielectric strength in air and nitrogen

    NASA Astrophysics Data System (ADS)

    Leonov, S. B.; Firsov, A. A.; Shurupov, M. A.; Michael, J. B.; Shneider, M. N.; Miles, R. B.; Popov, N. A.

    2012-12-01

    The use of a low energy, high peak intensity (>100 TW/cm2) femtosecond laser pulse is investigated for guiding and control of a sub-microsecond high voltage discharge. Study of the laser induced plasma channel and measurements of the field required for breakdown in air and nitrogen at atmospheric pressure are presented. Direct imaging of the dynamics of the discharge breakdown shows effective laser guiding. The effectiveness of laser guiding is shown to be critically dependent on the laser focusing geometry, timing, and location relative to the electrodes.

  11. Electrical/Electronic Technology (Energy/Power). Industrial Arts, Senior High--Level II. North Dakota Senior High Industrial Arts Curriculum Guides.

    ERIC Educational Resources Information Center

    Lawrence, Allen; And Others

    This course guide for an electrical/electronic technology course is one of four developed for the energy/power area in the North Dakota senior high industrial arts education program. (Eight other guides are available for two other areas of Industrial Arts--graphic communications and production.) Part 1 provides such introductory information as a…

  12. Inception of a national multidisciplinary registry for stereotactic radiosurgery.

    PubMed

    Sheehan, Jason P; Kavanagh, Brian D; Asher, Anthony; Harbaugh, Robert E

    2016-01-01

    Stereotactic radiosurgery (SRS) represents a multidisciplinary approach to the delivery of ionizing high-dose radiation to treat a wide variety of disorders. Much of the radiosurgical literature is based upon retrospective single-center studies along with a few randomized controlled clinical trials. More timely and effective evidence is needed to enhance the consistency and quality of and clinical outcomes achieved with SRS. The authors summarize the creation and implementation of a national SRS registry. The American Association of Neurological Surgeons (AANS) through NeuroPoint Alliance, Inc., started a successful registry effort with its lumbar spine initiative. Following a similar approach, the AANS and NeuroPoint Alliance collaborated with corporate partners and the American Society for Radiation Oncology to devise a data dictionary for an SRS registry. Through administrative and financial support from professional societies and corporate partners, a framework for implementation of the registry was created. Initial plans were devised for a 3-year effort encompassing 30 high-volume SRS centers across the country. Device-specific web-based data-extraction platforms were built by the corporate partners. Data uploaders were then used to port the data to a common repository managed by Quintiles, a national and international health care trials company. Audits of the data for completeness and veracity will be undertaken by Quintiles to ensure data fidelity. Data governance and analysis are overseen by an SRS board comprising equal numbers of representatives from the AANS and NeuroPoint Alliance. Over time, quality outcome assessments and post hoc research can be performed to advance the field of SRS. Stereotactic radiosurgery offers a high-technology approach to treating complex intracranial disorders. Improvements in the consistency and quality of care delivered to patients who undergo SRS should be afforded by the national registry effort that is underway. PMID

  13. Exploration of the horizontally staggered light guides for high concentration CPV applications.

    PubMed

    Selimoglu, Ozgur; Turan, Rasit

    2012-08-13

    The material and processing costs are still the major drawbacks of the c-Si based photovoltaic (PV) technology. The wafer cost comprises up to 35-40% of the total module cost. New approaches and system designs are needed in order to reduce the share of the wafer cost in photovoltaic energy systems. Here we explore the horizontally staggered light guide solar optics for use in Concentrated Photovoltaic (CPV) applications. This optical system comprises a lens array system coupled to a horizontal light guide which directs the incoming light beam to its edge. We have designed and simulated this system using a commercial ray tracing software (Zemax). The system is more compact, thinner and more robust compared to the conventional CPV systems. Concentration levels as high as 1000x can easily be reached when the system is properly designed. With such a high concentration level, a good acceptance angle of + -1 degree is still be conserved. The analysis of the system reveals that the total optical efficiency of the system could be as high as %94.4 without any anti-reflection (AR) coating. Optical losses can be reduced by just accommodating a single layer AR coating on the initial lens array leading to a %96.5 optical efficiency. Thermal behavior of high concentration linear concentrator is also discussed and compared with a conventional point focus CPV system. PMID:23038554

  14. Application of stereotactic body radiation therapy to cancer liver metastasis.

    PubMed

    Zhang, Si-Yuan; Zhu, Guang-Ying; Li, Gong; Zhang, Yi-Bao; Geng, Jian-Hao

    2016-09-01

    As an accurate external beam irradiation method, stereotactic body radiotherapy (SBRT) has been increasingly used to deliver high dose in less fractions. The liver is one of the most common organs for cancer metastasis. Recently, there have been several trials applying SBRT to cancer liver metastasis and have proved to be effective and safe with local control (LC) rates ranging from 70% to 100% within one or two years and 2-year overall survival (OS) rates ranging from 30% to 38%. Many published studies indicate that SBRT for cancer liver metastasis results in good outcomes without severe toxicities. However, the validated contribution of SBRT to an improved progression-free survival is still missing and more randomized trials should be conducted. PMID:26704306

  15. Stereotactic microresection of small cerebral vascular malformations (SCVM).

    PubMed

    Lerch, K D; Schaefer, D; Palleske, H

    1994-01-01

    Between 1988-1993 we performed CT-stereotactic guided microsurgical resection as a one-session-procedure in 46 patients bearing small (< 30 mm) cerebral vascular malformations (SCVM). The location of the SCVM was deep subcortical in 38 patients, temporal medio- basal in 3 and brainstem in 5. The surgical technique intended to minimise invasiveness by reducing the operative approach to a size less than the diameter of the lesion concerned. The mean diameter of our SCVM's was 20 mm ranging from 10 to 30 mm. Histologically we found 23 arteriovenous malformations, 22 cavernous malformations and 1 capillary telangiectasia (capillary malformation). Clinical symptomatology consisted mainly of seizures, (progressive) neurological deficit and (minute) acute intracerebral bleeding. The SCVMs could be demonstrated by contrast-enhanced CT as well as by MRI. 15 of the AVM's revealed as angiographically occult. Complete microsurgical resection of the SCVM was accomplished in all cases with a surgical morbidity of 6.5% and no operative mortality. In 14 patients, most of them with initial acute intracerebral haemorrhage, the pronounced focal neurological deficit improved. During the follow-up period (1/2-5 years) no rebleeding occurred. As far as epileptic seizures were concerned 13 patients became seizure-free without anticonvulsants and 11 patients seizure-free with anticonvulsant, in the remaining 4 patients seizures were reduced in frequency. PMID:7725939

  16. Stereotactic guidance for navigated percutaneous sacroiliac joint fusion

    PubMed Central

    Lee, Darrin J.; Kim, Sung-Bum; Rosenthal, Philip; Panchal, Ripul R.; Kim, Kee D.

    2016-01-01

    Abstract Arthrodesis of the sacroiliac joint (SIJ) for surgical treatment of SIJ dysfunction has regained interest among spine specialists. Current techniques described in the literature most often utilize intraoperative fluoroscopy to aid in implant placement; however, image guidance for SIJ fusion may allow for minimally invasive percutaneous instrumentation with more precise implant placement. In the following cases, we performed percutaneous stereotactic navigated sacroiliac instrumentation using O-arm® multidimensional surgical imaging with StealthStation® navigation (Medtronic, Inc. Minneapolis, MN). Patients were positioned prone and an image-guidance reference frame was placed contralateral to the surgical site. O-arm® integrated with StealthStation® allowed immediate auto-registration. The skin incision was planned with an image-guidance probe. An image-guided awl, drill and tap were utilized to choose a starting point and trajectory. Threaded titanium cage(s) packed with autograft and/or allograft were then placed. O-arm® image-guidance allowed for implant placement in the SIJ with a small skin incision. However, we could not track the cage depth position with our current system, and in one patient, the SIJ cage had to be revised secondary to the anterior breach of sacrum.

  17. Composite fan exit guide vanes for high bypass ratio gas turbine engines

    NASA Technical Reports Server (NTRS)

    Blecherman, S. S.; Stankunas, T. N.

    1981-01-01

    Various composite materials were identified for reduced weight applications as fan exit guide vanes in high bypass ratio gas turbine engines. Candidate materials, airfoil geometry and ply orientation were evaluated using NASTRAN finite element analysis. A vane core and shell design approach utilizing several different fiber orientation concepts was selected and variations in bending and torsional stiffness were documented. Material suppliers and airfoil fabricators were selected to provide panels and airfoils which were inspected, environmentally conditioned and tested. Static and dynamic airfoil tests established durability characteristics for a range of composite material/design approaches.

  18. Multi-cm Long High Density Magnetic Plasmas for Optical Guiding

    SciTech Connect

    Pollock, B; Froula, D; Tynan, G; Divol, L; Price, D; Costa, R; Yepiz, F; Fulkerson, S; Mangini, F; Glenzer, S

    2008-05-01

    We present a platform for producing long plasma channels suitable for guiding lasers over several centimeters by applying magnetic fields to limit the radial heat flux from a pre-forming laser beam. The resulting density gradient will be used as an optical plasma waveguide. The plasma conditions have been chosen to be consistent with the requirements for Laser Wakefield Acceleration where multi-GeV electrons are predicted. A detailed description of the system used to produce the high (5 T) magnetic fields and initial results that show a 5 cm long plasma column are discussed.

  19. Image-guided high-dose-rate brachytherapy in inoperable endometrial cancer

    PubMed Central

    Petsuksiri, J; Chansilpa, Y; Hoskin, P J

    2014-01-01

    Inoperable endometrial cancer may be treated with curative aim using radical radiotherapy alone. The radiation techniques are external beam radiotherapy (EBRT) alone, EBRT plus brachytherapy and brachytherapy alone. Recently, high-dose-rate brachytherapy has been used instead of low-dose-rate brachytherapy. Image-guided brachytherapy enables sufficient coverage of tumour and reduction of dose to the organs at risk, thus increasing the therapeutic ratio of treatment. Local control rates with three-dimensional brachytherapy appear better than with conventional techniques (about 90–100% and 70–90%, respectively). PMID:24807067

  20. Correlation of 18F-fluoroethyl tyrosine positron-emission tomography uptake values and histomorphological findings by stereotactic serial biopsy in newly diagnosed brain tumors using a refined software tool

    PubMed Central

    Lopez, William Omar Contreras; Cordeiro, Joacir Graciolli; Albicker, Ulrich; Doostkam, Soroush; Nikkhah, Guido; Kirch, Robert D; Trippel, Michael; Reithmeier, Thomas

    2015-01-01

    Background Magnetic resonance imaging (MRI) is the standard neuroimaging method to diagnose neoplastic brain lesions, as well as to perform stereotactic biopsy surgical planning. MRI has the advantage of providing structural anatomical details with high sensitivity, though histological specificity is limited. Although combining MRI with other imaging modalities, such as positron-emission tomography (PET), has proven to increment specificity, exact correlation between PET threshold uptake ratios (URs) and histological diagnosis and grading has not yet been described. Objectives The aim of this study was to correlate exactly the histopathological criteria of the biopsy site to its PET uptake value with high spatial resolution (mm3), and to analyze the diagnostic value of PET using the amino acid O-(2-[18F]fluoroethyl)-l-tyrosine (18F-FET) PET in patients with newly diagnosed brain lesions in comparison to histological findings obtained from stereotactic serial biopsy. Patients and methods A total of 23 adult patients with newly diagnosed brain tumors on MRI were enrolled in this study. Subsequently to diagnoses, all patients underwent a 18F-FET PET-guided stereotactic biopsy, using an original newly developed software module, which is presented here. Conventional MRI, stereotactic computed tomography series, and 18F-FET PET images were semiautomatically fused, and hot-spot detection was performed for target planning. UR was determined using the uptake value from the biopsy sites in relation to the contralateral frontal white matter. UR values ≥1.6 were considered positive for glioma. High-grade glioma (HGG) was suspected with URs ≥3.0, while low-grade glioma (LGG) was suspected with URs between 1.6 and 3.0. Stereotactic serial biopsies along the trajectory at multiple sites were performed in millimeter steps, and the FET URs for each site were correlated exactly with a panel of 27 different histopathological markers. Comparisons between FET URs along the biopsy

  1. Frameless Angiogram-Based Stereotactic Radiosurgery for Treatment of Arteriovenous Malformations

    SciTech Connect

    Lu Xingqi; Mahadevan, Anand; Mathiowitz, George; Lin, Pei-Jan P.; Thomas, Ajith; Kasper, Ekkehard M.; Floyd, Scott R.; Holupka, Edward; La Rosa, Salvatore; Wang, Frank; Stevenson, Mary Ann

    2012-09-01

    Purpose: Stereotactic radiosurgery (SRS) is an effective alternative to microsurgical resection or embolization for definitive treatment of arteriovenous malformations (AVMs). Digital subtraction angiography (DSA) is the gold standard for pretreatment diagnosis and characterization of vascular anatomy, but requires rigid frame (skull) immobilization when used in combination with SRS. With the advent of advanced proton and image-guided photon delivery systems, SRS treatment is increasingly migrating to frameless platforms, which are incompatible with frame-based DSA. Without DSA as the primary image, target definition may be less than optimal, in some cases precluding the ability to treat with a frameless system. This article reports a novel solution. Methods and Materials: Fiducial markers are implanted into the patient's skull before angiography. Angiography is performed according to the standard clinical protocol, but, in contrast to the previous practice, without the rigid frame. Separate images of a specially designed localizer box are subsequently obtained. A target volume projected on DSA can be transferred to the localizer system in three dimensions, and in turn be transferred to multiple CT slices using the implanted fiducials. Combined with other imaging modalities, this 'virtual frame' approach yields a highly precise treatment plan that can be delivered by frameless SRS technologies. Results: Phantom measurements for point and volume targets have been performed. The overall uncertainty of placing a point target to CT is 0.4 mm. For volume targets, deviation of the transformed contour from the target CT image is within 0.6 mm. The algorithm and software are robust. The method has been applied clinically, with reliable results. Conclusions: A novel and reproducible method for frameless SRS of AVMs has been developed that enables the use of DSA without the requirement for rigid immobilization. Multiple pairs of DSA can be used for better conformality

  2. A Rabbit Irradiation Platform for Outcome Assessment of Lung Stereotactic Radiosurgery

    SciTech Connect

    Cai Jing; Mata, Jaime F.; Orton, Matthew D.; Hagspiel, Klaus D.; Mugler, John P.; Larner, James M.; Sheng Ke; Read, Paul W.

    2009-04-01

    Purpose: To evaluate a helical tomotherapy-based rodent radiosurgery platform that reproduces human image-guided radiosurgery treatment to study radiobiologic effects of stereotactic radiosurgery on lung tissues using functional magnetic resonance imaging (MRI). Methods and Materials: Hypofractionated radisourgery (20 Gy x 3) was delivered to the right lung of three New Zealand rabbits using Helical TomoTherapy with MVCT image guidance. Contrast-enhanced MR perfusion, hyperpolarized helium-3 MR ventilation, and CT were obtained before radiation and monthly for 4 months after radiation. All MRI was performed on a 1.5-T whole-body scanner with broad-band capabilities. Results: Precise dose delivery to 1.6 cc of the lower right lung was achieved without additional immobilization. No deficits were detected at baseline with respect to perfusion and ventilation. Lung perfusion deficits in the irradiated lung regions began at 2 months after radiation and worsened with time. No ventilation deficits were observed after radiation. Decrease in lung CT density in irradiated regions was observed after radiation, but the changes were less significant than those in perfusion MRI. Conclusions: We demonstrated that highly conformal radiation can be reproducibly delivered to a small volume of rodent lung on a widely available clinical unit. The radiation-induced lung injury can be detected as early as 2 months after radiation with perfusion MRI. The primary pattern of injury agrees with previously reported endothelial damage to radiosurgical radiation doses. This experimental design provides a cost-effective methodology for producing radiosurgical injuries in rodents that reproduces current human treatments for studying radiation injury and agents that might affect it.

  3. Stereotactic Body Radiotherapy for Localized Prostate Cancer: Interim Results of a Prospective Phase II Clinical Trial

    SciTech Connect

    King, Christopher R. Brooks, James D.; Gill, Harcharan; Pawlicki, Todd; Cotrutz, Cristian; Presti, Joseph C.

    2009-03-15

    Purpose: The radiobiology of prostate cancer favors a hypofractionated dose regimen. We report results of a prospective Phase II clinical trial of stereotactic body radiotherapy (SBRT) for localized prostate cancer. Methods and Materials: Forty-one low-risk prostate cancer patients with 6 months' minimum follow-up received 36.25 Gy in five fractions of 7.25 Gy with image-guided SBRT alone using the CyberKnife. The early (<3 months) and late (>6 months) urinary and rectal toxicities were assessed using validated quality of life questionnaires (International Prostate Symptom Score, Expanded Prostate Cancer Index Composite) and the Radiation Therapy Oncology Group (RTOG) toxicity criteria. Patterns of prostate-specific antigen (PSA) response are analyzed. Results: The median follow-up was 33 months. There were no RTOG Grade 4 acute or late rectal/urinary complications. There were 2 patients with RTOG Grade 3 late urinary toxicity and none with RTOG Grade 3 rectal complications. A reduced rate of severe rectal toxicities was observed with every-other-day vs. 5 consecutive days treatment regimen (0% vs. 38%, p = 0.0035). A benign PSA bounce (median, 0.4 ng/mL) was observed in 12 patients (29%) occurring at 18 months (median) after treatment. At last follow-up, no patient has had a PSA failure regardless of biochemical failure definition. Of 32 patients with 12 months minimum follow-up, 25 patients (78%) achieved a PSA nadir {<=}0.4 ng/mL. A PSA decline to progressively lower nadirs up to 3 years after treatment was observed. Conclusions: The early and late toxicity profile and PSA response for prostate SBRT are highly encouraging. Continued accrual and follow-up will be necessary to confirm durable biochemical control rates and low toxicity profiles.

  4. Long-Term PSA Control with Repeated Stereotactic Body Radiotherapy in a Patient with Oligometastatic Castration-Resistant Prostate Cancer.

    PubMed

    Pasqualetti, Francesco; Cocuzza, Paola; Coraggio, Gabriele; Ferrazza, Patrizia; Derosa, Lisa; Galli, Luca; Pasqualetti, Giuseppe; Locantore, Luisa; Boni, Roberto; Fabrini, Maria G; Erba, Paola A

    2016-01-01

    Prostate cancer (PCa) is one of the most common malignancies and main causes of cancer death in Western countries. In the presence of metastatic disease, systemic treatment remains the main clinical option. However, since the introduction of highly sensitive imaging techniques, a new clinical 'entity' of metastatic patients with a limited number of lesions has been defined: oligometastatic patients. In this patient group, the use of stereotactic body radiotherapy (SBRT) or other local therapies against all active sites of disease revealed by 18F-choline positron emission tomography/computed tomography (PET/CT) could achieve sufficient prostate-specific antigen (PSA) control. However, a clear benefit of this procedure in terms of significant endpoints is yet to be demonstrated. This case report describes our experience with treating a castration-resistant PCa patient with 18F-choline PET/CT-guided SBRT. Because of the occurrence of 5 metachronous lesions over 4 years, the pattern of recurrence was defined by the local multidisciplinary team as oligometastatic disease, and the patient was treated with 5 courses of SBRT which yielded good PSA control. He started systemic therapy with abiraterone acetate almost 5 years after the diagnosis of recurrent PCa. PMID:27160394

  5. Fluorescence-guided resections and photodynamic therapy for malignant gliomas using 5-aminolevulinic acid

    NASA Astrophysics Data System (ADS)

    Stepp, Herbert G.; Beck, Tobias; Beyer, Wolfgang; Pongratz, Thomas; Sroka, Ronald; Baumgartner, Reinhold; Stummer, Walter; Olzowy, Bernhard; Mehrkens, Jan H.; Tonn, Joerg C.; Reulen, Hans J.

    2005-04-01

    Oral application of 20 mg/kg bw of 5-aminolevulinic acid results in a highly specific accumulation of fluorescent and phototoxic Protoporphyrin IX in malignant glioma tissue. Surgical removal with fluorescence guidance is studied in a phase III clinical trial, adjuvant Photodynamic Therapy (PDT) to the surgical cavity is in phase II and for interstitial PDT of recurrent gliomas, a phase I/II study has started. Fluorescence guided resections have been shown to be safe and effective in augmenting neurosurgical removal of malignant gliomas in 52 consecutive patients. Intra-operative fluorescence spectroscopy showed statistically significant higher sensitizer accumulation in vital brain tumor versus the infiltration zone and in the infiltration zone versus adjacent normal brain, which contained very little PPIX. This is promisingly exploited for PDT - both to the surgical cavity by surface irradiation and for stereotactically guided interstitial irradiation.

  6. High Temperature Shear Horizontal Electromagnetic Acoustic Transducer for Guided Wave Inspection

    PubMed Central

    Kogia, Maria; Gan, Tat-Hean; Balachandran, Wamadeva; Livadas, Makis; Kappatos, Vassilios; Szabo, Istvan; Mohimi, Abbas; Round, Andrew

    2016-01-01

    Guided Wave Testing (GWT) using novel Electromagnetic Acoustic Transducers (EMATs) is proposed for the inspection of large structures operating at high temperatures. To date, high temperature EMATs have been developed only for thickness measurements and they are not suitable for GWT. A pair of water-cooled EMATs capable of exciting and receiving Shear Horizontal (SH0) waves for GWT with optimal high temperature properties (up to 500 °C) has been developed. Thermal and Computational Fluid Dynamic (CFD) simulations of the EMAT design have been performed and experimentally validated. The optimal thermal EMAT design, material selection and operating conditions were calculated. The EMAT was successfully tested regarding its thermal and GWT performance from ambient temperature to 500 °C. PMID:27110792

  7. High Temperature Shear Horizontal Electromagnetic Acoustic Transducer for Guided Wave Inspection.

    PubMed

    Kogia, Maria; Gan, Tat-Hean; Balachandran, Wamadeva; Livadas, Makis; Kappatos, Vassilios; Szabo, Istvan; Mohimi, Abbas; Round, Andrew

    2016-01-01

    Guided Wave Testing (GWT) using novel Electromagnetic Acoustic Transducers (EMATs) is proposed for the inspection of large structures operating at high temperatures. To date, high temperature EMATs have been developed only for thickness measurements and they are not suitable for GWT. A pair of water-cooled EMATs capable of exciting and receiving Shear Horizontal (SH₀) waves for GWT with optimal high temperature properties (up to 500 °C) has been developed. Thermal and Computational Fluid Dynamic (CFD) simulations of the EMAT design have been performed and experimentally validated. The optimal thermal EMAT design, material selection and operating conditions were calculated. The EMAT was successfully tested regarding its thermal and GWT performance from ambient temperature to 500 °C. PMID:27110792

  8. [Stereotactic aspiration of Spirometra mansonides larvae].

    PubMed

    Caballero, Joel; Morales, Losmill; García, Diana; Alarcón, Idelmys; Torres, Anay; Sáez, Gladys

    2015-08-01

    Brain sparganosis is a non-common parasite infection by Diphyllobothrium or Spirometra mansonoides larvae. This last one is responsible for most of the infestations in humans. We report a 19 years male patient bearer of a brain sparganosis. The patient presented with headache and left hemiparesis. CT diagnosis of right thalamic lesions was made and aspiration biopsy was performed using stereotactic system, obtaining a whole and death larvae. Histopathology confirms a CNS parasitism and it was treated initially with albendazol. ELISA test confirmed Spirometra spp. infestation. The patient developed asymptomatic with total remission of the lesions. It constitutes the second report in Cuba of brain sparganosis. PMID:26436792

  9. Stereotactic Body Radiosurgery for Spinal Metastatic Disease: An Evidence-Based Review

    PubMed Central

    Hall, William A.; Stapleford, Liza J.; Hadjipanayis, Costas G.; Curran, Walter J.; Crocker, Ian; Shu, Hui-Kuo G.

    2011-01-01

    Spinal metastasis is a problem that afflicts many cancer patients. Traditionally, conventional fractionated radiation therapy and/or surgery have been the most common approaches for managing such patients. Through technical advances in radiotherapy, high dose radiation with extremely steep drop off can now be delivered to a limited target volume along the spine under image-guidance with very high precision. This procedure, known as stereotactic body radiosurgery, provides a technique to rapidly treat selected spinal metastasis patients with single- or limited-fraction treatments that have similar to superior efficacies compared with more established approaches. This review describes current treatment systems in use to deliver stereotactic body radiosurgery as well as results of some of the larger case series from a number of institutions that report outcomes of patients treated for spinal metastatic disease. These series include nearly 1400 patients and report a cumulative local control rate of 90% with myelopathy risk that is significantly less than 1%. Based on this comprehensive review of the literature, we believe that stereotactic body radiosurgery is an established treatment modality for patients with spinal metastatic disease that is both safe and highly effective. PMID:22312536

  10. Ultrasmall Cu2-x S Nanodots for Highly Efficient Photoacoustic Imaging-Guided Photothermal Therapy.

    PubMed

    Mou, Juan; Li, Pei; Liu, Chengbo; Xu, Huixiong; Song, Liang; Wang, Jin; Zhang, Kun; Chen, Yu; Shi, Jianlin; Chen, Hangrong

    2015-05-20

    Monodisperse, ultrasmall (<5 nm) Cu(2-x)S nanodots (u-Cu(2-x)S NDs) with significantly strong near-infrared absorption and conversion are successfully demonstrated for effective deep-tissue photoacoustic imaging-guided photothermal therapy both in vitro and in vivo. Owing to ultrasmall nanoparticle size and high water dispersibility as well as long stability, such nanodots possess a prolonged circulation in blood and good passive accumulation within tumors through the enhanced permeability and retention effect. These u-Cu(2-x)S NDs have negligible side effects to both blood and normal tissues according to in vivo toxicity evaluations for up to 3 months, showing excellent hemo/histocompatibility. Furthermore, these u-Cu(2-x)S NDs can be thoroughly cleared through feces and urine within 5 days, showing high biosafety for further potential clinical translation. This novel photoacoustic imaging-guided photothermal therapy based on u-Cu(2-x)S NDs composed of a single component shows great prospects as a multifunctional nanoplatform with integration and multifunction for cancer diagnosis and therapy. PMID:25641784

  11. Image-Guided Radio-Frequency Gain Calibration for High-Field MRI

    PubMed Central

    Breton, Elodie; McGorty, KellyAnne; Wiggins, Graham C.; Axel, Leon; Kim, Daniel

    2010-01-01

    High-field (≥ 3T) MRI provides a means to increase the signal-to-noise ratio, due to its higher tissue magnetization compared with 1.5T. However, both the static magnetic field (B0) and the transmit radio-frequency (RF) field (B1+) inhomogeneities are comparatively higher than those at 1.5T. These challenging factors at high-field strengths make it more difficult to accurately calibrate the transmit RF gain using standard RF calibration procedures. An image-based RF calibration procedure was therefore developed, in order to accurately calibrate the transmit RF gain within a specific region-of-interest (ROI). Using a single-shot ultra-fast gradient echo pulse sequence with centric k-space reordering, a series of “saturation-no-recovery” images was acquired by varying the flip angle of the preconditioning pulse. In the resulting images, the signal null occurs in regions where the flip angle of the preconditioning pulse is 90°. For a given ROI, the mean signal can be plotted as a function of the nominal flip angle, and the resulting curve can be used to quantitatively identify the signal null. This image-guided RF calibration procedure was evaluated through phantom and volunteer imaging experiments at 3T and 7T. The image-guided RF calibration results in vitro were consistent with standard B0 and B1+ maps. The standard automated RF calibration procedure produced approximately 20% and 15–30% relative error in the transmit RF gain in the left kidney at 3T and brain at 7T, respectively. For initial application, a T2 mapping pulse sequence was applied at 7T. The T2 measurements in the thalamus at 7T were 60.6 ms and 48.2 ms using the standard and image-guided RF calibration procedures, respectively. This rapid, image-guided RF calibration procedure can be used to optimally calibrate the flip angle for a given ROI and thus minimize measurement errors for quantitative MRI and MR spectroscopy. PMID:20014333

  12. Rapid tumor growth with glial differentiation of central neurocytoma after stereotactic radiosurgery.

    PubMed

    Tanaka, Hirotomo; Sasayama, Takashi; Yamashita, Haruo; Hara, Yoshie; Hayashi, Shigeto; Yamamoto, Yusuke; Fujita, Yuichi; Okino, Takeshi; Mizowaki, Takashi; Yamaguchi, Yoji; Tanaka, Kazuhiro; Kohmura, Eiji

    2016-09-01

    Although stereotactic radiosurgery (SRS) is effective for central neurocytoma (CN), the long-term outcome of SRS remains unclear. We present a case of recurrent CN that was diagnosed 10years after surgical resection and consecutive stereotactic radiotherapy. The patient was treated with SRS for the recurrent tumor, but underwent two-staged surgery once again due to rapid tumor growth. Histological features of the recurrent tumor were consistent with the diagnosis of CN. However, an increased Ki-67 proliferation index (3.4%), aberrant angiogenesis and glial differentiation of the tumor cells were observed, which were not identified in the initial CN. In addition, vascular endothelial growth factor (VEGF) and VEGF receptor were highly expressed in the recurrent tumor cells, as well as in the vascular endothelial cells. Our case suggests that malignant transition with aberrant angiogenesis and glial differentiation may be attributable to SRS. PMID:27242062

  13. Dose profile measurements during respiratory-gated lung stereotactic radiotherapy: A phantom study

    NASA Astrophysics Data System (ADS)

    Jong, W. L.; Wong, J. H. D.; Ng, K. H.; Ung, N. M.

    2016-03-01

    During stereotactic body radiotherapy, high radiation dose (∼60 Gy) is delivered to the tumour in small fractionation regime. In this study, the dosimetric characteristics were studied using radiochromic film during respiratory-gated and non-gated lung stereotactic body radiotherapy (SBRT). Specifically, the effect of respiratory cycle and amplitude, as well as gating window on the dosimetry were studied. In this study, the dose profiles along the irradiated area were measured. The dose profiles for respiratory-gated radiation delivery with different respiratory or tumour motion amplitudes, gating windows and respiratory time per cycle were in agreement with static radiation delivery. The respiratory gating system was able to deliver the radiation dose accurately (±1.05 mm) in the longitudinal direction. Although the treatment time for respiratory-gated SBRT was prolonged, this approach can potentially reduce the margin for internal tumour volume without compromising the tumour coverage. In addition, the normal tissue sparing effect can be improved.

  14. Quality Assurance of Immobilization and Target Localization Systems for Frameless Stereotactic Cranial and Extracranial Hypofractionated Radiotherapy

    SciTech Connect

    Solberg, Timothy D. Medin, Paul M.; Mullins, John; Li Sicong

    2008-05-01

    The success of stereotactic radiosurgery has stimulated significant interest in the application of such an approach for the treatment of extracranial tumors. The potential benefits of reduced healthcare costs and improved patient outcomes that could be realized in a high-precision, hypofractionated treatment paradigm are numerous. Image-guidance technologies are eliminating the historic requirement for rigid head fixation and will also accelerate the clinical implementation of the approach in extracranial sites. An essential prerequisite of 'frameless' stereotactic systems is that they provide localization accuracy consistent with the safe delivery of a therapeutic radiation dose given in one or few fractions. In this report, we reviewed the technologies for frameless localization of cranial and extracranial targets with emphasis on the quality assurance aspects.

  15. Clinical accuracy of ExacTrac intracranial frameless stereotactic system

    SciTech Connect

    Ackerly, T.; Lancaster, C. M.; Geso, M.; Roxby, K. J.

    2011-09-15

    Purpose: In this paper, the authors assess the accuracy of the Brainlab ExacTrac system for frameless intracranial stereotactic treatments in clinical practice. Methods: They recorded couch angle and image fusion results (comprising lateral, longitudinal, and vertical shifts, and rotation corrections about these axes) for 109 stereotactic radiosurgery and 166 stereotactic radiotherapy patient treatments. Frameless stereotactic treatments involve iterative 6D image fusion corrections applied until the results conform to customizable pass criteria, theirs being 0.7 mm and 0.5 deg. for each axis. The planning CT slice thickness was 1.25 mm. It has been reported in the literature that the CT slices' thickness impacts the accuracy of localization to bony anatomy. The principle of invariance with respect to patient orientation was used to determine spatial accuracy. Results: The data for radiosurgery comprised 927 image pairs, of which 532 passed (pass ratio of 57.4%). The data for radiotherapy comprised 15983 image pairs, of which 10 050 passed (pass ratio of 62.9%). For stereotactic radiotherapy, the combined uncertainty of ExacTrac calibration, image fusion, and intrafraction motion was (95% confidence interval) 0.290-0.302 and 0.306-0.319 mm in the longitudinal and lateral axes, respectively. The combined uncertainty of image fusion and intrafraction motion in the anterior-posterior coordinates was 0.174-0.182 mm. For stereotactic radiosurgery, the equivalent ranges are 0.323-0.393, 0.337-0.409, and 0.231-0.281 mm. The overall spatial accuracy was 1.24 mm for stereotactic radiotherapy (SRT) and 1.35 mm for stereotactic radiosurgery (SRS). Conclusions: The ExacTrac intracranial frameless stereotactic system spatial accuracy is adequate for clinical practice, and with the same pass criteria, SRT is more accurate than SRS. They now use frameless stereotaxy exclusively at their center.

  16. Optimizing wavefront-guided corrections for highly aberrated eyes in the presence of registration uncertainty

    PubMed Central

    Shi, Yue; Queener, Hope M.; Marsack, Jason D.; Ravikumar, Ayeswarya; Bedell, Harold E.; Applegate, Raymond A.

    2013-01-01

    Dynamic registration uncertainty of a wavefront-guided correction with respect to underlying wavefront error (WFE) inevitably decreases retinal image quality. A partial correction may improve average retinal image quality and visual acuity in the presence of registration uncertainties. The purpose of this paper is to (a) develop an algorithm to optimize wavefront-guided correction that improves visual acuity given registration uncertainty and (b) test the hypothesis that these corrections provide improved visual performance in the presence of these uncertainties as compared to a full-magnitude correction or a correction by Guirao, Cox, and Williams (2002). A stochastic parallel gradient descent (SPGD) algorithm was used to optimize the partial-magnitude correction for three keratoconic eyes based on measured scleral contact lens movement. Given its high correlation with logMAR acuity, the retinal image quality metric log visual Strehl was used as a predictor of visual acuity. Predicted values of visual acuity with the optimized corrections were validated by regressing measured acuity loss against predicted loss. Measured loss was obtained from normal subjects viewing acuity charts that were degraded by the residual aberrations generated by the movement of the full-magnitude correction, the correction by Guirao, and optimized SPGD correction. Partial-magnitude corrections optimized with an SPGD algorithm provide at least one line improvement of average visual acuity over the full magnitude and the correction by Guirao given the registration uncertainty. This study demonstrates that it is possible to improve the average visual acuity by optimizing wavefront-guided correction in the presence of registration uncertainty. PMID:23757512

  17. Radioisotope guided surgery with imaging probe, a hand-held high-resolution gamma camera

    NASA Astrophysics Data System (ADS)

    Soluri, A.; Trotta, C.; Scopinaro, F.; Tofani, A.; D'Alessandria, C.; Pasta, V.; Stella, S.; Massari, R.

    2007-12-01

    Since 1997, our group of Physics together with Nuclear Physicians studies imaging probes (IP), hand-held, high-resolution gamma cameras for radio-guided surgery (RGS). Present work is aimed to verify the usefulness of two updated IP in different surgical operations. Forty patients scheduled for breast cancer sentinel node (SN) biopsy, five patients with nodal recurrence of thyroid cancer, seven patients with parathyroid adenomas, five patients with neuroendocrine tumours (NET), were operated under the guide of IP. We used two different IP with field of view of 1 and 4 in. 2, respectively and intrinsic spatial resolution of about 2 mm. Radioisotopes were 99mTc, 123I and 111In. The 1 in. 2 IP detected SN in all the 40 patients and more than one node in 24, whereas anger camera (AC) failed locating SN in four patients and detected true positive second nodes in only nine patients. The 4 in. 2 IP was used for RGS of thyroid, parathyroid and NETs. It detected eight latero-cervical nodes. In the same patients, AC detected five invaded nodes. Parathyroid adenomas detected by IP were 10 in 7 patients, NET five in five patients. One and 4 in. 2 IPs showed usefulness in all operations. Initial studies on SN biopsy were carried out on small series of patients to validate IP and to demonstrate the effectiveness and usefulness of IP alone or against conventional probes. We propose the use of the IP as control method for legal documentation and surgeon strategy guide before and after lesion(s) removal.

  18. Miniature high-resolution guided-wave spectrometer for atmospheric remote sensing

    NASA Astrophysics Data System (ADS)

    Sloan, James; Kruzelecky, Roman; Wong, Brian; Zou, Jing; Jamroz, Wes; Haddad, Emile; Poirier, Michel

    This paper describes the design and application of an innovative spectrometer in which a guided-wave integrated optical spectrometer (IOSPEC) has been coupled with a Fabry-Perot (FP) interferometer. This miniature spectrometer has a net mass under 3 kg, but is capable of broadband operation at spectral resolutions below 0.03 nm full width half maximum (FWHM). The tuneable FP filter provides very high spectral resolution combined with a large input aper-ture. The solid state guided-wave spectrometer is currently configured for a 512-channel array detector, which provides sub-nm coarse resolution. The ultimate resolution is determined by the FP filter, which is tuned across the desired spectral bands, thereby providing a signal-to-noise ratio (SNR) advantage over scanned spectrometer systems of the square root of the number of detector channels. The guided-wave optics provides robust, long-term optical alignment, while minimising the mechanical complexity. The miniaturisation of the FP-IOSPEC spectrometer allows multiple spectrometers to be accommodated on a single MicroSat. Each of these can be optimised for selected measurement tasks and views, thereby enabling more flexible data acquisition strategies with enhanced information content, while minimizing the mission cost. The application of this innovative technology in the proposed Miniature Earth Observation Satellite (MEOS) mission will also be discussed. The MEOS mission, which is designed for the investigation of the carbon and water cycles, relies on multiple IO-SPEC instruments for the simultaneous measurement of a range of atmospheric and surface properties important to climate change.

  19. Career Preparation in Agricultural Resources: A Curriculum Guide for High School Vocational Agriculture. Test Edition.

    ERIC Educational Resources Information Center

    Householder, Larry

    This curriculum guide in agricultural resources is one of 10 guides developed as part of a vocational project stressing agribusiness, natural resources, and environmental protection. The scope of this guide includes eight occupational subgroups: fish, forestry, mining area restoration, outdoor recreation, soil, range, water, and wildlife. It is…

  20. Career Preparation in Agricultural Production: A Curriculum Guide for High School Vocational Agriculture. Test Edition.

    ERIC Educational Resources Information Center

    McGhee, Max B., Comp.

    This curriculum guide in agricultural production is one of 10 guides developed as part of a vocational project stressing agribusiness, natural resources, and environmental protection. The scope of this guide includes four occupational subgroups: animal science, plant science, farm mechanics, and farm business management. It is meant as an aid to…

  1. Career Preparation in Forestry: A Curriculum Guide for High School Vocational Agriculture. Test Edition.

    ERIC Educational Resources Information Center

    Householder, Larry; Moore, Eddie A.

    This curriculum guide in forestry is one of 10 guides developed as part of a vocational project stressing agribusiness, natural resources, and environmental protection. The scope of this guide includes six occupational subgroups: forest establishment, forest protection, logging (harvesting and transporting), wood utilization Christmas tree…

  2. Design of pulsed guiding magnetic field for high power microwave generators

    SciTech Connect

    Ju, J.-C. Zhang, H.; Zhang, J.; Shu, T.; Zhong, H.-H.

    2014-09-15

    In this paper, we present a comprehensive study on designing solenoid together with the corresponding power supply system to excite pulsed magnetic field required for high power microwave generators. Particularly, a solenoid is designed and the excited magnetic field is applied to a Ku-band overmoded Cerenkov generator. It is found in experiment that the electron beam is properly guided by the magnetic field and a 1.1 GW high power microwave is achieved at a central frequency of 13.76 GHz. Pulsed solenoid system has the advantages of compactness and low energy consumption, which are of great interest for repetitive operation. The reported studies and results can be generalized to other applications which require magnetic fields.

  3. Design of pulsed guiding magnetic field for high power microwave generators.

    PubMed

    Ju, J-C; Zhang, H; Zhang, J; Shu, T; Zhong, H-H

    2014-09-01

    In this paper, we present a comprehensive study on designing solenoid together with the corresponding power supply system to excite pulsed magnetic field required for high power microwave generators. Particularly, a solenoid is designed and the excited magnetic field is applied to a Ku-band overmoded Cerenkov generator. It is found in experiment that the electron beam is properly guided by the magnetic field and a 1.1 GW high power microwave is achieved at a central frequency of 13.76 GHz. Pulsed solenoid system has the advantages of compactness and low energy consumption, which are of great interest for repetitive operation. The reported studies and results can be generalized to other applications which require magnetic fields. PMID:25273750

  4. High Temperature Ceramic Guide Vane Temperature and Pressure Distribution Calculation for Flow with Cooling Jets

    NASA Technical Reports Server (NTRS)

    Srivastava, Rakesh

    2004-01-01

    A ceramic guide vane has been designed and tested for operation under high temperature. Previous efforts have suggested that some cooling flow may be required to alleviate the high temperatures observed near the trailing edge region. The present report describes briefly a three-dimensional viscous analysis carried out to calculate the temperature and pressure distribution on the blade surface and in the flow path with a jet of cooling air exiting from the suction surface near the trailing edge region. The data for analysis was obtained from Dr. Craig Robinson. The surface temperature and pressure distribution along with a flowfield distribution is shown in the results. The surface distribution is also given in a tabular form at the end of the document.

  5. Synchrotron stereotactic radiotherapy: dosimetry by Fricke gel and Monte Carlo simulations.

    PubMed

    Boudou, Caroline; Biston, Marie-Claude; Corde, Stéphanie; Adam, Jean-François; Ferrero, Claudio; Estève, François; Elleaume, Hélène

    2004-11-21

    Synchrotron stereotactic radiotherapy (SSR) consists in loading the tumour with a high atomic number element (Z), and exposing it to monochromatic x-rays from a synchrotron source (50-100 keV), in stereotactic conditions. The dose distribution results from both the stereotactic monochromatic x-ray irradiation and the presence of the high Z element. The purpose of this preliminary study was to evaluate the two-dimensional dose distribution resulting solely from the irradiation geometry, using Monte Carlo simulations and a Fricke gel dosimeter. The verification of a Monte Carlo-based dosimetry was first assessed by depth dose measurements in a water tank. We thereafter used a Fricke dosimeter to compare Monte Carlo simulations with dose measurements. The Fricke dosimeter is a solution containing ferrous ions which are oxidized to ferric ions under ionizing radiation, proportionally to the absorbed dose. A cylindrical phantom filled with Fricke gel was irradiated in stereotactic conditions over several slices with a continuous beam (beam section = 0.1 x 1 cm2). The phantom and calibration vessels were then imaged by nuclear magnetic resonance. The measured doses were fairly consistent with those predicted by Monte Carlo simulations. However, the measured maximum absolute dose was 10% underestimated regarding calculation. The loss of information in the higher region of dose is explained by the diffusion of ferric ions. Monte Carlo simulation is the most accurate tool for dosimetry including complex geometries made of heterogeneous materials. Although the technique requires improvements, gel dosimetry remains an essential tool for the experimental verification of dose distribution in SSR with millimetre precision. PMID:15609563

  6. Magnetic Resonance Lymphography-Guided Selective High-Dose Lymph Node Irradiation in Prostate Cancer

    SciTech Connect

    Meijer, Hanneke J.M.; Debats, Oscar A.; Kunze-Busch, Martina; Kollenburg, Peter van; Leer, Jan Willem; Witjes, J. Alfred; Kaanders, Johannes H.A.M.; Barentsz, Jelle O.; Lin, Emile N.J.Th. van

    2012-01-01

    Purpose: To demonstrate the feasibility of magnetic resonance lymphography (MRL) -guided delineation of a boost volume and an elective target volume for pelvic lymph node irradiation in patients with prostate cancer. The feasibility of irradiating these volumes with a high-dose boost to the MRL-positive lymph nodes in conjunction with irradiation of the prostate using intensity-modulated radiotherapy (IMRT) was also investigated. Methods and Materials: In 4 prostate cancer patients with a high risk of lymph node involvement but no enlarged lymph nodes on CT and/or MRI, MRL detected pathological lymph nodes in the pelvis. These lymph nodes were identified and delineated on a radiotherapy planning CT to create a boost volume. Based on the location of the MRL-positive lymph nodes, the standard elective pelvic target volume was individualized. An IMRT plan with a simultaneous integrated boost (SIB) was created with dose prescriptions of 42 Gy to the pelvic target volume, a boost to 60 Gy to the MRL-positive lymph nodes, and 72 Gy to the prostate. Results: All MRL-positive lymph nodes could be identified on the planning CT. This information could be used to delineate a boost volume and to individualize the pelvic target volume for elective irradiation. IMRT planning delivered highly acceptable radiotherapy plans with regard to the prescribed dose levels and the dose to the organs at risk (OARs). Conclusion: MRL can be used to select patients with limited lymph node involvement for pelvic radiotherapy. MRL-guided delineation of a boost volume and an elective pelvic target volume for selective high-dose lymph node irradiation with IMRT is feasible. Whether this approach will result in improved outcome for these patients needs to be investigated in further clinical studies.

  7. Dual mode stereotactic localization method and application

    DOEpatents

    Keppel, Cynthia E.; Barbosa, Fernando Jorge; Majewski, Stanislaw

    2002-01-01

    The invention described herein combines the structural digital X-ray image provided by conventional stereotactic core biopsy instruments with the additional functional metabolic gamma imaging obtained with a dedicated compact gamma imaging mini-camera. Before the procedure, the patient is injected with an appropriate radiopharmaceutical. The radiopharmaceutical uptake distribution within the breast under compression in a conventional examination table expressed by the intensity of gamma emissions is obtained for comparison (co-registration) with the digital mammography (X-ray) image. This dual modality mode of operation greatly increases the functionality of existing stereotactic biopsy devices by yielding a much smaller number of false positives than would be produced using X-ray images alone. The ability to obtain both the X-ray mammographic image and the nuclear-based medicine gamma image using a single device is made possible largely through the use of a novel, small and movable gamma imaging camera that permits its incorporation into the same table or system as that currently utilized to obtain X-ray based mammographic images for localization of lesions.

  8. Stereotactic localization using magnetic resonance imaging.

    PubMed

    Walton, L; Hampshire, A; Forster, D M; Kemeny, A A

    1995-01-01

    A phantom study has been carried out to assess the accuracy of stereotactic localisation, using magnetic resonance imaging. The stereotactic coordinates of an array of Perspex rods within the phantom were determined and compared with measured values, in a series of transverse, coronal and sagittal images. In the transverse plane, the maximum errors experienced were X = 2.3 mm and Y = 10.7 mm. If the third fiducial plate, at the front of the frame, were not used in the scaling of the images, there was considerable improvement in the Y direction (maximum error Y = 2.1 mm). However, some deterioration in the accuracy in the X direction resulted, particularly at the extremes of Z (maximum error X = 3.5 mm). In the coronal plane, the maximum errors were X = 1.8 mm and Z = 8.0 mm. With the third plate off, the errors decreased to X = 1.9 mm and Z = 3.3 mm. In the sagittal plane, the maximum errors recorded were Y = 1.1 mm and Z = 7.5 mm. It is not possible to calibrate in this plane without the third plate. PMID:8584823

  9. Survival after stereotactic biopsy of malignant gliomas

    SciTech Connect

    Coffey, R.J.; Lunsford, L.D.; Taylor, F.H.

    1988-03-01

    For many patients with malignant gliomas in inaccessible or functionally important locations, stereotactic biopsy followed by radiation therapy (RT) may be a more appropriate initial treatment than craniotomy and tumor resection. We studied the long term survival in 91 consecutive patients with malignant gliomas diagnosed by stereotactic biopsy: 64 had glioblastoma multiforme (GBM) and 27 had anaplastic astrocytoma (AA). Sixty-four per cent of the GBMs and 33% of the AAs involved deep or midline cerebral structures. The treatment prescribed after biopsy, the tumor location, the histological findings, and the patient's age at presentation (for AAs) were statistically important factors determining patient survival. If adequate RT (tumor dose of 5000 to 6000 cGy) was not prescribed, the median survival was less than or equal to 11 weeks regardless of tumor histology or location. The median survival for patients with deep or midline tumors who completed RT was similar in AA (19.4 weeks) and GBM (27 weeks) cases. Histology was an important predictor of survival only for patients with adequately treated lobar tumors. The median survival in lobar GBM patients who completed RT was 46.9 weeks, and that in lobar AA patients who completed RT was 129 weeks. Cytoreductive surgery had no statistically significant effect on survival. Among the clinical factors examined, age of less than 40 years at presentation was associated with prolonged survival only in AA patients. Constellations of clinical features, tumor location, histological diagnosis, and treatment prescribed were related to survival time.

  10. High aspect ratio 10-nm-scale nanoaperture arrays with template-guided metal dewetting.

    PubMed

    Wang, Ying Min; Lu, Liangxing; Srinivasan, Bharathi Madurai; Asbahi, Mohamed; Zhang, Yong Wei; Yang, Joel K W

    2015-01-01

    We introduce an approach to fabricate ordered arrays of 10-nm-scale silica-filled apertures in a metal film without etching or liftoff. Using low temperature (<400°C) thermal dewetting of metal films guided by nano-patterned templates, apertures with aspect ratios up to 5:1 are demonstrated. Apertures form spontaneously during the thermal process without need for further processing. Although the phenomenon of dewetting has been well studied, this is the first demonstration of its use in the fabrication of nanoapertures in a spatially controllable manner. In particular, the achievement of 10-nm length-scale patterning at high aspect ratio with thermal dewetting is unprecedented. By varying the nanotemplate design, we show its strong influence over the positions and sizes of the nanoapertures. In addition, we construct a three-dimensional phase field model of metal dewetting on nano-patterned substrates. The simulation data obtained closely corroborates our experimental results and reveals new insights to template dewetting at the nanoscale. Taken together, this fabrication method and simulation model form a complete toolbox for 10-nm-scale patterning using template-guided dewetting that could be extended to a wide range of material systems and geometries. PMID:25858792

  11. Laboratory study of diffusion region with electron energization during high guide field reconnection

    NASA Astrophysics Data System (ADS)

    Yamasaki, K.; Inoue, S.; Kamio, S.; Watanabe, T. G.; Ushiki, T.; Guo, X.; Sugawara, T.; Matsuyama, K.; Kawakami, N.; Yamada, T.; Inomoto, M.; Ono, Y.

    2015-10-01

    Floating potential profile was measured around the X-point during high guide field reconnection in UTST merging experiment where the ratio of guide field ( Bg ) to reconnecting magnetic field ( Brec ) is Bg/Brec>10 . Floating potential measurement revealed that a quadrupole structure of electric potential is formed around the X-point during the fast reconnection phase due to the polarization by inductive electric field. Also, our floating potential measurement revealed the existence of parallel electric field in the vicinity of the X-point. While field-aligned components of inductive electric field ( E∥ind ) and electrostatic electric field ( E∥es ) cancel out with each other away from the X-point, E∥ind exceeds E∥es around the X-point, indicating the deviation from ideal MHD criterion within the region. The diffusion region extends in the outflow region and the scale length of region is an order of ion skin depth, which is quite different from the VTF experiment result. Based on the measured magnetic field and electric field profile, our particle trajectory analysis indicates that fast electrons with energies over 300 eV are produced within 1 μs around the X-point in the non-ideal MHD region. These results indicate that production of fast electrons or electron heating are expected to be observed in the vicinity of the X-point.

  12. Multi-kilowatt CPV Installation Employing Low-cost, Highly Concentrating Wave-Guiding Optics

    NASA Astrophysics Data System (ADS)

    Beal, R. M.; Wilkins, M.; Wheeldon, J. F.; Haysom, J. E.; Valdivia, C. E.; Yandt, M.; Dufour, P.; Myrskog, S.; Fan, J.; Navarro, H.; Morgan, J. P.; Hall, T. J.; Hinzer, K.

    2011-12-01

    An on-sun, CPV test site has been built at the University of Ottawa consisting of two ring-mounted, dual-axis trackers fitted with 38 m2 of highly concentrating, light guiding optics and panels. The site has been designed to monitor photovoltaic performance on the system and panel scale and to record I-V measurements of individual optics under realistic operating conditions. Measurements of the light-guiding optic's optical transmission function, lab-based EQE measurements and time-synchronized DNI and spectral irradiance data have been used to develop a relative photovoltaic performance model that accurately predicts real-world results. The in situ I-V curve tracing system also allows us to estimate the absolute temperature of individual solar cells within a CPV panel. Results indicate a peak temperature of approximately 40 °C under DNI of 1009 W/m2 at an ambient temperature of 2 °C. Finally, optical alignment and acceptance angle measurements have been used to estimate short circuit current values of individual optics and indicate a good optical alignment on the panel scale.

  13. Design of a high efficiency relativistic backward wave oscillator with low guiding magnetic field

    NASA Astrophysics Data System (ADS)

    Li, Xiaoze; Song, Wei; Tan, Weibing; Zhang, Ligang; Su, Jiancang; Zhu, Xiaoxin; Hu, Xianggang; Shen, Zhiyuan; Liang, Xu; Ning, Qi

    2016-07-01

    A high efficiency relativistic backward wave oscillator working at a low guiding magnetic field is designed and simulated. A trapezoidal resonant reflector is used to reduce the modulation field in the resonant reflector to avoid overmodulation of the electron beam which will lead to a large momentum spread and then low conversion efficiency. The envelope of the inner radius of the slow wave structure (SWS) increases stepwise to keep conformal to the trajectory of the electron beam which will alleviate the bombardment of the electron on the surface of the SWS. The length of period of the SWS is reduced gradually to make a better match between phase velocity and electron beam, which decelerates continually and improves the RF current distribution. Meanwhile the modulation field is reduced by the introduction of nonuniform SWS also. The particle in cell simulation results reveal that a microwave with a power of 1.8 GW and a frequency of 14.7 GHz is generated with an efficiency of 47% when the diode voltage is 620 kV, the beam current 6.1 kA, and the guiding magnetic field 0.95 T.

  14. High aspect ratio 10-nm-scale nanoaperture arrays with template-guided metal dewetting

    PubMed Central

    Wang, Ying Min; Lu, Liangxing; Srinivasan, Bharathi Madurai; Asbahi, Mohamed; Zhang, Yong Wei; Yang, Joel K. W.

    2015-01-01

    We introduce an approach to fabricate ordered arrays of 10-nm-scale silica-filled apertures in a metal film without etching or liftoff. Using low temperature (<400°C) thermal dewetting of metal films guided by nano-patterned templates, apertures with aspect ratios up to 5:1 are demonstrated. Apertures form spontaneously during the thermal process without need for further processing. Although the phenomenon of dewetting has been well studied, this is the first demonstration of its use in the fabrication of nanoapertures in a spatially controllable manner. In particular, the achievement of 10-nm length-scale patterning at high aspect ratio with thermal dewetting is unprecedented. By varying the nanotemplate design, we show its strong influence over the positions and sizes of the nanoapertures. In addition, we construct a three-dimensional phase field model of metal dewetting on nano-patterned substrates. The simulation data obtained closely corroborates our experimental results and reveals new insights to template dewetting at the nanoscale. Taken together, this fabrication method and simulation model form a complete toolbox for 10-nm-scale patterning using template-guided dewetting that could be extended to a wide range of material systems and geometries. PMID:25858792

  15. Guided wave propagation in a honeycomb composite sandwich structure in presence of a high density core.

    PubMed

    Sikdar, Shirsendu; Banerjee, Sauvik

    2016-09-01

    A coordinated theoretical, numerical and experimental study is carried out in an effort to interpret the characteristics of propagating guided Lamb wave modes in presence of a high-density (HD) core region in a honeycomb composite sandwich structure (HCSS). Initially, a two-dimensional (2D) semi-analytical model based on the global matrix method is used to study the response and dispersion characteristics of the HCSS with a soft core. Due to the complex structural characteristics, the study of guided wave (GW) propagation in HCSS with HD-core region inherently poses many challenges. Therefore, a numerical simulation of GW propagation in the HCSS with and without the HD-core region is carried out, using surface-bonded piezoelectric wafer transducer (PWT) network. From the numerical results, it is observed that the presence of HD-core significantly decreases both the group velocity and the amplitude of the received GW signal. Laboratory experiments are then conducted in order to verify the theoretical and numerical results. A good agreement between the theoretical, numerical and experimental results is observed in all the cases studied. An extensive parametric study is also carried out for a range of HD-core sizes and densities in order to study the effect due to the change in size and density of the HD zone on the characteristics of propagating GW modes. It is found that the amplitudes and group velocities of the GW modes decrease with the increase in HD-core width and density. PMID:27290650

  16. High-efficiency FEL-oscillator with Bragg resonator operated in reversed guide field regime

    SciTech Connect

    Kaminsky, A.K.; Sedykh, S.N.; Sergeyev, A.P.

    1995-12-31

    The aim of the present work was to develop a narrow-band FEL-oscillator working in millimeter wavelength with, high efficiency. It looked promising to combine the high selective property of Bragg resonator with high efficiency and other advantages of FEL operation in the reversed guide-field regime. An experimental study of the FEL was performed using lilac LIU-3000 (JINR, Dubna) with the electron energy of 1 MeV, beam current up to 200 A and pulse duration of 200 ns. The beam was injected into the internction region with guide magnetic field of 2.9 kGs. Transverse oscillations of electrons were pumped by the helical wiggler with the period length of 6 cm and the field slowly up-tapering over the initial 6 periods. The FEI electrodynamic system consisted of a circular waveguide with diameter 20 mm and two Bragg reflectors. The H wave of the circular waveguide was shown for operation. Two effective feedback waves were observed in {open_quotes}cold{close_quotes} electrodynamic measurement in correspondence with calculations; the E wave near the frequency of 31. 5 GHz and the E wave - 37.5 GHz. The width of the both reflection resonances was about 2%. In {open_quotes}hot{close_quotes} experiments the radiation on the designed H wave and frequencies corresponding to the both feedback waves was registered separately. Selection of the frequency was realized by varying of the wiggler field strength. The spectrum was measured with a set of the cut--off waveguide filters with inaccuracy less than 2%. Calibrated Semiconductor detectors wire used to measure the radiation power. The radiation with the frequencies of 37.5 and 31.5 GHz was observed in vicinity of the wiggler field amplitude of 2.5 kGs. The measured spectrum width of the output FEL-oscillator radiation did not exceed the width of the Bragg reflector resonances for the both feedback waves.

  17. TU-D-BRD-01: Image Guided SBRT II: Challenges ' Pitfalls

    SciTech Connect

    Chang, Z; Yin, F; Cho, J

    2014-06-15

    Stereotactic body radiation therapy (SBRT) has been effective treatment for the management of various diseases, which often delivers high radiation dose in a single or a few fractions. SBRT therefore demands precise treatment delivery to the tumor while sparing adjacent healthy tissue. Recent developments in image guidance enable target localization with increased accuracy. With such improvements in localization, image-guided SBRT has been widely adopted into clinical practice. In SBRT, high radiation dose is generally delivered with small fields. Therefore, it is crucial to accurately measure dosimetric data for the small fields during commissioning. In addition, image-guided SBRT demands accurate image localization to ensure safety and quality of patient care. Lately, the reports of AAPM TG 142 and TG 104 have been published and added recommendations for imaging devices that are integrated with the linear accelerator for SBRT. Furthermore, various challenges and potential pitfalls lie in the clinical implementation of image-guided SBRT. In this lecture, these challenges and pitfalls of image-guided SBRT will be illustrated and discussed from dosimetric, technical and clinical perspectives.Being a promising technique, image-guided SBRT has shown great potentials, and will lead to more accurate and safer SBRT treatments. Learning Objectives: To understand dosimetric challenges and pitfalls for IGRT application in SBRT. To understand major clinical challenges and pitfalls for IGRT application in SBRT. To understand major technical challenges and pitfalls for IGRT application in SBRT.

  18. Digital x-ray cameras for real-time stereotactic breast needle biopsy

    NASA Astrophysics Data System (ADS)

    Roehrig, Hans; Fajardo, Laurie L.; Yu, Tong

    1993-09-01

    This paper describes experiments performed to determine image quality of three x-ray imaging systems designed for stereotactic breast needle biopsy: A system developed in-house, a LoRad DSM and a Fischer MammoVision. All systems have been successfully used to perform stereotactic breast needle biopsies and preoperative needle localizations. They all successfully decrease the time for stereotactic needle biopsy procedures. The systems are being characterized with respect to image quality for a variety of mammographic x-ray screens. The sensitivity can be as high as 96 ADU/mR and as low as 28 ADU/mR, depending on the phosphor screen and the gain used. The response is linear with respect to x-ray exposure. The highest spatial resolution found was on the order of 10 lp/mm, which is the Nyquist frequency for systems with 1024 pixels at a linear field of 5 cm. The noise at zero spatial frequency was found to be mainly determined by x-ray photon noise.

  19. Symmetry-Guided Synthesis of Highly Porous Metal-Organic Frameworks with Fluorite Topology

    SciTech Connect

    Zhang, MW; Chen, YP; Bosch, M; Gentle, T; Wang, KC; Feng, DW; Wang, ZYU; Zhou, HC

    2013-11-11

    Two stable, non-interpenetrated MOFs, PCN-521 and PCN-523, were synthesized by a symmetry-guided strategy. Augmentation of the 4-connected nodes in the fluorite structure with a rigid tetrahedral ligand and substitution of the 8-connected nodes by the Zr/Hf clusters yielded MOFs with large octahedral interstitial cavities. They are the first examples of Zr/Hf MOFs with tetrahedral linkers. PCN-521 has the largest BET surface area (3411 m(2) g(-1)), pore size (20.5 x 20.5 x 37.4 angstrom) and void volume (78.5%) of MOFs formed from tetrahedral ligands. This work not only demonstrates a successful implementation of rational design of MOFs with desired topology, but also provides a systematic way of constructing non-interpenetrated MOFs with high porosity.

  20. MR-guided high-intensity focused ultrasound: current status of an emerging technology.

    PubMed

    Napoli, Alessandro; Anzidei, Michele; Ciolina, Federica; Marotta, Eugenio; Cavallo Marincola, Beatrice; Brachetti, Giulia; Di Mare, Luisa; Cartocci, Gaia; Boni, Fabrizio; Noce, Vincenzo; Bertaccini, Luca; Catalano, Carlo

    2013-10-01

    The concept of ideal tumor surgery is to remove the neoplastic tissue without damaging adjacent normal structures. High-intensity focused ultrasound (HIFU) was developed in the 1940s as a viable thermal tissue ablation approach. In clinical practice, HIFU has been applied to treat a variety of solid benign and malignant lesions, including pancreas, liver, prostate, and breast carcinomas, soft tissue sarcomas, and uterine fibroids. More recently, magnetic resonance guidance has been applied for treatment monitoring during focused ultrasound procedures (magnetic resonance-guided focused ultrasound, MRgFUS). Intraoperative magnetic resonance imaging provides the best possible tumor extension and dynamic control of energy deposition using real-time magnetic resonance imaging thermometry. We introduce the fundamental principles and clinical indications of the MRgFUS technique; we also report different treatment options and personal outcomes. PMID:23474917

  1. MR-Guided High-Intensity Focused Ultrasound: Current Status of an Emerging Technology

    SciTech Connect

    Napoli, Alessandro Anzidei, Michele Ciolina, Federica Marotta, Eugenio Cavallo Marincola, Beatrice Brachetti, Giulia Mare, Luisa Di Cartocci, Gaia Boni, Fabrizio Noce, Vincenzo Bertaccini, Luca Catalano, Carlo

    2013-10-15

    The concept of ideal tumor surgery is to remove the neoplastic tissue without damaging adjacent normal structures. High-intensity focused ultrasound (HIFU) was developed in the 1940s as a viable thermal tissue ablation approach. In clinical practice, HIFU has been applied to treat a variety of solid benign and malignant lesions, including pancreas, liver, prostate, and breast carcinomas, soft tissue sarcomas, and uterine fibroids. More recently, magnetic resonance guidance has been applied for treatment monitoring during focused ultrasound procedures (magnetic resonance-guided focused ultrasound, MRgFUS). Intraoperative magnetic resonance imaging provides the best possible tumor extension and dynamic control of energy deposition using real-time magnetic resonance imaging thermometry. We introduce the fundamental principles and clinical indications of the MRgFUS technique; we also report different treatment options and personal outcomes.

  2. Adverse Events of Extracorporeal Ultrasound-Guided High Intensity Focused Ultrasound Therapy

    PubMed Central

    Yu, Tinghe; Luo, Jun

    2011-01-01

    Background High-intensity focused ultrasound (HIFU) is considered to be an alternative to surgery. Extracorporeal ultrasound-guided HIFU (USgFU) has been clinically used to treat solid tumors. Preliminary trials in a small sample of a Western population suggested that this modality was safe. Most trials are performed in China thereby providing comprehensive data for understanding the safety profile. The aim of this study was to evaluate adverse events of USgFU therapy. Methods and Findings Clinical data were searched in 2 Chinese databases. Adverse events of USgFU were summarized and compared with those of magnetic resonance-guided HIFU (MRgFU; for uterine, bone or breast tumor) and transrectal ultrasound-guided HIFU (for prostate cancer or benign prostate hyperplasia). USgFU treatment was performed using 7 types of device. Side effects were evaluated in 13262 cases. There were fewer adverse events in benign lesions than in malignant lesions (11.81% vs. 21.65%, p<0.0001). Rates of adverse events greatly varied between the disease types (0–280%, p<0.0001) and between the applied HIFU devices in both malignant (10.58–44.38%, p<0.0001) and benign lesions (1.67–17.57%, p<0.0001). Chronological analysis did not demonstrate a decrease in the rate of adverse events. Based upon evaluable adverse events, incidences in USgFU were consistent with those in MRgFU or transrectal HIFU. Some side effects frequently occurred following transrectal HIFU were not reported in USgFU. Several events including intrahepatic metastasis, intraoperative high fever, and occlusions of the superior mesenteric artery should be of particular concern because they have not been previously noted. The types of adverse events suggested that they were ultrasonic lesions. Conclusion The frequency of adverse events depended on the location of the lesion and the type of HIFU device; however, side effects of USgFU were not yet understood. USgFU did not decrease the incidence of adverse events compared

  3. High definition cross-well electrical resistivity imaging using seismoelectric focusing and image-guided inversion

    NASA Astrophysics Data System (ADS)

    Sava, P.; Revil, A.; Karaoulis, M.

    2014-08-01

    We propose a new, simple and efficient method to image electrical resistivity between a set of wells. Our procedure consists of two steps: first, we map the interfaces between various subsurface formations using seismoelectric conversions; second, we derive the formation resistivity using image-guided cross-well electric tomography. In the first step, we focus seismic energy at a set of points located on a regular grid between wells, which enables us to map the geological formations in terms of heterogeneities in electrical, hydraulic and/or seismic properties. The density of the scanning points (i.e. the seismoelectric image resolution) is related to the wavelength of the seismic impulse used to scan the formations. Each time the seismic energy is focused at a point, the resulting electrical potential burst (equivalent to the one generated by a volumetric seismic source) is recorded remotely at a set of electrodes positioned in wells (the reference electrode can be located on the ground surface or far enough to be considered at infinity). We construct a high-resolution `seismoelectric' image by assigning the electrical potential simulated at these fixed electrodes to the location of the seismic focus. In a follow-up step, the structure of this image is used in image-guided inversion to improve electrical resistivity tomography between the two wells. The structural information from the seismoelectric image is used to impose constraints on the model covariance matrix used in the inversion of the electrical resistivity data. This approach offers new perspectives in recovering fine structure of resistivity (high definition resistivity tomography) between the wells, which cannot be resolved through conventional cross-well resistivity or from seismic tomography alone.

  4. Characteristics of a novel treatment system for linear accelerator-based stereotactic radiosurgery.

    PubMed

    Wen, Ning; Li, Haisen; Song, Kwang; Chin-Snyder, Karen; Qin, Yujiao; Kim, Jinkoo; Bellon, Maria; Gulam, Misbah; Gardner, Stephen; Doemer, Anthony; Devpura, Suneetha; Gordon, James; Chetty, Indrin; Siddiqui, Farzan; Ajlouni, Munther; Pompa, Robert; Hammoud, Zane; Simoff, Michael; Kalkanis, Steven; Movsas, Benjamin; Siddiqui, M Salim

    2015-01-01

    The purpose of this study is to characterize the dosimetric properties and accuracy of a novel treatment platform (Edge radiosurgery system) for localizing and treating patients with frameless, image-guided stereotactic radiosurgery (SRS) and stereotactic body radiotherapy (SBRT). Initial measurements of various components of the system, such as a comprehensive assessment of the dosimetric properties of the flattening filter-free (FFF) beams for both high definition (HD120) MLC and conical cone-based treatment, positioning accuracy and beam attenuation of a six degree of freedom (6DoF) couch, treatment head leakage test, and integrated end-to-end accuracy tests, have been performed. The end-to-end test of the system was performed by CT imaging a phantom and registering hidden targets on the treatment couch to determine the localization accuracy of the optical surface monitoring system (OSMS), cone-beam CT (CBCT), and MV imaging systems, as well as the radiation isocenter targeting accuracy. The deviations between the percent depth-dose curves acquired on the new linac-based system (Edge), and the previously published machine with FFF beams (TrueBeam) beyond D(max) were within 1.0% for both energies. The maximum deviation of output factors between the Edge and TrueBeam was 1.6%. The optimized dosimetric leaf gap values, which were fitted using Eclipse dose calculations and measurements based on representative spine radiosurgery plans, were 0.700 mm and 1.000 mm, respectively. For the conical cones, 6X FFF has sharper penumbra ranging from 1.2-1.8 mm (80%-20%) and 1.9-3.8 mm (90%-10%) relative to 10X FFF, which has 1.2-2.2mm and 2.3-5.1mm, respectively. The relative attenuation measurements of the couch for PA, PA (rails-in), oblique, oblique (rails-out), oblique (rails-in) were: -2.0%, -2.5%, -15.6%, -2.5%, -5.0% for 6X FFF and -1.4%, -1.5%, -12.2%, -2.5%, -5.0% for 10X FFF, respectively, with a slight decrease in attenuation versus field size. The systematic

  5. Clinical Assessment Of Stereotactic IGRT: Spinal Radiosurgery

    SciTech Connect

    Gerszten, Peter C. Burton, Steven A.

    2008-07-01

    The role of stereotactic radiosurgery for the treatment of intracranial lesions is well established. Its use for the treatment of spinal lesions has been limited because of the availability of effective target immobilization devices. Recent advances in stereotactic IGRT have allowed for spinal applications. Large clinical experience with spinal radiosurgery to properly assess clinical outcomes has previously been limited. At our institution, we have developed a successful multidisciplinary spinal radiosurgery program in which 542 spinal lesions (486 malignant and 56 benign lesions) were treated with a single-fraction radiosurgery technique. Patient ages ranged from 18 to 85 years (mean 56 years). Lesion location included 92 cervical, 234 thoracic, 130 lumbar, and 86 sacral. The most common metastatic tumors were renal cell (89 cases), breast (74 cases), and lung (71 cases). The most common benign tumors were neurofibroma (24 cases), schwannoma (13 cases), and meningioma (7 cases). Eighty-nine cervical lesions were treated using skull tracking. Thoracic, lumbar, and sacral tumors were tracked relative to either gold or stainless steel fiducial markers. The maximum intratumoral dose ranged from 12.5 to 30 Gy (mean 20 Gy). Tumor volume ranged from 0.16 to 298 mL (mean 47 mL). Three hundred thirty-seven lesions had received prior external beam irradiation with spinal cord doses precluding further conventional irradiation. The primary indication for radiosurgery was pain in 326 cases, as a primary treatment modality in 70 cases, for tumor radiographic tumor progression in 65 cases, for post-surgical treatment in 38 cases, for progressive neurological deficit in 35 cases, and as a radiation boost in 8 cases. Follow-up period was at least 3 to 49 months. Axial and/or radicular pain improved in 300 of 326 cases (92%). Long-term tumor control was demonstrated in 90% of lesions treated with radiosurgery as a primary treatment modality and in 88% of lesions treated for

  6. Plasma devices to guide and collimate a high density of MeV electrons.

    PubMed

    Kodama, R; Sentoku, Y; Chen, Z L; Kumar, G R; Hatchett, S P; Toyama, Y; Cowan, T E; Freeman, R R; Fuchs, J; Izawa, Y; Key, M H; Kitagawa, Y; Kondo, K; Matsuoka, T; Nakamura, H; Nakatsutsumi, M; Norreys, P A; Norimatsu, T; Snavely, R A; Stephens, R B; Tampo, M; Tanaka, K A; Yabuuchi, T

    2004-12-23

    The development of ultra-intense lasers has facilitated new studies in laboratory astrophysics and high-density nuclear science, including laser fusion. Such research relies on the efficient generation of enormous numbers of high-energy charged particles. For example, laser-matter interactions at petawatt (10(15) W) power levels can create pulses of MeV electrons with current densities as large as 10(12) A cm(-2). However, the divergence of these particle beams usually reduces the current density to a few times 10(6) A cm(-2) at distances of the order of centimetres from the source. The invention of devices that can direct such intense, pulsed energetic beams will revolutionize their applications. Here we report high-conductivity devices consisting of transient plasmas that increase the energy density of MeV electrons generated in laser-matter interactions by more than one order of magnitude. A plasma fibre created on a hollow-cone target guides and collimates electrons in a manner akin to the control of light by an optical fibre and collimator. Such plasma devices hold promise for applications using high energy-density particles and should trigger growth in charged particle optics. PMID:15616556

  7. Users’ guide to the surgical literature: how to perform a high-quality literature search

    PubMed Central

    Waltho, Daniel; Kaur, Manraj Nirmal; Haynes, R. Brian; Farrokhyar, Forough; Thoma, Achilleas

    2015-01-01

    Summary The article “Users’ guide to the surgical literature: how to perform a literature search” was published in 2003, but the continuing technological developments in databases and search filters have rendered that guide out of date. The present guide fills an existing gap in this area; it provides the reader with strategies for developing a searchable clinical question, creating an efficient search strategy, accessing appropriate databases, and skillfully retrieving the best evidence to address the research question. PMID:26384150

  8. Functional MRI for immediate monitoring stereotactic thalamotomy in a patient with essential tremor.

    PubMed

    Hesselmann, Volker; Maarouf, Mohammed; Hunsche, Stefan; Lasek, Kathrin; Schaaf, Maike; Krug, Barbara; Lackner, Klaus; Sturm, Volker; Wedekind, Christoph

    2006-10-01

    The effect of stereotactic thalamotomy was assessed with pre- and postoperative functional magnetic resonance imaging (fMRI) under motor stimulation. A patient with unilateral essential tremor (ET) of the left arm underwent stereotactically guided thalamotomy of the right ventral intermediate thalamic nucleus (VIM). FMRI was done directly before and after surgery on a 1.5-Tesla scanner. The stimulation paradigm was maintainance of the affected arm in an extended position and hand clenching being performed in a block design manner. Statistical analysis was done with Brain Voyager 2000. After thalamotomy the tremor diminished completely. As a difference between the pre- and postoperative fMRI, a significant activation was found in the VIM contralateral to the activation site, adjacent to the inferior olivary nucleus contralateral to the activation site and in the dorsal cingulum. In conclusion, fMRI can detect the functional effect of thalamotomy for tremor treatment. Direct postoperative fMRI provides a sufficient method for estimating the effect of thalamotomy immediately after intervention. The importance of the intermediate thalamic nucleus and the olivary nucleus in tremor generation is supported by our findings. PMID:16625350

  9. Effects of combined sunitinib and extracranial stereotactic radiotherapy on bone marrow hematopoiesis

    PubMed Central

    Kao, Johnny; Timmins, Jonathan; Ozao-Choy, Junko; Packer, Stuart

    2016-01-01

    There is considerable interest in deploying stereotactic body radiotherapy in combination with immune therapy for patients with extracranial oligometastases. In addition to angiogenesis inhibition, sunitinib appears to mediate antitumor immunity through effects on circulating monocytic cells. The current study investigated the effects of combined sunitinib and stereotactic radiotherapy on hematopoiesis. As part of a phase I/II clinical trial utilizing concurrent sunitinib (25–50 mg on days 1–28) and image-guided radiation therapy (40–50 Gy in 10 fractions starting on days 8–19) for patients with metastatic cancer, the complete blood count, platelet count and automatic differential were performed pretreatment and on days 8 and 19. On average, sunitinib monotherapy for 7 days resulted in a 33% decrease in monocytes and an 18% decrease in neutrophils (P<0.01 for all). Compared to sunitinib alone, combined sunitinib and radiation resulted in a further decrease in neutrophils, lymphocytes and platelets (P<0.05). Following sunitinib and radiation treatment, a greater than average decrease in monocytes (≥200/µl) was associated with a significant increase in progression-free and overall survival times. This exploratory study provides further evidence that monocytes represent a potential biomarker in patients with solid tumors treated with sunitinib. PMID:27602153

  10. Gamma Knife radiosurgery combined with stereotactic aspiration as an effective treatment method for large cystic brain metastases

    PubMed Central

    WANG, HONGWEI; QI, SONGTAO; DOU, CHANGWU; JU, HAITAO; HE, ZHANBIAO; MA, QINGHAI

    2016-01-01

    In the present study, the efficacy and clinical outcomes of stereotactic aspiration combined with the Gamma Knife radiosurgery (GKRS) method were evaluated retrospectively for patients with large cystic brain metastases. This combined method aims to decrease the tumor weight (volume) and increase the possible radiation dose. The present study involved 48 patients who were diagnosed with cystic metastatic brain tumors between January 2008 and December 2012 in the Department of Neurosurgery of Nanfang Hospital Southern Medical University (Guangzhou, China). Every patient underwent Leksell stereotactic frame, 1.5T magnetic resonance imaging (MRI)-guided stereotactic cyst aspiration and Leksell GKRS. Subsequent to the therapy, MRI was performed every 3 months. The results indicated that 48 cases were followed up for 24–72 months, with a mean follow-up duration of 36.2 months. Following treatment, 44 patients (91.7%) exhibited tumor control and 4 patients (8.3%) experienced progression of the local tumor. During this period, 35 patients (72.9%) succumbed, but only 2 (4.2%) of these succumbed to the brain metastases. The total local control rate was 91.7% and the median overall survival time of all patients was 19.5 months. The 1-year overall survival rate was 70.8% and the 2-year overall survival rate was 26.2%. In conclusion, these results indicated that the method of stereotactic cyst aspiration combined with GKRS was safe and effective for patients with large cystic brain metastases. This method is effective for patients whose condition is too weak for general anesthesia and in whom the tumors are positioned at eloquent areas. This method enables patients to avoid a craniotomy, and provides a good tumor control rate, survival time and quality of life. PMID:27347148

  11. Medical applications of fast 3D cameras in real-time image-guided radiotherapy (IGRT) of cancer

    NASA Astrophysics Data System (ADS)

    Li, Shidong; Li, Tuotuo; Geng, Jason

    2013-03-01

    Dynamic volumetric medical imaging (4DMI) has reduced motion artifacts, increased early diagnosis of small mobile tumors, and improved target definition for treatment planning. High speed cameras for video, X-ray, or other forms of sequential imaging allow a live tracking of external or internal movement useful for real-time image-guided radiation therapy (IGRT). However, none of 4DMI can track real-time organ motion and no camera has correlated with 4DMI to show volumetric changes. With a brief review of various IGRT techniques, we propose a fast 3D camera for live-video stereovision, an automatic surface-motion identifier to classify body or respiratory motion, a mechanical model for synchronizing the external surface movement with the internal target displacement by combination use of the real-time stereovision and pre-treatment 4DMI, and dynamic multi-leaf collimation for adaptive aiming the moving target. Our preliminary results demonstrate that the technique is feasible and efficient in IGRT of mobile targets. A clinical trial has been initiated for validation of its spatial and temporal accuracies and dosimetric impact for intensity-modulated RT (IMRT), volumetric-modulated arc therapy (VMAT), and stereotactic body radiotherapy (SBRT) of any mobile tumors. The technique can be extended for surface-guided stereotactic needle insertion in biopsy of small lung nodules.

  12. Stereotactic body radiotherapy for prostate cancer.

    PubMed

    Henderson, D R; Tree, A C; van As, N J

    2015-05-01

    The use of stereotactic body radiotherapy (SBRT) for localised prostate cancer is now supported by a substantial body of non-randomised data, with medium-term outcomes consistent with current standard radiotherapy. The ability to deliver profoundly hypofractionated treatment, combined with the relatively low α/β ratio of prostate cancer, may result in a more favourable therapeutic ratio, presenting an opportunity for isotoxic dose escalation. Furthermore, as treatment can be given in five attendances, SBRT has the potential both to reduce costs and improve patient quality of life. However, in a treatment landscape with many competing options of broadly similar efficacy, randomised trials are essential to define the relative benefits of this approach. SBRT also has an emerging application in oligometastatic prostate cancer, with promising early outcomes for delaying disease progression and deferring the need for androgen deprivation therapy. PMID:25707911

  13. Emerging applications of stereotactic body radiotherapy.

    PubMed

    Lo, Simon S; Loblaw, Andrew; Chang, Eric L; Mayr, Nina A; Teh, Bin S; Huang, Zhibin; Yao, Min; Ellis, Rodney J; Biswas, Tithi; Sohn, Jason W; Machtay, Mitchell; Sahgal, Arjun

    2014-05-01

    Stereotactic body radiotherapy (SBRT) has been used extensively in patients with lung, liver and spinal tumors, and the treatment outcomes are very favorable. For certain conditions such as medically inoperable stage I non-small-cell lung cancer, liver and lung oligometastases, primary liver cancer and spinal metastases, SBRT is regarded as one of the standard therapies. In the recent years, the use of SBRT has been extended to other disease conditions and sites such as recurrent head and neck cancer, renal cell carcinoma, prostate cancer, adrenal metastasis, pancreatic cancer, gynecological malignancies, spinal cord compression, breast cancer, and stage II-III non-small-cell lung cancer. Preliminary data in the literature show promising results but the follow-up intervals are short for most studies. This paper will provide an overview of these emerging applications. PMID:24947266

  14. Commissioning and initial stereotactic ablative radiotherapy experience with Vero.

    PubMed

    Solberg, Timothy D; Medin, Paul M; Ramirez, Ezequiel; Ding, Chuxiong; Foster, Ryan D; Yordy, John

    2014-01-01

    The purpose of this study is to describe the comprehensive commissioning process and initial clinical performance of the Vero linear accelerator, a new radiotherapy device recently installed at UT Southwestern Medical Center specifically developed for delivery of image-guided stereotactic ablative radiotherapy (SABR). The Vero system utilizes a ring gantry to integrate a beam delivery platform with image guidance systems. The ring is capable of rotating ± 60° about the vertical axis to facilitate noncoplanar beam arrangements ideal for SABR delivery. The beam delivery platform consists of a 6 MV C-band linac with a 60 leaf MLC projecting a maximum field size of 15 × 15 cm² at isocenter. The Vero planning and delivery systems support a range of treatment techniques, including fixed beam conformal, dynamic conformal arcs, fixed gantry IMRT in either SMLC (step-and-shoot) or DMLC (dynamic) delivery, and hybrid arcs, which combines dynamic conformal arcs and fixed beam IMRT delivery. The accelerator and treatment head are mounted on a gimbal mechanism that allows the linac and MLC to pivot in two dimensions for tumor tracking. Two orthogonal kV imaging subsystems built into the ring facilitate both stereoscopic and volumetric (CBCT) image guidance. The system is also equipped with an always-active electronic portal imaging device (EPID). We present our commissioning process and initial clinical experience focusing on SABR applications with the Vero, including: (1) beam data acquisition; (2) dosimetric commissioning of the treatment planning system, including evaluation of a Monte Carlo algorithm in a specially-designed anthropomorphic thorax phantom; (3) validation using the Radiological Physics Center thorax, head and neck (IMRT), and spine credentialing phantoms; (4) end-to-end evaluation of IGRT localization accuracy; (5) ongoing system performance, including isocenter stability; and (6) clinical SABR applications. PMID:24710458

  15. Disabling amnestic syndrome following stereotactic laser ablation of a hypothalamic hamartoma in a patient with a prior temporal lobectomy☆

    PubMed Central

    Zubkov, Sarah; Del Bene, Victor A.; MacAllister, William S.; Shepherd, Timothy M.; Devinsky, Orrin

    2015-01-01

    A 19-year-old man with cortical dysplasia and intractable focal seizures underwent a right temporal lobectomy. A hypothalamic hamartoma was subsequently recognized, and he then underwent MRI-guided stereotactic laser ablation. Unfortunately, he sustained damage to the bilateral medial mammillary bodies and suffered significant memory loss. We review laser ablation therapy for hypothalamic hamartomas and the anatomy of the memory network. We postulate that his persistent memory disorder resulted from a combination of the right temporal lobectomy and injury to the bilateral medial mammillary bodies. PMID:26288758

  16. Clinical Application of High-Dose, Image-Guided Intensity-Modulated Radiotherapy in High-Risk Prostate Cancer

    SciTech Connect

    Bayley, Andrew; Rosewall, Tara; Craig, Tim; Bristow, Rob; Chung, Peter; Gospodarowicz, Mary; Menard, Cynthia; Milosevic, Michael; Warde, Padraig; Catton, Charles

    2010-06-01

    Purpose: To report the feasibility and early toxicity of dose-escalated image-guided IMRT to the pelvic lymph nodes (LN), prostate (P), and seminal vesicles (SV). Methods and Materials: A total of 103 high-risk prostate cancer patients received two-phase, dose-escalated, image-guided IMRT with 3 years of androgen deprivation therapy. Clinical target volumes (CTVs) were delineated using computed tomography/magnetic resonance co-registration and included the prostate, portions of the SV, and the LN. Planning target volume margins (PTV) used were as follows: P (10 mm, 7 mm posteriorly), SV (10 mm), and LN (5 mm). Organs at risk (OaR) were the rectal and bladder walls, femoral heads, and large and small bowel. The IMRT was planned with an intended dose of 55.1 Gy in 29 fractions to all CTVs (Phase 1), with P+SV consecutive boost of 24.7 Gy in 13 fractions. Daily online image guidance was performed using bony landmarks and intraprostatic markers. Feasibility criteria included delivery of intended doses in 80% of patients, 95% of CTV displacements incorporated within PTV during Phase 1, and acute toxicity rate comparable to that of lower-dose pelvic techniques. Results: A total of 91 patients (88%) received the total prescription dose. All patients received at least 72 Gy. In Phase 1, 63 patients (61%) received the intended 55.1 Gy, whereas 87% of patients received at least 50 Gy. Dose reductions were caused by small bowel and rectal wall constraints. All CTVs received the planned dose in >95% of treatment fractions. There were no Radiation Therapy Oncology Group acute toxicities greater than Grade 3, although there were five incidences equivalent to Grade 3 within a median follow-up of 23 months. Conclusion: These results suggest that dose escalation to the PLN+P+SV using IMRT is feasible, with acceptable rates of acute toxicity.

  17. Wetlands & Wildlife: Alaska Wildlife Curriculum Junior & Senior High Teacher's Guide 7-12.

    ERIC Educational Resources Information Center

    Sigman, Marilyn; And Others

    This curriculum guide was designed to give students at the secondary level an awareness of Alaska's wetlands and the fish and wildlife that live there. The guide is divided into the following sections which include related learning activities: (1) definition and location of wetlands; (2) wetland functions in energy flow and ecological balance; (3)…

  18. Selecting Computer-Based High School Science Curricula: A Guide for Teachers

    ERIC Educational Resources Information Center

    Flynn, Joseph; Hiles, Elisabeth

    2005-01-01

    This guide is intended for teachers and other educators confronting the challenge of using technology to enhance the way they teach science. Accompanying the recent boom in education Web sites has been the production of guides and guidelines, models, and methodologies for planning technology reforms in school districts, school buildings, and…

  19. Room for Five: Senior High School English Language Arts. Teacher Guide.

    ERIC Educational Resources Information Center

    Young, Carol

    This teacher guide contains teaching and learning activities to accompany "Room for Five," a video series developed by Alberta Learning. The teacher guide is designed to give teachers ideas for using and connecting the videos from the series to the outcomes of the new Alberta curricular programs. It features student activities for the opening…

  20. Individualized Education Program (IEP) Planning Guide for Special Education Students Entering High School Vocational Education Programs.

    ERIC Educational Resources Information Center

    Burrell, Lewis P.

    This guide is designed to assist school program planners who are working with mainstreamed special education students in vocational education programs. The guide, covering grades 11 and 12, contains vocational program goals, objectives, and evaluation measures for 30 secondary vocational education programs in 15 curriculum areas, as well as for…

  1. A Guide to Establishing a Science/Mathematics Research Program in High School. Experimental.

    ERIC Educational Resources Information Center

    Goodman, Harvey; And Others

    This guide has been designed to help teachers, supervisors, and administrators set up a science or mathematics research program which should provide students with a set of basic "tools" for use in problem solving situations. The guide is organized into 17 chapters. The first 15 chapters focus on: organizing a research program; recruiting students;…

  2. Career Exploration Occupational Information for the Junior High/Middle School. A Planning Curriculum Guide.

    ERIC Educational Resources Information Center

    Lawson, Dorothy M.; McDonald, Dorothea V.

    Materials contained in this guide are designed to be used in planning a comprehensive career education program and for developing individual career education units for grades 6-9. Section 1 is the planning guide and contains strategies for organizing, planning, and implementing a program, developing staff inservice, conducting a needs assessment,…

  3. INTER- AND INTRAFRACTION MOTION FOR STEREOTACTIC RADIOSURGERY IN DOGS AND CATS USING A MODIFIED BRAINLAB FRAMELESS STEREOTACTIC MASK SYSTEM.

    PubMed

    Dieterich, Sonja; Zwingenberger, Allison; Hansen, Katherine; Pfeiffer, Isabella; Théon, Alain; Kent, Michael S

    2015-01-01

    Precise and accurate patient positioning is necessary when doing stereotactic radiosurgery (SRS) to ensure adequate dosing to the tumor and sparing of normal tissues. This prospective cross-sectional study aimed to assess feasibility of a commercially available modified frameless SRS positioning system for use in veterinary radiotherapy patients with brain tumors. Fifty-one dogs and 12 cats were enrolled. Baseline and verification CT images were acquired. The verification CT images from 32 dogs and five cats had sufficient images for fusion to baseline CT images. A rigid box-based fusion was performed to determine interfraction motion. Forty-eight dogs and 11 cats were assessed for intrafraction motion by cine CT. Seventy percent of dogs and 60% of cats had interfraction 3D vector translational shifts >1 mm, with mean values of 1.9 mm in dogs, and 1.8 mm in cats. In dogs muscle wasting was weakly correlated with translational shifts. The maximum angular interfraction motion observed was 6.3° (roll), 3.5° (pitch), and 3.3° (yaw). There was no correlation between angular interfraction motion and weight, brachycephaly, or muscle wasting. Fifty-seven percent of dogs and 50% of cats had respiration-related intrafraction motion. Of these, 4.5% of dogs and 10% of cats had intrafraction motion >1 mm. This study demonstrates the modified Brainlab system is feasible for SRS in dogs and cats. The smaller cranial size and difference in anatomy increases setup uncertainty in some animals beyond limits usually accepted in SRS. Image-guided positioning is recommended to achieve clinically acceptable setup accuracy (<1 mm) for SRS. PMID:26118737

  4. High-performance iron oxide nanoparticles for magnetic particle imaging - guided hyperthermia (hMPI).

    PubMed

    Bauer, Lisa M; Situ, Shu F; Griswold, Mark A; Samia, Anna Cristina S

    2016-06-16

    Magnetic particle imaging (MPI) is an emerging imaging modality that allows the direct and quantitative mapping of iron oxide nanoparticles. In MPI, the development of tailored iron oxide nanoparticle tracers is paramount to achieving high sensitivity and good spatial resolution. To date, most MPI tracers being developed for potential clinical applications are based on spherical undoped magnetite nanoparticles. For the first time, we report on the systematic investigation of the effects of changes in chemical composition and shape anisotropy on the MPI performance of iron oxide nanoparticle tracers. We observed a 2-fold enhancement in MPI signal through selective doping of magnetite nanoparticles with zinc. Moreover, we demonstrated focused magnetic hyperthermia heating by adapting the field gradient used in MPI. By saturating the iron oxide nanoparticles outside of a field free region (FFR) with an external static field, we can selectively heat a target region in our test sample. By comparing zinc-doped magnetite cubic nanoparticles with undoped spherical nanoparticles, we could show a 5-fold improvement in the specific absorption rate (SAR) in magnetic hyperthermia while providing good MPI signal, thereby demonstrating the potential for high-performance focused hyperthermia therapy through an MPI-guided approach (hMPI). PMID:27210742

  5. Dynamic T2-mapping during magnetic resonance guided high intensity focused ultrasound ablation of bone marrow

    NASA Astrophysics Data System (ADS)

    Waspe, Adam C.; Looi, Thomas; Mougenot, Charles; Amaral, Joao; Temple, Michael; Sivaloganathan, Siv; Drake, James M.

    2012-11-01

    Focal bone tumor treatments include amputation, limb-sparing surgical excision with bone reconstruction, and high-dose external-beam radiation therapy. Magnetic resonance guided high intensity focused ultrasound (MR-HIFU) is an effective non-invasive thermotherapy for palliative management of bone metastases pain. MR thermometry (MRT) measures the proton resonance frequency shift (PRFS) of water molecules and produces accurate (<1°C) and dynamic (<5s) thermal maps in soft tissues. PRFS-MRT is ineffective in fatty tissues such as yellow bone marrow and, since accurate temperature measurements are required in the bone to ensure adequate thermal dose, MR-HIFU is not indicated for primary bone tumor treatments. Magnetic relaxation times are sensitive to lipid temperature and we hypothesize that bone marrow temperature can be determined accurately by measuring changes in T2, since T2 increases linearly in fat during heating. T2-mapping using dual echo times during a dynamic turbo spin-echo pulse sequence enabled rapid measurement of T2. Calibration of T2-based thermal maps involved heating the marrow in a bovine femur and simultaneously measuring T2 and temperature with a thermocouple. A positive T2 temperature dependence in bone marrow of 20 ms/°C was observed. Dynamic T2-mapping should enable accurate temperature monitoring during MR-HIFU treatment of bone marrow and shows promise for improving the safety and reducing the invasiveness of pediatric bone tumor treatments.

  6. High quality electron beams from a plasma channel guided laser wakefield accelerator

    SciTech Connect

    Geddes, C.G.R.; Toth, Cs.; van Tilborg, J.; Esarey, E.; Schroeder, C.B.; Bruhwiler, D.; Nieter, C.; Cary, J.; Leemans, W.P.

    2004-07-08

    Laser driven accelerators, in which particles are accelerated by the electric field of a plasma wave driven by an intense laser, have demonstrated accelerating electric fields of hundreds of GV/m. These fields are thousands of times those achievable in conventional radiofrequency (RF) accelerators, spurring interest in laser accelerators as compact next generation sources of energetic electrons and radiation. To date however, acceleration distances have been severely limited by lack of a controllable method for extending the propagation distance of the focused laser pulse. The ensuing short acceleration distance results in low energy beams with 100% electron energy spread, limiting applications. Here we demonstrate that a relativistically intense laser can be guided by a preformed plasma density channel and that the longer propagation distance can result in electron beams of percent energy spread with low emittance and increased energy, containing >10{sup 9} electrons above 80 MeV. The preformed plasma channel technique forms the basis of a new class of accelerators, combining beam quality comparable to RF accelerators with the high gradients of laser accelerators to produce compact tunable high brightness electron and radiation sources.

  7. Let's Poem: The Essential Guide to Teaching Poetry in a High-Stakes, Multimodal World (Middle through High School). Language & Literacy Practitioners Bookshelf

    ERIC Educational Resources Information Center

    Dressman, Mark

    2010-01-01

    This cutting-edge guide presents multiple approaches to teaching poetry at the middle and high school levels. The author provides field-tested activities with detailed how-to instructions, as well as advice for how educators can "justify" their teaching within a high-stakes curriculum environment. "Let's Poem" will show pre- and inservice teachers…

  8. Fractionated Stereotactic Radiotherapy in the Treatment of Vestibular Schwannoma (Acoustic Neuroma): Predicting the Risk of Hydrocephalus;Vestibular schwannoma; Hydrocephalus; Fractionated; Stereotactic radiotherapy

    SciTech Connect

    Powell, Ceri; Micallef, Caroline; Gonsalves, Adam; Wharram, Bev; Ashley, Sue; Brada, Michael

    2011-07-15

    Purpose: To determine the incidence and predictive factors for the development of hydrocephalus in patients with acoustic neuromas (AN) treated with fractionated stereotactic radiotherapy. Patients and Methods: Seventy-two patients with AN were treated with fractionated stereotactic radiotherapy between 1998 and 2007 (45-50 Gy in 25-30 fractions over 5 to 6 weeks). The pretreatment MRI scan was assessed for tumor characteristics and anatomic distortion independently of subsequent outcome and correlated with the risk of hydrocephalus. Results: At a median follow-up of 49 months (range, 1-120 months), 5-year event-free survival was 95%. Eight patients (11%) developed hydrocephalus within 19 months of radiotherapy, which was successfully treated. On univariate analysis, pretreatment factors predictive of hydrocephalus were maximum diameter (p = 0.005), proximity to midline (p = 0.009), displacement of the fourth ventricle (p = 0.02), partial effacement of the fourth ventricle (p < 0.001), contact with the medulla (p = 0.005), and more brainstem structures (p = 0.004). On multivariate analysis, after adjusting for fourth ventricular effacement, no other variables remained independently associated with hydrocephalus formation. Conclusions: Fractionated stereotactic radiotherapy results in excellent tumor control of AN, albeit with a risk of developing hydrocephalus. Patients at high risk, identified as those with larger tumors with partial effacement of the fourth ventricle before treatment, should be monitored more closely during follow-up. It would also be preferable to offer treatment to patients with progressive AN while the risk of hydrocephalus is low, before the development of marked distortion of fourth ventricle before tumor diameter significantly exceeds 2 cm.

  9. NAGC Pre-K-Grade 12 Gifted Education Programming Standards: A Guide to Planning and Implementing High-Quality Services

    ERIC Educational Resources Information Center

    Johnsen, Susan K., Ed.

    2012-01-01

    The new Pre-K-Grade 12 Gifted Education Programming Standards should be part of every school district's repertoire of standards to ensure that the learning needs of advanced students are being met. "NAGC Pre-K-Grade 12 Gifted Education Programming Standards: A Guide to Planning and Implementing High-Quality Services" details six standards that…

  10. Foods and Nutrition Curriculum Guide for Junior High, Secondary, and Adult Vocational Home Economics Programs. Bulletin 1595.

    ERIC Educational Resources Information Center

    Louisiana State Dept. of Education, Baton Rouge. Div. of Vocational Education.

    This comprehensive curriculum guide for junior high through adult levels presents foods and nutrition as they relate to quality living, career orientation, and occupational training. The first section is a conceptual outline of core material in foods and nutrition. Five instructional levels are I (grades 7-9), II (9-10), III (10-11), IV (11-12),…

  11. Advancing Students' Academic and Technical Achievement by Improving Classroom Assessment. Site Development Guide #10. High Schools That Work.

    ERIC Educational Resources Information Center

    Southern Regional Education Board, Atlanta, GA.

    This guide for those in the "High Schools That Work" initiative is designed to help teachers use classroom assessment to motivate students to work harder to meet challenging standards; to get students to organize information, make interdisciplinary connections, synthesize new knowledge, and draw conclusions from what they learn; to promote…

  12. Exploring Career Pathways. A Guide for Expanding Vocational-Technical Education in the Middle School/Junior High School.

    ERIC Educational Resources Information Center

    Baxter, Jim

    This guide, which was developed for Idaho middle and junior high school teachers, provides a framework for developing hands-on curricula that will acquaint students with concepts and activities common to a wide range of occupations. Presented after a brief introduction explaining the rationale for a curriculum based on career pathways are a…

  13. Using "Reader's Guide to Periodical Literature" on CD-Rom To Teach Database Searching to High School Students.

    ERIC Educational Resources Information Center

    Kern, Joanne F.

    The lack of opportunity for high school sophomores to learn database searching was addressed by the implementation of a computerized magazine article search program. "Reader's Guide to Periodical Literature" on CD-ROM was used to train students in database searching during the time they were assigned to the library to do research papers for…

  14. A Lifetime for Fire Safety. Health (High School). Fire Safety for Texans: Fire and Burn Prevention Curriculum Guide.

    ERIC Educational Resources Information Center

    Texas State Commission on Fire Protection, Austin.

    This booklet comprises the high school health component of a series of curriculum guides on fire and burn prevention. It is designed to meet the age-specific needs of ninth and tenth grade students. Objectives include: (1) reviewing comprehensive fire and burn prevention techniques and emergency actions; (2) developing an awareness of fire safety…

  15. A Guide for Teaching Consumer Education for a Coeducational Class in Home Economics at the High School Level.

    ERIC Educational Resources Information Center

    Orange County Dept. of Education, Santa Ana, CA.

    This guide for teaching consumer education for a coeducational class in home economics at the high school level is organized to capitalize on student interests. The course is for one semester, but more material than needed is provided. Overall course objectives are stated, and suggested course titles are listed. Eleven teaching units are…

  16. A Curriculum Activities Guide to Selected Environmental Topics for Use With Elementary and Junior High School Students.

    ERIC Educational Resources Information Center

    Sexton, Alan D., Ed.

    This guide contains learning activities in environmental education developed by teachers and intended for use at the elementary or junior high school levels. Topics covered include: water, esthetics, air, soil and sediment, solid waste, energy, noise, population, and transportation. Generally, each activity contains an introduction, a listing of…

  17. Failure Is Not an Option (TM). Six Principles That Guide Student Achievement in High-Performing Schools

    ERIC Educational Resources Information Center

    Blankstein, Alan M.

    2004-01-01

    The author builds upon a foundation which identifies courageous school leadership and the professional learning community as the center of effective school reform. The author offers six guiding principles steps for creating and sustaining a high-performing school: (1) Common mission, vision, values, and goals: (2) Systems for prevention and…

  18. Multiple Intelligences: Theory to Practice in New York City Schools. Middle School/High School. [Manual and Video Guide].

    ERIC Educational Resources Information Center

    Leopold, Marjorie

    This program is a self-guided professional development experience that explains how to use multiple intelligences (MI) theory to improve teaching, learning, and achievement in middle and high school classrooms. The program consists of one manual and six VHS videos, each of which corresponds to one of the six modules listed in the table of…

  19. Old Enough to Care. Teacher's Guide. A Series of 6/15-Minute Programs for High School Students about Aging.

    ERIC Educational Resources Information Center

    Tyminski, Lucy T.; And Others

    Intended to accompany a series of six 15-minute color videocassette programs, this teacher's guide contains suggestions for teaching high school students to achieve the series goals, which are to: (1) acquire accurate information about the elderly and the aging process by debunking myths that currently surround this biological, psychological, and…

  20. High School Senior's Guide to Merit and Other No-Need Funding, 1998-2000, 2nd Edition.

    ERIC Educational Resources Information Center

    Schlachter, Gail Ann; Webber, R. David

    This volume provides information on 1,100 merit scholarships and other no-need funding programs available specifically to high school seniors applying to college. Programs listed in the guide make decisions based upon student academic records, writing or artistic ability, speech-making skills, religious or ethnic background, parents'…

  1. A PLANNING GUIDE FOR VOCATIONAL-INDUSTRIAL AND VOCATIONAL-TECHNICAL BUILDING FACILITIES FOR COMPREHENSIVE HIGH SCHOOLS, NUMBER 18.

    ERIC Educational Resources Information Center

    State Univ. of New York, Albany.

    THIS BOOKLET IS INTENDED AS A GUIDE FOR THOSE RESPONSIBLE FOR PLANNING VOCATIONAL HIGH SCHOOL FACILITIES. DISCUSSION OF TYPES OF INDUSTRIAL EDUCATION, PLANNING PROCEDURES, AND GENERAL CONSIDERATIONS ARE INCLUDED AND INFORMATION IS GIVEN ON--(1) SIZES, SHAPES, AND NUMBER OF SHOPS, (2) BUILDING FLEXIBILITY, (3) LAYOUT OF FLOOR SPACE, (4) SERVICES IN…

  2. Teaching Science Using Guided Inquiry as the Central Theme: A Professional Development Model for High School Science Teachers

    ERIC Educational Resources Information Center

    Banerjee, Anil

    2010-01-01

    The author describes a professional development model for high school science teachers based on the framework of inquiry and science standards. The "Learn-Teach-Assess Inquiry" model focuses on guided inquiry labs as the central theme and builds on these labs to reinforce science concepts and abilities to understand and engage in inquiry in…

  3. Using adverse outcome pathway analysis to guide development of high-throughput screening assays for thyroid-disruptors

    EPA Science Inventory

    Using Adverse Outcome Pathway Analysis to Guide Development of High-Throughput Screening Assays for Thyroid-Disruptors Katie B. Paul1,2, Joan M. Hedge2, Daniel M. Rotroff4, Kevin M. Crofton4, Michael W. Hornung3, Steven O. Simmons2 1Oak Ridge Institute for Science Education Post...

  4. Topology-Guided Design and Syntheses of Highly Stable Mesoporous Porphyrinic Zirconium Metal-Organic Frameworks with High Surface Area

    SciTech Connect

    Liu, TF; Feng, DW; Chen, YP; Zou, LF; Bosch, M; Yuan, S; Wei, ZW; Fordham, S; Wang, KC; Zhou, HC

    2015-01-14

    Through a topology-guided strategy, a series of Zr-6-containing isoreticular porphyrinic metalorganic frameworks (MOFs), PCN-228, PCN-229, and PCN-230, with ftw-a topology were synthesized using the extended porphyrinic linkers. The bulky porphyrin ring ligand effectively prevents the network interpenetration which often appears in MOFs with increased linker length. The pore apertures of the structures range from 2.5 to 3.8 nm, and PCN-229 demonstrates the highest porosity and BET surface area among the previously reported Zr-MOFs. Additionally, by changing the relative direction of the terminal phenyl rings, this series replaces a Zr-8 cluster with a smaller Zr-6 cluster in a topologically identical framework. The high connectivity of the Zr-6 cluster yields frameworks with enhanced stability despite high porosity and ultralarge linker. As a representative example, PCN-230, constructed with the most extended porphyrinic linker, shows excellent stability in aqueous solutions with pH values ranging from 0 to 12 and demonstrates one of the highest pH tolerances among all porphyrinic MOFs. This work not only presents a successful example of rational design of MOFs with desired topology, but also provides a strategy for construction of stable mesoporous MOFs.

  5. Topology-guided design and syntheses of highly stable mesoporous porphyrinic zirconium metal-organic frameworks with high surface area

    SciTech Connect

    Liu, Tian -Fu; Feng, Dawei; Chen, Ying -Pin; Zou, Lanfang; Bosch, Mathieu; Yuan, Shuai; Wei, Zhangwen; Fordham, Stephen; Wang, Kecheng; Zhou, Hong -Cai

    2015-01-14

    Through a topology-guided strategy, a series of Zr₆-containing isoreticular porphyrinic metal–organic frameworks (MOFs), PCN-228, PCN-229, and PCN-230, with ftw-a topology were synthesized using the extended porphyrinic linkers. The bulky porphyrin ring ligand effectively prevents the network interpenetration which often appears in MOFs with increased linker length. The pore apertures of the structures range from 2.5 to 3.8 nm, and PCN-229 demonstrates the highest porosity and BET surface area among the previously reported Zr-MOFs. Additionally, by changing the relative direction of the terminal phenyl rings, this series replaces a Zr₈ cluster with a smaller Zr₆ cluster in a topologically identical framework. The high connectivity of the Zr₆ cluster yields frameworks with enhanced stability despite high porosity and ultralarge linker. As a representative example, PCN-230, constructed with the most extended porphyrinic linker, shows excellent stability in aqueous solutions with pH values ranging from 0 to 12 and demonstrates one of the highest pH tolerances among all porphyrinic MOFs. This work not only presents a successful example of rational design of MOFs with desired topology, but also provides a strategy for construction of stable mesoporous MOFs.

  6. Image-guided high-dose-rate brachytherapy of malignancies in various inner organs – technique, indications, and perspectives

    PubMed Central

    Bretschneider, Tina; Ricke, Jens; Gebauer, Bernhard

    2016-01-01

    In the last few years, minimally invasive tumor ablation performed by interventional radiologists has gained increasing relevance in oncologic patient care. Limitations of thermal ablation techniques such as radiofrequency ablation (RFA), microwave ablation (MWA), and laser-induced thermotherapy (LITT), including large tumor size, cooling effects of adjacent vessels, and tumor location near thermosensitive structures, have led to the development of image-guided high-dose-rate (HDR) brachytherapy, especially for the treatment of liver malignancies. This article reviews technical properties of image-guided brachytherapy, indications and its current clinical role in multimodal cancer treatment. Furthermore, perspectives of this novel therapy option will be discussed. PMID:27504135

  7. Image-guided high-dose-rate brachytherapy of malignancies in various inner organs - technique, indications, and perspectives.

    PubMed

    Bretschneider, Tina; Ricke, Jens; Gebauer, Bernhard; Streitparth, Florian

    2016-06-01

    In the last few years, minimally invasive tumor ablation performed by interventional radiologists has gained increasing relevance in oncologic patient care. Limitations of thermal ablation techniques such as radiofrequency ablation (RFA), microwave ablation (MWA), and laser-induced thermotherapy (LITT), including large tumor size, cooling effects of adjacent vessels, and tumor location near thermosensitive structures, have led to the development of image-guided high-dose-rate (HDR) brachytherapy, especially for the treatment of liver malignancies. This article reviews technical properties of image-guided brachytherapy, indications and its current clinical role in multimodal cancer treatment. Furthermore, perspectives of this novel therapy option will be discussed. PMID:27504135

  8. 10 CFR 35.2645 - Records of periodic spot-checks for gamma stereotactic radiosurgery units.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 1 2010-01-01 2010-01-01 false Records of periodic spot-checks for gamma stereotactic... MATERIAL Records § 35.2645 Records of periodic spot-checks for gamma stereotactic radiosurgery units. (a) A... and intercom systems, timer termination, treatment table retraction mechanism, and stereotactic...

  9. 10 CFR 35.2645 - Records of periodic spot-checks for gamma stereotactic radiosurgery units.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 1 2014-01-01 2014-01-01 false Records of periodic spot-checks for gamma stereotactic... MATERIAL Records § 35.2645 Records of periodic spot-checks for gamma stereotactic radiosurgery units. (a) A... and intercom systems, timer termination, treatment table retraction mechanism, and stereotactic...

  10. 10 CFR 35.2645 - Records of periodic spot-checks for gamma stereotactic radiosurgery units.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 1 2013-01-01 2013-01-01 false Records of periodic spot-checks for gamma stereotactic... MATERIAL Records § 35.2645 Records of periodic spot-checks for gamma stereotactic radiosurgery units. (a) A... and intercom systems, timer termination, treatment table retraction mechanism, and stereotactic...

  11. 10 CFR 35.2645 - Records of periodic spot-checks for gamma stereotactic radiosurgery units.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 1 2012-01-01 2012-01-01 false Records of periodic spot-checks for gamma stereotactic... MATERIAL Records § 35.2645 Records of periodic spot-checks for gamma stereotactic radiosurgery units. (a) A... and intercom systems, timer termination, treatment table retraction mechanism, and stereotactic...

  12. Effective Rat Lung Tumor Model for Stereotactic Body Radiation Therapy.

    PubMed

    Zhang, Zhang; Wodzak, Michelle; Belzile, Olivier; Zhou, Heling; Sishc, Brock; Yan, Hao; Stojadinovic, Strahinja; Mason, Ralph P; Brekken, Rolf A; Chopra, Rajiv; Story, Michael D; Timmerman, Robert; Saha, Debabrata

    2016-06-01

    Stereotactic body radiation therapy (SBRT) has found an important role in the treatment of patients with non-small cell lung cancer, demonstrating improvements in dose distribution and even tumor cure rates, particularly for early-stage disease. Despite its emerging clinical efficacy, SBRT has primarily evolved due to advances in medical imaging and more accurate dose delivery, leaving a void in knowledge of the fundamental biological mechanisms underlying its activity. Thus, there is a critical need for the development of orthotropic animal models to further probe the biology associated with high-dose-per-fraction treatment typical of SBRT. We report here on an improved surgically based methodology for generating solitary intrapulmonary nodule tumors, which can be treated with simulated SBRT using the X-RAD 225Cx small animal irradiator and Small Animal RadioTherapy (SmART) Plan treatment system. Over 90% of rats developed solitary tumors in the right lung. Furthermore, the tumor response to radiation was monitored noninvasively via bioluminescence imaging (BLI), and complete ablation of tumor growth was achieved with 36 Gy (3 fractions of 12 Gy each). We report a reproducible, orthotopic, clinically relevant lung tumor model, which better mimics patient treatment regimens. This system can be utilized to further explore the underlying biological mechanisms relevant to SBRT and high-dose-per-fraction radiation exposure and to provide a useful model to explore the efficacy of radiation modifiers in the treatment of non-small cell lung cancer. PMID:27223828

  13. Stereotactic body radiation therapy for prostate cancer: Rational and reasonable.

    PubMed

    Kupelian, Patrick; Mehta, Niraj H; King, Chris; Steinberg, Michael; Finkelstein, Steven E; Fernandez, Eduardo

    2015-01-01

    Stereotactic body radiation therapy (SBRT), a treatment procedure that uses large doses per fraction, is currently being used to treat prostate cancer with external radiation therapy in 4 to 5 treatments. Published series in the clinical use of SBRT in patients with localized prostate cancer demonstrate high efficacy within the available follow-up time periods. Rectal and sexual toxicity profiles have been favorable compared with other radiation techniques and surgery. Urinary toxicity profiles might be more comparable to those observed with brachytherapy, more pronounced in the acute setting. SBRT is technically more challenging, requiring precise geometric targeting with in-room image guidance. The use of large doses per fraction potentially provides unique biological effects on both tumor and normal tissues. Immunologic responses in normal tissues, local stromal microenvironment, and specific antigen-presenting cells induced by such high doses likely contribute to effective tumor kill. Ultimately, SBRT for prostate cancer offers significant logistical advantages, with increased convenience to patients and decreased overall cost to the health care delivery system. PMID:25413392

  14. Pulmonary imaging after stereotactic radiotherapy-does RECIST still apply?

    PubMed

    Mattonen, Sarah A; Ward, Aaron D; Palma, David A

    2016-09-01

    The use of stereotactic ablative radiotherapy (SABR) for the treatment of primary lung cancer and metastatic disease is rapidly increasing. However, the presence of benign fibrotic changes on CT imaging makes response assessment following SABR a challenge, as these changes develop with an appearance similar to tumour recurrence. Misclassification of benign fibrosis as local recurrence has resulted in unnecessary interventions, including biopsy and surgical resection. Response evaluation criteria in solid tumours (RECIST) are widely used as a universal set of guidelines to assess tumour response following treatment. However, in the context of non-spherical and irregular post-SABR fibrotic changes, the RECIST criteria can have several limitations. Positron emission tomography can also play a role in response assessment following SABR; however, false-positive results in regions of inflammatory lung post-SABR can be a major clinical issue and optimal standardized uptake values to distinguish fibrosis and recurrence have not been determined. Although validated CT high-risk features show a high sensitivity and specificity for predicting recurrence, most recurrences are not detected until more than 1-year post-treatment. Advanced quantitative radiomic analysis on CT imaging has demonstrated promise in distinguishing benign fibrotic changes from local recurrence at earlier time points, and more accurately, than physician assessment. Overall, the use of RECIST alone may prove inferior to novel metrics of assessing response. PMID:27245137

  15. Federal High Performance and Sustainable Buildings: Guiding Principles for the Laboratory Support Building (LSB)

    SciTech Connect

    Pope, Jason E.

    2014-09-01

    This report documents the federal Guiding Principles conformance effort for LSB at PNNL. The effort is part of continued progress toward a campus building inventory that is 100% compliant with the Guiding Principles. The report documentation provides a narrative of how the LSB complies with each of the Guiding Principles requirements. These narratives draw from the many sources that are explained in the text and rely on extensive data collection. The descriptions point to each of these sources, providing the reader with specific policies, procedures, and data points.

  16. [Stereotactic radiotherapy is established treatment in localized non-small cell lung cancer].

    PubMed

    Sailas, Liisa; Virsunen, Heli

    2016-01-01

    Surgery has been the standard treatment in localized non-small cell lung cancer. Some of the early stage lung cancer patients are not suitable for surgery owing to associated diseases or refusing surgery. Ninety percent of untreated patients die within five years. Stereotactic ablative radiotherapy is a technique in which highly focused radiation treatment is given at a couple of high single doses to the tumor region. The treatment results in an average of 90% local control of the cancer, and the adverse effects are minor. Treatment outcome is equivalent to those of surgical therapy and is better than obtained with conventional external radiation therapy. PMID:27132296

  17. High volume image guided injections and structured rehabilitation in shoulder impingement syndrome: a retrospective study

    PubMed Central

    Morton, Sarah; Chan, Otto; Ghozlan, Asser; Price, Jessica; Perry, John; Morrissey, Dylan

    2015-01-01

    Summary Background the aim was to establish the effect of a high volume-image guided injection and structured rehabilitation (HVIGI&SR) on both pain and function in shoulder impingement syndrome (SIS). Methods 44 participants treated between January 2008 and January 2012 with a >3 month history of recalcitrant ultrasound-confirmed SIS were sent a retrospective questionnaire. All participants had received a HVIGI under ultrasound-guidance consisting of 20 mls of Marcaine with 50 mg of hydrocortisone, followed by a period of physiotherapist-led rehabilitation. The validated Shoulder Pain and Disability Index (SPADI) score was used to establish the change in the score between 1 week pre-injection and 3 weeks post-injection, along with an 11-point pain scale. Results 59% of participants responded. There was a clinically and statistically significant decrease in the SPADI score of 58.7 ± 29.9 (p<0.01). 76% of participants had an improvement in their score of over 50% from their initial score. There was a clinically and statistically significant improvement in pain of 5.19 ± 2.62 (p<0.01) on the numerical rating scale of pain. Conclusion HVIGI&SR should be considered for short-term treatment of SIS as it showed a significant improvement in both pain and function. A prolonged period of physiotherapist-led rehabilitation can then be undertaken for long term benefits. PMID:26605194

  18. Extracorporeal ultrasound-guided high intensity focused ultrasound: implications from the present clinical trials.

    PubMed

    Yu, Tinghe; Fu, Xiao

    2014-01-01

    Extracorporeal ultrasound-guided high intensity focused ultrasound (HIFU) has been clinically used for 15 years, and over 36000 cases have been reported. However, there yet lacked a consensus in the clinical values, suggesting the necessity of checking clinical findings. Clinical trials were searched and data reevaluated. HIFU was hardly performed alone; almost all present anticancer means have been applied during an HIFU treatment, and a specific regimen varied between trials; there were heterogeneity and disagreement between trials. The complexity made it difficult to distinguish the effect of HIFU. Based upon evaluable data, the efficacy of HIFU was similar to that of radio frequency, chemoembolization, chemotherapy, radiotherapy, or hormone therapy; a combined therapy did not improve the efficacy. The survival rate of HIFU plus radiotherapy was lower than that of radical surgery in liver cancers. Adverse events had no downtrend in the past years. HIFU was not a standardized procedure where the intensity and insonation mode were modified constantly throughout a treatment, limiting an evaluation from the perspective of ultrasonics. These implied that HIFU should be applied as an alternative at most occasions. The present clinical trials had defects making against the understating of HIFU. PMID:24982965

  19. High-quality electron beams from a laser wakefield accelerator using plasma-channel guiding.

    PubMed

    Geddes, C G R; Toth, C S; Van Tilborg, J; Esarey, E; Schroeder, C B; Bruhwiler, D; Nieter, C; Cary, J; Leemans, W P

    2004-09-30

    Laser-driven accelerators, in which particles are accelerated by the electric field of a plasma wave (the wakefield) driven by an intense laser, have demonstrated accelerating electric fields of hundreds of GV m(-1) (refs 1-3). These fields are thousands of times greater than those achievable in conventional radio-frequency accelerators, spurring interest in laser accelerators as compact next-generation sources of energetic electrons and radiation. To date, however, acceleration distances have been severely limited by the lack of a controllable method for extending the propagation distance of the focused laser pulse. The ensuing short acceleration distance results in low-energy beams with 100 per cent electron energy spread, which limits potential applications. Here we demonstrate a laser accelerator that produces electron beams with an energy spread of a few per cent, low emittance and increased energy (more than 10(9) electrons above 80 MeV). Our technique involves the use of a preformed plasma density channel to guide a relativistically intense laser, resulting in a longer propagation distance. The results open the way for compact and tunable high-brightness sources of electrons and radiation. PMID:15457252

  20. Extracorporeal Ultrasound-Guided High Intensity Focused Ultrasound: Implications from the Present Clinical Trials

    PubMed Central

    Yu, Tinghe; Fu, Xiao

    2014-01-01

    Extracorporeal ultrasound-guided high intensity focused ultrasound (HIFU) has been clinically used for 15 years, and over 36000 cases have been reported. However, there yet lacked a consensus in the clinical values, suggesting the necessity of checking clinical findings. Clinical trials were searched and data reevaluated. HIFU was hardly performed alone; almost all present anticancer means have been applied during an HIFU treatment, and a specific regimen varied between trials; there were heterogeneity and disagreement between trials. The complexity made it difficult to distinguish the effect of HIFU. Based upon evaluable data, the efficacy of HIFU was similar to that of radio frequency, chemoembolization, chemotherapy, radiotherapy, or hormone therapy; a combined therapy did not improve the efficacy. The survival rate of HIFU plus radiotherapy was lower than that of radical surgery in liver cancers. Adverse events had no downtrend in the past years. HIFU was not a standardized procedure where the intensity and insonation mode were modified constantly throughout a treatment, limiting an evaluation from the perspective of ultrasonics. These implied that HIFU should be applied as an alternative at most occasions. The present clinical trials had defects making against the understating of HIFU. PMID:24982965

  1. Predictors of Toxicity After Image-guided High-dose-rate Interstitial Brachytherapy for Gynecologic Cancer

    SciTech Connect

    Lee, Larissa J.; Viswanathan, Akila N.

    2012-12-01

    Purpose: To identify predictors of grade 3-4 complications and grade 2-4 rectal toxicity after three-dimensional image-guided high-dose-rate (HDR) interstitial brachytherapy for gynecologic cancer. Methods and Materials: Records were reviewed for 51 women (22 with primary disease and 29 with recurrence) treated with HDR interstitial brachytherapy. A single interstitial insertion was performed with image guidance by computed tomography (n = 43) or magnetic resonance imaging (n = 8). The median delivered dose in equivalent 2-Gy fractions was 72.0 Gy (45 Gy for external-beam radiation therapy and 24 Gy for brachytherapy). Toxicity was reported according to the Common Toxicity Criteria for Adverse Events. Actuarial toxicity estimates were calculated by the Kaplan-Meier method. Results: At diagnosis, the median patient age was 62 years and the median tumor size was 3.8 cm. The median D90 and V100 were 71.4 Gy and 89.5%; the median D2cc for the bladder, rectum, and sigmoid were 64.6 Gy, 61.0 Gy, and 52.7 Gy, respectively. The actuarial rates of all grade 3-4 complications at 2 years were 20% gastrointestinal, 9% vaginal, 6% skin, 3% musculoskeletal, and 2% lymphatic. There were no grade 3-4 genitourinary complications and no grade 5 toxicities. Grade 2-4 rectal toxicity was observed in 10 patients, and grade 3-4 complications in 4; all cases were proctitis with the exception of 1 rectal fistula. D2cc for rectum was higher for patients with grade 2-4 (68 Gy vs 57 Gy for grade 0-1, P=.03) and grade 3-4 (73 Gy vs 58 Gy for grade 0-2, P=.02) rectal toxicity. The estimated dose that resulted in a 10% risk of grade 2-4 rectal toxicity was 61.8 Gy (95% confidence interval, 51.5-72.2 Gy). Discussion: Image-guided HDR interstitial brachytherapy results in acceptable toxicity for women with primary or recurrent gynecologic cancer. D2cc for the rectum is a reliable predictor of late rectal complications. Three-dimensional-based treatment planning should be performed to ensure

  2. Transvaginal 3D Image-Guided High Intensity Focused Ultrasound Array

    NASA Astrophysics Data System (ADS)

    Held, Robert; Nguyen, Thuc Nghi; Vaezy, Shahram

    2005-03-01

    The goal of this project is to develop a transvaginal image-guided High Intensity Focused Ultrasound (HIFU) device using piezocomposite HIFU array technology, and commercially-available ultrasound imaging. Potential applications include treatment of uterine fibroids and abnormal uterine bleeding. The HIFU transducer was an annular phased array, with a focal length range of 30-60 mm, an elliptically-shaped aperture of 35×60 mm, and an operating frequency of 3 MHz. A pillow-shaped bag with water circulation will be used for coupling the HIFU energy into the tissue. An intra-cavity imaging probe (C9-5, Philips) was integrated with the HIFU array such that the focal axis of the HIFU transducer was within the image plane. The entire device will be covered by a gel-filled condom when inserted in the vaginal cavity. To control it, software packages were developed in the LabView programming environment. An imaging algorithm processed the ultrasound image to remove noise patterns due to the HIFU signal. The device will be equipped with a three-dimensional tracking system, using a six-degrees-of-freedom articulating arm. Necrotic lesions were produced in a tissue-mimicking phantom and a turkey breast sample for all focal lengths. Various HIFU doses allow various necrotic lesion shapes, including thin ellipsoidal, spherical, wide cylindrical, and teardrop-shaped. Software control of the device allows multiple foci to be activated sequentially for desired lesion patterns. Ultrasound imaging synchronization can be achieved using hardware signals obtained from the imaging system, or software signals determined empirically for various imaging probes. The image-guided HIFU device will provide a valuable tool in visualization of uterine fibroid tumors for the purposes of planning and subsequent HIFU treatment of the tumor, all in a 3D environment. The control system allows for various lesions of different shapes to be optimally positioned in the tumor to cover the entire tumor

  3. High resolution (3 Tesla) MRI-guided conformal brachytherapy for cervical cancer: consequences of different high-risk CTV sizes

    PubMed Central

    Anderson, James W.; Xia, Junyi; Flynn, Ryan T.; Modrick, Joseph M.; Bhatia, Sudershan K.; Jacobson, Geraldine M.

    2013-01-01

    Purpose To evaluate conventional brachytherapy (BT) plans using dose-volume parameters and high resolution (3 Tesla) MRI datasets, and to quantify dosimetric benefits and limitations when MRI-guided, conformal BT (MRIG-CBT) plans are generated. Material and methods Fifty-five clinical high-dose-rate BT plans from 14 cervical cancer patients were retrospectively studied. All conventional plans were created using MRI with titanium tandem-and-ovoid applicator (T&O) for delivery. For each conventional plan, a MRIG-CBT plan was retrospectively generated using hybrid inverse optimization. Three categories of high risk (HR)-CTV were considered based on volume: non-bulky (< 20 cc), low-bulky (> 20 cc and < 40 cc) and bulky (≥ 40 cc). Dose-volume metrics of D90 of HR-CTV and D2cc and D0.1cc of rectum, bladder, and sigmoid colon were analyzed. Results Tumor coverage (HR-CTV D90) of the conventional plans was considerably affected by the HR-CTV size. Sixteen percent of the plans covered HR-CTV D90 with the prescription dose within 5%. At least one OAR had D2cc values over the GEC-ESTRO recommended limits in 52.7% of the conventional plans. MRIG-CBT plans showed improved target coverage for HR-CTV D90 of 98 and 97% of the prescribed dose for non-bulky and low-bulky tumors, respectively. No MRIG-CBT plans surpassed the D2cc limits of any OAR. Only small improvements (D90 of 80%) were found for large targets (> 40 cc) when using T&O applicator approach. Conclusions MRIG-CBT plans displayed considerable improvement for tumor coverage and OAR sparing over conventional treatment. When the HR-CTV volume exceeded 40 cc, its improvements were diminished when using a conventional intracavitary applicator. PMID:23878555

  4. Predictors of Rectal Tolerance Observed in a Dose-Escalated Phase 1-2 Trial of Stereotactic Body Radiation Therapy for Prostate Cancer

    SciTech Connect

    Kim, D.W. Nathan; Cho, L. Chinsoo; Straka, Christopher; Christie, Alana; Lotan, Yair; Pistenmaa, David; Kavanagh, Brian D.; Nanda, Akash; Kueplian, Patrick; Brindle, Jeffrey; Cooley, Susan; Perkins, Alida; Raben, David; Xie, Xian-Jin; Timmerman, Robert D.

    2014-07-01

    Purpose: To convey the occurrence of isolated cases of severe rectal toxicity at the highest dose level tested in 5-fraction stereotactic body radiation therapy (SBRT) for localized prostate cancer; and to rationally test potential causal mechanisms to guide future studies and experiments to aid in mitigating or altogether avoiding such severe bowel injury. Methods and Materials: Clinical and treatment planning data were analyzed from 91 patients enrolled from 2006 to 2011 on a dose-escalation (45, 47.5, and 50 Gy in 5 fractions) phase 1/2 clinical study of SBRT for localized prostate cancer. Results: At the highest dose level, 6.6% of patients treated (6 of 91) developed high-grade rectal toxicity, 5 of whom required colostomy. Grade 3+ delayed rectal toxicity was strongly correlated with volume of rectal wall receiving 50 Gy >3 cm{sup 3} (P<.0001), and treatment of >35% circumference of rectal wall to 39 Gy (P=.003). Grade 2+ acute rectal toxicity was significantly correlated with treatment of >50% circumference of rectal wall to 24 Gy (P=.010). Conclusion: Caution is advised when considering high-dose SBRT for treatment of tumors near bowel structures, including prostate cancer. Threshold dose constraints developed from physiologic principles are defined, and if respected can minimize risk of severe rectal toxicity.

  5. Early Warning System Implementation Guide: For Use with the National High School Center's Early Warning System Tool v2.0

    ERIC Educational Resources Information Center

    Therriault, Susan Bowles; Heppen, Jessica; O'Cummings, Mindee; Fryer, Lindsay; Johnson, Amy

    2010-01-01

    This Early Warning System (EWS) Implementation Guide is a supporting document for schools and districts that are implementing the National High School Center's Early Warning System (EWS) Tool v2.0. Developed by the National High School Center at the American Institutes for Research (AIR), the guide and tool support the establishment and…

  6. High-performance iron oxide nanoparticles for magnetic particle imaging - guided hyperthermia (hMPI)

    NASA Astrophysics Data System (ADS)

    Bauer, Lisa M.; Situ, Shu F.; Griswold, Mark A.; Samia, Anna Cristina S.

    2016-06-01

    Magnetic particle imaging (MPI) is an emerging imaging modality that allows the direct and quantitative mapping of iron oxide nanoparticles. In MPI, the development of tailored iron oxide nanoparticle tracers is paramount to achieving high sensitivity and good spatial resolution. To date, most MPI tracers being developed for potential clinical applications are based on spherical undoped magnetite nanoparticles. For the first time, we report on the systematic investigation of the effects of changes in chemical composition and shape anisotropy on the MPI performance of iron oxide nanoparticle tracers. We observed a 2-fold enhancement in MPI signal through selective doping of magnetite nanoparticles with zinc. Moreover, we demonstrated focused magnetic hyperthermia heating by adapting the field gradient used in MPI. By saturating the iron oxide nanoparticles outside of a field free region (FFR) with an external static field, we can selectively heat a target region in our test sample. By comparing zinc-doped magnetite cubic nanoparticles with undoped spherical nanoparticles, we could show a 5-fold improvement in the specific absorption rate (SAR) in magnetic hyperthermia while providing good MPI signal, thereby demonstrating the potential for high-performance focused hyperthermia therapy through an MPI-guided approach (hMPI).Magnetic particle imaging (MPI) is an emerging imaging modality that allows the direct and quantitative mapping of iron oxide nanoparticles. In MPI, the development of tailored iron oxide nanoparticle tracers is paramount to achieving high sensitivity and good spatial resolution. To date, most MPI tracers being developed for potential clinical applications are based on spherical undoped magnetite nanoparticles. For the first time, we report on the systematic investigation of the effects of changes in chemical composition and shape anisotropy on the MPI performance of iron oxide nanoparticle tracers. We observed a 2-fold enhancement in MPI signal

  7. Highly directional transurethral ultrasound applicators with rotational control for MRI-guided prostatic thermal therapy

    NASA Astrophysics Data System (ADS)

    Ross, Anthony B.; Diederich, Chris J.; Nau, William H.; Gill, Harcharan; Bouley, Donna M.; Daniel, Bruce; Rieke, Viola; Butts, R. Kim; Sommer, Graham

    2004-01-01

    Transurethral ultrasound applicators with highly directional energy deposition and rotational control were investigated for precise treatment of benign prostatic hyperplasia (BPH) and adenocarcinoma of the prostate (CaP). Two types of catheter-based applicators were fabricated, using either 90° sectored tubular (3.5 mm OD × 10 mm) or planar transducers (3.5 mm × 10 mm). They were constructed to be MRI compatible, minimally invasive and allow for manual rotation of the transducer array within a 10 mm cooling balloon. In vivo evaluations of the applicators were performed in canine prostates (n = 3) using MRI guidance (0.5 T interventional magnet). MR temperature imaging (MRTI) utilizing the proton resonance frequency shift method was used to acquire multiple-slice temperature overlays in real time for monitoring and guiding the thermal treatments. Post-treatment T1-weighted contrast-enhanced imaging and triphenyl tetrazolium chloride stained tissue sections were used to define regions of tissue coagulation. Single sonications with the 90° tubular applicator (9-15 W, 12 min, 8 MHz) produced coagulated zones covering an 80° wedge of the prostate extending from 1-2 mm outside the urethra to the outer boundary of the gland (16 mm radial coagulation). Single sonications with the planar applicator (15-20 W, 10 min, ~8 MHz) generated thermal lesions of ~30° extending to the prostate boundary. Multiple sequential sonications (sweeping) of a planar applicator (12 W with eight rotations of 30° each) demonstrated controllable coagulation of a 270° contiguous section of the prostate extending to the capsule boundary. The feasibility of using highly directional transurethral ultrasound applicators with rotational capabilities to selectively coagulate regions of the prostate while monitoring and controlling the treatments with MRTI was demonstrated in this study.

  8. Multicentre results of stereotactic body radiotherapy for secondary liver tumours

    PubMed Central

    Berber, Betul; Ibarra, Rafael; Snyder, Laura; Yao, Min; Fabien, Jeffrey; Milano, Michael T; Katz, Alan W; Goodman, Karyn; Stephans, Kevin; El-Gazzaz, Galal; Aucejo, Federico; Miller, Charles; Fung, John; Lo, Simon; Machtay, Mitchell; Sanabria, Juan

    2013-01-01

    Background Surgical resection is the standard treatment for liver metastases, although for the majority of patients this is not possible. Stereotactic body radiotherapy (SBRT) is an alternative local-regional therapy. The purpose of this study was to evaluate the results of SBRT for secondary liver tumours from a combined multicentre database. Methods Variables from patients treated with SBRT from four Academic Medical Centres were entered into a common database. Local tumour control and 1-year survival rates were calculated. Results In total, 153 patients (91 women) 59 ± 8.4 years old with 363 metastatic liver lesions were treated with SBRT. The underlying primary tumour arose from gastrointestinal (GI), retroperitoneal and from extra-abdominal primaries in 56%, 8% and 36% of patients, respectively. Metastases, with a gross tumour volume (GTV) of 138.5 ± 126.8 cm3, were treated with a total radiation dose of 37.5 ± 8.2 Gy in 5 ± 3 fractions. The 1-year overall survival was 51% with an overall local control rate of 62% at a mean follow-up of 25.2 ± 5.9 months. A complete tumour response was observed in 32% of patients. Grade 3–5 adverse events were noted in 3% of patients. Conclusion Secondary liver tumours treated with SBRT had a high rate of local control with a low incidence of adverse events. PMID:23458468

  9. Stereotactic Ablative Radiotherapy for Oligometastatic Disease in Liver

    PubMed Central

    Kim, Myungsoo; Son, Seok Hyun; Won, Yong Kyun; Kay, Chul Seung

    2014-01-01

    Liver metastasis in solid tumors, including colorectal cancer, is the most frequent and lethal complication. The development of systemic therapy has led to prolonged survival. However, in selected patients with a finite number of discrete lesions in liver, defined as oligometastatic state, additional local therapies such as surgical resection, radiofrequency ablation, cryotherapy, and radiotherapy can lead to permanent local disease control and improve survival. Among these, an advance in radiation therapy made it possible to deliver high dose radiation to the tumor more accurately, without impairing the liver function. In recent years, the introduction of stereotactic ablative radiotherapy (SABR) has offered even more intensive tumor dose escalation in a few fractions with reduced dose to the adjacent normal liver. Many studies have shown that SABR for oligometastases is effective and safe, with local control rates widely ranging from 50% to 100% at one or two years. And actuarial survival at one and two years has been reported ranging from 72% to 94% and from 30% to 62%, respectively, without severe toxicities. In this paper, we described the definition and technical aspects of SABR, clinical outcomes including efficacy and toxicity, and related parameters after SABR in liver oligometastases from colorectal cancer. PMID:24868526

  10. Stereotactic ablative radiotherapy for oligometastatic disease in liver.

    PubMed

    Kim, Myungsoo; Son, Seok Hyun; Won, Yong Kyun; Kay, Chul Seung

    2014-01-01

    Liver metastasis in solid tumors, including colorectal cancer, is the most frequent and lethal complication. The development of systemic therapy has led to prolonged survival. However, in selected patients with a finite number of discrete lesions in liver, defined as oligometastatic state, additional local therapies such as surgical resection, radiofrequency ablation, cryotherapy, and radiotherapy can lead to permanent local disease control and improve survival. Among these, an advance in radiation therapy made it possible to deliver high dose radiation to the tumor more accurately, without impairing the liver function. In recent years, the introduction of stereotactic ablative radiotherapy (SABR) has offered even more intensive tumor dose escalation in a few fractions with reduced dose to the adjacent normal liver. Many studies have shown that SABR for oligometastases is effective and safe, with local control rates widely ranging from 50% to 100% at one or two years. And actuarial survival at one and two years has been reported ranging from 72% to 94% and from 30% to 62%, respectively, without severe toxicities. In this paper, we described the definition and technical aspects of SABR, clinical outcomes including efficacy and toxicity, and related parameters after SABR in liver oligometastases from colorectal cancer. PMID:24868526

  11. NOTE: Comprehensive quality assurance for stereotactic radiosurgery treatments

    NASA Astrophysics Data System (ADS)

    Ramaseshan, R.; Heydarian, M.

    2003-07-01

    We have used a commercially available high precision LucyTM phantom to perform comprehensive quality assurance for stereotactic radiosurgery treatments. The quantitative evaluation of system uncertainties included imaging, planning and treatment delivery systems. The quality assurance tests showed that the well-defined targets were identified to within +/-1 mm in all the imaging modalities. The pre-known target volumes were reproduced within 2 cm3 in both MR and CT. The planned target was delivered within 2% of the prescribed dose and to within 2 mm accuracy. The inaccuracy in the isocentre position at the Linac was less than 1.2 mm. The maximum error observed in the depth helmet was 0.5 mm and the overall uncertainty was within 0.23 mm. We have also established a quality assurance program based on the study and proposed the tolerance and the frequency of the tests required to be carried out. The tests were carried out using a Radionics planning system and delivered on a Varian Clinac 2100 linear accelerator machine. These tests also established a base line for future comparisons.

  12. Fractionated Stereotactic Radiotherapy for Facial Nerve Schwannomas.

    PubMed

    Shi, Wenyin; Jain, Varsha; Kim, Hyun; Champ, Colin; Jain, Gaurav; Farrell, Christopher; Andrews, David W; Judy, Kevin; Liu, Haisong; Artz, Gregory; Werner-Wasik, Maria; Evans, James J

    2016-02-01

    Purpose Data on the clinical course of irradiated facial nerve schwannomas (FNS) are lacking. We evaluated fractionated stereotactic radiotherapy (FSRT) for FNS. Methods Eight consecutive patients with FNS treated at our institution between 1998 and 2011 were included. Patients were treated with FSRT to a median dose of 50.4 Gy (range: 46.8-54 Gy) in 1.8 or 2.0 Gy fractions. We report the radiographic response, symptom control, and toxicity associated with FSRT for FNS. Results The median follow-up time was 43 months (range: 10-75 months). All patients presented with symptoms including pain, tinnitus, facial asymmetry, diplopia, and hearing loss. The median tumor volume was 1.57 cc. On the most recent follow-up imaging, five patients were noted to have stable tumor size; three patients had a net reduction in tumor volume. Additionally, six patients had improvement in clinical symptoms, one patient had stable clinical findings, and one patient had worsened House-Brackmann grade due to cystic degeneration. Conclusion FSRT treatment of FNS results in excellent control of growth and symptoms with a small rate of radiation toxicity. Given the importance of maintaining facial nerve function, FSRT could be considered as a primary management modality for enlarging or symptomatic FNS. PMID:26949592

  13. Stereotactic Body Radiotherapy for Oligometastatic Lung Tumors

    SciTech Connect

    Norihisa, Yoshiki; Nagata, Yasushi Takayama, Kenji; Matsuo, Yukinori; Sakamoto, Takashi; Sakamoto, Masato; Mizowaki, Takashi; Yano, Shinsuke; Hiraoka, Masahiro

    2008-10-01

    Purpose: Since 1998, we have treated primary and oligometastatic lung tumors with stereotactic body radiotherapy (SBRT). The term 'oligometastasis' is used to indicate a small number of metastases limited to an organ. We evaluated our clinical experience of SBRT for oligometastatic lung tumors. Methods and Materials: A total of 34 patients with oligometastatic lung tumors were included in this study. The primary involved organs were the lung (n = 15), colorectum (n = 9), head and neck (n = 5), kidney (n = 3), breast (n = 1), and bone (n = 1). Five to seven, noncoplanar, static 6-MV photon beams were used to deliver 48 Gy (n = 18) or 60 Gy (n = 16) at the isocenter, with 12 Gy/fraction within 4-18 days (median, 12 days). Results: The overall survival rate, local relapse-free rate, and progression-free rate at 2 years was 84.3%, 90.0%, and 34.8%, respectively. No local progression was observed in tumors irradiated with 60 Gy. SBRT-related pulmonary toxicities were observed in 4 (12%) Grade 2 cases and 1 (3%) Grade 3 case. Patients with a longer disease-free interval had a greater overall survival rate. Conclusion: The clinical result of SBRT for oligometastatic lung tumors in our institute was comparable to that after surgical metastasectomy; thus, SBRT could be an effective treatment of pulmonary oligometastases.

  14. Stereotactic ventral pallidotomy for Parkinson's disease.

    PubMed

    Dogali, M; Fazzini, E; Kolodny, E; Eidelberg, D; Sterio, D; Devinsky, O; Berić, A

    1995-04-01

    Eighteen patients with medically intractable Parkinson's disease that was characterized by bradykinesia, rigidity, and marked "on-off" fluctuations underwent stereotactic ventral pallidotomy under local anesthesia. Targeting was aided by anatomic coordinates derived from the MRI, intraoperative cell recordings, and electrical stimulation prior to lesioning. A nonsurgically treated group of seven similarly affected individuals was also followed. Assessment of motor function was made at baseline and at 3-month intervals for 1 year. Following the lesioning, patients improved in bradykinesia, rigidity, resting tremor, and balance with resolution of medication-induced contralateral dyskinesia. When compared with preoperative baseline, all quantifiable test scores after surgery improved significantly with the patients off medications for 12 hours: UPDRS by 65%, and CAPIT subtest scores on the contralateral limb by 38.2% and the ipsilateral limb by 24.2%. Walk scores improved by 45%. Medication requirements were unchanged, but the patients who had had surgery were able to tolerate larger doses because of reduced dyskinesia. Ventral pallidotomy produces statistically significant reduction in parkinsonism and contralateral "on" dyskinesia without morbidity or mortality and with a short hospitalization in Parkinson's disease patients for whom medical therapy has failed. PMID:7723966

  15. Repeat Stereotactic Radiosurgery for Acoustic Neuromas

    SciTech Connect

    Kano, Hideyuki; Kondziolka, Douglas; Niranjan, Ajay M.Ch.; Flannery, Thomas J.; Flickinger, John C.; Lunsford, L. Dade

    2010-02-01

    Purpose: To evaluate the outcome of repeat stereotactic radiosurgery (SRS) for acoustic neuromas, we assessed tumor control, clinical outcomes, and the risk of adverse radiation effects in patients whose tumors progressed after initial management. Methods and Materials: During a 21-year experience at our center, 1,352 patients underwent SRS as management for their acoustic neuromas. We retrospectively identified 6 patients who underwent SRS twice for the same tumor. The median patient age was 47 years (range, 35-71 years). All patients had imaging evidence of tumor progression despite initial SRS. One patient also had incomplete surgical resection after initial SRS. All patients were deaf at the time of the second SRS. The median radiosurgery target volume at the time of the initial SRS was 0.5 cc and was 2.1 cc at the time of the second SRS. The median margin dose at the time of the initial SRS was 13 Gy and was 11 Gy at the time of the second SRS. The median interval between initial SRS and repeat SRS was 63 months (range, 25-169 months). Results: At a median follow-up of 29 months after the second SRS (range, 13-71 months), tumor control or regression was achieved in all 6 patients. No patient developed symptomatic adverse radiation effects or new neurological symptoms after the second SRS. Conclusions: With this limited experience, we found that repeat SRS for a persistently enlarging acoustic neuroma can be performed safely and effectively.

  16. Stereotactic radiosurgery for intramedullary spinal arteriovenous malformations.

    PubMed

    Kalani, Maziyar A; Choudhri, Omar; Gibbs, Iris C; Soltys, Scott G; Adler, John R; Thompson, Patricia A; Tayag, Armine T; Samos, Cindy H; Chang, Steven D

    2016-07-01

    Spinal cord arteriovenous malformations (AVM) are rare lesions associated with recurrent hemorrhage and progressive ischemia. Occasionally a favorable location, size or vascular anatomy may allow management with endovascular embolization and/or microsurgical resection. For most, however, there is no good treatment option. Between 1997 and 2014, we treated 37 patients (19 females, 18 males, median age 30years) at our institution diagnosed with intramedullary spinal cord AVM (19 cervical, 12 thoracic, and six conus medullaris) with CyberKnife (Accuray, Sunnyvale, CA, USA) stereotactic radiosurgery. A history of hemorrhage was present in 50% of patients. The mean AVM volume of 2.3cc was treated with a mean marginal dose of 20.5Gy in a median of two sessions. Clinical and MRI follow-up were carried out annually, and spinal angiography was repeated at 3years. We report an overall obliteration rate of 19% without any post-treatment hemorrhagic events. In those AVM that did not undergo obliteration, significant volume reduction was noted at 3years. Although the treatment paradigm for spinal cord AVM continues to evolve, radiosurgical treatment is capable of safely obliterating or significantly shrinking most intramedullary spinal cord AVM. PMID:26869363

  17. New Strategies in Stereotactic Radiotherapy for Oligometastases.

    PubMed

    Palma, David A; Louie, Alexander V; Rodrigues, George B

    2015-12-01

    Patients with metastatic solid tumors are usually treated with palliative intent. Systemic therapy and palliative radiation are often used, with the goals of prolonging survival or maintaining quality of life, but not of cure. In contrast to this paradigm, the theory of oligometastasis suggests that some patients who have a small number of metastases may be amenable to cure if all lesions can be eradicated. Aggressive treatment of patients with oligometastases, using either surgery or radiotherapy, has become more common in the past decade, yet in most situations, no randomized evidence is available to support such an approach. Stereotactic ablative radiotherapy (SABR) is a novel treatment for oligometastases, delivering large doses of radiotherapy in only a few treatments, with excellent rates of local control, and appears to be an excellent noninvasive alternative to surgical resection of metastases. This article reviews recent biologic and clinical data that support the existence of the oligometastatic state and discusses gaps in this evidence base. The emerging role for SABR in the management of this challenging patient population is discussed with a focus on ongoing clinical trials in an attempt to improve overall survival, delay progression, or induce immunologic anticancer effects through the abscopal effect. PMID:26626571

  18. Highly compliant guided-mode resonance nanogratings: From theory to application in mechanical strain sensing

    NASA Astrophysics Data System (ADS)

    Foland, Steven J.

    This work reports the theory, design, fabrication, and characterization of highly-compliant polymer-based guided-mode resonance (GMR) grating devices. GMR devices have been widely researched in recent years for their applications in telecommunications and biosensing. The vast majority of GMR-based sensors are fabricated and characterized on rigid transparent substrates, and are designed to respond to changes in the optical properties of their surrounding media. While useful in a number of conventional sensing configurations, the applications of rigid gratings for mechanical sensing are extremely limited. To enable a GMR sensor to respond to mechanical stimuli, both the grating and its substrate must be compliant, a property inherent to the devices presented herein. An extensive toolset is required for the design of such resonant optical devices; this dissertation defines the theoretical and simulations models used for the analysis of these dynamic grating devices, and provides a clear understanding of both their strengths and limitations. These tools include a waveguide-theory based theoretical model for rapid approximation of grating resonance conditions, and finite element method (FEM) simulation for full-field solutions to Maxwell's equations. A number of challenges which arise when attempting to fabricate nanostructures on a thin polymer are also addressed, and a fabrication process is developed to enable a practical embodiment of the proposed devices. The results of this process are subwavelength titanium dioxide (TiO2) gratings embedded at the surface of compliant polydimethylsiloxane (PDMS) structures. Both a one-dimensional, membrane-embedded GMR grating for local measurement of microfluidic channel pressure, and a two-dimensional, slab-embedded GMR grating for biaxial strain detection are discussed, demonstrated, and evaluated. Additionally, potential improvements to the devices' performance and suggestions for future work are provided.

  19. Usefulness of High Suction Pressure for Sufficient Tissue Collection During Endobronchial Ultrasound Guided Transbronchial Needle Aspiration

    PubMed Central

    Shiroyama, Takayuki; Okamoto, Norio; Suzuki, Hidekazu; Tamiya, Motohiro; Yamadori, Tadahiro; Morishita, Naoko; Otsuka, Tomoyuki; Morita, Satomu; Kurata, Kanako; Okimura, Akira; Kawahara, Kunimitsu; Sasada, Shinji; Hirashima, Tomonori; Kawase, Ichiro

    2013-01-01

    Introduction The optimal suction pressure during endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) remains to be determined. The aim of this study was to compare suction pressures for performance in collecting sufficient tissue specimens from mediastinal and hilar lymph nodes during EBUS-TBNA. Methods Retrospective analysis of consecutive patients with mediastinal and hilar lymphadenopathy who underwent EBUS-TBNA over a 3-year period. Results from patients who underwent EBUS-TBNA using a dedicated 20-mL VacLoc (Merit Medical Systems, Inc, South Jordan, UT) syringe (conventional method, group C) were compared with results from patients in whom a disposable 30-mL syringe (high pressure group, group H) was used. The yield for sufficient histologic specimen retrieval and amount of tissue obtained were compared between the 2 groups. Results Of 178 patients who underwent EBUS-TBNA, 131 had lung cancer confirmed by EBUS-TBNA: 35 in group C and 96 in group H. There were 7 patients in group C and 6 in group H who received final diagnoses by cytology alone. There were 28 in group C and 90 in group H who were diagnosed by both cytology and histology. There was a statistically significant difference between the groups in terms of the rate of sufficient sampling for histological specimens (p = 0.04). The H group revealed a tissue area approximately twice that of the C group (p = 0.003). There were no major procedure-related complications in either group. Conclusion Higher suction pressures with larger syringe volumes during EBUS-TBNA may be useful for safely collecting sufficient tissue specimens. PMID:24340058

  20. A cost effective and high fidelity fluoroscopy simulator using the Image-Guided Surgery Toolkit (IGSTK)

    NASA Astrophysics Data System (ADS)

    Gong, Ren Hui; Jenkins, Brad; Sze, Raymond W.; Yaniv, Ziv

    2014-03-01

    The skills required for obtaining informative x-ray fluoroscopy images are currently acquired while trainees provide clinical care. As a consequence, trainees and patients are exposed to higher doses of radiation. Use of simulation has the potential to reduce this radiation exposure by enabling trainees to improve their skills in a safe environment prior to treating patients. We describe a low cost, high fidelity, fluoroscopy simulation system. Our system enables operators to practice their skills using the clinical device and simulated x-rays of a virtual patient. The patient is represented using a set of temporal Computed Tomography (CT) images, corresponding to the underlying dynamic processes. Simulated x-ray images, digitally reconstructed radiographs (DRRs), are generated from the CTs using ray-casting with customizable machine specific imaging parameters. To establish the spatial relationship between the CT and the fluoroscopy device, the CT is virtually attached to a patient phantom and a web camera is used to track the phantom's pose. The camera is mounted on the fluoroscope's intensifier and the relationship between it and the x-ray source is obtained via calibration. To control image acquisition the operator moves the fluoroscope as in normal operation mode. Control of zoom, collimation and image save is done using a keypad mounted alongside the device's control panel. Implementation is based on the Image-Guided Surgery Toolkit (IGSTK), and the use of the graphics processing unit (GPU) for accelerated image generation. Our system was evaluated by 11 clinicians and was found to be sufficiently realistic for training purposes.

  1. The Technique, Resources and Costs of Stereotactic Body Radiotherapy of Prostate Cancer: A Comparison of Dose Regimens and Delivery Systems.

    PubMed

    Sharieff, Waseem; Greenspoon, Jeffrey N; Dayes, Ian; Chow, Tom; Wright, James; Lukka, Himu

    2016-02-01

    Robotic system has been used for stereotactic body radiotherapy (SBRT) of prostate cancer. Arc-based and fixed-gantry systems are used for hypofractionated regimens (10-20 ractions) and the standard regimen (39 fractions); they may also be used to deliver SBRT. Studies are currently underway to compare efficacy and safety of these systems and regimens. Thus, we describe the technique and required resources for the provision of robotic SBRT in relation to the standard regimen and other systems to guide investment decisions. Using administrative data of resource volumes and unit prices, we computed the cost per patient, cost per cure and cost per quality adjusted life year (QALY) of four regimens (5, 12, 20 and 39 fractions) and three delivery systems (robotic, arc-based and fixed-gantry) from a payer's perspective. We performed sensitivity analyses to examine the effects of daily hours of operation and in-room treatment delivery times on cost per patient. In addition, we estimated the budget impact when a robotic system is preferred over an arc-based or fixed-gantry system. Costs of SBRT were $6333/patient (robotic), $4368/patient (arc-based) and $4443/patient (fixed-gantry). When daily hours of operation were varied, the cost of robotic SBRT varied from $9324/patient (2 hours daily) to $5250/patient (10 hours daily). This was comparable to the costs of 39 fraction standard regimen which were $5935/patient (arc-based) and $7992/ patient (fixed-gantry). In settings of moderate to high patient volume, robotic SBRT is cost effective compared to the standard regimen. If SBRT can be delivered with equivalent efficacy and safety, the arc-based system would be the most cost effective system. PMID:24750007

  2. Positioning accuracy for lung stereotactic body radiotherapy patients determined by on-treatment cone-beam CT imaging.

    PubMed

    Richmond, N D; Pilling, K E; Peedell, C; Shakespeare, D; Walker, C P

    2012-06-01

    Stereotactic body radiotherapy for early stage non-small cell lung cancer is an emerging treatment option in the UK. Since relatively few high-dose ablative fractions are delivered to a small target volume, the consequences of a geometric miss are potentially severe. This paper presents the results of treatment delivery set-up data collected using Elekta Synergy (Elekta, Crawley, UK) cone-beam CT imaging for 17 patients immobilised using the Bodyfix system (Medical Intelligence, Schwabmuenchen, Germany). Images were acquired on the linear accelerator at initial patient treatment set-up, following any position correction adjustments, and post-treatment. These were matched to the localisation CT scan using the Elekta XVI software. In total, 71 fractions were analysed for patient set-up errors. The mean vector error at initial set-up was calculated as 5.3 ± 2.7 mm, which was significantly reduced to 1.4 ± 0.7 mm following image guided correction. Post-treatment the corresponding value was 2.1 ± 1.2 mm. The use of the Bodyfix abdominal compression plate on 5 patients to reduce the range of tumour excursion during respiration produced mean longitudinal set-up corrections of -4.4 ± 4.5 mm compared with -0.7 ± 2.6 mm without compression for the remaining 12 patients. The use of abdominal compression led to a greater variation in set-up errors and a shift in the mean value. PMID:22665927

  3. High frequency guided ultrasonic waves for hidden fatigue crack growth monitoring in multi-layer model aerospace structures

    NASA Astrophysics Data System (ADS)

    Chan, Henry; Masserey, Bernard; Fromme, Paul

    2015-02-01

    Especially for ageing aircraft the development of fatigue cracks at fastener holes due to stress concentration and varying loading conditions constitutes a significant maintenance problem. High frequency guided waves offer a potential compromise between the capabilities of local bulk ultrasonic measurements with proven defect detection sensitivity and the large area coverage of lower frequency guided ultrasonic waves. High frequency guided waves have energy distributed through all layers of the specimen thickness, allowing in principle hidden (2nd layer) fatigue damage monitoring. For the integration into structural health monitoring systems the sensitivity for the detection of hidden fatigue damage in inaccessible locations of the multi-layered components from a stand-off distance has to be ascertained. The multi-layered model structure investigated consists of two aluminium plate-strips with an epoxy sealant layer. During cyclic loading fatigue crack growth at a fastener hole was monitored. Specific guided wave modes (combination of fundamental A0 and S0 Lamb modes) were selectively excited above the cut-off frequencies of higher modes using a standard ultrasonic wedge transducer. Non-contact laser measurements close to the defect were performed to qualify the influence of a fatigue crack in one aluminium layer on the guided wave scattering. Fatigue crack growth monitoring using laser interferometry showed good sensitivity and repeatability for the reliable detection of small, quarter-elliptical cracks. Standard ultrasonic pulse-echo equipment was employed to monitor hidden fatigue damage from a stand-off distance without access to the damaged specimen layer. Sufficient sensitivity for the detection of fatigue cracks located in the inaccessible aluminium layer was verified, allowing in principle practical in situ ultrasonic monitoring of fatigue crack growth.

  4. Tumour recurrence vs radionecrosis: an indication for multitrajectory serial stereotactic biopsies.

    PubMed

    Zamorano, L; Katanick, D; Dujovny, M; Yakar, D; Malik, G; Ausman, J I

    1989-01-01

    External RT has been proved to be an important adjuvant to surgery in the treatment of malignant glioma. It has also been demonstrated, that its effect on survival is dose-dependent, although accompanied by a higher morbidity. Intents to localize the field of high dose RT to the tumour area have been performed with the aim to spare damage of the normal brain tissue. Between August 1983 to December 1987, 40 patients with malignant astrocytoma (16 GM, 24 AA) underwent high dose localized hyperfractionated external RT after surgical resection. Patients received 57.6 Gy to the tumour and oedema area associated with a boost localized to the tumour of 7.4, 14.4 or 24 Gy. In the follow-up, 16 patients died with evidence of increase in size of lesion diagnosed by CT/MRI. Since July 1987, 12 patients with recurrence or increase on size of CT/MRI lesion have undergone multitrajectory serial stereotactic biopsies. From the biopsies 8 patients were histologically diagnosed was compatible with radionecrosis. From the 4 recurrences, 2 patients were treated with 125I implants and 1 with new resection. Patients with radionecrosis were treated with corticoides and diuretics, obtaining partial or complete remission of symptoms and decrease in size of CT lesion. Undoubtly, Multiplanar/3D multitrajectory serial stereotactic biopsies play a major role in the follow-up of these patients, and accurate diagnosis need to be established for further treatment therapy. The question remains if these localized boost should be replaced by 3D Multiplanar stereotactic interstitial radiotherapy boost after surgery and conventional radiotherapy. PMID:2549769

  5. A ToF-MS with a highly efficient electrostatic ion guide for characterization of ionic liquid electrospray sources.

    PubMed

    Chakraborty, Subha; Ataman, Caglar; Courtney, Daniel G; Dandavino, Simon; Shea, Herbert

    2014-08-01

    We report on the development of a time-of-flight (ToF) mass spectrometer with a highly efficient electrostatic ion guide for enhancing detectability in ToF mass spectrometry. This 65-cm long ion guide consists of 13 cascaded stages of Einzel lens to collect a large fraction of emitted charges over a wide emission angle and energy spread for time-of-flight measurements. Simulations show that the ion guide can collect 100% of the charges with up to 23° emission half-angle or 30% energy spread irrespective of their specific charge. We demonstrate this ion guide as applied to electrospray ion sources. Experiments performed with tungsten needle electrospraying the ionic liquid EMI-BF4 showed that up to 80% of the emitted charges could be collected at the end of the flight tube. Flight times of monomers and dimers emitted from the needles were measured in both positive and negative emission polarities. The setup was also used to characterize the electrospray from microfabricated silicon capillary emitters and nearly 30% charges could be collected even from a 40(°) emission half-angle. This setup can thus increase the fraction of charge collection for ToF measurement and spray characteristics can be obtained from a very large fraction of the emission in real time. PMID:24833357

  6. A ToF-MS with a Highly Efficient Electrostatic Ion Guide for Characterization of Ionic Liquid Electrospray Sources

    NASA Astrophysics Data System (ADS)

    Chakraborty, Subha; Ataman, Caglar; Courtney, Daniel G.; Dandavino, Simon; Shea, Herbert

    2014-08-01

    We report on the development of a time-of-flight (ToF) mass spectrometer with a highly efficient electrostatic ion guide for enhancing detectability in ToF mass spectrometry. This 65-cm long ion guide consists of 13 cascaded stages of Einzel lens to collect a large fraction of emitted charges over a wide emission angle and energy spread for time-of-flight measurements. Simulations show that the ion guide can collect 100% of the charges with up to 23° emission half-angle or 30% energy spread irrespective of their specific charge. We demonstrate this ion guide as applied to electrospray ion sources. Experiments performed with tungsten needle electrospraying the ionic liquid EMI-BF4 showed that up to 80% of the emitted charges could be collected at the end of the flight tube. Flight times of monomers and dimers emitted from the needles were measured in both positive and negative emission polarities. The setup was also used to characterize the electrospray from microfabricated silicon capillary emitters and nearly 30% charges could be collected even from a 40° emission half-angle. This setup can thus increase the fraction of charge collection for ToF measurement and spray characteristics can be obtained from a very large fraction of the emission in real time.

  7. Space bandwidth product enhancement of holographic display using high-order diffraction guided by holographic optical element.

    PubMed

    Li, Gang; Jeong, Jinsoo; Lee, Dukho; Yeom, Jiwoon; Jang, Changwon; Lee, Seungjae; Lee, Byoungho

    2015-12-28

    A space bandwidth product (SBP) enhancement method for holographic display using high-order diffraction of a spatial light modulator (SLM) is proposed. Among numerous high order diffraction terms, the plus-minus first and the zeroth are adopted and guided by holographic optical elements (HOEs) to an identical direction with the same intensity. By using a set of electro-shutters synchronized with corresponding order component, the system acts as if three SLMs are tiled in the horizontal direction. To confirm the feasibility of using HOE as the guiding optics for the system, several optical characteristics of the recording material are measured before using them. Furthermore, a computer generated hologram algorithm is proposed for compensating the wavefront distortion caused by use of the HOE. The demonstrated system achieves a three-fold increase in SBP of a single SLM. The results are verified experimentally. PMID:26831985

  8. AEROX: Computer program for transonic aircraft aerodynamics to high angles of attack. Volume 1: Aerodynamic methods and program users' guide

    NASA Technical Reports Server (NTRS)

    Axelson, J. A.

    1977-01-01

    The AEROX program estimates lift, induced-drag and pitching moments to high angles (typ. 60 deg) for wings and for wingbody combinations with or without an aft horizontal tail. Minimum drag coefficients are not estimated, but may be input for inclusion in the total aerodynamic parameters which are output in listed and plotted formats. The theory, users' guide, test cases, and program listing are presented.

  9. Treatment time reduction through parameter optimization in magnetic resonance guided high intensity focused ultrasound treatments

    NASA Astrophysics Data System (ADS)

    Coon, Joshua

    Magnetic Resonance guided High Intensity Focused Ultrasound (MRgHIFU) treatments are a promising modality for cancer treatments in which a focused beam of ultrasound energy is used to kill tumor tissue. However, obstacles still exist to its widespread clinical implementation, including long treatment times. This research demonstrates reductions in treatment times through intelligent selection of the user-controllable parameters, including: the focal zone treatment path, focal zone size, focal zone spacing, and whether to treat one or several focal zone locations at any given time. Several treatments using various combinations of these parameters were simulated using a finite difference method to solve the Pennes bio-heat transfer equation for an ultrasonically heated tissue region with a wide range of acoustic, thermal, geometric, and tumor properties. The total treatment time was iteratively optimized using either a heuristic method or routines included in the Matlab software package, with constraints imposed for patient safety and treatment efficacy. The results demonstrate that large reductions in treatment time are possible through the intelligent selection of user-controllable treatment parameters. For the treatment path, treatment times are reduced by as much as an order of magnitude if the focal zones are arranged into stacks along the axial direction and a middle-front-back ordering is followed. For situations where normal tissue heating constraints are less stringent, these focal zones should have high levels of adjacency to further decrease treatment times; however, adjacency should be reduced in some cases where normal tissue constraints are more stringent. Also, the use of smaller, more concentrated focal zones produces shorter treatment times than larger, more diluted focal zones, a result verified in an agar phantom model. Further, focal zones should be packed using only a small amount of overlap in the axial direction and with a small gap in the

  10. Quantitative evaluation of 3D dosimetry for stereotactic volumetric-modulated arc delivery using COMPASS.

    PubMed

    Vikraman, Subramani; Manigandan, Durai; Karrthick, Karukkupalayam Palaniappan; Sambasivaselli, Raju; Senniandavar, Vellaingiri; Ramu, Mahendran; Rajesh, Thiyagarajan; Lutz, Muller; Muthukumaran, Manavalan; Karthikeyan, Nithyanantham; Tejinder, Kataria

    2015-01-01

    at 50% of volume (D50), and maximum point doses were evaluated. Comparison was carried out using gamma analysis with passing criteria of 3 mm and 3%. Mean deviation of 1.9% ± 1% was observed for dose at 95% of volume (D95) of target volumes, whereas much less difference was noticed for critical organs. However, significant dose difference was noticed in two cases due to the smaller tumor size. Evaluation of this study revealed that the COMPASS 3D dosimetry is efficient and easy to use for patient-specific QA of VMAT stereotactic delivery. 3D dosimetric QA with COMPASS provides additional degrees of freedom to check the high-dose modulated stereotactic delivery with very high precision on patient CT images. PMID:25679152

  11. Gain-guided soliton fiber laser with high-quality rectangle spectrum for ultrafast time-stretch microscopy.

    PubMed

    Hu, Song; Yao, Jian; Liu, Meng; Luo, Ai-Ping; Luo, Zhi-Chao; Xu, Wen-Cheng

    2016-05-16

    The ultrafast time-stretch microscopy has been proposed to enhance the temporal resolution of a microscopy system. The optical source is a key component for ultrafast time-stretch microscopy system. Herein, we reported on the gain-guided soliton fiber laser with high-quality rectangle spectrum for ultrafast time-stretch microscopy. By virtue of the excellent characteristics of the gain-guided soliton, the output power and the 3-dB bandwidth of the stable mode-locked soliton could be up to 3 mW and 33.7 nm with a high-quality rectangle shape, respectively. With the proposed robust optical source, the ultrafast time-stretch microscopy with the 49.6 μm resolution and a scan rate of 11 MHz was achieved without the external optical amplification. The obtained results demonstrated that the gain-guided soliton fiber laser could be used as an alternative high-quality optical source for ultrafast time-stretch microscopy and will introduce some applications in fields such as biology, chemical, and optical sensing. PMID:27409899

  12. Survey of the Mass Media: Curriculum Guide for Stow Senior High School 1971-1972.

    ERIC Educational Resources Information Center

    Hackman, Judith; And Others

    An outline guide for a survey of major mass media--newspapers, magazines, radio, television, movies, books, and advertising--is presented. The course intends to help students develop critical judgement of the media by improving viewing, reading, and listening skills. The objectives include: (1) presentation of the characteristics of each major…

  13. The Librarian's Internet Survival Guide: Strategies for the High-Tech Reference Desk.

    ERIC Educational Resources Information Center

    McDermott, Irene E.; Quint, Barbara, Ed.

    This guide discusses the use of the World Wide Web for library reference service. Part 1, "Ready Reference on the Web: Resources for Patrons," contains chapters on searching and meta-searching the Internet, using the Web to find people, news on the Internet, quality reference resources on the Web, Internet sites for kids, free full-text resources,…

  14. WAVAI Curriculum Guide for Instruction in Wisconsin High Schools. 1975 Revision. Bulletin No. 5011.

    ERIC Educational Resources Information Center

    Wisconsin State Dept. of Public Instruction, Madison. Bureau for Career and Manpower Development.

    This guide is designed to aid the development of vocational education programs in agriculture in local school districts. Major program objectives, good learning conditions, program evaluation, suggested teaching methods, and Wisconsin's philosophy and procedures in developing occupational experience programs in vocational agriculture/agribusiness…

  15. Options for Equivalent Credit in the High School Curriculum. A Guide for Local Decision Making.

    ERIC Educational Resources Information Center

    Yakima Valley Vocational Skills Center, WA.

    This guide is intended to assist local planners in developing a policy for awarding equivalent credit for materials taught in vocational and regular academic classrooms. The first section summarizes the benefits of developing an equivalent credit policy. The second section provides details on developing an equivalent credit plan. It lists the…

  16. INSTRUCTIONAL GUIDE FOR THE TEACHING OF HEALTH AND PHYSICAL EDUCATION. PRIMARY THROUGH SENIOR HIGH SCHOOL.

    ERIC Educational Resources Information Center

    BROCKMEYER, W.

    AN INSTRUCTIONAL GUIDE FOR THE TEACHING OF HEALTH AND PHYSICAL EDUCATION, EMPHASIZING EDUCATION BY EXPERIENCE IN ACTIVITY, WAS PRESENTED. THE GOALS WERE TO DEVELOP GOOD HUMAN RELATIONSHIPS, GOOD SELF-REALIZATION, CIVIC RESPONSIBILITY, AND ECONOMIC EFFICIENCY. THE PROGRAM FOR BOYS, GRADES SEVEN THROUGH NINE, INCLUDED CALISTHENICS APPARATUS (SUCH AS…

  17. Peopling the High Plains: Wyoming's European Heritage. Curriculum Ideas and Guides for Teachers.

    ERIC Educational Resources Information Center

    Willems, Arnold L.

    The teacher's guide contains 25 K-12 lessons which illustrate the activities of all ethnic groups in Wyoming. The Basque, British, Eastern European, German-speaking, Greek, and Italian immigrants are highlighted. Titles include "Costumes by Flannelboard,""National Basque Week,""Dolls From Our Heritage,""Cook-In/Dance-In Ethnic…

  18. The First Amendment: Free Speech & a Free Press. A Curriculum Guide for High School Teachers.

    ERIC Educational Resources Information Center

    Eveslage, Thomas

    This curriculum guide is intended to encourage students to learn how everyone benefits when young people, other citizens, and the media exercise the constitutional rights of free speech and free press. Background information on free speech issues is provided, along with classroom activities, discussion questions, and student worksheets. There are…

  19. Cognitively Guided Instruction: An Implementation Case Study of a High Performing School District

    ERIC Educational Resources Information Center

    Dowdy, William D. B.

    2011-01-01

    No Child Left Behind legislation developed goals for every student to be proficient in each academic subject by 2014. California's students are far from meeting this goal, especially in mathematics. One Southern Californian school district, renamed Green Valley Unified School District for anonymity, began using Cognitively Guided Instruction…

  20. The Student Guide: High School Seniors/College Students, 2004-2005.

    ERIC Educational Resources Information Center

    Department of Education, Washington, DC.

    This guide explains student financial aid programs the U.S. Department of Education's Federal Student Aid (FSA) office administers. The first three pages are a quick reference; the rest of the publication provides more of what you need to know about the financial aid programs offered. (AMT)

  1. Human Sexuality. A Resource Guide for Parents and Teachers on Teaching...High School Level.

    ERIC Educational Resources Information Center

    Utah State Office of Education, Salt Lake City.

    This guide provides information and resources that will facilitate parents' ability to help adolescents understand human sexuality within the context of home and family values and ideals. It provides teachers with resources to facilitate the decision making process. Contents are organized within a framework of objectives and guidelines for both…

  2. How High Is It? An Educator's Guide with Activities Focused on Scale Models of Distances.

    ERIC Educational Resources Information Center

    Rosenberg, Carla B.; Rogers, Melissa J. B.

    This guide focuses on scale models of distances. Activities also incorporate mathematics but can be used in science and technology grades 5-8 classes. The content of the book is divided into three sections: (1) Introductory Activities; (2) Core Activities; and (3) Activity/Assessment. Activities include: (1) KWL Chart; (2) Ball and String…

  3. Curriculum Guide in Reading. Developmental Reading: Junior and Senior High Schools, Grades 7-12.

    ERIC Educational Resources Information Center

    Hand, John, Ed.; And Others

    GRADES OR AGES: Grades 7-12. SUBJECT MATTER: Developmental reading. ORGANIZATION AND PHYSICAL APPEARANCE: The guide is divided into nine short chapters and several appendixes. It is offset printed and edition bound with a paper cover. OBJECTIVES AND ACTIVITIES: No objectives are mentioned. General guidelines are given for planning activities to…

  4. School Health Index: A Self-Assessment and Planning Guide. Middle School/High School.

    ERIC Educational Resources Information Center

    Barrios, Lisa C.; Burgeson, Charlene R.; Crossett, Linda; Harrykissoon, Samantha D.; Pritzl, Jane; Wechsler, Howell; Kuester, Sarah A.; Pederson, Linda; Graffunder, Corinne; Rainford, Neil; Sleet, David

    2004-01-01

    The "School Health Index" is a self-assessment and planning guide that will enable schools to: (1) identify the strengths and weaknesses of school policies and programs for promoting health and safety; (2) develop an action plan for improving student health and safety, and (3) involve teachers, parents, students, and the community in improving…

  5. Coastal Awareness: A Resource Guide for Teachers in Senior High Science. Preprint.

    ERIC Educational Resources Information Center

    Rasmussen, Frederick A.

    The stated purpose of this resource guide is to entice teachers to explore ecological aspects of coastal awareness. Discussions describe different characteristics of the coast such as: (1) waves, currents, and tides; (2) sandy beaches; (3) rocky shores; (4) estuaries; and (5) marshes. These discussions present some of the physical processes that…

  6. Space Science Educational Media Resources, A Guide for Junior High School Teachers.

    ERIC Educational Resources Information Center

    McIntyre, Kenneth M.

    This guide, developed by a panel of teacher consultants, is a correlation of educational media resources with the "North Carolina Curricular Bulletin for Eighth Grade Earth and Space Science" and the state adopted textbook, pModern Earth Science." The three major divisions are (1) the Earth in Space (Astronomy), (2) Space Exploration, and (3)…

  7. Ocean Prospects: A High School Teacher's Guide to Ocean-Related Topics.

    ERIC Educational Resources Information Center

    Plummer, C. M.

    Provided in this guide are resources for these 11 topics: the physical/geological ocean; the chemical/biological ocean; the ocean's coasts; fishing and aquaculture; tourism, recreation, and development; mining and drilling; research and exploration; maritime and military; ocean technology; pollution; and resource management. These resources…

  8. Canadian Studies for Elementary and Junior High School Teachers. A Syllabus and Resource Guide.

    ERIC Educational Resources Information Center

    State Univ., of New York, Plattsburgh. Coll. at Plattsburgh. Center for the Study of Canada.

    Developed to promote greater awareness and understanding of Canada by American students and teachers, this interdisciplinary curriculum guide includes not only social studies, but also activities dealing with mathematics, science, environmental studies, English, art, and music. The book is divided into five modules, each giving a different…

  9. Cooperative Marketing and Distributive Education I and II (Junior and Senior High School Students). Vocational Education Teacher-Coordinators Curriculum Guide. Bulletin 1702.

    ERIC Educational Resources Information Center

    Louisiana State Dept. of Education, Baton Rouge. Div. of Vocational Education.

    Developed by experienced vocational teacher-coordinators and teacher-educators, this guide is intended to be used as a resource by cooperative distributive education and marketing teachers in Louisiana junior and senior high schools. The guide contains suggested curriculum for both beginning and advanced courses. Course I consists of 19 units in…

  10. Master Curriculum Guide in Economics for the Nation's Schools. Part II, Strategies for Teaching Economics: Junior High School Level (Grades 7-9).

    ERIC Educational Resources Information Center

    Banaszak, Ronald A.; Clawson, Elmer U.

    This guide contains concept-based lessons and activities in economics for use with students in grades 7-9. One component of a two-part publication, the guide demonstrates how the conceptual structure of the economics discipline presented in the first publication (ED 148 648) can be used to help students at the junior high school level make more…

  11. 75 FR 76019 - Compliance Policy Guide Sec. 390.500 Definition of “High-Voltage Vacuum Switch”-21 CFR 1002.61(a...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-07

    ... FR 48180 at 48233), FDA included the Compliance Policy Guides Manual, which includes CPG Sec. 390.500...-Voltage Vacuum Switch''--21 CFR 1002.61(a)(3) and (b)(2); Withdrawal of Guidance AGENCY: Food and Drug... the withdrawal of Compliance Policy Guide Sec. 390.500 Definition of ``High-Voltage Vacuum...

  12. A Performance-Based Training Qualification Guide/Checklist Developed for Reactor Operators at the High Flux Beam Reactor at Brookhaven National Laboratory.

    ERIC Educational Resources Information Center

    McNair, Robert C.

    A Performance-Based Training (PBT) Qualification Guide/Checklist was developed that would enable a trainee to attain the skills, knowledge, and attitude required to operate the High Flux Beam Reactor at Brookhaven National Laboratory. Design of this guide/checklist was based on the Instructional System Design Model. The needs analysis identified…

  13. Technology and human errors in image-guided surgeries

    NASA Astrophysics Data System (ADS)

    Jiang, Zhaowei; Miao, Song; Zamorano, Lucia J.; Li, Qinghang; Gong, JianXing; Diaz, Fernando

    1998-06-01

    Using image guidance for stereotactic surgery has been widely adopted in neurosurgery, orthopedic surgery and other surgery operations. Careful, precise and robust implementation of image-guidance can offer surgeon accurate intra-operative information that traditional techniques can not reach. Weak design, careless utilization, and dilemma in quality assurance protocol may result in severe scenarios. It is because that introducing image guidance into the operating room involves high precise technologies, delicate instruments and sophisticated processes. These can offer precision as well as space for human errors. A method based on the 'failure modes and effects analysis' is introduced to systematically study human errors in the image-guided surgery field. The paper presented the fundamental steps and architectures of the method. For better understanding of the method, a simple example is also provided. Analyzing human errors with the 'failure mode and effects analysis' benefits the development life cycle of the image-guided surgery system. It also helps for designing the clinical quality assurance process and the training courses for surgeons.

  14. Integration of Functional MRI and White Matter Tractography in Stereotactic Radiosurgery Clinical Practice

    SciTech Connect

    Pantelis, Evaggelos; Papadakis, Nikolaos; Verigos, Kosmas; Stathochristopoulou, Irene; Antypas, Christos; Lekas, Leonidas; Tzouras, Argyrios; Georgiou, Evangelos; Salvaras, Nikolaos

    2010-09-01

    Purpose: To study the efficacy of the integration of functional magnetic resonance imaging (fMRI) and diffusion tensor imaging tractography data into stereotactic radiosurgery clinical practice. Methods and Materials: fMRI and tractography data sets were acquired and fused with corresponding anatomical MR and computed tomography images of patients with arteriovenous malformation (AVM), astrocytoma, brain metastasis, or hemangioma and referred for stereotactic radiosurgery. The acquired data sets were imported into a CyberKnife stereotactic radiosurgery system and used to delineate the target, organs at risk, and nearby functional structures and fiber tracts. Treatment plans with and without the incorporation of the functional structures and the fiber tracts into the optimization process were developed and compared. Results: The nearby functional structures and fiber tracts could receive doses of >50% of the maximum dose if they were excluded from the planning process. In the AVM case, the doses received by the Broadmann-17 structure and the optic tract were reduced to 700 cGy from 1,400 cGy and to 1,200 cGy from 2,000 cGy, respectively, upon inclusion into the optimization process. In the metastasis case, the motor cortex received 850 cGy instead of 1,400 cGy; and in the hemangioma case, the pyramidal tracts received 780 cGy instead of 990 cGy. In the astrocytoma case, the dose to the motor cortex bordering the lesion was reduced to 1,900 cGy from 2,100 cGy, and therefore, the biologically equivalent dose in three fractions was delivered instead. Conclusions: Functional structures and fiber tracts could receive high doses if they were not considered during treatment planning. With the aid of fMRI and tractography images, they can be delineated and spared.

  15. Bevacizumab for the treatment of post-stereotactic radiosurgery adverse radiation effect

    PubMed Central

    Fanous, Andrew A.; Fabiano, Andrew J.

    2016-01-01

    Background: Adverse radiation effect (ARE) is one of the complications of stereotactic radiosurgery. Its treatment with conventional medications, such as corticosteroids, vitamin E, and pentoxifylline carries a high risk of failure, with up to 20% of lesions refractory to such medications. In addition, deep lesions and those occurring in patients with significant medical comorbidities may not be suitable for surgical resection. Bevacizumab is an antiangiogenic monoclonal antibody against vascular endothelial growth factor, a known mediator of cerebral edema. It can be used to successfully treat ARE. Case Description: An 85-year-old man with a history of small-cell lung cancer presented with metastatic disease to the brain. He underwent stereotactic radiosurgery to a brain metastasis involving the right external capsule. Three months later, the lesion had increased in size, with significant surrounding edema. The patient developed an adverse reaction to steroid treatment and had a poor response to treatment with pentoxifylline and vitamin E. He was deemed a poor surgical candidate because of his medical comorbidities. He was eventually treated with 3 doses of bevacizumab, and the treatment resulted in significant clinical improvement. Magnetic resonance imaging showed some decrease in the size of the lesion and significant decrease in the surrounding edema. Conclusions: Bevacizumab can be successfully used to treat ARE induced by stereotactic radiosurgery in patients with cerebral metastases. It is of particular benefit in patients considered unsuitable for surgical decompression. It is also beneficial in patients with poor tolerance to corticosteroids and in patients who do not respond to other medications. PMID:27583180

  16. Quality of Life After Stereotactic Radiotherapy for Stage I Non-Small-Cell Lung Cancer

    SciTech Connect

    Voort van Zyp, Noelle C. van der; Prevost, Jean-Briac; Holt, Bronno van der; Braat, Cora; Klaveren, Robertus J. van; Pattynama, Peter M.; Levendag, Peter C.; Nuyttens, Joost J.

    2010-05-01

    Purpose: To determine the impact of stereotactic radiotherapy on the quality of life of patients with inoperable early-stage non-small-cell lung cancer (NSCLC). Overall survival, local tumor control, and toxicity were also evaluated in this prospective study. Methods and Materials: From January 2006 to February 2008, quality of life, overall survival, and local tumor control were assessed in 39 patients with pathologically confirmed T1 to 2N0M0 NSCLC. These patients were treated with stereotactic radiotherapy. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ) C30 and the QLQ LC13 lung cancer-specific questionnaire were used to investigate changes in quality of life. Assessments were done before treatment, at 3 weeks, and at 2, 4, 6, 9, and 12 months after treatment, until death or progressive disease. Toxicity was evaluated using common terminology criteria for adverse events version 3.0. Results: Emotional functioning improved significantly after treatment. Other function scores and QLQ C30 and QLQ LC13 lung symptoms (such as dyspnea and coughing) showed no significant changes. The overall 2-year survival rate was 62%. After a median follow-up of 17 months, 1 patient had a local recurrence (3%). No grade 4 or 5 treatment-related toxicity occurred. Grade 3 toxicity consisted of thoracic pain, which occurred in 1 patient within 4 months of treatment, while it occurred thereafter in 2 patients. Conclusions: Quality of life was maintained, and emotional functioning improved significantly after stereotactic radiotherapy for stage I NSCLC, while survival was acceptable, local tumor control was high, and toxicity was low.

  17. Stereotactic Body Radiation Therapy in Spinal Metastases

    SciTech Connect

    Ahmed, Kamran A.; Stauder, Michael C.; Miller, Robert C.; Bauer, Heather J.; Rose, Peter S.; Olivier, Kenneth R.; Brown, Paul D.; Brinkmann, Debra H.; Laack, Nadia N.

    2012-04-01

    Purpose: Based on reports of safety and efficacy, stereotactic body radiotherapy (SBRT) for treatment of malignant spinal tumors was initiated at our institution. We report prospective results of this population at Mayo Clinic. Materials and Methods: Between April 2008 and December 2010, 85 lesions in 66 patients were treated with SBRT for spinal metastases. Twenty-two lesions (25.8%) were treated for recurrence after prior radiotherapy (RT). The mean age of patients was 56.8 {+-} 13.4 years. Patients were treated to a median dose of 24 Gy (range, 10-40 Gy) in a median of three fractions (range, 1-5). Radiation was delivered with intensity-modulated radiotherapy (IMRT) and prescribed to cover 80% of the planning target volume (PTV) with organs at risk such as the spinal cord taking priority over PTV coverage. Results: Tumor sites included 48, 22, 12, and 3 in the thoracic, lumbar, cervical, and sacral spine, respectively. The mean actuarial survival at 12 months was 52.2%. A total of 7 patients had both local and marginal failure, 1 patient experienced marginal but not local failure, and 1 patient had local failure only. Actuarial local control at 1 year was 83.3% and 91.2% in patients with and without prior RT. The median dose delivered to patients who experienced local/marginal failure was 24 Gy (range, 18-30 Gy) in a median of three fractions (range, 1-5). No cases of Grade 4 toxicity were reported. In 1 of 2 patients experiencing Grade 3 toxicity, SBRT was given after previous radiation. Conclusion: The results indicate SBRT to be an effective measure to achieve local control in spinal metastases. Toxicity of treatment was rare, including those previously irradiated. Our results appear comparable to previous reports analyzing spine SBRT. Further research is needed to determine optimum dose and fractionation to further improve local control and prevent toxicity.

  18. Stereotactic Body Radiotherapy for Primary Hepatocellular Carcinoma

    SciTech Connect

    Andolino, David L.; Johnson, Cynthia S.; Maluccio, Mary; Kwo, Paul; Tector, A. Joseph; Zook, Jennifer; Johnstone, Peter A.S.; Cardenes, Higinia R.

    2011-11-15

    Purpose: To evaluate the safety and efficacy of stereotactic body radiotherapy (SBRT) for the treatment of primary hepatocellular carcinoma (HCC). Methods and Materials: From 2005 to 2009, 60 patients with liver-confined HCC were treated with SBRT at the Indiana University Simon Cancer Center: 36 Child-Turcotte-Pugh (CTP) Class A and 24 CTP Class B. The median number of fractions, dose per fraction, and total dose, was 3, 14 Gy, and 44 Gy, respectively, for those with CTP Class A cirrhosis and 5, 8 Gy, and 40 Gy, respectively, for those with CTP Class B. Treatment was delivered via 6 to 12 beams and in nearly all cases was prescribed to the 80% isodose line. The records of all patients were reviewed, and treatment response was scored according to Response Evaluation Criteria in Solid Tumors v1.1. Toxicity was graded according to the Common Terminology Criteria for Adverse Events v4.0. Local control (LC), time to progression (TTP), progression-free survival (PFS), and overall survival (OS) were calculated according to the method of Kaplan and Meier. Results: The median follow-up time was 27 months, and the median tumor diameter was 3.2 cm. The 2-year LC, PFS, and OS were 90%, 48%, and 67%, respectively, with median TTP of 47.8 months. Subsequently, 23 patients underwent transplant, with a median time to transplant of 7 months. There were no {>=}Grade 3 nonhematologic toxicities. Thirteen percent of patients experienced an increase in hematologic/hepatic dysfunction greater than 1 grade, and 20% experienced progression in CTP class within 3 months of treatment. Conclusions: SBRT is a safe, effective, noninvasive option for patients with HCC {<=}6 cm. As such, SBRT should be considered when bridging to transplant or as definitive therapy for those ineligible for transplant.

  19. Parents' Guide to Highly Rated Educational Software. Over Two Hundred Highly Rated Software Programs for Home Education.

    ERIC Educational Resources Information Center

    Educational Products Information Exchange Inst., Water Mill, NY.

    The guide presents a collection of over 200 microcomputer programs appropriate for home education. All software packages have been evaluated by at least two reviewing agencies using the following criteria: (1) emphasis on user control of the learning process; (2) usable by several age groups; (3) usable for remedial purposes as well as first-time…

  20. High-resolution mini gamma camera for diagnosis and radio-guided surgery in diabetic foot infection

    NASA Astrophysics Data System (ADS)

    Scopinaro, F.; Capriotti, G.; Di Santo, G.; Capotondi, C.; Micarelli, A.; Massari, R.; Trotta, C.; Soluri, A.

    2006-12-01

    The diagnosis of diabetic foot osteomyelitis is often difficult. 99mTc-WBC (White Blood Cell) scintigraphy plays a key role in the diagnosis of bone infections. Spatial resolution of Anger camera is not always able to differentiate soft tissue from bone infection. Aim of present study is to verify if HRD (High-Resolution Detector) is able to improve diagnosis and to help surgery. Patients were studied by HRD showing 25.7×25.7 mm 2 FOV, 2 mm spatial resolution and 18% energy resolution. The patients were underwent to surgery and, when necessary, bone biopsy, both guided by HRD. Four patients were positive at Anger camera without specific signs of osteomyelitis. HRS (High-Resolution Scintigraphy) showed hot spots in the same patients. In two of them the hot spot was bar-shaped and it was localized in correspondence of the small phalanx. The presence of bone infection was confirmed at surgery, which was successfully guided by HRS. 99mTc-WBC HRS was able to diagnose pedal infection and to guide the surgery of diabetic foot, opening a new way in the treatment of infected diabetic foot.

  1. Fractionated Stereotactic Radiotherapy in Patients With Optic Nerve Sheath Meningioma

    SciTech Connect

    Paulsen, Frank; Doerr, Stefan; Wilhelm, Helmut; Becker, Gerd; Bamberg, Michael; Classen, Johannes

    2012-02-01

    Purpose: To evaluate the effectiveness of fractionated stereotactic radiotherapy (SFRT) in the treatment of optic nerve sheath meningioma (ONSM). Methods and Materials: Between 1993 and 2005, 109 patients (113 eyes) with primary (n = 37) or secondary (n = 76) ONSM were treated according to a prospective protocol with SFRT to a median dose of 54 Gy. All patients underwent radiographic, ophthalmologic, and endocrine analysis before and after SFRT. Radiographic response, visual control, and late side effects were endpoints of the analysis. Results: Median time to last clinical, radiographic, and ophthalmologic follow up was 30.2 months (n = 113), 42.7 months (n = 108), and 53.7 months (n = 91), respectively. Regression of the tumor was observed in 5 eyes and progression in 4 eyes, whereas 104 remained stable. Visual acuity improved in 12, deteriorated in 11, and remained stable in 68 eyes. Mean visual field defects reduced from 33.6% (n = 90) to 17.8% (n = 56) in ipsilateral and from 10% (n = 94) to 6.7% (n = 62) in contralateral eyes. Ocular motility improved in 23, remained stable in 65, and deteriorated in 3 eyes. Radiographic tumor control was 100% at 3 years and 98% at 5 years. Visual acuity was preserved in 94.8% after 3 years and in 90.9% after 5 years. Endocrine function was normal in 90.8% after 3 years and in 81.3% after 5 years. Conclusions: SFRT represents a highly effective treatment for ONSM. Interdisciplinary counseling of the patients is recommended. Because of the high rate of preservation of visual acuity we consider SFRT the standard approach for the treatment of ONSM. Prolonged observation is warranted to more accurately assess late visual impairment. Moderate de-escalation of the radiation dose might improve the preservation of visual acuity and pituitary gland function.

  2. Small Bowel Dose Tolerance for Stereotactic Body Radiation Therapy.

    PubMed

    LaCouture, Tamara A; Xue, Jinyu; Subedi, Gopal; Xu, Qianyi; Lee, Justin T; Kubicek, Gregory; Asbell, Sucha O

    2016-04-01

    Inconsistencies permeate the literature regarding small bowel dose tolerance limits for stereotactic body radiation therapy (SBRT) treatments. In this review, we organized these diverse published limits with MD Anderson at Cooper data into a unified framework, constructing the dose-volume histogram (DVH) Risk Map, demonstrating low-risk and high-risk SBRT dose tolerance limits for small bowel. Statistical models of clinical data from 2 institutions were used to assess the safety spectrum of doses used in the exposure of the gastrointestinal tract in SBRT; 30% of the analyzed cases had vascular endothelial growth factor inhibitors (VEGFI) or other biological agents within 2 years before or after SBRT. For every dose tolerance limit in the DVH Risk Map, the probit dose-response model was used to estimate the risk level from our clinical data. Using the current literature, 21Gy to 5cc of small bowel in 3 fractions has low toxicity and is reasonably safe, with 6.5% estimated risk of grade 3 or higher complications, per Common Terminology Criteria for Adverse Events version 4.0. In the same fractionation for the same volume, if lower risk is required, 16.2Gy has an estimated risk of only 2.5%. Other volumes and fractionations are also reviewed; for all analyzed high-risk small bowel limits, the risk is 8.2% or less, and the low-risk limits have 4% or lower estimated risk. The results support current clinical practice, with some possibility for dose escalation. PMID:27000513

  3. Conformality Study for Stereotactic Radiosurgery of the Lung

    SciTech Connect

    Ewing, Marvene M.; DesRosiers, Colleen; Fakiris, Achilles J.; DeBliek, Carolyn R.; Kiszka, Daniel N.; Stinson, Eric R.; Young, Lanice E.; Bartlett, Gregory K.

    2011-04-01

    The purpose of this study is to compare two techniques of developing highly conformal plans for stereotactic body radiation therapy (SBRT) that target a high ablative dose to the center of the tumor while dropping off rapidly in normal tissues to determine which technique produced a more desirable treatment plan. The techniques used for comparison are 'field in field' (FIF) and 'non field in field' (NFIF). Twelve case studies were used, all of which had been treated using the FIF technique. Each FIF plan was edited, maintaining the same geometry for each field but reducing the total number of fields to one half by deleting all of the fields that were inside another field; this edited plan was the NFIF plan. Normalization was made to the isodose line (NFIF-I) and to the target volume (NFIF-V) and both plans were compared with the standard FIF plan independently. Dose-ratio comparisons were made of the 80% and 50% isodose volumes, as well as maximum doses outside of the planning target volume, mean dose to the gross tumor volume (GTV), minimum dose coverage on the GTV, maximum dose to the spinal cord, and the dose to the volume of noninvolved lung receiving 2000 cGy (V20). The FIF plans resulted in the best sparing of normal tissue. The NFIF-I had the best target coverage but also resulted in the highest doses to normal tissues. The NFIF-V was not significantly different from the FIF in doses to normal tissue but had the lowest coverage to targets of any of the techniques. Overall, in our department, we have chosen to use the FIF technique for SBRT conformality to obtain optimal coverage while minimizing the dose to normal tissue.

  4. Compared performance of different centroiding algorithms for high-pass filtered laser guide star Shack-Hartmann wavefront sensors

    NASA Astrophysics Data System (ADS)

    Lardière, Olivier; Conan, Rodolphe; Clare, Richard; Bradley, Colin; Hubin, Norbert

    2010-07-01

    Variations of the sodium layer altitude and atom density profile induce errors on laser-guide-star (LGS) adaptive optics systems. These errors must be mitigated by (i), optimizing the LGS wavefront sensor (WFS) and the centroiding algorithm, and (ii), by adding a high-pass filter on the LGS path and a low-bandwidth natural-guide-star WFS. In the context of the ESO E-ELT project, five centroiding algorithms, namely the centre-of-gravity (CoG), the weighted CoG, the matched filter, the quad-cell and the correlation, have been evaluated in closedloop on the University of Victoria LGS wavefront sensing test bed. Each centroiding algorithm performance is compared for a central versus side-launch laser, different fields of view, pixel sampling, and LGS flux.

  5. Frame-Based Immobilization and Targeting for Stereotactic Body Radiation Therapy

    SciTech Connect

    Murray, Bryan C. . E-mail: bryan.murray@utsouthwestern.edu; Forster, Kenneth; Timmerman, Robert

    2007-07-01

    Frame-based stereotactic body radiation therapy (SBRT), such as that conducted with Elekta's Stereotactic Body Frame, can provide an extra measure of precision in the delivery of radiation to extracranial targets, and facilitates secure patient immobilization. In this paper, we review the steps involved in optimal use of an extra-cranial immobilization device for SBRT treatments. Our approach to using frame-based SBRT consists of 4 steps: patient immobilization, tumor and organ motion control, treatment/planning correlation, and daily targeting with pretreatment quality assurance. Patient immobilization was achieved with the Vac-Loc bag, which uses styrofoam beads to conform to the patient's shape comfortably within the body frame. Organ and motion control was assessed under fluoroscopy and controlled via a frame-mounted abdominal pressure plate. The compression screw was tightened until the diaphragmatic excursion range was < 1 cm. Treatment planning was performed using the Philips Pinnacle 6.2b system. In this treatment process, a 20 to 30 noncoplanar beam arrangement was initially selected and an inverse beam weight optimization algorithm was applied. Those beams with low beam weights were removed, leaving a manageable number of beams for treatment delivery. After planning, daily targeting using computed tomography (CT) to verify x-, y-, and z-coordinates of the treatment isocenter were used as a measure of quality assurance. We found our daily setup variation typically averaged < 5 mm in all directions, which is comparable to other published studies on Stereotactic Body Frame. Treatment time ranged from 30 to 45 minutes. Results demonstrate that patients have experienced high rates of local control with acceptable rates of severe side effects-by virtue of the tightly constrained treatment fields. The body frame facilitated comfortable patient positioning and quality assurance checks of the tumor, in relation to another set of independent set of coordinates

  6. In-vivo reflection spectroscopy measurements in pig brain during stereotactic surgery

    NASA Astrophysics Data System (ADS)

    Antonsson, Johan; Eriksson, Ola; Wardell, Karin

    2003-07-01

    Radio frequency (RF) lesioning in the human brain is a common surgical therapy for relieving severe pain as well as for movement disorders such as Parkinsonia. During the procedure a small electrode is introduced by stereotactic means towards a target area localized by CT or MRI. An RF-current is applied through the electrode tip when positioned in the target area. The tissue in the proximity of the tip is heated by the current and finally coagulated. The overall aim of this study was to improve the RF-technique and its ability to estimate lesion size by means of optical methods. Therefore, the optical differences between white and gray matter, as well as lesioned and unlesioned tissue were investigated. Reflection spectroscopy measurements in the range of 450-800 nm were conducted on fully anesthetized pigs during stereotactic RF-lesioning (n=6). Light from a tungsten lamp was guided to the electrode tip through optical fibers, inserted along a 2 mm in diameter monopolar RF-electrode. Measurements were performed in steps of 0-10 mm from the target in each hemisphere towards the entry point of the skull. In the central gray of the porcine brain measurements were performed both before and after the creation of a lesion. A total of 55 spectra were collected during this study. Correlation to tissue type was done using post-operative MR-images. The spectral signature for white and gray matter differs significantly for the entire spectral range of 450-800 nm. Pre- and post-lesioning reflection spectroscopy showed the largest differences below 600 and above 620 nm, which implies that lasers within this wavelength range may be useful for in-vivo measurements of tissue optical changes during RF-lesioning.

  7. Design and implementation of a high power rf oscillator on a printed circuit board for multipole ion guides

    NASA Astrophysics Data System (ADS)

    Mathur, Raman; O'Connor, Peter B.

    2006-11-01

    Radio frequency (rf) oscillators are commonly used to drive electrodes of ion guides. In this article a rf oscillator circuit design and its implementation is presented. The printed circuit board for the rf oscillator is designed and fabricated. The performance of the circuit was tested to transfer ions through a hexapole in a matrix-assisted laser desorption/ionization Fourier transform mass spectrometer. A comprehensive discussion of several aspects of printed circuit board design for high power and high frequency circuits is presented.

  8. A high transmission wave-guide wire network made by self-assembly

    NASA Astrophysics Data System (ADS)

    Salvatore, Stefano; Vignolini, Silvia; Philpott, Julian; Stefik, Morgan; Wiesner, Ulrich; Baumberg, Jeremy J.; Steiner, Ullrich

    2014-12-01

    Polymer self-assembly of a 3D continuous gyroid morphology was replicated into a network consisting of hollow gold struts. This was achieved by first replicating a gyroid structured film into nickel. The Ni network was employed as an electrode for electrochemical Au deposition, followed by the removal of Ni. The resulting hollow network of plasmonic gold exhibited a substantial optical transmission enhancement by a factor of nearly 3, compared to a network of full Au struts. The overall transmission across the hollow wave-guide morphology depends sensitively on the wall-thickness of the hollow struts down to 1 nm. The dramatic transmission increase arises from an interplay of three mechanisms: (1) the additional number of modes propagating through the wave-guide structure, (2) the increased efficiency of light in-coupling, and (3) a reduction of dissipation by decreasing the Au-volume experienced in plasmon mode propagation.

  9. Stereotactic radiosurgery of prostate cancer - dose distribution for VMAT and CyberKnife techniques

    NASA Astrophysics Data System (ADS)

    Ślosarek, Krzysztof; Osewski, Wojciech; Grządziel, Aleksandra; Stąpór-Fudzińska, Małgorzata; Szlag, Marta

    2016-06-01

    New capabilities of biomedical accelerators allow for very precise depositing of the radiation dose and imaging verification during the therapy. In addition, computer algorithms calculating dose distributions are taking into account the increasing number of physical effects. Therefore, administration of high dose fractionation, which is consistent with radiobiology used in oncology, becomes safer and safer. Stereotactic radiosurgery (SRS), which is very precise irradiation with high dose fractionation is increasingly widespread use in radiotherapy of prostate cancer. For this purpose different biomedical accelerators are used. The aim of this study is to compare dose distributions for two techniques: VMAT and CyberKnife. Statistical analysis was performed for the two groups of patients treated by VMAT technique (25 patients), and CyberKnife technique (15 patients). The analysis shows that the dose distributions are comparable, both in the treated area (prostate) and in the critical organs (rectum, urinary bladder, femoral heads). The results show that stereotactic radiosurgery of prostate cancer can be carried out on CyberKnife accelerator as well as on the classical accelerator with the use of VMAT technique.

  10. Stereotactic Ablative Body Radiation Therapy for Octogenarians With Non-Small Cell Lung Cancer

    SciTech Connect

    Takeda, Atsuya; Sanuki, Naoko; Eriguchi, Takahisa; Kaneko, Takeshi; Morita, Satoshi; Handa, Hiroshi; Aoki, Yousuke; Oku, Yohei; Kunieda, Etsuo

    2013-06-01

    Purpose: To retrospectively investigate treatment outcomes of stereotactic ablative body radiation therapy (SABR) for octogenarians with non-small cell lung cancer (NSCLC). Methods and Materials: Between 2005 and 2012, 109 patients aged ≥80 years with T1-2N0M0 NSCLC were treated with SABR: 47 patients had histology-unproven lung cancer; 62 patients had pathologically proven NSCLC. The prescribed doses were either 50 Gy/5 fractions for peripheral tumors or 40 Gy/5 fractions for centrally located tumors. The treatment outcomes, toxicities, and the correlating factors for overall survival (OS) were evaluated. Results: The median follow-up duration after SABR was 24.2 (range, 3.0-64.6) months. Only limited toxicities were observed, except for 1 grade 5 radiation pneumonitis. The 3-year local, regional, and distant metastasis-free survival rates were 82.3%, 90.1%, and 76.8%, respectively. The OS and lung cancer-specific survival rates were 53.7% and 70.8%, respectively. Multivariate analysis revealed that medically inoperable, low body mass index, high T stage, and high C-reactive protein were the predictors for short OS. The OS for the operable octogenarians was significantly better than that for inoperable (P<.01). Conclusions: Stereotactic ablative body radiation therapy for octogenarians was feasible, with excellent OS. Multivariate analysis revealed that operability was one of the predictors for OS. For medically operable octogenarians with early-stage NSCLC, SABR should be prospectively compared with resection.

  11. Stereotactic radiosurgery of angiographically occult vascular malformations: Indications and preliminary experience

    SciTech Connect

    Kondziolka, D.; Lunsford, L.D.; Coffey, R.J.; Bissonette, D.J.; Flickinger, J.C. )

    1990-12-01

    Stereotactic radiosurgery has been shown to treat successfully angiographically demonstrated arteriovenous malformations of the brain. Angiographic obliteration has represented cure and eliminated the risk of future hemorrhage. The role of radiosurgery in the treatment of angiographically occult vascular malformations (AOVMs) has been less well defined. In the initial 32 months of operation of the 201-source cobalt-60 gamma knife at the University of Pittsburgh, 24 patients meeting strict criteria for high-risk AOVMs were treated. Radiosurgery was used conservatively; each patient had sustained two or more hemorrhages and had a magnetic resonance imaging-defined AOVM located in a region of the brain where microsurgical removal was judged to pose an excessive risk. Venous angiomas were excluded by performance of high-resolution subtraction angiography in each patient. Fifteen malformations were in the medulla, pons, and/or mesencephalon, and 5 were located in the thalamus or basal ganglia. Follow-up ranged from 4 to 24 months. Nineteen patients either improved or remained clinically stable and did not hemorrhage again during the follow-up interval. One patient suffered another hemorrhage 7 months after radiosurgery. Five patients experienced temporary worsening of pre-existing neurological deficits that suggested delayed radiation injury. Magnetic resonance imaging demonstrated signal changes and edema surrounding the radiosurgical target. Dose-volume guidelines for avoiding complications were constructed. Our initial experience indicates that stereotactic radiosurgery can be performed safely in patients with small, well-circumscribed AOVMs located in deep, critical, or relatively inaccessible cerebral locations.

  12. SMIP Chemistry Curriculum Guides.

    ERIC Educational Resources Information Center

    Wilkes Coll., Wilkes-Barre, PA.

    Included are most guides for a one-year course in senior high school chemistry. The guides may be interchanged at the teacher's discretion, following any text sequence or course outline. Each guide consists of six sections: (1) an approach, which briefly discusses the unit in terms of background material, pitfalls to be avoided, and suggested…

  13. Maximum kinetic energy considerations in proton stereotactic radiosurgery

    PubMed Central

    Sengbusch, Evan R.; Mackie, Thomas R.

    2016-01-01

    The purpose of this study was to determine the maximum proton kinetic energy required to treat a given percentage of patients eligible for stereotactic radiosurgery (SRS) with coplanar arc-based proton therapy, contingent upon the number and location of gantry angles used. Treatment plans from 100 consecutive patients treated with SRS at the University of Wisconsin Carbone Cancer Center between June of 2007 and March of 2010 were analyzed. For each target volume within each patient, in-house software was used to place proton pencil beam spots over the distal surface of the target volume from 51 equally-spaced gantry angles of up to 360°. For each beam spot, the radiological path length from the surface of the patient to the distal boundary of the target was then calculated along a ray from the gantry location to the location of the beam spot. This data was used to generate a maximum proton energy requirement for each patient as a function of the arc length that would be spanned by the gantry angles used in a given treatment. If only a single treatment angle is required, 100% of the patients included in the study could be treated by a proton beam with a maximum kinetic energy of 118 MeV. As the length of the treatment arc is increased to 90°, 180°, 270°, and 360°, the maximum energy requirement increases to 127, 145, 156, and 179 MeV, respectively. A very high percentage of SRS patients could be treated at relatively low proton energies if the gantry angles used in the treatment plan do not span a large treatment arc. Maximum proton kinetic energy requirements increase linearly with size of the treatment arc. PMID:21844866

  14. Optical coherence tomography guided microinjections in live mouse embryos: high-resolution targeted manipulation for mouse embryonic research

    PubMed Central

    Syed, Saba H.; Coughlin, Andrew J.; Garcia, Monica D.; Wang, Shang; West, Jennifer L.; Larin, Kirill V.; Larina, Irina V.

    2015-01-01

    Abstract. The ability to conduct highly localized delivery of contrast agents, viral vectors, therapeutic or pharmacological agents, and signaling molecules or dyes to live mammalian embryos is greatly desired to enable a variety of studies in the field of developmental biology, such as investigating the molecular regulation of cardiovascular morphogenesis. To meet such a demand, we introduce, for the first time, the concept of employing optical coherence tomography (OCT)-guide microinjections in live mouse embryos, which provides precisely targeted manipulation with spatial resolution at the micrometer scale. The feasibility demonstration is performed with experimental studies on cultured live mouse embryos at E8.5 and E9.5. Additionally, we investigate the OCT-guided microinjection of gold–silica nanoshells to the yolk sac vasculature of live cultured mouse embryos at the stage when the heart just starts to beat, as a potential approach for dynamic assessment of cardiovascular form and function before the onset of blood cell circulation. Also, the capability of OCT to quantitatively monitor and measure injection volume is presented. Our results indicate that OCT-guided microinjection could be a useful tool for mouse embryonic research. PMID:25581495

  15. Ultrasound-guided high intensity focused ultrasound for the treatment of gynaecological diseases: A review of safety and efficacy.

    PubMed

    Zhang, Lian; Zhang, Wenyi; Orsi, Franco; Chen, Wenzhi; Wang, Zhibiao

    2015-05-01

    As a non-surgical treatment, high intensity focused ultrasound (HIFU) has received increasing interest for the treatment of gynaecological diseases over the last 10 years. Many studies have shown that HIFU is safe and effective in treating patients with uterine fibroids, adenomyosis, cervicitis or vulvar diseases. Both magnetic resonance imaging-guided HIFU (MRgHIFU) and ultrasound-guided HIFU (USgHIFU) can offer gynaecologists non-invasive techniques to treat patients with uterine benign diseases. Focused ultrasound therapy can also be used effectively to treat cervicitis and vulvar diseases. As gynaecologists gain more experience with this technology, the rate of severe adverse effects has been lowered with the development of this non-invasive technique. In this paper we review the literature available regarding the utilisation of magnetic resonance imaging-guided focused ultrasound/MRgHIFU or USgHIFU and new findings from our group in the treatment of gynaecological diseases: uterine fibroids, adenomyosis, cervicitis, vulvar diseases, caesarean scar pregnancies, and abdominal wall endometriosis. PMID:25609456

  16. Optical coherence tomography guided microinjections in live mouse embryos: high-resolution targeted manipulation for mouse embryonic research

    NASA Astrophysics Data System (ADS)

    Syed, Saba H.; Coughlin, Andrew J.; Garcia, Monica D.; Wang, Shang; West, Jennifer L.; Larin, Kirill V.; Larina, Irina V.

    2015-05-01

    The ability to conduct highly localized delivery of contrast agents, viral vectors, therapeutic or pharmacological agents, and signaling molecules or dyes to live mammalian embryos is greatly desired to enable a variety of studies in the field of developmental biology, such as investigating the molecular regulation of cardiovascular morphogenesis. To meet such a demand, we introduce, for the first time, the concept of employing optical coherence tomography (OCT)-guide microinjections in live mouse embryos, which provides precisely targeted manipulation with spatial resolution at the micrometer scale. The feasibility demonstration is performed with experimental studies on cultured live mouse embryos at E8.5 and E9.5. Additionally, we investigate the OCT-guided microinjection of gold-silica nanoshells to the yolk sac vasculature of live cultured mouse embryos at the stage when the heart just starts to beat, as a potential approach for dynamic assessment of cardiovascular form and function before the onset of blood cell circulation. Also, the capability of OCT to quantitatively monitor and measure injection volume is presented. Our results indicate that OCT-guided microinjection could be a useful tool for mouse embryonic research.

  17. Guiding of high intensity ultrashort laser pulses in plasma channels produced with the dual laser pulse ignitor-heater technique

    SciTech Connect

    Volfbeyn, P.; Leemans, W.P.

    1998-07-01

    The authors present results of experimental investigations of laser guiding in plasma channels. A new technique for plasma channel creation, the Ignitor-Heater scheme is proposed and experimentally tested in hydrogen and nitrogen. It makes use of two laser pulses. The Ignitor, an ultrashort (< 100 fs) laser pulse, is brought to a line focus using a cylindrical lens to ionize the gas. The Heater pulse (160 ps long) is used subsequently to heat the existing spark via inverse Bremsstrahlung. The hydrodynamic shock expansion creates a partially evacuated plasma channel with a density minimum on axis. Such a channel has properties of an optical waveguide. This technique allows creation of plasma channels in low atomic number gases, such as hydrogen, which is of importance for guiding of highly intense laser pulses. The channel density was diagnosed with time resolved longitudinal interferometry. From these measurements the plasma temperature was inferred. The guiding properties of the channels were tested by injecting a > 5 {times} 10{sup 17} W/cm{sup 2}, 75 fs laser pulse.

  18. High-Dose, Single-Fraction Image-Guided Intensity-Modulated Radiotherapy for Metastatic Spinal Lesions

    SciTech Connect

    Yamada, Yoshiya Bilsky, Mark H.; Lovelock, D. Michael; Venkatraman, Ennapadam S.; Toner, Sean; Johnson, Jared; Zatcky, Joan N.P.; Zelefsky, Michael J.; Fuks, Zvi

    2008-06-01

    Purpose: To report tumor control and toxicity for patients treated with image-guided intensity-modulated radiotherapy (RT) for spinal metastases with high-dose single-fraction RT. Methods and Materials: A total of 103 consecutive spinal metastases in 93 patients without high-grade epidural spinal cord compression were treated with image-guided intensity-modulated RT to doses of 18-24 Gy (median, 24 Gy) in a single fraction between 2003 and 2006. The spinal cord dose was limited to a 14-Gy maximal dose. The patients were prospectively examined every 3-4 months with clinical assessment and cross-sectional imaging. Results: The overall actuarial local control rate was 90% (local failure developed in 7 patients) at a median follow-up of 15 months (range, 2-45 months). The median time to local failure was 9 months (range, 2-15 months) from the time of treatment. Of the 93 patients, 37 died. The median overall survival was 15 months. In all cases, death was from progression of systemic disease and not local failure. The histologic type was not a statistically significant predictor of survival or local control. The radiation dose was a significant predictor of local control (p = 0.03). All patients without local failure also reported durable symptom palliation. Acute toxicity was mild (Grade 1-2). No case of radiculopathy or myelopathy has developed. Conclusion: High-dose, single-fraction image-guided intensity-modulated RT is a noninvasive intervention that appears to be safe and very effective palliation for patients with spinal metastases, with minimal negative effects on quality of life and a high probability of tumor control.

  19. Sampling strategies for subsampled segmented EPI PRF thermometry in MR guided high intensity focused ultrasound

    SciTech Connect

    Odéen, Henrik Diakite, Mahamadou; Todd, Nick; Minalga, Emilee; Payne, Allison; Parker, Dennis L.

    2014-09-15

    Purpose: To investigate k-space subsampling strategies to achieve fast, large field-of-view (FOV) temperature monitoring using segmented echo planar imaging (EPI) proton resonance frequency shift thermometry for MR guided high intensity focused ultrasound (MRgHIFU) applications. Methods: Five different k-space sampling approaches were investigated, varying sample spacing (equally vs nonequally spaced within the echo train), sampling density (variable sampling density in zero, one, and two dimensions), and utilizing sequential or centric sampling. Three of the schemes utilized sequential sampling with the sampling density varied in zero, one, and two dimensions, to investigate sampling the k-space center more frequently. Two of the schemes utilized centric sampling to acquire the k-space center with a longer echo time for improved phase measurements, and vary the sampling density in zero and two dimensions, respectively. Phantom experiments and a theoretical point spread function analysis were performed to investigate their performance. Variable density sampling in zero and two dimensions was also implemented in a non-EPI GRE pulse sequence for comparison. All subsampled data were reconstructed with a previously described temporally constrained reconstruction (TCR) algorithm. Results: The accuracy of each sampling strategy in measuring the temperature rise in the HIFU focal spot was measured in terms of the root-mean-square-error (RMSE) compared to fully sampled “truth.” For the schemes utilizing sequential sampling, the accuracy was found to improve with the dimensionality of the variable density sampling, giving values of 0.65 °C, 0.49 °C, and 0.35 °C for density variation in zero, one, and two dimensions, respectively. The schemes utilizing centric sampling were found to underestimate the temperature rise, with RMSE values of 1.05 °C and 1.31 °C, for variable density sampling in zero and two dimensions, respectively. Similar subsampling schemes

  20. Installation of a Neuromate Robot for Stereotactic Surgery: Efforts to Conform to Japanese Specifications and an Approach for Clinical Use—Technical Notes

    PubMed Central

    KAJITA, Yasukazu; NAKATSUBO, Daisuke; KATAOKA, Hirotada; NAGAI, Toshiya; NAKURA, Takahiro; WAKABAYASHI, Toshihiko

    2015-01-01

    The neuromate is a commercially available, image-guided robotic system for use in stereotactic surgery and is employed in Europe and North America. In June 2015, this device was approved in accordance with the Pharmaceutical Affairs Law in Japan. The neuromate can be specified to a wide range of stereotactic procedures in Japan. The stereotactic X-ray system, developed by a Japanese manufacturer, is normally attached to the operating table that provides lateral and anteroposterior images to verify the positions of the recording electrodes. The neuromate is designed to be used with the patient in the supine position on a flat operating table. In Japan, deep brain stimulation surgery is widely performed with the patient's head positioned upward so as to minimize cerebrospinal fluid leakage. The robot base where the patient's head is fixed has an adaptation for a tilted head position (by 25 degrees) to accommodate the operating table at proper angle to hold the patient's upper body. After these modifications, the accuracy of neuromate localization was examined on a computed tomography phantom preparation, showing that the root mean square error was 0.12 ± 0.10 mm. In our hospital, robotic surgeries, such as those using the Da Vinci system or neuromate, require operative guidelines directed by the Medical Risk Management Office and Biomedical Research and Innovation Office. These guidelines include directions for use, procedural manuals, and training courses. PMID:26511113

  1. Process window and defect monitoring using high-throughput e-beam inspection guided by computational hot spot detection

    NASA Astrophysics Data System (ADS)

    Wang, Fei; Zhang, Pengcheng; Fang, Wei; Liu, Kevin; Jau, Jack; Wang, Lester; Wan, Alex; Hunsche, Stefan; Halder, Sandip; Leray, Philippe

    2016-03-01

    As design rules for leading edge devices have shrunk to 1x nm size and below, device patterns have become sensitive to sub-10nm size defects. Additionally, defectivity and yield are now increasingly dominated by systematic patterning defects. A method for identifying and inspecting these hot spot (HS) locations is necessary for both technology development and High Volume Manufacturing (HVM). In order to achieve sufficient statistical significance across the wafer for a specific product and layer, a guided, high-speed e-beam inspection system is needed to cover a significant amount of high-volume hot spot locations for process window monitoring. In this paper, we explore the capabilities of a novel, highthroughput e-beam hot spot inspection tool, SkyScanTM 5000, on a 10nm back-end-of-line (BEOL) wafer patterned using a triple lithography-etch process. ASML's high-resolution, design-aware computational hot spot inspection is used to identify relevant hot spot locations, including overlay-sensitive patterns. We guide the e-beam tool to these Points of Interest (POI) and obtain experimental data from inspection of 430k wafer locations. The large amount of data allows detection of wafer-level and intra-field defect signatures for a large number of hot spot patterns.

  2. Biological equivalent dose studies for dose escalation in the stereotactic synchrotron radiation therapy clinical trials

    SciTech Connect

    Prezado, Y.; Fois, G.; Edouard, M.; Nemoz, C.; Renier, M.; Requardt, H.; Esteve, F.; Adam, JF.; Elleaume, H.; Bravin, A.

    2009-03-15

    Synchrotron radiation is an innovative tool for the treatment of brain tumors. In the stereotactic synchrotron radiation therapy (SSRT) technique a radiation dose enhancement specific to the tumor is obtained. The tumor is loaded with a high atomic number (Z) element and it is irradiated in stereotactic conditions from several entrance angles. The aim of this work was to assess dosimetric properties of the SSRT for preparing clinical trials at the European Synchrotron Radiation Facility (ESRF). To estimate the possible risks, the doses received by the tumor and healthy tissues in the future clinical conditions have been calculated by using Monte Carlo simulations (PENELOPE code). The dose enhancement factors have been determined for different iodine concentrations in the tumor, several tumor positions, tumor sizes, and different beam sizes. A scheme for the dose escalation in the various phases of the clinical trials has been proposed. The biological equivalent doses and the normalized total doses received by the skull have been calculated in order to assure that the tolerance values are not reached.

  3. Prolonged survival of Fischer rats bearing F98 glioma after iodine-enhanced synchrotron stereotactic radiotherapy

    SciTech Connect

    Adam, Jean-Francois; Joubert, Aurelie; Biston, Marie-Claude; Charvet, Anne-Marie; Peoc'h, Michel; Le Bas, Jean-Francois; Balosso, Jacques; Esteve, Francois; Elleaume, Helene . E-mail: h.elleaume@esrf.fr

    2006-02-01

    Purpose: Heavy-atom-enhanced synchrotron stereotactic radiotherapy (SSR) is a treatment that involves selective accumulation of high-Z elements in tumors followed by stereotactic irradiation with X-rays from a synchrotron source. The purpose of this study was to determine whether the efficacy of iodine-enhanced SSR could be further improved in the F98 rodent glioma model, by using a concomitant injection of an iodinated contrast agent and a transient blood-brain barrier opener (mannitol) during irradiation. Methods and Materials: Fourteen days after intracerebral inoculations of F98 cells, the rats were irradiated with 50-keV X-rays while receiving an infusion of hyperosmotic mannitol with iodine, either intravenously or via the carotid (9 to 15 rats per group, 117 rats total). Results: For doses {<=}15 Gy, the intracarotid infusion of mannitol and iodine improved the rats' survival compared with intravenous injection or irradiation alone. The percentage-increased life spans (ILS) were 91%, 116%, and 169% without iodine, after infusion of iodine and mannitol intravenously, and intracarotid, respectively (15 Gy). At 25 Gy, the rats irradiated without iodine had the longest survival (ILS = 607%), but no additional benefit was obtained with iodine and mannitol. Conclusions: Iodine-enhanced SSR is significantly improved with concomitant intracarotid infusion of iodine and mannitol for radiation doses {<=}15 Gy.

  4. [Linear accelerator-based stereotactic radiation treatment of patients with medial middle fossa meningiomas].

    PubMed

    Golanov, A V; Cherekaev, V A; Serova, N K; Pronin, I N; Gorlachev, G E; Kotel'nikova, T M; Podoprigora, A E; Kudriavtseva, P A; Galkin, M V

    2010-01-01

    Medial middle fossa meningiomas are challenging for neurosurgical treatment. Invasion of cranial nerves and vessels leads to high risk of complications after removal of such meningiomas. Currently methods of conformal stereotactic radiation treatment are applied wider and wider for the discussed lesions. During a 3.5-year period 80 patients with medial middle fossa meningiomas were treated in Burdenko Moscow Neurosurgical Institute using linear accelerator "Novalis". In 31 case radiation treatment was preceded by surgical resection. In majority of patients symptoms included cranial nerve dysfunction: oculomotor disturbances in 62.5%, trigeminal impairment--in 37.5%, visual deficit--in 43.8%, facial nerve palsy--in 1.25%. 74 patients underwent radiotherapy with classical fractioning, 2--in hypofractionated mode and 4 received radiosurgery. In cases of classical fractioning mean marginal dose reached 46.3 Gy during 28-33 fractions, in hypofractioning (7 fractions)--31.5 Gy, in radiosurgery--16.25 Gy. Mean follow-up period was 18.4 months (6-42 months). Control of tumor growth was achieved in 97.5% of cases (78 patients): in 42 (52.5%) lesion shrinked, in 36 (45%) stabilization was observed. Clinical examination revealed improvement of visual function in 15 patients (18%) and deterioration in 2 (2.5%). No new neuropathies were found. Stereotactic radiation treatment is the method of choice for medial anterior and middle fossa meningiomas due to effective control of tumor progression and minimal rate of complications. PMID:20429360

  5. Stereotactic Radiosurgery Versus Gold Grain Implantation in Salvaging Local Failures of Nasopharyngeal Carcinoma

    SciTech Connect

    Chua, Daniel Wei, William I.; Sham, Jonathan S.T.; Hung, Kwan Ngai; Au, Gordon K.H.

    2007-10-01

    Background: Limited local failure of nasopharyngeal carcinoma (NPC) can often be salvaged by reirradiation using different techniques. Both gold grain implantation (GGI) and stereotactic radiosurgery (SRS) have been used as salvage treatment of NPC but the relative efficacy of these two treatments is not known. Methods and Materials: A total of 74 patients with local NPC failure were included in this retrospective analysis. Of these patients, 37 underwent SRS (median dose, 12.5 Gy) and 37 split-palatal GGI at a dose of 60 Gy. The two groups were individually matched for prognostic factors, except for tumor volume. The median follow-up was 42 months. Results: Local control was better in the GGI group. The 3-year local failure-free rate was 77.9% for the GGI group compared with 68.3% for the SRS group. However, the difference was not statistically significant (p = 0.098). In the subgroup with a tumor volume of {<=}5 cm{sup 3}, the 3-year local failure-free rates were similar, with 79.3% in the GGI group and 72.4% in the SRS group. Neuroendocrine complications were more common in the SRS group, and headache and fistula were more common in the GGI group. Conclusion: Stereotactic radiosurgery and GGI are both effective salvage treatment for NPC. In patients with limited local failure, both yielded comparable high tumor control rates.

  6. Prospective study on stereotactic radiotherapy of limited-stage non-small-cell lung cancer

    SciTech Connect

    Hoyer, Morten . E-mail: hoyer@as.aaa.dk; Roed, Henrik D.; Hansen, Anders Traberg; Ohlhuis, Lars; Petersen, Jorgen; Nellemann, Hanne; Berthelsen, Anne Kiil; Grau, Cai D.; Engelholm, Svend Aage D.; Maase, Hans D. von der

    2006-11-15

    Purpose: To test the effect of stereotactic body radiotherapy (SBRT) in the treatment of medically inoperable patients with limited-stage non-small-cell lung cancer (NSCLC) in a Phase II trial. Methods and Materials: Forty patients with Stage I NSCLC were treated with SBRT with a central dose of 15 Gy x 3 within 5-8 days. Results: Eight patients (20%) obtained a complete response, 15 (38%) had a partial response, and 12 (30%) had no change or could not be evaluated. Only 3 patients had a local recurrence, and the local control rate 2 years after SBRT was 85%. At 2 years, 54% were without local or distant progression, and overall survival was 47%. Within 6 months after treatment, one or more Grade {>=}2 reactions were observed in 48% of the patients. Conclusions: Stereotactic body radiotherapy in patients with limited-stage NSCLC resulted in a high probability of local control and a promising survival rate. The toxicity after SBRT of lung tumors was moderate. However, deterioration in performance status, respiratory insufficiency, and other side effects were observed.

  7. Analyzing modal behavior of guided waves using high order eigenvalue derivatives.

    PubMed

    Krome, Fabian; Gravenkamp, Hauke

    2016-09-01

    This paper presents a mode-tracing approach for elastic guided waves based on analytically computed derivatives and includes a study of interesting phenomena in the dispersion curve representation. Numerical simulation is done by means of the Scaled Boundary Finite Element Method (SBFEM). Two approaches are used to identify the characteristics of the resulting wave modes: Taylor approximation and Padé approximation. Higher order differentials of the underlying eigenvalue problem are the basis for these approaches. Remarkable phenomena in potentially critical frequency regions are identified and the tracing approach is adapted to these regions. Additionally, a stabilization of the solution process is suggested. PMID:27286265

  8. Experimental investigation of a Ka band high power millimeter wave generator operated at low guiding magnetic field

    SciTech Connect

    Zhu Jun; Shu Ting; Zhang Jun; Li Guolin; Zhang Zehai; Fan Yuwei

    2011-05-15

    An overmoded slow wave type Ka band generator is investigated experimentally to produce high power millimeter waves in this paper. The experiments were carried out at the TORCH-01 accelerator. The produced microwave frequency was measured by dispersive line method, and the power was estimated by integrating over the radiation pattern at far field. With relatively low guiding magnetic field of 0.8 T and diode voltage and beam current of 590 kV and 5.2 kA, respectively, a 33.56 GHz millimeter wave with an output power of 320 MW was generated, and the microwave mode was quasi-TM{sub 01} mode.

  9. High contrast optical imaging methods for image guided laser ablation of dental caries lesions

    NASA Astrophysics Data System (ADS)

    LaMantia, Nicole R.; Tom, Henry; Chan, Kenneth H.; Simon, Jacob C.; Darling, Cynthia L.; Fried, Daniel

    2014-02-01

    Laser based methods are well suited for automation and can be used to selectively remove dental caries to minimize the loss of healthy tissues and render the underlying enamel more resistant to acid dissolution. The purpose of this study was to determine which imaging methods are best suited for image-guided ablation of natural non-cavitated carious lesions on occlusal surfaces. Multiple caries imaging methods were compared including near-IR and visible reflectance and quantitative light fluorescence (QLF). In order for image-guided laser ablation to be feasible, chemical and physical modification of tooth surfaces due to laser irradiation cannot greatly reduce the contrast between sound and demineralized dental hard tissues. Sound and demineralized surfaces of 48 extracted human molar teeth with non-cavitated lesions were examined. Images were acquired before and after laser irradiation using visible and near-IR reflectance and QLF at several wavelengths. Polarization sensitive-optical coherence tomography was used to confirm that lesions were present. The highest contrast was attained at 1460-nm and 1500-1700-nm, wavelengths coincident with higher water absorption. The reflectance did not decrease significantly after laser irradiation for those wavelengths.

  10. High contrast optical imaging methods for image guided laser ablation of dental caries lesions

    PubMed Central

    LaMantia, Nicole R.; Tom, Henry; Chan, Kenneth H.; Simon, Jacob C.; Darling, Cynthia L.; Fried, Daniel

    2014-01-01

    Laser based methods are well suited for automation and can be used to selectively remove dental caries to minimize the loss of healthy tissues and render the underlying enamel more resistant to acid dissolution. The purpose of this study was to determine which imaging methods are best suited for image-guided ablation of natural non-cavitated carious lesions on occlusal surfaces. Multiple caries imaging methods were compared including near-IR and visible reflectance and quantitative light fluorescence (QLF). In order for image-guided laser ablation to be feasible, chemical and physical modification of tooth surfaces due to laser irradiation cannot greatly reduce the contrast between sound and demineralized dental hard tissues. Sound and demineralized surfaces of 48 extracted human molar teeth with non-cavitated lesions were examined. Images were acquired before and after laser irradiation using visible and near-IR reflectance and QLF at several wavelengths. Polarization sensitive-optical coherence tomography was used to confirm that lesions were present. The highest contrast was attained at 1460-nm and 1500–1700-nm, wavelengths coincident with higher water absorption. The reflectance did not decrease significantly after laser irradiation for those wavelengths. PMID:24791129

  11. Fluoroscopy-Guided Percutaneous Gallstone Removal Using a 12-Fr Sheath in High-Risk Surgical Patients with Acute Cholecystitis

    PubMed Central

    Kim, Yong Joo; Shin, Tae Beom

    2011-01-01

    Objective To evaluate the technical feasibility and clinical efficacy of percutaneous transhepatic cholecystolithotomy under fluoroscopic guidance in high-risk surgical patients with acute cholecystitis. Materials and Methods Sixty-three consecutive patients of high surgical risk with acute calculous cholecystitis underwent percutaneous transhepatic gallstone removal under conscious sedation. The stones were extracted through the 12-Fr sheath using a Wittich nitinol stone basket under fluoroscopic guidance on three days after performing a percutaneous cholecystostomy. Large or hard stones were fragmented using either the snare guide wire technique or the metallic cannula technique. Results Gallstones were successfully removed from 59 of the 63 patients (94%). Reasons for stone removal failure included the inability to grasp a large stone in two patients, and the loss of tract during the procedure in two patients with a contracted gallbladder. The mean hospitalization duration was 7.3 days for acute cholecystitis patients and 9.4 days for gallbladder empyema patients. Bile peritonitis requiring percutaneous drainage developed in two patients. No symptomatic recurrence occurred during follow-up (mean, 608.3 days). Conclusion Fluoroscopy-guided percutaneous gallstone removal using a 12-Fr sheath is technically feasible and clinically effective in high-risk surgical patients with acute cholecystitis. PMID:21430938

  12. Neuronavigation-guided focused ultrasound-induced blood-brain barrier opening: A preliminary study in swine

    NASA Astrophysics Data System (ADS)

    Liu, Hao-Li; Tsai, Hong-Chieh; Lu, Yu-Jen; Wei, Kuo-Chen

    2012-11-01

    FUS-induced BBB opening is a promising technique for noninvasive and local delivery of drugs into the brain. Here we propose the novel use of a neuronavigation system to guide the FUS-induced BBB opening procedure, and investigate its feasibility in vivo in large animals. We developed an interface between the neuronavigator and FUS to allow guidance of the focal energy produced by the FUS transducer. The system was tested in 29 pigs by more than 40 sonication procedures and evaluated by MRI. Gd-DTPA concentration was quantitated in vivo by MRI R1 relaxometry and compared by ICP-OES assay. Brain histology after FUS exposure was investigated by HE and TUNEL staining. Neuronavigation could successfully guide the focal beam with comparable precision to neurosurgical stereotactic procedures (2.3 ± 0.9 mm). FUS pressure of 0.43 MPa resulted in consistent BBB-opening. Neuronavigation-guided BBB-opening increased Gd-DTPA deposition by up to 1.83 mM (140% increase). MR relaxometry demonstrated high correlation to ICP-OES measurements (r2 = 0.822), suggesting that Gd-DTPA deposition can be directly measured by imaging. Neuronavigation could provide sufficient precision for guiding FUS to temporally and locally open the BBB. Gd-DTPA deposition in the brain could be quantified by MR relaxometry, providing a potential tool for the in vivo quantification of therapeutic agents in CNS disease treatment.

  13. The use of RapidArc volumetric-modulated arc therapy to deliver stereotactic radiosurgery and stereotactic body radiotherapy to intracranial and extracranial targets

    SciTech Connect

    Roa, Dante E.; Schiffner, Daniel C.; Zhang Juying; Dietrich, Salam N.; Kuo, Jeffrey V.; Wong, Jason; Ramsinghani, Nilam S.; Al-Ghazi, Muthana S.A.L.

    2012-10-01

    Twenty-three targets in 16 patients treated with stereotactic radiosurgery (SRS) or stereotactic body radiotherapy (SBRT) were analyzed in terms of dosimetric homogeneity, target conformity, organ-at-risk (OAR) sparing, monitor unit (MU) usage, and beam-on time per fraction using RapidArc volumetric-modulated arc therapy (VMAT) vs. multifield sliding-window intensity-modulated radiation therapy (IMRT). Patients underwent computed tomography simulation with site-specific immobilization. Magnetic resonance imaging fusion and optical tracking were incorporated as clinically indicated. Treatment planning was performed using Eclipse v8.6 to generate sliding-window IMRT and 1-arc and 2-arc RapidArc plans. Dosimetric parameters used for target analysis were RTOG conformity index (CI{sub RTOG}), homogeneity index (HI{sub RTOG}), inverse Paddick Conformity Index (PCI), D{sub mean} and D5-D95. OAR sparing was analyzed in terms of D{sub max} and D{sub mean}. Treatment delivery was evaluated based on measured beam-on times delivered on a Varian Trilogy linear accelerator and recorded MU values. Dosimetric conformity, homogeneity, and OAR sparing were comparable between IMRT, 1-arc RapidArc and 2-arc RapidArc plans. Mean beam-on times {+-} SD for IMRT and 1-arc and 2-arc treatments were 10.5 {+-} 7.3, 2.6 {+-} 1.6, and 3.0 {+-} 1.1 minutes, respectively. Mean MUs were 3041, 1774, and 1676 for IMRT, 1-, and 2-arc plans, respectively. Although dosimetric conformity, homogeneity, and OAR sparing were similar between these techniques, SRS and SBRT fractions treated with RapidArc were delivered with substantially less beam-on time and fewer MUs than IMRT. The rapid delivery of SRS and SBRT with RapidArc improved workflow on the linac with these otherwise time-consuming treatments and limited the potential for intrafraction organ and patient motion, which can cause significant dosimetric errors. These clinically important advantages make image-guided RapidArc useful in the delivery

  14. Dose enhancement close to platinum implants for the 4, 6, and 10 MV stereotactic radiosurgery

    SciTech Connect

    Cheung, Joel Y.C.; Ng, Ben K.P.; Yu, K.N.

    2004-10-01

    Three photon interaction processes, namely, the photoelectric effect, Compton effect, and pair production, can occur when materials with high atomic numbers are irradiated by the high- and low-energy bremsstrahlung photons from a linear accelerator. A dose enhancement, due to the photoelectric effect and pair production, near targets with platinum implants (with a high atomic number) in radiosurgery cannot be predicted by the XKnife{sup reg} radiosurgery treatment planning system. In the present work, Monte Carlo simulations using PRESTA EGS4 were employed to investigate the resulting dose enhancements from 4, 6, and 10 MV energies commonly used in the stereotactic radiosurgery system. Dose enhancements from 32% to 68% were observed close to the platinum implant for the above energies when using a 12.5 mm collimator. Comparatively higher dose enhancements were observed when using smaller collimators. It was found that this dose enhancement increased with beam energy but decreased as beam size increased.

  15. The Application of Synthetically Focused Imaging Techniques for High Resolution Guided Wave Pipe Inspection

    NASA Astrophysics Data System (ADS)

    Davies, J.; Cawley, P.

    2007-03-01

    Synthetically focused guided wave imaging techniques have previously been employed for plate like structures. Much work has been has been done using algorithms such as the synthetic aperture focusing technique (SAFT), the total focusing method (TFM) and common source method (CSM) using both linear and circular arrays. The resolutions for such algorithms for the plate case are well known. We have attempted to use these algorithms for imaging defects in pipes using an array of piezoelectric shear transducers clamped around the pipe circumference. We show that the SAFT and the TFM methods both suffer from coherent noise in the image caused by circumferentially propagating wave modes. It is shown that the common source method (CSM) method does not suffer from this problem though the resolution obtained is poorer. Results from the different imaging algorithms are presented for an 8 inch pipe using 50 kHz excitation, both from finite element simulations and laboratory experiments.

  16. Synthetic Focusing for High Resolution Guided Wave Pipe Inspection: Further Results and Robustness Studies

    NASA Astrophysics Data System (ADS)

    Davies, J.; Cawley, P.

    2008-02-01

    We have employed synthetic focusing of guided waves for imaging defects in pipes using an array of piezoelectric shear transducers clamped around the pipe circumference. The performance of the focused system is tested and compared to an unfocused system using data from finite element simulations of an 8 inch pipe with circumferentially orientated cracks and laboratory experiments with circumferential slots, both excited at 50 kHz. The amplitude of the reflection from smaller features is increased by around 17 dB with the focused system. It is also possible to estimate the circumferential extent of the feature if it is larger than two wavelengths of the interrogating signal, in this case, the shear horizontal wavelength. The robustness of the focused system to possible setup errors, such as coupling or phase errors is then thoroughly investigated by synthetically corrupting finite element data. The system is shown to be very robust against realistic levels of setup errors.

  17. Developing and implementing a high precision setup system

    NASA Astrophysics Data System (ADS)

    Peng, Lee-Cheng

    The demand for high-precision radiotherapy (HPRT) was first implemented in stereotactic radiosurgery using a rigid, invasive stereotactic head frame. Fractionated stereotactic radiotherapy (SRT) with a frameless device was developed along a growing interest in sophisticated treatment with a tight margin and high-dose gradient. This dissertation establishes the complete management for HPRT in the process of frameless SRT, including image-guided localization, immobilization, and dose evaluation. The most ideal and precise positioning system can allow for ease of relocation, real-time patient movement assessment, high accuracy, and no additional dose in daily use. A new image-guided stereotactic positioning system (IGSPS), the Align RT3C 3D surface camera system (ART, VisionRT), which combines 3D surface images and uses a real-time tracking technique, was developed to ensure accurate positioning at the first place. The uncertainties of current optical tracking system, which causes patient discomfort due to additional bite plates using the dental impression technique and external markers, are found. The accuracy and feasibility of ART is validated by comparisons with the optical tracking and cone-beam computed tomography (CBCT) systems. Additionally, an effective daily quality assurance (QA) program for the linear accelerator and multiple IGSPSs is the most important factor to ensure system performance in daily use. Currently, systematic errors from the phantom variety and long measurement time caused by switching phantoms were discovered. We investigated the use of a commercially available daily QA device to improve the efficiency and thoroughness. Reasonable action level has been established by considering dosimetric relevance and clinic flow. As for intricate treatments, the effect of dose deviation caused by setup errors remains uncertain on tumor coverage and toxicity on OARs. The lack of adequate dosimetric simulations based on the true treatment coordinates from

  18. Stereotactic Body Radiation Therapy for Recurrent Head and Neck Cancer.

    PubMed

    Ling, Diane C; Vargo, John A; Heron, Dwight E

    2016-01-01

    Stereotactic body radiation therapy (SBRT) offers a promising opportunity for cure and/or palliation to patients with recurrent head and neck cancer whose comorbidities, performance status, and history of prior treatment may preclude many other salvage options. Stereotactic body radiation therapy appears to have a favorable response and toxicity profile compared with other nonoperative salvage options for recurrent head and neck cancer. However, the risk of severe toxicity remains, with carotid blowout syndrome a unique concern, although the incidence of this complication may be minimized with alternating-day fractionation. The short overall treatment time and low rates of acute toxicity make SBRT an optimal vehicle to integrate with novel systemic therapies, and several phase II studies have used concurrent cetuximab as a radiosensitizer with SBRT with promising results. Ongoing studies aim to evaluate the potential synergistic effect of SBRT with immune checkpoint inhibitors in recurrent head and neck cancer. PMID:27441751

  19. Multimodality stereotactic brain tissue identification: the NASA smart probe project

    NASA Technical Reports Server (NTRS)

    Andrews, R.; Mah, R.; Aghevli, A.; Freitas, K.; Galvagni, A.; Guerrero, M.; Papsin, R.; Reed, C.; Stassinopoulos, D.

    1999-01-01

    Real-time tissue identification can benefit procedures such as stereotactic brain biopsy, functional neurosurgery and brain tumor excision. Optical scattering spectroscopy has been shown to be effective at discriminating cancer from noncancerous conditions in the colon, bladder and breast. The NASA Smart Probe extends the concept of 'optical biopsy' by using neural network techniques to combine the output from 3 microsensors contained within a cannula 2. 7 mm in diameter (i.e. the diameter of a stereotactic brain biopsy needle). Experimental data from 5 rats show the clear differentiation between tissues such as brain, nerve, fat, artery and muscle that can be achieved with optical scattering spectroscopy alone. These data and previous findings with other modalities such as (1) analysis of the image from a fiberoptic neuroendoscope and (2) the output from a microstrain gauge suggest the Smart Probe multiple microsensor technique shows promise for real-time tissue identification in neurosurgical procedures. Copyright 2000 S. Karger AG, Basel.

  20. Monte Carlo dosimetry for synchrotron stereotactic radiotherapy of brain tumours

    NASA Astrophysics Data System (ADS)

    Boudou, Caroline; Balosso, Jacques; Estève, François; Elleaume, Hélène

    2005-10-01

    A radiation dose enhancement can be obtained in brain tumours after infusion of an iodinated contrast agent and irradiation with kilovoltage x-rays in tomography mode. The aim of this study was to assess dosimetric properties of the synchrotron stereotactic radiotherapy technique applied to humans (SSR) for preparing clinical trials. We designed an interface for dose computation based on a Monte Carlo code (MCNPX). A patient head was constructed from computed tomography (CT) data and a tumour volume was modelled. Dose distributions were calculated in SSR configuration for various energy beam and iodine content in the target volume. From the calculations, it appears that the iodine-filled target (10 mg ml-1) can be efficiently irradiated by a monochromatic beam of energy ranging from 50 to 85 keV. This paper demonstrates the feasibility of stereotactic radiotherapy for treating deep-seated brain tumours with monoenergetic x-rays from a synchrotron.