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Sample records for 125i interstitial brachytherapy

  1. Polymer gel dosimetry close to an 125I interstitial brachytherapy seed

    NASA Astrophysics Data System (ADS)

    Pantelis, E.; Lymperopoulou, G.; Papagiannis, P.; Sakelliou, L.; Stiliaris, E.; Sandilos, P.; Seimenis, I.; Kozicki, M.; Rosiak, J. M.

    2005-09-01

    Despite its advantages, the polymer gel-magnetic resonance imaging (MRI) method has not, as yet, been successfully employed in dosimetry of low energy/low dose rate photon-emitting brachytherapy sources such as 125I or 103Pd interstitial seeds. In the present work, two commercially available 125I seed sources, each of approximately 0.5 U, were positioned at two different locations of a polymer gel filled vial. The gel vial was MR scanned with the sources in place 19 and 36 days after seed implantation. Calibration curves were acquired from the coupling of MRI measurements with accurate Monte Carlo dose calculations obtained simulating the exact experimental setup geometry and materials. The obtained gel response data imply that while linearity of response is sustained, sensitivity (calibration curve slope) is significantly increased (approximately 60%) compared to its typical value for the 192Ir (or 60Co and 6 MV LINAC) photon energies. Water equivalence and relative energy response corrections of the gel cannot account for more than 3-4% of this increase, which, therefore, has to be mainly attributed to physicochemical processes related to the low dose rate of the sources and the associated prolonged irradiation time. The calibration data obtained from one 125I source were used to provide absolute dosimetry results for the other 125I source, which were found to agree with corresponding Monte Carlo calculations within experimental uncertainties. It is therefore suggested that, regardless of the underlying factors accounting for the gel dose response to 125I irradiations, polymer gel dosimetry of new 125I or 103Pd sources should be carried out as originally proposed by Heard and Ibbot (2004 J. Phys.: Conf. Ser. 3 221-3), i.e., by irradiating the same gel sample with the new low dose rate source, as well as with a well-characterized low dose rate source which will provide the dose calibration curve for the same irradiation conditions.

  2. CT-Guided 125I Seed Interstitial Brachytherapy as a Salvage Treatment for Recurrent Spinal Metastases after External Beam Radiotherapy

    PubMed Central

    Yao, Lihong; Cao, Qianqian; Yang, Jiwen; Meng, Na; Guo, Fuxin; Jiang, Yuliang; Tian, Suqing; Sun, Haitao

    2016-01-01

    The aim of this study is to evaluate the feasibility, safety, and clinical efficacy of CT-guided 125I seed interstitial brachytherapy in patients with recurrent spinal metastases after external beam radiotherapy (EBRT). Between August 2003 and September 2015, 26 spinal metastatic lesions (24 patients) were reirradiated by this salvage therapy modality. Treatment for all patients was preplanned using a three-dimensional treatment planning system 3–5 days before 125I seed interstitial brachytherapy; dosimetry verification was performed immediately after seed implantation. Median actual D90 was 99 Gy (range, 90–176), and spinal cord median Dmax was 39 Gy (range, 6–110). Median local control (LC) was 12 months (95% CI: 7.0–17.0). The 6- and 12-month LC rates were 52% and 40%, respectively. Median overall survival (OS) was 11 months (95% CI: 7.7–14.3); 6-month and 1-, 2-, and 3-year OS rates were 65%, 37%, 14%, and 9%, respectively. Pain-free survival ranged from 2 to 42 months (median, 6; 95% CI: 4.6–7.4). Treatment was well-tolerated, with no radiation-induced vertebral compression fractures or myelopathy reported. Reirradiation with CT-guided 125I seed interstitial brachytherapy appears to be feasible, safe, and effective as pain relief or salvage treatment for patients with recurrent spinal metastases after EBRT. PMID:28105434

  3. Clinical research on the treatment effects of radioactive (125)I seeds interstitial brachytherapy on children with primary orbital rhabdomyosarcoma.

    PubMed

    Ge, Xin; Ma, Jianmin; Dai, Haojie; Ren, Ling; Li, Quan; Shi, Jitong

    2014-09-01

    Rhabdomyosarcoma (RMS) is one of the most common primary orbital malignancies. However, orbital RMS is a very rare disease, especially in childhood, and the tumor has a high degree of malignancy and rapid development. The objective of the present study was to investigate the clinical treatment effects of radioactive (125)I seeds interstitial brachytherapy on children with primary orbital RMS, which may provide a new method for treating RMS in clinical applications. Radioactive (125)I seeds were used in the present study. Primary lesions from ten children with orbital RMS, including three male and seven female patients, were selected as the targeted areas. The activity, number and spatial location of the seeds were optimized and simulated by applying computer three-dimensional treatment planning system (TPS) software. The interstitial implantation of the radioactive (125)I seeds was conducted on children under general anesthesia according to the TPS simulation results. Quality verifications of the operation were conducted by orbital computed tomography and X-ray plain film at the early stage after operation, and the children were followed up. The patients were followed up by October 2012 with an average follow-up time of 57 ± 17.43 months and a median follow-up time of 55 months. Nine cases achieved complete remission, and one case achieved partial remission, resulting in a total efficiency and survival rate of 100.0 % (10/10). Most patients recovered after treatment or had no radiotherapy side effect after the operations, though 20.0 % of the patients (2/10) experienced corneal opacity, eyeball movement disorder, or loss of sight. Radioactive (125)I seeds interstitial brachytherapy was an effective treatment for children with primary orbital RMS. Results from this study may provide a new clinical approach for the treatment of child patients with primary orbital RMS.

  4. Near-field dosimetry of {sup 125}I sources for interstitial brachytherapy implants measured using thermoluminescent sheets

    SciTech Connect

    Iwata, Kazuro; Yue, Ning J.; Nath, Ravinder

    2004-12-01

    The dosimetric characteristics were measured for two types of {sup 125}I low-energy photon-emitting sources by using a wide and highly sensitive thermoluminescent (TL) sheet film, which was developed for two-dimensional dose distribution measurements. The TL film is made of Teflon homogeneously mixed with small powders of thermoluminescence (BaSO{sub 4}:Eu doped). Various dosimetric parameters (i.e., radial dose function, 2D and 1D anisotropy functions) of model 6711 and 6702 {sup 125}I sources were obtained at various distances from the source surfaces to 15 mm. These parameters obtained with TL sheet were compared with the data recommended in the updated AAPM TG-43 report. The radial dose functions measured with TL sheet are in agreement with those established data of model 6711 {sup 125}I seed and model 6702 {sup 125}I seed at most of the distances within 5% and 7%, respectively. All the measured anisotropy functions showed symmetry about the longitudinal source axis. The anisotropy of dose distributions was clearly present in the immediate vicinity of the source edges. The measured 2D anisotropy function values at 1 cm are in reasonably good agreement with the recommended values. The differences at two points in the 1D anisotropy functions measured with TL sheet and the established data at 1 cm from source center were 0.7% and 1.9% for model 6711 and 6702 {sup 125}I sources, respectively; the differences at 0.5 cm were 1.5% and 1.7% for model 6711 and 6702 {sup 125}I sources, respectively. The relative dosimetric characteristics in the vicinity of actual interstitial brachytherapy sources containing {sup 125}I have been experimentally determined by using the TL sheet as a 2D dosimeter.

  5. Interstitial brachytherapy for pancreatic cancer: Report of seven cases treated with 125I and a review of the literature

    SciTech Connect

    Montemaggi, P.; Dobelbower, R.; Crucitti, F.; Caracciolo, F.; Morganti, A.G.; Smaniotto, D.; Luzi, S.; Cellini, N. )

    1991-07-01

    Since 1975, seven groups of investigators have reported clinical results of interstitial brachytherapy (IBT) for pancreatic cancer. The reports are comprised of data from 254 patients, 21 of whom died in the postoperative period for an overall operative mortality rate of 8.7%. Operative mortality rate range from 0% to 32% in individual reports. Most patients have been treated with 125I, although 25 patients were treated with 198Au seeds. Most investigators report combining IBT with external beam radiation therapy (EBRT) {plus minus} adjuvant chemotherapy. In general, IBT has been associated with considerable morbidity. Median patient survival time has not exceeded 15 months. This report describes an additional seven patients with locally unresectable pancreatic cancer, without distant metastases, treated primarily with 60 to 100 Gy matched peripheral dose (MPD) by 125I IBT. One patient died postoperatively of a pulmonary embolus. Four of the remaining six patients were also treated with modest doses (10.5 to 30 Gy) of EBRT late in the course of the disease for local tumor progression. One developed a pancreaticocutaneous fistula, and one developed exacerbation of pre-existing diabetes mellitus. The median patient survival time from the date of IBT was 7 months (range: 0 to 21 months). One patient is alive without clinical evidence of cancer 9 months after IBT. 25 refs.

  6. Polymer gel dosimetry for the TG-43 dosimetric characterization of a new 125I interstitial brachytherapy seed.

    PubMed

    Papagiannis, P; Pantelis, E; Georgiou, E; Karaiskos, P; Angelopoulos, A; Sakelliou, L; Stiliaris, S; Baltas, D; Seimenis, I

    2006-04-21

    In this work, a polymer gel-magnetic resonance (MR) imaging method is employed for the dosimetric characterization of a new 125I low dose rate seed (IsoSeed model I25.S17). Two vials filled with PABIG gel were prepared in-house and one new seed as well as one commercially available 125I seed of similar dose rate and well-known dosimetric parameters (IsoSeed model I25.S06) were positioned in each vial. Both seeds in each vial were MR scanned simultaneously on days 11 and 26 after implantation. The data obtained from the known seed in each vial are used to calibrate the gel dose response which, for the prolonged irradiation duration necessitated by the investigated dose rates, depends on the overall irradiation time. Data for this study are presented according to the AAPM TG-43 dosimetric formalism. Polymer gel results concerning the new seed are compared to corresponding, published dosimetric results obtained, for the purpose of the new seed clinical implementation, by our group using the established methods of Monte Carlo (MC) simulation and thermo-luminescence dosimetry (TLD). Polymer gel dosimetry yields an average dose rate constant value of lambda = (0.921 +/- 0.031) cGy h(-1) U(-1) relative to (MC)lambda = (0.929 +/- 0.014) cGy h(-1) U(-1), (TLD)lambda = (0.951 +/- 0.044) cGy h(-1) U(-1) and the average value of Lambda = (0.940 +/- 0.051) cGy h(-1) U(-1) proposed for the clinical implementation of the new seed. Results for radial dose function, g(L)(r), and anisotropy function, F(r, theta), also agree with corresponding MC calculations within experimental uncertainties which are smaller for the polymer gel method compared to TLD. It is concluded that the proposed polymer gel-magnetic resonance imaging methodology could be used at least as a supplement to the established techniques for the dosimetric characterization of new low energy and low dose rate interstitial brachytherapy seeds.

  7. Monte Carlo and thermoluminescence dosimetry of the new IsoSeed registered model I25.S17 {sup 125}I interstitial brachytherapy seed

    SciTech Connect

    Lymperopoulou, G.; Papagiannis, P.; Sakelliou, L.; Karaiskos, P.; Sandilos, P.; Przykutta, A.; Baltas, D.

    2005-11-15

    Monte Carlo simulation and experimental thermoluminescence dosimetry were utilized for the dosimetric characterization of the new IsoSeed registered model I25.S17 {sup 125}I interstitial brachytherapy seed. The new seed design is similar to that of the selectSeed and 6711 seeds, with the exception of its molybdenum marker. Full dosimetric data are presented following the recommendations in the Update of the AAPM Task Group 43 report (TG-43U1). A difference of 3.3% was found between Monte Carlo dose rate constant results calculated by air kerma strengths from simulations using a point detector and a detector resembling the solid angle subtended to the seed by the Wide Angle Free Air Chamber (WAFAC) in the primary standard calibration geometry. Following the TG-43U1 recommendations, an average value of {lambda}{sub MC}=(0.929{+-}0.014) cGy h{sup -1} U{sup -1} was adopted for the new seed. This value was then averaged with the measured value of {lambda}{sub EXP}=(0.951{+-}0.044) cGy h{sup -1} U{sup -1} to yield the proposed dose rate constant for the new seed that is equal to {lambda}=(0.940{+-}0.051) cGy h{sup -1} U{sup -1}. The Monte Carlo calculated radial dose function and two-dimensional (2-D) anisotropy function results for the new seed were found in agreement with experimental results to within statistical uncertainty of repeated measurements. Monte Carlo simulations were also performed for {sup 125}I seeds of similar geometry and dimensions for the purpose of comparison. The new seed presents dosimetric characteristics that are very similar to that of the selectSeed. In comparison to the most extensively studied Amersham 6711 seed, the new one presents similar dosimetric characteristics with a slightly reduced dose rate constant (1.5%)

  8. Dosimetric characteristic of a new 125I brachytherapy source.

    PubMed

    Sadeghi, Mahdi; Khanmohammadi, Zahra

    2011-11-01

    A new brachytherapy (125)I source has been investigated at Iranian Agricultural, Medical and Industrial Research School. Dosimetric characteristics [dose-rate constant Λ, radial dose function g(l)(r) and anisotropy function F(r,)] of IRA-(125)I were theoretically determined in terms of the updated AAPM task group 43 (TG-43U1) recommendations. Versions 5 and 4C of the Monte Carlo radiation transport code were used to calculate the dosimetry parameters around the source. The Monte Carlo calculated dose-rate constant of the (125)I source in water was found to be 92×10(-4) Gy h(-1) U(-1) with an approximate uncertainty of ±3 %. Brachytherapy seed model, 6711-(125)I, carrying (125)I radionuclides, was modelled and benchmarked against previously published values. Finally, the calculated results were compared with the published results of those of other source manufacturers.

  9. Postoperative 125I brachytherapy delivered by digital model obturators for recurrent or locally advanced maxillary cancers.

    PubMed

    Huang, Ming-wei; Zhang, Jian-guo; Tong, Dai; Zhang, Jie; Zheng, Lei; Zhang, Yi; Yu, Guang-yan

    2012-11-01

    We aimed to evaluate the feasibility and effectiveness of postoperative (125) I brachytherapy delivered by use of digital model obturators for recurrent or locally advanced maxillary cancers. Retrospective study. From 2006 to 2008, 12 patients (seven females; median age, 65 years; range, 22-86 years) with recurrent or locally advanced maxillary cancers showing positive margins after surgery underwent (125) I brachytherapy by use of digital model obturators and interstitial implants. The radioactivity was 18.5 to 33.3 MBq per seed, and the prescription dose was 80 to 160 Gy. Functional outcome of patients was evaluated by the Performance Status Scale (PSS) for head and neck cancer before and after brachytherapy. The (125) I seeds and dosages were well distributed in the radiation fields, and all patients had higher PSS scores after than before treatment with obturators. During a median follow-up of 53 months (range, 28-62 months), local control at 3 and 5 years was 83.3% and 66.7%, respectively, with a mean local control time of 53.5 ± 3.79 months. Overall survival at 3 and 5 years was 91.7% and 71.4%, respectively, with a mean survival time of 56.6 ± 2.99 months. Two patients died due to local recurrence, and one patient died due to lung metastasis. No patient had severe complications during follow-up. (125) I brachytherapy delivered by digital model obturator is effective in treating maxillary cancers with positive margins after maxillectomy for advanced or recurrent cancer. The method may improve the quality of life of patients with maxillary defects. Laryngoscope, 2012. Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.

  10. Bioevaluation of 125I Ocu-Prosta seeds for application in prostate cancer brachytherapy

    PubMed Central

    Mukherjee, Archana; Sarma, Haladhar Dev; Saxena, Sanjay; Kumar, Yogendra; Chaudhari, Pradip; Goda, Jayant Sastri; Adurkar, Pranjal; Dash, Ashutosh; Samuel, Grace

    2014-01-01

    Background & objectives: In recent years, brachytherapy involving permanent radioactive seed implantation has emerged as an effective modality for the management of cancer of prostate. 125I-Ocu-Prosta seeds were indigenously developed and studies were carried out to assess the safety of the indigenously developed 125I-Ocu-Prosta seeds for treatment of prostate cancer. Methods: Animal experiments were performed to assess the likelihood of in vivo release of 125I from radioactive seeds and migration of seeds implanted in the prostate gland of the rabbit. In vivo release of 125I activity was monitored by serial blood sampling from the auricular vein and subsequent measurement of 125I activity. Serial computed tomography (CT) scans were done at regular intervals till 6 months post implant to assess the physical migration of the seeds. Results: The laser welded seeds maintained their hermeticity and prevented the in vivo release of 125I activity into the blood as no radioactivity was detected during follow up blood measurements. Our study showed that the miniature 125I seeds were clearly resolved in CT images. Seeds remained within the prostate gland during the entire study period. Moreover, the seed displacement was minimal even within the prostate gland. Interpretation & conclusions: Our findings have demonstrated that indigenously developed 125I-Ocu-Prosta seeds may be suitable for application in treatment of prostate cancer. PMID:24927341

  11. 125I Seed Implant Brachytherapy for Painful Bone Metastases After Failure of External Beam Radiation Therapy

    PubMed Central

    Feng, Shi; Wang, Li; Xiao, Zhang; Maharjan, Rakesh; Chuanxing, Li; Fujun, Zhang; Jinhua, Huang; Peihong, Wu

    2015-01-01

    Abstract The purpose of this study was to evaluate the safety and therapeutic efficacy of computed tomography (CT)-guided 125I seed implant brachytherapy in patients with painful metastatic bone lesions after failure of external beam radiation therapy (EBRT). From August 2012 to July 2014, 26 patients with painful bone metastases after failure of EBRT were treated with CT-guided 125I seed implant brachytherapy. Patient pain and analgesic use were measured using the Brief Pain Inventory before treatment, weekly for 4 weeks, and every 4 weeks thereafter for a total of 24 weeks. Opioid analgesic medications and complications were monitored at the same follow-up intervals. Before 125I seed implantation, the mean score for worst pain in a 24-hour period was 7.3 out of 10. Following treatment, at weeks 1, 4, 8, 12, and 24, worst pain decreased to 5.0 (P < 0.0001), 3.0 (P < 0.0001), 2.8 (P < 0.0001), 2.6 (P < 0.0001), and 2.0 (P = 0.0001), respectively. Opioid usage significantly decreased at weeks 4, 8, and 12. Overall response rates of osseous metastases after 125I seed implantation at 1, 4, 8, 12, and 24 weeks were 58%, 79%, 81%, 82%, and 80%, respectively. Adverse events were seen in 4 patients, including Grade 1 myelosuppression and Grade 1 late skin toxicity. 125I seed brachytherapy is a safe and effective treatment for patients with painful bone metastases after failure of EBRT. PMID:26252288

  12. Radiofrequency ablation versus 125I-seed brachytherapy for painful metastases involving the bone

    PubMed Central

    Jiao, Dechao; Wu, Gang; Ren, Jianzhuang; Han, Xinwei

    2016-01-01

    This retrospective study aimed to demonstrate and compare the safety and effectiveness of computed tomography-guided radiofrequency ablation (RFA) and 125I-seed brachytherapy for painful bone metastases after failure of external beam radiotherapy (EBRT). From June 2013 to October 2015, 79 patients with moderate-to-severe pain caused by metastatic bone lesions who underwent either RFA (n = 41) or 125I-seed brachytherapy (n = 38) were enrolled. Pain in patients was measured using the brief pain inventory (BPI) before treatment, 1 week after treatment, and 3 months after treatment. Response rates were assessed by measuring the changes in pain and incorporation of changes in the analgesic requirements. At baseline, 1 week, and 3 months, the mean worst pain scores of BPI were 7.8, 5.4, and 2.7, respectively, for the RFA group and 7.7, 6.1, and 2.8, respectively, for the brachytherapy group. At 1 week, the complete and partial response rates were 12% and 59%, respectively, in the RFA group compared with 3% and 45%, respectively, in the brachytherapy group. At 3 months, the complete and partial response rates were 23% and 58%, respectively, in the RFA group compared with 24% and 52% in the brachytherapy group (p = 0.95). The response rates in the RFA group were significantly higher than those in the brachytherapy group at 1 week (p = 0.32), but comparable at 3 weeks (p = 0.95). Both groups had low rates of complications and no treatment-related mortality. In conclusion, the short-term curative efficiency of RFA was better than that of brachytherapy, but the log-term efficiency of both treatments was equal. PMID:27636995

  13. Directional interstitial brachytherapy from simulation to application

    NASA Astrophysics Data System (ADS)

    Lin, Liyong

    Organs at risk (OAR) are sometimes adjacent to or embedded in or overlap with the clinical target volume (CTV) to be treated. The purpose of this PhD study is to develop directionally low energy gamma-emitting interstitial brachytherapy sources. These sources can be applied between OAR to selectively reduce hot spots in the OARs and normal tissues. The reduction of dose over undesired regions can expand patient eligibility or reduce toxicities for the treatment by conventional interstitial brachytherapy. This study covers the development of a directional source from design optimization to construction of the first prototype source. The Monte Carlo code MCNP was used to simulate the radiation transport for the designs of directional sources. We have made a special construction kit to assemble radioactive and gold-shield components precisely into D-shaped titanium containers of the first directional source. Directional sources have a similar dose distribution as conventional sources on the treated side but greatly reduced dose on the shielded side, with a sharp dose gradient between them. A three-dimensional dose deposition kernel for the 125I directional source has been calculated. Treatment plans can use both directional and conventional 125I sources at the same source strength for low-dose-rate (LDR) implants to optimize the dose distributions. For prostate tumors, directional 125I LDR brachytherapy can potentially reduce genitourinary and gastrointestinal toxicities and improve potency preservation for low risk patients. The combination of better dose distribution of directional implants and better therapeutic ratio between tumor response and late reactions enables a novel temporary LDR treatment, as opposed to permanent or high-dose-rate (HDR) brachytherapy for the intermediate risk T2b and high risk T2c tumors. Supplemental external-beam treatments can be shortened with a better brachytherapy boost for T3 tumors. In conclusion, we have successfully finished the

  14. Spectroscopic output of {sup 125}I and {sup 103}Pd low dose rate brachytherapy sources

    SciTech Connect

    Usher-Moga, Jacqueline; Beach, Stephen M.; DeWerd, Larry A.

    2009-01-15

    The spectroscopic output of low dose rate (LDR) brachytherapy sources is dependent on the physical design and construction of the source. Characterization of the emitted photons from 12 {sup 125}I and 3 {sup 103}Pd LDR brachytherapy source models is presented. Photon spectra, both along the transverse bisector and at several polar angles, were measured in air with a high-purity reverse electrode germanium (REGe) detector. Measured spectra were corrected to in vacuo conditions via Monte Carlo and analytical methods. The tabulated and plotted spectroscopic data provide a more complete understanding of each source model's output characteristics than can be obtained with other measurement techniques. The variation in fluorescence yield of the {sup 125}I sources containing silver caused greater differences in the emitted spectra and average energies among these seed models than was observed for the {sup 103}Pd sources or the {sup 125}I sources that do not contain silver. Angular spectroscopic data further highlighted the effects of source construction unique to each model, as well as the asymmetric output of many seeds. These data demonstrate the need for the incorporation of such physically measured output characteristics in the Monte Carlo modeling process.

  15. Ejaculatory Function After Permanent {sup 125}I Prostate Brachytherapy for Localized Prostate Cancer

    SciTech Connect

    Huyghe, Eric Delannes, Martine; Wagner, Fabien M.; Delaunay, Boris; Nohra, Joe; Thoulouzan, Matthieu; Shut-Yee, J. Yeung; Plante, Pierre; Soulie, Michel; Thonneau, Patrick; Bachaud, Jean Marc

    2009-05-01

    Purpose: Ejaculatory function is an underreported aspect of male sexuality in men treated for prostate cancer. We conducted the first detailed analysis of ejaculatory function in patients treated with permanent {sup 125}I prostate brachytherapy for localized prostate cancer. Patients and Methods: Of 270 sexually active men with localized prostate cancer treated with permanent {sup 125}I prostate brachytherapy, 241 (89%), with a mean age of 65 years (range, 43-80), responded to a mailed questionnaire derived from the Male Sexual Health Questionnaire regarding ejaculatory function. Five aspects of ejaculatory function were examined: frequency, volume, dry ejaculation, pleasure, and pain. Results: Of the 241 sexually active men, 81.3% had conserved ejaculatory function after prostate brachytherapy; however, the number of patients with rare/absent ejaculatory function was double the pretreatment number (p < .0001). The latter finding was correlated with age (p < .001) and the preimplant International Index of Erectile Function score (p < .001). However, 84.9% of patients with maintained ejaculatory function after implantation reported a reduced volume of ejaculate compared with 26.9% before (p < .001), with dry ejaculation accounting for 18.7% of these cases. After treatment, 30.3% of the patients experienced painful ejaculation compared with 12.9% before (p = .0001), and this was associated with a greater number of implanted needles (p = .021) and the existence of painful ejaculation before implantation (p < .0001). After implantation, 10% of patients who continued to be sexually active experienced no orgasm compared with only 1% before treatment. in addition, more patients experienced late/difficult or weak orgasms (p = .001). Conclusion: Most men treated with brachytherapy have conserved ejaculatory function after prostate brachytherapy. However, most of these men experience a reduction in volume and a deterioration in orgasm.

  16. 125I brachytherapy for localized prostate cancer: a single institution experience.

    PubMed

    Guarneri, Alessia; Botticella, Angela; Filippi, Andrea Riccardo; Munoz, Fernando; Beltramo, Giancarlo; Casetta, Giovanni; Giglioli, Francesca Romana; Tizzani, Alessandro; Ragona, Riccardo; Ricardi, Umberto

    2013-01-01

    To evaluate the clinical outcome of a cohort of localized prostate cancer patients treated with 125I permanent brachytherapy at the University of Turin. A retrospective analysis was carried out on 167 consecutive patients with early stage prostate adenocarcinoma who underwent 125I brachytherapy between January 2003 and December 2010. A minimum follow-up of ≥ 12 months was mandatory for inclusion. Biochemical disease-free survival (defined on the basis of the ASTRO definition and the ASTRO-Phoenix definition) was chosen as the primary end point. Secondary end points were gastrointestinal and genitourinary toxicity (acute and late, defined according to the RTOG scale). With a median follow-up of 42 months (range, 13.5-90.7), biochemical disease-free survival at 3 and 5 years was respectively 91.1% and 85.7%, according to the ASTRO definition and 94.5% and 85.1% according to ASTRO-Phoenix definition (for statistical purposes, only the ASTRO definition was used). Hormone treatment and nadir PSA (cutoff of 0.35 ng/ml) were the only factors affecting biochemical disease-free survival both on univariate (P = 0.02 and P = 0.001, respectively) and multivariate analysis (HR 0.024; P = 0.021 and HR 21.6; P = 0.006, respectively). Only 3.6% of patients experienced ≥ grade 3 acute urinary toxicity and 5% ≥ grade 3 late urinary toxicity. Prior transurethral prostate resection was the only independent predictor of grade 3 late urinary toxicity on multivariate analysis (HR 0.13; P = 0.009). This mono-institutional series confirmed that brachytherapy is an effective and safe treatment modality for localized prostate cancer, with acceptable short- and long-term morbidity rates.

  17. Differential dose contributions on total dose distribution of 125I brachytherapy source

    PubMed Central

    Camgöz, B.; Yeğin, G.; Kumru, M.N.

    2010-01-01

    This work provides an improvement of the approach using Monte Carlo simulation for the Amersham Model 6711 125I brachytherapy seed source, which is well known by many theoretical and experimental studies. The source which has simple geometry was researched with respect to criteria of AAPM Tg-43 Report. The approach offered by this study involves determination of differential dose contributions that come from virtual partitions of a massive radioactive element of the studied source to a total dose at analytical calculation point. Some brachytherapy seeds contain multi-radioactive elements so the dose at any point is a total of separate doses from each element. It is momentous to know well the angular and radial dose distributions around the source that is located in cancerous tissue for clinical treatments. Interior geometry of a source is effective on dose characteristics of a distribution. Dose information of inner geometrical structure of a brachytherapy source cannot be acquired by experimental methods because of limits of physical material and geometry in the healthy tissue, so Monte Carlo simulation is a required approach of the study. EGSnrc Monte Carlo simulation software was used. In the design of a simulation, the radioactive source was divided into 10 rings, partitioned but not separate from each other. All differential sources were simulated for dose calculation, and the shape of dose distribution was determined comparatively distribution of a single-complete source. In this work anisotropy function was examined also mathematically. PMID:24376927

  18. Monte Carlo dosimetry for {sup 125}I and {sup 103}Pd eye plaque brachytherapy

    SciTech Connect

    Thomson, R. M.; Taylor, R. E. P.; Rogers, D. W. O.

    2008-12-15

    A Monte Carlo study of dosimetry for eye plaque brachytherapy is performed. BrachyDose, an EGSnrc user code which makes use of Yegin's multi-geometry package, is used to fully model {sup 125}I (model 6711) and {sup 103}Pd (model 200) brachytherapy seeds and the standardized plaques of the Collaborative Ocular Melanoma Study (COMS). Three-dimensional dose distributions in the eye region are obtained. In general, dose to water is scored; however, the implications of replacing water with eye tissues are explored. The effect of the gold alloy (Modulay) backing is investigated and the dose is found to be sensitive to the elemental composition of the backing. The presence of the silicone polymer (Silastic) seed carrier results in substantial dose decreases relative to water, particularly for {sup 103}Pd. For a 20 mm plaque with a Modulay backing and Silastic insert, fully loaded with 24 seeds, the dose decrease relative to water is of the order of 14% for {sup 125}I and 20% for {sup 103}Pd at a distance of 1 cm from the inner sclera along the plaque's central axis. For the configurations of seeds used in COMS plaques, interseed attenuation is a small effect within the eye region. The introduction of an air interface results in a dose reduction in its vicinity which depends on the plaque's position within the eye and the radionuclide. Introducing bone in the eye's vicinity also causes dose reductions. The dose distributions in the eye for the two different radionuclides are compared and, for the same prescription dose, {sup 103}Pd generally offers a lower dose to critical normal structures. BrachyDose is sufficiently fast to allow full Monte Carlo dose calculations for routine clinical treatment planning.

  19. Radiation complications and tumor control after {sup 125}I plaque brachytherapy for ocular melanoma

    SciTech Connect

    Jensen, Ashley W.; Petersen, Ivy A. . E-mail: petersen.ivy@mayo.edu; Kline, Robert W.; Stafford, Scott L.; Schomberg, Paula J.; Robertson, Dennis M.

    2005-09-01

    Purpose: To determine the outcome of {sup 125}I plaque brachytherapy at our institution and identify the risk factors associated with the development of radiation complications, tumor recurrence, and metastasis. Patients and Methods: From 1986 to 2000, 156 patients underwent {sup 125}I episcleral plaque (COMS design) application for the treatment of ocular melanoma. Chart analysis of follow-up ophthalmologic appointments assessed the incidence of ocular side effects after therapy. Statistical analysis assessed outcomes and significant influencing factors. Results: With a median follow-up of 6.2 years, the 5-year overall survival was 83%. The 5-year disease-specific survival was 91%. Initial local control at 5 years was 92%, with 100% ultimate local control after secondary therapy that included 9 enucleations. The risk of metastasis was 10% at 5 years and 27% at 10 years. Vision stayed the same or improved in 25% of patients, and 44% of patients maintained visual acuity better than 20/200. Thirteen percent of patients experienced chronic pain or discomfort in the treated eye. Dose rates to the tumor apex greater than 90 to 100 cGy/h were associated with increased systemic control but worse radiation toxicity. Conclusion: Patients in our series experienced excellent local tumor control. Higher dose rates to the tumor apex were associated with reduced rates of distant metastases but worse ocular function.

  20. Model-based dose calculations for {sup 125}I lung brachytherapy

    SciTech Connect

    Sutherland, J. G. H.; Furutani, K. M.; Garces, Y. I.; Thomson, R. M.

    2012-07-15

    Purpose: Model-baseddose calculations (MBDCs) are performed using patient computed tomography (CT) data for patients treated with intraoperative {sup 125}I lung brachytherapy at the Mayo Clinic Rochester. Various metallic artifact correction and tissue assignment schemes are considered and their effects on dose distributions are studied. Dose distributions are compared to those calculated under TG-43 assumptions. Methods: Dose distributions for six patients are calculated using phantoms derived from patient CT data and the EGSnrc user-code BrachyDose. {sup 125}I (GE Healthcare/Oncura model 6711) seeds are fully modeled. Four metallic artifact correction schemes are applied to the CT data phantoms: (1) no correction, (2) a filtered back-projection on a modified virtual sinogram, (3) the reassignment of CT numbers above a threshold in the vicinity of the seeds, and (4) a combination of (2) and (3). Tissue assignment is based on voxel CT number and mass density is assigned using a CT number to mass density calibration. Three tissue assignment schemes with varying levels of detail (20, 11, and 5 tissues) are applied to metallic artifact corrected phantoms. Simulations are also performed under TG-43 assumptions, i.e., seeds in homogeneous water with no interseed attenuation. Results: Significant dose differences (up to 40% for D{sub 90}) are observed between uncorrected and metallic artifact corrected phantoms. For phantoms created with metallic artifact correction schemes (3) and (4), dose volume metrics are generally in good agreement (less than 2% differences for all patients) although there are significant local dose differences. The application of the three tissue assignment schemes results in differences of up to 8% for D{sub 90}; these differences vary between patients. Significant dose differences are seen between fully modeled and TG-43 calculations with TG-43 underestimating the dose (up to 36% in D{sub 90}) for larger volumes containing higher proportions of

  1. Evaluation of the dosimetric parameters for 125I brachytherapy determined in prostate medium using CT images.

    PubMed

    Hanada, Takashi; Yorozu, Atsunori; Ohashi, Toshio; Shigematsu, Naoyuki; Maruyama, Koichi

    2010-01-01

    In the present study, the prostate medium determined from the CT images of 149 patients was developed. The dosimetric parameters such as Λ, g(L)(r) and F(r, θ) used in TG-43U1-based calculation for an iodine-125 ((125)I) brachytherapy-source were examined using Monte Carlo code Geant4. Clinical dosimetry parameters such as the D(90) were evaluated among a subgroup of 50 randomly selected patients who had been treated with permanent brachytherapy between January 2008 and December 2008 at the Tokyo Medical Center. The results show a slight difference in the dose rate constant Λ (within 1.0%). The radial dose function g(L)(r) exhibits a prominent difference in the region over 3 cm, and this difference is maintained within 2.9% in the region close to the source. The calculated values of F(r, θ) for the prostate medium were similar to values for water (within 1%), except in the longitudinal axis. A comparison of D(90) values shows a systematic dose overestimation of 2.8 ± 0.7 Gy in water, where the distribution of the differences can be seen with a spread of 1.8 ± 0.3% compared to that in prostate medium. It was concluded that the introduction of any kind of tissue correction for the TG-43U1-based calculation was not necessary to allow for the differences in elemental compositions and densities between water and prostate medium. PACS number: 87.00.00; 87.55.dk; 87.55.K-; 87.56.B-.

  2. New National Air-Kerma-Strength Standards for (125)I and (103)Pd Brachytherapy Seeds.

    PubMed

    Seltzer, Stephen M; Lamperti, Paul J; Loevinger, Robert; Mitch, Michael G; Weaver, James T; Coursey, Bert M

    2003-01-01

    The new U.S. measurement standard for the air-kerma strength from low-energy photon-emitting brachytherapy seed sources is formally described in detail. This instrument-based standard was implemented on 1 January 1999, with its salient features and the implications of differences with the previous standard given only through a series of informal communications. The Wide-Angle Free-Air Chamber (WAFAC) is specially designed to realize air kerma from a single-seed source emitting photons with energies up to about 40 keV, and is now used to measure the wide variety of seeds used in prostate-cancer therapy that has appeared in the last few years. For the two (125)I seed models that have been subject to both the old and new standards, the new standard reduces the air-kerma strength by 10.3 %. This change is mainly due to the removal of the influence on the measurement of the Ti K x rays produced in the source encapsulation, a component with no clinical significance.

  3. 125I brachytherapy alone for recurrent or locally advanced adenoid cystic carcinoma of the oral and maxillofacial region.

    PubMed

    Huang, M-W; Zheng, L; Liu, S-M; Shi, Y; Zhang, J; Yu, G-Y; Zhang, J-G

    2013-06-01

    This retrospective study was to evaluate the local control and survival of (125)I brachytherapy for recurrent and/or locally advanced adenoid cystic carcinoma (ACC) of the oral and maxillofacial region. A total of 38 patients with recurrent and/or locally advanced ACC of the oral and maxillofacial region received (125)I brachytherapy alone from 2001-2010. Twenty-nine were recurrent cases following previous surgery and radiation therapy. The other 9 cases involved primary tumors. Overall, 12 tumors were located in the major salivary glands, 12 in the minor salivary glands, and 14 in the paranasal region, the nasal cavity or the skull base. The prescribed dose was 100-160 Gy. Patients were followed for 12-122 months (median 51 months). The 2-, 5-, and 10-year local tumor control rates were 86.3, 59, and 31.5 %, respectively. The 2-, 5-, and 10-year overall survival rates were 92.1, 65 and 34.1 %, respectively. Tumors > 6 cm had significantly lower local control and survival rates. No severe complications were observed during follow-up. (125)I brachytherapy is a feasible and effective modality for the treatment of locally advanced unresectable or recurrent ACC.

  4. Localization of linked {sup 125}I seeds in postimplant TRUS images for prostate brachytherapy dosimetry

    SciTech Connect

    Xue Jinyu . E-mail: Jinyu.Xue@mail.tju.edu; Waterman, Frank; Handler, Jay; Gressen, Eric

    2005-07-01

    Purpose: To demonstrate that {sup 125}I seeds can be localized in transrectal ultrasound (TRUS) images obtained with a high-resolution probe when the implant is performed with linked seeds and spacers. Adequate seed localization is essential to the implementation of TRUS-based intraoperative dosimetry for prostate brachytherapy. Methods and Materials: Thirteen preplanned peripherally loaded prostate implants were performed using {sup 125}I seeds and spacers linked together in linear arrays that prevent seed migration and maintain precise seed spacing. A set of two-dimensional transverse images spaced at 0.50-cm intervals were obtained with a high-resolution TRUS probe at the conclusion of the procedure with the patient still under anesthesia. The image set extended from 1.0 cm superior to the base to 1.0 cm inferior to the apex. The visible echoes along each needle track were first localized and then compared with the known construction of the implanted array. The first step was to define the distal and proximal ends of each array. The visible echoes were then identified as seeds or spacers from the known sequence of the array. The locations of the seeds that did not produce a visible echo were interpolated from their known position in the array. A CT scan was obtained after implantation for comparison with the TRUS images. Results: On average, 93% (range, 86-99%) of the seeds were visible in the TRUS images. However, it was possible to localize 100% of the seeds in each case, because the locations of the missing seeds could be determined from the known construction of the arrays. Two factors complicated the interpretation of the TRUS images. One was that the spacers also produced echoes. Although weak and diffuse, these echoes could be mistaken for seeds. The other was that the number of echoes along a needle track sometimes exceeded the number of seeds and spacers implanted. This was attributed to the overall length of the array, which was approximately 0.5 cm

  5. Brain damage from sup 125 I brachytherapy evaluated by MR imaging, a blood-brain barrier tracer, and light and electron microscopy in a rat model

    SciTech Connect

    Bernstein, M.; Marotta, T.; Stewart, P.; Glen, J.; Resch, L.; Henkelman, M. )

    1990-10-01

    Changes in normal rat brain were studied acutely, and at 3, 6, 9, and 12 months following interstitial brachytherapy with high-activity {sup 125}I seeds. An 80-Gy radiation dose was administered to an area with a 5.5-mm radius. Effects were measured with magnetic resonance (MR) imaging (with and without gadolinium enhancement), leakage of horseradish peroxidase (HRP), electron microscopy, and light microscopy. Significant histological damage was seen at radiation doses above 295 Gy, and breakdown of the blood-brain barrier was observed only in tissue receiving a dose of 165 Gy or greater. Blood-brain barrier breakdown increased up to the 6-month time point, and thereafter appeared to stabilize or decrease. The area of blood-brain barrier disruption indicated by gadolinium-enhanced MR imaging was greater than that indicated by leakage of HRP.

  6. A comparison study on various low energy sources in interstitial prostate brachytherapy

    PubMed Central

    Bakhshabadi, Mahdi; Ghorbani, Mahdi; Knaup, Courtney; Meigooni, Ali S.

    2016-01-01

    Purpose Low energy sources are routinely used in prostate brachytherapy. 125I is one of the most commonly used sources. Low energy 131Cs source was introduced recently as a brachytherapy source. The aim of this study is to compare dose distributions of 125I, 103Pd, and 131Cs sources in interstitial brachytherapy of prostate. Material and methods ProstaSeed 125I brachytherapy source was simulated using MCNPX Monte Carlo code. Additionally, two hypothetical sources of 103Pd and 131Cs were simulated with the same geometry as the ProstaSeed 125I source, while having their specific emitted gamma spectra. These brachytherapy sources were simulated with distribution of forty-eight seeds in a phantom including prostate. The prostate was considered as a sphere with radius of 1.5 cm. Absolute and relative dose rates were obtained in various distances from the source along the transverse and longitudinal axes inside and outside the tumor. Furthermore, isodose curves were plotted around the sources. Results Analyzing the initial dose profiles for various sources indicated that with the same time duration and air kerma strength, 131Cs delivers higher dose to tumor. However, relative dose rate inside the tumor is higher and outside the tumor is lower for the 103Pd source. Conclusions The higher initial absolute dose in cGy/(h.U) of 131Cs brachytherapy source is an advantage of this source over the others. The higher relative dose inside the tumor and lower relative dose outside the tumor for the 103Pd source are advantages of this later brachytherapy source. Based on the total dose the 125I source has advantage over the others due to its longer half-life. PMID:26985200

  7. A comparison study on various low energy sources in interstitial prostate brachytherapy.

    PubMed

    Bakhshabadi, Mahdi; Ghorbani, Mahdi; Khosroabadi, Mohsen; Knaup, Courtney; Meigooni, Ali S

    2016-02-01

    Low energy sources are routinely used in prostate brachytherapy. (125)I is one of the most commonly used sources. Low energy (131)Cs source was introduced recently as a brachytherapy source. The aim of this study is to compare dose distributions of (125)I, (103)Pd, and (131)Cs sources in interstitial brachytherapy of prostate. ProstaSeed (125)I brachytherapy source was simulated using MCNPX Monte Carlo code. Additionally, two hypothetical sources of (103)Pd and (131)Cs were simulated with the same geometry as the ProstaSeed (125)I source, while having their specific emitted gamma spectra. These brachytherapy sources were simulated with distribution of forty-eight seeds in a phantom including prostate. The prostate was considered as a sphere with radius of 1.5 cm. Absolute and relative dose rates were obtained in various distances from the source along the transverse and longitudinal axes inside and outside the tumor. Furthermore, isodose curves were plotted around the sources. Analyzing the initial dose profiles for various sources indicated that with the same time duration and air kerma strength, (131)Cs delivers higher dose to tumor. However, relative dose rate inside the tumor is higher and outside the tumor is lower for the (103)Pd source. The higher initial absolute dose in cGy/(h.U) of (131)Cs brachytherapy source is an advantage of this source over the others. The higher relative dose inside the tumor and lower relative dose outside the tumor for the (103)Pd source are advantages of this later brachytherapy source. Based on the total dose the (125)I source has advantage over the others due to its longer half-life.

  8. Interstitial hyperthermia in combination with brachytherapy.

    PubMed

    Coughlin, C T; Douple, E B; Strohbehn, J W; Eaton, W L; Trembly, B S; Wong, T Z

    1983-07-01

    Flexible coaxial cables were modified to serve as microwave antennas operating at a frequency of 915 MHz. These antennas were inserted into nylon afterloading tubes that had been implanted in tumors using conventional interstitial implantation techniques for iridium-192 seed brachytherapy. The tumor volume was heated to 42-45 degrees C within 15 minutes and heating was continued for a total of 1 hour per treatment. Immediately following a conventional brachytherapy dose and removal of the iridium seeds the tumors were heated again in a second treatment. This interstitial technique for delivering local hyperthermia should be compatible with most brachytherapy methods. The technique has proved so far to be practical and without complications. Temperature distributions obtained in tissue phantoms and a patient are described.

  9. COMS eye plaque brachytherapy dosimetry simulations for {sup 103}Pd, {sup 125}I, and {sup 131}Cs

    SciTech Connect

    Melhus, Christopher S.; Rivard, Mark J.

    2008-07-15

    Monte Carlo (MC) simulations were performed to estimate brachytherapy dose distributions for Collaborative Ocular Melanoma Study (COMS) eye plaques. Brachytherapy seed models 200, 6711, and CS-1 Rev2 carrying {sup 103}Pd, {sup 125}I, and {sup 131}Cs radionuclides, respectively, were modeled and benchmarked against previously published values. Calculated dose rate constants {sub MC}{lambda} were 0.684, 0.924, and 1.052 cGy h{sup -1} U{sup -1} ({+-}2.6%, k=1 uncertainty) for models 200, 6711, and CS-1 Rev2, respectively. The seeds were distributed into 10, 12, 14, 16, 18, 20, and 22 mm-diameter COMS eye plaques. Simulations were performed in both heterogeneous and homogeneous environments, where the latter were in-water and the former included the silastic seed carrier insert and gold-alloy plaque. MC-based homogenous central axis dose distributions agreed within 2%{+-}1% ({+-}1 s.d.) to hand-calculated values. For heterogeneous simulations, notable photon attenuation was observed, with dose reduction at 5 mm of 19%, 11%, and 9% for {sup 103}Pd, {sup 125}I, and {sup 131}Cs, respectively. A depth-dependent correction factor was derived to correct homogenous central-axis dose distributions for plaque component heterogeneities, which were found to be significant at short radial distances.

  10. CT-guided 125I seed implantation for inoperable retroperitoneal sarcoma: A technique for delivery of local tumor brachytherapy

    PubMed Central

    Yang, Biao; Guo, Wen-Hao; Lan, Ting; Yuan, Fang; Liu, Guan-Jian; Zan, Rui-Yu; You, Xin; Tan, Qiao-Yue; Liao, Zheng-Yin

    2016-01-01

    Radical surgery is currently the first treatment of choice for retroperitoneal soft tissue sarcoma (RSTS). However, the prognosis of RSTS remains poor due to ineffective local control and a high incidence of metastasis after surgical resection. Brachytherapy has been shown to safely provide local radiotherapy for numerous types of cancer when used alone or in combination with surgical resection, but has not been well characterized in the management of RSTS. The aim of this study was to evaluate CT-guided 125I seed implantation for local control and pain relief in the treatment of inoperable RSTS. A total of 23 patients with RSTS were treated with 125I implantation. Pain was assessed using a visual analog scale. Other endpoints were evaluated via computed tomography scan or phone call/e-mail records. The occurrence of complications was assessed preoperatively (baseline) and during postoperatively follow-up or until patient succumbed. All patients were successfully treated with 125I implantation. A mean number of 70.87 radioactive seeds were applied in each patient. During the follow-up, two patients were unaccounted for, local recurrence occurred in three patients, five succumbed and complications were observed in sixteen. The patient's VAS score changed from 7.4 preoperatively to 7.6, 2.3, 2.0, 1.2, 1.5, 1.4 and 2.5 at 24 h, 1, 3, 6, 12, 24 and 36 months after the procedure, respectively. Good local control and significant pain relief after 125I seed implantation was observed in patients with inoperable RSTS. Thus, the present results suggest that this method could be an effective treatment option for patients with inoperable RSTS. PMID:28101168

  11. Monte Carlo dosimetry for {sup 125}I and {sup 103}Pd eye plaque brachytherapy with various seed models

    SciTech Connect

    Thomson, R. M.; Rogers, D. W. O.

    2010-01-15

    Purpose: Dose distributions are calculated for various models of {sup 125}I and {sup 103}Pd seeds in the standardized plaques of the Collaborative Ocular Melanoma Study (COMS). The sensitivity to seed model of dose distributions and dose distributions relative to TG-43 are investigated. Methods: Monte Carlo simulations are carried out with the EGSnrc user-code BrachyDose. Brachytherapy seeds and eye plaques are fully modeled. Simulations of one seed in the central slot of a 20 mm Modulay (gold alloy) plaque backing with and without the Silastic (silicone polymer) insert and of a 16 mm fully loaded Modulay/Silastic plaque are performed. Dose distributions are compared to those calculated under TG-43 assumptions, i.e., ignoring the effects of the plaque backing and insert and interseed attenuation. Three-dimensional dose distributions for different {sup 125}I and {sup 103}Pd seed models are compared via depth-dose curves, isodose contours, and tabulation of doses at points of interest in the eye. Results are compared to those of our recent BrachyDose study for COMS plaques containing model 6711 ({sup 125}I) or 200 ({sup 103}Pd) seeds [R. M. Thomson et al., Med. Phys. 35, 5530-5543 (2008)]. Results: Along the central axis of a plaque containing one seed, variations of less than 1% are seen in the effect of the Modulay backing alone for different seed models; for the Modulay/Silastic combination, variations are 2%. For a 16 mm plaque fully loaded with {sup 125}I ({sup 103}Pd) seeds, dose decreases relative to TG-43 doses are 11%-12% (19%-20%) and 14%-15% (20%) at distances of 0.5 and 1 cm from the inner sclera along the plaque's central axis, respectively. For the same prescription dose, doses at points of interest vary by up to 8% with seed model. Doses to critical normal structures are lower for all {sup 103}Pd seed models than for {sup 125}I with the possible exception of the sclera adjacent to the plaque; scleral doses vary with seed model and are not always higher

  12. Comparative cost-effectiveness of focal and total salvage 125I brachytherapy for recurrent prostate cancer after primary radiotherapy

    PubMed Central

    Piena, Marjanne A.; Steuten, Lotte M.G.; van der Voort van Zyp, Jochem R.N.; Moerland, Marinus A.; van Vulpen, Marco

    2016-01-01

    Purpose Focal salvage (FS) iodine 125 (125I) brachytherapy could be an effective treatment for locally radiorecurrent prostate cancer (PCa). Toxicity is often reduced compared to total salvage (TS) while cancer control can be maintained, which could increase cost-effectiveness. The current study estimates the incremental cost per quality-adjusted life year (QALY) of FS compared to TS. Material and methods A decision analytic Markov model was developed, which compares costs and QALYs associated with FS and TS. A 3-year time horizon was adopted with six month cycles, with a hospital perspective on costs. Probabilities for genitourinary (GU) and gastrointestinal (GI) toxicity and their impact on health-related quality of life (SF-36) were derived from clinical studies in the University Medical Center Utrecht (UMCU). Probabilistic sensitivity analysis, using 10,000 Monte Carlo simulations, was performed to quantify the joint decision uncertainty up to the recommended maximum willingness-to-pay threshold of €80,000/QALY. Results Focal salvage dominates TS as it results in less severe toxicity and lower treatment costs. Decision uncertainty is small, with a 97-100% probability for FS to be cost-effective compared to TS (€0-€80,000/QALY). Half of the difference in costs between FS and TS was explained by higher treatment costs of TS, the other half by higher incidence of severe toxicity. One-way sensitivity analyses show that model outcomes are most sensitive to utilities and probabilities for severe toxicity. Conclusions Focal salvage 125I brachytherapy dominates TS, as it has lower treatment costs and leads to less toxicity in our center. Larger comparative studies with longer follow-up are necessary to assess the exact influence on (biochemical disease free) survival and toxicity. PMID:28115953

  13. Does location of prostate cancer by sextant biopsies predict for relapse after (125)I seed implant brachytherapy?

    PubMed

    Hill, Jesse; Hackett, Cian; Sloboda, Ron; Menon, Geetha; Singhal, Sandeep; Pervez, Nadeem; Pedersen, John; Yee, Don; Murtha, Albert; Amanie, John; Usmani, Nawaid

    2015-01-01

    To report on the importance of cancer location from diagnostic prostate biopsies in predicting biochemical relapse for patients treated with (125)I seed implant brachytherapy as monotherapy for favorable risk disease; specifically, to assess the clinical significance of potentially underdosing the base region of the prostate gland. Of 1145 consecutive patients, 846 had pretreatment biopsies allowing for sextant analysis and consequent evaluation of biochemical failure tendencies. Biochemical failure was defined as a posttreatment rise in the nadir prostate-specific antigen (PSA) by at least 2 ng/mL. Patient and tumor characteristics, dosimetry, the use of hormone therapy, source strength, and postimplant PSA kinetics were analyzed between sextant subgroups. Sixty-two patients (7.3%) with sextant pathology had biochemical failure. There was no significant difference between the failure locations. There were 528 patients (62.4%) with some element of base involvement (BI), and 318 patients (37.6%) with no evidence of BI. Of the 62 patients with biochemical failure, 42 (67.7%) showed BI on biopsy and 20 (32.3%) had no BI. The 10-year relapse-free survival rate is 88.2% (95% confidence interval: 84.3%, 92.2%) and 92.0% (95% confidence interval: 88.4%, 95.8%) for the BI and no BI groups, respectively (p = 0.17). The mean D90 delivered to the base, midgland, and apex was 140.8 (±21.8) Gy, 170.8 (±22.5) Gy, and 177.9 (±29.5) Gy, respectively, for all patients. There are no significantly worse outcomes for patients treated with an (125)I seed implant for favorable risk prostate cancer with some element of BI, despite lower doses of radiation delivered to the base region. Copyright © 2015 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  14. Modified COMS Plaques for {sup 125}I and {sup 103}Pd Iris Melanoma Brachytherapy

    SciTech Connect

    Thomson, Rowan M.; Furutani, Keith M.; Pulido, Jose S.; Stafford, Scott L.; Rogers, D.W.O.

    2010-11-15

    Purpose: Novel plaques are used to treat iris melanoma at the Mayo Clinic Rochester. The plaques are a modification of the Collaborative Ocular Melanoma Study (COMS) 22 mm plaque design with a gold alloy backing, outer lip, and silicone polymer insert. An inner lip surrounds a 10 mm diameter cutout region at the plaque center. Plaques span 360{sup o}, 270{sup o}, and 180{sup o} arcs. This article describes dosimetry for these plaques and others used in the treatment of anterior eye melanomas. Methods and Materials: The EGSnrc user-code BrachyDose is used to perform Monte Carlo simulations. Plaques and seeds are fully modeled. Three-dimensional dose distributions for different plaque models, TG-43 calculations, and {sup 125}I (model 6711) and {sup 103}Pd (model 200) seeds are compared via depth-dose curves, tabulation of doses at points of interest, and isodose contours. Results: Doses at points of interest differ by up to 70% from TG-43 calculations. The inner lip reduces corneal doses. Matching plaque arc length to tumor extent reduces doses to eye regions outside the treatment area. Maintaining the same prescription dose, {sup 103}Pd offers lower doses to critical structures than {sup 125}I, with the exception of the sclera adjacent to the plaque. Conclusion: The Mayo Clinic plaques offer several advantages for anterior eye tumor treatments. Doses to regions outside the treatment area are significantly reduced. Doses differ considerably from TG-43 predictions, illustrating the importance of complete Monte Carlo simulations. Calculations take a few minutes on a single CPU, making BrachyDose sufficiently fast for routine clinical treatment planning.

  15. Towards clinical application of RayStretch for heterogeneity corrections in LDR permanent (125)I prostate brachytherapy.

    PubMed

    Hueso-González, Fernando; Ballester, Facundo; Perez-Calatayud, Jose; Siebert, Frank-André; Vijande, Javier

    RayStretch is a simple algorithm proposed for heterogeneity corrections in low-dose-rate brachytherapy. It is built on top of TG-43 consensus data, and it has been validated with Monte Carlo (MC) simulations. In this study, we take a real clinical prostate implant with 71 (125)I seeds as reference and we apply RayStretch to analyze its performance in worst-case scenarios. To do so, we design two cases where large calcifications are located in the prostate lobules. RayStretch resilience under various calcification density values is also explored. Comparisons against MC calculations are performed. Dose-volume histogram-related parameters like prostate D90, rectum D2cc, or urethra D10 obtained with RayStretch agree within a few percent with the detailed MC results for all cases considered. The robustness and compatibility of RayStretch with commercial treatment planning systems indicate its applicability in clinical practice for dosimetric corrections in prostate calcifications. Its use during intraoperative ultrasound planning is foreseen. Copyright © 2017 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  16. Updated Solid Water trade mark sign to water conversion factors for {sup 125}I and {sup 103}Pd brachytherapy sources

    SciTech Connect

    Meigooni, Ali S.; Awan, Shahid B.; Thompson, Nathan S.; Dini, Sharifeh A.

    2006-11-15

    Dosimetric characteristics of brachytherapy sources are normally determined in water using a Monte Carlo simulation technique and in water equivalent phantom material using both experimental and Monte Carlo simulation techniques. The consensuses of these results are then calculated for clinical applications by converting experimental data obtained in water equivalent material to water using a conversion factor. These conversion factors are normally determined as a ratio of the Monte Carlo-simulated dose rate constant in liquid water to the dose rate constant in a water-equivalent phantom material. However, it has been noted that conversion factors utilized by some investigators have been derived using incorrect phantom material composition and incorrect cross-sectional data information. The impact of errors associated with the cross-sectional data and chemical composition of the phantom material used in dosimetric evaluation of brachytherapy sources has been investigated in this project. Results of these investigations have shown that the use of Solid Water trade mark sign with 1.7% calcium content, as compared to the 2.3% value stated by the manufacturer, may lead to 5% and 9% differences in conversion factors for {sup 125}I and {sup 103}Pd, respectively.

  17. Health-Related Quality of Life up to Six Years After {sup 125}I Brachytherapy for Early-Stage Prostate Cancer

    SciTech Connect

    Roeloffzen, Ellen M.A.; Lips, Irene M.; Gellekom, Marion P.R. van; Roermund, Joep van; Frank, Steven J.; Battermann, Jan J.; Vulpen, Marco van

    2010-03-15

    Purpose: Health-related quality of life (HRQOL) after prostate brachytherapy has been extensively described in published reports but hardly any long-term data are available. The aim of the present study was to prospectively assess long-term HRQOL 6 years after {sup 125}I prostate brachytherapy. Methods and Materials: A total of 127 patients treated with {sup 125}I brachytherapy for early-stage prostate cancer between December 2000 and June 2003 completed a HRQOL questionnaire at five time-points: before treatment and 1 month, 6 months, 1 year, and 6 years after treatment. The questionnaire included the RAND-36 generic health survey, the cancer-specific European Organization for Research and Treatment of Cancer core questionnaire (EORTCQLQ-C30), and the tumor-specific EORTC prostate cancer module (EORTC-PR25). A change in a score of >=10 points was considered clinically relevant. Results: Overall, the HRQOL at 6 years after {sup 125}I prostate brachytherapy did not significantly differ from baseline. Although a statistically significant deterioration in HRQOL at 6 years was seen for urinary symptoms, bowel symptoms, pain, physical functioning, and sexual activity (p <.01), most changes were not clinically relevant. A statistically significant improvement at 6 years was seen for mental health, emotional functioning, and insomnia (p <.01). The only clinically relevant changes were seen for emotional functioning and sexual activity. Conclusion: This is the first study presenting prospective HRQOL data up to 6 years after {sup 125}I prostate brachytherapy. HRQOL scores returned to approximately baseline values at 1 year and remained stable up to 6 years after treatment. {sup 125}I prostate brachytherapy did not adversely affect patients' long-term HRQOL.

  18. An overview of interstitial brachytherapy and hyperthermia

    SciTech Connect

    Brandt, B.B.; Harney, J.

    1989-11-01

    Interstitial thermoradiotherapy, an experimental cancer treatment that combines interstitial radiation implants (brachytherapy) and interstitial hyperthermia, is in the early stages of investigation. In accordance with the procedure used in a current national trial protocol, a 60-minute hyperthermia treatment is administered after catheters are placed into the tumor area while the patient is under general anesthesia. This is immediately followed by loading of radioactive Iridium-192 seeds into the catheters for a defined period of time. Once the prescribed radiation dose is delivered, the radioactive sources are removed and a second, 60-minute hyperthermia treatment is administered. Clinical trials with hyperthermia in combination with radiation have increased in recent years. Nurses caring for these patients need to become more knowledgeable about this investigational therapy. This paper provides an overview of the biologic rationale for this therapy, as well as a description of the delivery method and clinical application. Specific related nursing interventions are defined in a nursing protocol.23 references.

  19. Comparison of 3 different postimplant dosimetry methods following permanent {sup 125}I prostate seed brachytherapy

    SciTech Connect

    Marcu, Loredana G.; Gowda, Raghu

    2013-10-01

    Postimplant dosimetry (PID) after Iodine-125 ({sup 125}I) implant of the prostate should offer a reliable qualitative assessment. So far, there is no consensus regarding the optimum PID method, though the latest literature is in favor of magnetic resonance imaging (MRI). This study aims to simultaneously compare 3 PID techniques: (1) MRI-computed tomography (CT) fusion; (2) ultrasound (US)-CT fusion; and (3) manual target delineation on CT. The study comprised 10 patients with prostate cancer. CT/MR scans with urinary catheters in place for PID were done either on day 0 or day 1 postimplantation. The main parameter evaluated and compared among methods was target D90. The results show that CT-based D90s are lower than US-CT D90s (median difference,−6.85%), whereas MR-CT PID gives higher D90 than US-CT PID (median difference, 4.25%). Manual contouring on CT images tends to overestimate the prostate volume compared with transrectal ultrasound (TRUS) (median difference, 23.33%), whereas on US images the target is overestimated compared with MR-based contouring (median difference, 13.25%). Although there are certain differences among the results given by various PID techniques, the differences are statistically insignificant for this small group of patients. Any dosimetric comparison between 2 PID techniques should also account for the limitations of each technique, to allow for an accurate quantification of data. Given that PID after permanent radioactive seed implant is mandatory for quality assurance, any imaging method–based PID (MR-CT, US-CT, and CT) available in a radiotherapy department can be indicative of the quality of the procedure.

  20. Computed tomography (CT)-guided interstitial permanent implantation of (125)I seeds for refractory chest wall metastasis or recurrence.

    PubMed

    Jiang, Ping; Liu, Chen; Wang, Junjie; Yang, Ruijie; Jiang, Yuliang; Tian, Suqing

    2015-02-01

    To evaluate the efficacy and safety of 125I seeds implantation for refractory chest wall (CW) metastasis or recurrence under CT guidance. In addition we assessed initial data obtained on the therapeutic response for refractory CW metastasis or recurrence. Twenty consecutive patients underwent permanent implantation of 125I seeds (from Jul. 2004 to Jan. 2011) under computed tomography (CT) guidance. Postoperative dosimetry was routinely performed for all patients. The actuarial D90 of the implanted 125I seeds ranged from 100 Gy to 160 Gy (median: 130 Gy). The activity of 125I seeds ranged from 0.5 mCi to 0.78 mCi (median: 0.71 mCi). The total number of seeds implanted ranged from 8 to 269 (median: 53). The follow-up period ranged from 3 to 54 months (median: 11.5 months). The survival and local control probabilities were calculated by the Kaplan-Meier method. Among all the 20 patients, 3 patients had complete remission CR (15%), 12 patients had partial remission PR (60%), 5 patients had stable disease SD. The 1-, 2-, 3- and 4-year tumor control rates were all 88.7% respectively. The 1- and 2-, 3-, 4-year cancer specific survival rates were 56.5% and 47.1%, 47.1%, 47.1% respectively. The 1- and 2-, 3-, 4-year overall survival rates were 53.3% and 35.6%, 35.6%, 35.6% respectively, with a median survival of 15 months (95% CI, 7.0-22.9). Mild brachial plexus injury was seen in one patient; grade 1 or 2 skin reactions were seen in 6 patients (30%) who had received external beam radiation therapy (EBRT) before. No grade 3 and 4 skin side effects were found. Rib fracture, ulceration, pneumothorax or hemopneumothorax were not seen. Interstitial permanent implantation of 125I seeds under CT guidance is feasible, efficacious and safe for refractory CW metastasis or recurrence. © The Author(s) 2014.

  1. Y-configured metallic stent combined with 125I seed strands cavity brachytherapy for a patient with type IV Klatskin tumor

    PubMed Central

    Dechao, Jiao; Yanli, Wang; Zhen, Li

    2016-01-01

    We report a case in an inoperable patient with type IV Klatskin tumor treated by the use of a novel, two piece, Y-configured self-expandable metallic stent (SEMS) combined with two 125I seed strands via bilateral approach. The placement of the Y-shaped SEMS was successful and resulted in adequate biliary drainage. After 2 months of intraluminal brachytherapy (ILBT), both 125I seed strands and temporary drainage catheter were removed after patency of the expanded stents was confirmed by the cholangiogram. This technique was feasible and could be considered for the treatment of patients with Bismuth type IV Klatskin tumors. PMID:27648091

  2. 125I brachytherapy of locally advanced non-small-cell lung cancer after one cycle of first-line chemotherapy: a comparison with best supportive care

    PubMed Central

    Song, Jingjing; Fan, Xiaoxi; Zhao, Zhongwei; Chen, Minjiang; Chen, Weiqian; Wu, Fazong; Zhang, Dengke; Chen, Li; Tu, Jianfei; Ji, Jiansong

    2017-01-01

    Objectives The objective of this study was to assess the efficacy of computed tomography (CT)-guided 125I brachytherapy alone in improving the survival and quality of life of patients with unresectable locally advanced non-small-cell lung cancer (NSCLC) after one cycle of first-line chemotherapy. Patients and methods Sixteen patients with locally advanced NSCLC were treated with CT-guided 125I brachytherapy after one cycle of first-line chemotherapy (group A). Sixteen patients who received only best supportive care (group B) were matched up with the patients in group A. Primary end point included survival, and secondary end point included assessment of safety, effectiveness of CT-guided 125I brachytherapy, and improvement in the quality of life. Results The two groups were well balanced in terms of age, disease histology, tumor stage, tumor location, and performance status (P>0.05). The median follow-up time was 16 months (range, 3–30). The total tumor response rate was 75.0% in group A, which was significantly higher than that in group B (0.0%) (P<0.01). The median progression-free survival time was 4.80 months for patients in group A and 1.35 months for patients in group B (P<0.001). Kaplan–Meier survival analysis showed that the median survival time of group A was 9.4±0.3 months versus 8.4±0.1 months in group B (P=0.013). Tumor-related symptoms of patients were significantly relieved, and the quality of life was markedly improved in group A than in group B. Conclusion CT-guided 125I brachytherapy improved the survival of patients with locally advanced NSCLC and quality of life after one cycle of first-line chemotherapy compared with best supportive care. PMID:28280369

  3. [Perioperative interstitial brachytherapy for recurrent keloid scars].

    PubMed

    Rio, E; Bardet, E; Peuvrel, P; Martinet, L; Perrot, P; Baraer, F; Loirat, Y; Sartre, J-Y; Malard, O; Ferron, C; Dreno, B

    2010-01-01

    Evaluation of the results of perioperative interstitial brachytherapy with low dose-rate (LDR) Ir-192 in the treatment of keloid scars. We performed a retrospective analysis of 73 histologically confirmed keloids (from 58 patients) resistant to medicosurgical treated by surgical excision plus early perioperative brachytherapy. All lesions were initially symptomatic. Local control was evaluated by clinical evaluation. Functional and cosmetic results were assessed in terms of patient responses to a self-administered questionnaire. Median age was 28 years (range 13-71 years). Scars were located as follows: 37% on the face, 32% on the trunk or abdomen, 16% on the neck, and 15% on the arms or legs. The mean delay before loading was four hours (range, 1-6h). The median dose was 20Gy (range, 15-40Gy). Sixty-four scars (from 53 patients) were evaluated. Local control was 86% (follow-up, 44.5 months; range, 14-150 months). All relapses occurred early - within 2 years posttreatment. At 20 months, survival without recurrence was significantly lower when treated lengths were more than 6cm long. The rate was 100% for treated scars below 4.5cm in length, 95% (95% CI: 55-96) for those 4.5-6cm long, and 75% (95% CI: 56-88) beyond 6cm (p=0.038). Of the 35 scars (28 patients) whose results were reassessed, six remained symptomatic and the esthetic results were considered to be good in 51% (18/35) and average in 37% (13/35) (median follow-up, 70 months; range, 16-181 months). Early perioperative LDR brachytherapy delivering 20Gy at 5mm reduced the rate of recurrent keloids resistant to other treatments and gave good functional results. 2009 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.

  4. Interstitial rotating shield brachytherapy for prostate cancer

    SciTech Connect

    Adams, Quentin E. Xu, Jinghzu; Breitbach, Elizabeth K.; Li, Xing; Rockey, William R.; Kim, Yusung; Wu, Xiaodong; Flynn, Ryan T.; Enger, Shirin A.

    2014-05-15

    Purpose: To present a novel needle, catheter, and radiation source system for interstitial rotating shield brachytherapy (I-RSBT) of the prostate. I-RSBT is a promising technique for reducing urethra, rectum, and bladder dose relative to conventional interstitial high-dose-rate brachytherapy (HDR-BT). Methods: A wire-mounted 62 GBq{sup 153}Gd source is proposed with an encapsulated diameter of 0.59 mm, active diameter of 0.44 mm, and active length of 10 mm. A concept model I-RSBT needle/catheter pair was constructed using concentric 50 and 75 μm thick nickel-titanium alloy (nitinol) tubes. The needle is 16-gauge (1.651 mm) in outer diameter and the catheter contains a 535 μm thick platinum shield. I-RSBT and conventional HDR-BT treatment plans for a prostate cancer patient were generated based on Monte Carlo dose calculations. In order to minimize urethral dose, urethral dose gradient volumes within 0–5 mm of the urethra surface were allowed to receive doses less than the prescribed dose of 100%. Results: The platinum shield reduced the dose rate on the shielded side of the source at 1 cm off-axis to 6.4% of the dose rate on the unshielded side. For the case considered, for the same minimum dose to the hottest 98% of the clinical target volume (D{sub 98%}), I-RSBT reduced urethral D{sub 0.1cc} below that of conventional HDR-BT by 29%, 33%, 38%, and 44% for urethral dose gradient volumes within 0, 1, 3, and 5 mm of the urethra surface, respectively. Percentages are expressed relative to the prescription dose of 100%. For the case considered, for the same urethral dose gradient volumes, rectum D{sub 1cc} was reduced by 7%, 6%, 6%, and 6%, respectively, and bladder D{sub 1cc} was reduced by 4%, 5%, 5%, and 6%, respectively. Treatment time to deliver 20 Gy with I-RSBT was 154 min with ten 62 GBq {sup 153}Gd sources. Conclusions: For the case considered, the proposed{sup 153}Gd-based I-RSBT system has the potential to lower the urethral dose relative to HDR-BT by 29

  5. Effect of improved TLD dosimetry on the determination of dose rate constants for {sup 125}I and {sup 103}Pd brachytherapy seeds

    SciTech Connect

    Rodriguez, M.; Rogers, D. W. O.

    2014-11-01

    Purpose: To more accurately account for the relative intrinsic energy dependence and relative absorbed-dose energy dependence of TLDs when used to measure dose rate constants (DRCs) for {sup 125}I and {sup 103}Pd brachytherapy seeds, to thereby establish revised “measured values” for all seeds and compare the revised values with Monte Carlo and consensus values. Methods: The relative absorbed-dose energy dependence, f{sup rel}, for TLDs and the phantom correction, P{sub phant}, are calculated for {sup 125}I and {sup 103}Pd seeds using the EGSnrc BrachyDose and DOSXYZnrc codes. The original energy dependence and phantom corrections applied to DRC measurements are replaced by calculated (f{sup rel}){sup −1} and P{sub phant} values for 24 different seed models. By comparing the modified measured DRCs to the MC values, an appropriate relative intrinsic energy dependence, k{sub bq}{sup rel}, is determined. The new P{sub phant} values and relative absorbed-dose sensitivities, S{sub AD}{sup rel}, calculated as the product of (f{sup rel}){sup −1} and (k{sub bq}{sup rel}){sup −1}, are used to individually revise the measured DRCs for comparison with Monte Carlo calculated values and TG-43U1 or TG-43U1S1 consensus values. Results: In general, f{sup rel} is sensitive to the energy spectra and models of the brachytherapy seeds. Values may vary up to 8.4% among {sup 125}I and {sup 103}Pd seed models and common TLD shapes. P{sub phant} values depend primarily on the isotope used. Deduced (k{sub bq}{sup rel}){sup −1} values are 1.074 ± 0.015 and 1.084 ± 0.026 for {sup 125}I and {sup 103}Pd seeds, respectively. For (1 mm){sup 3} chips, this implies an overall absorbed-dose sensitivity relative to {sup 60}Co or 6 MV calibrations of 1.51 ± 1% and 1.47 ± 2% for {sup 125}I and {sup 103}Pd seeds, respectively, as opposed to the widely used value of 1.41. Values of P{sub phant} calculated here have much lower statistical uncertainties than literature values, but

  6. Cluster pattern analysis of energy deposition sites for the brachytherapy sources 103Pd, 125I, 192Ir, 137Cs, and 60Co.

    PubMed

    Villegas, Fernanda; Tilly, Nina; Bäckström, Gloria; Ahnesjö, Anders

    2014-09-21

    Analysing the pattern of energy depositions may help elucidate differences in the severity of radiation-induced DNA strand breakage for different radiation qualities. It is often claimed that energy deposition (ED) sites from photon radiation form a uniform random pattern, but there is indication of differences in RBE values among different photon sources used in brachytherapy. The aim of this work is to analyse the spatial patterns of EDs from 103Pd, 125I, 192Ir, 137Cs sources commonly used in brachytherapy and a 60Co source as a reference radiation. The results suggest that there is both a non-uniform and a uniform random component to the frequency distribution of distances to the nearest neighbour ED. The closest neighbouring EDs show high spatial correlation for all investigated radiation qualities, whilst the uniform random component dominates for neighbours with longer distances for the three higher mean photon energy sources (192Ir, 137Cs, and 60Co). The two lower energy photon emitters (103Pd and 125I) present a very small uniform random component. The ratio of frequencies of clusters with respect to 60Co differs up to 15% for the lower energy sources and less than 2% for the higher energy sources when the maximum distance between each pair of EDs is 2 nm. At distances relevant to DNA damage, cluster patterns can be differentiated between the lower and higher energy sources. This may be part of the explanation to the reported difference in RBE values with initial DSB yields as an endpoint for these brachytherapy sources.

  7. Cluster pattern analysis of energy deposition sites for the brachytherapy sources 103Pd, 125I, 192Ir, 137Cs, and 60Co

    NASA Astrophysics Data System (ADS)

    Villegas, Fernanda; Tilly, Nina; Bäckström, Gloria; Ahnesjö, Anders

    2014-09-01

    Analysing the pattern of energy depositions may help elucidate differences in the severity of radiation-induced DNA strand breakage for different radiation qualities. It is often claimed that energy deposition (ED) sites from photon radiation form a uniform random pattern, but there is indication of differences in RBE values among different photon sources used in brachytherapy. The aim of this work is to analyse the spatial patterns of EDs from 103Pd, 125I, 192Ir, 137Cs sources commonly used in brachytherapy and a 60Co source as a reference radiation. The results suggest that there is both a non-uniform and a uniform random component to the frequency distribution of distances to the nearest neighbour ED. The closest neighbouring EDs show high spatial correlation for all investigated radiation qualities, whilst the uniform random component dominates for neighbours with longer distances for the three higher mean photon energy sources (192Ir, 137Cs, and 60Co). The two lower energy photon emitters (103Pd and 125I) present a very small uniform random component. The ratio of frequencies of clusters with respect to 60Co differs up to 15% for the lower energy sources and less than 2% for the higher energy sources when the maximum distance between each pair of EDs is 2 nm. At distances relevant to DNA damage, cluster patterns can be differentiated between the lower and higher energy sources. This may be part of the explanation to the reported difference in RBE values with initial DSB yields as an endpoint for these brachytherapy sources.

  8. Comparison of Dosimetric and Biologic Effective Dose Parameters for Prostate and Urethra Using {sup 131}Cs and {sup 125}I for Prostate Permanent Implant Brachytherapy

    SciTech Connect

    Sahgal, Arjun; Jabbari, Siavash; Chen, Josephine; Pickett, Barbie; Roach, Mack; Weinberg, Vivian; Hsu, I-C.; Pouliot, Jean

    2008-09-01

    Purpose: To compare the urethral and prostate absolute and biologic effective doses (BEDs) for {sup 131}Cs and {sup 125}I prostate permanent implant brachytherapy (PPI). Methods and Materials: Eight previously implanted manually planned {sup 125}I PPI patients were replanned manually with {sup 131}Cs, and re-planned using Inverse Planning Simulated Annealing. {sup 131}Cs activity and the prescribed dose (115 Gy) were determined from that recommended by IsoRay. The BED was calculated for the prostate and urethra using an {alpha}/{beta} ratio of 2 and was also calculated for the prostate using an {alpha}/{beta} ratio of 6 and a urethral {alpha}/{beta} ratio of 2. The primary endpoints of this study were the prostate D{sub 90} BED (pD{sub 90}BED) and urethral D{sub 30} BED normalized to the maximal potential prostate D{sub 90} BED (nuD{sub 30}BED). Results: The manual plan comparison ({alpha}/{beta} = 2) yielded no significant difference in the prostate D{sub 90} BED (median, 192 Gy{sub 2} for both isotopes). No significant difference was observed for the nuD{sub 30}BED (median, 199 Gy{sub 2} and 202 Gy{sub 2} for {sup 125}I and {sup 131}Cs, respectively). For the inverse planning simulated annealing plan comparisons ({alpha}/{beta} 2), the prostate D{sub 90} BED was significantly lower with {sup 131}Cs than with {sup 125}I (median, 177 Gy{sub 2} vs. 187 Gy{sub 2}, respectively; p = 0.01). However, the nuD{sub 30}BED was significantly greater with {sup 131}Cs than with {sup 125}I (median, 192 Gy{sub 2} vs. 189 Gy{sub 2}, respectively; p = 0.01). Both the manual and the inverse planning simulated annealing plans resulted in a significantly lower prostate D{sub 90} BED (p = 0.01) and significantly greater nuD{sub 30}BED for {sup 131}Cs (p = 0.01), compared with {sup 125}I, when the prostate {alpha}/{beta} ratio was 6 and the urethral {alpha}/{beta} ratio was 2. Conclusion: This report highlights the controversy in comparing the dose to both the prostate and the organs

  9. Percutaneous interstitial brachytherapy for adrenal metastasis: technical report

    PubMed Central

    Kishi, Kazushi; Tamura, Shinji; Mabuchi, Yasushi; Sonomura, Tetsuo; Noda, Yasutaka; Nakai, Motoki; Sato, Morio; Ino, Kazuhiko; Yamanaka, Noboru

    2012-01-01

    We developed and evaluated the feasibility of a brachytherapy technique as a safe and effective treatment for adrenal metastasis. Adapting a paravertebral insertion technique in radiofrequency ablation of adrenal tumors, we developed an interstitial brachytherapy for adrenal metastasis achievable on an outpatient basis. Under local anesthesia and under X-ray CT guidance, brachytherapy applicator needles were percutaneously inserted into the target. A treatment plan was created to eradicate the tumor while preserving normal organs including the spinal cord and kidney. We applied this interstitial brachytherapy technique to two patients: one who developed adrenal metastasis as the third recurrence of uterine cervical cancer after reirradiation, and one who developed metachronous multiple metastases from malignant melanoma. The whole procedure was completed in 2.5 hours. There were no procedure-related or radiation-related early/late complications. FDG PET-CT images at two and three months after treatment showed absence of FDG uptake, and no recurrence of the adrenal tumor was observed for over seven months until expiration, and for six months until the present, respectively. This interventional interstitial brachytherapy procedure may be useful as a safe and eradicative treatment for adrenal metastasis. PMID:22843376

  10. Percutaneous interstitial brachytherapy for adrenal metastasis: technical report.

    PubMed

    Kishi, Kazushi; Tamura, Shinji; Mabuchi, Yasushi; Sonomura, Tetsuo; Noda, Yasutaka; Nakai, Motoki; Sato, Morio; Ino, Kazuhiko; Yamanaka, Noboru

    2012-09-01

    We developed and evaluated the feasibility of a brachytherapy technique as a safe and effective treatment for adrenal metastasis. Adapting a paravertebral insertion technique in radiofrequency ablation of adrenal tumors, we developed an interstitial brachytherapy for adrenal metastasis achievable on an outpatient basis. Under local anesthesia and under X-ray CT guidance, brachytherapy applicator needles were percutaneously inserted into the target. A treatment plan was created to eradicate the tumor while preserving normal organs including the spinal cord and kidney. We applied this interstitial brachytherapy technique to two patients: one who developed adrenal metastasis as the third recurrence of uterine cervical cancer after reirradiation, and one who developed metachronous multiple metastases from malignant melanoma. The whole procedure was completed in 2.5 hours. There were no procedure-related or radiation-related early/late complications. FDG PET-CT images at two and three months after treatment showed absence of FDG uptake, and no recurrence of the adrenal tumor was observed for over seven months until expiration, and for six months until the present, respectively. This interventional interstitial brachytherapy procedure may be useful as a safe and eradicative treatment for adrenal metastasis.

  11. Approaches to calculating AAPM TG-43 brachytherapy dosimetry parameters for {sup 137}Cs, {sup 125}I, {sup 192}Ir, {sup 103}Pd, and {sup 169}Yb sources

    SciTech Connect

    Melhus, Christopher S.; Rivard, Mark J.

    2006-06-15

    Underlying characteristics in brachytherapy dosimetry parameters for medical radionuclides {sup 137}Cs, {sup 125}I, {sup 192}Ir, {sup 103}Pd, and {sup 169}Yb were examined using Monte Carlo methods. Sources were modeled as unencapsulated point or line sources in liquid water to negate variations due to materials and construction. Importance of phantom size, mode of radiation transport physics--i.e., photon transport only or coupled photon:electron transport, phantom material, volume averaging, and Monte Carlo tally type were studied. For noninfinite media, g(r) was found to degrade as r approached R, the phantom radius. MCNP5 results were in agreement with those published using GEANT4. Brachytherapy dosimetry parameters calculated using coupled photon:electron radiation transport simulations did not differ significantly from those using photon transport only. Dose distributions from low-energy photon-emitting radionuclides {sup 125}I and {sup 103}Pd were sensitive to phantom material by upto a factor of 1.4 and 2.0, respectively, between tissue-equivalent materials and water at r=9 cm. In comparison, high-energy photons from {sup 137}Cs, {sup 192}Ir, and {sup 169}Yb demonstrated {+-}5% differences in dose distributions between water and tissue substitutes at r=20 cm. Similarly, volume-averaging effects were found to be more significant for low-energy radionuclides. When modeling line sources with L{<=}0.5 cm, the two-dimensional anisotropy function was largely within {+-}0.5% of unity for {sup 137}Cs, {sup 125}I, and {sup 192}Ir. However, an energy and geometry effect was noted for {sup 103}Pd and {sup 169}Yb, with {sub Pd-103}F(0.5,0 deg.)=1.05 and {sub Yb-169}F(0.5,0 deg.)=0.98 for L=0.5 cm. Simulations of monoenergetic photons for L=0.5 cm produced energy-dependent variations in F(r,{theta}) having a maximum value at 10 keV, minimum at 50 keV, and {approx}1.0 for higher-energy photons up to 750 keV. Both the F6 cell heating and track-length estimators were

  12. Determination of the intrinsic energy dependence of LiF:Mg,Ti thermoluminescent dosimeters for {sup 125}I and {sup 103}Pd brachytherapy sources relative to {sup 60}Co

    SciTech Connect

    Reed, J. L. Micka, J. A.; Culberson, W. S.; DeWerd, L. A.; Rasmussen, B. E.; Davis, S. D.

    2014-12-15

    Purpose: To determine the intrinsic energy dependence of LiF:Mg,Ti thermoluminescent dosimeters (TLD-100) for {sup 125}I and {sup 103}Pd brachytherapy sources relative to {sup 60}Co. Methods: LiF:Mg,Ti TLDs were irradiated with low-energy brachytherapy sources and with a {sup 60}Co teletherapy source. The brachytherapy sources measured were the Best 2301 {sup 125}I seed, the OncoSeed 6711 {sup 125}I seed, and the Best 2335 {sup 103}Pd seed. The TLD light output per measured air-kerma strength was determined for the brachytherapy source irradiations, and the TLD light output per air kerma was determined for the {sup 60}Co irradiations. Monte Carlo (MC) simulations were used to calculate the dose-to-TLD rate per air-kerma strength for the brachytherapy source irradiations and the dose to TLD per air kerma for the {sup 60}Co irradiations. The measured and MC-calculated results for all irradiations were used to determine the TLD intrinsic energy dependence for {sup 125}I and {sup 103}Pd relative to {sup 60}Co. Results: The relative TLD intrinsic energy dependences (relative to {sup 60}Co) and associated uncertainties (k = 1) were determined to be 0.883 ± 1.3%, 0.870 ± 1.4%, and 0.871 ± 1.5% for the Best 2301 seed, OncoSeed 6711 seed, and Best 2335 seed, respectively. Conclusions: The intrinsic energy dependence of TLD-100 is dependent on photon energy, exhibiting changes of 13%–15% for {sup 125}I and {sup 103}Pd sources relative to {sup 60}Co. TLD measurements of absolute dose around {sup 125}I and {sup 103}Pd brachytherapy sources should explicitly account for the relative TLD intrinsic energy dependence in order to improve dosimetric accuracy.

  13. Experimental determination of the dose rate constant for selected 125I- and 192Ir-brachytherapy sources

    NASA Astrophysics Data System (ADS)

    Selbach, Hans-Joachim; Bambynek, Markus; Aubineau-Lanièce, Isabelle; Gabris, Frantisek; Stefano Guerra, Antonio; Toni, Maria Pia; de Pooter, Jacco; Sander, Thorsten; Schneider, Thorsten

    2012-10-01

    In 2008, the European project ‘T2.J06, Increasing cancer treatment efficacy using 3D brachytherapy’ was launched. One of the main goals of the Joint Research Project was the experimental determination of the dose rate constant Λ to allow the linkage between the air kerma strength or reference air kerma rate currently used for the source characterization and the ‘new’ absorbed dose rate to water with an uncertainty of <3% (k = 1) for some selected brachytherapy sources. The results obtained by five National Metrology Institutes (NMI) for four different types of brachytherapy sources are presented and compared with consensus data published in the literature. A further goal of the project was to develop a calibration chain for the transfer of the new reference quantity to the end user, minimizing the uncertainty. A first direct calibration in terms of absorbed dose rate to water of a secondary standard and the dissemination to the hospitals is presented.

  14. Postoperative interstitial brachytherapy in eyelid cancer: long term results and assessment of Cosmesis After Interstitial Brachytherapy scale

    PubMed Central

    Basu, Trinanjan; Chaudhary, Suresh; Chaukar, Devendra; Nadkarni, Mandar; GN, Manjunatha

    2014-01-01

    Purpose To analyse feasibility and safety of postoperative interstitial brachytherapy (IBRT) in patients of eyelid cancer treated primarily by surgical excision. Material and methods In this series, 8 patients with eyelid cancer were treated using postoperative interstitial brachytherapy. Patients were followed up for local control, cosmetic outcome, and acute and late toxicities. Cosmetic outcome was measured using a 6 point indigenous Cosmesis After Interstitial Brachytherapy (CAIB) scale. Results The patients were between 23-82 years (median: 71 years). There were 3 females and 5 males, and 3 patients had lesions in upper eyelid. Postoperative high-dose-rate brachytherapy was used in all with 2 catheters implanted in most of them (6 out of 8). Local control was calculated from end of treatment to last follow-up. At last follow-up, all patients remained locally controlled. Two patients had nodal recurrence 6 months after interstitial brachytherapy and were salvaged effectively by external beam radiotherapy. At last follow-up, 7 patients were loco-regionally controlled and one was lost to follow up. All patients had Radiation Therapy Oncology Group (RTOG) grade 1 acute toxicity and 2 had grade 1 Common Terminology Criteria for Adverse Events (CTCAE) version.3 late toxicities. The cosmesis score for the whole group ranged between 0-1 indicating excellent to very good cosmesis. Conclusions Postoperative high-dose-rate brachytherapy resulted in excellent disease control and cosmesis without significant acute or late toxicities. It is an effective modality for treatment of eyelid cancers in selected patients. Future prospective studies with the validation of CAIB scale would give us more insight to this effective yet often ignored modality of IBRT. PMID:25834578

  15. Monte Carlo calculated microdosimetric spread for cell nucleus-sized targets exposed to brachytherapy 125I and 192Ir sources and 60Co cell irradiation

    NASA Astrophysics Data System (ADS)

    Villegas, Fernanda; Tilly, Nina; Ahnesjö, Anders

    2013-09-01

    The stochastic nature of ionizing radiation interactions causes a microdosimetric spread in energy depositions for cell or cell nucleus-sized volumes. The magnitude of the spread may be a confounding factor in dose response analysis. The aim of this work is to give values for the microdosimetric spread for a range of doses imparted by 125I and 192Ir brachytherapy radionuclides, and for a 60Co source. An upgraded version of the Monte Carlo code PENELOPE was used to obtain frequency distributions of specific energy for each of these radiation qualities and for four different cell nucleus-sized volumes. The results demonstrate that the magnitude of the microdosimetric spread increases when the target size decreases or when the energy of the radiation quality is reduced. Frequency distributions calculated according to the formalism of Kellerer and Chmelevsky using full convolution of the Monte Carlo calculated single track frequency distributions confirm that at doses exceeding 0.08 Gy for 125I, 0.1 Gy for 192Ir, and 0.2 Gy for 60Co, the resulting distribution can be accurately approximated with a normal distribution. A parameterization of the width of the distribution as a function of dose and target volume of interest is presented as a convenient form for the use in response modelling or similar contexts.

  16. Monte Carlo calculated microdosimetric spread for cell nucleus-sized targets exposed to brachytherapy 125I and 192Ir sources and 60Co cell irradiation.

    PubMed

    Villegas, Fernanda; Tilly, Nina; Ahnesjö, Anders

    2013-09-07

    The stochastic nature of ionizing radiation interactions causes a microdosimetric spread in energy depositions for cell or cell nucleus-sized volumes. The magnitude of the spread may be a confounding factor in dose response analysis. The aim of this work is to give values for the microdosimetric spread for a range of doses imparted by (125)I and (192)Ir brachytherapy radionuclides, and for a (60)Co source. An upgraded version of the Monte Carlo code PENELOPE was used to obtain frequency distributions of specific energy for each of these radiation qualities and for four different cell nucleus-sized volumes. The results demonstrate that the magnitude of the microdosimetric spread increases when the target size decreases or when the energy of the radiation quality is reduced. Frequency distributions calculated according to the formalism of Kellerer and Chmelevsky using full convolution of the Monte Carlo calculated single track frequency distributions confirm that at doses exceeding 0.08 Gy for (125)I, 0.1 Gy for (192)Ir, and 0.2 Gy for (60)Co, the resulting distribution can be accurately approximated with a normal distribution. A parameterization of the width of the distribution as a function of dose and target volume of interest is presented as a convenient form for the use in response modelling or similar contexts.

  17. Calibration of the NPL secondary standard radionuclide calibrator for 125I seeds used for prostate brachytherapy. National Physical Laboratory.

    PubMed

    Baker, M; Bass, G A; Woods, M J

    2002-01-01

    In the therapeutic use of radionuclides, by far the most rapid growth in recent years is that of 125I seeds used for the treatment of prostate cancer. Large numbers of these seeds are used in each treatment and there is a need for a simple but accurate means of confirming their dose rates. This mechanism requires a transfer device for which the calibration factors are traceable to national standards. The NPL secondary standard radionuclide calibrator, because of its guaranteed reproducibility and traceable calibration procedure, is ideally suited for this purpose. A series of characterisation measurements have been performed on the NPL radionuclide calibrator in order to estimate the uncertainty levels that can be achieved and these are presented together with the relevant calibration factors for some typical seeds.

  18. Monte Carlo dosimetry for {sup 103}Pd, {sup 125}I, and {sup 131}Cs ocular brachytherapy with various plaque models using an eye phantom

    SciTech Connect

    Lesperance, Marielle; Martinov, M.; Thomson, R. M.

    2014-03-15

    Purpose: To investigate dosimetry for ocular brachytherapy for a range of eye plaque models containing{sup 103}Pd, {sup 125}I, or {sup 131}Cs seeds with model-based dose calculations. Methods: Five representative plaque models are developed based on a literature review and are compared to the standardized COMS plaque, including plaques consisting of a stainless steel backing and acrylic insert, and gold alloy backings with: short collimating lips and acrylic insert, no lips and silicone polymer insert, no lips and a thin acrylic layer, and individual collimating slots for each seed within the backing and no insert. Monte Carlo simulations are performed using the EGSnrc user-code BrachyDose for single and multiple seed configurations for the plaques in water and within an eye model (including nonwater media). Simulations under TG-43 assumptions are also performed, i.e., with the same seed configurations in water, neglecting interseed and plaque effects. Maximum and average doses to ocular structures as well as isodose contours are compared for simulations of each radionuclide within the plaque models. Results: The presence of the plaque affects the dose distribution substantially along the plaque axis for both single seed and multiseed simulations of each plaque design in water. Of all the plaque models, the COMS plaque generally has the largest effect on the dose distribution in water along the plaque axis. Differences between doses for single and multiple seed configurations vary between plaque models and radionuclides. Collimation is most substantial for the plaque with individual collimating slots. For plaques in the full eye model, average dose in the tumor region differs from those for the TG-43 simulations by up to 10% for{sup 125}I and {sup 131}Cs, and up to 17% for {sup 103}Pd, and in the lens region by up to 29% for {sup 125}I, 34% for {sup 103}Pd, and 28% for {sup 131}Cs. For the same prescription dose to the tumor apex, the lowest doses to critical

  19. Experimental determination of the Task Group-43 dosimetric parameters of the new I25.S17plus (125)I brachytherapy source.

    PubMed

    Moutsatsos, Argyris; Pantelis, Evaggelos; Papagiannis, Panagiotis; Baltas, Dimos

    2014-01-01

    To present experimental dosimetry results for the new IsoSeed I25.S17plus (125)I brachytherapy source, in fulfillment of the American Association of Physicists in Medicine recommendation for, at least one, experimental dosimetry characterization of new low-energy seeds before their clinical implementation. A batch of 100 LiF thermoluminescent dosimeter (TLD)-100 microcubes was used for the experimental determination of the dose-rate constant, radial dose, and anisotropy functions, in irradiations performed using two Solid Water phantoms. Monte Carlo (MC) simulations were used to determine appropriate correction factors that account for the use of Solid Water as a phantom material instead of liquid water and for the different energy response of the TLD dosimeters in the experimental (125)I photon energies relative to the 6 MV x-ray photon beam used for the TLD calibration. Measurements were performed for four I25.S17plus seeds; one with direct traceability of air-kerma strength calibration to National Institute of Standards and Technology and three with secondary National Institute of Standards and Technology traceability. A mean dose-rate constant, Λ, of 0.956 ± 0.043 cGy h(-1) U(-1) was experimentally determined for the I25.S17plus source, which agrees within uncertainties with the MC result of 0.925 ± 0.013 cGy h(-1) U(-1) calculated independently for the same seed model in a previous study. Agreement was also observed between the measured and the MC-calculated radial dose and anisotropy function values. Experimental dosimetry results for the I25.S17plus (125)I source verify corresponding independent MC results in the form of Task Group-43 dosimetry parameters. The latter are found in agreement within uncertainties with sources of similar design incorporating a silver marker, such as the Oncura OncoSeed Model 6711. Copyright © 2014 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  20. Urinary Symptom Flare in 712 {sup 125}I Prostate Brachytherapy Patients: Long-Term Follow-Up

    SciTech Connect

    Keyes, Mira; Miller, Stacy; Moravan, Veronika; Pickles, Tom; Liu, Mitchell; Spadinger, Ingrid; Lapointe, Vincent; Morris, W. James

    2009-11-01

    Purpose: To describe the late transient worsening of urinary symptoms ('urinary symptom flare') in 712 consecutive prostate brachytherapy patients, associated predictive factors, association with rectal and urinary toxicity, and the development of erectile dysfunction. Methods and Materials: Patients underwent implantation between 1998 and 2003 (median follow-up, 57 months). International Prostate Symptom Score (IPSS), Radiation Therapy Oncology Group (RTOG) toxicity, and erectile function data were prospectively collected. Flare was defined as an increase in IPSS of >=5 and of >=8 points greater than the post-treatment nadir. The relationships between the occurrence of flare and the patient, tumor, and treatment characteristics were examined. The Cox proportional hazards method was used to test individual variables and the multivariate models. Results: The incidence of flare was 52% and 30% using the flare definition of an IPSS of >=5 and >=8 points greater than the postimplant nadir, respectively. Of the patients with symptoms, 65% had resolution of their symptoms within 6 months and 91% within 1 year. Flares most commonly occurred 16-24 months after implantation. On multivariate analysis, a greater baseline IPSS and greater maximal postimplant IPSS were the predictors of flare, regardless of the flare definition used. Androgen suppression was a predictor for fewer flares (IPSS >=5). Diabetes and prostate edema predicted for more frequent flares (IPSS >=8). Patients with flare had a greater incidence of RTOG Grade 3 urinary toxicity and RTOG Grade 2 or greater rectal toxicity. No association was found between erectile dysfunction and the occurrence of flare. Conclusion: Urinary symptom flare is a common, transient phenomenon after prostate brachytherapy. A greater baseline IPSS and maximal postimplant IPSS were the strongest predictive factors. Flare was associated with a greater incidence of late RTOG Grade 3 urinary toxicity and greater rate of late RTOG Grade

  1. Novel Silicone-Coated 125I Seeds for the Treatment of Extrahepatic Cholangiocarcinoma

    PubMed Central

    Zhang, Weixing; Cai, Xiaobo; Chen, Dafan; Wan, Xinjian

    2016-01-01

    125I seeds coated with titanium are considered a safe and effective interstitial brachytherapy for tumors, while the cost of 125I seeds is a major problem for the patients implanting lots of seeds. The aim of this paper was to develop a novel silicone coating for 125I seeds with a lower cost. In order to show the radionuclide utilization ratio, the silicone was coated onto the seeds using the electro-spinning method and the radioactivity was evaluated, then the anti-tumor efficacy of silicone 125I seeds was compared with titanium 125I seeds. The seeds were divided into four groups: A (control), B (pure silicone), C (silicone 125I), D (titanium 125I) at 2 Gy or 4 Gy. Their anti-tumour activity and mechanism were assessed in vitro and in vivo using a human extrahepatic cholangiocarcinoma cell line FRH-0201 and tumor-bearing BALB/c nude mice. The silicone 125I seeds showed higher radioactivity; the rate of cell apoptosis in vitro and the histopathology in vivo demonstrated that the silicone 125I seeds shared similar anti-tumor efficacy with the titanium 125I seeds for the treatment of extrahepatic cholangiocarcinoma, while they have a much lower cost. PMID:26840346

  2. Novel Silicone-Coated 125I Seeds for the Treatment of Extrahepatic Cholangiocarcinoma.

    PubMed

    Lin, Lizhou; Guo, Lili; Zhang, Weixing; Cai, Xiaobo; Chen, Dafan; Wan, Xinjian

    2016-01-01

    125I seeds coated with titanium are considered a safe and effective interstitial brachytherapy for tumors, while the cost of 125I seeds is a major problem for the patients implanting lots of seeds. The aim of this paper was to develop a novel silicone coating for 125I seeds with a lower cost. In order to show the radionuclide utilization ratio, the silicone was coated onto the seeds using the electro-spinning method and the radioactivity was evaluated, then the anti-tumor efficacy of silicone 125I seeds was compared with titanium 125I seeds. The seeds were divided into four groups: A (control), B (pure silicone), C (silicone 125I), D (titanium 125I) at 2 Gy or 4 Gy. Their anti-tumour activity and mechanism were assessed in vitro and in vivo using a human extrahepatic cholangiocarcinoma cell line FRH-0201 and tumor-bearing BALB/c nude mice. The silicone 125I seeds showed higher radioactivity; the rate of cell apoptosis in vitro and the histopathology in vivo demonstrated that the silicone 125I seeds shared similar anti-tumor efficacy with the titanium 125I seeds for the treatment of extrahepatic cholangiocarcinoma, while they have a much lower cost.

  3. Long-Term Efficacy and Toxicity of Low-Dose-Rate {sup 125}I Prostate Brachytherapy as Monotherapy in Low-, Intermediate-, and High-Risk Prostate Cancer

    SciTech Connect

    Kittel, Jeffrey A.; Reddy, Chandana A.; Smith, Kristin L.; Stephans, Kevin L.; Tendulkar, Rahul D.; Ulchaker, James; Angermeier, Kenneth; Campbell, Steven; Stephenson, Andrew; Klein, Eric A.; Wilkinson, D. Allan; Ciezki, Jay P.

    2015-07-15

    Purpose/Objectives: To report long-term efficacy and toxicity for a single-institution cohort of patients treated with low-dose-rate prostate brachytherapy permanent implant (PI) monotherapy. Methods and Materials: From 1996 to 2007, 1989 patients with low-risk (61.3%), intermediate-risk (29.8%), high-intermediate-risk (4.5%), and high-risk prostate cancer (4.4%) were treated with PI and followed up prospectively in a registry. All patients were treated with {sup 125}I monotherapy to 144 Gy. Late toxicity was coded retrospectively according to a modified Common Terminology Criteria for Adverse Events 4.0 scale. The rates of biochemical relapse-free survival (bRFS), distant metastasis-free survival (DMFS), overall survival (OS), and prostate cancer–specific mortality (PCSM) were calculated. We identified factors associated with late grade ≥3 genitourinary (GU) and gastrointestinal (GI) toxicity, bRFS, DMFS, OS, PCSM, and incontinence. Results: The median age of the patients was 67 years, and the median overall and prostate-specific antigen follow-up times were 6.8 years and 5.8 years, respectively. The overall 5-year rates for bRFS, DMFS, OS, and PCSM were 91.9%, 97.8%, 93.7%, and 0.71%, respectively. The 10-year rates were 81.5%, 91.5%, 76.1%, and 2.5%, respectively. The overall rates of late grade ≥3 GU and GI toxicity were 7.6% and 0.8%, respectively. On multivariable analysis, age and prostate length were significantly associated with increased risk of late grade ≥3 GU toxicity. The risk of incontinence was highly correlated with both pre-PI and post-PI transurethral resection of the prostate. Conclusions: Prostate brachytherapy as monotherapy is an effective treatment for low-risk and low-intermediate-risk prostate cancer and appears promising as a treatment for high-intermediate-risk and high-risk prostate cancer. Significant long-term toxicities are rare when brachytherapy is performed as monotherapy.

  4. Dosimetry of two new interstitial brachytherapy sources

    NASA Astrophysics Data System (ADS)

    Saidi, Pooneh; Sadeghi, Mahdi

    2011-01-01

    With increased demand for low 103Pd (palladium) seed sources, to treat prostate and eye cancers, new sources have been designed and introduced. This article presents the two new palladium brachytherapy sources, IR03-103Pd and IR04-103Pd that have been developed at Nuclear Science and Technology Research Institute. The dosimetry parameters such as the dose rate constant Λ, the radial dose function g(r), and the anisotropy function F(r,θ), around the sources have been characterized using Version 5 Monte Carlo radiation transport code in accordance with the update AAPM Task Group No. 43 report (TG-43U1). The results indicated the dose rate constant of 0.689±0.02 and 0.667±0.02 cGy h-1 U-1 for the IR03-103Pd and IR04-103Pd sources respectively, which are in acceptable agreement with other commercial seeds. The calculated results were compared with published results for those of other source manufacturers. However, they show an acceptable dose distribution, using for clinical applications is pending experimental dosimetry.

  5. Distortions induced by radioactive seeds into interstitial brachytherapy dose distributions.

    PubMed

    Zhou, Chuanyu; Inanc, Feyzi; Modrick, Joseph M

    2004-12-01

    In a previous article, we presented development and verification of an integral transport equation-based deterministic algorithm for computing three-dimensional brachytherapy dose distributions. Recently, we have included fluorescence radiation physics and parallel computation to the standing algorithms so that we can compute dose distributions for a large set of seeds without resorting to the superposition methods. The introduction of parallel computing capability provided a means to compute the dose distribution for multiple seeds in a simultaneous manner. This provided a way to study strong heterogeneity and shadow effects induced by the presence of multiple seeds in an interstitial brachytherapy implant. This article presents the algorithm for computing fluorescence radiation, algorithm for parallel computing, and display results for an 81-seed implant that has a perfect and imperfect lattice. The dosimetry data for a single model 6711 seeds is presented for verification and heterogeneity factor computations using simultaneous and superposition techniques are presented.

  6. Survival following interstitial brachytherapy for recurrent malignant glioma.

    PubMed

    Kitchen, N D; Hughes, S W; Taub, N A; Sofat, A; Beaney, R P; Thomas, D G

    1994-01-01

    The treatment of recurrent malignant glioma is difficult and at present largely disappointing. Furthermore the results of any treatment modality need to be interpreted with knowledge regarding patient selection and timing of treatment. The results of interstitial brachytherapy using iodine-125 in 23 patients are presented. There were no operative complications. Median survival time from tumour recurrence and implantation was 36 and 25 weeks respectively. Karnofsky Performance Status (KPS) was significantly associated with survival, though patient age, original tumour histology, prior chemotherapy, and time to recurrence were not. Treatment does confer modest survival benefit as compared to controls, but our results are not as impressive as others. Reasons for this finding are discussed.

  7. Prophylactic tamsulosin (Flomax) in patients undergoing prostate {sup 125}I brachytherapy for prostate carcinoma: Final report of a double-blind placebo-controlled randomized study

    SciTech Connect

    Elshaikh, Mohamed A.; Ulchaker, James C.; Reddy, Chandana A.; Angermeier, Kenneth W.; Klein, Eric A.; Chehade, Nabil; Altman, Andrew; Ciezki, Jay P. . E-mail: ciezkj@ccf.org

    2005-05-01

    Purpose: To evaluate the effectiveness of prophylactic tamsulosin (Flomax) in reducing the urinary symptoms in patients undergoing {sup 125}I prostate implantation (PI) for prostate adenocarcinoma. Methods and materials: This is a single-institution, double-blind, placebo-controlled, randomized trial for patients undergoing PI for prostate adenocarcinoma comparing prophylactic tamsulosin versus placebo. Eligibility criteria included patients not taking tamsulosin or other {alpha}-blockers treated with PI. The patients were randomly assigned to either tamsulosin (0.8 mg, orally once a day) or matched placebo. All patients started the medication 4 days before PI and continued for 60 days. The American Urologic Association (AUA) symptom index questionnaire was used to assess urinary symptoms. The AUA questionnaire was administered before PI for a baseline score and weekly for 8 weeks after PI. Patients were taken off the study if they developed urinary retention, had intolerable urinary symptoms, or wished to discontinue with the trial. Results: One hundred twenty-six patients were enrolled in this study from November 2001 to January 2003 (118 were evaluable: 58 in the tamsulosin arm and 60 in the placebo group). Pretreatment and treatment characteristics were comparably matched between the two groups. The urinary retention rate was 17% (10 patients) in the placebo group compared with 10% (6 patients) in the tamsulosin group (p = 0.3161). Eighty-eight percent (14 patients) of those who developed urinary retention experienced it within 2 weeks after the PI. Intolerable urinary symptoms were reported equally (10 patients in each group) with 70% occurring in the first 2 weeks after PI. There was a significant difference in mean AUA score in favor of tamsulosin at Week 5 after PI (p = 0.03). Conclusions: Prophylactic tamsulosin (0.8 mg/day) before prostate brachytherapy did not significantly affect urinary retention rates, but had a positive effect on urinary morbidity at

  8. Growth delay effect of combined interstitial hyperthermia and brachytherapy in a rat solid tumor model.

    PubMed

    Papadopoulos, D; Kimler, B F; Estes, N C; Durham, F J

    1989-01-01

    The rat mammary AC33 solid tumor model was used to investigate the efficacy of interstitial hyperthermia and/or brachytherapy. Subcutaneous flank tumors were heated with an interstitial microwave (915 MHz) antenna to a temperature of 43 +/- 0.5 degrees C for 45 min for two treatments, three days apart, and/or implanted with Ir-192 seeds for three days (-25 Gy tumor dose). Following treatments, tumors were measured 2 to 3 times per week. Hyperthermia alone produced a modest delay in tumor volume regrowth, while brachytherapy was substantially more effective. The combination produced a improvement in tumor regrowth delay compared to brachytherapy alone.

  9. Impact of prostate edema on cell survival and tumor control after permanent interstitial brachytherapy for early stage prostate cancers

    PubMed Central

    Chen, Zhe (Jay); Roberts, Kenneth; Decker, Roy; Pathare, Pradip; Rockwell, Sara; Nath, Ravinder

    2011-01-01

    Previous studies have shown that the procedure-induced prostate edema during permanent interstitial brachytherapy (PIB) can cause significant variations in the dose delivered to the prostate gland. Because the clinical impact of edema-induced dose variations depends strongly on the magnitude of the edema, the temporal pattern of its resolution and its interplay with the decay of radioactivity and the underlying biological processes of tumor cells (such as tumor potential doubling time), we investigated the impact of edema-induced dose variations on the tumor cell survival and tumor control probability after PIB with the 131Cs, 125I and 103Pd sources used in current clinical practice. The exponential edema resolution model reported by Waterman et al. (Int. J. Radiat. Oncol. Biol. Phys. 41, 1069–1077–1998) was used to characterize the edema evolutions observed previously during clinical PIB for prostate cancer. The concept of biologically effective dose (BED), taking into account tumor cell proliferation and sublethal damage repair during dose delivery, was used to characterize the effects of prostate edema on cell survival and tumor control probability. Our calculation indicated that prostate edema, if not taken into account appropriately, can increase the cell survival and decrease the probability of local control of PIB. The edema-induced increase in cell survival increased with increasing edema severity, decreasing half-life for radioactive decay and decreasing energy of the photons energy emitted by the source. At the doses currently prescribed for PIB and for prostate cancer cells characterized by nominal radiobiology parameters recommended by AAPM TG-137, PIB using 125I sources was less affected by edema than PIB using 131Cs or 103Pd sources due to the long radioactive decay half-life of 125I. The effect of edema on PIB using 131Cs or 103Pd was similar. The effect of edema on 103Pd PIB was slightly greater, even though the decay half-life of 103Pd (17 days

  10. The impact of prostate edema on cell survival and tumor control after permanent interstitial brachytherapy for early stage prostate cancers

    NASA Astrophysics Data System (ADS)

    (Jay Chen, Zhe; Roberts, Kenneth; Decker, Roy; Pathare, Pradip; Rockwell, Sara; Nath, Ravinder

    2011-08-01

    Previous studies have shown that procedure-induced prostate edema during permanent interstitial brachytherapy (PIB) can cause significant variations in the dose delivered to the prostate gland. Because the clinical impact of edema-induced dose variations strongly depends on the magnitude of the edema, the temporal pattern of its resolution and its interplay with the decay of radioactivity and the underlying biological processes of tumor cells (such as tumor potential doubling time), we investigated the impact of edema-induced dose variations on the tumor cell survival and tumor control probability after PIB with the 131Cs, 125I and 103Pd sources used in current clinical practice. The exponential edema resolution model reported by Waterman et al (1998 Int. J. Radiat. Oncol. Biol. Phys. 41 1069-77) was used to characterize the edema evolutions previously observed during clinical PIB for prostate cancer. The concept of biologically effective dose, taking into account tumor cell proliferation and sublethal damage repair during dose delivery, was used to characterize the effects of prostate edema on cell survival and tumor control probability. Our calculation indicated that prostate edema, if not appropriately taken into account, can increase the cell survival and decrease the probability of local control of PIB. The magnitude of an edema-induced increase in cell survival increased with increasing edema severity, decreasing half-life of radioactive decay and decreasing photon energy emitted by the source. At the doses currently prescribed for PIB and for prostate cancer cells characterized by nominal radiobiology parameters recommended by AAPM TG-137, PIB using 125I sources was less affected by edema than PIB using 131Cs or 103Pd sources due to the long radioactive decay half-life of 125I. The effect of edema on PIB using 131Cs or 103Pd was similar. The effect of edema on 103Pd PIB was slightly greater, even though the decay half-life of 103Pd (17 days) is longer than

  11. Reevaluation of the AAPM TG-43 brachytherapy dosimetry parameters for an 125I seed, and the influence of eye plaque design on dose distributions and dose-volume histograms

    NASA Astrophysics Data System (ADS)

    Aryal, Prakash

    The TG-43 dosimetry parameters of the Advantage(TM) 125I model IAI-125A brachytherapy seed were studied. An investigation using modern MCNP radiation transport code with updated cross-section libraries was performed. Twelve different simulation conditions were studied for a single seed by varying the coating thickness, mass density, photon energy spectrum and cross-section library. The dose rate was found to be 6.3% lower at 1 cm in comparison to published results. New TG-43 dosimetry parameters are proposed. The dose distribution for a brachytherapy eye plaque, model EP917, was investigated, including the effects of collimation from high-Z slots. Dose distributions for 26 slot designs were determined using Monte Carlo methods and compared between the published literature, a clinical treatment planning system, and physical measurements. The dosimetric effect of the composition and mass density of the gold backing was shown to be less than 3%. Slot depth, width, and length changed the central axis (CAX) dose distributions by < 1% per 0.1 mm in design variation. Seed shifts in the slot towards the eye and shifts of the 125I-laden silver rod within the seed had the greatest impact on the CAX dose distribution, changing it by 14%, 9%, 4.3%, and 2.7% at 1, 2, 5, and 10 mm, respectively, from the inner scleral surface. The measured, full plaque slot geometry delivered 2.4% +/- 1.1% higher dose along the plaque's CAX than the geometry provided by the manufacturer and 2.2%+/-2.3% higher than Plaque Simulator(TM) (PS) treatment planning software (version 5.7.6). The D10 for the simulated tumor, inner sclera, and outer sclera for the measured slot plaque to manufacturer provided slot design was 9%, 10%, and 19% higher, respectively. In comparison to the measured plaque design, a theoretical plaque having narrow and deep slots delivered 30%, 37%, and 62% lower D 10 doses to the tumor, inner sclera, and outer sclera, respectively. CAX doses at --1, 0, 1, and 2 mm were also

  12. Comparing the RTOG/EORTC and LENT-SOMA scoring systems for the evaluation of late skin toxicity after (125)I seed brachytherapy for parotid gland cancer.

    PubMed

    Mao, Ming-Hui; Feng, Zhien; Li, Hua; Qin, Li-Zheng; Li, Jian-Hua; Huang, Xin; Xing, Ru-Dong; Zhang, Jie; Zhang, Jian-Guo; Han, Zheng-Xue

    The Radiation Therapy Oncology Group (RTOG) and Late Effects Normal Tissue Task Force-Subjective, Objective, Management and Analytic (LENT-SOMA) scoring systems were compared for grading late skin effects after iodine-125 seed brachytherapy in parotid gland cancer patients. A total of 109 patients diagnosed with parotid gland carcinoma were treated postoperatively with iodine-125 seed brachytherapy at a dose of 100-120 Gy. After 6-24 months of followup, telangiectasia, skin pigmentation, atrophy, fibrosis, and ulceration were scored according to both RTOG and LENT-SOMA scale criteria. The strength of correlation between the scores and the interobserver variability were calculated. Of 109 patients, 22.9% had telangiectasia; 78.9%, pigmentation; 28.4%, fibrosis; 4.6%, edema; 0.9%, ulceration; 37.6%, retraction and/or atrophy; 22.9%, sensation change; and 11%, scaliness and/or roughness. Compared with RTOG, LENT-SOMA criteria resulted in the upgrading of pigmentation in 17% of cases, the downgrading of all instances of telangiectasia and the downgrading of one instance of Grade 4 ulceration to Grade 3. Between the two scales, fibrosis and atrophy correlated well (Spearman ρ, 0.992, 0.986). An additional 229 side effects were observed using LENT-SOMA criteria. The LENT-SOMA scale was more accurate than the RTOG scale for the evaluation of late skin and subcutaneous toxicity. The downgrading of telangiectasia and upgrading of pigmentation with the LENT-SOMA scale reflected the patients' conditions better than the scores obtained with the RTOG scale. The assessment of fibrosis and atrophy correlated well between the two scales. The use of the sum of the individual scores of the LENT-SOMA is therefore advocated. The addition of decreased sweating and the removal of the alopecia (scalp) metric should be considered to standardize the reporting of late radiation morbidity. Copyright © 2017 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  13. Review of the Poster 'Dosimetric Comparison of Gamma Knife Radiosurgery vs. {sup 125}I Plaque Brachytherapy in a Cohort of Choroidal Melanomas'

    SciTech Connect

    Odell, Kelly R.

    2009-07-01

    Historically, treatment for choroidal melanomas was surgical enucleation. Currently, treatment methods such as stereotactic radiosurgery and brachytherapy are being used to spare the eye. The poster 'Dosimetric Comparison of Gamma Knife Radiosurgery vs. I-125 Plaque Brachytherapy in a Cohort of Choroidal Melanomas' presented at ASTRO 2007 by Anderson et al. provides a comparison of these methods. The dose to disk, fovea and lens in 29 patients from a simulated I-125 treatment and a delivered Gamma Knife radiosurgery was compared. Thirty Gy was prescribed to the 50% Isodose line in the radiosurgery and 85 Gy was prescribed to the apex of the tumor in the I-125 simulation. It was found that the Gamma Knife spares the disk better in 59% of the tumors, including those {>=}6.5 mm in height; spares the fovea better in 69% of the tumors, including those {>=}5.5 mm; and spares lens better in only 30% of the tumors, with no distinction in size. Tumor location was not taken into account for this study, which could explain the variations in smaller tumors. For larger tumors, gamma knife will protect most organs at risk more effectively. This study shows how a tumor's parameters can be used in selecting treatment modality.

  14. Review of the poster "Dosimetric comparison of gamma knife radiosurgery vs. 125I plaque brachytherapy in a cohort of choroidal melanomas".

    PubMed

    Odell, Kelly R

    2009-01-01

    Historically, treatment for choroidal melanomas was surgical enucleation. Currently, treatment methods such as stereotactic radiosurgery and brachytherapy are being used to spare the eye. The poster "Dosimetric Comparison of Gamma Knife Radiosurgery vs. I-125 Plaque Brachytherapy in a Cohort of Choroidal Melanomas" presented at ASTRO 2007 by Anderson et al. provides a comparison of these methods. The dose to disk, fovea and lens in 29 patients from a simulated I-125 treatment and a delivered Gamma Knife radiosurgery was compared. Thirty Gy was prescribed to the 50% Isodose line in the radiosurgery and 85 Gy was prescribed to the apex of the tumor in the I-125 simulation. It was found that the Gamma Knife spares the disk better in 59% of the tumors, including those >or=6.5 mm in height; spares the fovea better in 69% of the tumors, including those >or=5.5 mm; and spares lens better in only 30% of the tumors, with no distinction in size. Tumor location was not taken into account for this study, which could explain the variations in smaller tumors. For larger tumors, gamma knife will protect most organs at risk more effectively. This study shows how a tumor's parameters can be used in selecting treatment modality.

  15. [The use of disposable vascular catheters in interstitial brachytherapy of skin cancers (author's transl)].

    PubMed

    Daly, N J; Malissard, L; Douchez, J; Combes, P F

    1978-05-01

    Authors present technical improvements dealing with interstitial brachytherapy (Ir192) of skin cancers. They use fine disposable plastic tubes fitted with mandril, which allow loading of light radioactive material in any case. Short term results are discussed according to 101 applications.

  16. Electromagnetic tracking for treatment verification in interstitial brachytherapy

    PubMed Central

    Kellermeier, Markus; Tanderup, Kari

    2016-01-01

    Electromagnetic tracking (EMT) is used in several medical fields to determine the position and orientation of dedicated sensors, e.g., attached to surgical tools. Recently, EMT has been introduced to brachytherapy for implant reconstruction and error detection. The manuscript briefly summarizes the main issues of EMT and error detection in brachytherapy. The potential and complementarity of EMT as treatment verification technology will be discussed in relation to in vivo dosimetry and imaging. PMID:27895688

  17. Evaluation of neuropathic pain occurring after high-dose-rate interstitial brachytherapy of oral tongue

    PubMed Central

    Sharma, Suresh C.; Kapoor, Rakesh; Ahuja, Chirag K.; Oinam, Arun S.; Ghoshal, Sushmita

    2015-01-01

    Purpose To recognize neuropathic pain as a complication of high-dose-rate (HDR) interstitial brachytherapy of oral tongue and to evaluate the possible causes of neuropathy. Material and methods Twenty one patients who underwent interstitial brachytherapy for early cancer of oral tongue were evaluated. The patients either underwent primary brachytherapy (42-48 Gy at 3-4 Gy/fraction) or a boost (18-24 Gy at 3 Gy/fraction) after external radiation to 40 Gy. Lingual nerve was the nerve concerned and the sublingual space (SLS) was contoured as its surrogate. Dosimetric parameters were correlated with onset of pain. Results Ten patients out of 21 (47.61%) developed painful neuropathy. Five patients of six (5/6) who underwent primary brachytherapy developed neuropathy. Five out of 15 (5/15) patients who underwent brachytherapy as a boost developed neuropathy. The patients who underwent primary brachytherapy were ten times more likely to develop neuropathy. Among the patients receiving boost treatment, the equivalent dose at 2 Gy/fraction (EQD2) to 2 cc of SLS was higher (39.25 Gy) in the patients who developed pain compared to those without pain (10.29 Gy). Conclusions This is the first report to recognize neuropathic pain as a complication of HDR brachytherapy of oral tongue. Patients undergoing primary brachytherapy were more likely to develop pain. Among other factors like dose to SLS, number of catheters, size of the primary tumor, and the dose rate, only dose to 2 cc of the SLS correlated with onset of pain. The SLS (containing the lingual nerve) may be considered an organ at risk to prevent the occurrence of this complication. PMID:26034495

  18. Air density dependence of the response of the PTW SourceCheck 4pi ionization chamber for (125)I brachytherapy seeds.

    PubMed

    Torres Del Río, J; Tornero-López, A M; Guirado, D; Pérez-Calatayud, J; Lallena, A M

    2017-06-01

    To analyze the air density dependence of the response of the new SourceCheck 4pi ionization chamber, manufactured by PTW. The air density dependence of three different SourceCheck 4pi chambers was studied by measuring (125)I sources. Measurements were taken by varying the pressure from 746.6 to 986.6hPa in a pressure chamber. Three different HDR 1000 Plus ionization chambers were also analyzed under similar conditions. A linear and a potential-like function of the air density were fitted to experimental data and their achievement in describing them was analyzed. SourceCheck 4pi chamber response showed a residual dependence on the air density once the standard pressure and temperature factor was applied. The chamber response was overestimated when the air density was below that under normal atmospheric conditions. A similar dependence was found for the HDR 1000 Plus chambers analyzed. A linear function of the air density permitted a very good description of this residual dependence, better than with a potential function. No significant variability between the different specimens of the same chamber model studied was found. The effect of overestimation observed in the chamber responses once they are corrected for the standard pressure and temperature may represent a non-negligible ∼4% overestimation in high altitude cities as ours (700m AMSL). This overestimation behaves linearly with the air density in all cases analyzed. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  19. Dose optimization in gynecological 3D image based interstitial brachytherapy using martinez universal perineal interstitial template (MUPIT) -an institutional experience

    PubMed Central

    Sharma, Pramod Kumar; Sharma, Praveen Kumar; Swamidas, Jamema V; Mahantshetty, Umesh; Deshpande, D. D.; Manjhi, Jayanand; Rai, D V

    2014-01-01

    The aim of this study was to evaluate the dose optimization in 3D image based gynecological interstitial brachytherapy using Martinez Universal Perineal Interstitial Template (MUPIT). Axial CT image data set of 20 patients of gynecological cancer who underwent external radiotherapy and high dose rate (HDR) interstitial brachytherapy using MUPIT was employed to delineate clinical target volume (CTV) and organs at risk (OARs). Geometrical and graphical optimization were done for optimum CTV coverage and sparing of OARs. Coverage Index (CI), dose homogeneity index (DHI), overdose index (OI), dose non-uniformity ratio (DNR), external volume index (EI), conformity index (COIN) and dose volume parameters recommended by GEC-ESTRO were evaluated. The mean CTV, bladder and rectum volume were 137 ± 47cc, 106 ± 41cc and 50 ± 25cc, respectively. Mean CI, DHI and DNR were 0.86 ± 0.03, 0.69 ± 0.11 and 0.31 ± 0.09, while the mean OI, EI, and COIN were 0.08 ± 0.03, 0.07 ± 0.05 and 0.79 ± 0.05, respectively. The estimated mean CTV D90 was 76 ± 11Gy and D100 was 63 ± 9Gy. The different dosimetric parameters of bladder D2cc, D1cc and D0.1cc were 76 ± 11Gy, 81 ± 14Gy, and 98 ± 21Gy and of rectum/recto-sigmoid were 80 ± 17Gy, 85 ± 13Gy, and 124 ± 37Gy, respectively. Dose optimization yields superior coverage with optimal values of indices. Emerging data on 3D image based brachytherapy with reporting and clinical correlation of DVH parameters outcome is enterprizing and provides definite assistance in improving the quality of brachytherapy implants. DVH parameter for urethra in gynecological implants needs to be defined further. PMID:25190999

  20. Radioactive seed migration following parotid gland interstitial brachytherapy.

    PubMed

    Fan, Yi; Huang, Ming-Wei; Zhao, Yi-Jiao; Gao, Hong; Zhang, Jian-Guo

    2017-09-15

    To evaluate the incidence and associated factors of pulmonary seed migration after parotid brachytherapy using a novel migrated seed detection technique. Patients diagnosed with parotid cancer who underwent permanent parotid brachytherapy from January 2006 to December 2011 were reviewed retrospectively. Head and neck CT scans and chest X-rays were evaluated during routine follow-up. Mimics software and Geomagic Studio software were used for seed reconstruction and migrated seed detection from the original implanted region, respectively. Postimplant dosimetry analysis was performed after seeds migration if the seeds were still in their emitting count. Adverse clinical sequelae from seed embolization to the lung were documented. The radioactive seed implants were identified on chest X-rays in 6 patients. The incidence rate of seed migration in 321 parotid brachytherapy patients was 1.87% (6/321) and that of individual seed migration was 0.04% (6/15218 seeds). All migrated seeds were originally from the retromandibular region. No adverse dosimetric consequences were found in the target region. Pulmonary symptoms were not reported by any patient in this study. In our patient set, migration of radioactive seeds with an initial radioactivity of 0.6-0.7 mCi to the chest following parotid brachytherapy was rare. Late migration of a single seed from the central target region did not affect the dosimetry significantly, and patients did not have severe short-term complications. This study proposed a novel technique to localize the anatomical origin of the migrated seeds during brachytherapy. Our evidence suggested that placement of seeds adjacent to blood vessels was associated with an increased likelihood of seed migration to the lungs. Copyright © 2017 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  1. Clinical application of computed tomography-guided (125)I seed interstitial implantation for head and neck cancer patients with unmanageable cervical lymph node metastases.

    PubMed

    Huang, Hai; Xu, Shaonian; Li, Fusheng; Du, Zhenguang; Wang, Liang

    2016-04-27

    To assess clinical application of computed tomography (CT)-guided (125)I seed implantation for patients who cannot endure or unwillingly receive repeated surgery, chemotherapy, or radiotherapy for unmanageable cervical lymph node metastases in head and neck cancer (HNC). Thirty-one consecutive patients received CT-guided (125)I seed implantation between February 2010 and December 2013. To evaluate the clinical efficiency, karnofsky performance score (KPS), numeric rating scale (NRS), and tumor volume at 3-, and 6-month post-implantation were compared with pre-implantation, along with local control rate (LCR), overall survival rate (OSR), and complications at 3, 6 months, 1, and 2 years. The tumor volume was obviously decreased at 3-, and 6-month post-implantation (21.23 ± 8.83 versus 9.19 ± 7.52 cm(2); 21.23 ± 8.83 versus 6.42 ± 9.79 cm(2); P < 0.05) compared with pre-implantation. The NRS was statistically reduced (3.06 ± 1.06 versus 7.77 ± 0.92; 2.39 ± 1.15 versus 7.77 ± 0.92; P < 0.05), while KPS was significantly improved (83.18 ± 5.97 versus 73.60 ± 7.90; 82.86 ± 5.43 versus 73.60 ± 7.90; P < 0.05) postoperatively at 3 and 6 months, respectively. The LCR at 3, 6 months, 1, and 2 years was 96.30, 83.87, 64.51, and 45.16%, respectively. The OSR was 100, 100, 67.74, and 45.16%, respectively. Three cases experienced grade I and two had grade II acute radiation toxicity. CT-guided seed implantation may be feasible and safe for HNC patients whose neck nodes are not manageable by routine strategies with fewer complications, higher LCR, and significant pain relief.

  2. Functional imaging of interstitial brachytherapy in pancreatic carcinoma xenografts using spectral CT: how does iodine concentration correlate with standardized uptake value of 18FDG-PET-CT?

    PubMed Central

    Hu, Shudong; Shi, Xiaofeng; Chen, Yerong; Huang, Wei; Song, Qi; Lin, Xiaozhu; Liu, Yu; Chen, Kemin

    2016-01-01

    Objective: This study aimed to investigate the correlation between iodine concentration (IC) for the quantitative analysis of spectral CT and maximum standardized uptake value (SUVmax) of 18 fludeoxyglucose positron emission tomography–CT (18FDG PET–CT) as an indicator of therapeutic response to interstitial brachytherapy in transplanted human pancreatic carcinomas in BALB/c-nu mice. Methods: Xenograft models were created by subcutaneous injection of SW1990 human pancreatic cancer cell suspensions into immunodeficient BALB/c-nu mice. 30 mice bearing SW1990 human pancreatic cancer cell xenografts were randomly separated into two groups: experimental (n = 15; 1.0 mCi) and control (n = 15, 0 mCi). After 2 weeks of treatment, spectral CT and 18FDG micro-PET–CT scan were performed. IC values and SUVmax in the lesions were measured. IC normalized to the muscle tissue is indicated as nIC. The relationships between the nIC and SUVmax of the transplantation tumours were analysed. Results: 2 weeks after treatment, the nIC in three-phase scans and SUVmax of the experimental group were significantly lower than those of the control group. The nIC values of the three-phase scans have certain positive correlation with the SUVmax values (r = 0.69, p < 0.05; r = 0.73 and p < 0.05; r = 0.80, p < 0.05 in the 10-, 25- and 60-s phase, respectively). Conclusion: Spectral CT could serve as a valuable imaging modality, as our results suggest that nIC correlates with SUVmax of 18FDG PET–CT for evaluating the therapeutic effect of 125I interstitial brachytherapy in a pancreatic carcinoma xenograft. Advances in knowledge: Spectral CT offers opportunities to assess the therapeutic response of pancreatic cancer. This study supports the conclusion that nIC values in spectral CT could also serve as a valuable functional imaging parameter for early monitoring and evaluation of the therapeutic response of 125I interstitial brachytherapy mouse models

  3. Functional imaging of interstitial brachytherapy in pancreatic carcinoma xenografts using spectral CT: how does iodine concentration correlate with standardized uptake value of (18)FDG-PET-CT?

    PubMed

    Hu, Shudong; Shi, Xiaofeng; Chen, Yerong; Huang, Wei; Song, Qi; Lin, Xiaozhu; Liu, Yu; Chen, Kemin; Wang, Zhongmin

    2016-01-01

    This study aimed to investigate the correlation between iodine concentration (IC) for the quantitative analysis of spectral CT and maximum standardized uptake value (SUVmax) of 18 fludeoxyglucose positron emission tomography-CT ((18)FDG PET-CT) as an indicator of therapeutic response to interstitial brachytherapy in transplanted human pancreatic carcinomas in BALB/c-nu mice. Xenograft models were created by subcutaneous injection of SW1990 human pancreatic cancer cell suspensions into immunodeficient BALB/c-nu mice. 30 mice bearing SW1990 human pancreatic cancer cell xenografts were randomly separated into two groups: experimental (n = 15; 1.0 mCi) and control (n = 15, 0 mCi). After 2 weeks of treatment, spectral CT and (18)FDG micro-PET-CT scan were performed. IC values and SUVmax in the lesions were measured. IC normalized to the muscle tissue is indicated as nIC. The relationships between the nIC and SUVmax of the transplantation tumours were analysed. 2 weeks after treatment, the nIC in three-phase scans and SUVmax of the experimental group were significantly lower than those of the control group. The nIC values of the three-phase scans have certain positive correlation with the SUVmax values (r = 0.69, p < 0.05; r = 0.73 and p < 0.05; r = 0.80, p < 0.05 in the 10-, 25- and 60-s phase, respectively). Spectral CT could serve as a valuable imaging modality, as our results suggest that nIC correlates with SUVmax of (18)FDG PET-CT for evaluating the therapeutic effect of (125)I interstitial brachytherapy in a pancreatic carcinoma xenograft. Spectral CT offers opportunities to assess the therapeutic response of pancreatic cancer. This study supports the conclusion that nIC values in spectral CT could also serve as a valuable functional imaging parameter for early monitoring and evaluation of the therapeutic response of (125)I interstitial brachytherapy mouse models because the nIC correlates with the SUVmax of (18)FDG PET-CT.

  4. Potential role of ultrasound imaging in interstitial image based cervical cancer brachytherapy

    PubMed Central

    2014-01-01

    In 2012, more than 500,000 cases of cervical cancer were diagnosed worldwide. Over three quarters of these cases occur in less developed countries [1]. Advancements in image-guided brachytherapy are resulting in improved outcomes and reduced morbidity for women with this disease, but its worldwide adoption is hampered by lack of accessibility to advanced imaging techniques. Ultrasound is emerging as a potential option for tumor visualization, brachytherapy catheter placement, and treatment planning. While additional work is needed, ultrasound can potentially serve as the sole imaging modality for catheter insertion and planning. This paper will review our current knowledge on the use of ultrasound in interstitial brachytherapy treatment for cervical cancer. PMID:25097565

  5. A new, simple method of making a spacer in interstitial brachytherapy for mobile tongue cancer.

    PubMed

    Yuasa, K; Kawazu, T; Morita, M; Uehara, S; Kunitake, N; Kanda, S

    2000-04-01

    This article demonstrates a new method of making a spacer that increases the distance between the mandible and implanted radioactive sources in interstitial brachytherapy for patients with mobile tongue cancer. Fifty-three patients with mobile tongue cancer underwent interstitial brachytherapy with spacers made by this new technique. Our spacer is not difficult to create or to use. The spacer was made from a plastic splint by using thermoforming techniques and quick self-curing resin, which did not need waxing, wiring, or casting. The surface of the spacer, which comes in contact with the tongue, is smooth because it is covered with tissue-conditioning material. There were no complaints of pain from the patients. Osteoradionecrosis of the mandible developed in only 1 (1.9%) of these patients. This spacer is simple to make and prevented osteoradionecrosis.

  6. Comparison of accelerated partial breast irradiation via multicatheter interstitial brachytherapy versus whole breast radiation

    PubMed Central

    2012-01-01

    Background Brachytherapy as adjuvant treatment for early-stage breast cancer has become widely available and offers patients an expedited treatment schedule. Given this, many women are electing to undergo brachytherapy in lieu of standard fractionation radiotherapy. We compare outcomes between patients treated with accelerated partial breast irradiation (APBI) via multicatheter interstitial brachytherapy versus patients who were also eligible for and offered APBI but who chose whole breast radiation (WBI). Methods Patients treated from December 2002 through May 2007 were reviewed. Selection criteria included patients with pTis-T2N0 disease, ≤ 3 cm unifocal tumors, and negative margins who underwent breast conservation surgery. Local control (LC), cause-specific (CSS) and overall survival (OS) were analyzed. Results 202 patients were identified in the APBI cohort and 94 patients in the WBI cohort. Median follow-up for both groups exceeded 60 months. LC was 97.0% for the APBI cohort and 96.2% for the WBI cohort at 5 years (ns). Classification by 2010 ASTRO APBI consensus statement categories did not predict worse outcomes. Conclusion APBI via multicatheter interstitial brachytherapy provides similar local failure rates compared to WBI at 5 years for properly selected patients. Excellent results were seen despite the high fraction of younger patients (< 60 years old) and patients with DCIS. PMID:22458887

  7. The role of interstitial brachytherapy in the management of primary radiation therapy for uterine cervical cancer

    PubMed Central

    Kobayashi, Kazuma; Kato, Tomoyasu; Nakamura, Satoshi; Wakita, Akihisa; Okamoto, Hiroyuki; Shima, Satoshi; Tsuchida, Keisuke; Kashihara, Tairo; Harada, Ken; Takahashi, Kana; Umezawa, Rei; Inaba, Koji; Ito, Yoshinori; Igaki, Hiroshi; Itami, Jun

    2016-01-01

    Purpose The aim of this study was to report the clinical results of uterine cervical cancer patients treated by primary radiation therapy including brachytherapy, and investigate the role of interstitial brachytherapy (ISBT). Material and methods All consecutive uterine cervical cancer patients who were treated by primary radiation therapy were reviewed, and those who were treated by ISBT were further investigated for clinical outcomes and related toxicities. Results From December 2008 to October 2014, 209 consecutive uterine cervical cancer patients were treated with primary radiation therapy. Among them, 142 and 42 patients were treated by intracavitary and hybrid brachytherapy, respectively. Twenty-five patients (12%) were treated by high-dose-rate (HDR)-ISBT. Five patients with distant metastasis other than para-aortic lymph node were excluded, and 20 patients consisted of the analysis. Three-year overall survival (OS), progression-free survival (PFS), and local control (LC) rate were 44.4%, 38.9%, and 87.8%, respectively. Distant metastasis was the most frequent site of first relapse after HDR-ISBT. One and four patients experienced grade 3 and 2 rectal bleeding, one grade 2 cystitis, and two grade 2 vaginal ulcer. Conclusions Feasibility and favorable local control of interstitial brachytherapy for locally advanced cervical cancer was demonstrated through a single institutional experience with a small number of patients. PMID:27895680

  8. Salvage high-dose-rate interstitial brachytherapy for locally recurrent rectal cancer*

    PubMed Central

    Pellizzon, Antônio Cássio Assis

    2016-01-01

    For tumors of the lower third of the rectum, the only safe surgical procedure is abdominal-perineal resection. High-dose-rate interstitial brachytherapy is a promising treatment for local recurrence of previously irradiated lower rectal cancer, due to the extremely high concentrated dose delivered to the tumor and the sparing of normal tissue, when compared with a course of external beam radiation therapy. PMID:27403021

  9. Development of an open source software module for enhanced visualization during MR-guided interstitial gynecologic brachytherapy.

    PubMed

    Chen, Xiaojun; Egger, Jan

    2014-01-01

    In 2010, gynecologic malignancies were the 4th leading cause of death in U.S. women and for patients with extensive primary or recurrent disease, treatment with interstitial brachytherapy may be an option. However, brachytherapy requires precise insertion of hollow catheters with introducers into the tumor in order to eradicate the cancer. In this study, a software solution to assist interstitial gynecologic brachytherapy has been investigated and the software has been realized as an own module under (3D) Slicer, which is a free open source software platform for (translational) biomedical research. The developed research module allows on-time processing of intra-operative magnetic resonance imaging (iMRI) data over a direct DICOM connection to a MR scanner. Afterwards follows a multi-stage registration of CAD models of the medical brachytherapy devices (template, obturator) to the patient's MR images, enabling the virtual placement of interstitial needles to assist the physician during the intervention.

  10. Primary peritoneal clear cell carcinoma treated with IMRT and interstitial HDR brachytherapy: a case report.

    PubMed

    Johnson, Skyler B; Prisciandaro, Joann I; Zhou, Jessica; Hadley, Scott W; Reynolds, R Kevin; Jolly, Shruti

    2014-01-06

    Primary peritoneal clear cell carcinoma (PP-CCC), which is a rare tumor with poor prognosis, is typically managed with surgery and/or chemotherapy. We present a unique treatment approach for a patient with a pelvic PP-CCC, consisting of postchemotherapy intensity-modulated radiation therapy (IMRT) followed by interstitial high-dose-rate (HDR) brachytherapy. A 54-year-old female with an inoperable pelvic-supravaginal 5.6 cm T3N0M0 PP-CCC tumor underwent treatment with 6 cycles of carboplatin and taxol chemotherapy. Postchemotherapy PET/CT scan revealed a residual 3.3 cm tumor. The patient underwent CT and MR planning simulation, and was treated with 50 Gy to the primary tumor and 45 Gy to the pelvis including the pelvic lymph nodes, using IMRT to spare bowel. Subsequently, the patient was treated with an interstitial HDR brachytherapy implant, planned using both CT and MR scans. A total dose of 15 Gy in 5 Gy fractions over two days was delivered with Ir-192 HDR brachytherapy. The total prescribed equivalent 2 Gy dose (EQD2) to the HDR planning target volume (PTV) from both the EBRT and HDR treatments ranged between 63 and 68.8 Gy2 due to differential dosing of the primary and pelvic targets. The patient tolerated radiotherapy well, except for mild diarrhea not requiring medication. There was no patient-reported acute toxicity one month following the radiotherapy course. At four months following adjuvant radiation therapy, the patient had near complete resolution of local tumor on PET/CT without any radiation-associated toxicity. However, the patient was noted to have metastatic disease outside of the radiation field, specifically lesions in the liver and bone. This case report illustrates the feasibility of the treatment of a pelvic PP-CCC with IMRT followed by interstitial HDR brachytherapy boost, which resulted in near complete local tumor response without significant morbidity.

  11. American Brachytherapy Society recommends no change for prostate permanent implant dose prescriptions using iodine-125 or palladium-103.

    PubMed

    Rivard, Mark J; Butler, Wayne M; Devlin, Phillip M; Hayes, John K; Hearn, Robert A; Lief, Eugene P; Meigooni, Ali S; Merrick, Gregory S; Williamson, Jeffrey F

    2007-01-01

    In 2004, the American Association of Physicists in Medicine (AAPM) issued a report outlining recommended 125I and 103Pd datasets for consistency in calculating brachytherapy dose distributions. In 2005, to aid evaluating the clinical impact of implementing these datasets, the AAPM assessed the historical dependence of how prescribed doses differed from administered doses for 125I and 103Pd for permanent implantation of the prostate. Consequently, the American Brachytherapy Society (ABS) considered the nature of these changes towards issuing recommended dose prescriptions for 125I and 103Pd interstitial brachytherapy implants for monotherapy and standard boosts. An investigation was performed of the 2005 AAPM analysis to determine changes in administered dose while affixing prescribed dose using 2004 AAPM 125I and 103Pd brachytherapy dosimetry datasets for prostate implants. For 125I and 103Pd, administered dose would change by +1.4% and +4.2%, respectively. The biological and societal impact of changing prescribed dose was considered. Based on the need for clinical constancy and in recognition of overall uncertainties, the ABS recommends immediate implementation of the 2004 AAPM consensus brachytherapy dosimetry datasets and no changes to 125I and 103Pd dose prescriptions at this time. Radiation oncologists should continue to prescribe monotherapy doses of 145 Gy and 125 Gy for 125I and 103Pd, respectively, and standard boost doses of 100-110 Gy and 90-100 Gy for 125I and 103Pd, respectively.

  12. Dosimetry of the 198Au Source used in Interstitial Brachytherapy

    SciTech Connect

    Dauffy, L; Braby, L; Berner, B

    2004-05-18

    The American Association of Physicists in Medicine Task Group 43 report, AAPM TG-43, provides an analytical model and a dosimetry protocol for brachytherapy dose calculations, as well as documentation and results for some sealed sources. The radionuclide {sup 198}Au (T{sub 1/2} = 2.70 days, E{gamma} = 412 keV) has been used in the form of seeds for brachytherapy treatments including brain, eye, and prostate tumors. However, the TG-43 report has no data for {sup 198}Au seeds, and none have previously been obtained. For that reason, and because of the conversion of most treatment planning systems to TG-43 based methods, both Monte Carlo calculations (MCNP 4C) and thermoluminescent dosimeters (TLDs) are used in this work to determine these data. The geometric variation in dose is measured using an array of TLDs in a solid water phantom, and the seed activity is determined using both a well ion chamber and a High Purity Germanium detector (HPGe). The results for air kerma strength, S{sub k}, per unit apparent activity, are 2.06 (MCNP) and 2.09 (measured) U mCi{sup -1}. The former is identical to what was published in 1991 in the AAPM Task Group 32 report. The dose rate constant results, {Lambda}, are 1.12 (MCNP) and 1.10 (measured), cGy h{sup -1} U{sup -1}. The radial dose function, g(r), anisotropy function, F(r,{theta}), and anisotropy factor, {psi}{sub an}(r), are given. The anisotropy constant values are 0.973 (MCNP) and 0.994 (measured) and are consistent with both source geometry and the emitted photon energy.

  13. Toxicity associated with bowel or bladder puncture during gynecologic interstitial brachytherapy.

    PubMed

    Shah, Anand P; Strauss, Jonathan B; Gielda, Benjamin T; Zusag, Thomas W

    2010-05-01

    Interstitial brachytherapy for gynecologic malignancies is associated with significant toxicity. Some reports have correlated this toxicity with needle puncture of the visceral organs. This study examined our experience with interstitial brachytherapy and investigated the relationship between the visceral puncture and toxicity. The outcomes of 36 patients treated with interstitial brachytherapy for gynecologic malignancies at a single institution between 2002 and 2007 were reviewed. Computed tomography was used to guide needle placement based solely on tumor coverage. No attempts were made to avoid visceral puncture; however, the source dwell times were minimized in these areas. At a median follow-up of 21 months, the crude locoregional control rate was 78%. Bowel puncture was noted in 26 patients and bladder puncture in 19. The mean operating time was 50 min, and 86% of patients were discharged in

  14. 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

  15. Interstitial high-dose-rate brachytherapy in locally advanced and recurrent vulvar cancer

    PubMed Central

    Białas, Brygida; Fijałkowski, Marek; Wojcieszek, Piotr; Szlag, Marta; Cholewka, Agnieszka; Ślęczka, Maciej; Kołosza, Zofia

    2016-01-01

    Purpose The aim of the study was to report our experience with high-dose-rate interstitial brachytherapy (HDR-ISBT) in locally advanced and recurrent vulvar cancer. Material and methods Between 2004 and 2014, fourteen women with locally advanced or recurrent vulvar cancer were treated using HDR-ISBT in our Centre. High-dose-rate interstitial brachytherapy was performed as a separate treatment or in combination with external beam radiotherapy (EBRT) (given prior to brachytherapy). Results Patients were divided into: group I (n = 6) with locally advanced tumors, stages III-IVA after an incisional biopsy only, and group II (n = 8) with recurrent vulvar cancer after previous radical surgery. In group I, median follow up was 12 months (range 7-18 months); 1-year overall survival (OS) was 83%. Transient arrest of cancer growth or tumor regression was noticed in all patients but 4/6 developed relapse. Median time to failure was 6.3 months (range 3-11 months). The 1-year progression-free survival (PFS) was 33%. In group II, median follow up was 28 months (range 13-90 months). The 1-year and 3-year OS was 100% and 80%, respectively. The arrest of cancer growth or tumor regression was achieved in all patients. In 4/8 patients neither clinical nor histological symptoms of relapse were observed but 4/8 women experienced relapse. Median time to failure was 31 months (range 13-76 months). The 1-year and 3-year PFS was 100% and 62.5%, respectively. Two patients (14.3%) in group II had severe late toxicity (G3). Conclusions High-dose-rate interstitial brachytherapy is a well-tolerated treatment option in selected patients with advanced or recurrent vulvar cancer. It is a safe and effective treatment modality for advanced and recurrent vulvar cancer, yielding good local control with acceptable late treatment related side effects. In our study, patients with recurrent vulvar cancer had better results in HDR-ISBT treatment, probably because of the smaller tumor volume. This

  16. Assessment of dose homogeneity in conformal interstitial breast brachytherapy with special respect to ICRU recommendations

    PubMed Central

    Fröhlich, Georgina; Polgar, Csaba

    2011-01-01

    Purpose To present the results of dose homogeneity analysis for breast cancer patients treated with image-based conformal interstitial brachytherapy, and to investigate the usefulness of the ICRU recommendations. Material and methods Treatment plans of forty-nine patients who underwent partial breast irradiation with interstitial brachytherapy were analyzed. Quantitative parameters were used to characterize dose homogeneity. Dose non-uniformity ratio (DNR), dose homogeneity index (DHI), uniformity index (UI) and quality index (QI) were calculated. Furthermore, parameters recommended by the ICRU 58 such as minimum target dose (MTD), mean central dose (MCD), high dose volume, low dose volume and the spread between local minimum doses were determined. Correlations between the calculated homogeneity parameters and usefulness of the ICRU parameters in image-based brachytherapy were investigated. Results Catheters with mean number of 15 (range: 6-25) were implanted in median 4 (range: 3-6) planes. The volume of the PTV ranged from 15.5 cm3 to 176 cm3. The mean DNR was 0.32, the DHI 0.66, the UI 1.49 and the QI 1.94. Related to the prescribed dose, the MTD was 69% and the MCD 135%. The mean high dose volume was 8.1 cm3 (10%), while the low dose volume was 63.8 cm3 (96%). The spread between minimum doses in central plane ranged from −14% to +20%. Good correlation was found between the DNR and the DHI (R2=0.7874), and the DNR correlated well with the UI (R2=0.7615) also. No correlation was found between the ICRU parameters and any other volumetric parameters. Conclusions To characterize the dose uniformity in high-dose rate breast implants, DVH-related homogeneity parameters representing the full 3D dose distributions are mandatory to be used. In many respects the current recommendations of the ICRU Report 58 are already outdated, and it is well-timed to set up new recommendations, which are more feasible for image-guided conformal interstitial brachytherapy. PMID

  17. Stereotactic interstitial brachytherapy of malignant astrocytomas with remarks on postimplantation computed tomographic appearance

    SciTech Connect

    Willis, B.K.; Heilbrun, M.P.; Sapozink, M.D.; McDonald, P.R.

    1988-09-01

    Seventeen patients were treated with stereotactically implanted high activity iodine-125 seeds, 12 patients for recurrent malignant astrocytomas (Protocol I) and 5 patients for newly diagnosed glioblastomas (Protocol II). Total radiation dosage to the recurrent tumors in Protocol I, including prior external beam irradiation, averaged 13,500 cGy. In the follow-up period of 6 to 50 months, the survival rate was 93% at 6 months, 60% at 12 months, 50% at 18 months, and 38% at 24 months after implantation. In Protocol II, brachytherapy was used as an interstitial radiation boost to the conventional treatment of newly diagnosed glioblastomas. External beam therapy and interstitial brachytherapy provided 11,000 cGy to these tumors. In the follow-up period of 15 to 27 months, there was a 100% survival at 12 months, 75% at 18 months, and 25% at 24 months after implantation. Eight of our 17 patients required reoperation for persistent or recurrent mass lesions at 6 to 15 months postimplantation; 7 were found to harbor masses of radionecrosis containing nests of anaplastic astrocytes; 1 had frank tumor recurrence. Median survival in this group of patients requiring reoperation was 18.7 months postimplantation. In a review of postimplantation computed tomographic scans, significant mass effect and crossover of hypodensity or enhancement into the corpus callosum or opposite hemisphere were found to have prognostic significance; persistent areas of contrast enhancement and excessive peritumoral hypodensity did not.

  18. Outpatient combined intracavitary and interstitial cervical brachytherapy: barriers and solutions to implementation of a successful programme – a single institutional experience

    PubMed Central

    Tan, Poh Wee; Koh, Vicky Y.

    2015-01-01

    Involvement of parametrial disease in locally advanced cervical patients poses a challenge for women undergoing brachytherapy. Current use of the Fletcher suit applicator may not adequately cover the high risk clinical target volume (HR CTV), especially in the parametrial region due to the physical qualities of brachytherapy from the inverse square law and the need to respect organs at risk (OAR) constraints, and leads to lower local control rates. Combined intracavitary and interstitial brachytherapy with the use of 1 or 2 interstitial needles allows adequate coverage of the HR CTV and the clinical evidence have demonstrated a correlation with better clinical results. This procedure is often resource intensive, requiring inpatient stay and magnetic resonance imaging (MRI) planning. In departments where such resources are limited, there is a poor uptake of interstitial brachytherapy. This article discusses the technique of combined intracavitary and interstitial brachytherapy in an outpatient setting, and explores the issues and barriers for implementation and suggestions to overcome such barriers. PMID:26207117

  19. The use of ultrasonography in the localization of the lumpectomy cavity for interstitial brachytherapy of the breast.

    PubMed

    DeBiose, D A; Horwitz, E M; Martinez, A A; Edmundson, G K; Chen, P Y; Gustafson, G S; Madrazo, B; Wimbish, K; Mele, E; Vicini, F A

    1997-07-01

    To determine the value of breast ultrasonography (US) in defining the lumpectomy cavity for patients treated with interstitial brachytherapy. In March 1993, a protocol of low dose rate (LDR) interstitial brachytherapy as the sole radiation modality in selected patients with early breast cancer was initiated at William Beaumont Hospital. To date, 60 patients have been entered in this protocol, and 38 have undergone US assisted placement of interstitial brachytherapy needles. The lumpectomy cavity was outlined in all dimensions and corresponding skin marks were placed for reference at time of implantation. These US dimensions were compared to the physician's clinical estimate of the location of the lumpectomy cavity, the patient's presurgical mammogram, and the position of the surgical scar. In the intraoperative setting, the dimensions of the lumpectomy cavity were also obtained and the placement of the deep plane of interstitial needles was verified by US. The full extent of the lumpectomy cavity was underestimated by clinical examination (physical exam, operative report, mammographic information and location of the surgical scar) in 33 of 38 patients (87%). The depth to the chest wall was also incorrectly estimated in 34 (90%) patients when compared to US examination. Intraoperatively, US was performed in nine patients and was useful in verifying the accurate placement of the deepest plane of interstitial brachytherapy needles. In 7 of 9 patients (75%), clinical placement of needles did not ensure adequate coverage of the posterior extent of the lumpectomy cavity as visualized by intraoperative US. In breast cancer patients considered for interstitial brachytherapy, US appears to be a more accurate means of identifying the full extent of the lumpectomy cavity when compared to clinical estimates. In addition, US allows real-time verification of needle placement in the intraoperative setting.

  20. Breast conservation therapy without capsular contracture in young augmented women using interstitial brachytherapy

    PubMed Central

    2014-01-01

    Purpose To describe a breast-conserving technique using interstitial brachytherapy after lumpectomy and axillary nodal sampling in selected women who are diagnosed with breast cancer in the presence of augmentation mammoplasty. Material and methods Over the past 20 years, we have developed and improved a technique of “pinch view” image-guided catheter insertion that avoids implant puncture. Selection criteria include: 1) women of any age with either subpectoral or retroglandular, augmentation implants (silicone or saline) who were diagnosed with stages Tis, T1, T2, N0, or N1 breast cancer; 2) any pathologic subtype of malignant breast cancer was accepted; 3) microscopic tumor extent ≤ 3 cm; 4) axillary node negative or metastasis to 1 to 3 nodes without extracapsular extension; and 5) surgical margins clear by the NSABP “no ink on tumor” definition. More than 250 women have been successfully treated. Patients were treated with high dose rate Iridium-192 brachytherapy to 34 Gy in 10 or 32 Gy in 8 twice daily fractions. The target volume was the surgical cavity edge with 1.5 to 2 cm margin using 3-D treatment planning systems. Results The implant technique as currently employed is described. There have been no implant ruptures, and the Planning Treatment Volume (PTV-eval) exhibited at least 90% coverage by the 90% isodose line in the vast majority of cases. Dose Homogeneity Index exceeded 70% in most cases. The maximum skin dose was below the prescription dose in every case. Other than some patients with pre-existing capsular contracture, less than 5% experience new capsular contracture after interstitial brachytherapy. Conclusions A technique of reliable and reproducible accelerated partial breast irradiation is described that minimizes the risk of capsular contracture by avoiding circumferential dose to the foreign body in the breast. PMID:25097566

  1. Quality assurance of multifractionated pelvic interstitial brachytherapy for postoperative recurrences of cervical cancers: a prospective study.

    PubMed

    Shukla, Pragya; Chopra, Supriya; Engineer, Reena; Mahantshetty, Umesh; Paul, Siji Nojin; Phurailatpam, Reena; SV, Jamema; Shrivastava, Shyam K

    2012-03-15

    To evaluate three-dimensional needle displacements during multifractionated interstitial brachytherapy (BT) for cervical cancers. Patients scheduled to undergo pelvic interstitial BT for postoperative and or postradiation vault recurrences were included from November 2009 to December 2010. All procedures were performed under spinal anesthesia. Postprocedure BT planning CT scans were obtained with patients in supine position with arms on the chest (interslice thickness of 3 mm). Thereafter, verification CT was repeated at every alternate fraction. Needle displacements were measured in reference to a relocatable bony point. The mean cranial, caudal, anteroposterior, and mediolateral displacements were recorded. Statistical significance of mean interfraction displacements was evaluated with Wilcoxon Test. Twenty patients were included. Seventeen received boost BT (20 Gy/5 fractions/3 days) after external radiation, three received radical BT alone (36 Gy/9 fractions/5-8 days). An average of three scans (range, 2-3) were available per patient, and 357 needle displacements were analyzed. For the entire study cohort, the average of mean needle displacement was 2.5 mm (range, 0-7.4), 17.4 mm (range, 0-27.9), 1.7 mm (range, 0-6.7), 2.1 mm (range, 0-9.5), 1.7 mm (range, 0-9.3), and 0.6 mm (range, 0-7.8) in cranial, caudal, anterior, posterior, right, and left directions, respectively. The mean displacement in the caudal direction was higher between Days 1 and 2 than that between Days 2 and 3 (13.4 mm vs. 3.8 mm; p = 0.01). The average caudal displacements were no different between reirradiation and boost cohort (15.2 vs. 17.8 mm). Clinically significant caudal displacements occur during multifractionated pelvic brachytherapy. Optimal margins need to be incorporated while preplanning brachytherapy to account for interfraction displacements. Copyright © 2012 Elsevier Inc. All rights reserved.

  2. Quality Assurance of Multifractionated Pelvic Interstitial Brachytherapy for Postoperative Recurrences of Cervical Cancers: A Prospective Study

    SciTech Connect

    Shukla, Pragya; Chopra, Supriya; Engineer, Reena; Mahantshetty, Umesh; Paul, Siji Nojin; Phurailatpam, Reena; SV, Jamema; Shrivastava, Shyam K.

    2012-03-15

    Purpose: To evaluate three-dimensional needle displacements during multifractionated interstitial brachytherapy (BT) for cervical cancers. Methods and Materials: Patients scheduled to undergo pelvic interstitial BT for postoperative and or postradiation vault recurrences were included from November 2009 to December 2010. All procedures were performed under spinal anesthesia. Postprocedure BT planning CT scans were obtained with patients in supine position with arms on the chest (interslice thickness of 3 mm). Thereafter, verification CT was repeated at every alternate fraction. Needle displacements were measured in reference to a relocatable bony point. The mean cranial, caudal, anteroposterior, and mediolateral displacements were recorded. Statistical significance of mean interfraction displacements was evaluated with Wilcoxon Test. Results: Twenty patients were included. Seventeen received boost BT (20 Gy/5 fractions/3 days) after external radiation, three received radical BT alone (36 Gy/9 fractions/5-8 days). An average of three scans (range, 2-3) were available per patient, and 357 needle displacements were analyzed. For the entire study cohort, the average of mean needle displacement was 2.5 mm (range, 0-7.4), 17.4 mm (range, 0-27.9), 1.7 mm (range, 0-6.7), 2.1 mm (range, 0-9.5), 1.7 mm (range, 0-9.3), and 0.6 mm (range, 0-7.8) in cranial, caudal, anterior, posterior, right, and left directions, respectively. The mean displacement in the caudal direction was higher between Days 1 and 2 than that between Days 2 and 3 (13.4 mm vs. 3.8 mm; p = 0.01). The average caudal displacements were no different between reirradiation and boost cohort (15.2 vs. 17.8 mm). Conclusions: Clinically significant caudal displacements occur during multifractionated pelvic brachytherapy. Optimal margins need to be incorporated while preplanning brachytherapy to account for interfraction displacements.

  3. Long-Term Outcome for Clinically Localized Prostate Cancer Treated With Permanent Interstitial Brachytherapy

    SciTech Connect

    Taira, Al V.; Merrick, Gregory S.; Butler, Wayne M.; Galbreath, Robert W.; Lief, Jonathan; Adamovich, Edward; Wallner, Kent E.

    2011-04-01

    Purpose: To present the largest series of prostate cancer brachytherapy patients treated with modern brachytherapy techniques and postimplant day 0 dosimetric evaluation. Methods and Materials: Between April 1995 and July 2006, 1,656 consecutive patients were treated with permanent interstitial brachytherapy. Risk group stratification was carried out according to the Mt. Sinai guidelines. Median follow-up was 7.0 years. The median day 0 minimum dose covering at least 90% of the target volume was 118.8% of the prescription dose. Cause of death was determined for each deceased patient. Multiple clinical, treatment, and dosimetric parameters were evaluated for impact on the evaluated survival parameters. Results: At 12 years, biochemical progression-free survival (bPFS), cause-specific survival (CSS), and overall survival (OS) for the entire cohort was 95.6%, 98.2%, and 72.6%, respectively. For low-, intermediate-, and high-risk patients, bPFS was 98.6%, 96.5%, and 90.5%; CSS was 99.8%, 99.3%, and 95.2%; and OS was 77.5%, 71.1%, and 69.2%, respectively. For biochemically controlled patients, the median posttreatment prostate-specific antigen (PSA) concentration was 0.02 ng/ml. bPFS was most closely related to percent positive biopsy specimens and risk group, while Gleason score was the strongest predictor of CSS. OS was best predicted by patient age, hypertension, diabetes, and tobacco use. At 12 years, biochemical failure and cause-specific mortality were 1.8% and 0.2%, 5.1% and 2.1%, and 10.4% and 7.1% for Gleason scores 5 to 6 and 7 and {>=}8, respectively. Conclusions: Excellent long-term outcomes are achievable with high-quality brachytherapy for low-, intermediate-, and high-risk patients. These results compare favorably to alternative treatment modalities including radical prostatectomy.

  4. CT-guided interstitial brachytherapy in the local treatment of extrahepatic, extrapulmonary secondary malignancies.

    PubMed

    Wieners, Gero; Pech, Maciej; Rudzinska, Malgorzata; Lehmkuhl, Lukas; Wlodarczyk, Waldemar; Miersch, Alexandra; Hengst, Susanne; Felix, Roland; Wust, Peter; Ricke, Jens

    2006-11-01

    The purpose was to evaluate the safety and efficacy of high-dose-rate (HDR) CT-guided interstitial brachytherapy in the treatment of extrahepatic, extrapulmonary, secondary malignancies. Nineteen patients were included in this prospective study. The median age was 66 years (49-77). Underlying primaries comprised colorectal carcinomas in six, renal cell carcinoma in three, pancreatic carcinoma in three, cervical cancer in two, endometrial cancer in two and NSCLC, breast cancer and sarcoma in one patient each. All patients had undergone extensive pretreatments. CT-guided HDR brachytherapy employed a 192Iridium source. Dose planning for brachytherapy was performed using 3D CT data acquired after CT-guided percutaneous applicator positioning. MRI follow-up was performed 6 weeks and every 3 months post intervention. Primary endpoints were complications, local tumor control and progression-free survival. The median tumor diameter was 6 cm (2-15 cm). Tumor locations included the hepatoduodenal ligament, mesentery, adrenal gland, mesogastrium and local recurrences after rectal or pancreatic cancer. The minimal median dose in the target volume was 11 Gy (4-18 Gy). Minor complications comprised pain and fever (n=6, 32%). Major complications included one hospital death of unknown causes (n=1; 5%). Median follow-up was 7 months (1-16). Four patients (21%) died during the follow-up period. Local tumor control was 76.5% after 6 months and progression-free survival 47% after 6 months. Minimally invasive CT-guided HDR brachytherapy is safe and effective in the palliative treatment of extrahepatic, extrapulmonary secondary malignancies.

  5. Clinical outcome of high-dose-rate interstitial brachytherapy in vulvar cancer: A single institutional experience.

    PubMed

    Mahantshetty, Umesh; Naga, Pushpa; Engineer, Reena; Sastri, Supriya; Ghadi, Yogesh; Upreti, Udita; Somesan, Vijaya; Kadam, Sudarshan; Kohle, Satish; Deshpande, Deepak; Shrivastava, Shyam Kishore

    With an aim to evaluate and report high dose date interstitial brachytherapy (HDR-ISBT) in vulvar cancers, we undertook this retrospective analysis. Histologically proven vulvar cancers treated with HDR-ISBT between 2001 and 2016 were analyzed. Radiotherapy details, clinical outcome in terms of local control rates, survivals, and toxicities were evaluated. A total of 38 patients received HDR-ISBT, with definitive radiation in 29 (76.3%), adjuvant postoperative in six (15.8%) and salvage radiation in three (7.9%) patients. Of them, 29 patients received brachytherapy boost and nine patients ISBT alone. BT procedure included freehand plastic tube technique in 23 (single [n = 5] or multiple plane [n = 18]), 13 patients with template based and two patients combined approach. Patients with brachytherapy alone received median EQD2 of 38.4 Gy10 (35.5-46.7 Gy10), as boost received median 23.3 Gy10 (13-37.3 Gy10). At 3-month post-treatment response evaluation, 30 patients achieved clinically complete response, two patients partial response and six maintained postoperative status. With a median follow-up of 30 months, 29 (76.3%) were disease free, and 9 (23.7%) patients had relapsed disease with four patients expired due to disease and two died of other causes. The 5-year overall survival, disease free survival, and local control rates were 82%, 51%, and 77%, respectively. HDR-ISBT in vulvar cancer is a feasible and a viable option with acceptable and comparable outcomes. Copyright © 2016 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  6. Trans-bronchoscopy with implantation of (125)I radioactive seeds in patients with pulmonary atelectasis induced by lung cancer.

    PubMed

    Lu, Mingjian; Pu, Deli; Zhang, Weidong; Liao, Jiangrong; Zhang, Tao; Yang, Guang; Liu, Zhenyin; Singh, Sristi; Gao, Fei; Zhang, Fujun

    2015-07-01

    To evaluate the role of low-dose-rate interstitial brachytherapy using trans-bronchoscope (125)I radioactive seeds implantation in patients with pulmonary atelectasis induced by lung cancer, in terms of feasibility, safety, quality of life (QOL), and survival time. Between April 2008 and June 2011, 15 patients from two medical institutions that had obstructive pulmonary atelectasis caused by inoperable lung cancer were assigned to receive (125)I implantation endoluminal brachytherapy by bronchoscopy. Subsequent to the implantation of (125)I seeds, the outcomes were measured in terms of procedure success rate, reopening of atelectasis, complications associated with the procedure, Karnofsky performance status (KPS) scores and survival time. The surgical procedure was successfully performed in all 15 patients. No procedure-associated mortality occurred and the complications were mild and considered acceptable. Irritable cough and temporary increase of hemoptysis occurred in 11 (73.3%) and 10 (66.7%) patients respectively, and were the most common complications. The pulmonary atelectasis reopening rate subsequent to the procedure was 86.7, 76.9, 80.0, 75.0 and 50.0% at 2, 6, 12, 18 and 24 months, respectively. The KPS score significantly improved following the implantation of (125)I seeds and the duration of improvement ranged between 3 and 27 months. The median and mean survival times were 15.6 and 16 months, respectively. Actuarial survival rates at 6, 12 and 24 months after the procedure were 86.7, 66.7 and 13.3%, respectively. In patients with advanced lung cancer and those presenting with obstructive pulmonary atelectasis, treatment with intraluminal implantation of (125)I seeds is a safe and effective therapy option with easy accessibility.

  7. Trans-bronchoscopy with implantation of 125I radioactive seeds in patients with pulmonary atelectasis induced by lung cancer

    PubMed Central

    LU, MINGJIAN; PU, DELI; ZHANG, WEIDONG; LIAO, JIANGRONG; ZHANG, TAO; YANG, GUANG; LIU, ZHENYIN; SINGH, SRISTI; GAO, FEI; ZHANG, FUJUN

    2015-01-01

    To evaluate the role of low-dose-rate interstitial brachytherapy using trans-bronchoscope 125I radioactive seeds implantation in patients with pulmonary atelectasis induced by lung cancer, in terms of feasibility, safety, quality of life (QOL), and survival time. Between April 2008 and June 2011, 15 patients from two medical institutions that had obstructive pulmonary atelectasis caused by inoperable lung cancer were assigned to receive 125I implantation endoluminal brachytherapy by bronchoscopy. Subsequent to the implantation of 125I seeds, the outcomes were measured in terms of procedure success rate, reopening of atelectasis, complications associated with the procedure, Karnofsky performance status (KPS) scores and survival time. The surgical procedure was successfully performed in all 15 patients. No procedure-associated mortality occurred and the complications were mild and considered acceptable. Irritable cough and temporary increase of hemoptysis occurred in 11 (73.3%) and 10 (66.7%) patients respectively, and were the most common complications. The pulmonary atelectasis reopening rate subsequent to the procedure was 86.7, 76.9, 80.0, 75.0 and 50.0% at 2, 6, 12, 18 and 24 months, respectively. The KPS score significantly improved following the implantation of 125I seeds and the duration of improvement ranged between 3 and 27 months. The median and mean survival times were 15.6 and 16 months, respectively. Actuarial survival rates at 6, 12 and 24 months after the procedure were 86.7, 66.7 and 13.3%, respectively. In patients with advanced lung cancer and those presenting with obstructive pulmonary atelectasis, treatment with intraluminal implantation of 125I seeds is a safe and effective therapy option with easy accessibility. PMID:26171002

  8. Iodine-125 Interstitial Brachytherapy for Pediatric Desmoid-Type Fibromatosis of the Head and Neck: A Case Report.

    PubMed

    Wu, Wen-Jie; Guo, Hua-Qiu; Yu, Guang-Yan; Zhang, Jian-Guo

    2017-04-01

    Desmoid-type fibromatosis (DF) is a locally aggressive benign soft tissue tumor. It is rarely observed in the head and neck region and is particularly uncommon in the parotid gland. This report describes the case of a 32-month-old girl with DF of the head and neck. The tumor was resected with gross residual tumors. Recurrence occurred 3 months later and then the patient was treated with iodine-125 interstitial brachytherapy. The tumor was completely absent 6 months after brachytherapy. No recurrence was found 60 months after brachytherapy during follow-up. No severe toxicities or growth abnormalities were observed. Very-low-dose rate brachytherapy as the sole modality could be a reasonable alternative for the treatment of inoperable DF of the head and neck, which avoids the risk of cosmetic deformity caused by surgery, especially in pediatric patients. In addition, long-term follow-up is recommended.

  9. Dosimetric Consequences of Interobserver Variability in Delineating the Organs at Risk in Gynecologic Interstitial Brachytherapy

    PubMed Central

    Damato, Antonio L.; Townamchai, Kanopkis; Albert, Michele; Bair, Ryan J.; Cormack, Robert A.; Jang, Joanne; Kovacs, Arpad; Lee, Larissa J.; Mak, Kimberley S.; Mirabeau-Beale, Kristina L.; Mouw, Kent W.; Phillips, John G.; Pretz, Jennifer L.; Russo, Andrea L.; Lewis, John H.; Viswanathan, Akila N.

    2014-01-01

    Purpose To investigate the dosimetric variability associated with interobserver organ-at-risk delineation differences on computed tomography in patients undergoing gynecologic interstitial brachytherapy. Methods and Materials The rectum, bladder and sigmoid of 14 patients treated with gynecologic interstitial brachytherapy were retrospectively contoured by 13 physicians. Geometric variability was calculated using κ statistics, conformity index (CIgen), and coefficient of variation (CV) of volumes contoured across physicians. Dosimetric variability of the single-fraction D0.1cc and D2cc was assessed through CV across physicians, and the standard deviation of the total EQD2 (equivalent dose in 2 Gy per fraction) brachytherapy dose (SDTOT) was calculated. Results The population mean ± 1 standard deviation of κ, CIgen and volume CV were, respectively: 0.77 ± 0.06, 0.70 ± 0.08 and 20% ± 6% for bladder; 0.74 ± 06, 0.67 ± 0.08 and 20% ± 5% for rectum, and 0.33 ± 0.20, 0.26 ± 0.17 and 82% ± 42% for sigmoid. Dosimetric variability was: for bladder, CV = 31% ± 19% (SDTOT = 72 ± 64 Gy) for D0.1cc and CV = 16% + 10% (SDTOT = 9 ± 6 Gy) for D2cc; for rectum, CV = 11% ± 5% (SDTOT = 16 ± 17 Gy) for D0.1cc and CV = 7% ± 2% (SDTOT = 4 ± 3 Gy) for D2cc; for sigmoid, CV = 39% ± 28% (SDTOT = 12 ± 18 Gy) for D0.1cc and CV = 34% ± 19% (SDTOT = 4 ± 4 Gy) for D2cc. Conclusions Delineation of bladder and rectum by 13 physicians demonstrated substantial geometric agreement and resulted in good dosimetric agreement for all dose-volume histogram parameters except bladder D0.1cc. Small delineation differences in high-dose regions by the posterior bladder wall may explain these results. The delineation of sigmoid showed fair geometric agreement. The higher dosimetric variability for sigmoid compared with rectum and bladder did not correlate with higher variability in the total brachytherapy dose but rather may be due to the sigmoid being positioned in low-dose regions in

  10. Salvage prostate HDR brachytherapy combined with interstitial hyperthermia for local recurrence after radiation therapy failure.

    PubMed

    Kukiełka, A M; Hetnał, M; Dąbrowski, T; Walasek, T; Brandys, P; Nahajowski, D; Kudzia, R; Dybek, D; Reinfuss, M

    2014-02-01

    The aim of the present retrospective study is to evaluate toxicity and early clinical outcomes of interstitial hyperthermia (IHT) combined with high-dose rate (HDR) brachytherapy as a salvage treatment in patients with biopsy-confirmed local recurrence of prostate cancer after previous external beam radiotherapy. Between September 2008 and March 2013, 25 patients with local recurrence of previously irradiated prostate cancer were treated. The main eligibility criteria for salvage prostate HDR brachytherapy combined with interstitial hyperthermia were biopsy confirmed local recurrence and absence of nodal and distant metastases. All patients were treated with a dose of 30 Gy in 3 fractions at 21-day intervals. We performed 62 hyperthermia procedures out of 75 planned (83 %). The aim of the hyperthermia treatment was to heat the prostate to 41-43 °C for 60 min. Toxicity for the organs of the genitourinary system and rectum was assessed according to the Common Terminology Criteria for Adverse Events (CTCAE, v. 4.03). Determination of subsequent biochemical failure was based on the Phoenix definition (nadir + 2 ng/ml). The median age was 71 years (range 62-83 years), the median initial PSA level was 16.3 ng/ml (range 6.37-64 ng/ml), and the median salvage PSA level was 2.8 ng/ml (1.044-25.346 ng/ml). The median follow-up was 13 months (range 4-48 months). The combination of HDR brachytherapy and IHT was well tolerated. The most frequent complications were nocturia, weak urine stream, urinary frequency, hematuria, and urgency. Grade 2 rectal hemorrhage was observed in 1 patient. No grade 3 or higher complications were observed. The 2-year Kaplan-Meier estimate of biochemical control after salvage treatment was 74 %. The PSA in 20 patients decreased below the presalvage level, while 11 patients achieved a PSA nadir < 0.5 ng/ml. All patients are still alive. Of the 7 patients who experienced biochemical failure, bone metastases were found in

  11. Dosimetric Consequences of Interobserver Variability in Delineating the Organs at Risk in Gynecologic Interstitial Brachytherapy

    SciTech Connect

    Damato, Antonio L.; Bair, Ryan J.; Cormack, Robert A.; Kovacs, Arpad; Lee, Larissa J.; Lewis, John H.; Viswanathan, Akila N.

    2014-07-01

    Purpose: To investigate the dosimetric variability associated with interobserver organ-at-risk delineation differences on computed tomography in patients undergoing gynecologic interstitial brachytherapy. Methods and Materials: The rectum, bladder, and sigmoid of 14 patients treated with gynecologic interstitial brachytherapy were retrospectively contoured by 13 physicians. Geometric variability was calculated using κ statistics, conformity index (CI{sub gen}), and coefficient of variation (CV) of volumes contoured across physicians. Dosimetric variability of the single-fraction D{sub 0.1cc} and D{sub 2cc} was assessed through CV across physicians, and the standard deviation of the total EQD2 (equivalent dose in 2 Gy per fraction) brachytherapy dose (SD{sup TOT}) was calculated. Results: The population mean ± 1 standard deviation of κ, CI{sub gen}, and volume CV were, respectively: 0.77 ± 0.06, 0.70 ± 0.08, and 20% ± 6% for bladder; 0.74 ± 06, 0.67 ± 0.08, and 20% ± 5% for rectum; and 0.33 ± 0.20, 0.26 ± 0.17, and 82% ± 42% for sigmoid. Dosimetric variability was as follows: for bladder, CV = 31% ± 19% (SD{sup TOT} = 72 ± 64 Gy) for D{sub 0.1cc} and CV = 16% ± 10% (SD{sup TOT} = 9 ± 6 Gy) for D{sub 2cc}; for rectum, CV = 11% ± 5% (SD{sup TOT} = 16 ± 17 Gy) for D{sub 0.1cc} and CV = 7% ± 2% (SD{sup TOT} = 4 ± 3 Gy) for D{sub 2cc}; for sigmoid, CV = 39% ± 28% (SD{sup TOT} = 12 ± 18 Gy) for D{sub 0.1cc} and CV = 34% ± 19% (SD{sup TOT} = 4 ± 4 Gy) for D{sub 2cc.} Conclusions: Delineation of bladder and rectum by 13 physicians demonstrated substantial geometric agreement and resulted in good dosimetric agreement for all dose-volume histogram parameters except bladder D{sub 0.1cc.} Small delineation differences in high-dose regions by the posterior bladder wall may explain these results. The delineation of sigmoid showed fair geometric agreement. The higher dosimetric variability for sigmoid compared with rectum and bladder did not correlate with

  12. Neuro-oncology update: radiation safety and nursing care during interstitial brachytherapy

    SciTech Connect

    Randall, T.M.; Drake, D.K.; Sewchand, W.

    1987-12-01

    Radiation control and safety are major considerations for nursing personnel during the care of patients receiving brachytherapy. Since the theory and practice of radiation applications are not part of the routine curriculum of nursing programs, the education of nurses and other health care professionals in radiation safety procedures is important. Regulatory agencies recommend that an annual safety course be given to all persons frequenting, using, or associated with patients containing radioactive materials. This article presents pertinent aspects of the principles and procedures of radiation safety, the role of personnel dose-monitoring devices, and the value of additional radiation control features, such as a lead cubicle, during interstitial brain implants. One institution's protocol and procedures for the care of high-intensity iridium-192 brain implants are discussed. Preoperative teaching guidelines and nursing interventions included in the protocol focus on radiation control principles.

  13. Metallofullerene-Nanoplatform-Delivered Interstitial Brachytherapy Improved Survival in a Murine Model of Glioblastoma Multiforme

    PubMed Central

    Wilson, John D.; Broaddus, William C.; Dorn, Harry C.; Fatouros, Panos P.; Chalfant, Charles E.; Shultz, Michael D.

    2012-01-01

    Fullerenes are used across scientific disciplines because of their diverse properties gained by altering encapsulated or surface bound components. In this study, the recently developed theranostic agent based on a radiolabeled functionalized metallofullerene (177Lu-DOTA-f-Gd3N@C80) was synthesized with high radiochemical yield and purity. The efficacy of this agent was demonstrated in two orthotopic xenograft brain tumor models of glioblastoma multiforme (GBM). A dose-dependent improvement in survival was also shown. The in vivo stability of the agent was verified through dual label measurements of biological elimination from the tumor. Overall, these results provide evidence that nanomaterial platforms can be used to deliver effective interstitial brachytherapy. PMID:22881865

  14. Use of Ir192 interstitial brachytherapy for an equine malignant dermal schwannoma.

    PubMed

    Saulez, M N; Voigt, A; Steyl, J C A; van Wilpe, E; Kotzen, J; Daniels, F

    2009-12-01

    A 10-year-old Hanoverian mare was evaluated for a right buccal swelling that recurred 3 months following surgical resection. Ultrasonographic examination showed a broadly pedunculated subcutaneous mass at the level of 106-109 and 406-409 cheek teeth associated with an erosive mucosal lesion on the inside of the cheek. Histological examination of a biopsy specimen revealed a well-demarcated, malignant, dermal schwannoma. Following subcutaneous placement of platinum coated Ir192 wires under general anaesthesia, low-dose radiation of 5 gray per day was delivered for 14 days. Short-term complications included loss of patency of the right nasolacrimal duct, erythema, dermatitis, leukotrichia and left-sided deviation of the muzzle. Ten months later, there has been no tumour recurrence. Findings suggest that the use of interstitial brachytherapy should be considered for a malignant, dermal schwannoma that has recurred or is not amenable to surgery.

  15. Dosimetric perturbations of a lead shield for surface and interstitial high-dose-rate brachytherapy.

    PubMed

    Candela-Juan, Cristian; Granero, Domingo; Vijande, Javier; Ballester, Facundo; Perez-Calatayud, Jose; Rivard, Mark J

    2014-06-01

    In surface and interstitial high-dose-rate brachytherapy with either (60)Co, (192)Ir, or (169)Yb sources, some radiosensitive organs near the surface may be exposed to high absorbed doses. This may be reduced by covering the implants with a lead shield on the body surface, which results in dosimetric perturbations. Monte Carlo simulations in Geant4 were performed for the three radionuclides placed at a single dwell position. Four different shield thicknesses (0, 3, 6, and 10 mm) and three different source depths (0, 5, and 10 mm) in water were considered, with the lead shield placed at the phantom surface. Backscatter dose enhancement and transmission data were obtained for the lead shields. Results were corrected to account for a realistic clinical case with multiple dwell positions. The range of the high backscatter dose enhancement in water is 3 mm for (60)Co and 1 mm for both (192)Ir and (169)Yb. Transmission data for (60)Co and (192)Ir are smaller than those reported by Papagiannis et al (2008 Med. Phys. 35 4898-4906) for brachytherapy facility shielding; for (169)Yb, the difference is negligible. In conclusion, the backscatter overdose produced by the lead shield can be avoided by just adding a few millimetres of bolus. Transmission data provided in this work as a function of lead thickness can be used to estimate healthy organ equivalent dose saving. Use of a lead shield is justified.

  16. Permanent Iodine-125 Interstitial Planar Seed Brachytherapy for Close or Positive Margins for Thoracic Malignancies

    SciTech Connect

    Mutyala, Subhakar; Stewart, Alexandra; Khan, Atif J.; Cormack, Robert A.; O'Farrell, Desmond; Sugarbaker, David; Devlin, Phillip M.

    2010-03-15

    Purpose: To assess toxicity and outcome following permanent iodine-125 seed implant as an adjunct to surgical resection in cases of advanced thoracic malignancy. Methods and Materials: An institutional review board-approved retrospective review was performed. Fifty-nine patients were identified as having undergone thoracic brachytherapy seed implantation between September 1999 and December 2006. Data for patient demographics, tumor details, and morbidity and mortality were recorded. Results: Fifty-nine patients received 64 implants. At a median follow-up of 17 months, 1-year and 2-year Kaplan-Meier rates of estimated overall survival were 94.1% and 82.0%, respectively. The 1-year and 2-year local control rates were 80.1% and 67.4%, respectively. The median time to develop local recurrence was 11 months. Grades 3 and 4 toxicity rates were 12% at 1 year. Conclusions: This review shows relatively low toxicity for interstitial planar seed implantation after thoracic surgical resection. The high local control results suggest that an incomplete oncologic surgery plus a brachytherapy implant for treating advanced thoracic malignancy merit further investigation.

  17. The Vienna applicator for combined intracavitary and interstitial brachytherapy of cervical cancer: Design, application, treatment planning, and dosimetric results

    SciTech Connect

    Kirisits, Christian . E-mail: Christian.Kirisits@meduniwien.ac.at; Lang, Stefan; Dimopoulos, Johannes; Berger, Daniel; Georg, Dietmar; Poetter, Richard

    2006-06-01

    Purpose: To present a combined intracavitary and interstitial dedicated applicator and magnetic resonance imaging (MRI) treatment planning for cervical cancer brachytherapy. Methods and Materials: A modified ring applicator allows interstitial needles to be implanted in parallel to the intrauterine tandem. MRI treatment planning based on a standard loading pattern with stepwise dwell weight adaptation and needle loading is performed to achieve optimal dose coverage and sparing of organs at risk. Dose constraints are applied for dose-volume histogram parameters. Results: The use of additional interstitial needles provides prescription dose up to 15 mm lateral to point A. Twenty-two patients with high-risk clinical target volumes of mean 44 cm{sup 3} were treated with a mean prescribed total dose of 85 Gy (biologically equivalent to 2 Gy fractionation, {alpha}/{beta} = 10 Gy) and 93% coverage (V100). The dose to organs at risk was within standard limits for intracavitary brachytherapy alone. Conclusions: A combined interstitial-intracavitary applicator results in reproducible implants for cervical cancer brachytherapy. MRI-based treatment planning based on a target concept, dose-volume constraints, and limitations for the relative dwell weight allows for an increase in target coverage, treated volume, and total dose without increasing the dose to critical structures.

  18. Treatment results of stereotactic interstitial brachytherapy for primary and metastatic brain tumors

    SciTech Connect

    Lucas, G.L.; Luxton, G.; Cohen, D.; Petrovich, Z.; Langholz, B.; Apuzzo, M.L.; Sapozink, M.D. )

    1991-08-01

    A total of 41 stereotactic interstitial brain implants in 39 patients were performed for recurrence after teletherapy (recurrence implant), or as part of initial treatment in conjunction with teletherapy (primary implant). Implanted tumors consisted of malignant gliomas (33), other primary brain tumors (3), and single metastatic lesions (3). All patients were temporarily implanted with Ir-192 using a coaxial catheter afterloading system; two patients were implanted twice. Survival post-implant for glioblastoma multiforme (GBM), 13 patients, was 10 months whether implanted primarily or for recurrence. Mean time to recurrence, measured from initiation of teletherapy to implantation, was 10 months. Twenty patients with anaplastic astrocytoma (AA) had a median survival post-implant of 23 months for primary implants (7 patients) and 11 months for recurrence implants (13 patients). Mean time to recurrence, measured from initiation of teletherapy to implantation, was 19 months. Three patients (9%) of the evaluable group required reoperation for symptomatic mass effect, all with initial diagnosis of AA. Survival for this subgroup was 14, 22, and 32 months post-implantation. Using stereotactic techniques, interstitial brachytherapy of brain tumors was technically feasible with negligible acute morbidity and mortality, and appeared to offer limited prolongation of control for a subset of patients with recurrent malignant gliomas. The role of this modality in primary treatment for malignant gliomas needs to be further defined by prospectively randomized trials.

  19. Outpatient template-guided permanent interstitial brachytherapy using (131)Cs in gynecologic malignancies: Initial report.

    PubMed

    Feddock, Jonathan; Aryal, Prakash; Steber, Cole; Edwards, Jason; Cheek, Dennis; Randall, Marcus

    Optimal curative intent brachytherapy for certain gynecologic cancers requires interstitial brachytherapy, often using template-guided techniques such as a Syed-Neblett implant. Whether high or low dose rate (LDR), these procedures pose significant risks to patients, partly attributable to the prolonged period of bed rest. Published results of free-handed permanent interstitial brachytherapy (PIB) with (131)Cs demonstrate it to be an effective modality for the management of small volume gynecologic cancers. This report is the first to describe a permanent template-guided interstitial technique using (131)Cs for gynecologic cancers, performed as an LDR outpatient procedure. Five sequential patients with recurrent or primary gynecologic malignancies underwent template-guided PIB using (131)Cs. A posttreatment planning CT was obtained immediately after the procedure and again 3-4 weeks later. Both CT data sets were fused and the relative positions compared to assess for migration in the x, y, and z planes. Seed positions as well as dosimetric parameters including D90, D100, V100, and the dose to 2 cc of rectum and bladder were compared to quantify migration of sources and the resulting effect, if any, on the treatment. The median age was 69 years (range 64-85). All patients received a template-guided (131)Cs PIB implant to treat gross disease. All 5 patients had significant medical comorbidities that limited treatment options. Considering all 5 patients, a total of 40 interstitial needles were placed. Ten needles carried only Vicryl-stranded sources, and 30 needles carried a combination of stranded (131)Cs seeds and free seeds. Needle count was between 6 and 10 needles per patient, with active lengths of 4-10 cm. The median dose was 30 Gy (range 25-55 Gy) to permanent decay, enabling a cumulative median biological effective dose 91.5 Gy (range 60.9-92.1 Gy) and equivalent dose at 2 Gy per fraction 75.9 Gy (range 50.7-76.8 Gy). All implants were performed as

  20. Calculation of mean central dose in interstitial brachytherapy using Delaunay triangulation.

    PubMed

    Astrahan, M A; Streeter, O E; Jozsef, G

    2001-06-01

    In 1997 the ICRU published Report 58 "Dose and Volume Specification for Reporting Interstitial Therapy" with the objective of addressing the problem of absorbed dose specification for reporting contemporary interstitial therapy. One of the concepts proposed in that report is "mean central dose." The fundamental goal of the mean central dose (MCD) calculation is to obtain a single, readily reportable and intercomparable value which is representative of dose in regions of the implant "where the dose gradient approximates a plateau." Delaunay triangulation (DT) is a method used in computational geometry to partition the space enclosed by the convex hull of a set of distinct points P into a set of nonoverlapping cells. In the three-dimensional case, each point of P becomes a vertex of a tetrahedron and the result of the DT is a set of tetrahedra. All treatment planning for interstitial brachytherapy inherently requires that the location of the radioactive sources, or dwell positions in the case of HDR, be known or digitized. These source locations may be regarded as a set of points representing the implanted volume. Delaunay triangulation of the source locations creates a set of tetrahedra without manual intervention. The geometric centers of these tetrahedra define a new set of points which lie "in between" the radioactive sources and which are distributed uniformly over the volume of the implant. The arithmetic mean of the dose at these centers is a three dimensional analog of the two-dimensional triangulation and inspection methods proposed for calculating MCD in ICRU 58. We demonstrate that DT can be successfully incorporated into a computerized treatment planning system and used to calculate the MCD.

  1. Treatment of periocular and non-ocular sarcoids in 18 horses by interstitial brachytherapy with iridium-192.

    PubMed

    Byam-Cook, K L; Henson, F M D; Slater, J D

    2006-09-09

    Treatment of the equine sarcoid has posed a significant challenge to clinicians for years and many different methods have been tried with varying success, including ionising radiation. The aim of this study was to review the efficacy of iridium-192 interstitial brachytherapy for the treatment of eight periocular sarcoids and 15 non-ocular sarcoids on 18 horses. All the periocular sarcoids and 13 of the 15 non-ocular sarcoids were treated successfully.

  2. Evaluation of an active magnetic resonance tracking system for interstitial brachytherapy.

    PubMed

    Wang, Wei; Viswanathan, Akila N; Damato, Antonio L; Chen, Yue; Tse, Zion; Pan, Li; Tokuda, Junichi; Seethamraju, Ravi T; Dumoulin, Charles L; Schmidt, Ehud J; Cormack, Robert A

    2015-12-01

    In gynecologic cancers, magnetic resonance (MR) imaging is the modality of choice for visualizing tumors and their surroundings because of superior soft-tissue contrast. Real-time MR guidance of catheter placement in interstitial brachytherapy facilitates target coverage, and would be further improved by providing intraprocedural estimates of dosimetric coverage. A major obstacle to intraprocedural dosimetry is the time needed for catheter trajectory reconstruction. Herein the authors evaluate an active MR tracking (MRTR) system which provides rapid catheter tip localization and trajectory reconstruction. The authors assess the reliability and spatial accuracy of the MRTR system in comparison to standard catheter digitization using magnetic resonance imaging (MRI) and CT. The MRTR system includes a stylet with microcoils mounted on its shaft, which can be inserted into brachytherapy catheters and tracked by a dedicated MRTR sequence. Catheter tip localization errors of the MRTR system and their dependence on catheter locations and orientation inside the MR scanner were quantified with a water phantom. The distances between the tracked tip positions of the MRTR stylet and the predefined ground-truth tip positions were calculated for measurements performed at seven locations and with nine orientations. To evaluate catheter trajectory reconstruction, fifteen brachytherapy catheters were placed into a gel phantom with an embedded catheter fixation framework, with parallel or crossed paths. The MRTR stylet was then inserted sequentially into each catheter. During the removal of the MRTR stylet from within each catheter, a MRTR measurement was performed at 40 Hz to acquire the instantaneous stylet tip position, resulting in a series of three-dimensional (3D) positions along the catheter's trajectory. A 3D polynomial curve was fit to the tracked positions for each catheter, and equally spaced dwell points were then generated along the curve. High-resolution 3D MRI of the

  3. Evaluation of an active magnetic resonance tracking system for interstitial brachytherapy

    PubMed Central

    Wang, Wei; Viswanathan, Akila N.; Damato, Antonio L.; Chen, Yue; Tse, Zion; Pan, Li; Tokuda, Junichi; Seethamraju, Ravi T.; Dumoulin, Charles L.; Schmidt, Ehud J.; Cormack, Robert A.

    2015-01-01

    Purpose: In gynecologic cancers, magnetic resonance (MR) imaging is the modality of choice for visualizing tumors and their surroundings because of superior soft-tissue contrast. Real-time MR guidance of catheter placement in interstitial brachytherapy facilitates target coverage, and would be further improved by providing intraprocedural estimates of dosimetric coverage. A major obstacle to intraprocedural dosimetry is the time needed for catheter trajectory reconstruction. Herein the authors evaluate an active MR tracking (MRTR) system which provides rapid catheter tip localization and trajectory reconstruction. The authors assess the reliability and spatial accuracy of the MRTR system in comparison to standard catheter digitization using magnetic resonance imaging (MRI) and CT. Methods: The MRTR system includes a stylet with microcoils mounted on its shaft, which can be inserted into brachytherapy catheters and tracked by a dedicated MRTR sequence. Catheter tip localization errors of the MRTR system and their dependence on catheter locations and orientation inside the MR scanner were quantified with a water phantom. The distances between the tracked tip positions of the MRTR stylet and the predefined ground-truth tip positions were calculated for measurements performed at seven locations and with nine orientations. To evaluate catheter trajectory reconstruction, fifteen brachytherapy catheters were placed into a gel phantom with an embedded catheter fixation framework, with parallel or crossed paths. The MRTR stylet was then inserted sequentially into each catheter. During the removal of the MRTR stylet from within each catheter, a MRTR measurement was performed at 40 Hz to acquire the instantaneous stylet tip position, resulting in a series of three-dimensional (3D) positions along the catheter’s trajectory. A 3D polynomial curve was fit to the tracked positions for each catheter, and equally spaced dwell points were then generated along the curve. High

  4. Evaluation of an active magnetic resonance tracking system for interstitial brachytherapy

    SciTech Connect

    Wang, Wei; Pan, Li; Tokuda, Junichi; Schmidt, Ehud J.; Seethamraju, Ravi T.; Dumoulin, Charles L.

    2015-12-15

    Purpose: In gynecologic cancers, magnetic resonance (MR) imaging is the modality of choice for visualizing tumors and their surroundings because of superior soft-tissue contrast. Real-time MR guidance of catheter placement in interstitial brachytherapy facilitates target coverage, and would be further improved by providing intraprocedural estimates of dosimetric coverage. A major obstacle to intraprocedural dosimetry is the time needed for catheter trajectory reconstruction. Herein the authors evaluate an active MR tracking (MRTR) system which provides rapid catheter tip localization and trajectory reconstruction. The authors assess the reliability and spatial accuracy of the MRTR system in comparison to standard catheter digitization using magnetic resonance imaging (MRI) and CT. Methods: The MRTR system includes a stylet with microcoils mounted on its shaft, which can be inserted into brachytherapy catheters and tracked by a dedicated MRTR sequence. Catheter tip localization errors of the MRTR system and their dependence on catheter locations and orientation inside the MR scanner were quantified with a water phantom. The distances between the tracked tip positions of the MRTR stylet and the predefined ground-truth tip positions were calculated for measurements performed at seven locations and with nine orientations. To evaluate catheter trajectory reconstruction, fifteen brachytherapy catheters were placed into a gel phantom with an embedded catheter fixation framework, with parallel or crossed paths. The MRTR stylet was then inserted sequentially into each catheter. During the removal of the MRTR stylet from within each catheter, a MRTR measurement was performed at 40 Hz to acquire the instantaneous stylet tip position, resulting in a series of three-dimensional (3D) positions along the catheter’s trajectory. A 3D polynomial curve was fit to the tracked positions for each catheter, and equally spaced dwell points were then generated along the curve. High

  5. Interstitial brachytherapy of periorificial skin carcinomas of the face: A retrospective study of 97 cases

    SciTech Connect

    Rio, Emmanuel . E-mail: e-rio@nantes.fnclcc.fr; Bardet, Etienne; Ferron, Christophe; Peuvrel, Patrick; Supiot, Stephane; Campion, Loic; Beauvillain De Montreuil, Claude; Mahe, Marc Andre; Dreno, Brigitte

    2005-11-01

    Purpose: To analyze outcomes after interstitial brachytherapy of facial periorificial skin carcinomas. Patients and Methods: We performed a retrospective analysis of 97 skin carcinomas (88 basal cell carcinomas, 9 squamous cell carcinomas) of the nose, periorbital areas, and ears from 40 previously untreated patients (Group 1) and 57 patients who had undergone surgery (Group 2). The average dose was 55 Gy (range, 50-65 Gy) in Group 1 and 52 Gy (range, 50-60 Gy) in Group 2 (mean implantation times: 79 and 74 hours, respectively). We calculated survival rates and assessed functional and cosmetic results de visu. Results: Median age was 71 years (range, 17-97 years). There were 29 T1, 8 T2, 1 T3, and 2 Tx tumors in Group 1. Tumors were <2 cm in Group 2. Local control was 92.5% in Group 1 and 88% in Group 2 (median follow-up, 55 months; range, 6-132 months). Five-year disease-free survival was better in Group 1 (91%; range, 75-97) than in Group 2 (80%; range, 62-90; p = 0.23). Of the 34 patients whose results were reassessed, 8 presented with pruritus or epiphora; 1 Group 2 patient had an impaired eyelid aperture. Cosmetic results were better in Group 1 than in Group 2 with, respectively, 72% (8/11) vs. 52% (12/23) good results and 28 (3/11) vs. 43% (10/23) fair results. Conclusions: Brachytherapy provided a high level of local control and good cosmetic results for facial periorificial skin carcinomas that pose problems of surgical reconstruction. Results were better for untreated tumors than for incompletely excised tumors or tumors recurring after surgery.

  6. Inverse planning for combination of intracavitary and interstitial brachytherapy for locally advanced cervical cancer

    PubMed Central

    Yoshio, Kotaro; Murakami, Naoya; Morota, Madoka; Harada, Ken; Kitaguchi, Mayuka; Yamagishi, Kentaro; Sekii, Shuhei; Takahashi, Kana; Inaba, Koji; Mayahara, Hiroshi; Ito, Yoshinori; Sumi, Minako; Kanazawa, Susumu; Itami, Jun

    2013-01-01

    The main purpose of this study was to compare three different treatment plans for locally advanced cervical cancer: (i) the inverse-planning simulated annealing (IPSA) plan for combination brachytherapy (BT) of interstitial and intracavitary brachytherapy, (ii) manual optimization based on the Manchester system for combination-BT, and (iii) the conventional Manchester system using only tandem and ovoids. This was a retrospective study of 25 consecutive implants. The high-risk clinical target volume (HR-CTV) and organs at risk were defined according to the GEC-ESTRO Working Group definitions. A dose of 6 Gy was prescribed. The uniform cost function for dose constraints was applied to all IPSA-generated plans. The coverage of the HR-CTV by IPSA for combination-BT was equivalent to that of manual optimization, and was better than that of the Manchester system using only tandem and ovoids. The mean V100 achieved by IPSA for combination-BT, manual optimization and Manchester was 96 ± 3.7%, 95 ± 5.5% and 80 ± 13.4%, respectively. The mean D100 was 483 ± 80, 487 ± 97 and 335 ± 119 cGy, respectively. The mean D90 was 677 ± 61, 681 ± 88 and 513 ± 150 cGy, respectively. IPSA resulted in significant reductions of the doses to the rectum (IPSA D2cm3: 408 ± 71 cGy vs manual optimization D2cm3: 485 ± 105 cGy; P = 0.03) and the bladder (IPSA D2cm3: 452 ± 60 cGy vs manual optimization D2cm3: 583 ± 113 cGy; P < 0.0001). In conclusion, combination-BT achieved better tumor coverage, and plans using IPSA provided significant sparing of normal tissues without compromising CTV coverage. PMID:23728322

  7. Opioid consumption and pain in gynecological cancer patients treated with interstitial brachytherapy.

    PubMed

    Mendez, Lucas C; Choi, Stephen; D'Alimonte, Laura; Barnes, Elizabeth; Barbera, Lisa; Leung, Eric

    Interstitial brachytherapy (ISBT) has advantages over the intracavitary techniques in the treatment of gynecological malignancies. The insertion of catheters into tumor enables higher dose conformality and normal tissue sparing. However ISBT can be associated with pain due its invasiveness. The goal of this study is to assess pain and opioid consumption of patients implanted with a perineal ISBT applicator. Forty-eight patients were treated with ISBT from September 2014 to April 2016. Mean age was 63. Malignancies included 18 cervical cancers, 12 vaginal, 14 recurrent endometrial, and four others. Patient characteristics and technical ISBT data were collected. Opioid consumption was quantified as oral morphine equivalent per day (OMEq/day) from postimplant until removal. Pain score levels were collected by using an 11-point scoring system. Twenty-three patients had a single ISBT implantation, whereas 25 had a second. Twenty-eight patients required IV-patient-controlled analgesia. Mean OMEq/day for the first insertion was 55 mg. In the second insertion, an increase of 22 mg was seen (p = 0.0004). Patients with IV-patient-controlled analgesia had higher opioid consumption (OMEq/day 69.8 mg vs 32.1 mg, p = 0.001) and maximum pain scores (5.5 vs 3.4, p = 0.007) as compared with patients on oral opioids. Higher levels of pain were detected in the first hours postimplant. Previous opioids and age were associated with increased opioid consumption. Pain from perineal-ISBT can be managed with oral opioids in a select group of patients. For repeat insertions, there may be an increase in opioid consumption. While age and previous opioids affected opioid requirements, other factors such as number of needles and insertion depth were not associated factors. Copyright © 2017 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  8. Interstitial microwave-induced hyperthermia and iridium brachytherapy for the treatment of obstructing biliary carcinomas.

    PubMed

    Coughlin, C T; Wong, T Z; Ryan, T P; Jones, E L; Crichlow, R W; Spiegel, P K; Jeffery, R

    1992-01-01

    In a phase I clinical study, 10 patients with obstructive biliary carcinomas were treated with single-antenna interstitial microwave hyperthermia and iridium-192 brachytherapy. For each patient a standard biliary drainage catheter was implanted percutaneously through the obstructed common bile duct. This catheter accommodated a single microwave antenna which operated at 915 MHz, and one or two fibreoptic thermometry probes for temperature measurement. Under fluoroscopic guidance the microwave antenna and temperature probes were positioned in the CT-determined tumour mass. The 60-min heat treatment achieved a central tumour temperature of 45-55 degrees C while keeping temperatures at the proximal and distal margins at 43 degrees C. Immediately following the hyperthermia treatment the microwave antenna and temperature probes were removed, and a single strand of iridium-192 double-strength seeds was inserted to irradiate the tumour length. A dose of 5500-7900 cGy calculated at 0.5 cm radially from the catheter was administered over 5-7 days. Upon removal of the iridium a second hyperthermia treatment was performed. A total of 18 hyperthermia treatments were administered to the 10 patients. In two cases the second hyperthermia treatment after brachytherapy was not possible due to a kink in the catheter, or bile precipitation in the catheter. All patients tolerated the procedure well, and there were no acute complications. To evaluate the volumetric heating potential of this hyperthermia method, specific absorption rate (SAR) values were measured at 182 planar points in muscle phantom. Insulated and non-insulated antenna performance was tested at 915 MHz in a biliary catheter filled with air, saline, or bile to mimic clinical treatments. The insulated antenna exhibited the best performance. Differences between antenna performance in saline and bile were also noted. In summary, this technique may have potential for tumours which obstruct biliary drainage and are

  9. Feasibility of salvage interstitial microwave thermal therapy for prostate carcinoma following failed brachytherapy: studies in a tissue equivalent phantom

    NASA Astrophysics Data System (ADS)

    McCann, Claire; Kumaradas, J. Carl; Gertner, Mark R.; Davidson, Sean R. H.; Dolan, Alfred M.; Sherar, Michael D.

    2003-04-01

    Thermal therapy is an experimental treatment to destroy solid tumours by heating them to temperatures ranging from 55 °C to 90 °C, inducing thermal coagulation and necrosis of the tumour. We are investigating the feasibility of interstitial microwave thermal therapy as a salvage treatment for prostate cancer patients with local recurrence following failed brachytherapy. Due to the electrical and thermal conductivity of the brachytherapy seeds, we hypothesized that the seeds could scatter the microwave energy and cause unpredictable heating. To investigate this, a 915 MHz helical antenna was inserted into a muscle-equivalent phantom with and without brachytherapy seeds. Following a 10 W, 5 s input to the antenna, the temperature rise was used to calculate absorbed power, also referred to as specific absorption rate (SAR). Plane wave models based on Maxwell's equations were also used to characterize the electromagnetic scattering effect of the seeds. In addition, the phantom was heated with 8 W for 5 min to quantify the effect of the seeds on the temperature distribution during extended heating. SAR measurements indicated that the seeds had no significant effect on the shape and size of the SAR pattern of the antenna. However, the plane wave simulations indicated that the seeds could scatter the microwave energy resulting in hot spots at the seed edges. Lack of experimental evidence of these hot spots was probably due to the complex polarization of the microwaves emitted by the helical antenna. Extended heating experiments also demonstrated that the seeds had no significant effect on the temperature distributions and rates of temperature rise measured in the phantom. The results indicate that brachytherapy seeds are not a technical impediment to interstitial microwave thermal therapy as a salvage treatment following failed brachytherapy.

  10. Performance and suitability assessment of a real-time 3D electromagnetic needle tracking system for interstitial brachytherapy

    PubMed Central

    Boutaleb, Samir; Fillion, Olivier; Bonillas, Antonio; Hautvast, Gilion; Binnekamp, Dirk; Beaulieu, Luc

    2015-01-01

    Purpose Accurate insertion and overall needle positioning are key requirements for effective brachytherapy treatments. This work aims at demonstrating the accuracy performance and the suitability of the Aurora® V1 Planar Field Generator (PFG) electromagnetic tracking system (EMTS) for real-time treatment assistance in interstitial brachytherapy procedures. Material and methods The system's performance was characterized in two distinct studies. First, in an environment free of EM disturbance, the boundaries of the detection volume of the EMTS were characterized and a tracking error analysis was performed. Secondly, a distortion analysis was conducted as a means of assessing the tracking accuracy performance of the system in the presence of potential EM disturbance generated by the proximity of standard brachytherapy components. Results The tracking accuracy experiments showed that positional errors were typically 2 ± 1 mm in a zone restricted to the first 30 cm of the detection volume. However, at the edges of the detection volume, sensor position errors of up to 16 mm were recorded. On the other hand, orientation errors remained low at ± 2° for most of the measurements. The EM distortion analysis showed that the presence of typical brachytherapy components in vicinity of the EMTS had little influence on tracking accuracy. Position errors of less than 1 mm were recorded with all components except with a metallic arm support, which induced a mean absolute error of approximately 1.4 mm when located 10 cm away from the needle sensor. Conclusions The Aurora® V1 PFG EMTS possesses a great potential for real-time treatment assistance in general interstitial brachytherapy. In view of our experimental results, we however recommend that the needle axis remains as parallel as possible to the generator surface during treatment and that the tracking zone be restricted to the first 30 cm from the generator surface. PMID:26622231

  11. Feasibility of salvage interstitial microwave thermal therapy for prostate carcinoma following failed brachytherapy: studies in a tissue equivalent phantom.

    PubMed

    McCann, Claire; Kumaradas, J Carl; Gertner, Mark R; Davidson, Sean R H; Dolan, Alfred M; Sherar, Michael D

    2003-04-21

    Thermal therapy is an experimental treatment to destroy solid tumours by heating them to temperatures ranging from 55 degrees C to 90 degrees C, inducing thermal coagulation and necrosis of the tumour. We are investigating the feasibility of interstitial microwave thermal therapy as a salvage treatment for prostate cancer patients with local recurrence following failed brachytherapy. Due to the electrical and thermal conductivity of the brachytherapy seeds, we hypothesized that the seeds could scatter the microwave energy and cause unpredictable heating. To investigate this, a 915 MHz helical antenna was inserted into a muscle-equivalent phantom with and without brachytherapy seeds. Following a 10 W, 5 s input to the antenna, the temperature rise was used to calculate absorbed power, also referred to as specific absorption rate (SAR). Plane wave models based on Maxwell's equations were also used to characterize the electromagnetic scattering effect of the seeds. In addition, the phantom was heated with 8 W for 5 min to quantify the effect of the seeds on the temperature distribution during extended heating. SAR measurements indicated that the seeds had no significant effect on the shape and size of the SAR pattern of the antenna. However, the plane wave simulations indicated that the seeds could scatter the microwave energy resulting in hot spots at the seed edges. Lack of experimental evidence of these hot spots was probably due to the complex polarization of the microwaves emitted by the helical antenna. Extended heating experiments also demonstrated that the seeds had no significant effect on the temperature distributions and rates of temperature rise measured in the phantom. The results indicate that brachytherapy seeds are not a technical impediment to interstitial microwave thermal therapy as a salvage treatment following failed brachytherapy.

  12. Analysis of Fat Necrosis Following Adjuvant High-Dose-Rate Interstitial Brachytherapy for Early-Stage Breast Cancer

    PubMed Central

    Garsa, Adam A.; Ferraro, Daniel J.; DeWees, Todd; Margenthaler, Julie A.; Naughton, Michael; Aft, Rebecca; Gillanders, William E.; Eberlein, Timothy; Matesa, Melissa A.; Zoberi, Imran

    2014-01-01

    Purpose To report the incidence and potential predictors of fat necrosis in women with early-stage breast cancer treated with adjuvant high-dose-rate (HDR) multicatheter interstitial brachytherapy. Methods and Materials Between 2003 and 2010, 238 treated breasts in 236 women were treated with accelerated partial breast irradiation (APBI) using HDR interstitial brachytherapy. Selection criteria included patients with Tis-T2 tumors measuring ≤ 3 cm, without nodal involvement, who underwent breast-conserving surgery (BCS). 99% of treatments were to a total dose of 34 Gy. The presence and severity of fat necrosis was prospectively recorded during follow up. Cosmesis was qualitatively scored in all patients. Cosmesis was quantitatively measured via the percentage breast retraction assessment (pBRA) in 151 cases. Results Median follow-up was 56 months. The crude rate of fat necrosis was 17.6%. The rate of symptomatic fat necrosis was 10.1%. In univariate analysis acute breast infection and anthracycline-based chemotherapy, number of catheters, V100, V150, V200 and integrated reference air-kerma (IRAK) were significantly associated with fat necrosis. There was significant collinearity between the brachytherapy related factors, of these V150 was most predictive. In multivariate analysis only V150 was significantly associated with fat necrosis. At 3 years, patients with fat necrosis were more likely to have a fair/poor cosmetic outcome and a larger pBRA. Conclusions Mammary fat necrosis is a common adverse event after BCS and HDR interstitial brachytherapy. Fat necrosis is associated with worse qualitative and quantitative cosmetic outcomes. Minimizing exposure volumes such as V150 may decrease the incidence of fat necrosis and improve cosmesis. PMID:22726878

  13. The Vienna applicator for combined intracavitary and interstitial brachytherapy of cervical cancer: Clinical feasibility and preliminary results

    SciTech Connect

    Dimopoulos, Johannes . E-mail: johannes.dimopoulos@akhwien.at; Kirisits, Christian; Petric, Primoz; Georg, Petra; Lang, Stefan; Berger, Daniel; Poetter, Richard

    2006-09-01

    Purpose: The aims of this study were to investigate the clinical feasibility and to report on preliminary treatment outcomes of combined intracavitary/interstitial brachytherapy, using a novel applicator and magnetic resonance imaging (MRI)-based treatment planning in patients with locally advanced cervical cancer. Methods and Materials: A total of 22 cervical cancer patients with insufficient response and/or unfavorable topography after external-beam irradiation were included in this study. Parametrial extent of the disease in these patients was judged to exceed the coverage limit of intracavitary brachytherapy alone. A modified tandem/ring (T/R) applicator for guidance of parametrial needles (N) was used to perform high-dose-rate-brachytherapy with MRI-based treatment planning. Clinical feasibility and preliminary treatment outcomes were assessed. Results: A total of 44 interstitial needle implants were performed. The spatial relations between the T/R + N applicator, high-risk clinical target volume, and organs at risk were visible clearly in all cases. Accurate and reproducible needle placement could be achieved in the majority of cases. No severe adverse events were caused by the intervention. The mean follow-up period was 20 months (range, 5-35 months). No G3 to G4 early or persistent late side effects were observed. Complete remission was achieved in 21 patients (95%). One local recurrence was observed within the high-risk clinical target volume area during follow-up. Conclusions: Our preliminary clinical experience indicates that combined intracavitary and interstitial MRI-based brachytherapy in patients with significant residual disease after external-beam therapy extending up to the distal third of parametria is feasible and allows excellent local control and a low rate of morbidity.

  14. Treatment of cervical carcinoma employing a template for transperineal interstitial Ir192 brachytherapy.

    PubMed

    Gaddis, O; Morrow, C P; Klement, V; Schlaerth, J B; Nalick, R H

    1983-06-01

    The development of a template technique at this institution for transperineal interstitial-intracavitary brachytherapy employing Ir192 wire has previously been reported. In this paper we report the results of radiation treatment of 84 women with fresh, primary squamous carcinoma of the cervix admitted to the Los Angeles County--University of Southern California Medical Center from April, 1975 to September, 1979 who received at least one transperineal template implant as part of their initial treatment. The 75 evaluable patients were followed 3 to 60 months, with a median of 17 months. Recurrence rates in the pelvic treatment field by clinical (FIGO) stage grouping were 35.7% (5/14) Stage IB;0% (0/8) Stage IIA; 20% (5/25) Stage IIB; 46.2% (12/26) Stage III; and 0% (0/2) Stage IVA. The overall failure rate within the treatment field was 29.3% (22/75). The non-tumor associated rectovaginal and vesicovaginal fistula rate was 14.3% (2/14) in Stage IB; 0% (0/8) in Stage IIA; 16.0% (4/25) in Stage IIB; 15.4% (4/26) in Stage III; and 0% (0/2) in Stage IVA. The non-tumor associated fistula rate for all stages was 13.3% (10/75). Severe or grade III nonfistulous, delayed adverse effects (proctosigmoiditis, cystitis, vault necrosis) occurred in an additional 6 patients. Thus, 21.3% (16/75) of all evaluable patients experienced severe adverse radiation effects during the follow-up period. Pre-radiation staging laparotomy was performed on 31 patients. It had no obvious effect on the pattern or rate of radiation complications. The role of the interstitial-intracavitary template in the treatment of primary cervical carcinoma is discussed.

  15. [Brachytherapy].

    PubMed

    Itami, Jun

    2014-12-01

    Brachytherapy do require a minimal expansion of CTV to obtain PTV and it is called as ultimate high precision radiation therapy. In high-dose rate brachytherapy, applicators will be placed around or into the tumor and CT or MRI will be performed with the applicators in situ. With such image-guided brachytherapy (IGBT) 3-dimensional treatment planning becomes possible and DVH of the tumor and organs at risk can be obtained. It is now even possible to make forward planning satisfying dose constraints. Traditional subjective evaluation of brachytherapy can be improved to the objective one by IGBT. Brachytherapy of the prostate cancer, cervical cancer, and breast cancer with IGBT technique was described.

  16. Image-guided high-dose-rate interstitial brachytherapy – a valuable salvage treatment approach for loco-regional recurrence of papillary thyroid cancer

    PubMed Central

    Wu, Ning; Zhao, Hongfu; Han, Dongmei; Zhao, Zhipeng; Ge, Yuxin

    2016-01-01

    Purpose To report the treatment effect of image-guided high-dose-rate (HDR) interstitial brachytherapy for refractory recurrence of papillary thyroid cancer (PTC). Case report This 66-year-old female presented with recurrence 5 years after thyroidectomy for PTC. Despite external irradiation and radioactive 131I, the lesion expanded as 3.7 × 3.0 × 2.3 cm3 and 2.0 × 1.5 × 1.5 cm3. The locoregional recurrent tumor was treated with image-guided HDR interstitial brachytherapy. The total dose of 30 Gy in 6 fractions were delivered on the whole recurrent tumor. Results Removal of the recurrent tumor was securely achieved by HDR interstitial brachytherapy guided with ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI) scanning. The refractory tumor in the patients healed uneventfully after HDR interstitial brachytherapy without recurrence during the 14 months of follow-up. Conclusions The image-guided HDR interstitial brachytherapy may be a valuable salvage treatment approach for refractory recurrence of PTC. PMID:27257420

  17. 125I Seed Permanent Implantation as a Palliative Treatment for Stage III and IV Hypopharyngeal Carcinoma

    PubMed Central

    Li, Lei; Yang, Jie; Li, Xiaojiang; Wang, Xiaoli; Ren, Yanxin; Fei, Jimin; Xi, Yan; Sun, Ruimei; Ma, Jing

    2016-01-01

    Objectives. The aim of this study was to investigate the feasibility and safety of percutaneous 125I seed permanent implantation for advanced hypopharyngeal carcinoma from toxicity, tumor response, and short-term outcome. Methods. 125I seeds implant procedures were performed under computed tomography for 34 patients with advanced hypopharyngeal carcinoma. We observed the local control rate, overall survival, and acute or late toxicity rate. Results. In the 34 patients (stage III, n=6; stage IV, n=28), the sites of origin were pyriform sinus (n=29) and postcricoid area (n=5). All patients also received one to four cycles of chemotherapy after seed implantation. The post-plan showed that the actuarial D90 of 125I seeds ranged from 90 to 158 Gy (median, 127 Gy). The mean follow-up was 12.3 months (range, 3.4 to 43.2 months). The local control was 2.1–31.0 months with a median of 17.7 months (95% confidence interval [CI], 13.4 to 22.0 months). The 1-, 2-, and 3-year local controls were 65.3%, 28.6%, and 9.5% respectively. Twelve patients (35%) died of local recurrence, fourteen patients (41%) died of distant metastases, and three patients (9%) died of recurrence and metastases at the same time. Five patients (15%) still survived to follow-up. At the time of analysis, the median survival time was 12.5 months (95% CI, 9.5 to 15.4 months). The 1-, 2-, and 3-year overall survival rates were 55.2%, 20.3%, and 10.9%, respectively. Five patients (15%) experienced grade 3 toxic events and nine patients (26%) have experienced grade 2 toxic events. Conclusion. This review shows relatively low toxicity for interstitial 125I seed implantation in the patients with advanced stage hypopharyngeal cancer. The high local control results suggest that 125I seed brachytherapy implant as a salvage or palliative treatment for advanced hypopharyngeal carcinoma merit further investigation. PMID:27440132

  18. Evaluation of quality indices during multifractionated pelvic interstitial brachytherapy for cervical cancer.

    PubMed

    Chopra, Supriya; Shukla, Pragya; Paul, Siji Nojin; Engineer, Reena; Phurailatpam, Reena; Swamidas, Jamema; Mahantshetty, Umesh; Shrivastava, Shyam Kishore

    2013-01-01

    To evaluate the impact of needle displacements on quality indices during multifractionated pelvic interstitial brachytherapy (IBT). Patients undergoing boost IBT were included. Postprocedure planning and verification CT scans were obtained. Three-dimensional needle displacements were measured. Clinical target volume and organ at risk were delineated. Coverage index (CI), dose homogeneity index (DHI), dose nonuniformity ratio (DNR), V170, V200, V250, and dose received by 2cc of organs at risk were obtained at baseline. The displacements were simulated by shifting dwell positions, and dose point optimized and graphically optimized plans were generated. Wilcoxon test determined statistical significance of differences in quality indices. Fifteen patients were included and received five fractions of IBT over 3 days. Maximum displacements were observed in caudal direction (average, 19.1mm). At baseline, CI of 0.94 (range, 0.91-0.99), DHI of 0.90 (range, 0.80-0.94), and DNR of 0.10 (range, 0.05-0.10) were attained. The CI, DHI, and DNR in Day 3 dose point optimized plans were 0.76 (range, 0.4-0.99), 0.76 (range, 0.40-0.94), and 0.23 (range, 0.06-0.64), respectively. The difference in CI, DHI, and DNR between baseline and Day 3 dose point optimized plans was statistically significant (p = 0.002, 0.007, and 0.001, respectively). Day 3 graphically optimized plans were superior to Day 3 dose point optimized plans (CI, 0.82 vs. 0.76; p = 0.01). Graphically optimized could however improve CI without compromise in DHI, DNR, V170, V200, and V250 only in patients wherein caudal displacements ≤15mm. Caudal needle displacements during multifractionated IBT cause significant deterioration of quality indices. Replanning with graphically optimized and/or needle repositioning maybe required for maintaining the quality of IBT. Copyright © 2013 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  19. Transition from Paris dosimetry system to 3D image-guided planning in interstitial breast brachytherapy

    PubMed Central

    Wronczewska, Anna; Kabacińska, Renata; Makarewicz, Roman

    2015-01-01

    Purpose The purpose of this study is to evaluate our first experience with 3D image-guided breast brachytherapy and to compare dose distribution parameters between Paris dosimetry system (PDS) and image-based plans. Material and methods First 49 breast cancer patients treated with 3D high-dose-rate interstitial brachytherapy as a boost were selected for the study. Every patient underwent computed tomography, and the planning target volume (PTV) and organs at risk (OAR) were outlined. Two treatment plans were created for every patient. First, based on a Paris dosimetry system (PDS), and the second one, imaged-based plan with graphical optimization (OPT). The reference isodose in PDS implants was 85%, whereas in OPT plans the isodose was chosen to obtain proper target coverage. Dose and volume parameters (D90, D100, V90, V100), doses at OARs, total reference air kerma (TRAK), and quality assurance parameters: dose nonuniformity ratio (DNR), dose homogeneity index (DHI), and conformity index (COIN) were used for a comparison of both plans. Results The mean number of catheters was 7 but the mean for 20 first patients was 5 and almost 9 for the next 29 patients. The mean value of prescribed isodose for OPT plans was 73%. The mean D90 was 88.2% and 105.8%, the D100 was 59.8% and 75.7%, the VPTV90 was 88.6% and 98.1%, the VPTV100 was 79.9% and 98.9%, and the TRAK was 0.00375 Gym–1 and 0.00439 Gym–1 for the PDS and OPT plans, respectively. The mean DNR was 0.29 and 0.42, the DHI was 0.71 and 0.58, and the COIN was 0.68 and 0.76, respectively. Conclusions The target coverage in image-guided plans (OPT) was significantly higher than in PDS plans but the dose homogeneity was worse. Also, the value of TRAK increased because of change of prescribing isodose. The learning curve slightly affected our results. PMID:26816505

  20. Treatment of hepatic metastases of breast cancer with CT-guided interstitial brachytherapy - a phase II-study.

    PubMed

    Wieners, Gero; Mohnike, Konrad; Peters, Nils; Bischoff, Joachim; Kleine-Tebbe, Anke; Seidensticker, Ricarda; Seidensticker, Max; Gademann, Günther; Wust, Peter; Pech, Maciej; Ricke, Jens

    2011-08-01

    The aim of the study was the evaluation of feasibility, safety and effectiveness of interstitial brachytherapy for the treatment of hepatic metastases of breast cancer. Forty-one consecutive patients with 115 unresectable hepatic metastases of breast cancer were included in this phase-II-trial. They were treated in 69 interventions of CT-guided-interstitial-brachytherapy of the liver. Brachytherapy was applied as a single fraction high-dose-irradiation (15-25Gy (Gray)) using a (192)Ir-source of 10Ci. Nineteen patients presented systemically pretreated extrahepatic tumors. Primary endpoints were complications, local tumor control and progression-free survival. The median tumor diameter was 4.6 cm (1.5-11 cm). The median irradiation time per intervention was 26.5 min (range: 7-47 min). The applied median minimal dose at the CTV (clinical target volume) margin was 18.5 Gy (12-25 Gy). In 69 interventions and during the postinterventional period, one major complication (symptomatic post-interventional bleeding) (1.5%) and six minor complications occurred (8.7%). The median follow-up time was 18 months (range: 1-56). After 6, 12 and 18 months, local tumor control was 97%, 93.5% and 93.5%, intra- and extrahepatic progression free survival was 53%, 40% and 27%, and overall survival was 97%, 79% and 60%, respectively. CT-guided-brachytherapy is safe and effective for the treatment of liver metastases of breast cancer. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  1. Brachytherapy

    MedlinePlus

    ... care for brachytherapy catheters. top of page What equipment is used? For permanent implants, radioactive material (which ... the tumor. top of page Who operates the equipment? The equipment is operated by a medical physicist, ...

  2. Brachytherapy

    MedlinePlus

    ... Who will be involved in this procedure? The delivery of brachytherapy requires a treatment team, including a ... are specially trained technologists who may assist in delivery of the treatments. The radiation therapy nurse provides ...

  3. Long term results from a prospective database on high dose rate (HDR) interstitial brachytherapy for primary cervical carcinoma.

    PubMed

    Fallon, Julia; Park, Sang-Jung; Yang, Lisa; Veruttipong, Darlene; Zhang, Mingle; Van, Thanh; Wang, Pin-Chieh; Fekete, Alexandra M; Cambeiro, Mauricio; Kamrava, Mitchell; Steinberg, Michael L; Demanes, D Jeffrey

    2016-10-29

    Present long-term outcomes in primary cervical cancer treated with external beam and high dose rate interstitial brachytherapy. High dose rate (HDR) interstitial (IS) brachytherapy (BT) and external beam (EBRT) were administered from 1992 to 2009 to 315 patients who were unsuitable for intracavitary (IC) BT alone. Histology was 89% squamous cell, 8% adenocarcinoma, and 3% adenosquamous. FIGO stage was I-14%, II-47%, III-34%, and IVA-5%. Median tumor size was 6cm. Lymph node metastases were 26% pelvic and 9.5% para-aortic. Treatment planning was 49% 2D and 51% 3D-CT. The mean doses were central EBRT EQD210 37.3±4.3Gy (sidewall 49.2±3.6Gy) and HDR EQD210 42.3±5.3Gy (nominal 5.4Gy×6 fractions using a mean of 24 catheters and 1 tandem). Total EQD210 mean target dose was 79.5±5.4Gy. Standardized planned dose constraints were ICRU points or D0.1cc bladder 80%, rectum 75% and urethra 90% of the HDR dose per fraction. Morbidity assessment was CTCAEv3. Median and mean follow-up were 50 and 61months (3-234). The 10-year actuarial local control was 87%, regional control 84%, and loco-regional control 77%. Distant metastasis free survival was 66%, cause specific survival 56%, disease free survival 54%, and overall survival 40%. The rates of late grade GU and GI toxicities were 4.8% G3 and 5.4% G4. Template-guided interstitial can be safely performed to successfully deliver high radiation dose to locally advanced cervix cancer and avoid excessive dose and injury to adjacent vital pelvic organs. We achieved high tumor control with low morbidity in patients who were poor candidates for intracavitary brachytherapy. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Electromagnetic tracking (EMT) technology for improved treatment quality assurance in interstitial brachytherapy.

    PubMed

    Kellermeier, Markus; Herbolzheimer, Jens; Kreppner, Stephan; Lotter, Michael; Strnad, Vratislav; Bert, Christoph

    2017-01-01

    Electromagnetic Tracking (EMT) is a novel technique for error detection and quality assurance (QA) in interstitial high dose rate brachytherapy (HDR-iBT). The purpose of this study is to provide a concept for data acquisition developed as part of a clinical evaluation study on the use of EMT during interstitial treatment of breast cancer patients. The stability, accuracy, and precision of EMT-determined dwell positions were quantified. Dwell position reconstruction based on EMT was investigated on CT table, HDR table and PDR bed to examine the influence on precision and accuracy in a typical clinical workflow. All investigations were performed using a precise PMMA phantom. The track of catheters inserted in that phantom was measured by manually inserting a 5 degree of freedom (DoF) sensor while recording the position of three 6DoF fiducial sensors on the phantom surface to correct motion influences. From the corrected data, dwell positions were reconstructed along the catheter's track. The accuracy of the EMT-determined dwell positions was quantified by the residual distances to reference dwell positions after using a rigid registration. Precision and accuracy were investigated for different phantom-table and sensor-field generator (FG) distances. The measured precision of the EMT-determined dwell positions was ≤ 0.28 mm (95th percentile). Stability tests showed a drift of 0.03 mm in the first 20 min of use. Sudden shaking of the FG or (large) metallic objects close to the FG degrade the precision. The accuracy with respect to the reference dwell positions was on all clinical tables < 1 mm at 200 mm FG distance and 120 mm phantom-table distance. Phantom measurements showed that EMT-determined localization of dwell positions in HDR-iBT is stable, precise, and sufficiently accurate for clinical assessment. The presented method may be viable for clinical applications in HDR-iBT, like implant definition, error detection or quantification of uncertainties

  5. A new template for MRI-based intracavitary/interstitial gynecologic brachytherapy: design and clinical implementation

    PubMed Central

    Sancho, Jose Richart; Palacin, Antonio Otal; Calatayud, Jose Perez; Ortega, Manuel Santos

    2015-01-01

    Purpose To describe the potential clinical use of a new brachytherapy applicator for gynecological tumors, with special attention to locally advanced cervical carcinoma. This device allows the combination of intracavitary radiotherapy and MRI-compatible transperineal interstitial needles. The design of this template addresses the disadvantages of currently commercially available templates: the inability of the intracavitary component to reach deep into the cervix (MUPIT), and the MRI-incompatibility of these templates (MUPIT and Syed), which necessitates use of CT imaging for the dosimetry. Material and methods The newly developed Benidorm Template applicator allows titanium needles in a template with straight and angled holes to provide different angles of divergence to be used with currently existing MRI-compatible intrauterine tubes. It can provide total coverage of the craniocaudal and lateral extension of the tumor (intrautherus, parametrial, and paravaginal). This method is mainly indicated in advanced cervical carcinoma with bulky parametrial invasion (medial or distal), with bulky primary disease that responds poorly to external beam radiotherapy extensive paravaginal involvement (tumor thickness greater than 0.5 cm) extending to the middle or lower third of the vagina, or for disease that has invaded the bladder or rectum (stage IVA). Results Between April 2013 until December 2014, we treated 15 patients with locally advanced cervical carcinoma employing the Benidorm Template. The median dose at D90 for the CTV was 79.8 Gy (71.5-89.9 Gy), at D2cc for the bladder it was 77.6 Gy (69.8-90.8 Gy), and at D2cc for the rectum it was 71.9 Gy (58.3-83.7 Gy). Values expressed in EQD2, assuming α/β of 10 for CTV and 3 for OAR. Conclusions This new applicator allows the use of MRI-based dosimetry, thus providing the advantages of MRI volume definition. As such, it facilitates determination of complete intracavitary and interstitial CTV coverage and the sparing of

  6. Quality of Life of Oral Cancer Patients After Low-Dose-Rate Interstitial Brachytherapy

    SciTech Connect

    Yoshimura, Ryo-ichi Shibuya, Hitoshi; Miura, Masahiko; Watanabe, Hiroshi; Ayukawa, Fumio; Hayashi, Keiji; Toda, Kazuma

    2009-03-01

    Purpose: To assess the quality of life (QOL) of oral cancer patients treated with low-dose-rate interstitial brachytherapy (LDR-BT) alone. Methods and Materials: Between June 2005 and July 2006, a total of 56 patients with oral cancer were enrolled in this prospective study. QOL was assessed by means of the core questionnaire and head and neck questionnaire module of the European Organization for Research and Treatment of Cancer (EORTC Quality of Life Questionnaire-Core 30 [QLQ-C30] and QLQ Head and Neck 35 [H and N35]). The questionnaires were distributed to the patients before the start of treatment and 3 months, 6 months, and 12 months after the start of LDR-BT. Results: It was possible to analyze the results for 20 of the initial 56 patients because they did not experience metastasis or recurrence during this study. No functions or symptoms asked about in the QLQ-C30 deteriorated during the first year. The emotional function score steadily and significantly increased. No symptoms in the QLQ-H and N35 significantly deteriorated. The scores for pain, trouble with social eating, and weight loss on the QLQ-H and N35 steadily and significantly decreased. Age, gender, and LDR-BT source had no effect on the change in QOL during the first year, but T-stage significantly affected the change in global health status, tumor site affected the changes in swallowing, sensory problems, sticky saliva, and complications affected the changes in pain, swallowing, and mouth opening. Conclusions: QOL of oral cancer patients treated with LDR-BT is high. However, tumor stage, tumor site, and complications affected the changes in a few functions and symptoms during the first year.

  7. Prospective evaluation of quality of life after interstitial brachytherapy for localized prostate cancer.

    PubMed

    Caffo, Orazio; Fellin, Gianni; Bolner, Andrea; Coccarelli, Franco; Divan, Claudio; Frisinghelli, Michela; Mussari, Salvatore; Ziglio, Franco; Malossini, Gianni; Tomio, Luigi; Galligioni, Enzo

    2006-09-01

    Permanent interstitial brachytherapy (IB) has become an increasingly appealing therapeutic option for localized prostate cancer (LPC) among physicians and patients because it involves short hospitalization and treatment and its postulated low degree of toxicity may reduce its impact on the patients' quality of life (QoL). The aim of this prospective study was to assess the impact of IB on the QoL of patients with LPC. A validated self-completed questionnaire was administered to the patients before and after IB and then at yearly intervals. The items allowed the identification of seven subscales exploring physical well-being (PHY), physical autonomy (POW), psychological well-being (PSY), relational life (REL), urinary function (URI), rectal function (REC), and sexual function (SEX). The assessment of the QoL of 147 patients treated between May 2000 and February 2005 revealed no relevant differences in the PHY scale scores 1 month after IB or later, and the same was true of the POW, PSY, and REL scales. Urinary function significantly worsened after IB and returned to pretreatment levels only after 3 years; the impact of the treatment on the URI scale was greater in the patients with good baseline urinary function than in those presenting more urinary symptoms before IB. Rectal and sexual functions were significantly worse only at the post-IB evaluation. The results of the present study confirm that the impact of IB on the patients' QoL is low despite its transient negative effects on some function, and extend existing knowledge concerning QoL after IB.

  8. Iridium-192 interstitial brachytherapy for equine periocular tumours: treatment results and prognostic factors in 115 horses.

    PubMed

    Théon, A P; Pascoe, J R

    1995-03-01

    One hundred and fifteen horses with periocular tumours were treated with iridium-192 interstitial brachytherapy. Tumours included squamous cell carcinomas (n = 52) and sarcoids (n = 63). All horses were scheduled to receive 60 Gy (minimal tumour dose) given at a low dose rate (0.034 +/- 0.010 Gy/h). The mean and median follow-up times to last contact or death were 24 and 16 months, respectively. Chronic radiation reactions included palpebral fibrosis (10.4%), cataract (7.8%), keratitis and corneal ulceration (6.9%). Cosmetic changes included permanent epilation (21.7%) and hair dyspigmentation (78.3%). The one year progression-free survival (PFS) rates for sarcoids and carcinomas were 86.6% and 81.8% and the 5 year PFS rates were 74.0% and 63.5%, respectively. The horse age and sex, histopathological type, anatomical subsite and classification (WHO T1-3) were included in the analysis of prognostic factors. The only significant prognostic factor that independently affected PFS time was the WHO T-classification (P = 0.009, relative risk = 0.85). When compared to horses with T1 lesions, horses with T2 and T3 lesions had 1.8-fold and 3.4-fold increased risks, respectively, for tumour recurrence (relative excess risk). The one year PFS rates for T1, T2 and T3 lesions were 95.2%, 89.5% and 66.2%, respectively. The 5 year PFS rates were 72.2%, 74.0% and 53.1%, respectively. The results of this study indicate that irradiation is an effective treatment option for horses with T1-2 lesions and should be part of a combined treatment modality for horses with T3 lesions.

  9. Prospective evaluation of quality of life after interstitial brachytherapy for localized prostate cancer

    SciTech Connect

    Caffo, Orazio . E-mail: orazio.caffo@apss.tn.it; Fellin, Gianni; Bolner, Andrea; Coccarelli, Franco; Divan, Claudio; Frisinghelli, Michela; Mussari, Salvatore; Ziglio, Franco; Malossini, Gianni; Tomio, Luigi; Galligioni, Enzo

    2006-09-01

    Purpose: Permanent interstitial brachytherapy (IB) has become an increasingly appealing therapeutic option for localized prostate cancer (LPC) among physicians and patients because it involves short hospitalization and treatment and its postulated low degree of toxicity may reduce its impact on the patients' quality of life (QoL). The aim of this prospective study was to assess the impact of IB on the QoL of patients with LPC. Methods and Materials: A validated self-completed questionnaire was administered to the patients before and after IB and then at yearly intervals. The items allowed the identification of seven subscales exploring physical well-being (PHY), physical autonomy (POW), psychological well-being (PSY), relational life (REL), urinary function (URI), rectal function (REC), and sexual function (SEX). Results: The assessment of the QoL of 147 patients treated between May 2000 and February 2005 revealed no relevant differences in the PHY scale scores 1 month after IB or later, and the same was true of the POW, PSY, and REL scales. Urinary function significantly worsened after IB and returned to pretreatment levels only after 3 years; the impact of the treatment on the URI scale was greater in the patients with good baseline urinary function than in those presenting more urinary symptoms before IB. Rectal and sexual functions were significantly worse only at the post-IB evaluation. Conclusions: The results of the present study confirm that the impact of IB on the patients' QoL is low despite its transient negative effects on some function, and extend existing knowledge concerning QoL after IB.

  10. Helical Tomotherapy Delivery of an IMRT Boost in Lieu of Interstitial Brachytherapy in the Setting of Gynecologic Malignancy: Feasibility and Dosimetric Comparison

    SciTech Connect

    Gielda, Benjamin T.; Shah, Anand P.; Marsh, James C.; Smart, Joseph P.; Bernard, Damian; Rotmensch, Jacob; Griem, Katherine L.

    2011-07-01

    Interstitial brachytherapy is an important means by which to improve local control in gynecologic malignancy when intracavitary brachytherapy is untenable. Patients unable to receive brachytherapy have traditionally received conventional external beam radiation alone with modest results. We investigated the ability of Tomotherapy (Tomotherapy Inc., Madison, WI) to replace interstitial brachytherapy. Six patients were selected. The planning CT of each patient was contoured with the planning target volume (PTV), bladder, rectum, femoral heads, and bowel. Identical contour sets were exported to Tomotherapy and Nucletron PLATO (Nucletron B.V., Veenendaal, The Netherlands). With Tomotherapy, the PTV was prescribed 31 Gy in 5 fractions to 90% of the volume. With PLATO, 600 cGy x 5 fractions was prescribed to the surface of the PTV. Dose delivered was normalized to 2 Gy fractions (EQD2) and added to a hypothetical homogenous 45-Gy pelvic dose. Tomotherapy achieved a D90 of 87 Gy EQD2 versus 86 Gy with brachytherapy. PTV dose was more homogeneous with tomotherapy. The dose to the most at-risk 2 mL of bladder and rectum with Tomotherapy was of 78 and 71 Gy EQD2 versus 81 and 75 Gy with brachytherapy. Tomotherapy delivered more dose to the femoral heads (mean 1.23 Gy per fraction) and bowel. Tomotherapy was capable of replicating the peripheral dose achieved with brachytherapy, without the PTV hotspots inherent to interstitial brachytherapy. Similar maximum doses to bowel and bladder were achieved with both methods. Excessive small bowel and femoral head toxicity may result if previous pelvic irradiation is not planned accordingly. Significant challenges related to interfraction and intrafraction motion must be overcome if treatment of this nature is to be contemplated.

  11. Treatment planning for multicatheter interstitial brachytherapy of breast cancer – from Paris system to anatomy-based inverse planning

    PubMed Central

    Polgár, Csaba

    2017-01-01

    In the last decades, treatment planning for multicatheter interstitial breast brachytherapy has evolved considerably from fluoroscopy-based 2D to anatomy-based 3D planning. To plan the right positions of the catheters, ultrasound or computed tomography (CT) imaging can be used, but the treatment plan is always based on postimplant CT images. With CT imaging, the 3D target volume can be defined more precisely and delineation of the organs at risk volumes is also possible. Consequently, parameters calculated from dose-volume histogram can be used for quantitative plan evaluation. The catheter reconstruction is also easier and faster on CT images compared to X-ray films. In high dose rate brachytherapy, using a stepping source, a number of forward dose optimization methods (manual, geometrical, on dose points, graphical) are available to shape the dose distribution to the target volume, and these influence dose homogeneities to different extent. Currently, inverse optimization algorithms offer new possibilities to improve dose distributions further considering the requirements for dose coverage, dose homogeneity, and dose to organs at risk simultaneously and automatically. In this article, the evolvement of treatment planning for interstitial breast implants is reviewed, different forward optimization methods are discussed, and dose-volume parameters used for quantitative plan evaluation are described. Finally, some questions of the inverse optimization method are investigated and initial experiences of the authors are presented. PMID:28344609

  12. Treatment planning for multicatheter interstitial brachytherapy of breast cancer - from Paris system to anatomy-based inverse planning.

    PubMed

    Major, Tibor; Polgár, Csaba

    2017-02-01

    In the last decades, treatment planning for multicatheter interstitial breast brachytherapy has evolved considerably from fluoroscopy-based 2D to anatomy-based 3D planning. To plan the right positions of the catheters, ultrasound or computed tomography (CT) imaging can be used, but the treatment plan is always based on postimplant CT images. With CT imaging, the 3D target volume can be defined more precisely and delineation of the organs at risk volumes is also possible. Consequently, parameters calculated from dose-volume histogram can be used for quantitative plan evaluation. The catheter reconstruction is also easier and faster on CT images compared to X-ray films. In high dose rate brachytherapy, using a stepping source, a number of forward dose optimization methods (manual, geometrical, on dose points, graphical) are available to shape the dose distribution to the target volume, and these influence dose homogeneities to different extent. Currently, inverse optimization algorithms offer new possibilities to improve dose distributions further considering the requirements for dose coverage, dose homogeneity, and dose to organs at risk simultaneously and automatically. In this article, the evolvement of treatment planning for interstitial breast implants is reviewed, different forward optimization methods are discussed, and dose-volume parameters used for quantitative plan evaluation are described. Finally, some questions of the inverse optimization method are investigated and initial experiences of the authors are presented.

  13. Intercomparison of ionisation chamber measurements from (125)I seeds.

    PubMed

    Davies, J B; Enari, K F; Baldock, C

    2007-05-01

    The reference air kerma rates of a set of individual (125)I seeds were calculated from current measurements of a calibrated re-entrant ionisation chamber. Single seeds were distributed to seven Australian brachytherapy centres for the same measurement with the user's instrumentation. Results are expressed as the ratio of the reference air kerma rate measured by the Australian Nuclear Science & Technology Organisation (ANSTO) to the reference air kerma rate measured at the centre. The intercomparison ratios of all participants were within +/-5% of unity.

  14. Development of 3D ultrasound needle guidance for high-dose-rate interstitial brachytherapy of gynaecological cancers

    NASA Astrophysics Data System (ADS)

    Rodgers, J.; Tessier, D.; D'Souza, D.; Leung, E.; Hajdok, G.; Fenster, A.

    2016-04-01

    High-dose-rate (HDR) interstitial brachytherapy is often included in standard-of-care for gynaecological cancers. Needles are currently inserted through a perineal template without any standard real-time imaging modality to assist needle guidance, causing physicians to rely on pre-operative imaging, clinical examination, and experience. While two-dimensional (2D) ultrasound (US) is sometimes used for real-time guidance, visualization of needle placement and depth is difficult and subject to variability and inaccuracy in 2D images. The close proximity to critical organs, in particular the rectum and bladder, can lead to serious complications. We have developed a three-dimensional (3D) transrectal US system and are investigating its use for intra-operative visualization of needle positions used in HDR gynaecological brachytherapy. As a proof-of-concept, four patients were imaged with post-insertion 3D US and x-ray CT. Using software developed in our laboratory, manual rigid registration of the two modalities was performed based on the perineal template's vaginal cylinder. The needle tip and a second point along the needle path were identified for each needle visible in US. The difference between modalities in the needle trajectory and needle tip position was calculated for each identified needle. For the 60 needles placed, the mean trajectory difference was 3.23 +/- 1.65° across the 53 visible needle paths and the mean difference in needle tip position was 3.89 +/- 1.92 mm across the 48 visible needles tips. Based on the preliminary results, 3D transrectal US shows potential for the development of a 3D US-based needle guidance system for interstitial gynaecological brachytherapy.

  15. 360-degree 3D transvaginal ultrasound system for high-dose-rate interstitial gynaecological brachytherapy needle guidance

    NASA Astrophysics Data System (ADS)

    Rodgers, Jessica R.; Surry, Kathleen; D'Souza, David; Leung, Eric; Fenster, Aaron

    2017-03-01

    Treatment for gynaecological cancers often includes brachytherapy; in particular, in high-dose-rate (HDR) interstitial brachytherapy, hollow needles are inserted into the tumour and surrounding area through a template in order to deliver the radiation dose. Currently, there is no standard modality for visualizing needles intra-operatively, despite the need for precise needle placement in order to deliver the optimal dose and avoid nearby organs, including the bladder and rectum. While three-dimensional (3D) transrectal ultrasound (TRUS) imaging has been proposed for 3D intra-operative needle guidance, anterior needles tend to be obscured by shadowing created by the template's vaginal cylinder. We have developed a 360-degree 3D transvaginal ultrasound (TVUS) system that uses a conventional two-dimensional side-fire TRUS probe rotated inside a hollow vaginal cylinder made from a sonolucent plastic (TPX). The system was validated using grid and sphere phantoms in order to test the geometric accuracy of the distance and volumetric measurements in the reconstructed image. To test the potential for visualizing needles, an agar phantom mimicking the geometry of the female pelvis was used. Needles were inserted into the phantom and then imaged using the 3D TVUS system. The needle trajectories and tip positions in the 3D TVUS scan were compared to their expected values and the needle tracks visualized in magnetic resonance images. Based on this initial study, 360-degree 3D TVUS imaging through a sonolucent vaginal cylinder is a feasible technique for intra-operatively visualizing needles during HDR interstitial gynaecological brachytherapy.

  16. Toward a 3D transrectal ultrasound system for verification of needle placement during high-dose-rate interstitial gynecologic brachytherapy.

    PubMed

    Rodgers, Jessica Robin; Surry, Kathleen; Leung, Eric; D'Souza, David; Fenster, Aaron

    2017-05-01

    Treatment for gynecologic cancers, such as cervical, recurrent endometrial, and vaginal malignancies, commonly includes external-beam radiation and brachytherapy. In high-dose-rate (HDR) interstitial gynecologic brachytherapy, radiation treatment is delivered via hollow needles that are typically inserted through a template on the perineum with a cylinder placed in the vagina for stability. Despite the need for precise needle placement to minimize complications and provide optimal treatment, there is no standard intra-operative image-guidance for this procedure. While some image-guidance techniques have been proposed, including magnetic resonance (MR) imaging, X-ray computed tomography (CT), and two-dimensional (2D) transrectal ultrasound (TRUS), these techniques have not been widely adopted. In order to provide intra-operative needle visualization and localization during interstitial brachytherapy, we have developed a three-dimensional (3D) TRUS system. This study describes the 3D TRUS system and reports on the system validation and results from a proof-of-concept patient study. To obtain a 3D TRUS image, the system rotates a conventional 2D endocavity transducer through 170 degrees in 12 s, reconstructing the 2D frames into a 3D image in real-time. The geometry of the reconstruction was validated using two geometric phantoms to ensure the accuracy of the linear measurements in each of the image coordinate directions and the volumetric accuracy of the system. An agar phantom including vaginal and rectal canals, as well as a model uterus and tumor, was designed and used to test the visualization and localization of the interstitial needles under idealized conditions by comparing the needles' positions between the 3D TRUS scan and a registered MR image. Five patients undergoing HDR interstitial gynecologic brachytherapy were imaged using the 3D TRUS system following the insertion of all needles. This image was manually, rigidly registered to the clinical

  17. Implant strategies for endocervical and interstitial ultrasound hyperthermia adjunct to HDR brachytherapy for the treatment of cervical cancer

    NASA Astrophysics Data System (ADS)

    Wootton, Jeffery H.; Prakash, Punit; Hsu, I.-Chow Joe; Diederich, Chris J.

    2011-07-01

    Catheter-based ultrasound devices provide a method to deliver 3D conformable heating integrated with HDR brachytherapy delivery. Theoretical characterization of heating patterns was performed to identify implant strategies for these devices which can best be used to apply hyperthermia to cervical cancer. A constrained optimization-based hyperthermia treatment planning platform was used for the analysis. The proportion of tissue >=41 °C in a hyperthermia treatment volume was maximized with constraints Tmax <= 47 °C, Trectum <= 41.5 °C, and Tbladder <= 42.5 °C. Hyperthermia treatment was modeled for generalized implant configurations and complex configurations from a database of patients (n = 14) treated with HDR brachytherapy. Various combinations of endocervical (360° or 2 × 180° output; 6 mm OD) and interstitial (180°, 270°, or 360° output; 2.4 mm OD) applicators within catheter locations from brachytherapy implants were modeled, with perfusion constant (1 or 3 kg m-3 s-1) or varying with location or temperature. Device positioning, sectoring, active length and aiming were empirically optimized to maximize thermal coverage. Conformable heating of appreciable volumes (>200 cm3) is possible using multiple sectored interstitial and endocervical ultrasound devices. The endocervical device can heat >41 °C to 4.6 cm diameter compared to 3.6 cm for the interstitial. Sectored applicators afford tight control of heating that is robust to perfusion changes in most regularly spaced configurations. T90 in example patient cases was 40.5-42.7 °C (1.9-39.6 EM43 °C) at 1 kg m-3 s-1 with 10/14 patients >=41 °C. Guidelines are presented for positioning of implant catheters during the initial surgery, selection of ultrasound applicator configurations, and tailored power schemes for achieving T90 >= 41 °C in clinically practical implant configurations. Catheter-based ultrasound devices, when adhering to the guidelines, show potential to generate conformal therapeutic

  18. Dosimetric comparison of interstitial brachytherapy with multi-channel vaginal cylinder plans in patients with vaginal tumors.

    PubMed

    Mendez, Lucas C; Paudel, Moti; Wronski, Matt; Ravi, Ananth; Barbera, Lisa; Leung, Eric

    2017-05-18

    To evaluate the dosimetric performance of multi-channel vaginal cylinder (MCVC) against interstitial brachytherapy (ISBT) for the treatment of vaginal tumors. Vaginal tumors with extension of > 0.5 cm and ≤ 2 cm from the lateral vaginal wall and/or ≤ 1 cm in height above the vaginal vault were retrospectively selected from a ISBT registry trial database. The selected patients were treated with ISBT and targets included the intermediate (IRCTV) or high-risk (HRCTV) clinical target volumes. For technique comparison, a 35 mm MCVC was registered with the interstitial intra-vaginal cylinder. Bladder and rectum contours were transferred from the ISBT to the MCVC-BT plans. Vaginal mucosa was achieved by 3 mm uniform expansion from cylinder surface. Both the ISBT and MCVC-BT plans were optimized using the Inverse Planning Simulated Annealing optimization algorithm. After normalizing target D90 to 700 cGy, dose to organs at risk were measured and compared between ISBT and MCVC plans. Six interstitial patient plans met the inclusion criteria for this study. Four patients had vaginal primaries and two recurrent cancers in the vagina. Lower doses to bladder and rectum were seen with ISBT plans. In half of the MCVC plans, the rectal dose met the recommended constraints. For plans in which the rectal constraint was not met, the target volumes were abutting the rectum and had a cranial-caudal length ≥ 5 cm. Dose to vaginal mucosa was lower in ISBT plans directed to the HRCTVs, although no difference was seen in circumferential IRCTVs. Overall, ISBT results in decreased dose to OARs as compared to MCVC. However, MCVC BT results in acceptable doses to OARs with possible improvement in vaginal doses for circumferential targets. Careful consideration to tumor geometry and location may help guide optimal techniques in vaginal tumor brachytherapy.

  19. Salvage brachytherapy in combination with interstitial hyperthermia for locally recurrent prostate carcinoma following external beam radiation therapy: a prospective phase II study.

    PubMed

    Kukiełka, Andrzej M; Strnad, Vratislav; Stauffer, Paul; Dąbrowski, Tomasz; Hetnał, Marcin; Nahajowski, Damian; Walasek, Tomasz; Brandys, Piotr; Matys, Robert

    2015-06-01

    Optimal treatment for patients with only local prostate cancer recurrence after external beam radiation therapy (EBRT) failure remains unclear. Possible curative treatments are radical prostatectomy, cryosurgery, and brachytherapy. Several single institution series proved that high-dose-rate brachytherapy (HDRBT) and pulsed-dose-rate brachytherapy (PDRBT) are reasonable options for this group of patients with acceptable levels of genitourinary and gastrointestinal toxicity. A standard dose prescription and scheme have not been established yet, and the literature presents a wide range of fractionation protocols. Furthermore, hyperthermia has shown the potential to enhance the efficacy of re-irradiation. Consequently, a prospective trial is urgently needed to attain clear structured prospective data regarding the efficacy of salvage brachytherapy with adjuvant hyperthermia for locally recurrent prostate cancer. The purpose of this report is to introduce a new prospective phase II trial that would meet this need. The primary aim of this prospective phase II study combining Iridium-192 brachytherapy with interstitial hyperthermia (IHT) is to analyze toxicity of the combined treatment; a secondary aim is to define the efficacy (bNED, DFS, OS) of salvage brachytherapy. The dose prescribed to PTV will be 30 Gy in 3 fractions for HDRBT, and 60 Gy in 2 fractions for PDRBT. During IHT, the prostate will be heated to the range of 40-47°C for 60 minutes prior to brachytherapy dose delivery. The protocol plans for treatment of 77 patients.

  20. Salvage brachytherapy in combination with interstitial hyperthermia for locally recurrent prostate carcinoma following external beam radiation therapy: a prospective phase II study

    PubMed Central

    Strnad, Vratislav; Stauffer, Paul; Dąbrowski, Tomasz; Hetnał, Marcin; Nahajowski, Damian; Walasek, Tomasz; Brandys, Piotr; Matys, Robert

    2015-01-01

    Optimal treatment for patients with only local prostate cancer recurrence after external beam radiation therapy (EBRT) failure remains unclear. Possible curative treatments are radical prostatectomy, cryosurgery, and brachytherapy. Several single institution series proved that high-dose-rate brachytherapy (HDRBT) and pulsed-dose-rate brachytherapy (PDRBT) are reasonable options for this group of patients with acceptable levels of genitourinary and gastrointestinal toxicity. A standard dose prescription and scheme have not been established yet, and the literature presents a wide range of fractionation protocols. Furthermore, hyperthermia has shown the potential to enhance the efficacy of re-irradiation. Consequently, a prospective trial is urgently needed to attain clear structured prospective data regarding the efficacy of salvage brachytherapy with adjuvant hyperthermia for locally recurrent prostate cancer. The purpose of this report is to introduce a new prospective phase II trial that would meet this need. The primary aim of this prospective phase II study combining Iridium-192 brachytherapy with interstitial hyperthermia (IHT) is to analyze toxicity of the combined treatment; a secondary aim is to define the efficacy (bNED, DFS, OS) of salvage brachytherapy. The dose prescribed to PTV will be 30 Gy in 3 fractions for HDRBT, and 60 Gy in 2 fractions for PDRBT. During IHT, the prostate will be heated to the range of 40–47°C for 60 minutes prior to brachytherapy dose delivery. The protocol plans for treatment of 77 patients. PMID:26207116

  1. Interstitial HDR brachytherapy (HDR-BT) in early stage mobile tongue cancers in young patients – Gliwice experience

    PubMed Central

    Białas, Brygida; Fijałkowski, Marek; Składowski, Krzysztof; Szlag, Marta; Cholewka, Agnieszka

    2010-01-01

    Purpose In early stage mobile tongue cancer radical radiotherapy offers good local control and organ preservation, which is especially important in the group of young patients. In our department, for many years HDR-BT has been performed in mobile tongue cancers as a sole treatment or as a “boost” with EBRT. The aim of the study was to show our experience with HDR-BT in early stage mobile tongue cancers among young patients. Material and methods From 2001 to 2006 in Maria Skłodowska-Curie Memorial Cancer Centre and Institute of Oncology, Gliwice Branch, five patients under 45 years with mobile tongue cancer were treated with HDR brachytherapy (T1N0M0 – 3/5 and T2N0M0 – 2/5); 4 with HDR brachytherapy “boost” and 1 as a sole treatment. One woman was previously treated with tumour resection, but because of positive surgical margins was referred for radiotherapy. All patients had clinically negative lymph nodes, without dissection. They were treated with interstitial HDR-BT (3-8 catheters). In 4 patients treated with HDR-BT as a “boost”, total doses ranged from 18 to 21 Gy given in 6-7 fractions (twice a day, 3 Gy per fraction). Total doses in EBRT (to local lymph nodes and tumour bed) ranged from 50 to 60 Gy (1.8-2 Gy per fraction 5 days/week). One patient, treated with radical HDR brachytherapy, received 45 Gy in 10 fractions and 50 Gy in EBRT to regional lymph nodes. Results We did not notice local recurrences or distant metastases in our group of patients. Median follow-up was 67 months (range 47-79 months). All patients preserved normal tongue function. A severe late complication occurred in 1 patient – fracture of the mandible. Conclusions In the analysed group of young patients with mobile tongue cancer interstitial HDR brachytherapy in combination with EBRT was an effective and well tolerated treatment modality which allowed preservation of the tongue and its function. PMID:27829846

  2. Interstitial HDR brachytherapy (HDR-BT) in early stage mobile tongue cancers in young patients - Gliwice experience.

    PubMed

    Kellas-Ślęczka, Sylwia; Białas, Brygida; Fijałkowski, Marek; Składowski, Krzysztof; Szlag, Marta; Cholewka, Agnieszka

    2010-06-01

    In early stage mobile tongue cancer radical radiotherapy offers good local control and organ preservation, which is especially important in the group of young patients. In our department, for many years HDR-BT has been performed in mobile tongue cancers as a sole treatment or as a "boost" with EBRT. The aim of the study was to show our experience with HDR-BT in early stage mobile tongue cancers among young patients. From 2001 to 2006 in Maria Skłodowska-Curie Memorial Cancer Centre and Institute of Oncology, Gliwice Branch, five patients under 45 years with mobile tongue cancer were treated with HDR brachytherapy (T1N0M0 - 3/5 and T2N0M0 - 2/5); 4 with HDR brachytherapy "boost" and 1 as a sole treatment. One woman was previously treated with tumour resection, but because of positive surgical margins was referred for radiotherapy. All patients had clinically negative lymph nodes, without dissection. They were treated with interstitial HDR-BT (3-8 catheters). In 4 patients treated with HDR-BT as a "boost", total doses ranged from 18 to 21 Gy given in 6-7 fractions (twice a day, 3 Gy per fraction). Total doses in EBRT (to local lymph nodes and tumour bed) ranged from 50 to 60 Gy (1.8-2 Gy per fraction 5 days/week). One patient, treated with radical HDR brachytherapy, received 45 Gy in 10 fractions and 50 Gy in EBRT to regional lymph nodes. We did not notice local recurrences or distant metastases in our group of patients. Median follow-up was 67 months (range 47-79 months). All patients preserved normal tongue function. A severe late complication occurred in 1 patient - fracture of the mandible. In the analysed group of young patients with mobile tongue cancer interstitial HDR brachytherapy in combination with EBRT was an effective and well tolerated treatment modality which allowed preservation of the tongue and its function.

  3. High-dose-rate interstitial brachytherapy in oral cancer-Its impact on quality of life.

    PubMed

    Bajwa, Harjot Kaur; Singareddy, Rohith; Alluri, Krishnam Raju

    2016-01-01

    The aim of the study was to assess the impact of high-dose-rate (HDR) interstitial brachytherapy on quality of life (QOL) in oral cancer. Thirty-two patients of oral cancer treated at our institute from January 2010 to December 2014 with radical radiotherapy (external beam radiotherapy + brachytherapy) were included for analysis; 30 patients received external beam radiotherapy (50-54 Gy) and HDR brachytherapy boost (18-24.5 Gy); 2 patients received radical HDR brachytherapy (31.5 Gy). Quality of life (QOL) was assessed by Telugu, Hindi, and English versions of EORTC Quality of Life Core-30 and EORTC Quality of Life Head and Neck Module (QLQ H&N35) before treatment, at 3 months, 6 months, 1 year, and 2 years after treatment. Of the 32 patients, 2 patients died and 1 patient progressed on followup; 2 patients were re-irradiation cases. On excluding these cases, 27 patients were available for analysis. The followup duration was 6-55 months. At the time of analysis, 91% (29) patients were disease free, 3% (1) progressed, and 6% (2) died. At the end of 2 years, none of the QLQ-C30 functional scores fell below the baseline. Pain, swallowing, sensory, speech, social contact, and social eating worsened at 3 months but improved over 2 years (p < 0.001). Sexuality and financial status showed delayed improvement (p < 0.001). Among the head and neck parameters, dry mouth and sticky saliva were significant determinants of QOL with delayed improvement (p < 0.001). The impact of age, sex, and tumor stage and on QOL was analyzed. Women reported a poorer QOL for physical and emotional parameters, social eating, weight loss, and fatigue. Tumor stage significantly affected QOL, with early stages showing a better QOL. Almost all patients regained normal function after treatment and reported an excellent QOL at 2 years. However, tumor stage significantly affected the QOL. Copyright © 2016 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  4. Monte Carlo simulation of the dose distribution around 125I seeds.

    PubMed

    Burns, G S; Raeside, D E

    1987-01-01

    The Monte Carlo method was used to investigate dose distributions around the 3M Company model 6701 and model 6702 125I brachytherapy seeds. The transverse axis dose distributions of the two seed models were found to be nearly identical, but the longitudinal axis dose distributions differed significantly. Seed design influences upon dose distributions also were investigated.

  5. Projector-Based Augmented Reality for Intuitive Intraoperative Guidance in Image-Guided 3D Interstitial Brachytherapy

    SciTech Connect

    Krempien, Robert Hoppe, Harald; Kahrs, Lueder; Daeuber, Sascha; Schorr, Oliver; Eggers, Georg; Bischof, Marc; Munter, Marc W.; Debus, Juergen; Harms, Wolfgang

    2008-03-01

    Purpose: The aim of this study is to implement augmented reality in real-time image-guided interstitial brachytherapy to allow an intuitive real-time intraoperative orientation. Methods and Materials: The developed system consists of a common video projector, two high-resolution charge coupled device cameras, and an off-the-shelf notebook. The projector was used as a scanning device by projecting coded-light patterns to register the patient and superimpose the operating field with planning data and additional information in arbitrary colors. Subsequent movements of the nonfixed patient were detected by means of stereoscopically tracking passive markers attached to the patient. Results: In a first clinical study, we evaluated the whole process chain from image acquisition to data projection and determined overall accuracy with 10 patients undergoing implantation. The described method enabled the surgeon to visualize planning data on top of any preoperatively segmented and triangulated surface (skin) with direct line of sight during the operation. Furthermore, the tracking system allowed dynamic adjustment of the data to the patient's current position and therefore eliminated the need for rigid fixation. Because of soft-part displacement, we obtained an average deviation of 1.1 mm by moving the patient, whereas changing the projector's position resulted in an average deviation of 0.9 mm. Mean deviation of all needles of an implant was 1.4 mm (range, 0.3-2.7 mm). Conclusions: The developed low-cost augmented-reality system proved to be accurate and feasible in interstitial brachytherapy. The system meets clinical demands and enables intuitive real-time intraoperative orientation and monitoring of needle implantation.

  6. Outcomes of High-Dose-Rate Interstitial Brachytherapy in the Treatment of Locally Advanced Cervical Cancer: Long-term Results

    SciTech Connect

    Pinn-Bingham, Melva; Puthawala, Ajmel A.; Syed, A.M. Nisar; Sharma, Anil; DiSaia, Philip; Berman, Michael; Tewari, Krishnansu S.; Randall-Whitis, Leslie; Mahmood, Usama; Ramsinghani, Nilam; Kuo, Jeffrey; Chen, Wen-Pin; McLaren, Christine E.

    2013-03-01

    Purpose: The purpose of this study was to determine locoregional control (LRC), disease-free survival (DFS), and toxicity of high-dose-rate interstitial brachytherapy (HDR-ISBT) in the treatment of locally advanced cervical cancer. Methods and Materials: Between March 1996 and May 2009, 116 patients with cervical cancer were treated. Of these, 106 (91%) patients had advanced disease (International Federation of Gynecology and Obstetrics stage IIB-IVA). Ten patients had stage IB, 48 had stage II, 51 had stage III, and 7 had stage IVA disease. All patients were treated with a combination of external beam radiation therapy (EBRT) to the pelvis (5040 cGy) and 2 applications of HDR-ISBT to a dose of 3600 cGy to the implanted volume. Sixty-one percent of patients also received interstitial hyperthermia, and 94 (81%) patients received chemotherapy. Results: Clinical LRC was achieved in 99 (85.3%) patients. Three-year DFS rates were 59%, 67%, 71%, and 57% for patients with stage IB, II, III, and IVA disease, respectively. The 5-year DFS and overall survival rates for the entire group were 60% and 44%, respectively. Acute and late toxicities were within acceptable limits. Conclusions: Locally advanced cervical cancer patients for whom intracavitary BT is unsuitable can achieve excellent LRC and OS with a combination of EBRT and HDR-ISBT.

  7. Distant Metastases Following Permanent Interstitial Brachytherapy for Patients With Clinically Localized Prostate Cancer

    SciTech Connect

    Taira, Al V.; Merrick, Gregory S.; Galbreath, Robert W.; Butler, Wayne M.; Lief, Jonathan; Adamovich, Edward; Wallner, Kent E.

    2012-02-01

    Purpose: Recent publications have suggested high-risk patients undergoing radical prostatectomy have a lower risk of distant metastases and improved cause-specific survival (CSS) than patients receiving definitive external beam radiation therapy (XRT). To date, none of these studies has compared distant metastases and CSS in brachytherapy patients. In this study, we evaluate such parameters in a consecutive cohort of brachytherapy patients. Methods and Materials: From April 1995 to June 2007, 1,840 consecutive patients with clinically localized prostate cancer were treated with brachytherapy. Risk groups were stratified according to National Comprehensive Cancer Network ( (www.nccn.org)) guidelines. Subgroups of 658, 893, and 289 patients were assigned to low, intermediate, and high-risk categories. Median follow-up was 7.2 years. Along with brachytherapy implantation, 901 (49.0%) patients received supplemental XRT, and 670 (36.4%) patients received androgen deprivation therapy (median duration, 4 months). The mode of failure (biochemical, local, or distant) was determined for each patient for whom therapy failed. Cause of death was determined for each deceased patient. Multiple parameters were evaluated for impact on outcome. Results: For the entire cohort, metastases-free survival (MFS) and CSS at 12 years were 98.1% and 98.2%, respectively. When rates were stratified by low, intermediate, and high-risk groups, the 12-year MFS was 99.8%, 98.1%, and 93.8% (p < 0.001), respectively. CSS rates were 99.8%, 98.0%, and 95.3% (p < 0.001) for low, intermediate, and high-risk groups, respectively. Biochemical progression-free survival was 98.7%, 95.9% and 90.4% for low, intermediate, and high-risk patients, respectively (p < 0.001). In multivariate Cox-regression analysis, MFS was mostly closely related to Gleason score and year of treatment, whereas CSS was most closely associated with Gleason score. Conclusions: Excellent CSS and MFS rates are achievable with high

  8. Liver malignancies: CT-guided interstitial brachytherapy in patients with unfavorable lesions for thermal ablation.

    PubMed

    Ricke, Jens; Wust, Peter; Wieners, Gero; Beck, Alexander; Cho, Chie Hee; Seidensticker, Max; Pech, Maciej; Werk, Michael; Rosner, Christian; Hänninen, Enrique Lopez; Freund, Torsten; Felix, Roland

    2004-11-01

    To evaluate computed tomography (CT)-guided brachytherapy in patients with very large liver malignancies or with liver tumors located adjacent to the liver hilum. In this prospective nonrandomized phase II trial, we treated 20 patients (19 liver metastases and one cholangiocarcinoma) with CT-guided high-dose-rate (HDR) brachytherapy using a (192) Iridium source. All patients demonstrated no functional liver degradation prior to irradiation. Entry criteria were liver tumors > 5 cm (group A, n = 11, no upper limit) or liver tumors < or = 5 cm adjacent to the liver hilum (group B, n = 9). Dose planning for brachytherapy was performed with three dimensional (3D) CT data acquired after percutaneous applicator positioning. Magnetic resonance (MR) imaging follow-up was performed 6 weeks and every 3 months post intervention. Primary endpoints were complications, local tumor control (absence of tumor growth after treatment followed by shrinkage of the lesion starting at 6 months) and progression-free survival. The mean tumor diameter was 7.7 cm (range, 5.5-10.8 cm) in group A, 3.6 cm (range, 2.2-4.9 cm) in group B. On average, a minimal dose of 17 Gy in the target volume was applied (range, 12-25 Gy). Severe side effects were recorded in two patients (10%). One patient demonstrated an obstructive jaundice caused by tumor edema after irradiation of a metastasis adjacent to the bile duct bifurcation. One patient developed intra-abdominal hemorrhage that was treated by a single blood transfusion and has ceased. We frequently encountered moderate increases of liver enzymes (70% of patients) and bilirubin (50% of patients) without clinical symptoms and thus considered to be insignificant. The median follow-up was 13 months. In group A (tumors > 5 cm), primary local tumor control after 6 and 12 months was 74% and 40%, respectively; in group B, it was 100% and 71%, respectively. All but one local recurrence (in a patient with diffuse tumor progression) were successfully treated

  9. Natural History of Clinically Staged Low- and Intermediate-Risk Prostate Cancer Treated With Monotherapeutic Permanent Interstitial Brachytherapy

    SciTech Connect

    Taira, Al V.; Merrick, Gregory S.; Galbreath, Robert W.; Wallner, Kent E.; Butler, Wayne M.

    2010-02-01

    Purpose: To evaluate the natural history of clinically staged low- and intermediate-risk prostate cancer treated with permanent interstitial seed implants as monotherapy. Methods and Materials: Between April 1995 and May 2005, 463 patients with clinically localized prostate cancer underwent brachytherapy as the sole definitive treatment. Men who received supplemental external beam radiotherapy or androgen deprivation therapy were excluded. Dosimetric implant quality was determined based on the minimum dose that covered 90% of the target volume and the volume of the prostate gland receiving 100% of the prescribed dose. Multiple parameters were evaluated as predictors of treatment outcomes. Results: The 12-year biochemical progression-free survival (bPFS), cause-specific survival, and overall survival rates for the entire cohort were 97.1%, 99.7%, and 75.4%, respectively. Only pretreatment prostate-specific antigen level, percent positive biopsy cores, and minimum dose that covered 90% of the target volume were significant predictors of biochemical recurrence. The bPFS, cause-specific survival, and overall survival rates were 97.4%, 99.6%, and 76.2%, respectively, for low-risk patients and 96.4%, 100%, and 74.0%, respectively, for intermediate-risk patients. The bPFS rate was 98.8% for low-risk patients with high-quality implants versus 92.1% for those with less adequate implants (p < 0.01), and it was 98.3% for intermediate-risk patients with high-quality implants versus 86.4% for those with less adequate implants (p < 0.01). Conclusions: High-quality brachytherapy implants as monotherapy can provide excellent outcomes for men with clinically staged low- and intermediate-risk prostate cancer. For these men, a high-quality implant can achieve results comparable to high-quality surgery in the most favorable pathologically staged patient subgroups.

  10. Prostate-specific antigen percentage: An early predictive tool after iodine-125 interstitial brachytherapy for prostate cancer.

    PubMed

    Paoluzzi, Mauro; Losa, Andrea; Cerboneschi, Valentina; Colosimo, Caterina; Fontana, Nicola; Mangili, Paola; Mignogna, Marcello; Nava, Luciano; Ravaglia, Valentina

    2017-06-19

    After interstitial prostate iodine-125 brachytherapy (BT), prostate-specific antigen (PSA) evolution in time could predict overall biochemical relapse, but, considering the single patient, it is influenced by the presentation PSA amount and by the prostatic volume. It is also challenging to differentiate a PSA bounce from a biochemical relapse. To determine the usefulness of PSA percentage (PP) defined as the rate between PSA presented by a patient at time "t" and the PSA that the same patient had presented at the time of diagnosis (t0) assumed as 100% in predicting biochemical relapse and in differentiating them from PSA Bounces. We included 721 patients from Milan S. Raffaele Turro (399) and Lucca Campo di Marte (then S. Luca) Hospital (322). The mean age of patients was 66.5 years (range, 50-79). Mean followup was 150 months (range, 24-180). For each patient, PSA was recorded before and after iodine-125 BT, and PPs were calculated. Cox regression model, relative operating characteristic curves, and Kaplan-Meier regression model were elaborated, and a cutoff of 20% was defined. We observed that PP >20% is an independent variable highly associated with relapse risk (p < 0.0001) with a sensitivity of 79.7%, a specificity of 82%, and an hazard ratio of 12.1, since the 6 months of followup. A PSA increase above the nadir should be because of bounce (sensitivity and specificity of 81.4%, p < 0.0001) if patient had experienced at 6 months a PP <20%. PP might represent an early and useful tool, predictive of clinical outcome in patients after BT for prostate cancer. Copyright © 2017 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  11. WE-G-17A-05: Real-Time Catheter Localization Using An Active MR Tracker for Interstitial Brachytherapy

    SciTech Connect

    Wang, W; Damato, A; Viswanathan, A; Cormack, R; Penzkofer, T; Schmidt, E; Pan, L; Gilson, W; Seethamraju, R

    2014-06-15

    Purpose: To develop a novel active MR-tracking system which can provide accurate and rapid localization of brachytherapy catheters, and assess its reliability and spatial accuracy in comparison to standard catheter digitization using MR images. Methods: An active MR tracker for brachytherapy was constructed by adding three printed-circuit micro-coils to the shaft of a commercial metallic stylet. A gel phantom with an embedded framework was built, into which fifteen 14-Gauge catheters were placed, following either with parallel or crossed paths. The tracker was inserted sequentially into each catheter, with MR-tracking running continuously. Tracking was also performed during the tracker's removal from each catheter. Catheter trajectories measured from the insertion and the removal procedures using the same micro-coil were compared, as well as trajectories obtained using different micro-coils. A 3D high-resolution MR image dataset of the phantom was acquired and imported into a treatment planning system (TPS) for catheter digitization. A comparison between MR-tracked positions and positions digitized from MR images by TPS was performed. Results: The MR tracking shows good consistency for varying catheter paths and for all micro-coils (mean difference ∼1.1 mm). The average distance between the MR-tracking trajectory and catheter digitization from the MR images was 1.1 mm. Ambiguity in catheter assignment from images due to crossed paths was resolved by active tracking. When tracking was interleaved with imaging, real-time images were continuously acquired at the instantaneous tip positions and displayed on an external workstation. Conclusion: The active MR tracker may be used to provide an independent measurement of catheter location in the MR environment, potentially eliminating the need for subsequent CT. It may also be used to control realtime imaging of catheter placement. This will enable MR-based brachytherapy planning of interstitial implants without ionizing

  12. Nanodosimetry of (125)I Auger electrons.

    PubMed

    Bantsar, Aliaksandr; Pszona, Stanislaw

    2012-12-01

    The nanodosimetric description of the radiation action of Auger electrons on nitrogen targets of nanometric size is presented. Experimental microdosimetry at nanometer scale for Auger electrons has been accomplished with the set-up called Jet Counter. This consists of a pulse-operated valve which injects an expanding nitrogen jet into an interaction chamber where a gaseous sensitive volume of cylindrical shape is created. The ionization cluster size distributions (ICSD) created by Auger electrons emitted by (125)I while crossing a nanometer-sized volume have been measured. The ICSD for the sensitive volumes corresponding to 3 and 12 nm in diameter (in unit density 1 g/cm(3)) irradiated by electrons emitted by a (125)I source were collected and compared with the corresponding Monte Carlo (MC) simulation. The preliminary results of the experiments with Auger electrons of (125)I interacting with a nitrogen jet having nanometric size comparable to a deoxyribonucleic acid (DNA) and nucleosome, showing the discrete spectrum of ICSD with extended cluster size, are described. The presented paper describes for the first time the nanodosimetric experiments with Auger electrons emitted by (125)I. A set of the new descriptors of the radiation quality describing the radiation effect at nanometer level is proposed. The ICSD were determined for the first time for an Auger emitter of (125)I.

  13. Remote location interstitial brachytherapy with patient stabilization and subsequent transport to an outpatient center for treatment is safe and effective for the treatment of gynecologic malignancies.

    PubMed

    Tumati, Vasu; Folkert, Michael R; Lawson, Sandra; Wise, Elsa; Wolcott, Sheila; Richardson, Debra; Carlson, Matthew; Kehoe, Siobhan; Lea, Jayanthi; Abdulrahman, Ramzi; Albuquerque, Kevin

    2016-01-01

    Interstitial brachytherapy is an essential component of definitive treatment for locally advanced gynecological malignancies. Although many outpatient centers are capable of delivering the radiation component of brachytherapy, they are not associated with an operative center for implant placement, limiting the ability to deliver appropriate care. In this study, we report on our experience with noncolocated implant placement and radiation delivery, and the impact of patient stabilization improvements on patient safety. Between 9/2010 and 11/2014, 25 patients with gynecologic malignancy underwent interstitial implantation and subsequent transport for high-dose-rate brachytherapy treatment. From 9/2010 to 10/2012, patients were transported using a standard ambulance stretcher; from 11/2012 to 11/2014, patients were placed on a patient positioning board or a WAFFLE support. Potential transport-associated toxicity was assessed, and the association between standard and augmented transport types and toxicity was analyzed. A total of 234 transports were performed. Median cost of transport was $150 per transport. There were 14 (10 patients) potential transportation-associated toxicities, including two lacerations/local trauma, three infections, and nine ulcers. There were 6 Grade 3 toxicities, all in the standard group. There was no association between stretcher type and laceration or ulcers, but enhanced support was associated with fewer overall toxicities, Grade 3 toxicities, and infections. Noncolocated implantation and treatment is safe and facilitates optimal therapy. Toxicities potentially associated with transport are minimal and seem to be reduced by augmented stabilization. Understanding that this is a reasonable way to deliver brachytherapy may allow more stand-alone centers to deliver high-quality care for patients and improve gynecologic cancer outcomes in the United States. Copyright © 2016 American Brachytherapy Society. Published by Elsevier Inc. All rights

  14. SU-E-T-507: Interfractional Variation of Fiducial Marker Position During HDR Brachytherapy with Cervical Interstitial Needle Template

    SciTech Connect

    Shen, S; Kim, R; Benhabib, S; Araujo, J; Burnett, L; Duan, J; Popple, R; Wu, X; Cardan, R; Brezovich, I

    2014-06-01

    Purpose: HDR brachytherapy using interstitial needle template for cervical cancer is commonly delivered in 4-5 fractions. Routine verification of needle positions before each fraction is often based on radiographic imaging of implanted fiducial markers. The current study evaluated interfractional displacement of implanted fiducial markers using CT images. Methods: 9 sequential patients with cervical interstitial needle implants were evaluated. The superior and inferior borders of the target volumes were defined by fiducial markers in planning CT. The implant position was verified with kV orthogonal images before each fraction. A second CT was acquired prior 3rd fraction (one or 2 days post planning CT). Distances from inferior and superior fiducial markers to pubic symphysis plane (perpendicular to vaginal obtulator)were measured. Distance from needle tip of a reference needle (next to the inferior marker) to the pubic symphysis plane was also determined. The difference in fiducial marker distance or needle tip distance between planning CT and CT prior 3rd fraction were measured to assess markers migration and needle displacement. Results: The mean inferior marker displacement was 4.5 mm and ranged 0.9 to 11.3 mm. The mean superior marker displacement was 2.7 mm and ranged 0 to 10.4 mm. There was a good association between inferior and superior marker displacement (r=0.95). Mean averaged inferior and superior marker displacement was 3.3 mm and ranged from 0.1 to 10.9 mm, with a standard deviation of 3.2 mm. The mean needle displacement was 5.6 mm and ranged 0.2 to 15.6 mm. Needle displacements were reduced (p<0.05) after adjusting according to needle-to-fiducials distance. Conclusion: There were small fiducial marker displacements between HDR fractions. Our study suggests a target margin of 9.7 mm to cover interfractional marker displacements (in 95% cases) for pretreatment verification based on radiographic imaging.

  15. Multiple-estimate Monte Carlo calculation of the dose rate constant for a cesium-131 interstitial brachytherapy seed

    SciTech Connect

    Wittman, Richard S.; Fisher, Darrell R.

    2007-01-03

    The purpose of this study was to calculate a more accurate dose rate constant for the Cs-131 (model CS-1, IsoRay Medical, Inc., Richland, Washington) interstitial brachytherapy seed. Previous measurements of the dose rate constant for this seed have been reported by others with incongruity. Recent direct measurements by thermoluminescence dosimetry and by gamma-ray spectroscopy were about 15 percent greater than earlier thermoluminescence dosimetry measurements. Therefore, we set about to calculate independent values by a Monte Carlo approach that combined three estimates as a consistency check, and to quantify the computational uncertainty. The calculated dose rate constant for the Cs-131 seed was 1.040 cGy h^{-1} U^{-1} for an ionization chamber model and 1.032 cGy h^{-1} U^{-1} for a circular ring model. A formal value of 2.2% uncertainty was calculated for both values. The range of our multi-estimate values were from 1.032 cGy h^{-1} U^{-1} to 1.061 cGy h^{-1} U^{-1}. We also modeled three I-125 seeds with known dose rate constants to test the accuracy of this study's approach.

  16. Daily CT measurement of needle applicator displacement during multifractionated high-dose-rate interstitial brachytherapy for postoperative recurrent uterine cancer.

    PubMed

    Yoshida, Ken; Ueda, Mari; Takenaka, Tadashi; Yamazaki, Hideya; Kotsuma, Tadayuki; Aramoto, Kazumasa; Miyake, Shunsuke; Koretsune, Yukihiro; Ban, Chiaki; Tanaka, Eiichi

    2012-01-01

    We investigated daily needle applicator displacement during multifractionated high-dose-rate interstitial brachytherapy (HDR-ISBT) for postoperative recurrent uterine cancer. Eight patients with postoperative recurrent uterine cancer received HDR-ISBT with or without external beam radiotherapy using our unique ambulatory technique. To analyze displacement, we obtained daily computed tomography (CT) images for 122 flexible needle applicators at 21, 45, 69, and 93 hours after implantation. Displacement was defined as the length between the center of gravity of titanium markers and the needle applicator tips along the daily CT axis. For cases in which displacement was not corrected, we also calculated the dose that covered 90% of the clinical target volume (D90(CTV)) using a dose-volume histogram (DVH). Median caudal needle applicator displacement at 21, 45, 69, and 93 hours was 3, 2, 4, and 5 mm, respectively. More than 15 mm displacement was observed for 2% (2 of 122) and 17% (10 of 60) of needle applicators at 21 and 93 hours, respectively. Cases in which dwell positions were not changed to correct the treatment plan, 2 of 8 patients showed more than 10% reduction in D90(CTV) values compared with the initial treatment plan. Correction of dwell positions of the treatment source improves treatment DVH for multifractionated HDR-ISBT.

  17. A detailed dosimetric comparison between manual and inverse plans in HDR intracavitary/interstitial cervical cancer brachytherapy

    PubMed Central

    Baltas, Dimos; Karabis, Andreas; Stock, Markus; Dimopoulos, Johannes; Georg, Dietmar; Pötter, Richard; Kirisits, Christian

    2011-01-01

    Purpose The purpose of this study was to compare two inverse planning algorithms for cervical cancer brachytherapy and a conventional manual treatment planning according to the MUW (Medical University of Vienna) protocol. Material and methods For 20 patients, manually optimized, and, inversely optimized treatment plans with Hybrid Inverse treatment Planning and Optimization (HIPO) and with Inverse Planning Simulated Annealing (IPSA) were created. Dosimetric parameters, absolute volumes of normal tissue receiving reference doses, absolute loading times of tandem, ring and interstitial needles, Paddick and COIN conformity indices were evaluated. Results HIPO was able to achieve a similar dose distribution to manual planning with the restriction of high dose regions. It reduced the loading time of needles and the overall treatment time. The values of both conformity indices were the lowest. IPSA was able to achieve acceptable dosimetric results. However, it overloaded the needles. This resulted in high dose regions located in the normal tissue. The Paddick index for the volume of two times prescribed dose was outstandingly low. Conclusions HIPO can produce clinically acceptable treatment plans with the elimination of high dose regions in normal tissue. Compared to IPSA, it is an inverse optimization method which takes into account current clinical experience gained from manual treatment planning. PMID:27853479

  18. Pulsed dose-rate perioperative interstitial brachytherapy for soft tissue sarcomas of the extremities and skeletal muscles of the trunk.

    PubMed

    Lazzaro, Gianluca; Lazzari, Roberta; Pelosi, Giuseppe; De Pas, Tommaso; Mariani, Luigi; Mazzarol, Giovanni; Sances, Daniele; Tosti, Giulio; Baldini, Federica; Mosconi, Massimo; Tedeschi, Ines; Viale, Giuseppe; Marsiglia, Hugo; Chiappa, Antonio; Vavassori, Andrea; Orecchia, Roberto; Testori, Alessandro

    2005-11-01

    This study evaluated the role of pulsed dose-rate (PDR) brachytherapy (BRT), delivered alone or as a boost to external beam radiotherapy, as adjuvant therapy for the local control of soft tissue sarcomas of the extremities and skeletal muscles of the trunk that have undergone surgical treatment. Between July 1998 and January 2002, 42 patients were treated with a combination of surgery and BRT alone (18 patients) or BRT/external beam radiotherapy (24 patients) for the treatment of primary (n = 32) and recurrent (n = 10) soft tissue sarcomas located in the proximal extremity (n = 17), distal extremity (n = 17), and trunk (n = 8). Tumor size was <5 cm in 20 cases and >5 cm in 22 cases, with histological grading of 1 (n = 7), 2 (n = 18), or 3 (n = 17). The median BRT dose delivered was 15 Gy, and the median external beam irradiation dose was 50 Gy. With a median follow-up of 34 months, the 36-month survival was 83.9% (SE, 6.1%), and the local control was 89%. PDR interstitial BRT for soft tissue sarcoma is an effective, well-tolerated adjuvant radiation treatment that offers several practical advantages, among which are low acute and late toxicity with maximum normal tissue and critical structure sparing and overall shorter radiotherapy and hospital stay.

  19. [The first experience in interstitial brachytherapy for primary and metastatic tumors of the brain].

    PubMed

    Bentsion, D L; Gvozdev, P B; Sakovich, V P; Fialko, N V; Kolotvinov, V S; Baiankina, S N

    2006-01-01

    In 2001-2002, the authors performed a course of brachytherapy in 15 patients with inoperable primary, recurrent, and metastatic brain tumors. The histostructural distribution was as follows: low-grade astrocytoma (grade II according to the WHO classification) in 2 patients, anaplastic astrocytoma (AA) in 3, glioblastoma multiforme (GBM) in 5. Five patients had solid tumor deposits in the brain. Computer tomographic (CT) and magnetic resonance imaging (MRI) data were used to define a path for forthcoming biopsy and implantation at a "Stryker" navigation station, by taking into account the anatomy of the brain, vessels, and functionally significant areas. After having histological findings, plastic intrastats whose number had been determined by the volume of a target were implanted into a tumor by the predetermined path. Dosimetric planning was accomplished by using CT and MRI images on an "Abacus" system. The final stage involved irradiation on a "GammaMed plus" with a source of 192Ir. Irradiation was given, by hyperfractionating its dose (3-4 Gy twice daily at an interval of 4-5 hours) to the total focal dose (TFD) of 36-44 Gy. Patients with gliomas untreated with radiation also underwent external radiation in a TFD of 54-56 Gy and patients with brain metastases received total external irradiation of the brain in a TFD of 36-40 Gy. The tolerance of a course of irradiation was fair. In patients with AA and GBM, one-year survival was observed in 66 and 60%, respectively; in those having metastasis, it was in 20%. Six patients died from progressive disease. All patients with low-grade astrocytoma and one patient with anaplastic astrocytoma were alive at month 24 after treatment termination. The mean lifespan of patients with malignant gliomas and solid tumor metastasis was 11.5 and 5.8 months, respectively. Brachytherapy is a noninvasive and tolerable mode of radiotherapy that increases survival in some groups of patients with inoperable brain tumors.

  20. Daily computed tomography measurement of needle applicator displacement during high-dose-rate interstitial brachytherapy for previously untreated uterine cervical cancer.

    PubMed

    Mikami, Mari; Yoshida, Ken; Takenaka, Tadashi; Yamazaki, Hideya; Kotsuma, Tadayuki; Yoshida, Mineo; Aramoto, Kazumasa; Yamada, Shigetoshi; Ban, Chiaki; Tanaka, Eiichi; Honda, Kazuya

    2011-01-01

    We investigated daily needle applicator displacement during high-dose-rate interstitial brachytherapy. Ten patients with previously untreated uterine cervical cancer received 30Gy in five fractions during 3 days of high-dose-rate interstitial brachytherapy combined with external beam radiotherapy using our unique ambulatory technique. To analyze displacement, we obtained daily computed tomography (CT) images for 147 flexible needle applicators at 21 and 45h after implantation. The distance was defined as the length between the center of gravity of titanium markers and the needle applicator tips along the daily CT axis. We adapted dwell positions of the treatment source to cover clinical target volume with a 15-mm cranial margin. The median displacement was 1mm (range, -6 to 12mm) at 21h and 2mm (range, -9 to 14mm) at 45h, respectively. Statistically significant caudal displacement was observed only between the displacement at 0 and 21h (p<0.0001), and not between the displacement at 21 and 45h (p=0.1). In cases with displacement of 3mm or more, we changed dwell positions to correct the treatment plan. We corrected 45 applicators (31%) at 21h and 67 (46%) at 45h. We investigated needle applicator displacement in our ambulatory technique using daily CT examination and considered that a 15-mm cranial margin was sufficient to cover clinical target volume. Copyright © 2011 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  1. Comparison of IPSA with dose-point optimization and manual optimization for interstitial template brachytherapy for gynecologic cancers.

    PubMed

    Jamema, Swamidas V; Sharma, Smriti; Mahantshetty, Umesh; Engineer, Reena; Shrivastava, Shyam K; Deshpande, Deepak D

    2011-01-01

    To compare inverse planning simulated annealing (IPSA) algorithm with the dose-point optimized (DPO) plan and manual/graphically optimized (GrO) plan for interstitial template brachytherapy for gynecologic cancers. The data set of 10 consecutive patients was selected for this dosimetric study. For each patient, three plans were calculated: DPO, GrO, and IPSA. Dose-volume parameters from the three plans were compared to analyze the dosimetric outcome. Coverage of the clinical target volume (CTV) with GrO plan and IPSA algorithm was significantly better (mean V(100) of 88.8% and 89.1%; p=0.006) as compared with DPO plan (83.7%; p=0.62). Similarly, mean D(90) was same in both GrO plan and IPSA, 3.96±0.23 and 3.96±0.15Gy, respectively. DPO plans were homogeneous with homogeneity index being 0.82 as compared with 0.68±0.05 of GrO plan and 0.71±0.04 of IPSA. However, IPSA resulted in high conformity with conformity index of 0.78 as compared with 0.72 (p=0.001) and 0.68 (p≤0.001) for GrO and DPO plans, respectively. The dose to rectum (3.3±1.06Gy) and bladder (3.17±0.5Gy) was generally high for DPO plan. GrO plan reduced the dose to the rectum (2.91±0.63; p=0.011) and bladder (2.89±0.63Gy; p=0.003) significantly. IPSA resulted in a further reduction of the dose to rectum (2.79±0.67Gy; p=0.046) and bladder (2.81±0.67Gy; p=0.035), however with no statistical significance as compared with GrO plan. IPSA resulted in significant sparing of normal tissues without compromising CTV coverage as compared with DPO plan. However, IPSA did not show any significant improvement either in CTV coverage or in normal tissue sparing as compared with GrO plan. IPSA was found to be superior in terms of homogeneity and conformity as compared with GrO plan. Copyright © 2011 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  2. SU-F-19A-12: Split-Ring Applicator with Interstitial Needle for Improved Volumetric Coverage in HDR Brachytherapy for Cervical Cancer

    SciTech Connect

    Sherertz, T; Ellis, R; Colussi, V; Mislmani, M; Traughber, B; Herrmann, K; Podder, T

    2014-06-15

    Purpose: To evaluate volumetric coverage of a Mick Radionuclear titanium Split-Ring applicator (SRA) with/without interstitial needle compared to an intracavitary Vienna applicator (VA), interstitial-intracavitary VA, and intracavitary ring and tandem applicator (RTA). Methods: A 57 year-old female with FIGO stage IIB cervical carcinoma was treated following chemoradiotherapy (45Gy pelvic and 5.4Gy parametrial boost) with highdose- rate (HDR) brachytherapy to 30Gy in 5 fractions using a SRA. A single interstitial needle was placed using the Ellis Interstitial Cap for the final three fractions to increase coverage of left-sided gross residual disease identified on 3T-MRI. High-risk (HR) clinical target volume (CTV) and intermediate-risk (IR) CTV were defined using axial T2-weighted 2D and 3D MRI sequences (Philips PET/MRI unit). Organs-at-risks (OARs) were delineated on CT. Oncentra planning system was used for treatment optimization satisfying GEC-ESTRO guidelines for target coverage and OAR constraints. Retrospectively, treatment plans (additional 20 plans) were simulated using intracavitary SRA (without needle), intracavitary VA (without needle), interstitial-intracavitary VA, and intracavitary RTA with this same patient case. Plans were optimized for each fraction to maintain coverage to HR-CTV. Results: Interstitial-intracavitary SRA achieved the following combined coverage for external radiation and brachytherapy (EQD2): D90 HR-CTV =94.6Gy; Bladder-2cc =88.9Gy; Rectum-2cc =65.1Gy; Sigmoid-2cc =48.9Gy; Left vaginal wall (VW) =103Gy, Right VW =99.2Gy. Interstitial-intracavitary VA was able to achieve identical D90 HR-CTV =94.6Gy, yet Bladder-2cc =91.9Gy (exceeding GEC-ESTRO recommendations of 2cc<90Gy) and Left VW =120.8Gy and Right VW =115.5Gy. Neither the SRA nor VA without interstitial needle could cover HR-CTV adequately without exceeding dose to Bladder-2cc. Conventional RTA was unable to achieve target coverage for the HR-CTV >80Gy without severely

  3. Interstitial high-dose-rate brachytherapy as salvage treatment for locally recurrent prostate cancer after definitive radiation therapy: Toxicity and 5-year outcome.

    PubMed

    Jiang, Ping; van der Horst, Christof; Kimmig, Bernhard; Zinsser, Fabian; Poppe, Bjoern; Luetzen, Ulf; Juenemann, Klaus-Peter; Dunst, Juergen; Siebert, Frank-André

    We report our results with interstitial high-dose-rate brachytherapy (HDR-BT) as a salvage therapy option after external beam therapy with or without BT. Emphasis was put on toxicity and 5-year outcome. From 2003 to 2011, 29 patients with local failure after previous radiotherapy for prostate cancer were treated with salvage interstitial HDR-BT. The diagnosis of local recurrence was made on the basis of choline positron emission tomography. Salvage HDR-BT was given in three fractions with a single dose of 10 Gy per fraction and weekly. The target volume covered the peripheral zone of the prostate and the positron emission tomography-positive area. Acute and late toxicities were documented according to common terminology criteria for adverse events (CTCAE v 4.0). Twenty-two patients with minimum followup of 60 months were analyzed. The 5-year overall survival was 95.5% with a disease-specific survival of 100%. The 5-year biochemical control was 45%. Late grade 2 gastrointestinal toxicities were observed in two patients (9%). No grade 3 or higher gastrointestinal late toxicities were observed. Urinary incontinence found in 2 patients (9%) and grade 2 obstruction of urinary tract occurred in one patient (4%). Interstitial HDR-BT was feasible and effective in the treatment of locally recurrent prostate cancer after definitive radiotherapy. The long-term toxicity was low and acceptable. Copyright © 2016 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  4. SVI interstitial brachytherapy for primary malignant brain tumors: technical aspects of treatment planning and implantation methods

    SciTech Connect

    Findlay, P.A.; Wright, D.C.; Rosenow, U.; Harrington, F.S.; Miller, R.W.

    1985-11-01

    Use of interstitial radiation holds promise in the treatment of primary malignant brain tumors, but optimal technical factors have yet to be determined. We have developed a method of precise CT directed stereotactic placement of radioactive sources in a predetermined target volume. We use low activity (1-2 millicurie/speed) sources of SVI loaded in silastic catheters, which are positioned in a parallel array in the target. Positioning of such multiple sources toward the periphery of the volume enhances achievable dose homogeneity. Seeds of various activities can be differentially loaded into each catheter and the catheters can be positioned at various radii from the central target so that the treated volume corresponds to the identified (often irregular) target volume. Although the implant is designed to be permanent, the sources can be removed easily in a second procedure.

  5. [Physical and technical quality assurance and radiation protection in transperineal interstitial permanent prostate brachytherapy with 125-iodine seeds].

    PubMed

    Kaulich, Theodor W; Lamprecht, Ulf; Paulsen, Frank; Lorenz, Joachim; Maurer, Uwe; Loeser, Wolfgang; Bichler, Karl-Horst; Nüsslin, Fridtjof; Bamberg, Michael

    2002-12-01

    Early stage prostate cancer can be treated successfully by interstitial brachytherapy with 125-iodine seeds. A quality-assurance programme is presented that was designed for this purpose for internal clinical use. Furthermore the requirements of the new German Ordinance Governing Radiation Protection (StrlSchV) that came into force on August 1, 2001, are taken into account. For the 125-iodine monotherapy of the prostate we used RAPID STRANDS (Amersham Health, Braunschweig, Germany). According to the guidelines of the new Ordinance Governing Radiation Protection, the determination of the body dose of the staff is made to rely on the new measurement quantities H(p) (10) and H(p) (0.07). The nominal air kerma rate of the seeds is measured with a calibrated well-chamber of the type HDR 1000 Plus and an electrometer of the type MAX 4000 (Standard Imaging Inc., USA). The ultrasound images of the prostate are produced by an ultrasound device of the type Falcon 2101 (B-K Medical, Denmark). For treatment planning the programme VariSeed (Varian, Darmstadt, Germany) was employed. Correct loading of the needles is controlled by autoradiography before implantation. After the implantation radiation-protection measurements in the operating room are carried out. As regards the personnel, for the depth personal dose equivalent Hp(10) and relating to two applications each, measurement values between 0 microSv and 14 microSv resulted. The control of the radiation exposure of the hands revealed superficial personal dose values H(p) (0.07) of up to 1 mSv. The nominal air kerma rates of the RAPID STRANDS were all lying within the 95% confidence interval guaranteed by the producer. The autoradiographs documented -- except for one case -- the correct loading of the needles. The interstitial transperineal prostate implantation of the 125-iodine seeds succeeded as planned with all patients. Until now no contamination of the operating room was detected by the radiation

  6. Assessment of daily needle applicator displacement during high-dose-rate interstitial brachytherapy for prostate cancer using daily CT examinations.

    PubMed

    Takenaka, Tadashi; Yoshida, Ken; Ueda, Mari; Yamazaki, Hideya; Miyake, Shunsuke; Tanaka, Eiichi; Yoshida, Mineo; Yoshimura, Yasushi; Oka, Toshitsugu; Honda, Kazuya

    2012-01-01

    To improve treatment conformity for prostate cancer, we investigated daily applicator displacement during high-dose-rate interstitial brachytherapy (HDR-ISBT). Thirty patients treated with HDR-ISBT as monotherapy were examined. All patients received a treatment dosage of 49 Gy per 7 fractions over 4 days. For dose administration, we examined 376 flexible applicators (1128 points) using our unique ambulatory implant technique. Using CT images with a 3-mm slice thickness, we calculated the relative coordinates of the titanium markers and the tips of the applicators. We calculated the distance between the center of gravity of the markers and the tips of the catheters, and compared the distances measured on the day of implantation and the second, third, and fourth treatment days. The mean displacement distance for all applicators was 4.3 ± 3.4 mm, 4.6 ± 4.1 mm, and 5.8 ± 4.5 mm at 21, 45, and 69 hours after initial planning CT. We used a 15-mm margin for needle displacement and only 2 points of 2 patients (16 mm and 18 mm at 69 hours, 2/1128 = 0.2%) exceeded this range. Almost patients (87%) showed the largest displacement within the first 21 hours. The relative doses that covered 100% of CTV (D100(CTV)) values compared with the initial treatment plan were reduced to 0.96 ± 0.08, 0.96 ± 0.08 and 0.94 ± 0.1 at 21, 45 and 69 hours. However, the relative D90(CTV) values kept acceptable levels (1.01 ± 0.02, 1.01 ± 0.03 and 1.01 ± 0.03). Cranial margin of 15 mm seems to be effective to keep D90(CTV) level if we do not do corrective action.

  7. Monte Carlo modeling of the transverse-axis dose distribution of the model 200 103Pd interstitial brachytherapy source.

    PubMed

    Williamson, J F

    2000-04-01

    This study presents the first theoretical analysis of the absolute dose-rate distribution about the Model 200 103Pd interstitial brachytherapy source. Monte Carlo photon-transport (MCPT) simulation techniques have been used to evaluate the transverse-axis dose-rate distribution of the Model 200 source as a function of thickness of the Pd metal coating (containing the 103Pd) plated onto the surfaces of right cylindrical graphite pellets contained within the seed. The dose-rate constant, A, was realistically estimated by simulating the wide-angle, free-air chamber (WAFAC) calibration geometry. The WAFAC is the experimental realization of NIST's (National Institute of Standards and Technology) recently implemented primary standard of air-kerma strength (S(K)). Our results show that polar angle- and distance-dependent oblique filtration and shielding effects induce significant and unexpected photon fluence anisotropy near the transverse-axis and inverse square law deviations at typical calibration distances. Any source consisting of radioactivity deposited on a highly attenuating surface with sharp edges may exhibit such effects. In the case of the Model 200 seed, the Pd metal thickness does not significantly influence the relative dose distribution in water at distances less than 5 cm, but does make A sensitive to the S(K) measurement geometry. Fortunately, the WAFAC averages fluence over a sufficiently large aperture that the resultant A, 0.68 +/- 0.02 cGy x h(-1) x U(-1), is almost independent of Pd metal layer thickness and in close agreement with recent measurements and calculations. This value is 20% higher than that of the renormalized Task Group 43 A value.

  8. Edema worsens target coverage in high-dose-rate interstitial brachytherapy of mobile tongue cancer: a report of two cases

    PubMed Central

    Yamazaki, Hideya; Kotsuma, Tadayuki; Akiyama, Hironori; Takenaka, Tadashi; Masui, Koji; Yoshioka, Yasuo; Uesugi, Yasuo; Shimbo, Taiju; Yoshikawa, Nobuhiko; Yoshioka, Hiroto; Arika, Takumi; Tanaka, Eiichi; Narumi, Yoshifumi

    2017-01-01

    Purpose We report our study on two patients to highlight the risk of underdosage of the clinical target volume (CTV) due to edema during high-dose-rate interstitial brachytherapy (HDR-ISBT) of mobile tongue cancer. Material and methods To treat the lateral side of the CTV, flexible applicator tubes were implanted on the mouth floor. Two-dimensional planning was performed using X-ray images for Case 1, and three-dimensional (3D) planning was performed using computed tomography (CT) for Case 2. Prescribed doses for both cases were 54 Gy in nine fractions. Case reports Case 1 was treated for cancer of the right lateral border of the tongue in 2005. Tongue edema occurred after implantation, and part of the lateral border of the tongue protruded between the applicator tubes. Acute mucosal reaction abated in the protruded area earlier than in the other parts of the CTV. In this case, the tumor recurred in this area 5 months after the treatment. Case 2 was treated for cancer of the left lateral border of the tongue. Because tongue edema occurred in this case also, plastic splints were inserted between the applicator tubes to push the edematous region into the irradiated area. The mucosal surface of the CTV was covered by the 70% isodose, and 100% isodose line for before and after splint insertion. Local control of the tumor was achieved 4 years after treatment. Discussion and conclusions To ensure sufficient target coverage, 3D image-based planning using CT should be performed, followed by re-planning using repeated CT as needed. Also, the development of devices to prevent protrusion of the edematous tissue outside the target area will help to ensure the full dosing of CTV. PMID:28344606

  9. High-Dose-Rate Interstitial Brachytherapy as Monotherapy for Clinically Localized Prostate Cancer: Treatment Evolution and Mature Results

    SciTech Connect

    Zamboglou, Nikolaos; Tselis, Nikolaos; Baltas, Dimos; Buhleier, Thomas; Martin, Thomas; Milickovic, Natasa; Papaioannou, Sokratis; Ackermann, Hanns; Tunn, Ulf W.

    2013-03-01

    Purpose: To report the clinical outcome of high-dose-rate (HDR) interstitial (IRT) brachytherapy (BRT) as sole treatment (monotherapy) for clinically localized prostate cancer. Methods and Materials: Between January 2002 and December 2009, 718 consecutive patients with clinically localized prostate cancer were treated with transrectal ultrasound (TRUS)-guided HDR monotherapy. Three treatment protocols were applied; 141 patients received 38.0 Gy using one implant in 4 fractions of 9.5 Gy with computed tomography-based treatment planning; 351 patients received 38.0 Gy in 4 fractions of 9.5 Gy, using 2 implants (2 weeks apart) and intraoperative TRUS real-time treatment planning; and 226 patients received 34.5 Gy, using 3 single-fraction implants of 11.5 Gy (3 weeks apart) and intraoperative TRUS real-time treatment planning. Biochemical failure was defined according to the Phoenix consensus, and toxicity was evaluated using Common Toxicity Criteria for Adverse Events version 3. Results: The median follow-up time was 52.8 months. The 36-, 60-, and 96-month biochemical control and metastasis-free survival rates for the entire cohort were 97%, 94%, and 90% and 99%, 98%, and 97%, respectively. Toxicity was scored per event, with 5.4% acute grade 3 genitourinary and 0.2% acute grade 3 gastrointestinal toxicity. Late grade 3 genitourinary and gastrointestinal toxicities were 3.5% and 1.6%, respectively. Two patients developed grade 4 incontinence. No other instance of grade 4 or greater acute or late toxicity was reported. Conclusion: Our results confirm IRT-HDR-BRT is safe and effective as monotherapy for clinically localized prostate cancer.

  10. [Accelerated partial breast irradiation using interstitial high dose rate brachytherapy: preliminary clinical and dosimetric results after 61 patients].

    PubMed

    Hannoun-Levi, J-M; Ferré, M; Raoust, I; Lallement, M; Flipo, B; Ettore, F; Marcié, S

    2008-11-01

    Among all the accelerated and partial breast irradiation (APBI) techniques, low then high dose rate, interstitial brachytherapy (HDIB) was the first to be used in this field. This study presents the preliminary clinical and dosimetric results of the APBI using HDIB, performed in Antoine Lacassagne Cancer Center of Nice. From June 2004 to March 2008, 61 patients (37 primary tumors and 24 second conservative treatments after local recurrence) presenting with T1-2 pN0 non-lobular invasive breast carcinoma, underwent lumpectomy with sentinel lymph node dissection and intraoperative tube placement for HDIB. Dose distribution analysis, using dose-volume histograms, was achieved based on a postoperative CT scan. A comparative dosimetric study was performed between optimized (O) and non-optimized (NO) dose distribution. Then, based on conformal index calculation, a novel index was proposed taking into account not only the conformity but also the homogeneity of HDIB implant. An analysis of dose gradient impact on HDIB biological equivalence dose was also conducted. Statistical analysis used T test confirmed by Wilcoxon test for cohort including less than 30 patients. The comparative dosimetric analysis between O and NO dose distributions shown that conformity indexes (conformal index, conformal number, and D90%) were significantly increased after optimization. Improving conformity leads to increasing hyperdosage volumes (V150% and V200%). A new index named conformity and homogeneity index (CHI) including V150% values, modified the conformal index. A total dose of 34 Gy, delivered through HDIB in 10 fractions over five days was biologically equivalent to 41.93 Gy assuming alpha/beta = 4 Gy and 75.76 Gy if the dose gradient was considered in the calculation. HDIB is considered as one of the best IPAS technique. HDIB allows dose distribution optimization, skin spearing and accurate clinical target volume definition. Furthermore, HDIB dose gradient could play a key role for

  11. The theoretical basis and clinical methodology for stereotactic interstitial brain tumor irradiation using iododeoxyuridine as a radiation sensitizer and samarium-145 as a brachytherapy source

    SciTech Connect

    Goodman, J.H.; Gahbauer, R.A.; Kanellitsas, C.; Clendenon, N.R. ); Laster, B.H.; Fairchild, R.G. )

    1989-01-01

    High grade astrocytomas have proven resistant to all conventional therapy. A technique to produce radiation enhancement during interstitial brain tumor irradiation by using a radiation sensitizer (IdUrd) and by stimulation of Auger electron cascades through absorption of low energy photons in iodine (Photon activation) is described. Clinical studies using IdUrd, {sup 192}Ir as a brachytherapy source, and external radiation have produced promising results. Substituting samarium-145 for {sup 192}Ir in this protocol is expected to produce enhanced results. 15 refs.

  12. Image-guided therapy system for interstitial gynecologic brachytherapy in a multimodality operating suite.

    PubMed

    Egger, Jan

    2013-01-01

    In this contribution, an image-guided therapy system supporting gynecologic radiation therapy is introduced. The overall workflow of the presented system starts with the arrival of the patient and ends with follow-up examinations by imaging and a superimposed visualization of the modeled device from a PACS system. Thereby, the system covers all treatments stages (pre-, intra- and postoperative) and has been designed and constructed by a computer scientist with feedback from an interdisciplinary team of physicians and engineers. This integrated medical system enables dispatch of diagnostic images directly after acquisition to a processing workstation that has an on-board 3D Computer Aided Design model of a medical device. Thus, allowing precise identification of catheter location in the 3D imaging model which later provides rapid feedback to the clinician regarding device location. Moreover, the system enables the ability to perform patient-specific pre-implant evaluation by assessing the placement of interstitial needles prior to an intervention via virtual template matching with a diagnostic scan.

  13. Successful treatment of a 67-year-old woman with urethral adenocarcinoma with the use of external beam radiotherapy and image guided adaptive interstitial brachytherapy

    PubMed Central

    Mujkanovic, Jasmin; Tanderup, Kari; Agerbæk, Mads; Bisgaard, Ulla; Høyer, Søren; Lindegaard, Jacob Christian

    2016-01-01

    Primary urethral cancer (PUC) is a very rare disease. This case report illustrates a successful treatment approach of a 67-year-old woman with a urethral adenocarcinoma selected for an organ preserving treatment with external beam radiotherapy (EBRT) and interstitial brachytherapy (BT) boost, using the GEC-ESTRO target concept originally designed for locally advanced cervical cancer (LACC). Treatment included EBRT with 45 Gy in 25 fractions followed by image guided adaptive interstitial BT (IGABT) with a pulsed-dose-rate (PDR) BT boost with 30 Gy in 50 hourly pulses. The D90 for CTVHR was 79.1 Gy in EQD23. At 24 months follow-up, the patient was recurrence free and without treatment related side effects. PMID:27895686

  14. More accurate fitting of {sup 125}I and {sup 103}Pd radial dose functions

    SciTech Connect

    Taylor, R. E. P.; Rogers, D. W. O.

    2008-09-15

    In this study an improved functional form for fitting the radial dose functions, g(r), of {sup 125}I and {sup 103}Pd brachytherapy seeds is presented. The new function is capable of accurately fitting radial dose functions over ranges as large as 0.05 cm{<=}r{<=}10 cm for {sup 125}I seeds and 0.10 cm{<=}r{<=}10 cm for {sup 103}Pd seeds. The average discrepancies between fit and calculated data are less than 0.5% over the full range of fit and maximum discrepancies are 2% or less. The fitting function is also capable of accounting for the sharp increase in g(r) (upturn) seen for some sources for r<0.1 cm. This upturn has previously been attributed to the breakdown of the approximation of the sources as a line, however, in this study we demonstrate that another contributing factor is the 4.5 keV characteristic x-rays emitted from the Ti seed casing. Radial dose functions are calculated for 18 {sup 125}I seeds and 9 {sup 103}Pd seeds using the EGSnrc Monte Carlo user-code BrachyDose. Fitting coefficients of the new function are tabulated for all 27 seeds. Extrapolation characteristics of the function are also investigated. The new functional form is an improvement over currently used fitting functions with its main strength being the ability to accurately fit the rapidly varying radial dose function at small distances. The new function is an excellent candidate for fitting the radial dose function of all {sup 103}Pd and {sup 125}I brachytherapy seeds and will increase the accuracy of dose distributions calculated around brachytherapy seeds using the TG-43 protocol over a wider range of data. More accurate values of g(r) for r<0.5 cm may be particularly important in the treatment of ocular melanoma.

  15. Multi-Parametric MRI-Directed Focal Salvage Permanent Interstitial Brachytherapy for Locally Recurrent Adenocarcinoma of the Prostate: A Novel Approach

    PubMed Central

    Wallace, T.; Avital, I.; Stojadinovic, A.; Brücher, B.L.D.M.; Cote, E.; Yu, J.

    2013-01-01

    Even with the technological advances of dose-escalated IMRT with the addition of the latest image guidance technologies, local failures still occur. The combination of MRI-based imaging techniques can yield quantitative information that reflects on the biological properties of prostatic tissues. These techniques provide unique information that can be used for tumor detection in the treated gland. With the advent of these improved imaging modalities, it has become possible to more effectively image local recurrences within the prostate gland. With better imaging, these focal recurrences can be differentially targeted with salvage brachytherapy minimizing rectal and bladder toxicity. Here we report a novel use of MRI-directed focal brachytherapy after local recurrence. This technique offers a unique opportunity to safely and successfully treat recurrent prostate cancer, previously treated with definitive radiation therapy. The use of multi-parametric MRI-directed focal salvage permanent interstitial brachytherapy for locally recurrent adenocarcinoma of the prostate is a promising strategy to avoid more aggressive and expensive treatments that are associated with increased morbidity, potentially improving survival at potentially lower costs. PMID:23412660

  16. Multi-Parametric MRI-Directed Focal Salvage Permanent Interstitial Brachytherapy for Locally Recurrent Adenocarcinoma of the Prostate: A Novel Approach.

    PubMed

    Wallace, T; Avital, I; Stojadinovic, A; Brücher, B L D M; Cote, E; Yu, J

    2013-01-01

    Even with the technological advances of dose-escalated IMRT with the addition of the latest image guidance technologies, local failures still occur. The combination of MRI-based imaging techniques can yield quantitative information that reflects on the biological properties of prostatic tissues. These techniques provide unique information that can be used for tumor detection in the treated gland. With the advent of these improved imaging modalities, it has become possible to more effectively image local recurrences within the prostate gland. With better imaging, these focal recurrences can be differentially targeted with salvage brachytherapy minimizing rectal and bladder toxicity. Here we report a novel use of MRI-directed focal brachytherapy after local recurrence. This technique offers a unique opportunity to safely and successfully treat recurrent prostate cancer, previously treated with definitive radiation therapy. The use of multi-parametric MRI-directed focal salvage permanent interstitial brachytherapy for locally recurrent adenocarcinoma of the prostate is a promising strategy to avoid more aggressive and expensive treatments that are associated with increased morbidity, potentially improving survival at potentially lower costs.

  17. [Outcomes and predictors of T3a prostate cancer treated by permanent interstitial brachytherapy combined with external radiotherapy and hormone therapy].

    PubMed

    Mai, Zhipeng; Yan, Weigang; Li, Hanzhong; Zhou, Yi; Zhou, Zhien; Chen, Jian

    2014-10-01

    To evaluate the outcomes of T3a prostate cancer treated by permanent interstitial brachytherapy combined with external radiotherapy and hormone therapy, and analyse the influence of preoperative factors on prognosis. From January 2003 to December 2008, 38 pactients with T3a prostate cancer aged from 48 to 81 years (mean: 71 years) were enrolled, with serum prostate specific antigen (PSA) levels ranged from 10.000 to 99.800 µg/L (mean: 56.300 µg/L), Gleason score from 5 to 9 (mean: 7.6) and percentage of positive biopsy cores from 10.0% to 100% (mean: 65.3%). All patients were treated by permanent interstitial brachytherapy combined with external radiotherapy and hormone therapy. Survival curves were calculated using the Kaplan-Meier method. The predictive factors including patient's age, prostate volume, serum pre-treatment PSA, Gleason score and percentage of positive biopsy cores were used for univariate analysis on biochemical failure-free, distant metastasis-free and overall survival. The mean follow-up was 69 months (range: 9-109 months).Nineteen patients experienced biochemical failure. The average biochemical failure time was 13.4 months (range: 1-40 months). There were 13 patients developed as distant metastatic prostate cancer since average 19.7 months (range: 1-70 months) after brachytherapy. Of all patients, 9 died of prostate cancer recurrence, while 6 passed away because of other reasons, with an average of 52.2 months (range: 9.0- 98.5 months). The 5-year biochemical failure-free survival (BFFS), distant metastasis free survival (DMFS), cancer specific survival (CSS) and overall survival (OS) rate were 44.1%, 68.6%, 82.4 and 75.8%, respectively. Twenty-nine patients experienced grade 1-2 gastrointestinal toxicity and 18 patients experienced grade 1-2 genitourinary toxicity. In univariate analysis, the percentage of positive biopsy cores was significantly correlated with BFFS (χ(2) = 17.240, P = 0.000), DMFS (χ(2) = 18.641, P = 0.000) and OS (χ(2

  18. Vaginal tolerance of CT based image-guided high-dose rate interstitial brachytherapy for gynecological malignancies

    PubMed Central

    2014-01-01

    Background Purpose of this study was to identify predictors of vaginal ulcer after CT based three-dimensional image-guided high-dose-rate interstitial brachytherapy (HDR-ISBT) for gynecologic malignancies. Methods Records were reviewed for 44 female (14 with primary disease and 30 with recurrence) with gynecological malignancies treated with HDR-ISBT with or without external beam radiation therapy. The HDR-ISBT applicator insertion was performed with image guidance by trans-rectal ultrasound and CT. Results The median clinical target volume was 35.5 ml (2.4-142.1 ml) and the median delivered dose in equivalent dose in 2 Gy fractions (EQD2) for target volume D90 was 67.7 Gy (48.8-94.2 Gy, doses of external-beam radiation therapy and brachytherapy were combined). For re-irradiation patients, median EQD2 of D2cc for rectum and bladder, D0.5cc, D1cc, D2cc, D4cc, D6cc and D8cc for vaginal wall was 91.1 Gy, 100.9 Gy, 260.3 Gy, 212.3 Gy, 170.1 Gy, 117.1 Gy, 105.2 Gy, and 94.7 Gy, respectively. For those without prior radiation therapy, median EQD2 of D2cc for rectum and bladder, D0.5cc, D1cc, D2cc, D4cc, D6cc and D8cc for vaginal wall was 56.3 Gy, 54.3 Gy, 147.4 Gy, 126.2 Gy, 108.0 Gy, 103.5 Gy, 94.7 Gy, and 80.7 Gy, respectively. Among five patients with vaginal ulcer, three had prior pelvic radiation therapy in their initial treatment and three consequently suffered from fistula formation. On univariate analysis, re-irradiation and vaginal wall D2cc in EQD2 was the clinical predictors of vaginal ulcer (p = 0.035 and p = 0.025, respectively). The ROC analysis revealed that vaginal wall D2cc is the best predictor of vaginal ulcer. The 2-year incidence rates of vaginal ulcer in the patients with vaginal wall D2cc in EQD2 equal to or less than 145 Gy and over 145 Gy were 3.7% and 23.5%, respectively, with a statistically significant difference (p = 0.026). Conclusions Re-irradiation and vaginal D2cc is a significant predictor of vaginal ulcer after HDR-ISBT for

  19. Vaginal tolerance of CT based image-guided high-dose rate interstitial brachytherapy for gynecological malignancies.

    PubMed

    Murakami, Naoya; Kasamatsu, Takahiro; Sumi, Minako; Yoshimura, Ryoichi; Harada, Ken; Kitaguchi, Mayuka; Sekii, Shuhei; Takahashi, Kana; Yoshio, Kotaro; Inaba, Koji; Morota, Madoka; Ito, Yoshinori; Itami, Jun

    2014-01-23

    Purpose of this study was to identify predictors of vaginal ulcer after CT based three-dimensional image-guided high-dose-rate interstitial brachytherapy (HDR-ISBT) for gynecologic malignancies. Records were reviewed for 44 female (14 with primary disease and 30 with recurrence) with gynecological malignancies treated with HDR-ISBT with or without external beam radiation therapy. The HDR-ISBT applicator insertion was performed with image guidance by trans-rectal ultrasound and CT. The median clinical target volume was 35.5 ml (2.4-142.1 ml) and the median delivered dose in equivalent dose in 2 Gy fractions (EQD2) for target volume D90 was 67.7 Gy (48.8-94.2 Gy, doses of external-beam radiation therapy and brachytherapy were combined). For re-irradiation patients, median EQD2 of D(2cc) for rectum and bladder, D0.5cc, D(1cc), D(2cc), D(4cc), D(6cc) and D(8cc) for vaginal wall was 91.1 Gy, 100.9 Gy, 260.3 Gy, 212.3 Gy, 170.1 Gy, 117.1 Gy, 105.2 Gy, and 94.7 Gy, respectively. For those without prior radiation therapy, median EQD2 of D(2cc) for rectum and bladder, D(0.5cc), D(1cc), D(2cc), D(4cc), D(6cc) and D(8cc) for vaginal wall was 56.3 Gy, 54.3 Gy, 147.4 Gy, 126.2 Gy, 108.0 Gy, 103.5 Gy, 94.7 Gy, and 80.7 Gy, respectively. Among five patients with vaginal ulcer, three had prior pelvic radiation therapy in their initial treatment and three consequently suffered from fistula formation. On univariate analysis, re-irradiation and vaginal wall D(2cc) in EQD2 was the clinical predictors of vaginal ulcer (p = 0.035 and p = 0.025, respectively). The ROC analysis revealed that vaginal wall D(2cc) is the best predictor of vaginal ulcer. The 2-year incidence rates of vaginal ulcer in the patients with vaginal wall D(2cc) in EQD2 equal to or less than 145 Gy and over 145 Gy were 3.7% and 23.5%, respectively, with a statistically significant difference (p = 0.026). Re-irradiation and vaginal D(2cc) is a significant predictor of vaginal ulcer after HDR-ISBT for gynecologic

  20. Value of Combined PET/CT for Radiation Planning in CT-Guided Percutaneous Interstitial High-Dose-Rate Single-Fraction Brachytherapy for Colorectal Liver Metastases

    SciTech Connect

    Steffen, Ingo G.; Wust, Peter; Ruehl, Ricarda

    2010-07-15

    Purpose: To determine the additional value of fluorodeoxyglucose-positron emission tomography (PET) for clinical target volume definition in the planning of computed tomography (CT)-guided interstitial brachytherapy for liver metastases. Patients and Methods: A total of 19 patients with liver metastases from colorectal cancer treated in 25 sessions were included in the present study. All patients had undergone fluorodeoxyglucose-PET for patient evaluation before interstitial CT-guided brachytherapy. A contrast-enhanced CT scan of the upper abdomen was obtained for radiation planning. The clinical target volume (CTV) was defined by a radiation oncologist and radiologist. After registration of the CT scan with the PET data set, the target volume was defined again using the fusion images. Results: PET revealed one additional liver lesion that was not visible on CT. The median CT-CTV (defined using CT and magnetic resonance imaging) was 68 cm{sup 3} (range 4-260). The PET/CT-CTV (median, 78 cm{sup 3}; range, 4-273) was significantly larger, with a median gain of 24.5% (interquartile range, 2.1-71.5%; p = .022). An increased CTV was observed in 15 cases and a decrease in 6; in 4 cases, the CT-CTV and PET/CT-CTV were equal. Incomplete dose coverage of PET/CT-CTVs was indicative of early local progression (p = .004); however, CT-based radiation plans did not show significant differences in the local control rates when stratified by dose coverage. Conclusion: Retrospective implementation of fluorodeoxyglucose-PET for CTV specification for CT-guided brachytherapy for colorectal liver metastases revealed a significant change in the CTVs. Additional PET-positive tumor regions with incomplete dose coverage could explain unexpected early local progression.

  1. Study of the dosimetric differences between (192)Ir and (60)Co sources of high dose rate brachytherapy for breast interstitial implant.

    PubMed

    Sinnatamby, Mourougan; Nagarajan, Vivekanandan; Kanipakam Sathyanarayana, Reddy; Karunanidhi, Gunaseelan; Singhavajala, Vivekanandam

    2016-01-01

    The study intends to compare (192)Ir source against the (60)Co source for interstitial breast metal implant in high dose rate brachytherapy. Few studies have been reported to compare (60)Co and (192)Ir on HDR brachytherapy in gynaecology and prostate cancer and very few with reference to breast cancer. Twenty patients who had undergone interstitial template guided breast implant were treated in HDR (192)Ir brachytherapy unit. Plans were generated substituting (60)Co source without changing the dwell positions and optimization. Cumulative dose volume histograms were compared. The reference isodose line enclosing CTV (CTVref) and the 2.34% difference seen in the volume enclosed by the reference isodose line (V ref) between the two isotopes show small but statistically significant difference (p < 0.05). In DHI, no difference was observed in the relative dose between the two sources (p = 0.823). The over dose volume index showed 11% difference. The conformity index showed 2.32% difference compared to (192)Ir (p < 0.05). D mean (%) and D max (%) for the heart, ipsilateral lung, ipsilateral ribs, skin presented very small difference. V 5% and V 10% of the heart shows 25% and 32% difference in dose. D 2cc (%) and D 0.1cc (%) for the contralateral breast, contralateral lung and D 2cc (%) of the skin displayed significant difference (p < 0.05). However, D 0.1cc (%) of the skin indicated no noteworthy difference with p = 0.343. Based on the 3D dosimetric analysis of patient plans considered in this study, most of the DVH parameters showed statistically significant differences which can be reduced by treatment planning optimization techniques. (60)Co isotope can be used as a viable alternative because of its long half-life, logistic advantages in procurement, infrequent need of source replacement and disposal of used source.

  2. Model assessment of individual tumor control rate and adverse effects in comparing locally advanced cervical cancer treatment using intracavitary with and without interstitial brachytherapy

    PubMed Central

    Mehta, Keyur J; Yaparpalvi, Ravindra; Shankar, Viswanathan; Bodner, William; Garg, Madhur; Rivera, Amanda; Tomé, Wolfgang A.; Kalnicki, Shalom

    2016-01-01

    Purpose This study assessed the modeled probability of tumor control and organ at risk toxicities in locally advanced cervical cancer in patients treated by external beam radiation plus brachytherapy using intracavitary combined with interstitial brachytherapy (IC/IS) vs. intracavitary brachytherapy (IC) alone. Material and methods Twenty cervical cancer patients with a mean HR-CTV volume of 47.4 cm3 and a mean width of 54 mm were planned with both IC/IS and IC brachytherapy alone. A probit model was utilized to model 3-year (3-yr) local control rate (LC), 3-yr cancer specific survival rate (CSS), and the adverse effect (AE) of the organ at risk by using a modeled data set from multiple institutions. Modeling results were used to estimate the LC, CSS, and AE of the treatments in this study. Results Using the IC/IS technique, an EQD2 increase of 12.3 Gy to D90 (from 76.1 Gy to 88.3 Gy) of HR-CTV is expected to increase 3-yr LC and 3-yr CSS by 12.5%, and 11.0%, respectively. Comparing IC/IS to IC alone, the expected G2+ AE were 7.7% vs. 7.9% for the bladder, and 5.9% vs. 6.8% for the rectum. Conclusions The IC/IS technique improved dose coverage to the HR-CTV without significantly increasing dose to 2 cm3 of the organ at risk (OAR) surrounding it. With different regimens of EBRT combined with BT, IC/IS can be used to increase the probability of LC and CSS, or decrease the risk of AE. PMID:28115959

  3. Accelerated Partial Breast Irradiation: 5-Year Results of the German-Austrian Multicenter Phase II Trial Using Interstitial Multicatheter Brachytherapy Alone After Breast-Conserving Surgery

    SciTech Connect

    Strnad, Vratislav; Hildebrandt, Guido; Poetter, Richard; Hammer, Josef; Hindemith, Marion; Resch, Alexandra; Spiegl, Kurt; Lotter, Michael; Uter, Wolfgang; Bani, Mayada; Kortmann, Rolf-Dieter; Beckmann, Matthias W.; Fietkau, Rainer; Ott, Oliver J.

    2011-05-01

    Purpose: To evaluate the impact of accelerated partial breast irradiation on local control, side effects, and cosmesis using multicatheter interstitial brachytherapy as the sole method for the adjuvant local treatment of patients with low-risk breast cancer. Methods and Materials: 274 patients with low-risk breast cancer were treated on protocol. Patients were eligible for the study if the tumor size was < 3 cm, resection margins were clear by at least 2 mm, no lymph node metastases existed, age was >35 years, hormone receptors were positive, and histologic grades were 1 or 2. Of the 274 patients, 175 (64%) received pulse-dose-rate brachytherapy (D{sub ref} = 50 Gy). and 99 (36%) received high-dose-rate brachytherapy (D{sub ref} = 32.0 Gy). Results: Median follow-up was 63 months (range, 9-103). Only 8 of 274 (2.9%) patients developed an ipsilateral in-breast tumor recurrence at the time of analysis. The 5-year actuarial local recurrence-free survival probability was 98%. The 5- year overall and disease-free survival probabilities of all patients were 97% and 96%, respectively. Contralateral in-breast malignancies were detected in 2 of 274 (0.7%) patients, and distant metastases occurred in 6 of 274 (2.2%). Late side effects {>=}Grade 3 (i.e., breast tissue fibrosis and telangiectasia) occurred in 1 patient (0.4%, 95%CI:0.0-2.0%) and 6 patients (2.2%, 95%CI:0.8-4.7%), respectively. Cosmetic results were good to excellent in 245 of 274 patients (90%). Conclusions: The long-term results of this prospective Phase II trial confirm that the efficacy of accelerated partial breast irradiation using multicatheter brachytherapy is comparable with that of whole breast irradiation and that late side effects are negligible.

  4. Pulsed-dose-rate peri-operative brachytherapy as an interstitial boost in organ-sparing treatment of breast cancer

    PubMed Central

    Jaśkiewicz, Janusz; Dziadziuszko, Rafał; Jassem, Jacek

    2016-01-01

    Purpose To evaluate peri-operative multicatheter interstitial pulsed-dose-rate brachytherapy (PDR-BT) with an intra-operative catheter placement to boost the tumor excision site in breast cancer patients treated conservatively. Material and methods Between May 2002 and October 2008, 96 consecutive T1-3N0-2M0 breast cancer patients underwent breast-conserving therapy (BCT) including peri-operative PDR-BT boost, followed by whole breast external beam radiotherapy (WBRT). The BT dose of 15 Gy (1 Gy/pulse/h) was given on the following day after surgery. Results No increased bleeding or delayed wound healing related to the implants were observed. The only side effects included one case of temporary peri-operative breast infection and 3 cases of fat necrosis, both early and late. In 11 patients (11.4%), subsequent WBRT was omitted owing to the final pathology findings. These included eight patients who underwent mastectomy due to multiple adverse prognostic pathological features, one case of lobular carcinoma in situ, and two cases with no malignant tumor. With a median follow-up of 12 years (range: 7-14 years), among 85 patients who completed BCT, there was one ipsilateral breast tumor and one locoregional nodal recurrence. Six patients developed distant metastases and one was diagnosed with angiosarcoma within irradiated breast. The actuarial 5- and 10-year disease free survival was 90% (95% CI: 84-96%) and 87% (95% CI: 80-94%), respectively, for the patients with invasive breast cancer, and 91% (95% CI: 84-97%) and 89% (95% CI: 82-96%), respectively, for patients who completed BCT. Good cosmetic outcome by self-assessment was achieved in 58 out of 64 (91%) evaluable patients. Conclusions Peri-operative PDR-BT boost with intra-operative tube placement followed by EBRT is feasible and devoid of considerable toxicity, and provides excellent long-term local control. However, this strategy necessitates careful patient selection and histological confirmation of primary

  5. Comparison of two techniques of interstitial pulsed dose rate boost brachytherapy in conservative treatment of breast cancer

    PubMed Central

    Tarnawska, Zofia; Blukis, Andrzej; Badzio, Andrzej; Jaskiewicz, Janusz; Jassem, Jacek

    2009-01-01

    Purpose The aim of this work is to compare selected parameters of implants and natural dose volume histograms for two techniques of interstitial pulsed dose rate brachytherapy (PDR BT) as a boost to the tumour bed in breast-conserving therapy (BCT). Material and methods Data of T1-3N0-2M0 breast cancer patients who underwent BCT with BT boost between 05.2002 and 12.2008 were analysed. Ninety two patients were implanted with rigid tubes after breast irradiation (group A) and 96 had a peri-operative BT with an intra-operative flexible tube placement and subsequent whole breast radiotherapy (group B). In both groups PDR BT of 15 Gy (1 Gy/pulse/h) was administered based on Paris system rules, and volume optimization using BT planning system PLATO. Results Three-plane implant was used in 62% and 8% of patients in group A and B, respectively, and two-plane implant in 38% of group A and in 84% of group B, with a median of 11 and 9 tubes respectively. The average volume for the prescribed dose (V100) was 42.0 ± 25.4 cc (group A) and 34.1 ± 19.7 cc (group B), respectively (p = 0.017). The individual V50 and V200 were similar. Quality index (QI) was not impacted by the technique of BT (mean QI was 1.80 ± 0.10 and 1.75 ± 0.46 for the groups A and B, respectively). Uniformity index (UI) in respective groups was 1.60 ± 0.10 and 1.52 ± 0.21 (p = 0.001). Conclusions Implant volume encompassed by prescribed dose was significantly lower with intra-operative plastic tubes placement. In respect to the QI, these two BT techniques were comparable. The target volume coverage by the dose distribution as defined by UI was better for rigid tubes. PMID:27799951

  6. Extrascleral extension of choroidal melanoma: post-enucleation high-dose-rate interstitial brachytherapy of the orbit.

    PubMed

    Finger, Paul T; Tena, Lawrence B; Semenova, Ekaterina; Aridgides, Paul; Choi, Walter H

    2014-01-01

    To investigate if orbital extension of uveal melanoma can be treated with high-dose-rate (HDR) brachytherapy. This study is a retrospective analysis of the results of a clinical case series was performed on 10 patients. Each underwent primary enucleation for uveal melanoma, was discovered to have orbital extension, and consented for HDR brachytherapy. By American Joint Committee on Cancer (AJCC) initial tumor grading, there was one each (T1c, T2c, T2d, and T3d, three T4c, and two T4d-staged uveal melanomas. One was AJCC-staged R2 due to orbital recurrence presenting 16 months after enucleation. (192)Ir HDR brachytherapy involved transcutaneous circumferential orbital incisions allowing for evenly spaced brachytherapy catheters into the orbit. A target dose of 32.85 Gy (range, 32.85-34 Gy) was delivered in 9-10 twice-daily fractions (range, 3.4-3.65 Gy per fraction) over 5 consecutive days. Data analysis included but was not limited to radiation therapy methods, local tumor control, side effects, and metastatic rate. In the 9 patients who tolerated treatment, there has been no orbital recurrence at a median follow-up of 18 months (range, 1-62 months). Four patients died of metastatic disease (one presented with a treated solitary liver metastasis before brachytherapy). There was no significant eyelash or eyebrow loss. There was no radiation-induced eyelid erythema, orbital infection, or contracted sockets. All orbits accepted and maintained ocular prostheses. Brachytherapy was used as an alternative to external beam radiation treatment for postenucleation orbital melanoma. This series reports complete local control, few side effects, and excellent cosmetic results. Copyright © 2014 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  7. The Mechanism of Computed Tomography-Guided 125I Particle in Treating Lung Cancer

    PubMed Central

    Cheng, Jianzhong; Ma, Shaozeng; Yang, Guanghua; Wang, Lisen; Hou, Wei

    2017-01-01

    Background The incidence of malignant tumor has gradually increased. How to improve the survival and quality of life of patients who lose the opportunity for surgery or who are unwilling to receive surgery remains an obstacle. At present, 125I particle interstitial implant therapy has been applied in a variety of treatments of tumors. However, the mechanism of computed tomography (CT)-guided 125I particle therapy in lung cancer has not been fully elucidated. Material/Methods A total of 42 patients with advanced non-small cell lung cancer were retrospectively analyzed between January 2013 and December 2013, including 19 patients who received CT-guided 125I particle therapy and 23 patients who received chemotherapy. Curative effect and adverse reactions at 6 months and 12 months were compared and analyzed. A rabbit lung cancer VX2 model was treated by 125I particle implantation therapy under CT guidance. The change in tumor volume was detected. Tumor cell apoptosis was tested by flow cytometry. Bcl-2 and Bax expression were determined by real-time polymerase chain reaction (PCR) and Western blot. Results 125I particle therapy obviously reduced tumor volume after 6 months and 12 months. It showed significantly higher efficiency (57.9%, 57.9%) and control (78.9%, 73.7%) than the rates of efficiency and control in the chemotherapy group (P<0.05). 125I particle implantation therapy markedly suppressed rabbit VX2 transplanted tumor cell proliferation, promoted tumor regression, induced tumor cell apoptosis, reduced Bcl-2 expression, and upregulated Bax expression level (P<0.05). Conclusions CT-guided 125I particle implantation therapy can inhibit tumor proliferation and growth by regulating the expression of apoptosis-related genes and proteins, which is a promising approach in lung cancer treatment. PMID:28095393

  8. Is there a subset of patients with recurrent cancer in the vagina who are not candidates for interstitial brachytherapy that can be treated with multichannel vaginal brachytherapy using graphic optimization?

    PubMed

    Singh, Deepinder P; Bylund, Kevin C; Matloubieh, Ahmad; Mazloom, Ali; Gray, Alexander; Sidhu, Ravinder; Barrette, Lucille; Chen, Yuhchyau

    2015-04-01

    To evaluate recurrent vaginal cancer treated with vaginal brachytherapy (VBT) using graphic optimization in patients not amenable to surgery and interstitial brachytherapy (ISBT). We retrospectively reviewed the records of 5 patients with recurrent cancer in the vagina that were deemed not to be good candidates for ISBT implant because of medical reasons. All patients received computed tomography/magnetic resonance imaging (CT/MRI) based evaluation in addition to a detailed clinical examination, and were noted to have recurrent nodules in the vagina with size ranging from 10-25 mm. Four of the 5 patients had recurrent disease in the vaginal apex, whereas one patient had recurrence in the lateral vaginal wall. Subsequently, all patients were treated with external beam radiation therapy (EBRT) followed by multichannel vaginal cylinder (MVC)-based VBT using graphic optimization for shaping the isodose to improve the clinical target volume (CTV) coverage, as well as to spare the organs at risk (OAR). The dose to the bladder and rectum with regard to 0.1 cc, 1 cc, and 2 cc were recorded. Median age of the patients was 78 years (range 58-86 years). Thickness of the lesions before VBT ranged from 6-15 mm. All patients were followed up with MRI at 3 months. All patients but one demonstrated complete clinical/ radiological response of the tumor. No patient had any grade III/IV toxicity at 24 months. MVC-based VBT using graphic optimization is safe and yields favorable results if used judiciously.

  9. Effect of pedicle fixation combined with 125I seed implantation for metastatic thoracolumbar tumors

    PubMed Central

    Qian, Jiale; Bao, Zhaohua; Zou, Jun; Yang, Huilin

    2016-01-01

    Purpose The aim of this study was to investigate the clinical efficacy of pedicle fixation combined with 125I brachytherapy in treating metastatic thoracolumbar tumors. Patients and methods A retrospective analysis of the clinical data of seven metastatic thoracolumbar tumor patients who received pedicle fixation combined with radioactive 125I seed implantation brachytherapy in our department between January 2009 and December 2013 was performed. The visual analog scale (VAS) for pain and the Karnofsky performance status (KPS) score before the operation and 1, 6, and 12 months after the operation were observed and recorded. The changes in the scores at each time point were compared. Results All the patients underwent a successful operation, without any complications during their hospitalization. All the patients received postoperative follow-up, and the duration of follow-up was 15–50 months, with an average of 32.2 months. One pancreatic cancer patient died of liver failure and hypoproteinemia 28 months post surgery. The VAS scores of patients before the operation and 1, 6, and 12 months after the operation were 7.43±0.98, 2.71±0.49, 3.00±0.82, and 4.29±0.98, respectively; the KPS scores were 52.9±9.5, 84.3±5.3, 75.7±5.3, and 72.9±4.9, respectively. These results suggest that the VAS score at each time point was significantly decreased compared with that before the operation, while the KPS score was significantly increased compared with that before the operation. Both differences had statistical significance (P<0.05). Conclusion As a therapy for advanced malignant tumors with thoracolumbar metastasis, pedicle fixation combined with 125I brachytherapy can effectively relieve short-term pain and improve patient’s quality of life. PMID:27274307

  10. Comparisons of late vaginal mucosal reactions between interstitial and conventional intracavitary brachytherapy in patients with gynecological cancer: speculation on the relation between pallor reaction and stenosis.

    PubMed

    Yoshida, Ken; Yamazaki, Hideya; Nakamura, Satoaki; Masui, Koji; Kotsuma, Tadayuki; Baek, Sung Jae; Akiyama, Hironori; Tanaka, Eiichi; Yoshioka, Yasuo

    2013-09-01

    To examine late vaginal mucosal reactions in patients following interstitial brachytherapy (ISBT) compared with that of intracavitary brachytherapy (ICBT). We introduced a modified Dische score to examine late reactions in vaginal mucosa of patients with gynecological cancer who underwent vaginal brachytherapy at 6, 12, 18, 24, 36, and 60 months after treatment. A comparison was made between patients who underwent ISBT (n=37) and those under conventional ICBT (n=63) with a median follow-up time of 41 months. The ICBT group included only patients with newly diagnosed cervical cancer, whereas the ISBT group included 17 patients with recurrent and 20 with newly-diagnosed cancer. Grade 1 reactions of bleeding and discharge were exhibited by <12% of patients. Erythema was detected in approximately 30% (mainly grade 1) of the patients. A total of two (3%) patients developed superficial ulceration after ICBT, whereas three (8%) grade 1 ulcers were detected in patients after ISBT. Telangiectasias were detected in approximately 70% (60% grade 1 and 10% grade 2) of patients. No statistically significant difference was found between the patients after ISBT and ICBT. After ISBT, patients have a higher stenosis rate than after ICBT (p=0.003). The pallor scores showed a strong correlation with stenosis (p<0.0001) and were higher in patients after ICBT than in patients after ISBT (p=0.006). After ISBT, patients exhibited milder but similar late mucosal reactions compared to those after ICBT, except the fact that the stenosis was more severe and the pallor reaction was milder in these patients. It can be, therefore, concluded that the pallor reaction is related to stenosis.

  11. High-Risk Prostate Cancer With Gleason Score 8-10 and PSA Level {<=}15 ng/ mL Treated With Permanent Interstitial Brachytherapy

    SciTech Connect

    Fang, L. Christine; Merrick, Gregory S.; Butler, Wayne M.; Galbreath, Robert W.; Murray, Brian C.; Reed, Joshua L.; Adamovich, Edward; Wallner, Kent E.

    2011-11-15

    Purpose: With widespread prostate-specific antigen (PSA) screening, there has been an increase in men diagnosed with high-risk prostate cancer defined by a Gleason score (GS) {>=}8 coupled with a relatively low PSA level. The optimal management of these patients has not been defined. Cause-specific survival (CSS), biochemical progression-free survival (bPFS), and overall survival (OS) were evaluated in brachytherapy patients with a GS {>=}8 and a PSA level {<=}15 ng/mL with or without androgen-deprivation therapy (ADT). Methods and Materials: From April 1995 to October 2005, 174 patients with GS {>=}8 and a PSA level {<=}15 ng/mL underwent permanent interstitial brachytherapy. Of the patients, 159 (91%) received supplemental external beam radiation, and 113 (64.9%) received ADT. The median follow-up was 6.6 years. The median postimplant Day 0 minimum percentage of the dose covering 90% of the target volume was 121.1% of prescription dose. Biochemical control was defined as a PSA level {<=}0.40 ng/mL after nadir. Multiple parameters were evaluated for impact on survival. Results: Ten-year outcomes for patients without and with ADT were 95.2% and 92.5%, respectively, for CSS (p = 0.562); 86.5% and 92.6%, respectively, for bPFS (p = 0.204); and 75.2% and 66.0%, respectively, for OS (p = 0.179). The median post-treatment PSA level for biochemically controlled patients was <0.02 ng/mL. Multivariate analysis failed to identify any predictors for CSS, whereas bPFS and OS were most closely related to patient age. Conclusions: Patients with GS {>=}8 and PSA level {<=}15 ng/mL have excellent bPFS and CSS after brachytherapy with supplemental external beam radiotherapy. The use of ADT did not significantly impact bPFS, CSS, or OS.

  12. Phase II Feasibility Study on the Combination of Two Different Regional Treatment Approaches in Patients with Colorectal 'Liver-Only' Metastases: Hepatic Interstitial Brachytherapy Plus Regional Chemotherapy

    SciTech Connect

    Wieners, Gero Pech, Maciej; Hildebrandt, Bert; Peters, Nils; Nicolaou, Annett; Mohnike, Konrad; Seidensticker, Max; Sawicki, Marcin; Wust, Peter; Ricke, Jens

    2009-09-15

    The aim of this study was to evaluate the feasibility, safety, and efficacy of combined treatment with hepatic interstitial brachytherapy (HIB) and hepatic arterial infusion (HAI) of chemotherapy after interventional implantation of port catheter systems. Thirty-three patients with unresectable 'liver-only' metastases of colorectal cancer were treated with both HIB and HAI during the course of their disease. All 33 patients had recurrent disease and 27 had received previous chemotherapy. Of these, 15 received HAI first and were then consolidated with HIB, 9 started with HIB and were continued with HAI, and 9 received first HIB and subsequently HAI after hepatic disease progression. Patients were evaluated for treatment characteristics, side effects, and efficacy. Comparisons between treatment groups were also performed. The median tumor diameter of metastases treated with brachytherapy was 4.6 cm (range: 1-12 cm). The median minimal irradiation dose inside the tumor margin was 18 Gy administered to a mean of two metastases in 69 interventions. Minor (n = 4) and major (n = 3) complications occurred in 10% of interventions. WHO grade III adverse events of the regional chemotherapy were observed in seven patients; grade IV, in one patient. At a median follow-up of 28 months (range: 7-74 months), the median time to disease progression after first treatment was 10.5 months (range: 1-35 months). Of 138 metastases treated by brachytherapy, 16 local recurrences were seen (mean, 12.3 months; range, 3-45 months). No signs of hepatic failure were observed in any of our patients. In conclusion, combinations of two minimally invasive therapeutic methods are feasible, with acceptable complication rates, and provide promising results in colorectal cancer patients with unresectable hepatic metastases.

  13. Accelerated partial breast irradiation: An analysis of variables associated with late toxicity and long-term cosmetic outcome after high-dose-rate interstitial brachytherapy

    SciTech Connect

    Wazer, David E. . E-mail: dwazer@tufts-nemc.org; Kaufman, Seth; Cuttino, Laurie; Di Petrillo, Thomas; Arthur, Douglas W.

    2006-02-01

    Purpose: To perform a detailed analysis of variables associated with late tissue effects of high-dose-rate (HDR) interstitial brachytherapy accelerated partial breast irradiation (APBI) in a large cohort of patients with prolonged follow-up. Methods and Materials: Beginning in 1995, 75 women with Stage I/II breast cancer were enrolled in identical institutional trials evaluating APBI as monotherapy after lumpectomy. Patients eligible included those with T1-2, N0-1 ({<=}3 nodes positive), M0 tumors of nonlobular histology with negative surgical margins, no extracapsular nodal extension, and negative results on postexcision mammogram. All patients underwent surgical excision and postoperative irradiation with HDR interstitial brachytherapy. The planning target volume was defined as the excision cavity plus a 2-cm margin. Treatment was delivered with a high-activity Ir-192 source at 3.4 Gy per fraction twice daily for 5 days to a total dose of 34 Gy. Dosimetric analyses were performed with three-dimensional postimplant dose and volume reconstructions. All patients were evaluated at 3-6-month intervals and assessed with a standardized cosmetic rating scale and according to Radiation Therapy Oncology Group late normal tissue toxicity scoring criteria. Clinical and therapy-related features were analyzed for their relationship to cosmetic outcome and toxicity rating. Clinical features analyzed included age, volume of resection, history of diabetes or hypertension, extent of axillary surgery, and systemic therapies. Therapy-related features analyzed included volume of tissue encompassed by the 100%, 150%, and 200% isodose lines (V100, V150, and V200, respectively), the dose homogeneity index (DHI), number of source dwell positions, and planar separation. Results: The median follow-up of all patients was 73 months (range, 43-118 months). The cosmetic outcome at last follow-up was rated as excellent, good, and fair/poor in 67%, 24%, and 9% of patients, respectively

  14. The Protective Roles of ROS-Mediated Mitophagy on 125I Seeds Radiation Induced Cell Death in HCT116 Cells

    PubMed Central

    Hu, Lelin; Wang, Hao; Huang, Li; Zhao, Yong

    2016-01-01

    For many unresectable carcinomas and locally recurrent cancers (LRC), 125I seeds brachytherapy is a feasible, effective, and safe treatment. Several studies have shown that 125I seeds radiation exerts anticancer activity by triggering DNA damage. However, recent evidence shows mitochondrial quality to be another crucial determinant of cell fate, with mitophagy playing a central role in this control mechanism. Herein, we found that 125I seeds irradiation injured mitochondria, leading to significantly elevated mitochondrial and intracellular ROS (reactive oxygen species) levels in HCT116 cells. The accumulation of mitochondrial ROS increased the expression of HIF-1α and its target genes BINP3 and NIX (BINP3L), which subsequently triggered mitophagy. Importantly, 125I seeds radiation induced mitophagy promoted cells survival and protected HCT116 cells from apoptosis. These results collectively indicated that 125I seeds radiation triggered mitophagy by upregulating the level of ROS to promote cellular homeostasis and survival. The present study uncovered the critical role of mitophagy in modulating the sensitivity of tumor cells to radiation therapy and suggested that chemotherapy targeting on mitophagy might improve the efficiency of 125I seeds radiation treatment, which might be of clinical significance in tumor therapy. PMID:28119765

  15. The Protective Roles of ROS-Mediated Mitophagy on (125)I Seeds Radiation Induced Cell Death in HCT116 Cells.

    PubMed

    Hu, Lelin; Wang, Hao; Huang, Li; Zhao, Yong; Wang, Junjie

    2016-01-01

    For many unresectable carcinomas and locally recurrent cancers (LRC), (125)I seeds brachytherapy is a feasible, effective, and safe treatment. Several studies have shown that (125)I seeds radiation exerts anticancer activity by triggering DNA damage. However, recent evidence shows mitochondrial quality to be another crucial determinant of cell fate, with mitophagy playing a central role in this control mechanism. Herein, we found that (125)I seeds irradiation injured mitochondria, leading to significantly elevated mitochondrial and intracellular ROS (reactive oxygen species) levels in HCT116 cells. The accumulation of mitochondrial ROS increased the expression of HIF-1α and its target genes BINP3 and NIX (BINP3L), which subsequently triggered mitophagy. Importantly, (125)I seeds radiation induced mitophagy promoted cells survival and protected HCT116 cells from apoptosis. These results collectively indicated that (125)I seeds radiation triggered mitophagy by upregulating the level of ROS to promote cellular homeostasis and survival. The present study uncovered the critical role of mitophagy in modulating the sensitivity of tumor cells to radiation therapy and suggested that chemotherapy targeting on mitophagy might improve the efficiency of (125)I seeds radiation treatment, which might be of clinical significance in tumor therapy.

  16. Dosimetric effect of tissue heterogeneity for (125)I prostate implants.

    PubMed

    Oliveira, Susana Maria; Teixeira, Nuno José; Fernandes, Lisete; Teles, Pedro; Vaz, Pedro

    2014-11-01

    To use Monte Carlo (MC) together with voxel phantoms to analyze the tissue heterogeneity effect in the dose distributions and equivalent uniform dose (EUD) for (125)I prostate implants. Dose distribution calculations in low dose-rate brachytherapy are based on the dose deposition around a single source in a water phantom. This formalism does not take into account tissue heterogeneities, interseed attenuation, or finite patient dimensions effects. Tissue composition is especially important due to the photoelectric effect. The computed tomographies (CT) of two patients with prostate cancer were used to create voxel phantoms for the MC simulations. An elemental composition and density were assigned to each structure. Densities of the prostate, vesicles, rectum and bladder were determined through the CT electronic densities of 100 patients. The same simulations were performed considering the same phantom as pure water. Results were compared via dose-volume histograms and EUD for the prostate and rectum. The mean absorbed doses presented deviations of 3.3-4.0% for the prostate and of 2.3-4.9% for the rectum, when comparing calculations in water with calculations in the heterogeneous phantom. In the calculations in water, the prostate D 90 was overestimated by 2.8-3.9% and the rectum D 0.1cc resulted in dose differences of 6-8%. The EUD resulted in an overestimation of 3.5-3.7% for the prostate and of 7.7-8.3% for the rectum. The deposited dose was consistently overestimated for the simulation in water. In order to increase the accuracy in the determination of dose distributions, especially around the rectum, the introduction of the model-based algorithms is recommended.

  17. Dosimetric effect of tissue heterogeneity for 125I prostate implants

    PubMed Central

    Oliveira, Susana Maria; Teixeira, Nuno José; Fernandes, Lisete; Teles, Pedro; Vaz, Pedro

    2014-01-01

    Aim To use Monte Carlo (MC) together with voxel phantoms to analyze the tissue heterogeneity effect in the dose distributions and equivalent uniform dose (EUD) for 125I prostate implants. Background Dose distribution calculations in low dose-rate brachytherapy are based on the dose deposition around a single source in a water phantom. This formalism does not take into account tissue heterogeneities, interseed attenuation, or finite patient dimensions effects. Tissue composition is especially important due to the photoelectric effect. Materials and methods The computed tomographies (CT) of two patients with prostate cancer were used to create voxel phantoms for the MC simulations. An elemental composition and density were assigned to each structure. Densities of the prostate, vesicles, rectum and bladder were determined through the CT electronic densities of 100 patients. The same simulations were performed considering the same phantom as pure water. Results were compared via dose–volume histograms and EUD for the prostate and rectum. Results The mean absorbed doses presented deviations of 3.3–4.0% for the prostate and of 2.3–4.9% for the rectum, when comparing calculations in water with calculations in the heterogeneous phantom. In the calculations in water, the prostate D90 was overestimated by 2.8–3.9% and the rectum D0.1cc resulted in dose differences of 6–8%. The EUD resulted in an overestimation of 3.5–3.7% for the prostate and of 7.7–8.3% for the rectum. Conclusions The deposited dose was consistently overestimated for the simulation in water. In order to increase the accuracy in the determination of dose distributions, especially around the rectum, the introduction of the model-based algorithms is recommended. PMID:25337412

  18. A Prospective Longitudinal Clinical Trial Evaluating Quality of Life After Breast Conserving Surgery and High-Dose-Rate Interstitial Brachytherapy for Early-Stage Breast Cancer

    PubMed Central

    Garsa, Adam A.; Ferraro, Daniel J.; DeWees, Todd A.; Deshields, Teresa L.; Margenthaler, Julie A.; Cyr, Amy E.; Naughton, Michael; Aft, Rebecca; Gillanders, William E.; Eberlein, Timothy; Matesa, Melissa A.; Ochoa, Laura L.; Zoberi, Imran

    2013-01-01

    Purpose To prospectively examine quality of life (QOL) of patients with early-stage breast cancer treated with accelerated partial breast irradiation (APBI) using high-dose-rate (HDR) interstitial brachytherapy. Methods And Materials Between March 2004 and December 2008, 151 patients with early-stage breast cancer were enrolled in a phase II prospective clinical trial. Eligible patients included those with Tis-T2 tumors measuring ≤ 3 cm excised with negative surgical margins, with no nodal involvement. Patients received 3.4 Gy bid to a total dose of 34 Gy. QOL was measured using the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 version 3.0 and QLQ-BR23 questionnaires. The QLQ-C30 and QLQ-BR23 were evaluated pretreatment, 6-8 weeks, 3-4 months, 6-8 months, 1 year and 2 years after treatment. RESULTS The median follow-up was 55 months. Breast symptom scores remained stable in the months after treatment, and they significantly improved 6-8 months after treatment. Scores for emotional functioning, social functioning, and future perspective showed significant improvement 2 years after treatment. Symptomatic fat necrosis was associated with several changes in QOL, including increased pain, breast symptoms, systemic treatment side effects, dyspnea, and fatigue, as well as decreased role functioning, emotional functioning, and social functioning. Conclusions HDR multicatheter interstitial brachytherapy was well tolerated with no significant detrimental effect on measured QOL scales/items through 2 years of follow-up. Compared to pretreatment scores, there was improvement in breast symptoms, emotional functioning, social functioning and future perspective 2 years after treatment. PMID:24161428

  19. Cosmetic Analysis Following Breast-Conserving Surgery and Adjuvant High-Dose-Rate Interstitial Brachytherapy for Early-Stage Breast Cancer: A Prospective Clinical Study

    PubMed Central

    Garsa, Adam A.; Ferraro, Daniel J.; DeWees, Todd; Margenthaler, Julie A.; Naughton, Michael; Aft, Rebecca; Gillanders, William E.; Eberlein, Timothy; Matesa, Melissa A.; Zoberi, Imran

    2014-01-01

    Purpose To prospectively evaluate cosmetic outcomes in women treated with accelerated partial breast irradiation (APBI) using high-dose-rate (HDR) interstitial brachytherapy for early-stage breast cancer. Methods and Materials Between 2004 and 2008, 151 patients with early-stage breast cancer were enrolled in a phase II prospective clinical trial. Eligible patients had Tis-T2 tumors ≤3 cm, excised with negative margins, and with no nodal involvement. Patients received 3.4 Gy BID to a total dose of 34 Gy. Both patients and the treating radiation oncologist qualitatively rated cosmesis as excellent, good, fair, or poor over time and ascribed a cause for changes in cosmesis. Cosmetic outcome was evaluated quantitatively by the percentage breast retraction assessment (pBRA). Patients also reported their satisfaction with treatment over time. Results Median follow-up was 55 months. The rate of excellent/good cosmesis reported by patients and the treating radiation oncologist was as follows: 92% and 97% pretreatment, 91% and 97% at 3–4 months follow-up, 87% and 94% at 2 years, and 92% and 94% at 3 years. Breast infection and adjuvant chemotherapy were independent predictors of a fair/poor cosmetic outcome at 3 years. Compared to the pretreatment pBRA (7.35), there was no significant change in pBRA over time. V150 was the only significant predictor of pBRA. The vast majority of patients (86.6%) were completely satisfied with their treatment. Conclusions Patients and the treating physician reported a high rate of excellent/good cosmetic outcomes at all follow-up time points. Acute breast infection and chemotherapy were associated with worse cosmetic outcomes. Multicatheter interstitial brachytherapy does not significantly change breast size as measured by pBRA. PMID:23058060

  20. A Prospective Longitudinal Clinical Trial Evaluating Quality of Life After Breast-Conserving Surgery and High-Dose-Rate Interstitial Brachytherapy for Early-Stage Breast Cancer

    SciTech Connect

    Garsa, Adam A.; Ferraro, Daniel J.; DeWees, Todd A.; Deshields, Teresa L.; Margenthaler, Julie A.; Cyr, Amy E.; Naughton, Michael; Aft, Rebecca; Gillanders, William E.; Eberlein, Timothy; Matesa, Melissa A.; Ochoa, Laura L.; Zoberi, Imran

    2013-12-01

    Purpose: To prospectively examine quality of life (QOL) of patients with early stage breast cancer treated with accelerated partial breast irradiation (APBI) using high-dose-rate (HDR) interstitial brachytherapy. Methods and Materials: Between March 2004 and December 2008, 151 patients with early stage breast cancer were enrolled in a phase 2 prospective clinical trial. Eligible patients included those with Tis-T2 tumors measuring ≤3 cm excised with negative surgical margins and with no nodal involvement. Patients received 3.4 Gy twice daily to a total dose of 34 Gy. QOL was measured using European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30, version 3.0, and QLQ-BR23 questionnaires. The QLQ-C30 and QLQ-BR23 questionnaires were evaluated during pretreatment and then at 6 to 8 weeks, 3 to 4 months, 6 to 8 months, and 1 and 2 years after treatment. Results: The median follow-up was 55 months. Breast symptom scores remained stable in the months after treatment, and they significantly improved 6 to 8 months after treatment. Scores for emotional functioning, social functioning, and future perspective showed significant improvement 2 years after treatment. Symptomatic fat necrosis was associated with several changes in QOL, including increased pain, breast symptoms, systemic treatment side effects, dyspnea, and fatigue, as well as decreased role functioning, emotional functioning, and social functioning. Conclusions: HDR multicatheter interstitial brachytherapy was well tolerated, with no significant detrimental effect on measured QOL scales/items through 2 years of follow-up. Compared to pretreatment scores, there was improvement in breast symptoms, emotional functioning, social functioning, and future perspective 2 years after treatment.

  1. Cosmetic Analysis Following Breast-Conserving Surgery and Adjuvant High-Dose-Rate Interstitial Brachytherapy for Early-Stage Breast Cancer: A Prospective Clinical Study

    SciTech Connect

    Garsa, Adam A.; Ferraro, Daniel J.; DeWees, Todd; Margenthaler, Julie A.; Naughton, Michael; Aft, Rebecca; Gillanders, William E.; Eberlein, Timothy; Matesa, Melissa A.; Zoberi, Imran

    2013-03-15

    Purpose: To prospectively evaluate cosmetic outcomes in women treated with accelerated partial breast irradiation using high-dose-rate interstitial brachytherapy for early-stage breast cancer. Methods and Materials: Between 2004 and 2008, 151 patients with early-stage breast cancer were enrolled in a phase 2 prospective clinical trial. Eligible patients had stage Tis-T2 tumors of ≤3 cm that were excised with negative margins and with no nodal involvement. Patients received 3.4 Gy twice daily to a total dose of 34 Gy. Both the patients and the treating radiation oncologist qualitatively rated cosmesis as excellent, good, fair, or poor over time and ascribed a cause for changes in cosmesis. Cosmetic outcome was evaluated quantitatively by percentage of breast retraction assessment (pBRA). Patients also reported their satisfaction with treatment over time. Results: Median follow-up was 55 months. The rates of excellent-to-good cosmesis reported by patients and the treating radiation oncologist were 92% and 97% pretreatment, 91% and 97% at 3 to 4 months' follow-up, 87% and 94% at 2 years, and 92% and 94% at 3 years, respectively. Breast infection and adjuvant chemotherapy were independent predictors of a fair-to-poor cosmetic outcome at 3 years. Compared to pretreatment pBRA (7.35), there was no significant change in pBRA over time. The volume receiving more than 150 Gy (V150) was the only significant predictor of pBRA. The majority of patients (86.6%) were completely satisfied with their treatment. Conclusions: Patients and the treating physician reported a high rate of excellent-to-good cosmetic outcomes at all follow-up time points. Acute breast infection and chemotherapy were associated with worse cosmetic outcomes. Multicatheter interstitial brachytherapy does not significantly change breast size as measured by pBRA.

  2. High-dose-rate interstitial brachytherapy in head and neck cancer: do we need a look back into a forgotten art - a single institute experience.

    PubMed

    Bhalavat, Rajendra; Chandra, Manish; Pareek, Vibhay; Nellore, Lalitha; George, Karishma; Nandakumar, P; Bauskar, Pratibha

    2017-04-01

    To evaluate the treatment outcomes with high-dose-rate (HDR) interstitial brachytherapy (HDR-BRT) in head and neck cancers (HNC). Fifty-eight patients with HNC as per American Joint Committee on Cancer (AJCC) TNM staging criteria were analyzed retrospectively between 2008 and 2015. Forty-two patients received external beam radiotherapy (EBRT) with HDR-BRT and 16 patients received BRT alone. The survival was calculated with respect to median biological equivalent doses (BED) and median 2 Gy equivalent dose (EQD2), keeping α/β = 10 for tumor. Loco-regional control and disease free survival was assessed. The median follow-up period was 25 months (2-84 months). The disease-free survival (DFS) probability at year 1 was 82.7%, and 68% at year 7. The overall survival probability was 91.3% at year 1 and 85.8% at year 7. The local control rate was 70%. The rate of recurrence was 30%. Distant metastasis rate was 17.2%. The median BED and EQD2, respectively, were 86.78 Gy and 71.6 Gy. The DFS was 74.1% and 75.9% in patients receiving a dose more than median BED and EQD2, respectively, and was 64.8% and 61.5% for less than the median dose. The overall outcome was good with implementation of HDR-BRT used alone or as boost, and shows DFS as better when the dose received is more than the median BED and median EQD2. The role of HDR-BRT in HNC is a proven, effective, and safe treatment method with excellent long term outcome as seen in this study, which reflects the need for reviving the forgotten art and science of interstitial brachytherapy in HNC.

  3. Salvage interstitial brachytherapy based on computed tomography for recurrent cervical cancer after radical hysterectomy and adjuvant radiation therapy: case presentations and introduction of the technique

    PubMed Central

    Liu, Zhong-Shan; Guo, Jie; Zhao, Yang-Zhi; Lin, Xia; Chen, Bin; Zhang, Ming; Li, Jiang-Ming; Ren, Xiao-Jun; Zhang, Bing-Ya

    2016-01-01

    Purpose Locally recurring cervical cancer after surgery and adjuvant radiotherapy remains a major therapeutic challenge. This paper presents a new therapeutic technique for such patients: interstitial brachytherapy (BT) guided by real-time three-dimensional (3D) computed tomography (CT). Material and methods Sixteen patients with recurrent cervical cancer after radical surgery and adjuvant external-beam radiotherapy (EBRT) were included in this study. These patients underwent high-dose-rate (HDR) interstitial BT with free-hand placement of metal needles guided by real-time 3D-CT. Six Gy in 6 fractions were prescribed for the high-risk clinical target volume (HR-CTV). D90 and D100 for HR-CTV of BT, and the cumulative D2cc for the bladder, rectum, and sigmoid, including previous EBRT and present BT were analyzed. Treatment-related complications and 3-month tumor-response rates were investigated. Results The mean D90 value for HR-CTV was 52.5 ± 3.3 Gy. The cumulative D2cc for the bladder, rectum, and sigmoid were 85.6 ± 5.8, 71.6 ± 6.4, and 69.6 ± 5.9 Gy, respectively. The mean number of needles was 6.1 ± 1.5, with an average depth of 3.5 ± 0.9 cm for each application. Interstitial BT was associated with minor complications and passable tumor-response rate. Conclusions Interstitial BT guided by real-time 3D-CT for recurrent cervical cancer results in good dose-volume histogram (DVH) parameters. The current technique may be clinically feasible. However, long-term clinical outcomes should be further investigated. PMID:27895683

  4. Functional fitting of interstitial brachytherapy dosimetry data recommended by the AAPM Radiation Therapy Committee Task Group 43. American Association of Physicists in Medicine.

    PubMed

    Furhang, E E; Anderson, L L

    1999-02-01

    This work was undertaken to expedite implementation of the AAPM Task Group 43 recommendations, which call for significant modifications in the way dose is calculated for interstitial sources of 192Ir, 125I, and 103Pd as well as significant changes in the dose rate constant for 125I sources. The TG43 recommendations include a new formalism for dose calculation at points defined by the radial distance, r, from the source center and the angle, theta, that such a radius makes with the source axis. For each source type, values are tabulated for the radial dose function, the anisotropy function, and the anisotropy factor. The TG43 report includes fitting functions for the radial dose function in the form of polynomials, which are poorly behaved outside the range of fitted data. No functions are offered for the anisotropy function data or the anisotropy factor data, both of which could profit from some smoothing by such functions. We have found a double exponential fit to the radial dose function that not only approximates the data adequately but also appropriately approaches zero for very large distances. The anisotropy function is conveniently fit with a form of type 1 - f(r,theta)cos(theta)e(cr), which is exactly 1 at theta=90 degrees and approaches 1 for large r (for c<0), where f(r,theta) is a selected polynomial in the two variables. The form chosen for the anisotropy factor was 1 - (a+br)e(cr), which appropriately approaches 1 for large r (and c<0). Functional fits of these types are expected to facilitate implementation of TG43 recommendations, in that they may be either incorporated into dose algorithms or used to generate lookup tables of either the x, y or the r, theta format.

  5. A fast inverse treatment planning strategy facilitating optimized catheter selection in image-guided high-dose-rate interstitial gynecologic brachytherapy.

    PubMed

    Guthier, Christian V; Damato, Antonio L; Hesser, Juergen W; Viswanathan, Akila N; Cormack, Robert A

    2017-09-18

    Interstitial high-dose-rate (HDR) brachytherapy is an important therapeutic strategy for the treatment of locally advanced gynecologic (GYN) cancers. The outcome of this therapy is determined by the quality of dose distribution achieved. This paper focuses on a novel yet simple heuristic for catheter selection for GYN HDR brachytherapy and their comparison against state of the art optimization strategies. The proposed technique is intended to act as a decision-supporting tool to select a favorable needle configuration. The presented heuristic for catheter optimization is based on a shrinkage type algorithm (SACO). It is compared against state of the art planning in a retrospective study of 20 patients who previously received image-guided interstitial HDR brachytherapy using a Syed Neblett template. From those plans template orientation and position are estimated via a rigid registration of the template with the actual catheter trajectories. All potential straight trajectories intersecting the contoured clinical target volume (CTV) are considered for catheter optimization. Retrospectively generated plans and clinical plans are compared with respect to dosimetric performance and optimization time. All plans were generated with one single run of the optimizer lasting 0.6 to 97.4 seconds. Compared to manual optimization SACO yields a statistically significant (ρ ≤ 0.05) improved target coverage while on the same time fulfilling all dosimetric constraints for organs at risk (OARs). Comparing inverse planning strategies, dosimetric evaluation for SACO and "hybrid inverse planning and optimization" (HIPO), as gold standard, shows no statistically significant difference (ρ > 0.05). However, SACO provides the potential to reduce the number of used catheters without compromising plan quality. The proposed heuristic for needle selection provides fast catheter selection with optimization times suited for intraoperative treatment planning. Compared to manual optimization

  6. Measurement of /sup 125/I-low density lipoprotein uptake in selected tissues of the squirrel monkey by quantitative autoradiography

    SciTech Connect

    Tompkins, R.G.; Schnitzer, J.J.; Yarmush, M.L.; Colton, C.K.; Smith, K.A.

    1988-09-01

    A recently developed technique of absolute quantitative light microscopic autoradiography of /sup 125/I-labeled proteins in biologic specimens was used to measure /sup 125/I-low density lipoprotein (/sup 125/I-LDL) concentration levels in various tissues of the squirrel monkey after 30 minutes of in vivo LDL circulation. Liver and adrenal cortex exhibited high /sup 125/I-LDL concentrations, presumably because of binding to specific cell surface receptors and/or internalization in vascular beds with high permeability to LDL. High tissue concentrations of LDL were associated with the zona fasciculata and reticularis of the adrenal cortex and the interstitial cells of Leydig in the testis; significantly lower levels of /sup 125/I-LDL were observed in the adrenal medulla, the zona glomerulosa, and germinal centers of the testis. Contrary to previous reports, low /sup 125/I-LDL concentrations were observed throughout the gastrointestinal tract and in lymph nodes. In addition, multiple arterial intramural focal areas of high /sup 125/I-LDL concentrations were identified in arteries supplying the adrenal gland, lymph node, small bowel, and liver.

  7. Dose-volume parameters and clinical outcome of CT-guided free-hand high-dose-rate interstitial brachytherapy for cervical cancer

    PubMed Central

    Wang, Yi; Ye, Wei-Jun; Du, Le-Hui; Li, Ai-Ju; Ren, Yu-Feng; Cao, Xin-Ping

    2012-01-01

    Currently, image-based 3-dimentional (3D) planning brachytherapy allows for a better assessment of gross tumor volume (GTV) and the definition and delineation of target volume in cervix cancer. In this study, we investigated the feasibility of our novel computed tomography (CT)-guided free-hand high-dose-rate interstitial brachytherapy (HDRISBT) technique for cervical cancer by evaluating the dosimetry and preliminary clinical outcome of this approach. Dose-volume histogram (DVH) parameters were analyzed according to the Gynecological GEC-ESTRO Working Group recommendations for image-based 3D treatment in cervical cancer. Twenty cervical cancer patients who underwent CT-guided free-hand HDRISBT between March 2009 and June 2010 were studied. With a median of 5 (range, 4–7) implanted needles for each patient, the median dose of brachytherapy alone delivered to 90% of the target volume (D90) was 45 (range, 33–54) Gyα/β10 for high-risk clinical target volume (HR-CTV) and 30 (range, 20–36) Gyα/β10 for intermediate-risk clinical target volume (IR-CTV). The percentage of the CTV covered by the prescribed dose (V100) of HR-CTV with brachytherapy alone was 81.9%–99.2% (median, 96.7%). With an additional dose of external beam radiotherapy (EBRT), the median D90 was 94 (range, 83–104) Gyα/β10 for HR-CTV and 77 (range, 70–87) Gyα/β10 for IR-CTV; the median dose delivered to 100% of the target volume (D100) was 75 (range, 66–84) Gyα/β10 for HR-CTV and 65 (range, 57–73) Gyα/β10 for IR-CTV. The minimum dose to the most irradiated 2 cc volume (D2cc) was 73–96 (median, 83) Gyα/β3 for the bladder, 64–98 (median, 73) Gyα/β3 for the rectum, and 52–69 (median, 61) Gyα/β3 for the sigmoid colon. After a median follow-up of 15 months (range, 3–24 months), two patients experienced local failure, and 1 showed internal iliac nodal metastasis. Despite the relatively small number of needles used, CT-guided HDRISBT for cervical cancer showed favorable

  8. Evaluation of the dose distribution for prostate implants using various {sup 125}I and {sup 103}Pd sources

    SciTech Connect

    Meigooni, Ali S.; Luerman, Christine M.; Sowards, Keith T.

    2009-04-15

    Recently, several different models of {sup 125}I and {sup 103}Pd brachytherapy sources have been introduced in order to meet the increasing demand for prostate seed implants. These sources have different internal structures; hence, their TG-43 dosimetric parameters are not the same. In this study, the effects of the dosimetric differences among the sources on their clinical applications were evaluated. The quantitative and qualitative evaluations were performed by comparisons of dose distributions and dose volume histograms of prostate implants calculated for various designs of {sup 125}I and {sup 103}Pd sources. These comparisons were made for an identical implant scheme with the same number of seeds for each source. The results were compared with the Amersham model 6711 seed for {sup 125}I and the Theragenics model 200 seed for {sup 103}Pd using the same implant scheme.

  9. Preparation of 6-/sup 125/I-labeled amiloride derivatives

    SciTech Connect

    Cassel, D.; Rotman, M.; Cragoe, E.J. Jr.; Igarashi, P.

    1988-04-01

    Amiloride and certain of its derivatives are effective inhibitors of Na/H antiporters and of epithelial Na channels. We describe a simple method for the preparation of a variety of pharmacologically active 6-iodoamiloride derivatives that are labeled with /sup 125/I at high specific radioactivity. 6-Dechloroamiloride derivatives (bearing a hydrogen atom instead of the chlorine at the 6 position of the amiloride molecule) are reacted with /sup 125/ICl, prepared by the oxidation of the iodide in Na/sup 125/I preparations. The /sup 125/I-labeled derivatives are separated from free /sup 125/I by anion exchange chromatography, or purified by thin layer chromatography. Both 6-dechloroamiloride and 5-(N-alkyl)-6-dechloroamiloride derivatives can be labeled by this method, with yields varying between 10 and 70%, depending on the ICl concentration and the structure of the 5-N-alkyl group. Efficient radiolabeling at high specific radioactivity also depends on the use of freshly prepared batches of /sup 125/I. Using carrier-free /sup 125/I, (/sup 125/I)6-iodoamiloride and (/sup 125/I)6-iodo-5-(N-tert-butyl)amiloride were prepared with yields of 27 and 22%, respectively. Potential applications of the /sup 125/I-labeled amiloride derivatives include ligand binding and affinity labeling experiments.

  10. Computed tomography-guided interstitial HDR brachytherapy (CT-HDRBT) of the liver in patients with irresectable intrahepatic cholangiocarcinoma.

    PubMed

    Schnapauff, Dirk; Denecke, Timm; Grieser, Christian; Collettini, Federico; Colletini, Federico; Seehofer, Daniel; Sinn, Marianne; Banzer, Jan; Lopez-Hänninen, Enrique; Hamm, Bernd; Wust, Peter; Gebauer, Bernhard

    2012-06-01

    This study was designed to investigate the clinical outcome of patients with irresectable, intrahepatic cholangiocarcinoma (IHC) treated with computed tomography (CT)-guided HDR-brachytherapy (CT-HDRBT) for local tumor ablation. Fifteen consecutive patients with histologically proven cholangiocarcinoma were selected for this retrospective study. Patients were treated by high-dose-rate internal brachytherapy (HDRBT) using an Iridium-192 source in afterloading technique through CT-guided percutaneous placed catheters. A total of 27 brachytherapy treatments were performed in these patients between 2006 and 2009. Median tumor enclosing target dose was 20 Gy, and mean target volume of the radiated tumors was 131 (±90) ml (range, 10-257 ml). Follow-up consisted of clinical visits and magnetic resonance imaging of the liver every third month. Statistical evaluation included survival analysis using the Kaplan-Meier method. After a median follow-up of 18 (range, 1-27) months after local ablation, 6 of the 15 patients are still alive; 4 of them did not get further chemotherapy and are regarded as disease-free. The reached median local tumor control was 10 months; median local tumor control, including repetitive local ablation, was 11 months. Median survival after local ablation was 14 months and after primary diagnosis 21 months. In view of current clinical data on the clinical outcome of cholangiocarcinoma, locally ablative treatment with CT-HDRBT represents a promising and safe technique for patients who are not eligible for tumor resection.

  11. Is there a subset of patients with recurrent cancer in the vagina who are not candidates for interstitial brachytherapy that can be treated with multichannel vaginal brachytherapy using graphic optimization?

    PubMed Central

    Bylund, Kevin C.; Matloubieh, Ahmad; Mazloom, Ali; Gray, Alexander; Sidhu, Ravinder; Barrette, Lucille; Chen, Yuhchyau

    2015-01-01

    Purpose To evaluate recurrent vaginal cancer treated with vaginal brachytherapy (VBT) using graphic optimization in patients not amenable to surgery and interstitial brachytherapy (ISBT). Material and methods We retrospectively reviewed the records of 5 patients with recurrent cancer in the vagina that were deemed not to be good candidates for ISBT implant because of medical reasons. All patients received computed tomography/magnetic resonance imaging (CT/MRI) based evaluation in addition to a detailed clinical examination, and were noted to have recurrent nodules in the vagina with size ranging from 10-25 mm. Four of the 5 patients had recurrent disease in the vaginal apex, whereas one patient had recurrence in the lateral vaginal wall. Subsequently, all patients were treated with external beam radiation therapy (EBRT) followed by multichannel vaginal cylinder (MVC)-based VBT using graphic optimization for shaping the isodose to improve the clinical target volume (CTV) coverage, as well as to spare the organs at risk (OAR). The dose to the bladder and rectum with regard to 0.1 cc, 1 cc, and 2 cc were recorded. Results Median age of the patients was 78 years (range 58-86 years). Thickness of the lesions before VBT ranged from 6-15 mm. All patients were followed up with MRI at 3 months. All patients but one demonstrated complete clinical/ radiological response of the tumor. No patient had any grade III/IV toxicity at 24 months. Conclusions MVC-based VBT using graphic optimization is safe and yields favorable results if used judiciously. PMID:26034494

  12. Verification of air-kerma strength of 125I seed for permanent prostate implants in Japan.

    PubMed

    Sumida, Iori; Koizumi, Masahiko; Takahashi, Yutaka; Ogata, Toshiyuki; Akino, Yuichi; Isohashi, Fumiaki; Konishi, Koji; Yoshioka, Yasuo; Inoue, Takehiro

    2009-12-01

    To assure the physical quality of brachytherapy, we investigated the difference between measured and manufacturer's stated source strengths in a single model SourceTech Medical (STM)1251 (125)I seed. A well-type ionization chamber with a single-seed holder was used to measure the source strength of 2412 (125)I seeds before implant in 34 patients. The air-kerma strength was 0.450 U for all cases. The mean source strength for each patient was measured and compared with the manufacturer's stated value. The deviation from the measured value was compared with the tolerance range of the American Association of Physicists in Medicine (AAPM) TG-56 report's recommendation. The measured source strength was higher than the manufacturer's stated value, with a median difference of 1% (range, 2% to 5%). Sixteen of the total of 2412 seeds (0.7%) were more than 5% different from the manufacturer's stated value. The median SD from the mean value was 2.2% (range, 1.1% to 2.5%) for all patients. This is the first report of a single-seed assay performed for the model STM1251 (125)I seed. In this study the manufacturer's stated strength agreed well with the measured value. Nevertheless, the advisability of performing a single-seed assay at every institution should be considered, by referring to the appropriate regulations; for example, those used in the United States.

  13. Fragmentation of chromatin with 125I radioactive disintegrations.

    PubMed Central

    Turner, G N; Nobis, P; Dewey, W C

    1976-01-01

    The DNA in Chinese hamster cells was labeled first for 3 h with [3H]TdR and then for 3 h with [125I]UdR. Chromatin was extracted, frozen, and stored at -30 degrees C until 1.0 X 10(17) and 1.25 X 10(17) disintegrations/g of labeled DNA occurred for 125I and 3H respectively. Velocity sedimentation of chromatin (DNA with associated chromosomal proteins) in neutral sucrose gradients indicated that the localized energy from the 125I disintegrations, which gave about 1 double-strand break/disintegration plus an additional 1.3 single strand breaks, selectively fragmented the [125I] chromatin into pieces smaller than the [3H] chromatin. In other words, 125I disintegrations caused much more localized damage in the chromatin labeled with 125I than in the chromatin labeled with 3H, and fragments induced in DNA by 125I disintegrations were not held together by the associated chromosomal proteins. Use of this 125I technique for studying chromosomal proteins associated with different regions in the cellular DNA is discussed. For these studies, the number of disintegrations required for fragmenting DNA molecules of different sizes is illustrated. PMID:963201

  14. A Dose-Volume Analysis of Magnetic Resonance Imaging-Aided High-Dose-Rate Image-Based Interstitial Brachytherapy for Uterine Cervical Cancer

    SciTech Connect

    Yoshida, Ken; Yamazaki, Hideya; Takenaka, Tadashi; Kotsuma, Tadayuki; Yoshida, Mineo; Furuya, Seiichi; Tanaka, Eiichi; Uegaki, Tadaaki; Kuriyama, Keiko; Matsumoto, Hisanobu; Yamada, Shigetoshi; Ban, Chiaki

    2010-07-01

    Purpose: To investigate the feasibility of our novel image-based high-dose-rate interstitial brachytherapy (HDR-ISBT) for uterine cervical cancer, we evaluated the dose-volume histogram (DVH) according to the recommendations of the Gynecological GEC-ESTRO Working Group for image-based intracavitary brachytherapy (ICBT). Methods and Materials: Between June 2005 and June 2007, 18 previously untreated cervical cancer patients were enrolled. We implanted magnetic resonance imaging (MRI)-available plastic applicators by our unique ambulatory technique. Total treatment doses were 30-36 Gy (6 Gy per fraction) combined with external beam radiotherapy (EBRT). Treatment plans were created based on planning computed tomography with MRI as a reference. DVHs of the high-risk clinical target volume (HR CTV), intermediate-risk CTV (IR CTV), and the bladder and rectum were calculated. Dose values were biologically normalized to equivalent doses in 2-Gy fractions (EQD{sub 2}). Results: The median D90 (HR CTV) and D90 (IR CTV) per fraction were 6.8 Gy (range, 5.5-7.5) and 5.4 Gy (range, 4.2-6.3), respectively. The median V100 (HR CTV) and V100 (IR CTV) were 98.4% (range, 83-100) and 81.8% (range, 64-93.8), respectively. When the dose of EBRT was added, the median D90 and D100 of HR CTV were 80.6 Gy (range, 65.5-96.6) and 62.4 Gy (range, 49-83.2). The D{sub 2cc} of the bladder was 62 Gy (range, 51.4-89) and of the rectum was 65.9 Gy (range, 48.9-76). Conclusions: Although the targets were advanced and difficult to treat effectively by ICBT, MRI-aided image-based ISBT showed favorable results for CTV and organs at risk compared with previously reported image-based ICBT results.

  15. Multi-catheter interstitial brachytherapy for partial breast irradiation: an audit of implant quality based on dosimetric evaluation comparing intra-operative versus post-operative placement

    PubMed Central

    Gurram, Lavanya; Joshi, Kishor; Phurailatpam, Reena; Paul, Siji; Sarin, Rajiv

    2016-01-01

    Purpose The use of multicatheter interstitial brachytherapy (MIB) for accelerated partial breast irradiation (APBI) in early breast cancer (EBC) patients outside the trial setting has increased. Hence, there is a need to critically evaluate implant quality. Moreover, there is a scarcity of reports using an open cavity technique. We report the dosimetric indices of open and closed cavity MIB techniques. Material and methods The dosimetric parameters of 60 EBC patients treated with MIB (open and closed cavity) who underwent three dimensional, computerized tomography (CT) based planning for APBI from November 2011 to July 2015 were evaluated. Coverage Index (CI), Dose Homogeneity Index (DHI), Conformity Index (COIN), Plan Quality Index (PQI), and Dose Non-uniformity Index (DNR) were assessed. Results Forty-one patients underwent open cavity and 19 patients underwent closed cavity placement of brachytherapy catheters. The median number of planes was 4 and median number of needles was 20. Median dose was 34 Gy with dose per fraction of 3.4 Gy, given twice a day, 6 hours apart. The D90 of the cavity and clinical target volume (CTV) were 105% and 89%, respectively. The median doses to the surgical clips were greater than 100%. The median CI of the cavity and CTV was 0.96 and 0.82, respectively. The DHI and COIN index of the CTV was 0.73 and 0.67. There were no significant differences in the dosimetric parameters based on whether the technique was done open or closed. Conclusions Critical evaluation of the dosimetric parameters of MIB-APBI is important for optimal results. While the open and closed techniques have similar dosimetry, our institutional preference is for an open technique which eases the procedure due to direct visualization of the tumor cavity. PMID:27257415

  16. Biological effective dose for comparison and combination of external beam and low-dose rate interstitial brachytherapy prostate cancer treatment plans

    SciTech Connect

    Jani, Ashesh B.; Hand, Christopher M.; Lujan, Anthony E.; Roeske, John C.; Zagaja, Gregory P.; Vijayakumar, Srinivasan; Pelizzari, Charles A

    2004-03-31

    We report a methodology for comparing and combining dose information from external beam radiotherapy (EBRT) and interstitial brachytherapy (IB) components of prostate cancer treatment using the biological effective dose (BED). On a prototype early-stage prostate cancer patient treated with EBRT and low-dose rate I-125 brachytherapy, a 3-dimensional dose distribution was calculated for each of the EBRT and IB portions of treatment. For each component of treatment, the BED was calculated on a point-by-point basis to produce a BED distribution. These individual BED distributions could then be summed for combined therapies. BED dose-volume histograms (DVHs) of the prostate, urethra, rectum, and bladder were produced and compared for various combinations of EBRT and IB. Transformation to BED enabled computation of the relative contribution of each modality to the prostate dose, as the relative weighting of EBRT and IB was varied. The BED-DVHs of the prostate and urethra demonstrated dramatically increased inhomogeneity with the introduction of even a small component of IB. However, increasing the IB portion relative to the EBRT component resulted in lower dose to the surrounding normal structures, as evidenced by the BED-DVHs of the bladder and rectum. Conformal EBRT and low-dose rate IB conventional dose distributions were successfully transformed to the common 'language' of BED distributions for comparison and for merging prostate cancer radiation treatment plans. The results of this analysis can assist physicians in quantitatively determining the best combination and weighting of radiation treatment modalities for individual patients.

  17. Technical aspects of the integration of three-dimensional treatment planning dose parameters (GEC-ESTRO Working Group) into pre-implant planning for LDR gynecological interstitial brachytherapy.

    PubMed

    Chi, A; Gao, M; Nguyen, N P; Albuquerque, K

    2009-06-01

    This study investigates the technical feasibility of pre-implant image-based treatment planning for LDR GYN interstitial brachytherapy(IB) based on the GEC-ESTRO guidelines. Initially, a virtual plan is generated based on the prescription dose and GEC-ESTRO defined OAR dose constraints with a pre-implant CT. After the actual implant, a regular diagnostic CT was obtained and fused with our pre-implant scan/initial treatment plan in our planning software. The Flexi-needle position changes, and treatment plan modifications were made if needed. Dose values were normalized to equivalent doses in 2 Gy fractions (LQED 2 Gy) derived from the linear-quadratic model with alpha/beta of 3 for late responding tissues and alpha/beta of 10 for early responding tissues. D(90) to the CTV, which was gross tumor (GTV) at the time of brachytherapy with a margin to count for microscopic disease, was 84.7 +/- 4.9% of the prescribed dose. The OAR doses were evaluated by D(2cc) (EBRT+IB). Mean D(2cc) values (LQED(2Gy)) for the rectum, bladder, sigmoid, and small bowel were the following: 63.7 +/- 8.4 Gy, 61.2 +/- 6.9 Gy, 48.0 +/- 3.5 Gy, and 49.9 +/- 4.2 Gy. This study confirms the feasibility of applying the GEC-ESTRO recommended dose parameters in pre-implant CT-based treatment planning in GYN IB. In the process, this pre-implant technique also demonstrates a good approximation of the target volume dose coverage, and doses to the OARs.

  18. Validation of mathematical models for the prediction of organs-at-risk dosimetric metrics in high-dose-rate gynecologic interstitial brachytherapy

    SciTech Connect

    Damato, Antonio L.; Viswanathan, Akila N.; Cormack, Robert A.

    2013-10-15

    Purpose: Given the complicated nature of an interstitial gynecologic brachytherapy treatment plan, the use of a quantitative tool to evaluate the quality of the achieved metrics compared to clinical practice would be advantageous. For this purpose, predictive mathematical models to predict the D{sub 2cc} of rectum and bladder in interstitial gynecologic brachytherapy are discussed and validated.Methods: Previous plans were used to establish the relationship between D2cc and the overlapping volume of the organ at risk with the targeted area (C0) or a 1-cm expansion of the target area (C1). Three mathematical models were evaluated: D{sub 2cc}=α*C{sub 1}+β (LIN); D{sub 2cc}=α– exp(–β*C{sub 0}) (EXP); and a mixed approach (MIX), where both C{sub 0} and C{sub 1} were inputs of the model. The parameters of the models were optimized on a training set of patient data, and the predictive error of each model (predicted D{sub 2cc}− real D{sub 2cc}) was calculated on a validation set of patient data. The data of 20 patients were used to perform a K-fold cross validation analysis, with K = 2, 4, 6, 8, 10, and 20.Results: MIX was associated with the smallest mean prediction error <6.4% for an 18-patient training set; LIN had an error <8.5%; EXP had an error <8.3%. Best case scenario analysis shows that an error ≤5% can be achieved for a ten-patient training set with MIX, an error ≤7.4% for LIN, and an error ≤6.9% for EXP. The error decreases with the increase in training set size, with the most marked decrease observed for MIX.Conclusions: The MIX model can predict the D{sub 2cc} of the organs at risk with an error lower than 5% with a training set of ten patients or greater. The model can be used in the development of quality assurance tools to identify treatment plans with suboptimal sparing of the organs at risk. It can also be used to improve preplanning and in the development of real-time intraoperative planning tools.

  19. Three-dimensional-guided perineal-based interstitial brachytherapy in cervical cancer: A systematic review of technique, local control and toxicities.

    PubMed

    Mendez, Lucas C; Weiss, Yonatan; D'Souza, David; Ravi, Ananth; Barbera, Lisa; Leung, Eric

    2017-05-01

    To evaluate local control and toxicities of perineal-based interstitial brachytherapy (P-ISBT) in cervical cancers treated with three-dimensional (3D) image-based planning through a systematic review. The secondary objective of this review is to summarize the implant and dosimetric techniques in 3D P-ISBT. Systematic review of the literature using the PRISMA guideline was conducted through a search of Medline, EMBASE and Cochrane databases. This search resulted in 19 relevant manuscripts. Selected studies evaluated the role of perineal ISBT in cervical tumours treated using 3D planning. Eleven of nineteen manuscripts contained sufficient information for LC and toxicity calculations. Data were extracted by at least two investigators. A total of 672 cervical cancer patients were treated with P-ISBT and planned with 3D image-based planning. Clinical outcomes could be identified for 392 patients and 60% were staged IIIB or higher. Most patients received 45-50.4Gy EBRT to the pelvis followed by a P-ISBT boost with a range of dose between 28 and 48Gy EQD2Gy. Overall LC was 79% (310/392) with a median follow-up ranging from 14 to 55months. Almost half of the patients (48%) had a median follow-up ≥35months. Patients treated to a lower tumour EQD2Gy total dose had inferior LC. Procedure-related complications were rare (7 infections and 7 episodes of bleeding) and limited. Combined late gastro-intestinal, genitourinary and vaginal grade 3 and 4 toxicity was 12.1%. Promising LC rates were found in patients with cervical cancers treated with perineal ISBT with 3D image-based planning. In this systematic review, 60% had stage IIIB disease or higher and yet a LC rate of 79% was found. LC seemed to correlate with the dose delivered to the tumour, while toxicity rates were similar to other cervical cancer series using 3D image-based brachytherapy. Perineal ISBT with 3D planning seems to be an effective and safe treatment for large advanced cervical tumours and may be a

  20. Partial breast irradiation with interstitial multi-catheter high-dose-rate brachytherapy. Long-term results of a phase II prospective study.

    PubMed

    Aristei, Cynthia; Maranzano, Ernesto; Lancellotta, Valentina; Chirico, Luigia; Zucchetti, Claudio; Italiani, Marco; Anselmo, Paola; Mariucci, Cristina; Perrucci, Elisabetta; Arcidiacono, Fabio; Trippa, Fabio; Kovacs, György; Bini, Vittorio; Palumbo, Isabella

    2017-08-01

    We report the long-term results of phase II prospective study with accelerated partial breast irradiation (APBI) using interstitial multi-catheter high-dose-rate brachytherapy. 240 patients received APBI (4Gy, twice daily; total dose 32Gy). Median follow-up was 96months. Recurrences in the treated breast developed in 8 patients (3.3%) at a median of 73months after APBI. The 5- and 10-year cumulative incidences were respectively, 1.8% (95%CI: 0.6-4.3) and 6.6% (95%CI: 2.7-12.9). Regional recurrences developed in 5 patients (2%) at a median of 28months and distant metastases in 8 (3.3%) at a median of 32.5months. Breast cancer specific mortality occurred in 6 patients (2.5%) at a median of 60months. Acute toxicity developed in 71 (29.6%) patients (G1 in 60 and G2 in 11). Almost all were skin toxicity and hematomas. Late toxicity was observed in 90 patients (37.5%), G1 in 97 cases and G2 in 11. Some patients presented with more than one type of toxicity. Teleangectasia and fibrosis were the most common (48 and 44 cases respectively), followed by fat necrosis (in 18 patients) Tamoxifen emerged as the only risk factor for breast fibrosis (p=0.007). Cosmetic results were judged by the physicians as excellent in 174 (83.7%) patients, good in 25 (12%) fair in 8 (3.8%) and poor in 1 (0.5%); 174 patients (83.7%) judged outcomes as excellent, 26 (12.4%) as good, 7 (3.4%) as fair and 1 (0.5%) as poor. Physician/patient agreement was good (weighted k-value 0.72). APBI with interstitial multi-catheter brachytherapy was associated with good outcomes, low relapse and toxicity rates. Few events during this long-term follow-up preclude identifying specific features of patients at risk of relapse and illustrate the need for a large data-base. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. Acute urinary morbidity after a permanent 125I implantation for localized prostate cancer.

    PubMed

    Ohga, Saiji; Nakamura, Katsumasa; Shioyama, Yoshiyuki; Tatsugami, Katsunori; Sasaki, Tomonari; Nonoshita, Takeshi; Yoshitake, Tadamasa; Asai, Kaori; Hirata, Hideki; Naito, Seiji; Honda, Hiroshi

    2014-11-01

    We evaluated the predictive factors of acute urinary morbidity (AUM) after prostate brachytherapy. From November 2005 to January 2007, 62 patients with localized prostate cancer were treated using brachytherapy. The (125)Iodine ((125)I) seed-delivering method was a modified peripheral pattern. The prescribed dose was 144 Gy. Urinary morbidity was scored at 3 months after implantation. The clinical and treatment parameters were analysed for correlation with AUM. In particular, in this study, Du90 (the minimal dose received by 90% of the urethra), Dup90 (the minimal dose received by 90% of the proximal half of the urethra on the bladder side) and Dud90 (the minimal dose received by 90% of the distal half of the urethra on the penile side) were analysed. We found that 43 patients (69.4%) experienced acute urinary symptoms at 3 months after implantation. Of them, 40 patients had Grade 1 AUM, one patient had Grade 2 pain, and two patients had Grade 2 urinary frequency. None of the patients had ≥Grade 3. Univariate and multivariate analysis revealed that Du90 and Dup90 were significantly correlated with AUM. In this study, Du90 and Dup90 were the most significant predictors of AUM after prostate brachytherapy.

  2. Early biochemical outcomes following permanent interstitial brachytherapy as monotherapy in 1050 patients with clinical T1-T2 prostate cancer.

    PubMed

    Guedea, Ferran; Aguilo, Ferran; Polo, Alfredo; Langley, Stephen; Laing, Robert; Henderson, Alastair; Aaltomaa, Sirpa; Kataja, Vesa; Palmgren, Juni; Bladou, Franch; Salem, Naji; Gravis, Gwenaelle; Losa, Andrea; Guazzoni, Giorgio; Nava, Luciano

    2006-07-01

    Five European centres (France, Finland, Italy, Spain and the UK) have pooled data to generate a large patient series involving 1175 patients treated with prostate brachytherapy. This paper reports preliminary data on PSA outcome up to 4 years. Out of 1175 in the database, 1050 patients with localised prostate cancer who had received transperineal seed implantation as monotherapy between May 1998 and August 2003 were stage T1-T2. A total of 668 (63.6%) patients met the low-risk group definition, 297 (28.3%) as intermediate-risk definition and 66 (6.3%) the high-risk group definition. The majority of patients were Gleason score 6 or less (n=951) and disease stage was T1c in 557 patients. Of the 1050 patients, PSA data up to 4 years were available for 210 patients, while 364 patients with PSA values up to 36 months were evaluable by the Kaplan-Meier method for freedom from biochemical failure. The biochemical progression-free rate at 3 years was estimated to be 91%, with a 93% and 88% rate for low- and intermediate-risk groups, respectively, versus 80% for the high-risk group. PSA kinetics provide encouraging evidence of treatment efficacy. These data on 4-year PSA follow-up on patients treated with prostate brachytherapy reflect those previously reported in the literature. This patient series will be followed to provide long-term outcome in the future.

  3. 3D image-based adapted high-dose-rate brachytherapy in cervical cancer with and without interstitial needles: measurement of applicator shift between imaging and dose delivery

    PubMed Central

    Thunberg, Per; With, Anders; Mordhorst, Louise Bohr; Persliden, Jan

    2017-01-01

    Purpose Using 3D image-guided adaptive brachytherapy for cervical cancer treatment, it often means that patients are transported and moved during the treatment procedure. The purpose of this study was to determine the intra-fractional longitudinal applicator shift in relation to the high risk clinical target volume (HR-CTV) by comparing geometries at imaging and dose delivery for patients with and without needles. Material and methods Measurements were performed in 33 patients (71 fractions), where 25 fractions were without and 46 were with interstitial needles. Gold markers were placed in the lower part of the cervix as a surrogate for HR-CTV, enabling distance measurements between HR-CTV and the ring applicator. Shifts of the applicator relative to the markers were determined using planning computed tomography (CT) images used for planning, and the radiographs obtained at dose delivery. Differences in the physical D90 for HR-CTV due to applicator shifts were simulated individually in the treatment planning system to provide the relative dose variation. Results The maximum distances of the applicator shifts, in relation to the markers, were 3.6 mm (caudal), and –2.5 mm (cranial). There was a significant displacement of –0.7 mm (SD = 0.9 mm) without needles, while with needles there was no significant shift. The relative dose variation showed a significant increase in D90 HR-CTV of 1.6% (SD = 2.6%) when not using needles, and no significant dose variation was found when using needles. Conclusions The results from this study showed that there was a small longitudinal displacement of the ring applicator and a significant difference in displacement between using interstitial needles or not. PMID:28344604

  4. Impact of source-production revision on the dose-rate constant of {sup 131}Cs interstitial brachytherapy sources

    SciTech Connect

    Chen Zhe; Bongiorni, Paul; Nath, Ravinder

    2010-07-15

    Purpose: Since its introduction in 2004, the model CS-1 Rev.1 {sup 131}Cs source has been used in many radiation therapy clinics for prostate brachytherapy. In 2006, this source model underwent a Rev.2 production revision. The aim of this work was to investigate the dosimetric influences of the Rev.2 production revision using high-resolution photon spectrometry. Methods: Three CS-1 Rev.1 and three CS-1 Rev.2 {sup 131}Cs sources were used in this study. The relative photon energy spectrum emitted by each source in the transverse bisector of the source was measured using a high-resolution germanium detector designed for low-energy photon spectrometry. Based on the measured photon energy spectrum and the radioactivity distribution in the source, the dose-rate constant ({Lambda}) of each source was determined. The effects of the Rev.2 production revision were quantified by comparing the emitted photon energy spectra and the {Lambda} values determined for the sources manufactured before and after the production revision. Results: The relative photon energy spectrum originating from the principal emissions of {sup 131}Cs was found to be nearly identical before and after the Rev.2 revision. However, the portion of the spectrum originating from the production of fluorescent x rays in niobium, a trace element present in the source construction materials, was found to differ significantly between the Rev.1 and Rev.2 sources. The peak intensity of the Nb K{sub {alpha}} and Nb K{sub {beta}} fluorescent x rays from the Rev.2 source was approximately 35% of that from the Rev.1 source. Consequently, the nominal {Lambda} value of the Rev.2 source was found to be greater than that determined for the Rev.1 source by approximately 0.7%{+-}0.5%. Conclusions: A significant reduction (65%) in relative niobium fluorescent x-ray yield was observed in the Rev.2 {sup 131}Cs sources. The impact of this reduction on the dose-rate constant was found to be small, with a relative difference of

  5. Hypofractionated accelerated CT-guided interstitial ¹⁹²Ir-HDR-Brachytherapy as re-irradiation in inoperable recurrent cervical lymphadenopathy from head and neck cancer.

    PubMed

    Tselis, Nikolaos; Ratka, Markus; Vogt, Hans-Georg; Kolotas, Christos; Baghi, Mehran; Baltas, Dimos; Fountzilas, George; Georgoulias, Vassilios; Ackermann, Hanns; Zamboglou, Nikolaos

    2011-01-01

    Despite significant improvements in the treatment of head and neck cancer (HNC), lymph node recurrences remain a clinical challenge after primary radiotherapy. The value of interstitial (IRT) brachytherapy (BRT) for control of lymph node recurrence remains unclear. In order to clarify its role a retrospective review was undertaken on the value of computed tomography (CT)-guided IRT high-dose-rate (HDR)-BRT in isolated recurrent disease from HNC. From 2000 to 2007, 74 patients were treated for inoperable recurrent cervical lymphadenopathy. All patients had previously been treated with radical radiotherapy or chemoradiation with or without surgery. The HDR-BRT delivered a median salvage dose of 30.0 Gy (range, 12.0-36.0 Gy) in twice-daily fractions of 2.0-5.0 Gy in 71 patients and of 30.0 Gy (range, 10.0-36.0 Gy) in once-daily fractions of 6.0-10.0 Gy in three patients. The overall and disease-free survival rates at one, two and three years were 42%, 19%, 6%, and 42%, 37% and 19%, respectively. The local control probability at one, two and three years was 67% at all three time points. Grade III-IV complications occurred in 13% of patients. In patients with inoperable recurrent neck disease from HNC, hypofractionated accelerated CT-guided IRT-HDR-BRT can play an important role in providing palliation and tumor control. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  6. Validation of a novel robot-assisted 3DUS system for real-time planning and guidance of breast interstitial HDR brachytherapy

    SciTech Connect

    Poulin, Eric; Beaulieu, Luc; Gardi, Lori; Barker, Kevin; Montreuil, Jacques; Fenster, Aaron

    2015-12-15

    Purpose: In current clinical practice, there is no integrated 3D ultrasound (3DUS) guidance system clinically available for breast brachytherapy. In this study, the authors present a novel robot-assisted 3DUS system for real-time planning and guidance of breast interstitial high dose rate (HDR) brachytherapy treatment. Methods: For this work, a new computer controlled robotic 3DUS system was built to perform a hybrid motion scan, which is a combination of a 6 cm linear translation with a 30° rotation at both ends. The new 3DUS scanner was designed to fit on a modified Kuske assembly, keeping the current template grid configuration but modifying the frame to allow the mounting of the 3DUS system at several positions. A finer grid was also tested. A user interface was developed to perform image reconstruction, semiautomatic segmentation of the surgical bed as well as catheter reconstruction and tracking. A 3D string phantom was used to validate the geometric accuracy of the reconstruction. The volumetric accuracy of the system was validated with phantoms using magnetic resonance imaging (MRI) and computed tomography (CT) images. In order to accurately determine whether 3DUS can effectively replace CT for treatment planning, the authors have compared the 3DUS catheter reconstruction to the one obtained from CT images. In addition, in agarose-based phantoms, an end-to-end procedure was performed by executing six independent complete procedures with both 14 and 16 catheters, and for both standard and finer Kuske grids. Finally, in phantoms, five end-to-end procedures were performed with the final CT planning for the validation of 3DUS preplanning. Results: The 3DUS acquisition time is approximately 10 s. A paired Student t-test showed that there was no statistical significant difference between known and measured values of string separations in each direction. Both MRI and CT volume measurements were not statistically different from 3DUS volume (Student t-test: p > 0

  7. Diode dosimetry of models 6711 and 6712 125I seeds in a water phantom.

    PubMed

    Ahmad, M; Fontenla, D P; Chiu-Tsao, S T; Chui, C S; Reiff, J E; Anderson, L L; Huang, D Y; Schell, M C

    1992-01-01

    Two-dimensional relative dose distributions have been measured around 125I brachytherapy seeds. The two seed models studied, models 6711 and 6712, were manufactured by the 3M Company. Silicon detectors immersed in water phantoms were used to measure the dose. A computerized data acquisition system that controlled the radial position of the diode and the angular rotation of the seed, as well as a manually controlled system were used to collect and store the data. Our results show that the two seed models have relative dose distributions which are quite similar; however, the absolute dose distributions are sufficiently different to warrant separate look-up tables for the two seed models. Additionally, our results are compared with dose distribution data previously obtained for the model 6711 seed.

  8. Combined use of transverse and scout computed tomography scans to localize radioactive seeds in an interstitial brachytherapy implant.

    PubMed

    Yue, N; Chen, Z; Bond, J E; Son, Y H; Nath, R

    1999-04-01

    Various techniques have been developed to localize radioactive sources in brachytherapy implants. The most common methods include the orthogonal film method, the stereo-shift film method, and recently, direct localization from a series of contiguous CT transverse images. The major advantage of the CT method is that it provides the seed locations relative to anatomic structures. However, it is often the case that accurate identification and localization of the sources become difficult because of partial source artifacts in more than one transverse cut and other artifacts on CT images. A new algorithm has been developed to combine the advantages of using a pair of orthogonal scout views with the advantages of using a stack of transverse cuts. In the new algorithm, a common reference point is used to correlate CT transverse images and two orthogonal scout CT scans (AP and lateral). The radioactive sources are localized on CT transverse images. At the same time, the sources are displayed automatically on the two CT scout scans. In this way, the individual sources can be clearly distinguished and ambiguities arising from partial source artifacts are resolved immediately. Because of the finite slice thickness of transverse cuts, the longitudinal coordinates are more accurately obtained from the scout views. Therefore, the longitudinal coordinates of seeds localized on the transverse cuts are adjusted so that they match the position of the seeds on scout views. The algorithm has been tested on clinical cases and has proved to be a time saving and accurate method.

  9. A systematic evaluation of the dose-rate constant determined by photon spectrometry for 21 different models of low-energy photon-emitting brachytherapy sources

    NASA Astrophysics Data System (ADS)

    (Jay Chen, Zhe; Nath, Ravinder

    2010-10-01

    The aim of this study was to perform a systematic comparison of the dose-rate constant (Λ) determined by the photon spectrometry technique (PST) with the consensus value (CONΛ) recommended by the American Association of Physicists in Medicine (AAPM) for 21 low-energy photon-emitting interstitial brachytherapy sources. A total of 63 interstitial brachytherapy sources (21 different models with 3 sources per model) containing either 125I (14 models), 103Pd (6 models) or 131Cs (1 model) were included in this study. A PST described by Chen and Nath (2007 Med. Phys. 34 1412-30) was used to determine the dose-rate constant (PSTΛ) for each source model. Source-dependent variations in PSTΛ were analyzed systematically against the spectral characteristics of the emitted photons and the consensus values recommended by the AAPM brachytherapy subcommittee. The values of PSTΛ for the encapsulated sources of 103Pd, 125I and 131Cs varied from 0.661 to 0.678 cGyh-1 U-1, 0.959 to 1.024 cGyh-1U-1 and 1.066 to 1.073 cGyh-1U-1, respectively. The relative variation in PSTΛ among the six 103Pd source models, caused by variations in photon attenuation and in spatial distributions of radioactivity among the source models, was less than 3%. Greater variations in PSTΛ were observed among the 14 125I source models; the maximum relative difference was over 6%. These variations were caused primarily by the presence of silver in some 125I source models and, to a lesser degree, by the variations in photon attenuation and in spatial distribution of radioactivity among the source models. The presence of silver generates additional fluorescent x-rays with lower photon energies which caused the PSTΛ value to vary from 0.959 to 1.019 cGyh-1U-1 depending on the amount of silver used by a given source model. For those 125I sources that contain no silver, their PSTΛ was less variable and had values within 1% of 1.024 cGyh-1U-1. For the 16 source models that currently have an AAPM recommended

  10. Late rectal toxicity after image-based high-dose-rate interstitial brachytherapy for postoperative recurrent and/or residual cervical cancers: EQD2 predictors for Grade ≥II toxicity.

    PubMed

    Chopra, Supriya; Dora, Tapas; Engineer, Reena; Mechanery, Siji; Agarwal, Priyanka; Kannan, Sadhna; Ghadi, Yogesh; Swamidas, Jamema; Mahantshetty, Umesh; Shrivastava, Shyam Kishore

    2015-01-01

    To investigate the correlation of rectal dose volume metrics with late rectal toxicity after high-dose-rate pelvic interstitial brachytherapy. From October 2009 to November 2012, 50 patients with residual or recurrent cervical cancer were included. Patients received external radiation 50 Gy in 25 fractions over 5 weeks with weekly cisplatin. Rectum and rectal mucosal (RM) contours were delineated retrospectively. RM was defined as the outer surface of the flatus tube inserted at brachytherapy. The dose received by 0.1, 1, 2, 5 cc of rectum, RM, and sigmoid was recorded. Cumulative equivalent dose in 2 Gy (EQD2) for organs at risk was calculated assuming α/β of 3. Univariate analysis was performed to identify predictors of rectal toxicity. At a median follow-up of 34 months (12-51 months), Grade II and III late rectal toxicity was observed in 9 (18%) and 2 (4%) patients, respectively. On univariate analysis, rectal doses were not significant predictors; however, D 0.1-cc RM dose >72 Gy (p = 0.04), D 1-cc RM dose >65 Gy (p = 0.004), D 2-cc RM dose >62.3 Gy (p = 0.004), and D 5-cc RM dose >60 Gy (p = 0.007) correlated with Grade ≥II toxicity. On probit analysis, the estimated dose in EQD2 for a 10% and 20% risk of rectal toxicity was D 2-cc rectum of 55 and 66 Gy, and RM <55 and 63 Gy, respectively. Limiting 2-cc RM and rectal doses within the proposed thresholds can minimize Grade ≥II toxicity for gynecologic high-dose-rate interstitial brachytherapy. Copyright © 2015 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  11. AAPM recommendations on dose prescription and reporting methods for permanent interstitial brachytherapy for prostate cancer: report of Task Group 137.

    PubMed

    Nath, Ravinder; Bice, William S; Butler, Wayne M; Chen, Zhe; Meigooni, Ali S; Narayana, Vrinda; Rivard, Mark J; Yu, Yan

    2009-11-01

    During the past decade, permanent radioactive source implantation of the prostate has become the standard of care for selected prostate cancer patients, and the techniques for implantation have evolved in many different forms. Although most implants use 125I or 103Pd sources, clinical use of 131Cs sources has also recently been introduced. These sources produce different dose distributions and irradiate the tumors at different dose rates. Ultrasound was used originally to guide the planning and implantation of sources in the tumor. More recently, CT and/or MR are used routinely in many clinics for dose evaluation and planning. Several investigators reported that the tumor volumes and target volumes delineated from ultrasound, CT, and MR can vary substantially because of the inherent differences in these imaging modalities. It has also been reported that these volumes depend critically on the time of imaging after the implant. Many clinics, in particular those using intraoperative implantation, perform imaging only on the day of the implant. Because the effects of edema caused by surgical trauma can vary from one patient to another and resolve at different rates, the timing of imaging for dosimetry evaluation can have a profound effect on the dose reported (to have been delivered), i.e., for the same implant (same dose delivered), CT at different timing can yield different doses reported. Also, many different loading patterns and margins around the tumor volumes have been used, and these may lead to variations in the dose delivered. In this report, the current literature on these issues is reviewed, and the impact of these issues on the radiobiological response is estimated. The radiobiological models for the biological equivalent dose (BED) are reviewed. Starting with the BED model for acute single doses, the models for fractionated doses, continuous low-dose-rate irradiation, and both homogeneous and inhomogeneous dose distributions, as well as tumor cure

  12. AAPM recommendations on dose prescription and reporting methods for permanent interstitial brachytherapy for prostate cancer: Report of Task Group 137

    SciTech Connect

    Nath, Ravinder; Bice, William S.; Butler, Wayne M.; Chen Zhe; Meigooni, Ali S.; Narayana, Vrinda; Rivard, Mark J.; Yu Yan

    2009-11-15

    During the past decade, permanent radioactive source implantation of the prostate has become the standard of care for selected prostate cancer patients, and the techniques for implantation have evolved in many different forms. Although most implants use {sup 125}I or {sup 103}Pd sources, clinical use of {sup 131}Cs sources has also recently been introduced. These sources produce different dose distributions and irradiate the tumors at different dose rates. Ultrasound was used originally to guide the planning and implantation of sources in the tumor. More recently, CT and/or MR are used routinely in many clinics for dose evaluation and planning. Several investigators reported that the tumor volumes and target volumes delineated from ultrasound, CT, and MR can vary substantially because of the inherent differences in these imaging modalities. It has also been reported that these volumes depend critically on the time of imaging after the implant. Many clinics, in particular those using intraoperative implantation, perform imaging only on the day of the implant. Because the effects of edema caused by surgical trauma can vary from one patient to another and resolve at different rates, the timing of imaging for dosimetry evaluation can have a profound effect on the dose reported (to have been delivered), i.e., for the same implant (same dose delivered), CT at different timing can yield different doses reported. Also, many different loading patterns and margins around the tumor volumes have been used, and these may lead to variations in the dose delivered. In this report, the current literature on these issues is reviewed, and the impact of these issues on the radiobiological response is estimated. The radiobiological models for the biological equivalent dose (BED) are reviewed. Starting with the BED model for acute single doses, the models for fractionated doses, continuous low-dose-rate irradiation, and both homogeneous and inhomogeneous dose distributions, as well as

  13. Cosmetic changes following surgery and accelerated partial breast irradiation using HDR interstitial brachytherapy : Evaluation by a multidisciplinary/multigender committee.

    PubMed

    Soror, Tamer; Kovács, György; Seibold, Nina; Melchert, Corinna; Baumann, Kristin; Wenzel, Eike; Stojanovic-Rundic, Suzana

    2017-05-01

    Patients with early-stage breast cancer can benefit from adjuvant accelerated partial breast irradiation (APBI) following breast-conserving surgery (BCS). This work reports on cosmetic results following APBI using multicatheter high-dose-rate interstitial brachytherapy (HDR-IBT). Between 2006 and 2014, 114 patients received adjuvant APBI using multicatheter HDR-IBT. For each patient, two photographs were analyzed: the first was taken after surgery (baseline image) and the second at the last follow-up visit. Cosmesis was assessed by a multigender multidisciplinary team using the Harvard Breast Cosmesis Scale. Dose-volume histogram (DVH) parameters and the observed cosmetic results were investigated for potential correlations. The median follow-up period was 3.5 years (range 0.6-8.5 years). The final cosmetic scores were 30% excellent, 52% good, 14.5% fair, and 3.5% poor. Comparing the baseline and follow-up photographs, 59.6% of patients had the same score, 36% had a better final score, and 4.4% had a worse final score. Only lower target dose nonuniformity ratio (DNR) values (0.3 vs. 0.26; p = 0.009) were significantly associated with improved cosmetic outcome vs. same/worse cosmesis. APBI using multicatheter HDR-IBT adjuvant to BCS results in favorable final cosmesis. Deterioration in breast cosmesis occurs in less than 5% of patients. The final breast cosmetic outcome in patients treated with BCS and APBI using multicatheter HDR-IBT is influenced primarily by the cosmetic result of the surgery. A lower DNR value is significantly associated with a better cosmetic outcome.

  14. A Dosimetric Comparison of Accelerated Partial Breast Irradiation Techniques: Multicatheter Interstitial Brachytherapy, Three-Dimensional Conformal Radiotherapy, and Supine Versus Prone Helical Tomotherapy

    SciTech Connect

    Patel, Rakesh R. . E-mail: patel@humonc.wisc.edu; Becker, Stewart J.; Das, Rupak K.; Mackie, Thomas R.

    2007-07-01

    Purpose: To compare dosimetrically four different techniques of accelerated partial breast irradiation (APBI) in the same patient. Methods and Materials: Thirteen post-lumpectomy interstitial brachytherapy (IB) patients underwent imaging with preimplant computed tomography (CT) in the prone and supine position. These CT scans were then used to generate three-dimensional conformal radiotherapy (3D-CRT) and prone and supine helical tomotherapy (PT and ST, respectively) APBI plans and compared with the treated IB plans. Dose-volume histogram analysis and the mean dose (NTD{sub mean}) values were compared. Results: Planning target volume coverage was excellent for all methods. Statistical significance was considered to be a p value <0.05. The mean V100 was significantly lower for IB (12% vs. 15% for PT, 18% for ST, and 26% for 3D-CRT). A greater significant differential was seen when comparing V50 with mean values of 24%, 43%, 47%, and 52% for IB, PT, ST, and 3D-CRT, respectively. The IB and PT were similar and delivered an average lung NTD{sub mean} dose of 1.3 Gy{sub 3} and 1.2 Gy{sub 3}, respectively. Both of these methods were statistically significantly lower than the supine external beam techniques. Overall, all four methods yielded similar low doses to the heart. Conclusions: The use of IB and PT resulted in greater normal tissue sparing (especially ipsilateral breast and lung) than the use of supine external beam techniques of 3D-CRT or ST. However, the choice of APBI technique must be tailored to the patient's anatomy, lumpectomy cavity location, and overall treatment goals.

  15. (125)I Seeds Radiation Induces Paraptosis-Like Cell Death via PI3K/AKT Signaling Pathway in HCT116 Cells.

    PubMed

    Hu, Lelin; Wang, Hao; Zhao, Yong; Wang, Junjie

    2016-01-01

    (125)I seeds brachytherapy implantation has been extensively performed in unresectable and rerecurrent rectal carcinoma. Many studies on the cancer-killing activity of (125)I seeds radiation mainly focused on its ability to trigger apoptosis, which is the most well-known and dominant type of cell death induced by radiation. However our results showed some unique morphological features such as cell swelling, cytoplasmic vacuolation, and plasma membrane integrity, which is obviously different to apoptosis. In this study, clonogenic proliferation was carried out to assay survival fraction. Transmission electron microscopy was used to analyze ultrastructural and evaluate morphologic feature of HCT116 cells after exposure to (125)I seeds radiation. Immunofluorescence analysis was used to detect the origin of cytoplasmic vacuoles. Flow cytometry analysis was employed to detect the size and granularity of HCT116 cells. Western blot was performed to measure the protein level of AIP1, caspase-3, AKT, p-Akt (Thr308), p-Akt (Ser473), and β-actin. We found that (125)I seeds radiation activated PI3K/AKT signaling pathway and could trigger paraptosis-like cell death. Moreover, inhibitor of PI3K/AKT signaling pathway could inhibit paraptosis-like cell death induced by (125)I seeds radiation. Our data suggest that (125)I seeds radiation can induce paraptosis-like cell death via PI3K/AKT signaling pathway.

  16. 125I Seeds Radiation Induces Paraptosis-Like Cell Death via PI3K/AKT Signaling Pathway in HCT116 Cells

    PubMed Central

    Hu, Lelin; Wang, Hao; Zhao, Yong

    2016-01-01

    125I seeds brachytherapy implantation has been extensively performed in unresectable and rerecurrent rectal carcinoma. Many studies on the cancer-killing activity of 125I seeds radiation mainly focused on its ability to trigger apoptosis, which is the most well-known and dominant type of cell death induced by radiation. However our results showed some unique morphological features such as cell swelling, cytoplasmic vacuolation, and plasma membrane integrity, which is obviously different to apoptosis. In this study, clonogenic proliferation was carried out to assay survival fraction. Transmission electron microscopy was used to analyze ultrastructural and evaluate morphologic feature of HCT116 cells after exposure to 125I seeds radiation. Immunofluorescence analysis was used to detect the origin of cytoplasmic vacuoles. Flow cytometry analysis was employed to detect the size and granularity of HCT116 cells. Western blot was performed to measure the protein level of AIP1, caspase-3, AKT, p-Akt (Thr308), p-Akt (Ser473), and β-actin. We found that 125I seeds radiation activated PI3K/AKT signaling pathway and could trigger paraptosis-like cell death. Moreover, inhibitor of PI3K/AKT signaling pathway could inhibit paraptosis-like cell death induced by 125I seeds radiation. Our data suggest that 125I seeds radiation can induce paraptosis-like cell death via PI3K/AKT signaling pathway. PMID:28078301

  17. Clinical effectiveness of 125I-seed implantation in combination with nimotuzumab therapy for the advanced oral carcinoma: preliminary results.

    PubMed

    Meng, J; Wang, X; Zhuang, Q-W; Gu, Q-P; Zhang, J; Li, Z-P

    2014-01-01

    This study determines the short-term efficacy and toxicity of combined 125I-seed implantation and nimotuzumab in treating the advanced oral carcinoma. 125I-seed implantation is safe and has shown good short-term efficacy in clinical practice. Nimotuzumab is a useful biological agent for targeted therapy. Effect of 125I-seed implantation with nimotuzumab in treating oral carcinomas remains unclear. From November 2011 to December 2012, 11 patients with advanced oral carcinoma (pathologic types: 7 cases of squamous cell carcinoma and 4 cases of poorly differentiated adenocarcinoma) were enrolled in our hospital. The patients did not receive surgery due to systemic disease or locally advanced cancer. All of them underwent 125I-seed implantation with the matched peripheral doses (MPD) ranging from 90-100 Gy. The apparent activity per seed ranged from 0.6 mCi (2.22 MBq) to 0.7 mCi (2.59 MBq). Later, all patients were given nimotuzumab (200 mg, intravenous drip, weekly, for 6 weeks). The patients were then followed up and the response rate, acute/chronic radiation-induced injury, and safety of the induction treatment were analyzed. Three patients achieved complete while 6 patients had partial response; yielding a response rate of 81.8%. Major adverse events included radiation-induced oral mucositis, local hemorrhage, bone marrow suppression, nausea/vomiting, and alopecia. Adverse reaction was not significantly different between the group of patients under 65 years of age and over 65 years of age (p > 0.05). Nimotuzumab enhanced the tumor sensitivity to brachytherapy without increasing AEs and improved the patients' life quality. 125I-seed implantation combined with nimotuzumab is effective and safe for patients with unresectable oral carcinoma.

  18. CT-guided interstitial brachytherapy of liver malignancies alone or in combination with thermal ablation: phase I-II results of a novel technique.

    PubMed

    Ricke, Jens; Wust, Peter; Stohlmann, Anna; Beck, Alexander; Cho, Chie Hee; Pech, Maciej; Wieners, Gero; Spors, Birgit; Werk, Michael; Rosner, Christian; Hänninen, Enrique Lopez; Felix, Roland

    2004-04-01

    To assess the safety and efficacy of CT-guided brachytherapy alone or in combination with laser-induced thermotherapy (LITT) in patients with liver malignancies. Thirty-seven patients presented with 36 liver metastases and two primary liver carcinomas. Twenty-one patients were treated with CT-guided high-dose-rate brachytherapy alone using a 192Ir source. Sixteen patients received brachytherapy directly after MRI-guided LITT. The indications for brachytherapy alone were a tumor size >5 cm, adjacent central bile duct or adjacent major vessels causing unfavorable cooling effects for thermal ablation, and technical failures of LITT. The dosimetry for brachytherapy was performed using three-dimensional CT data acquired after percutaneous applicator positioning. On average, a minimal dose of 17 Gy inside the tumor margin was applied (range, 10-20 Gy). The mean tumor size was 4.6 cm (range, 2.5-11 cm). The mean liver volume receiving > or =5 Gy was 16% (range, 2-40%) of the total liver. Severe complications were recorded in 2 patients (5%). One patient developed acute liver failure possibly related to accidental continuation of oral capecitabine treatment. Another patient demonstrated obstructive jaundice owing to tumor edema after irradiation of a metastasis adjacent to the bile duct bifurcation. A commonly encountered moderate increase of liver enzymes was greatest in patients with combined treatment. The local control rate after 6 months was 73% and 87% for combined treatment and brachytherapy alone, respectively. CT-guided brachytherapy using three-dimensional CT data for dosimetry is safe and effective alone or in combination with LITT. Brachytherapy as a stand-alone treatment displayed genuine advantages over thermal tumor ablation.

  19. Scintillation Proximity Radioimmunoassay Utilizing 125I-Labeled Ligands

    NASA Astrophysics Data System (ADS)

    Udenfriend, Sidney; Diekmann Gerber, Louise; Brink, Larry; Spector, Sydney

    1985-12-01

    A unique type of radioimmunoassay is described that does not require centrifugation or separation. Microbeads containing a fluorophor are covalently linked to antibody. When an 125I-labeled antigen is added it binds to the beads and, by its proximity, the emitted short-range electrons of the 125I excite the fluorophor in the beads. The light emitted can be measured in a standard scintillation counter. Addition of unlabeled antigen from tissue extracts displaces the labeled ligand and diminishes the fluorescent signal. Application of scintillation proximity immunoassay to tissue enkephalins, serum thyroxin, and urinary morphine is described. Applications of the principle to study the kinetics of interaction between receptors and ligands are discussed.

  20. Scintillation proximity radioimmunoassay utilizing 125I-labeled ligands

    SciTech Connect

    Udenfriend, S.; Gerber, L.D.; Brink, L.; Spector, S.

    1985-12-01

    A unique type of radioimmunoassay is described that does not require centrifugation or separation. Microbeads containing a fluorophor are covalently linked to antibody. When an /sup 125/I-labeled antigen is added it binds to the beads and, by its proximity, the emitted short-range electrons of the /sup 125/I excite the fluorophor in the beads. The light emitted can be measured in a standard scintillation counter. Addition of unlabeled antigen from tissue extracts displaces the labeled ligand and diminishes the fluorescent signal. Application of scintillation proximity immunoassay to tissue enkephalins, serum thyroxin, and urinary morphine is described. Applications of the principle to study the kinetics of interaction between receptors and ligands are discussed.

  1. Renal catabolism of /sup 125/I-glicentin

    SciTech Connect

    Lopez-Novoa, J.M.; Santos, J.C.; Villamediana, L.M.; Garrote, F.J.; Thim, L.; Moody, A.J.; Valverde, I.

    1986-05-01

    The renal catabolism of /sup 125/I-glicentin has been studied in vivo by the disappearance of this peptide from the plasma of bilaterally nephrectomized, ureteral-ligated, or normal rats and by using tubular microinfusion techniques. In addition the catabolism of glicentin by the isolated, perfused kidney has been studied. Results from in vivo studies demonstrated that half-disappearance time was lower in control (59.5 +/- 1.8 min) than in bilaterally nephrectomized rats (97.2 +/- 2.6 min), and this value was significantly higher than that of ureteral-ligated animals (83.2 +/- 1.1 min, P less than 0.005). Microinfusion experiments revealed that when /sup 125/I-glicentin was injected into the proximal tubule, no trichloroacetic-precipitable radioactivity was recovered in the urine, whereas most of inulin injected was recovered. By contrast most of the /sup 125/I-glicentin injected into the distal tubule was recovered in the urine. In isolated kidney experiments, organ clearance rate of /sup 125/I-glicentin averaged 0.88 +/- 0.10 ml/min, a value significantly higher than that of glomerular filtration rate (0.72 +/- 0.06 ml/min, P less than 0.005, paired data), and both parameters showed a close linear relationship (r = 0.90). Urinary clearance of glicentin was negligible. These results demonstrate that the kidney plays a major role in the catabolism of glicentin, mainly by glomerular filtration and tubular catabolism. The site of tubular catabolism appears to be the proximal tubule. Peritubular uptake was minimal.

  2. [Quantitative autoradiography with (125I)cyanopindolol of ocular tissues].

    PubMed

    Kahle, G; Kaulen, P; Wollensak, J

    1990-01-01

    In the present study beta-adrenergic receptors were identified and localized by autoradiographic methods using [125I]cyanopindolol in human eyes, as well as in the eyes of marmosets and albino rabbits. Quantification revealed that the highest binding-site densities are in the ciliary body and the corneal epithelium and endothelium. Moreover, the iris and conjunctiva showed significant amounts of specific [125I]cyanopindolol binding. In pigmented human and marmoset eyes, binding to the ciliary epithelium and iris was not inhibited by 10 microM propranolol, thus representing nonspecific binding sites. In nonpigmented rabbit eyes, binding to all parts of the eye was reduced to the level of background by 10 microM propranolol and 100 nM ICI 118-551, which is a highly selective beta 2-adrenergic ligand. Being selective for serotonin1B receptors, 100 nM ICI 89-406 which blocks more than 95% of the beta 1-adrenergic receptors, and RU 24,969 have no effect on [125I]cyanopindolol binding, which suggests that there is binding to beta 2-adrenergic receptors. The anatomical location and quantification of beta 2-receptors in the mammalian eye may contribute to better understanding of beta 2-adrenoceptor function and the action of beta-adrenoceptor blocking agents in glaucoma therapy.

  3. Range of high LET effects from /sup 125/I decays

    SciTech Connect

    Charlton, D.E.

    1986-08-01

    Track structure techniques are applied to calculate energy depositions in cylindrical targets 20 A in diameter (simulating the DNA duplex) containing, or near, /sup 125/I decays. Two problems are examined: (1) The possible effects of incorporated versus nonincorporated /sup 125/I are evaluated; (2) the extent of the radiological damage along the DNA is described and discussed for individual decays taking place in the DNA. The results of three different calculations are presented: (1) The distribution of the total energy deposited in the target per decay: Here it is shown that the /sup 125/I decays deposit considerably more energy than 5-MeV alpha particles when the decay occurs on the central axis of the cylinder. When the decay occurs at 40 A from the axis, the energy depositions are small and infrequent, showing that the iodine decay must occur within this distance to produce a high LET-like effect. (2) The distribution of average energy depositions around a curved cylinder simulating the DNA duplex encircling the nucleosome: There is a rapid decrease in the energy deposited in elements (of size resembling a base pair) away from the location of the decay. At approximately 17 A (approximately 5 bp) from the decay the mean energy deposited in an element is reduced by a factor of 10. (3) The energy deposited in individual elements of the cylinder is presented for single decays: The smooth decrease in average energy depositions with distance from the decay ((2) above) is not reflected in individual decays.

  4. The effect of lead, gold, and silver backings on dose near 125I seeds.

    PubMed

    Meli, J A; Motakabbir, K A

    1993-01-01

    Brachytherapy for ocular melanoma uses 125I seeds backed by a gold shield. Conflicting results are reported in the literature on the effect of the gold on dose close to the seeds. In this work, a small lucite jig was constructed such that the seed-to-detector separation remained fixed as high-Z materials of lead, silver, and gold were moved in and out of position behind the seed. The jig was clamped in place in the water filled tank of a beam scanning system. The response of two p-type silicon diodes was measured at several distances from the seed with and without the high-Z backings. The response with the high-Z backing relative to water, found to be the same for each diode and the same for lead and gold, decreased from about 1.01 at 1.5 mm to about 0.92 at 20 mm. It has been suggested in the literature that L-shell fluorescent x rays of approximately 10 keV from the gold backing might contribute significantly to the dose within 7 mm of the seed. To test this, the response with the gold backing relative to water was measured with an aluminum cap of 1-mm wall thickness covering the diode. The cap transmits about 70% of the 125I influence but is essentially infinitely thick to 10-keV photons. The relative response (gold/water) was the same with and without the cap showing that the contribution of 10-keV x rays is negligible. Compared to water, the silver backing was found to enhance the diode response by about 14% between 5 to 10 mm from the seed.

  5. WE-A-17A-06: Evaluation of An Automatic Interstitial Catheter Digitization Algorithm That Reduces Treatment Planning Time and Provide Means for Adaptive Re-Planning in HDR Brachytherapy of Gynecologic Cancers

    SciTech Connect

    Dise, J; Liang, X; Lin, L; Teo, B

    2014-06-15

    Purpose: To evaluate an automatic interstitial catheter digitization algorithm that reduces treatment planning time and provide means for adaptive re-planning in HDR Brachytherapy of Gynecologic Cancers. Methods: The semi-automatic catheter digitization tool utilizes a region growing algorithm in conjunction with a spline model of the catheters. The CT images were first pre-processed to enhance the contrast between the catheters and soft tissue. Several seed locations were selected in each catheter for the region growing algorithm. The spline model of the catheters assisted in the region growing by preventing inter-catheter cross-over caused by air or metal artifacts. Source dwell positions from day one CT scans were applied to subsequent CTs and forward calculated using the automatically digitized catheter positions. This method was applied to 10 patients who had received HDR interstitial brachytherapy on an IRB approved image-guided radiation therapy protocol. The prescribed dose was 18.75 or 20 Gy delivered in 5 fractions, twice daily, over 3 consecutive days. Dosimetric comparisons were made between automatic and manual digitization on day two CTs. Results: The region growing algorithm, assisted by the spline model of the catheters, was able to digitize all catheters. The difference between automatic and manually digitized positions was 0.8±0.3 mm. The digitization time ranged from 34 minutes to 43 minutes with a mean digitization time of 37 minutes. The bulk of the time was spent on manual selection of initial seed positions and spline parameter adjustments. There was no significance difference in dosimetric parameters between the automatic and manually digitized plans. D90% to the CTV was 91.5±4.4% for the manual digitization versus 91.4±4.4% for the automatic digitization (p=0.56). Conclusion: A region growing algorithm was developed to semi-automatically digitize interstitial catheters in HDR brachytherapy using the Syed-Neblett template. This automatic

  6. Computed Tomography–Guided Interstitial High-Dose-Rate Brachytherapy in Combination With Regional Positive Lymph Node Intensity-Modulated Radiation Therapy in Locally Advanced Peripheral Non–Small Cell Lung Cancer: A Phase 1 Clinical Trial

    SciTech Connect

    Xiang, Li; Zhang, Jian-wen; Lin, Sheng; Luo, Hui-Qun; Wen, Qing-Lian; He, Li-Jia; Shang, Chang-Ling; Ren, Pei-Rong; Yang, Hong-Ru; Pang, Hao-Wen; Yang, Bo; He, Huai-Lin; Chen, Yue; Wu, Jing-Bo

    2015-08-01

    Purpose: To assess the technical safety, adverse events, and efficacy of computed tomography (CT)-guided interstitial high-dose-rate (HDR) brachytherapy in combination with regional positive lymph node intensity modulated radiation therapy in patients with locally advanced peripheral non–small cell lung cancer (NSCLC). Methods and Materials: Twenty-six patients with histologically confirmed NSCLC were enrolled in a prospective, officially approved phase 1 trial. Primary tumors were treated with HDR brachytherapy. A single 30-Gy dose was delivered to the 90% isodose line of the gross lung tumor volume. A total dose of at least 70 Gy was administered to the 95% isodose line of the planning target volume of malignant lymph nodes using 6-MV X-rays. The patients received concurrent or sequential chemotherapy. We assessed treatment efficacy, adverse events, and radiation toxicity. Results: The median follow-up time was 28 months (range, 7-44 months). There were 3 cases of mild pneumothorax but no cases of hemothorax, dyspnea, or pyothorax after the procedure. Grade 3 or 4 acute hematologic toxicity was observed in 5 patients. During follow-up, mild fibrosis around the puncture point was observed on the CT scans of 2 patients, but both patients were asymptomatic. The overall response rates (complete and partial) for the primary mass and positive lymph nodes were 100% and 92.3%, respectively. The 1-year and 2-year overall survival (OS) rates were 90.9% and 67%, respectively, with a median OS of 22.5 months. Conclusion: Our findings suggest that HDR brachytherapy is safe and feasible for peripheral locally advanced NSCLC, justifying a phase 2 clinical trial.

  7. Objective and Longitudinal Assessment of Dermatitis After Postoperative Accelerated Partial Breast Irradiation Using High-Dose-Rate Interstitial Brachytherapy in Patients With Breast Cancer Treated With Breast Conserving Therapy: Reduction of Moisture Deterioration by APBI

    SciTech Connect

    Tanaka, Eiichi; Yamazaki, Hideya; Yoshida, Ken; Takenaka, Tadashi; Masuda, Norikazu; Kotsuma, Tadayuki; Yoshioka, Yasuo; Inoue, Takehiro

    2011-11-15

    Purpose: To objectively evaluate the radiation dermatitis caused by accelerated partial breast irradiation (APBI) using high-dose-rate interstitial brachytherapy. Patients and Methods: The skin color and moisture changes were examined using a newly installed spectrophotometer and corneometer in 22 patients who had undergone APBI using open cavity implant high-dose-rate interstitial brachytherapy (36 Gy in six fractions) and compared with the corresponding values for 44 patients in an external beam radiotherapy (EBRT) control group (50-60 Gy in 25-30 fractions within 5-6 weeks) after breast conserving surgery. Results: All values changed significantly as a result of APBI. The extent of elevation in a Asterisk-Operator (reddish) and reduction in L Asterisk-Operator (black) values caused by APBI were similar to those for EBRT, with slightly delayed recovery for 6-12 months after treatment owing to the surgical procedure. In contrast, only APBI caused a change in the b Asterisk-Operator values, and EBRT did not, demonstrating that the reduction in b Asterisk-Operator values (yellowish) depends largely on the surgical procedure. The changes in moisture were less severe after APBI than after EBRT, and the recovery was more rapid. The toxicity assessment using the Common Toxicity Criteria, version 3, showed that all dermatitis caused by APBI was Grade 2 or less. Conclusion: An objective analysis can quantify the effects of APBI procedures on color and moisture cosmesis. The radiation dermatitis caused by APBI using the present schedule showed an equivalent effect on skin color and a less severe effect on moisture than the effects caused by standard EBRT.

  8. In Vivo Dosimetry of High-Dose-Rate Interstitial Brachytherapy in the Pelvic Region: Use of a Radiophotoluminescence Glass Dosimeter for Measurement of 1004 Points in 66 Patients With Pelvic Malignancy

    SciTech Connect

    Nose, Takayuki Koizumi, Masahiko; Yoshida, Ken; Nishiyama, Kinji; Sasaki, Junichi; Ohnishi, Takeshi; Kozuka, Takuyo; Gomi, Kotaro; Oguchi, Masahiko; Sumida, Iori; Takahashi, Yutaka; Ito, Akira; Yamashita, Takashi

    2008-02-01

    Purpose: To perform the largest in vivo dosimetry study for interstitial brachytherapy yet to be undertaken using a new radiophotoluminescence glass dosimeter (RPLGD) in patients with pelvic malignancy and to study the limits of contemporary planning software based on the results. Patients and Methods: Sixty-six patients with pelvic malignancy were treated with high-dose-rate interstitial brachytherapy, including prostate (n = 26), gynecological (n = 35), and miscellaneous (n = 5). Doses for a total of 1004 points were measured by RPLGDs and calculated with planning software in the following locations: rectum (n = 549), urethra (n = 415), vagina (n = 25), and perineum (n = 15). Compatibility (measured dose/calculated dose) was analyzed according to dosimeter location. Results: The compatibility for all dosimeters was 0.98 {+-} 0.23, stratified by location: rectum, 0.99 {+-} 0.20; urethra, 0.96 {+-} 0.26; vagina, 0.91 {+-} 0.08; and perineum, 1.25 {+-} 0.32. Conclusions: Deviations between measured and calculated doses for the rectum and urethra were greater than 20%, which is attributable to the independent movements of these organs and the applicators. Missing corrections for inhomogeneity are responsible for the 9% negative shift near the vaginal cylinder (specific gravity = 1.24), whereas neglect of transit dose contributes to the 25% positive shift in the perineal dose. Dose deviation of >20% for nontarget organs should be taken into account in the planning process. Further development of planning software and a real-time dosimetry system are necessary to use the current findings and to achieve adaptive dose delivery.

  9. Practical application of /sup 125/I-fibrinogen leg scanning

    SciTech Connect

    Hull, R.D.; Hirsh, J.

    1981-07-01

    The diagnosis of venous thrombosis by radioiodine-labeled fibrinogen scanning depends upon the incorporation of circulating labeled fibrinogen into a developing or established thrombus which is then detected by measuring the increase of overlying surface radioactivity with an isotope detector. The scanning procedure is simple and rapid, and one technician can screen 15 to 20 patients daily. A single intravenous injection of 100 ..mu..Ci of /sup 125/I-fibrinogen enables scanning to be performed for approximately 7 days. leg scanning has been a valuable research tool and is also useful for the clinical management of patients with venous thrombosis. Its limitations are its insensitivity to iliac vein thrombosis and relative insensitivity to thrombi in the upper thigh, and when used diagnostically in patients with clinically suspected venous thrombosis there is a delay of up to 2 days before a positive result is obtained. For these reasons leg scanning should not be used alone in patients with clinically suspected venous thrombosis. The practical indications for using /sup 125/I-fibrinogen leg scanning are (1) for diagnosis of clinically suspected venous thrombosis when used in combination with impedance plethysmography; (2) detection of acute venous thrombosis in patients with chronic venous insufficiency; (3) screening patients who develop calf vein thrombosis when there is contraindication to anticoagulant therapy; and (4) screening certain high-risk patients and patient groups in whom the prophylaxis is either contraindicated or ineffective.

  10. Approaches to sequence analysis of 125I-labeled RNA.

    PubMed Central

    Dickson, E; Pape, L K; Robertson, H D

    1979-01-01

    A method is described for the initial steps of sequence analysis of RNase T1-and pancreatic RN-ase-resistant oligonucleotides of RNA containing cytidylate residues labeled in vitro with 125I. In many cases an oligonucleotide sequence can be deduced from a consideration of (i) its relative position in the two-dimensional fingerprint (with DEAE thin layer homochromatographic second dimension), (ii) its electrophoretic mobility on DEAE paper at pH 1.9, and (iii) identification of its products of further enzymatic digestion by comparison with a set of marker oligonucleotides. Additional methods including analysis of oligonucleotides following chemical blocking of uridylate residues with CMCT and analysis of products of incomplete enzymatic digestion are also discussed. Images PMID:106369

  11. {sup 125}I Measurements for Occupational Exposure Assessment

    SciTech Connect

    Silva, L.; Pinhao, N. R.

    2008-08-14

    Whenever there is a risk of occupational exposure to dispersible radioactive material, it is necessary to have a monitoring program to assess the effective dose arising from the intake of radionuclides by workers. In this paper we present our experience in bioassay measurements of {sup 125}I in urine samples of workers using high resolution gamma spectrometry. For a 24-hour excretion period, we found activity values of the order of one Bq and estimated the committed effective doses to be less than one {mu}Sv. Although very small, these values led to a re-evaluation and improvement of the laboratory safety conditions. We discuss the calibration procedure followed for the activity measurements, the estimation of the uncertainty in the excreted activity, the calculation of detection and quantification limits and estimation of performance indicators. Aspects regarding the spectral analysis, true coincidence summing and matrix effects are also considered.

  12. /sup 125/I iothalamate an ideal marker for glomerular filtration

    SciTech Connect

    Odlind, B.; Haellgren, R.S.; Sohtell, M.; Lindstroem, B.

    1985-01-01

    The triiodinated angiographic contrast medium, iothalamate (usually labelled /sup 125/I), has been used extensively as a marker for glomerular filtration. The authors have studied the renal handling of /sup 125/I iothalamate (IOT) in vivo and in vitro in several species. In renal cortical slices from chicken, rabbit, rat, and monkey, the tissue-to-medium ratio of IOT was twice that of /sup 51/Cr-EDTA (EDTA) at 37 degrees C; a difference that was abolished at 0 degree C and markedly reduced by added o-iodohippurate or iodipamide. In five chickens the steady-state renal clearance of IOT (CIOT) was twice that of EDTA (CEDTA) or /sup 3/H inulin (C1); a difference that was abolished by administration of 100 mg/kg/hr of novobiocin, an organic anion transport inhibitor. CEDTA was similar to C1 before as well as after transport inhibition. Utilizing the Sperber technique the mean apparent tubular excretion fraction (ATEF) of IOT was 8%, while that of EDTA was 1%. After novobiocin coinfusion (new steady-state) ATEFIOT was significantly reduced and not different from that of EDTA (-1%). In the same animals the total urinary recovery of IOT was 84 and 57% before and after novobiocin, respectively, while corresponding values for EDTA was unchanged by the inhibitor. In seven rats the renal extraction of IOT was reduced from 29 to 17% by coinfusion of probenecid (5 mg/kg/hr). Corresponding extractions were 82 to 34% and 22% (unchanged) for PAH and EDTA, respectively.

  13. American Brachytherapy Society (ABS) recommendations for transperineal permanent brachytherapy of prostate cancer.

    PubMed

    Nag, S; Beyer, D; Friedland, J; Grimm, P; Nath, R

    1999-07-01

    To develop and disseminate the American Brachytherapy Society (ABS) recommendations for the clinical quality assurance and guidelines of permanent transperineal prostate brachytherapy with 125I or 103Pd. The ABS formed a committee of experts in prostate brachytherapy to develop consensus guidelines through a critical analysis of published data supplemented by their clinical experience. The recommendations of the panels were reviewed and approved by the Board of Directors of the ABS. Patients with high probability of organ-confined disease are appropriately treated with brachytherapy alone. Brachytherapy candidates with a significant risk of extraprostatic extension should be treated with supplemental external beam radiation therapy (EBRT). Patient selection guidelines were developed. Dosimetric planning of the implant should be carried out for all patients before seed insertion. A modified peripheral loading is preferred. The AAPM TG-43 recommendations requiring a change in prescription dose for 125I sources should be universally implemented. The recommended prescription doses for monotherapy are 145 Gy for 125I and 115-120 Gy for 103Pd. The corresponding boost doses (after 40-50 Gy EBRT) are 100-110 Gy and 80-90 Gy, respectively. Clinical evidence to guide selection of radionuclide (103Pd or 125I) is lacking. Post implant dosimetry and evaluation must be performed on all patients. It is suggested that the dose that covers 90% (D90) and 100% (D100) of the prostate volume and the percentage of the prostate volume receiving the prescribed dose (V100) be obtained from a dose-volume histogram (DVH) and reported. Guidelines for appropriate patient selection, dose reporting, and improved quality of permanent prostate brachytherapy are presented. These broad recommendations are intended to be technical and advisory in nature, but the ultimate responsibility for the medical decisions rests with the treating physician. This is a constantly evolving field, and the

  14. Brachytherapy for prostate cancer: summary of American Brachytherapy Society recommendations.

    PubMed

    Nag, S

    2000-05-01

    This article summarizes recent American Brachytherapy Society (ABS) recommendations for permanent prostate brachytherapy. The ABS recommends treating patients with high probability of organ-confined disease with brachytherapy alone. Brachytherapy candidates with a significant risk of extraprostatic extension should be treated with supplemental external beam radiation therapy (EBRT). The recommended prescription doses for monotherapy are 145 Gy for (125)I and 125 Gy for (103)Pd. The corresponding boost doses (after 40 to 50 Gy EBRT) are 110 Gy and 100 Gy, respectively. The ABS recommends that post-implant dosimetry should be performed on all patients undergoing permanent prostate brachytherapy for optimal patient care. A dose-volume histogram (DVH) of the prostate should be performed and the D(90) (dose to 90% of the prostate gland) reported by all centers. Additionally, the D(80) D(100), the fractional V(80), V(90), V(100), V(150), V(200) (ie, the percentage of prostate volume receiving 80%, 90%, 100%, 150%, and 200% of the prescribed dose, respectively), the rectal and urethral doses should be reported and ultimately correlated with clinical outcome in the research environment. On-line, real-time dosimetry, the effects of dose heterogeneity, and the effects of tissue heterogeneity need further investigation.

  15. Binding and internalization in vivo of (/sup 125/I)hCG in Leydig cells of the rat

    SciTech Connect

    Hermo, L.; Lalli, M.

    1988-01-01

    The present study was performed to demonstrate the binding, mode of uptake, pathway and fate of iodinated human chorionic gonadotropin ((/sup 125/I)hCG) by Leydig cells in vivo using electron microscope radioautography. Following a single injection of (/sup 125/I)hCG into the interstitial space of the testis, the animals were fixed by perfusion with glutaraldehyde at 20 minutes, 1, 3, 6 and 24 hours. The electron microscope radioautographs demonstrated a prominent and qualitatively similar binding of the labeled hCG on the microvillar processes of the Leydig cells at 20 minutes, 1, 3, and 6 hours. The specificity of the (/sup 125/I)hCG binding was determined by injecting a 100-fold excess of unlabeled hormone concurrently with the labeled hormone. Under these conditions, the surface, including the microvillar processes of Leydig cells, was virtually unlabeled, indicating that the binding was specific and receptor-mediated. In animals injected with labeled hCG and sacrificed 20 minutes later, silver grains were also seen overlying the limiting membrane of large, uncoated surface invaginations and large subsurface vacuoles with an electron-lucent content referred to as endosomes. A radioautographic reaction was also seen within multivesicular bodies with a pale stained matrix. At 1 hour, silver grains appeared over dense multivesicular bodies and occasionally over secondary lysosomes, in addition to the structures mentioned above, while at 3 and 6 hours, an increasing number of secondary lysosomes became labeled. At 24 hours, binding of (/sup 125/I)hCG to the microvillar processes of Leydig cells persisted but was diminished, although a few endosomes, multivesicular bodies and secondary lysosomes still showed a radioautographic reaction. No membranous tubules that were seen in close proximity to, or in continuity with, endosomes and multivesicular bodies were observed to be labeled at any time interval.

  16. SU-E-T-55: Biological Equivalent Dose (BED) Comparison Between Permanent Interstitial Brachytherapy and Conventional External Beam Radiotherapy for Prostate Cancer

    SciTech Connect

    Liu, X; Rahimian, J; Cosmatos, H; Goy, B; Heywood, C; Qian, Y

    2014-06-01

    Purpose: The goal of this research is to calculate and compare the Biological Equivalent Dose (BED) between permanent prostate Iodine-125 implant brachytherapy as monotherapy with the BED of conventional external beam radiation therapy (EBRT). Methods: A retrospective study of 605 patients treated with Iodine-125 seed implant was performed in which physician A treated 274 patients and physician B treated 331 patients. All the Brachytherapy treatment plans were created using VariSeed 8 planning system. The Iodine-125 seed source activities and loading patterns varied slightly between the two physicians. The prescription dose is 145 Gy to PTV for each patient. The BED and Tumor Control Probability (TCP) were calculated based on the TG 137 formulas. The BED for conventional EBRT of the prostate given in our institution in 2Gy per fraction for 38 fractions was calculated and compared. Results: Physician A treated 274 patients with an average BED of 123.92±0.87 Gy and an average TCP of 99.20%; Physician B treated 331 patients with an average BED of 124.87±1.12 Gy and an average TCP of 99.30%. There are no statistically significant differences (T-Test) between the BED and TCP values calculated for these two group patients.The BED of the patients undergoing conventional EBRT is calculated to be 126.92Gy. The BED of the patients treated with permanent implant brachytherapy and EBRT are comparable. Our BED and TCP values are higher than the reported values by TG 137 due to higher Iodine-125 seed activity used in our institution. Conclusion: We calculated the BED,a surrogate of the biological response to a permanent prostate brachytherapy using TG 137 formulas and recommendation. The TCP of better than 99% is calculated for these patients. A clinical outcome study of these patients correlating the BED and TCP values with PSA and Gleason Levels as well as patient survival is warranted.

  17. Retrospective Analysis of Local Control and Cosmetic Outcome of 147 Periorificial Carcinomas of the Face Treated With Low-Dose Rate Interstitial Brachytherapy

    SciTech Connect

    Ducassou, Anne; David, Isabelle; Filleron, Thomas; Rives, Michel; Bonnet, Jacques; Delannes, Martine

    2011-11-01

    Purpose: Skin cancer is the most common malignancy in white populations. We evaluated the local cure rate and cosmetic outcome of patients with basal cell carcinoma (BCC) or squamous cell carcinoma (SCC) of the face treated with low-dose rate brachytherapy. Methods and Materials: Between February 1990 and May 2000, 147 facial carcinomas in 132 patients were treated by {sup 192}Ir wire implantation. Side effects of brachytherapy were noted. Follow-up was 2 years or more. Locoregional recurrence-free survival (LRFS) and overall survival were recorded. Group A included patients treated by primary brachytherapy, and Group B included those treated after recurrence. Results: A total of 121 carcinomas were BCCs (82.3%) and 26 were SCCs (17.7%); the median tumor size was 10 mm. Of the tumors, 86 (58.5%) were in men and 61 (41.5%) were in women; the median age was 71 years. Group A comprised 116 lesions (78.9%), and Group B, 31 (21.1%). There were 17 relapses (11.6%) after a median follow-up of 72 months: 12 local, 4 nodal, and 1 local and nodal. Locoregional-free survival was 96.6% at 2 years and 87.3% at 5 years. Five-year LRFS was 82.6% in men and 93.3% in women (p = 0.027). After adjustment for gender, LRFS was better after primary treatment than after recurrence (hasard ratio HR, 2.91; 95% confidence interval, 1.06-8.03; p = 0.039). Five-year LRFS was 90.4% for BCC and 70.8% for SCC (p = 0.03). There were no Grade 3 complications. Conclusions: Low-dose rate brachytherapy offers good local control and cosmetic outcome in patients with periorificial skin carcinomas, with no Grade 3 complications. Brchytherapy is more efficient when used as primary treatment.

  18. Clinical Study on Using (125)I Seeds Articles Combined with Biliary Stent Implantation in the Treatment of Malignant Obstructive Jaundice.

    PubMed

    Wang, Tao; Liu, Sheng; Zheng, Yan-Bo; Song, Xue-Peng; Sun, Bo-Lin; Jiang, Wen-Jin; Wang, Li-Gang

    2017-08-01

    Aim: To study the feasibility and curative effect of(125)I seeds articles combined with biliary stent implantation in the treatment of malignant obstructive jaundice. Patients and Methods: Fifty patients with malignant obstructive jaundice were included. Twenty-four were treated by biliary stent implantation combined with intraluminal brachytherapy by (125)I seeds articles as the experimental group, while the remaining 26 were treated by biliary stent implantation only as the control group. The goal of this study was to evaluate total bilirubin, direct bilirubin and tumor markers (cancer antigen (CA)-199, CA-242 and carcinoembryonic antigen (CEA)), as well as biliary stent patency status and survival time before and after surgery. Results: Jaundice improved greatly in both groups. The decreases of CA-199 and CA-242 had statistical significance (p=0.003 and p=0.004) in the experimental group. The ratio of biliary stent patency was 83.3% (20/24) in the experimental group and 57.7% (15/26) in the control group (p=0.048). The biliary stent patency time in the experimental group was 1~15.5 (mean=9.84) months. The biliary stent patency time in the control group was 0.8~9 (mean=5.57) months, which was statistically significant (p=0.018). The median survival time was 10.2 months in the experimental group, while 5.4 months in control group (p<0.05). Conclusion:(125)I seeds articles combined with biliary stent implantation significantly prolongs biliary stent patency time and survival time for patients with malignant obstructive jaundice possibly by inhibiting the proliferation of vascular endothelial cells and the growth of tumor. Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

  19. Metabolism and placental transfer of /sup 125/I-proinsulin and /sup 125/I-tyrosylated C-peptide in the pregnant rhesus monkey

    SciTech Connect

    Gruppuso, P.A.; Susa, J.B.; Sehgal, P.; Frank, B.; Schwartz, R.

    1987-10-01

    /sup 125/I-Proinsulin or /sup 125/I-tyrosylated-C-peptide (/sup 125/I-tyr-CP) was administered to pregnant Rhesus monkeys by bolus followed by constant infusion to examine placental transfer of these peptides. At the end of each infusion, fetuses were exsanguinated in situ via the umbilical vein. The bolus-constant infusion technique produced a steady state in maternal plasma of immunoprecipitable label, measured using excess insulin or C-peptide antiserum. In animals infused with /sup 125/I-proinsulin, analysis of umbilical venous plasma revealed no apparent transfer to the fetus of immunoprecipitable label. In animals infused with /sup 125/I-tyr-CP, 3-13% of the umbilical venous plasma radioactivity was immunoprecipitable, representing 1.4-5.8% of the immunoprecipitable radioactivity in maternal plasma at delivery. Gel filtration chromatography of umbilical venous plasma revealed that the immunoprecipitated moiety was a fragment of /sup 125/I-tyr-CP. Analysis of maternal plasma showed that the predominant peak of radioactivity represented intact C-peptide. A peak corresponding to the fetal immunoprecipitable peak was also present. Analysis of simultaneous maternal arterial and uterine vein plasma samples showed that degradation of /sup 125/I-tyr-CP occurred across the uterus. Studies in one nonpregnant and three postpartum animals indicated that pregnancy increased the rate of metabolism of /sup 125/I-tyr-CP. When /sup 125/I-tyr-CP was incubated with trophoblastic cells in culture, degradation to a species corresponding on gel filtration to the immunoprecipitable fetal metabolite was found. We conclude that proinsulin, like insulin, does not traverse the placenta. Immunoreactive fragments of C-peptide do cross, however, and pregnancy alters the metabolism of /sup 125/I-tyr-CP, probably owing to placental degradation.

  20. Metabolism and placental transfer of 125I-proinsulin and 125I-tyrosylated C-peptide in the pregnant rhesus monkey.

    PubMed Central

    Gruppuso, P A; Susa, J B; Sehgal, P; Frank, B; Schwartz, R

    1987-01-01

    125I-Proinsulin or 125I-tyrosylated-C-peptide (125I-tyr-CP) was administered to pregnant Rhesus monkeys by bolus followed by constant infusion to examine placental transfer of these peptides. At the end of each infusion, fetuses were exsanguinated in situ via the umbilical vein. The bolus-constant infusion technique produced a steady state in maternal plasma of immunoprecipitable label, measured using excess insulin or C-peptide antiserum. In animals infused with 125I-proinsulin, analysis of umbilical venous plasma revealed no apparent transfer to the fetus of immunoprecipitable label. In animals infused with 125I-tyr-CP, 3-13% of the umbilical venous plasma radioactivity was immunoprecipitable, representing 1.4-5.8% of the immunoprecipitable radioactivity in maternal plasma at delivery. Gel filtration chromatography of umbilical venous plasma revealed that the immunoprecipitated moiety was a fragment of 125I-tyr-CP. Analysis of maternal plasma showed that the predominant peak of radioactivity represented intact C-peptide. A peak corresponding to the fetal immunoprecipitable peak was also present. Analysis of simultaneous maternal arterial and uterine vein plasma samples showed that degradation of 125I-tyr-CP occurred across the uterus. Studies in one nonpregnant and three postpartum animals indicated that pregnancy increased the rate of metabolism of 125I-tyr-CP. When 125I-tyr-CP was incubated with trophoblastic cells in culture, degradation to a species corresponding on gel filtration to the immunoprecipitable fetal metabolite was found. We conclude that proinsulin, like insulin, does not traverse the placenta. Immunoreactive fragments of C-peptide do cross, however, and pregnancy alters the metabolism of 125I-tyr-CP, probably owing to placental degradation. PMID:3654973

  1. Microbial contamination detection at low levels by [125]I radiolabeling

    NASA Astrophysics Data System (ADS)

    Summers, David; Karouia, Fathi

    Contamination of mission spacecraft is an ongoing issue. A broad diversity of microorganisms have been detected in clean rooms where spacecraft are assembled. Some of which, depicted as oligotroph, are of special regard, as they are capable of colonizing inorganic surfaces like metal, and have been shown to be a concern for forward contamination of pristine celestial bodies. Currently, the NASA standard assay is the only approved assay intended for the enumeration of spores and heterotrophic microbial populations. However, culture-based microbial detection methods underestimate the viable microbial population. More recently, adenosine triphosphate (ATP) bioluminescence and limulus amebocyte lysate (LAL) assays, which employ measure-ments of selected metabolic products as a proxy of biomass, have been used successfully to circumvent the necessity of the growth of microorganisms in order to estimate the biodurdens associated with spacecraft assembly facility. However, these methods have limitation in the amount of cells that can be detected, i.e., 103 cells, and the type of microorganisms respec-tively. This work seeks to develop a new highly sensitive method for the determination of bioburdens (and the detection of microorganisms and life) that is independant of the type of organism while preserving a good turn-around time for analysis for planetary protection purposes. The assay is based on the detection of the organism's protein by labeling them by radioiodination, 125 I, of aromatic rings on tyrosine amino acids residues. Radiolabeling techniques are inherently sensitive and 125 I, in particular, benefits from a 60 day half-life, providing greater activity and signal per unit number of labels. Furthermore, microorganisms can contain over 50% of protein by dry weight. Thus, just one label per protein increases the sensitivity, compared to the ATP and LAL assays, by one and three orders of magnitude by using standard detection methods and the use of multiphoton

  2. The use of new GAFCHROMIC EBT film for {sup 125}I seed dosimetry in Solid Water phantom

    SciTech Connect

    Chiu-Tsao, Sou-Tung; Medich, David; Munro, John III

    2008-08-15

    Radiochromic film dosimetry has been extensively used for intravascular brachytherapy applications for near field within 1 cm from the sources. With the recent introduction of new model of radiochromic films, GAFCHROMIC EBT, with higher sensitivity than earlier models, it is promising to extend the distances out to 5 cm for low dose rate (LDR) source dosimetry. In this study, the use of new model GAFCHROMIC EBT film for {sup 125}I seed dosimetry in Solid Water was evaluated for radial distances from 0.06 cm out to 5 cm. A multiple film technique was employed for four {sup 125}I seeds (Implant Sciences model 3500) with NIST traceable air kerma strengths. Each experimental film was positioned in contact with a {sup 125}I seed in a Solid Water phantom. The products of the air kerma strength and exposure time ranged from 8 to 3158 U-h, with the initial air kerma strength of 6 U in a series of 25 experiments. A set of 25 calibration films each was sequentially exposed to one {sup 125}I seed at about 0.58 cm distance for doses from 0.1 to 33 Gy. A CCD camera based microdensitometer, with interchangeable green (520 nm) and red (665 nm) light boxes, was used to scan all the films with 0.2 mm pixel resolution. The dose to each {sup 125}I calibration film center was calculated using the air kerma strength of the seed (incorporating decay), exposure time, distance from seed center to film center, and TG43U1S1 recommended dosimetric parameters. Based on the established calibration curve, dose conversion from net optical density was achieved for each light source. The dose rate constant was determined as 0.991 cGy U{sup -1} h{sup -1} ({+-}6.9%) and 1.014 cGy U{sup -1} h{sup -1} ({+-}6.8%) from films scanned using green and red light sources, respectively. The difference between these two values was within the uncertainty of the measurement. Radial dose function and 2D anisotropy function were also determined. The results obtained using the two light sources corroborated each

  3. A modern Monte Carlo investigation of the TG-43 dosimetry parameters for an 125I seed already having AAPM consensus data.

    PubMed

    Aryal, Prakash; Molloy, Janelle A; Rivard, Mark J

    2014-02-01

    To investigate potential causes for differences in TG-43 brachytherapy dosimetry parameters in the existent literature for the model IAI-125A(125)I seed and to propose new standard dosimetry parameters. The MCNP5 code was used for Monte Carlo (MC) simulations. Sensitivity of dose distributions, and subsequently TG-43 dosimetry parameters, was explored to reproduce historical methods upon which American Association of Physicists in Medicine (AAPM) consensus data are based. Twelve simulation conditions varying(125)I coating thickness, coating mass density, photon interaction cross-section library, and photon emission spectrum were examined. Varying(125)I coating thickness, coating mass density, photon cross-section library, and photon emission spectrum for the model IAI-125A seed changed the dose-rate constant by up to 0.9%, about 1%, about 3%, and 3%, respectively, in comparison to the proposed standard value of 0.922 cGy h(-1) U(-1). The dose-rate constant values by Solberg et al. ["Dosimetric parameters of three new solid core (125)I brachytherapy sources," J. Appl. Clin. Med. Phys. 3, 119-134 (2002)], Meigooni et al. ["Experimental and theoretical determination of dosimetric characteristics of IsoAid ADVANTAGE™ (125)I brachytherapy source," Med. Phys. 29, 2152-2158 (2002)], and Taylor and Rogers ["An EGSnrc Monte Carlo-calculated database of TG-43 parameters," Med. Phys. 35, 4228-4241 (2008)] for the model IAI-125A seed and Kennedy et al. ["Experimental and Monte Carlo determination of the TG-43 dosimetric parameters for the model 9011 THINSeed™ brachytherapy source," Med. Phys. 37, 1681-1688 (2010)] for the model 6711 seed were +4.3% (0.962 cGy h(-1) U(-1)), +6.2% (0.98 cGy h(-1) U(-1)), +0.3% (0.925 cGy h(-1) U(-1)), and -0.2% (0.921 cGy h(-1) U(-1)), respectively, in comparison to the proposed standard value. Differences in the radial dose functions between the current study and both Solberg et al. and Meigooni et al. were <10% for r ≤ 5 cm, and

  4. Whole-Pelvis Radiotherapy in Combination With Interstitial Brachytherapy: Does Coverage of the Pelvic Lymph Nodes Improve Treatment Outcome in High-Risk Prostate Cancer?

    SciTech Connect

    Bittner, Nathan; Wallner, Kent E.; Butler, Wayne M.; Galbreath, Robert; Adamovich, Edward

    2010-03-15

    Purpose: To compare biochemical progression-free survival (bPFS), cause-specific survival (CSS), and overall survival (OS) rates among high-risk prostate cancer patients treated with brachytherapy and supplemental external beam radiation (EBRT) using either a mini-pelvis (MP) or a whole-pelvis (WP) field. Methods and Materials: From May 1995 to October 2005, 186 high-risk prostate cancer patients were treated with brachytherapy and EBRT with or without androgen-deprivation therapy (ADT). High-risk prostate cancer was defined as a Gleason score of >=8 and/or a prostate-specific antigen (PSA) concentration of >=20 ng/ml. Results: With a median follow-up of 6.7 years, the 10-year bPFS, CSS, and OS rates for the WP vs. the MP arms were 91.7% vs. 84.4% (p = 0.126), 95.5% vs. 92.6% (p = 0.515), and 79.5% vs. 67.1% (p = 0.721), respectively. Among those patients who received ADT, the 10-year bPFS, CSS, and OS rates for the WP vs. the MP arms were 93.6% vs. 90.1% (p = 0.413), 94.2% vs. 96.0% (p = 0.927), and 73.7% vs. 70.2% (p = 0.030), respectively. Among those patients who did not receive ADT, the 10-year bPFS, CSS, and OS rates for the WP vs. the MP arms were 82.4% vs. 75.0% (p = 0.639), 100% vs. 88% (p = 0.198), and 87.5% vs. 58.8% (p = 0.030), respectively. Based on multivariate analysis, none of the evaluated parameters predicted for CSS, while bPFS was best predicted by ADT and percent positive biopsy results. OS was best predicted by age and percent positive biopsy results. Conclusions: For high-risk prostate cancer patients receiving brachytherapy, there is a nonsignificant trend toward improved bPFS, CSS, and OS rates when brachytherapy is given with WPRT. This trend is most apparent among ADT-naive patients, for whom a significant improvement in OS was observed.

  5. [The radiosensitization of nimotuzumab on CAL-27 cells after (125)I seeds irradiation].

    PubMed

    Wang, Xing; Gu, Jian-Min; Meng, Jian; Shao, Cui-Ling

    2016-08-01

    To observe the inhibitory effect of nimotuzumab combined with low-dose continuous irradiation using (125)I seeds on CAL-27 cells originating from human tongue squamous carcinoma, and explore the radiosensitization of nimotuzumab on human tongue squamous carcinoma CAL-27 irradiated with (125)I seeds. The exponential-phase CAL-27 cells were randomly divided into 4 groups: control group, (125)I seeds irradiation group, nimotuzumab group, nimotuzumab plus (125)I seeds irradiation group. CCK-8 assay was used to detect the inhibitory effect of (125)I seeds irradiation on CAL-27 cancer cells, and flow cytometry assays were performed to calculate the apoptosis rate of cells and cell cycle from each group. The morphology of cells was compared using Hoechst 33258 staining. The data were analyzed with SPSS17.0 software package. (125)I seeds inhibited the growth of CAL-27 cells in time-dose dependent manner. The apoptosis rate of cells irradiated by nimotuzumab combined with (125)I seeds irradiation was higher than that treated with nimotuzumab and (125)I seeds irradiation respectively, and nimotuzumab followed by radiation had a lower S phase cells(P<0.05). Nimotuzumab combined with (125)I seeds irradiation killed CAL-27 cells by inducing apoptosis. Nimotuzumab and low-dose γ ray emitted from 125I seeds can significantly enhance the radiosensitivity of CAL-27.

  6. [Application of (125)I seeds combined with biliary stent implantation in the treatment of malignant obstructive jaundice].

    PubMed

    Wang, T; Liu, S; Zheng, Y B; Song, X P; Jiang, W J; Sun, B L; Wang, L G

    2016-03-23

    To study the feasibility and therapeutic effect of the application of (125)I seeds combined with biliary stent implantation on the treatment of malignant obstructive jaundice. Fifty patients with malignant obstructive jaundice treated from September 2010 to February 2013 in Yantai Yuhuangding Hospital were included in this study. Among them, 24 patients received biliary stent implantation combined with (125)I seeds intraluminal brachytherapy as experimental group, and 26 were treated by biliary stent implantation as control group.The total bilirubin, direct bilirubin and tumor markers (CA-199, CA-242, CEA) before and after surgery, the biliary stent patency status was assessed, and the survival time was evaluated. The 24 patients in experimental group were implanted with 30 (125)I seeds successfully in a total of 450 seeds. Jaundice was improved greatly in both groups. The CA-199 and CA-242 after treatment in the experimental group were significantly decreased than that before treatment (P=0.003 and P=0.004). CEA was also decreased, but showed no statistical significance (P>0.05). There were no significant improvement comparing the CA-199, CA-242 and CEA before and 2 months after surgery in the control group (P>0.05). The rate of biliary stent patency was 83.3% (20/24) in the experimental group and 57.7% (15/26) in the control group (P=0.048). The mean biliary stent patency time in the experimental group was 9.84 months (range 1-15.5 months). The mean biliary stent patency time in the control group was 5.57 months (range 0.8-9 months). There was a significant difference between the two groups (P=0.018). The median survival time was 10.2 months in the experimental group and 5.4 months in the control group (P<0.05). (125)I seeds combined with biliary stent implantation can inhibit the proliferation of vascular endothelial cells and the growth of tumor effectively, and can prolong the biliary stent patency time and the survival time obviously for patients with

  7. Current status and perspectives of brachytherapy for breast cancer.

    PubMed

    Polgár, Csaba; Major, Tibor

    2009-02-01

    Before the era of breast-conserving therapy, brachytherapy implants were used to treat large inoperable breast tumors. In later years, interstitial brachytherapy with rigid needles or multiple flexible catheters has been used to deliver an additional (boost) dose to the tumor bed after breast-conserving surgery and whole-breast irradiation. Reexcision followed by reirradiation using interstitial breast implants has also been implemented as an alternative to mastectomy to treat ipsilateral breast local recurrence after previous breast-conserving therapy. In the past two decades, the new concept of accelerated partial breast irradiation opened a new perspective for breast brachytherapy. The first technique utilized in early accelerated partial breast irradiation studies was multicatheter interstitial brachytherapy. Beyond classical interstitial brachytherapy, recently, new intracavitary applicators have been developed in the United States to decrease the existing barriers against the widespread use of multicatheter brachytherapy. Furthermore, interstitial low-dose-rate seed implants have also been implemented as an alternative for stepping-source multicatheter brachytherapy. In this article, we give an overview of the past achievements, current status, and future perspectives of breast brachytherapy.

  8. Interaction of cultured mammalian cells with [125I] diphtheria toxin.

    PubMed Central

    Bonventre, P F; Saelinger, C B; Ivins, B; Woscinski, C; Amorini, M

    1975-01-01

    The characteristics of cell adsorption and pinocytotic uptake of diphtheria toxin by several mammalian cell types were studied. Purified toxin iodinated by a solid-state lactoperoxidase method provided preparations of high specific activity and unaltered biological activity. Dephtheria toxin-sensitive HEp-2 cells and guinea pig macrophage cultures were compared with resistant mouse L-929 cells. At 37 C the resistant cells in monolayer adsorbed and internalized [125I] toxin to a greater extent than did the HEp-2 cell cultures; no significant differences were observed at 5 C. Ammonium chloride protection levels did not alter uptake of toxin by either L-929 OR HEp-2 cells. Biological activity of the iodinated toxin, however, was negated provided the presence of ammonium chloride was maintained. The ammonium salt appears to maintain toxin in a state amenable to antitoxin neutralization. Guinea pig macrophages internalized iodinated toxin to a level 10 times greater than the established cell lines. In spite of the increased uptake of toxin by the endocytic cells, ammonium chloride prevented expression of toxicity. In an artificial system, toxin adsorbed to polystyrene latex spheres and internalized by guinea pig macrophages during phagocytosis did express biological activity. Ammonium chloride afforded some but not total protection against toxin present in the phagocytic vacuoles. The data suggest that two mechanisms of toxin uptake by susceptible cells may be operative. Toxin taken into the cell by a pinocytotic process probably is not ordinarily of physiological significance since it is usually degraded by lysosomal enzymes before it can reach cytoplasmic constituents on which it acts. When large quantities of toxin are pinocytized, toxicity may be expressed before enzymatic degradation is complete. A more specific uptake involving direct passage of the toxin through the plasma membrane may be the mechanism leading to cell death in the majority of instances. PMID

  9. Synthesis of [{sup 125}I]iodoDPA-713: A new probe for imaging inflammation

    SciTech Connect

    Wang, Haofan; Pullambhatla, Mrudula; Guilarte, Tomas R.; Mease, Ronnie C.; Pomper, Martin G.

    2009-11-06

    [{sup 125}I]IodoDPA-713 [{sup 125}I]1, which targets the translocator protein (TSPO, 18 kDa), was synthesized in seven steps from methyl-4-methoxybenzoate as a tool for quantification of inflammation in preclinical models. Preliminary in vitro autoradiography and in vivo small animal imaging were performed using [{sup 125}I]1 in a neurotoxicant-treated rat and in a murine model of lung inflammation, respectively. The radiochemical yield of [{sup 125}I]1 was 44 {+-} 6% with a specific radioactivity of 51.8 GBq/{mu}mol (1400 mCi/{mu}mol) and >99% radiochemical purity. Preliminary studies showed that [{sup 125}I]1 demonstrated increased specific binding to TSPO in a neurotoxicant-treated rat and increased radiopharmaceutical uptake in the lungs of an experimental inflammation model of lung inflammation. Compound [{sup 125}I]1 is a new, convenient probe for preclinical studies of TSPO activity.

  10. External beam boost versus interstitial high-dose-rate brachytherapy boost in the adjuvant radiotherapy following breast-conserving therapy in early-stage breast cancer: a dosimetric comparison

    PubMed Central

    Melchert, Corinna; Kovács, György

    2016-01-01

    Purpose This study aims to compare the dosimetric data of local tumor's bed dose escalation (boost) with photon beams (external beam radiation therapy – EBRT) versus high-dose-rate interstitial brachytherapy (HDR-BT) after breast-conserving treatment in women with early-stage breast cancer. Material and methods We analyzed the treatment planning data of 136 irradiated patients, treated between 2006 and 2013, who underwent breast-conserving surgery and adjuvant whole breast irradiation (WBI; 50.4 Gy) and boost (HDR-BT: 10 Gy in one fraction [n = 36]; EBRT: 10 Gy in five fractions [n = 100]). Organs at risk (OAR; heart, ipsilateral lung, skin, most exposed rib segment) were delineated. Dosimetric parameters were calculated with the aid of dose-volume histograms (DVH). A non-parametric test was performed to compare the two different boost forms. Results There was no difference for left-sided cancers regarding the maximum dose to the heart (HDR-BT 29.8% vs. EBRT 29.95%, p = 0.34). The maximum doses to the other OAR were significantly lower for HDR-BT (Dmax lung 47.12% vs. 87.7%, p < 0.01; rib 61.17% vs. 98.5%, p < 0.01; skin 57.1% vs. 94.75%, p < 0.01; in the case of right-sided breast irradiation, dose of the heart 6.00% vs. 16.75%, p < 0.01). Conclusions Compared to EBRT, local dose escalation with HDR-BT presented a significant dose reduction to the investigated OAR. Only left-sided irradiation showed no difference regarding the maximum dose to the heart. Reducing irradiation exposure to OAR could result in a reduction of long-term side effects. Therefore, from a dosimetric point of view, an interstitial boost complementary to WBI via EBRT seems to be more advantageous in the adjuvant radiotherapy of breast cancer. PMID:27648082

  11. Radiation dose to the left anterior descending coronary artery during interstitial pulsed-dose-rate brachytherapy used as a boost in breast cancer patients undergoing organ-sparing treatment

    PubMed Central

    Serkies, Krystyna; Dziadziuszko, Rafał; Narkowicz, Magdalena; Kamińska, Joanna; Lipniewicz, Joanna

    2017-01-01

    Purpose To assess dose received by the left anterior descending (LAD) coronary artery during interstitial pulsed-dose-rate brachytherapy (PDR-BT) boost for left-sided breast cancer patients undergoing organ-sparing treatment. Material and methods Thirty consecutive pT1-3N0-1M0 breast cancer patients boosted between 2014 and 2015 with 10 Gy/10 pulses/hour PDR-BT following a computed tomography (CT) simulation with the multi-catheter implant were included. The most common localization of primary tumor were upper quadrants. Patients were implanted with rigid tubes following breast conserving surgery and whole breast external beam irradiation (40 Gy/15 or 50 Gy/25 fractions). Computed tomography scans were retrospectively reviewed and LADs were contoured without and with margin of 5 mm (LAD5mm). Standard treatment plan encompassed tumor bed determined by the surgical clips with margin of 2 cm. Dosimetric parameters were extracted from the dose-volume histograms. Results The mean D90 and V100 were 10.3 Gy (range: 6.6-13.3), and 42.0 cc (range: 15.3-109.3), respectively. The median dose non-uniformity ratio (DNR) was 0.50 (range: 0.27-0.82). The mean doses to LAD and LAD5mm were 1.0 Gy and 0.96 Gy, and maximal doses were 1.57 Gy and 1.99 Gy, respectively. Dose to the 0.1 cc of the LAD and LAD5mm were 1.42 Gy and 1.85 Gy (range: 0.01-4.98 Gy and 0.1-6.89 Gy), respectively. Conclusions Interstitial multi-catheter PDR-BT used as a boost for left-sided breast cancer is generally associated with low dose to the LAD. However, higher dose in individual cases may require alternative approaches. PMID:28344598

  12. Binding and degradation of (/sup 125/I)human growth hormone in rat adipocytes

    SciTech Connect

    Gorin, E.; Grichting, G.; Goodman, H.M.

    1984-08-01

    Iodinated human growth hormone (( /sup 125/I)hGH) binds to both specific and nonspecific sites on the surface of adipocytes isolated from the epididymal fat of normal rats. When adipocytes were incubated at 37 C with 1 nM (/sup 125/I)hGH, specific binding increased for 30-60 min and thereafter remained approximately constant as long as the hormone was present in the medium. About 90% of the /sup 125/I released was soluble in 5% trichloroacetic acid and was in the form of iodotyrosine. The rate of /sup 125/I release from specific binding sites decreased by a factor of 4 when the temperature was lowered from 37 to 17 C. Replacement of some of the sodium chloride in the buffer with 25 mM ammonium chloride had little or no effect on the amount on /sup 125/I that bound to cells when (/sup 125/I)hGH was present in the medium, but completely blocked the release of /sup 125/I from cells transferred to hormone-free medium. Ammonium chloride also significantly reduced both the release of /sup 125/I from nonspecific binding sites and the amount of /sup 125/I recovered in trichloroacetic acid-soluble form. Cloroquine, leupeptin, or colchicine nearly doubled the specific binding of (/sup 125/I)hGH after 180 min and markedly slowed the release of /sup 125/I when cells were transferred to hormone-free medium. All of these agents also significantly reduced the rate of release of /sup 125/I from nonspecific binding sites. Incubation of adipose tissue from hypophysectomized rats with ammonium chloride, leupeptin, or colchicine failed to alter the ability of GH to increase glucose oxidation, induce refractoriness, or promote lipolysis in the presence of theophylline.

  13. Accelerated Partial Breast Irradiation With Low-Dose-Rate Interstitial Implant Brachytherapy After Wide Local Excision: 12-Year Outcomes From a Prospective Trial

    SciTech Connect

    Hattangadi, Jona A.; Powell, Simon N.; MacDonald, Shannon M.; Mauceri, Thomas; Ancukiewicz, Marek; Freer, Phoebe; Lawenda, Brian; Alm El-Din, Mohamed A.; Gadd, Michele A.; Smith, Barbara L.; Taghian, Alphonse G.

    2012-07-01

    Purpose: To evaluate the long-term toxicity, cosmesis, and local control of accelerated partial breast irradiation with implant brachytherapy after wide local excision for Stage T1N0 breast cancer (BCa). Materials and Methods: Between 1997 and 2001, 50 patients with Stage T1N0M0 BCa were treated in a Phase I-II protocol using low-dose-rate accelerated partial breast irradiation with implant brachytherapy after wide local excision and lymph node surgery. The total dose was escalated in three groups: 50 Gy (n = 20), 55 Gy (n = 17), and 60 Gy (n = 13). Patient- and physician-assessed breast cosmesis, patient satisfaction, toxicity, mammographic abnormalities, repeat biopsies, and disease status were prospectively evaluated at each visit. Kendall's tau ({tau}{sub {beta}}) and logistic regression analyses were used to correlate outcomes with dose, implant volume, patient age, and systemic therapy. Results: The median follow-up period was 11.2 years (range, 4-14). The patient satisfaction rate was 67%, 67% reported good-excellent cosmesis, and 54% had moderate-severe fibrosis. Higher dose was correlated with worse cosmetic outcome ({tau}{sub {beta}} 0.6, p < .0001), lower patient satisfaction ({tau}{sub {beta}} 0.5, p < .001), and worse fibrosis ({tau}{sub {beta}} 0.4, p = .0024). Of the 50 patients, 35% had fat necrosis and 34% developed telangiectasias {>=}1 cm{sup 2}. Grade 3-4 late skin and subcutaneous toxicities were seen in 4 patients (9%) and 6 patients (13%), respectively, and both correlated with higher dose ({tau}{sub {beta}} 0.3-0.5, p {<=} .01). One patient had Grade 4 skin ulceration and fat necrosis requiring surgery. Mammographic abnormalities were seen in 32% of the patients, and 30% underwent repeat biopsy, of which 73% were benign. Six patients had ipsilateral breast recurrence: five elsewhere in the breast, and one at the implant site. One patient died of metastatic BCa after recurrence. The 12-year actuarial local control, recurrence-free survival

  14. Thermal dosimetry analysis combined with patient-specific thermal modeling of clinical interstitial ultrasound hyperthermia integrated within HDR brachytherapy for treatment of locally advanced prostate cancer

    NASA Astrophysics Data System (ADS)

    Salgaonkar, Vasant A.; Wootton, Jeff; Prakash, Punit; Scott, Serena; Hsu, I. C.; Diederich, Chris J.

    2017-03-01

    This study presents thermal dosimetry analysis from clinical treatments where ultrasound hyperthermia (HT) was administered following high-dose rate (HDR) brachytherapy treatment for locally advanced prostate cancer as part of a clinical pilot study. HT was administered using ultrasound applicators from within multiple 13-g brachytherapy catheters implanted along the posterior periphery of the prostate. The heating applicators were linear arrays of sectored tubular transducers (˜7 MHz), with independently powered array elements enabling energy deposition with 3D spatial control. Typical heat treatments employed time-averaged peak acoustic intensities of 1 - 3 W/cm2 and lasted for 60 - 70 minutes. Throughout the treatments, temperatures at multiple points were monitored using multi-junction thermocouples, placed within available brachytherapy catheters throughout mid-gland prostate and identified as the hyperthermia target volume (HTV). Clinical constraints allowed placement of 8 - 12 thermocouple sensors in the HTV and patient-specific 3D thermal modeling based on finite element methods (FEM) was used to supplement limited thermometry. Patient anatomy, heating device positions, orientations, and thermometry junction locations were obtained from patient CT scans and HDR and hyperthermia planning software. The numerical models utilized the applied power levels recorded during the treatments. Tissue properties such as perfusion and acoustic absorption were varied within physiological ranges such that squared-errors between measured and simulated temperatures were minimized. This data-fitting was utilized for 6 HT treatments to estimate volumetric temperature distributions achieved in the HTV and surrounding anatomy devoid of thermocouples. For these treatments, the measured and simulated T50 values in the hyperthermia target volume (HTV) were between 40.1 - 43.9 °C and 40.3 - 44.9 °C, respectively. Maximum temperatures between 46.8 - 49.8 °C were measured during

  15. An (125)I-labeled octavalent peptide fluorescent nanoprobe for tumor-homing imaging in vivo.

    PubMed

    Luo, Haiming; Shi, Jiyun; Jin, Honglin; Fan, Di; Lu, Lisen; Wang, Fan; Zhang, Zhihong

    2012-06-01

    Targeting radiopeptides are promising agents for radio-theranostics. However, in vivo evaluation of their targeting specificity is often obscured by their short biologic half-lives and low binding affinities. Here, we report an approach to efficiently examine targeting radiopeptides with a new class of octavalent peptide fluorescent nanoprobe (Octa-FNP) platform, which is composed of candidate targeting peptides and a tetrameric far-red fluorescent protein (tfRFP) scaffold. To shed light on this process, (125)I-Octa-FNP, (125)I-tfRFP and (125)I-peptide were synthesized, and their targeting functionalities were compared. Both fluorescence imaging and radioactive quantification results confirmed that (125)I-Octa-FNP had a significantly higher cellular binding capability than (125)I-tfRFP. In vivo biodistribution studies show that at 6 h post-injection, (125)I-Octa-FNP had 2-fold and 30-fold higher tumor uptake than that of (125)I-tfRFP and (125)I-peptide, respectively. Moreover, γ-imaging at 24 h post-injection revealed a remarkable accumulation of (125)I-Octa-FNP in the tumor while maintaining an extremely low background contrast, which was further confirmed by immunofluorescence analysis. These data suggested that, as an engineered and multivalent platform, Octa-FNP could enhance the tumor targeting of a designed peptide and provide excellent contrast radioimaging, making it a valuable tool for the evaluation of the targeting ability of specifically designed radiopeptides for cancer theranostics.

  16. Partial breast brachytherapy

    MedlinePlus

    ... brachytherapy; Accelerated partial breast irradiation - brachytherapy; Partial breast radiation therapy - brachytherapy; Permanent breast seed implant; PBSI; Low-dose radiotherapy - breast; High-dose radiotherapy - breast; Electronic balloon ...

  17. Long-Term Followup Comparing Two Treatment Dosing Strategies of 125I Plaque Radiotherapy in the Management of Small/Medium Posterior Uveal Melanoma

    PubMed Central

    Murray, Timothy G.; Markoe, Arnold M.; Gold, Aaron S.; Ehlies, Fiona; Bermudez, Ernesto; Wildner, Andrea; Latiff, Azeema

    2013-01-01

    Objective. To investigate the efficacy of two different dosing strategies of radioactive iodine-125 (125I) in the management of small- and medium-sized posterior uveal melanoma. Patients and Methods. The medical records of consecutive patients with choroidal melanomas between 1.5 and 5.0 mm in apical height treated initially with 125I plaque radiotherapy were reviewed. Patients were treated with one of the following two treatment dosing strategies: (1) 85 Gy to the apical height of the tumor (group 1) or (2) 85 Gy to a prescription point of 5.0 mm (group 2). Results. Of 95 patients, 55 patients were treated to the apical height of the tumor, and 40 were treated to a prescription point of 5.0 mm. Comparative analysis of the incidence rates of specific complications between the two groups demonstrates that group 2 had a significantly higher incidence of radiation retinopathy, radiation optic neuropathy, and/or visually significant cataract formation than group 1 (P = 0.028). Conclusion. Treatment of choroidal melanomas less than 5 mm in apical height with 125I brachytherapy to the true apical height is equally effective when compared to treatment with 85 Gy to 5.0 mm. Treatment to the apical height of the tumor may result in lower incidence of radiation-related complications. PMID:23533708

  18. American Brachytherapy Society Task Group Report: Combined external beam irradiation and interstitial brachytherapy for base of tongue tumors and other head and neck sites in the era of new technologies.

    PubMed

    Takácsi-Nagy, Zoltán; Martínez-Mongue, Rafael; Mazeron, Jean-Jacques; Anker, Cristopher James; Harrison, Louis B

    Irradiation plays an important role in the treatment of cancers of the head and neck providing a high locoregional tumor control and preservation of organ functions. External beam irradiation (EBI) results in unnecessary radiation exposure of the surrounding normal tissues increasing the incidence of side effects (xerostomy, osteoradionecrosis, and so forth). Brachytherapy (BT) seems to be the best choice for dose escalation over a short treatment period and for minimizing radiation-related normal tissue damage due to the rapid dose falloff around the source. Low-dose-rate BT is being increasingly replaced by pulsed-dose-rate and high-dose-rate BT because the stepping source technology offers the advantage of optimizing dose distribution by varying dwell times. Pulsed-dose and high-dose rates appear to yield local control and complication rates equivalent to those of low-dose rate. BT may be applied alone; but in case of high risk of nodal metastases, it is used together with EBI. This review presents the results and the indications of combined BT and EBI in carcinoma of the base of tongue and other sites of the head and neck region, as well as the role BT plays among other-normal tissue protecting-modern radiotherapy modalities (intensity-modulated radiotherapy, stereotactic radiotherapy) applied in these localizations.

  19. A systematic evaluation of the dose-rate constant determined by photon spectrometry for 21 different models of low-energy photon-emitting brachytherapy sources.

    PubMed

    Chen, Zhe Jay; Nath, Ravinder

    2010-10-21

    The aim of this study was to perform a systematic comparison of the dose-rate constant (Λ) determined by the photon spectrometry technique (PST) with the consensus value ((CON)Λ) recommended by the American Association of Physicists in Medicine (AAPM) for 21 low-energy photon-emitting interstitial brachytherapy sources. A total of 63 interstitial brachytherapy sources (21 different models with 3 sources per model) containing either (125)I (14 models), (103)Pd (6 models) or (131)Cs (1 model) were included in this study. A PST described by Chen and Nath (2007 Med. Phys. 34 1412-30) was used to determine the dose-rate constant ((PST)Λ) for each source model. Source-dependent variations in (PST)Λ were analyzed systematically against the spectral characteristics of the emitted photons and the consensus values recommended by the AAPM brachytherapy subcommittee. The values of (PST)Λ for the encapsulated sources of (103)Pd, (125)I and (131)Cs varied from 0.661 to 0.678 cGyh(-1) U(-1), 0.959 to 1.024 cGyh(-1)U(-1) and 1.066 to 1.073 cGyh(-1)U(-1), respectively. The relative variation in (PST)Λ among the six (103)Pd source models, caused by variations in photon attenuation and in spatial distributions of radioactivity among the source models, was less than 3%. Greater variations in (PST)Λ were observed among the 14 (125)I source models; the maximum relative difference was over 6%. These variations were caused primarily by the presence of silver in some (125)I source models and, to a lesser degree, by the variations in photon attenuation and in spatial distribution of radioactivity among the source models. The presence of silver generates additional fluorescent x-rays with lower photon energies which caused the (PST)Λ value to vary from 0.959 to 1.019 cGyh(-1)U(-1) depending on the amount of silver used by a given source model. For those (125)I sources that contain no silver, their (PST)Λ was less variable and had values within 1% of 1.024 cGyh(-1)U(-1). For the 16

  20. Synthesis and properties of sulfhydryl-group-specific reagents containing 125I.

    PubMed

    Krueger, R J; Lin, C; Frank, J A

    1991-10-01

    125I-containing compounds that react specifically with sulfhydryl groups were prepared in yields of 30 to 40% on the basis of starting 125I quantity. The synthetic precursors were commercially available heterobifunctional crosslinkers and the peptide L-arginyl-L-tyrosine. Two types of sulfhydryl specific reagents were prepared: 3-(2-pyridyldithio)propionylarginyl-[125I]-monoiodotyrosine, which permits reversible incorporation of 125I at sulfhydryl sites, and 3-maleimidopropionylarginyl- [125I]monoiodotyrosine, an irreversible labeling reagent. These products were isolated in a highly radiochemically pure form by C18 HPLC. The second-order rate constants for the reaction of 3-(2-pyridyldithio)propionylarginylmonoiodotyrosine and 3-maleimidopropionylarginylmonoiodotyrosine with N-acetylcysteine were 28 +/- 3 M-1 s-1 and 154 +/- 4 M-1 s-1, respectively, at pH 7.3. Storage of carrier-free 3-(2-pyridyldithio)propionylarginyl-[125I]monoiodotyrosine and 3-maleimidopropionylarginyl-[125I]monoiodotyrosine at -80 degrees C at a radioactive concentration of 0.4 mCi/ml resulted in conversion of 125I to species that did not react covalently with sulfhydryl groups. This process occurred with first-order kinetics and a t1/2 of 5.7 days for the pyridyldithio compound and 7.5 days for the maleimido compound. No conversion was observed during storage at -80 degrees C at radioactive concentrations of 0.02 mCi/ml or less. The labeling properties of these compounds were examined using red blood cell proteins as a test system. 3-(2-Pyridyldithio)propionylarginyl- [125I]monoiodotyrosine and maleimidopropionylarginyl-[125I]monoiodotyrosine reacted preferentially with membrane - associated sulfhydryl groups when incubated with intact red blood cells.

  1. Isolation of /sup 125/I-concanavalin A-labeled plasma membrane from unfertilized mouse eggs

    SciTech Connect

    Boldt, J.; Wolf, D.P.

    1987-04-01

    A procedure was developed for isolation of plasma membrane (PM) preparations from unfertilized mouse eggs. Zona-free mouse eggs prepared by the method of Boldt and Wolf (Gamete Res 13:213-222, 1986) were labeled with 125I-concanavalin A (ConA) prior to sonication and fractionation on iso-osmotic self-generated Percoll density gradients. Experiments using the ConA-specific sugar alpha-methylmannoside (alpha MM) indicated that 125I-ConA bound specifically to the egg PM. Greater than 95% of 125I-ConA binding to zona-free eggs was blocked in the presence of 0.1 M alpha MM, and incubation of eggs in alpha MM after 125I-ConA labeling caused release of 85-90% of bound label. Fractionation of 125I-ConA-labeled eggs by Percoll density gradient centrifugation yielded a single radioactive peak at density = 1.025, corresponding to egg PM material. Prolonged incubation of 125I-ConA-labeled eggs or egg sonicates prior to fractionation did not alter the location of the radioactive peak, indicating that 125I-ConA did not label other organelles. As a control, human erythrocytes were labeled with 125I-ConA and fractionated under identical experimental conditions and yielded a single radioactive peak at density (1.020) comparable to that observed for 125I-ConA-labeled eggs. These results indicate that 125I-ConA can be used as a specific marker to support PM isolation from small numbers of zona-free mouse eggs.

  2. 125I-labeled anti-bFGF monoclonal antibody inhibits growth of hepatocellular carcinoma

    PubMed Central

    Hu, Peng-Hui; Pan, Lan-Hong; Wong, Patrick Ting-Yat; Chen, Wen-Hui; Yang, Yan-Qing; Wang, Hong; Xiang, Jun-Jian; Xu, Meng

    2016-01-01

    AIM: To investigate the inhibitory efficacy of 125I-labeled anti-basic fibroblast growth factor (bFGF) monoclonal antibody (mAb) in hepatocellular carcinoma (HCC). METHODS: bFGF mAb was prepared by using the 1G9B9 hybridoma cell line with hybridization technology and extracted from ascites fluid through a Protein G Sepharose affinity column. After labeling with 125I through the chloramine-T method, bFGF mAb was further purified by a Sephadex G-25 column. Gamma radiation counter GC-1200 detected radioactivity of 125I-bFGF mAb. The murine H22 HCC xenograft model was established and randomized to interventions with control (phosphate-buffered saline), 125I-bFGF mAb, 125I plus bFGF mAb, bFGF mAb, or 125I. The ratios of tumor inhibition were then calculated. Expression of bFGF, fibroblast growth factor receptor (FGFR), platelet-derived growth factor, and vascular endothelial growth factor (VEGF) mRNA was determined by quantitative reverse transcriptase real-time polymerase chain reaction. RESULTS: The purified bFGF mAb solution was 8.145 mg/mL with a titer of 1:2560000 and was stored at -20 °C. After coupling, 125I-bFGF mAb was used at a 1: 1280000 dilution, stored at 4 °C, and its specific radioactivity was 37 MBq/mg. The corresponding tumor weight in the control, 125I, bFGF mAb, 125I plus bFGF mAb, and 125I-bFGF mAb groups was 1.88 ± 0.25, 1.625 ± 0.21, 1.5 ± 0.18, 1.41 ± 0.16, and 0.98 ± 0.11 g, respectively. The tumor inhibition ratio in the 125I, bFGF mAb, 125I plus bFGF mAb, and 125I-bFGF mAb groups was 13.6%, 20.2%, 25.1%, and 47.9%, respectively. Growth of HCC xenografts was inhibited significantly more in the 125I-bFGF mAb group than in the other groups (P < 0.05). Expression of bFGF and FGFR mRNA in the 125I-bFGF mAb group was significantly decreased in comparison with other groups (P < 0.05). Groups under interventions revealed increased expression of VEGF mRNA (except for 125I group) compared with the control group. CONCLUSION: 125I-bFGF m

  3. Primary Gleason Grade 4 Impact on Biochemical Recurrence After Permanent Interstitial Brachytherapy in Japanese Patients With Low- or Intermediate-Risk Prostate Cancer

    SciTech Connect

    Uesugi, Tatsuya; Saika, Takashi; Edamura, Kohei; Nose, Hiroyuki; Kobuke, Makoto; Ebara, Shin; Abarzua, Fernand; Katayama, Norihisa; Yanai, Hiroyuki; Nasu, Yasutomo; Kumon, Hiromi

    2012-02-01

    Purpose: To reveal a predictive factor for biochemical recurrence (BCR) after permanent prostate brachytherapy (PPB) using iodine-125 seed implantation in patients with localized prostate cancer classified as low or intermediate risk based on National Comprehensive Cancer Network (NCCN) guidelines. Methods and Materials: From January 2004 to December 2009, 414 consecutive Japanese patients with clinically localized prostate cancer classified as low or intermediate risk based on the NCCN guidelines were treated with PPB. The clinical factors including pathological data reviewed by a central pathologist and follow-up data were prospectively collected. Kaplan-Meier and Cox regression analyses were used to assess the factors associated with BCR. Results: Median follow-up was 36.5 months. The 2-, 3-, 4-, and 5-year BCR-free rates using the Phoenix definition were 98.3%, 96.0%, 91.6%, and 87.0%, respectively. On univariate analysis, the Gleason score, especially primary Gleason grade 4 in biopsy specimens, was a strong predicting factor (p < 0.0001), while age, initial prostate-specific antigen (PSA) level, T stage, and minimal dose delivered to 90% of the prostate volume (D90) were insignificant. Multivariate analysis indicated that a primary Gleason grade 4 was the most powerful prognostic factor associated with BCR (hazard ratio = 6.576, 95% confidence interval, 2.597-16.468, p < 0.0001). Conclusions: A primary Gleason grade 4 carried a worse BCR prognosis than the primary grade 3 in patients treated with PPB. Therefore, the indication for PPB in patients with a Gleason sum of 4 + 3 deserves careful and thoughtful consideration.

  4. Assessment of [125I]WYE-230949 as a Novel Histamine H3 Receptor Radiopharmaceutical

    PubMed Central

    Lewis, David Y.; Champion, Sue; Wyper, David; Dewar, Deborah; Pimlott, Sally

    2014-01-01

    Histamine H3 receptor therapeutics have been proposed for several diseases such as schizophrenia, attention deficit hyperactivity disorder, Alzheimer's disease and obesity. We set out to evaluate the novel compound, [125I]WYE-230949, as a potential radionuclide imaging agent for the histamine H3 receptor in brain. [125I]WYE-230949 had a high in vitro affinity for the rat histamine H3 receptor (Kd of 6.9 nM). The regional distribution of [125I]WYE-230949 binding sites in rat brain, demonstrated by in vitro autoradiography, was consistent with the known distribution of the histamine H3 receptor. Rat brain uptake of intravenously injected [125I]WYE-230949 was low (0.11 %ID/g) and the ratio of specific: non-specific binding was less than 1.4, as determined by ex vivo autoradiography. In plasma, metabolism of [125I]WYE-230949 into a less lipophilic species occurred, such that less than 38% of the parent compound remained 30 minutes after injection. Brain uptake and metabolism of [125I]WYE-230949 were increased and specific binding was reduced in anaesthetised compared to conscious rats. [125I]WYE230949 is not a potential radiotracer for imaging rat histamine H3 receptors in vivo due to low brain uptake, in vivo metabolism of the parent compound and low specific binding. PMID:25542008

  5. Assessment of [125I]WYE-230949 as a novel histamine H3 receptor radiopharmaceutical.

    PubMed

    Lewis, David Y; Champion, Sue; Wyper, David; Dewar, Deborah; Pimlott, Sally

    2014-01-01

    Histamine H3 receptor therapeutics have been proposed for several diseases such as schizophrenia, attention deficit hyperactivity disorder, Alzheimer's disease and obesity. We set out to evaluate the novel compound, [125I]WYE-230949, as a potential radionuclide imaging agent for the histamine H3 receptor in brain. [125I]WYE-230949 had a high in vitro affinity for the rat histamine H3 receptor (Kd of 6.9 nM). The regional distribution of [125I]WYE-230949 binding sites in rat brain, demonstrated by in vitro autoradiography, was consistent with the known distribution of the histamine H3 receptor. Rat brain uptake of intravenously injected [125I]WYE-230949 was low (0.11 %ID/g) and the ratio of specific: non-specific binding was less than 1.4, as determined by ex vivo autoradiography. In plasma, metabolism of [125I]WYE-230949 into a less lipophilic species occurred, such that less than 38% of the parent compound remained 30 minutes after injection. Brain uptake and metabolism of [125I]WYE-230949 were increased and specific binding was reduced in anaesthetised compared to conscious rats. [125I]WYE230949 is not a potential radiotracer for imaging rat histamine H3 receptors in vivo due to low brain uptake, in vivo metabolism of the parent compound and low specific binding.

  6. ( sup 125 I)Iodoazidococaine, a photoaffinity label for the haloperidol-sensitive sigma receptor

    SciTech Connect

    Kahoun, J.R.; Ruoho, A.E. )

    1992-02-15

    A carrier-free radioiodinated cocaine photoaffinity label, (-)-3-({sup 125}I)iodo-4-azidococaine (({sup 125}I)IACoc), has been synthesized and used as a probe for cocaine-binding proteins. Photoaffinity labeling with 0.5 nM ({sup 125}I)IACoc resulted in selective derivatization of a 26-kDa polypeptide with the pharmacology of a sigma receptor in membranes derived from whole rat brain, rat liver, and human placenta. ({sup 125}I)IACoc labeling of the 26-kDa polypeptide was also inhibited by 10 {mu}M imipramine, amitriptyline, fluoxetine, benztropine, and tetrabenazine. The size of the ({sup 125}I)I-ACoc-labeled proteins is consistent with the size of proteins photolabeled in guinea pig brain and liver membranes by using the sigma photolabel azido-({sup 3}H)DTG. Kinetic analysis of ({sup 125}I)IACoc binding to rat liver microsomes revealed two sites with K{sub d} values of 19 and 126 pM, respectively. The presence or absence of proteolytic inhibitors during membrane preparation did not alter the size of the photolabeled sigma receptor, indicating that the 26-kDa polypeptide was not derived from a larger protein. In summary, ({sup 125}I)IACoc is a potent and highly specific photoaffinity label for the haloperidol-sensitive sigma receptor and will be useful for its biochemical and molecular characterization.

  7. Some quantitative aspects of the labelling of proteins with 125I by the iodine monochloride method

    PubMed Central

    Ceska, M.; Sjödin, A. V.; Grossmüller, F.

    1971-01-01

    The labelling of proteins by the iodine monochloride method was studied by using a mathematical model. The equations used were primarily derived from the mass law equation of the isotopic exchange reaction between [125I]iodide and iodine monochloride. For convenient application, all equations were programmed into a computing desk-top calculator. To support the validity of the theoretical model, a series of iodinations of insulin were performed under various labelling conditions. The results of these experiments compare well with the theoretically derived values. Deviations from the theoretical values occurring at molar ratios of [125I]iodide to iodine monochloride < 0.1 and > 4.0 are explained and suggestions made about how to prevent them. The mathematical model was used to simulate the isotopic exchange, and the iodination reaction under various conditions, to study (a) the influence of the amount of [125I]iodide on the amount of [125I]iodine monochloride formed, (b) the influence of the specific radioactivity of [125I]iodide on the amount of [125I]iodine monochloride formed, and (c) the influence of the specific radioactivity of [125I]iodide on the number of millicuries needed for labelling to a desired extent. PMID:5116527

  8. Brachytherapy in breast cancer: an effective alternative

    PubMed Central

    Chicheł, Adam

    2014-01-01

    Breast conserving surgery (BCS) with following external beam radiation therapy (EBRT) of the conserved breast has become widely accepted in the last decades for the treatment of early invasive breast cancer. The standard technique of EBRT after BCS is to treat the whole breast up to a total dose of 42.5 to 50 Gy. An additional dose is given to treated volume as a boost to a portion of the breast. In the early stage of breast cancer, research has shown that the area requiring radiation treatment to prevent the cancer from local recurrence is the breast tissue that surrounds the area where the initial cancer was removed. Accelerated partial breast irradiation (APBI) is an approach that treats only the lumpectomy bed plus a 1-2 cm margin rather than the whole breast and as a result allows accelerated delivery of the radiation dose in four to five days. There has been a growing interest for APBI and various approaches have been developed under phase I-III clinical studies; these include multicatheter interstitial brachytherapy, balloon catheter brachytherapy, conformal external beam radiation therapy (3D-EBRT) and intra-operative radiation therapy (IORT). Balloon-based brachytherapy approaches include MammoSite, Axxent electronic brachytherapy, Contura, hybrid brachytherapy devices. Another indication for breast brachytherapy is reirradiation of local recurrence after mastectomy. Published results of brachytherapy are very promising. We discuss the current status, indications, and technical aspects of breast cancer brachytherapy. PMID:26327829

  9. Survival of patients with advanced pancreatic cancer after iodine125 seeds implantation brachytherapy

    PubMed Central

    Han, Quanli; Deng, Muhong; Lv, Yao; Dai, Guanghai

    2017-01-01

    Abstract Background: Brachytherapy with iodine125-labeled seeds (125I-seeds) implantation is increasingly being used to treat tumors because of its positional precision, minimal invasion, least damage to noncancerous tissue due to slow and continuous release of radioactivity and facilitation with modern medical imaging technologies. This study evaluates the survival and pain relief outcomes of the 125I-seeds implantation brachytherapy in advanced pancreatic cancer patients. Methods: Literature search was carried out in multiple electronic databases (Google Scholar, Embase, Medline/PubMed, and Ovid SP) and studies reporting I125 seeds implantation brachytherapy in pancreatic cancer patients with unresectable tumor were selected by following predetermined eligibility criteria. Random effects meta-analysis was performed to achieve inverse variance weighted effect size of the overall survival rate after the intervention. Sensitivity and subgroups analyses were also carried out. Results: Twenty-three studies (824 patients’ data) were included in the meta-analysis. 125I-seeds implantation brachytherapy alone was associated with 8.98 [95% confidence interval (CI): 6.94, 11.03] months (P < 0.00001) overall survival with 1-year survival of 25.7 ± 9.3% (mean ± standard deviation; SD) and 2-year survival was 17.9 ± 8.6% (mean ± SD). In stage IV pancreatic cancer patients, overall survival was 7.13 [95% CI: 4.75, 9.51] months (P < 0.00001). In patients treated with 125I-seeds implantation along with 1 or more therapies, overall survival was 11.75 [95% CI: 9.84, 13.65] months (P < 0.00001) with 1-year survival of 47.4 ± 22.75% (mean ± SD) and 2-year survival was 16.97 ± 3.1% (mean ± SD). 125I-seeds brachytherapy was associated with relief of pain in 79.7 ± 9.9% (mean ± SD) of the patients. Conclusions: Survival of pancreatic cancer patients after 125I-seeds implantation brachytherapy is found to be 9 months

  10. Internalization of 125I-human choriogonadotropin in bovine luteal slices. A biochemical study.

    PubMed

    Chegini, N; Rao, C V; Carman, F R

    1984-04-01

    Various intracellular organelles as well as outer cell membranes of bovine corpora lutea intrinsically contain gonadotropin receptors (Rao et al., J biol chem 256 (1981) 2628 [5]). In order to investigate whether exogenously added human choriogonadotropin (hCG) can internalize and bind to the intracellular sites, bovine luteal slices that had been carefully checked with respect to structural and functional integrity were incubated with 0.1 nM 125I-hCG. Following incubation, specific radioactivity was found to be associated with various intracellular organelles, but not with cytosol. The order of radioactivity uptake by subcellular organelles following a 2-h incubation was: Golgi medium greater than Golgi heavy greater than Golgi light greater than plasma membranes = rough endoplasmic reticulum greater than mitochondria-lysosomes- greater than nuclei. The 5'-nucleotidase activity and electron microscopic examination of the fractions revealed that the presence of radioactivity in the intracellular organelles cannot be attributed solely to plasma membrane contamination. The internalization and intracellular binding of 125I-hCG was time and temperature-dependent. Only excess unlabeled hCG and hLH (but not hCG subunits, FSH and PRL) competed with 125I-hCG for internalization in luteal slices. Very little or no 125I-hCG added was internalized in liver or kidney slices; luteal, liver and kidney slices accumulated neither 125I-BSA nor 125I. The radioactivity eluted from various luteal subcellular organelles was able to rebind to fresh corresponding organelles and came off Sepharose 6B columns in a position corresponding to native 125I-hCG. The gel filtration profile of detergent-solubilized radioactivity revealed that 125I-hCG was macromolecular bound. The degraded and altered 125I-hCG was found in the incubation media.

  11. Intramolecular effects of /sup 125/I decay in o-iodotyrosine

    SciTech Connect

    Berridge, M.S.; Jiang, V.W.; Welch, M.J.

    1980-06-01

    As a model for iodinated proteins, 3-(/sup 125/I)iodo(U-/sup 14/C)tyrosine was synthesized by the chloramine-T method from (U-/sup 14/C)tyrosine. The products remaining after the iodine had decayed were characterized chromatographically. A reference system was used to correct for hydrolysis and secondary radiolytic effects. All products due to /sup 125/I decay were small polar molecules. The results demonstrate that after the Auger cascade accompanying /sup 125/I decay, a distribution of charge throughout the molecule occurs before disruption of the molecule. A coulombic explosion mechanism with some contributions due to internal radiolysis and charge neutralization is proposed for the destruction of the aromatic ring. Implications of these results for proteins labeled with /sup 125/I are also discussed.

  12. Tissue uptake and catabolic studies of /sup 125/I SS-B (La) injected into mice

    SciTech Connect

    Schrieber, L.; Melsom, R.D.; Venables, P.J.; Maini, R.N.

    1984-04-01

    The radiolabeled soluble cellular antigen /sup 125/I SS-B (La) has a plasma half-life of 3 min following iv injection into BALB/C mice. Uptake by Kupffer cells (KC) and proximal renal tubular (PRT) cells was demonstrated by autoradiography (ARG). That trichloracetic acid (TCA)-soluble products of /sup 125/I SS-B appeared in plasma within 1 min of iv injection suggests rapid in vivo breakdown. Activated peritoneal macrophages (APM) degraded /sup 125/I SS-B in a time- and cell-dose-dependent fashion. These findings suggest that the plasma clearance and catabolism of /sup 125/I SS-B may be dependent on its interaction with phagocytic cells. This rapid antigen elimination may protect against harmful autoantibody responses.

  13. Microfocus X-ray imaging of the internal geometry of brachytherapy seeds.

    PubMed

    Hasegawa, Tomoyuki; Hanada, Takashi; Yorozu, Atsunori; Ito, Hidetaka; Masuda, Shinji; Kawahara, Maki; Yogo, Katsunori; Hayakawa, Kazushige

    2014-04-01

    Precise and reliable geometrical data on the internal structure of seeds are indispensable for dosimetric calculation in brachytherapy. We used a novel microfocus X-ray imaging technique for observing the internal structure of brachytherapy seeds. Two popular (125)I seed models were evaluated. Obtained high precision images enabled us to observe the internal structure of seeds qualitatively. Geometrical size parameters were evaluated quantitatively with uncertainty of 0.01-0.04 mm (k=2).

  14. (125I)iodoazidococaine, a photoaffinity label for the haloperidol-sensitive sigma receptor.

    PubMed Central

    Kahoun, J R; Ruoho, A E

    1992-01-01

    A carrier-free radioiodinated cocaine photo-affinity label, (-)-3-(125I)iodo-4-azidococaine [(125I)IACoc], has been synthesized and used as a probe for cocaine-binding proteins. Photoaffinity labeling with 0.5 nM (125I)IACoc resulted in selective derivatization of a 26-kDa polypeptide with the pharmacology of a sigma receptor in membranes derived from whole rat brain, rat liver, and human placenta. Covalent labeling of the 26-kDa polypeptide was inhibited by 1 microM haloperidol, di(2-tolyl)guanidine (DTG), 3-(3-hydroxyphenyl)-N-(1-propyl)piperidine (3-PPP), dextromethorphan, and carbetapentane. Stereoselective protection of (125I)IACoc photolabeling by 3-PPP [(+)-3-PPP more potent than (-)-3-PPP] was observed. (125I)IACoc labeling of the 26-kDa polypeptide was also inhibited by 10 microM imipramine, amitriptyline, fluoxetine, benztropine, and tetrabenazine. The size of the (125I)I-ACoc-labeled proteins is consistent with the size of proteins photolabeled in guinea pig brain and liver membranes by using the sigma photolabel azido-[3H]DTG. Kinetic analysis of (125I)IACoc binding to rat liver microsomes revealed two sites with Kd values of 19 and 126 pM, respectively. The presence or absence of proteolytic inhibitors during membrane preparation did not alter the size of the photolabeled sigma receptor, indicating that the 26-kDa polypeptide was not derived from a larger protein. In summary, (125I)IACoc is a potent and highly specific photoaffinity label for the haloperidol-sensitive sigma receptor and will be useful for its biochemical and molecular characterization. Images PMID:1311097

  15. Microchemical synthesis of the serotonin receptor ligand, /sup 125/I-LSD

    SciTech Connect

    Hartig, P.R.; Krohn, A.M.; Hirschman, S.A.

    1985-02-01

    The synthesis and properties of 2-(/sup 125/I)-lysergic acid diethylamide, the first /sup 125/I-labeled serotonin receptor ligand, are described. A novel microsynthesis apparatus was developed for this synthesis. The apparatus employs a micromanipulator and glass micro tools to handle microliter to nanoliter volumes on a microscope stage. This apparatus should be generally useful for the synthesis of radioligands and other compounds when limited amounts of material must be handled in small volumes.

  16. Ornithine decarboxylase activity and: [125I]iododeoxyuridine incorporation in rat prostate.

    PubMed Central

    Fuller, D J; Donaldson, L J; Thomas, G H

    1975-01-01

    The relationship between ornithine decarboxylase activity and [125I]iododexyuridine incorporation was studied in prostates from castrated rats (aged 5, 26 and 80 weeks) injected daily with testosterone for up to 10 days. The results suggest that ornithine decarboxylase activity is a parameter of secretory activity, rather than growth, in the ventral prostate. In the dorsolateral prostate, ornithine decarboxylase activity tends to parallel [125I]iododeoxyuridine incorporation. PMID:1212206

  17. Heparin blocks /sup 125/I-calmodulin internalization by isolated rat renal brush border membrane vesicles

    SciTech Connect

    Meezan, E.; Elgavish, A.; Roden, L.; Wallace, R.W.

    1986-03-05

    /sup 125/I-Calmodulin is internalized by isolated rat renal brush border membrane vesicles (BBV) in a time, temperature and calcium dependent manner. Internalization of /sup 125/I-calmodulin into the osmotically sensitive space of BBV was distinguished from binding of the ligand to the outer BBV surface by examining the interaction of ligand and BBV at different medium osmolarities (300-1100 mosm), uptake was inversely proportional to medium osmolarity. Internalized /sup 125/I-calmodulin was intact and Western blots of solubilized BBV with /sup 125/I-calmodulin demonstrated the presence of several calmodulin-binding proteins of 143, 118, 50, 47.5, 46.5 and 35 kilodaltons which could represent potential intravesicular binding sites for the ligand. Heparin and the related glycosaminoglycan heparin sulfate both showed a dose-dependent inhibition (0.5-50 ..mu..g/ml) of /sup 125/I-calmodulin uptake by BBV, but other sulfated and nonsulfated glycosaminoglycans including chondroitin sulfates, keratan sulfate and hyaluronic acid showed little or no inhibitory effect. Desulfation of heparin virtually abolished the inhibition of uptake while depolymerization reduced it. Heparin did not block the binding of /sup 125/I-calmodulin to BBV proteins as assessed by Western blotting technique suggesting its effect was on internalization of the ligand rather than on its association with internal membrane proteins.

  18. Evidence for multiple pathways of sup 125 I-insulin internalization in isolated rat hepatocytes

    SciTech Connect

    Moss, A.L.

    1988-01-01

    Insulin internalization has been characterized frequently as occurring by the coated pit pathway of receptor-mediated endocytosis. The present study in rat hepatocytes demonstrates that insulin internalization is, in part, receptor-mediated, but also occurs by nonreceptor-mediated or fluid-phase endocytosis. Endocytosis was probed with four perturbations: depletion of metabolic energy with anoxia, inhibition of endocytosis with phenylarsine oxide, disruption of coated pits with hyperosmolar sucrose, and inhibition of receptor recycling or ligand-receptor dissociation with monensin. Internalization of {sup 125}I-epidermal growth factor and {sup 125}I-asialofetuin was compared to {sup 125}I-insulin internalization. Pretreatment of cells with anoxia or hyperosmolarity inhibited {sup 125}I-insulin internalization by 40%; pretreatment with phenylarsine oxide resulted in inhibition by 54%. Monensin has no effect on uptake or degradation of a high insulin concentration, but inhibited degradation of a low insulin concentration resulting in intracellular accumulation of insulin. In contract, all four perturbations inhibited {sup 125}I-asialofetuin internalization by greater than 90%. Phenylarsine oxide almost completely abolished {sup 125}I-epidermal growth factor uptake; the other perturbations caused partial inhibition. Competition studies demonstrated that insulin internalization was receptor-mediated over a wide concentration range.

  19. High dose rate brachytherapy for oral cancer

    PubMed Central

    YamazakI, Hideya; Yoshida, Ken; Yoshioka, Yasuo; Shimizutani, Kimishige; Furukawa, Souhei; Koizumi, Masahiko; Ogawa, Kazuhiko

    2013-01-01

    Brachytherapy results in better dose distribution compared with other treatments because of steep dose reduction in the surrounding normal tissues. Excellent local control rates and acceptable side effects have been demonstrated with brachytherapy as a sole treatment modality, a postoperative method, and a method of reirradiation. Low-dose-rate (LDR) brachytherapy has been employed worldwide for its superior outcome. With the advent of technology, high-dose-rate (HDR) brachytherapy has enabled health care providers to avoid radiation exposure. This therapy has been used for treating many types of cancer such as gynecological cancer, breast cancer, and prostate cancer. However, LDR and pulsed-dose-rate interstitial brachytherapies have been mainstays for head and neck cancer. HDR brachytherapy has not become widely used in the radiotherapy community for treating head and neck cancer because of lack of experience and biological concerns. On the other hand, because HDR brachytherapy is less time-consuming, treatment can occasionally be administered on an outpatient basis. For the convenience and safety of patients and medical staff, HDR brachytherapy should be explored. To enhance the role of this therapy in treatment of head and neck lesions, we have reviewed its outcomes with oral cancer, including Phase I/II to Phase III studies, evaluating this technique in terms of safety and efficacy. In particular, our studies have shown that superficial tumors can be treated using a non-invasive mold technique on an outpatient basis without adverse reactions. The next generation of image-guided brachytherapy using HDR has been discussed. In conclusion, although concrete evidence is yet to be produced with a sophisticated study in a reproducible manner, HDR brachytherapy remains an important option for treatment of oral cancer. PMID:23179377

  20. /sup 125/I-neuropeptide Y and /sup 125/I-peptide YY bind to multiple receptor sites in rat brain

    SciTech Connect

    Walker, M.W.; Miller, R.J.

    1988-12-01

    We describe the preparation of monoiodinated neuropeptide Y (Tyr1-125I-NPY) and monoiodinated peptide YY (Tyr36-125I-PYY). Using these ligands, we detected high, moderate, and low affinity receptor populations in rat brain. Only high and moderate affinity binding sites were suggested by saturation binding studies. Tyr1-125I-NPY bound to 8 +/- 3% of the sites with a Kd of 54 pM (Bmax = 19.4 fmol/mg of protein) and to 92 +/- 3% of the sites with a Kd of 0.92 nM (Bmax = 220.0 fmol/mg of protein). Tyr36-125I-PYY bound to 14 +/- 3% of the sites with a Kd of 23.5 pM (Bmax = 36.4 fmol/mg of protein) and to 86 +/- 3% of the sites with a Kd of 1.9 nM (Bmax = 220.1 fmol/mg of protein). The fragments NPY 13-36 and PYY 13-36 were able to compete with 10 pM Tyr1-125I-NPY for essentially all the binding sites. The fragments were 1 to 2 orders of magnitude less potent than the native peptides. Approximately 50% of the moderate affinity sites, but not the high affinity sites, were reversibly lost in the presence of 5'-guanylyl imidophosphate (Gpp(NH)p), a nonhydrolyzable analog of GTP. Kinetic studies revealed that Tyr1-125I-NPY dissociation could be best described by three dissociation rates. The proportions of slow and intermediate dissociation matched the proportions of moderate and high affinity binding sites, respectively, as suggested by equilibrium studies. There also existed a phase of fast dissociation. When Gpp(NH)p was added during dissociation, the proportion of slow dissociation decreased to the same extent that the fast dissociation was increased. However, the proportion of intermediate dissociation did not change. We propose that rat brain contains a minor population of high affinity NPY binding sites with an intermediate dissociation rate and no sensitivity to Gpp(NH)p.

  1. Dose and volume specification for reporting interstitial therapy

    SciTech Connect

    1997-12-30

    The ICRU has previously published reports dealing with Dose Specification for Reporting External Beam Therapy with Photons and Electrons (ICRU Report 29, ICRU, 1978), Dose Specification for Reporting External Beam Therapy (ICRU Report 50, ICRU, 1993) and Dose and Volume Specification for Reporting Intracavitary Therapy in Gynecology (ICRU Report 38, ICRU, 1985). The present report addresses the problem of absorbed dose specification for report interstitial therapy. Although specific to interstitial therapy, many of the concepts developed in this report are also applicable to certain other kinds of brachytherapy applications. In particular, special cases of intraluminal brachytherapy and plesio-brachytherapy via surface molds employing x or gamma emitters are addressed in this report.

  2. The American Brachytherapy Society recommendations for brachytherapy of uveal melanomas.

    PubMed

    Nag, Subir; Quivey, Jeanne M; Earle, John D; Followill, David; Fontanesi, James; Finger, Paul T

    2003-06-01

    This article presents the American Brachytherapy Society (ABS) guidelines for the use of brachytherapy for patients with choroidal melanomas. Members of the ABS with expertise in choroidal melanoma formulated brachytherapy guidelines based upon their clinical experience and a review of the literature. The Board of Directors of the ABS approved the final report. Episcleral plaque brachytherapy is a complex procedure and should only be undertaken in specialized medical centers with expertise in this sophisticated treatment program. Recommendations were made for patient selection, techniques, dose rates, and dosages. Most patients with very small uveal melanomas (<2.5 mm height and <10 mm in largest basal dimension) should be observed for tumor growth before treatment. Patients with a clinical diagnosis of medium-sized choroidal melanoma (between 2.5 and 10 mm in height and <16 mm basal diameter) are candidates for episcleral plaques if the patient is otherwise healthy and without metastatic disease. A histopathologic verification is not required. Small melanomas may be candidates if there is documented growth; some patients with large melanomas (>10 mm height or >16 mm basal diameter) may also be candidates. Patients with large tumors or with tumors at peripapillary and macular locations have a poorer visual outcome and lower local control that must be taken into account in the patient decision-making process. Patients with gross extrascleral extension, ring melanoma, and tumor involvement of more than half of the ciliary body are not suitable for plaque therapy. For plaque fabrication, the ophthalmologist must provide the tumor size (including basal diameters and tumor height) and a detailed fundus diagram. The ABS recommends a minimum tumor (125)I dose of 85 Gy at a dose rate of 0.60-1.05 Gy/h using AAPM TG-43 formalism for the calculation of dose. NRC or state licensing guidelines regarding procedures for handling of radioisotopes must be followed. Brachytherapy

  3. Brachytherapy of recurrent malignant brain tumors with removable high-activity iodine-125 sources

    SciTech Connect

    Gutin, P.H.; Phillips, T.L.; Wara, W.M.; Leibel, S.A.; Hosobuchi, Y.; Levin, V.A.; Weaver, K.A.; Lamb, S.

    1984-01-01

    Thirty-seven patients harboring recurrent malignant primary or metastatic brain tumors were treated by 40 implantations of high-activity iodine-125 (/sup 125/I) sources. All patients had been treated with irradiation and most had been treated with chemotherapeutic agents, primarily nitrosoureas. Implantations were performed using computerized tomography (CT)-directed stereotaxy; /sup 125/I sources were held in one or more afterloaded catheters that were removed after the desired dose (minimum tumor dose of 3000 to 12,000 rads) had been delivered. Patients were followed with sequential neurological examinations and CT scans. Results of 34 implantation procedures were evaluable: 18 produced documented tumor regression (response) for 4 to 13+ months; five, performed in deteriorating patients, resulted in disease stability for 4 to 12 months. The overall response rate was 68%. In 11 patients, implantation did not halt clinical deterioration. At exploratory craniotomy 5 to 12 months after implantation, focal radiation necrosis was documented in two patients whose tumor had responded initially and then progressed, and in three patients whose disease had progressed initially (four glioblastomas, one anaplastic astrocytoma); histologically identifiable tumor was documented in two of these patients. All improved after resection of the focal necrotic mass and are still alive 10, 15, 19, 24, and 25 months after the initial implantation procedure; only one patient has evidence of tumor regrowth. The median follow-up period after implantation for the malignant glioma (anaplastic astrocytoma and glioblastoma multiforme) group is 9 months, with 48% of patients still surviving. While direct comparison with the results of chemotherapy is difficult, results obtained in this patient group with interstitial brachytherapy are probably superior to results obtained with chemotherapy.

  4. Biodistribution and dosimetry of free 211At, 125I- and 131I- in rats.

    PubMed

    Spetz, Johan; Rudqvist, Nils; Forssell-Aronsson, Eva

    2013-11-01

    131I is widely used for therapy in the clinic and 125I and 131I, and increasingly 211At, are often used in experimental studies. It is important to know the biodistribution and dosimetry for these radionuclides to determine potential risk organs when using radiopharmaceuticals containing these radionuclides. The purpose of this study was to investigate the biodistribution of 125I-, 131I-, and free 211At in rats and to determine absorbed doses to various organs and tissues. Male Sprague Dawley rats were injected simultaneously with 0.1-0.3 MBq 125I- and 0.1-0.3 MBq 131I-, or 0.05-0.2 MBq 211At and sacrificed 1 hour to 7 days after injection. The activities and activity concentrations in organs and tissues were determined and mean absorbed doses were calculated. The biodistribution of 125I- was similar to that of 131I- but the biodistribution of free 211At was different compared to 125I- and 131I-. The activity concentration of radioiodine was higher compared with 211At in the thyroid and lower in all extrathyroidal tissues. The mean absorbed dose per unit injected activity was highest to the thyroid. 131I gave the highest absorbed dose to the thyroid, and 211At gave the highest absorbed dose to all other tissues studied.

  5. Radioimmunoassay for etorphine in horses with a /sup 125/I analog of etorphine

    SciTech Connect

    Tai, C.L.; Wang, C.; Weckman, T.J.; Popot, M.A.; Woods, W.E.; Yang, J.M.; Blake, J.; Tai, H.H.; Tobin, T.

    1988-05-01

    To improve the sensitivity and specificity of screening for etorphine in horses, an /sup 125/I-labeled etorphine analog was synthesized and an antibody to etorphine was raised in rabbits. A radioimmunoassay (RIA) for etorphine was developed, using these reagents. Bound and free /sup 125/I-labeled etorphine was separated by a double-antibody method that reduced interference from materials associated with equine urine. The /sup 125/I-labeled etorphine binding was rarely greater than 250 pg of background etorphine equivalents/ml in raw urine and was 100 pg/ml in hydrolyzed urine. The /sup 125/I-RIA was capable of detecting etorphine equivalents in urine above these background values. Etorphine equivalents were detected in equine urine samples for about 7 days after 4 mares were dosed with 0.22 microgram of etorphine/kg of body weight, IV. The stability of etorphine in urine from these mares was evaluated. Urine from these dosed mares was held in constant -20 C storage, and aliquots were repeatedly frozen and thawed. When analyzed for etorphine equivalents using an /sup 125/I-RIA, etorphine and its metabolites in urine samples were stable for less than or equal to 38 days if continuously frozen and also were resistant to repeated freezing and thawing.

  6. A sensitive radioimmunoassay for corticotropin using a fully biologically active 125I-labeled ligand

    SciTech Connect

    Buckley, D.I.; Hagman, J.; Ramachandran, J.

    1981-07-01

    The human corticotropin (ACTH) analog, Phe2,Nle4-ACTH-(1-38) was iodinated by the chloramine-T procedure and the product was purified by reverse phase high performance liquid chromatography. The specific radioactivity of (/sup 125/I)Tyr23,Phe2,Nle4-ACTH-(1-38) was determined by comparing the antiserum binding curves of the iodinated peptide and (3H)ACTH of known specific activity. This method gave a value of 1800 +/- 75 Ci/mmol, which is close to the theoretical radioactivity expected for the introduction of a single /sup 125/I atom into the peptide. (/sup 125/I)Tyr23,Phe2,Nle4-ACTH-(1-38) was as potent as ACTH in stimulating corticosterone production in isolated rat adrenocortical cells. The concentrations for half-maximal steroidogenesis were 36.5 +/- 6.1 pM for the /sup 125/I derivative and 37.6 +/- 6.7 pM for ACTH. By the use of this /sup 125/I-labeled ligand, a highly sensitive RIA capable of detecting 1 pg ACTH was developed.l The antiserum employed in this study appeared to be directed against residues 11-13 of ACTH.

  7. Radioimmunoassay of salivary cyclosporine with use of /sup 125/I-labeled cyclosporine

    SciTech Connect

    Coates, J.E.; Lam, S.F.; McGaw, W.T.

    1988-08-01

    We prepared /sup 125/I-labeled cyclosporine (/sup 125/I-CS) by modifying the procedure of Mahoney and Orf and characterized it with regards to maximal immunoreactivity (greater than 90%), trichloroacetic acid precipitability (greater than 90%), and stability (90% immunoreactive after five half-lives of /sup 125/I). For a particular preparation of /sup 125/I-CS, we estimated its immunoreaction concentration (50 pmol/L) and the equilibrium constant for its reaction with Sandoz polyclonal antiserum (K = 3.9 X 10(9) L/mol). By substituting /sup 125/I-CS as tracer in the Sandoz radioimmunoassay and by modifying other aspects of the assay, we developed a procedure that is sufficiently sensitive (0.34 micrograms/L) to allow measurement of trough (lowest inter-dose) cyclosporine concentrations in parotid saliva. Of 38 kidney-transplant patients, 35 had measurable concentrations in saliva (mean 8.3, SD 5.2 micrograms/L), and these correlated moderately with paired serum concentrations (r = 0.68, P less than 0.001). We believe that measurement of salivary cyclosporine may offer a simple way of estimating the free fraction of the drug in serum or plasma.

  8. Glutamic acid decarboxylase autoantibody assay using 125I-labelled recombinant GAD65 produced in yeast.

    PubMed

    Powell, M; Prentice, L; Asawa, T; Kato, R; Sawicka, J; Tanaka, H; Petersen, V; Munkley, A; Morgan, S; Rees Smith, B; Furmaniak, J

    1996-12-30

    We describe a new method for measuring autoantibodies (Ab) to the 65 kDa isoform of glutamic acid carboxylase (GAD65). In particular, GAD65 without the hydrophobic N-terminal region has been produced in yeast, purified, labelled with 125I and reacted with GAD65 Ab. Antibody bound 125I-GAD65 is then precipitated by the addition of solid phase protein A. With the assay, GAD65 Ab were detected in 59 of 71 (83%) islet cell antibody (ICA) positive IDDM patients and in 8 of 23 (35%) ICA negative IDDM patients (overall 67 of 94 (71%) of IDDM patients). Low concentrations of GAD65 Ab were also detected in 2/98 (2%) healthy blood donors and 1/27 (4%) Graves' disease patients had a high level of antibody. GAD65 Ab were not detected in any of 10 Hashimoto's thyroiditis, 20 Addison's disease or 19 myasthenia gravis sera. There was good agreement between the 125I assay and the current reference method based on 35S-labelled full-length GAD65 (produced by in vitro transcription/translation reaction) and solid phase protein A (r = 0.91, n = 108). Overall, our 125I assay showed sensitivity, precision and disease group specificity at least as good as any assay so far described. These features, combined with a simple assay protocol and the convenience of 125I counting and handling indicate that the method is suitable for routine GAD65 Ab measurements.

  9. /sup 125/I-spiperone: a novel ligand for D/sub 2/ dopamine receptors

    SciTech Connect

    Gundlach, A.L.; Largent, B.L.; Synder, S.H.

    1984-11-05

    /sup 125/I-Spiperone binds with high affinity K/sub D/ 0.3 nM) to a single specific site (B/sub max/ 34 pmole/g wet weight) in homogenates of rat corpus striatum. Specific binding is about 40-60 percent of total binding and is displaced stereo-specifically by butaclamol and clopenthixol. Neuroleptic drugs of various classes are potent inhibitors of /sup 125/I-spiperone binding (/sub i/'s 1-10 nM). Selective dopamine antagonists such as sulpiride (K/sub i/ 50 nM) and dopamine agonists such as apomorphine (K/sub i/ 200 nM) are also potent inhibitors. The drugs specificity of /sup 125/I-spiperone binding correlates well with that of /sup 3/H-spiperone binding, providing good evidence that /sup 125/I-spiperone labels D/sub 2/ dopamine receptors in striatal membranes. /sup 125/I-Spiperone, with its high specific activity (2200 Ci/mmol) may prove to be a useful ligand in studies examining D/sub 2/ dopamine receptors in soluble preparations and by autoradiography. Furthermore iodinated spiperone may be useful in radioreceptor assays of neuroleptic drug levels and, in a /sup 123/I-labeled form for imaging of dopamine receptors, in vivo, using single photon tomography. 18 references, 4 figures, 1 table.

  10. E-17 alpha(/sup 125/I)iodovinylestradiol: an estrogen-receptor-seeking radiopharmaceutical

    SciTech Connect

    Hanson, R.N.; Seitz, D.E.; Botarro, J.C.

    1982-05-01

    Through the use of radioiododestannylation, the specifically labeled E-17 alpha-(/sup 125/I)iodovinylestradiol ((/sup 125/I)VE2) was synthesized rapidly and in high yield from the stable precursor E-17 alpha-tributylstannylvinylestradiol (SnVE2), and its biodistribution was determined in immature female rats. The agent accumulated in the uterus, achieving a peak uptake of 0.465% ID-kg/g at 2 hr. Uterus-to-blood ratios of 19 and 16 occurred at 1 and 2 hr, respectively, declining to 7 by 4 hr after injection. The uptake of (/sup 125/I)VE2 by the uterus at 2 hr was reduced 58--65% by pretreatment of the immature rats with estradiol (5 micrograms) or tamoxifen (100 micrograms), and compared with 16 alpha-(/sup 125/I)iodoestradiol, (/sup 125/I)VE2 showed greater uterine uptake and similar uterus-to-blood ratios. The ease of preparation of the radioligand represents an advantage over the synthetic procedures for other estrogen-receptor-seeking agents.

  11. The American Brachytherapy Society Treatment Recommendations for Locally Advanced Carcinoma of the Cervix Part II: High Dose-Rate Brachytherapy

    PubMed Central

    Viswanathan, Akila N.; Beriwal, Sushil; De Los Santos, Jennifer; Demanes, D. Jeffrey; Gaffney, David; Hansen, Jorgen; Jones, Ellen; Kirisits, Christian; Thomadsen, Bruce; Erickson, Beth

    2012-01-01

    Purpose This report presents the 2011 update to the American Brachytherapy Society (ABS) high-dose-rate (HDR) brachytherapy guidelines for locally advanced cervical cancer. Methods Members of the American Brachytherapy Society (ABS) with expertise in cervical cancer brachytherapy formulated updated guidelines for HDR brachytherapy using tandem and ring, ovoids, cylinder or interstitial applicators for locally advanced cervical cancer were revised based on medical evidence in the literature and input of clinical experts in gynecologic brachytherapy. Results The Cervical Cancer Committee for Guideline Development affirms the essential curative role of tandem-based brachytherapy in the management of locally advanced cervical cancer. Proper applicator selection, insertion, and imaging are fundamental aspects of the procedure. Three-dimensional imaging with magnetic resonance or computed tomography or radiographic imaging may be used for treatment planning. Dosimetry must be performed after each insertion prior to treatment delivery. Applicator placement, dose specification and dose fractionation must be documented, quality assurance measures must be performed, and follow-up information must be obtained. A variety of dose/fractionation schedules and methods for integrating brachytherapy with external-beam radiation exist. The recommended tumor dose in 2 Gray (Gy) per fraction radiobiologic equivalence (EQD2) is 80–90 Gy, depending on tumor size at the time of brachytherapy. Dose limits for normal tissues are discussed. Conclusion These guidelines update those of 2000 and provide a comprehensive description of HDR cervical cancer brachytherapy in 2011. PMID:22265437

  12. Dosimetry of (125)I and (103)Pd COMS eye plaques for intraocular tumors: report of Task Group 129 by the AAPM and ABS.

    PubMed

    Chiu-Tsao, Sou-Tung; Astrahan, Melvin A; Finger, Paul T; Followill, David S; Meigooni, Ali S; Melhus, Christopher S; Mourtada, Firas; Napolitano, Mary E; Nath, Ravinder; Rivard, Mark J; Rogers, D W O; Thomson, Rowan M

    2012-10-01

    Dosimetry of eye plaques for ocular tumors presents unique challenges in brachytherapy. The challenges in accurate dosimetry are in part related to the steep dose gradient in the tumor and critical structures that are within millimeters of radioactive sources. In most clinical applications, calculations of dose distributions around eye plaques assume a homogenous water medium and full scatter conditions. Recent Monte Carlo (MC)-based eye-plaque dosimetry simulations have demonstrated that the perturbation effects of heterogeneous materials in eye plaques, including the gold-alloy backing and Silastic insert, can be calculated with reasonable accuracy. Even additional levels of complexity introduced through the use of gold foil "seed-guides" and custom-designed plaques can be calculated accurately using modern MC techniques. Simulations accounting for the aforementioned complexities indicate dose discrepancies exceeding a factor of ten to selected critical structures compared to conventional dose calculations. Task Group 129 was formed to review the literature; re-examine the current dosimetry calculation formalism; and make recommendations for eye-plaque dosimetry, including evaluation of brachytherapy source dosimetry parameters and heterogeneity correction factors. A literature review identified modern assessments of dose calculations for Collaborative Ocular Melanoma Study (COMS) design plaques, including MC analyses and an intercomparison of treatment planning systems (TPS) detailing differences between homogeneous and heterogeneous plaque calculations using the American Association of Physicists in Medicine (AAPM) TG-43U1 brachytherapy dosimetry formalism and MC techniques. This review identified that a commonly used prescription dose of 85 Gy at 5 mm depth in homogeneous medium delivers about 75 Gy and 69 Gy at the same 5 mm depth for specific (125)I and (103)Pd sources, respectively, when accounting for COMS plaque heterogeneities. Thus, the adoption of

  13. Study of two different radioactive sources for prostate brachytherapy treatment

    SciTech Connect

    Pereira Neves, Lucio; Perini, Ana Paula; Souza Santos, William de; Caldas, Linda V.E.

    2015-07-01

    In this study we evaluated two radioactive sources for brachytherapy treatments. Our main goal was to quantify the absorbed doses on organs and tissues of an adult male patient, submitted to a brachytherapy treatment with two radioactive sources. We evaluated a {sup 192}Ir and a {sup 125}I radioactive sources. The {sup 192}Ir radioactive source is a cylinder with 0.09 cm in diameter and 0.415 cm long. The {sup 125}I radioactive source is also a cylinder, with 0.08 cm in diameter and 0.45 cm long. To evaluate the absorbed dose distribution on the prostate, and other organs and tissues of an adult man, a male virtual anthropomorphic phantom MASH, coupled in the radiation transport code MCNPX 2.7.0, was employed.We simulated 75, 90 and 102 radioactive sources of {sup 125}I and one of {sup 192}Ir, inside the prostate, as normally used in these treatments, and each treatment was simulated separately. As this phantom was developed in a supine position, the displacement of the internal organs of the chest, compression of the lungs and reduction of the sagittal diameter were all taken into account. For the {sup 192}Ir, the higher doses values were obtained for the prostate and surrounding organs, as the colon, gonads and bladder. Considering the {sup 125}I sources, with photons with lower energies, the doses to organs that are far from the prostate were lower. All values for the dose rates are in agreement with those recommended for brachytherapy treatments. Besides that, the new seeds evaluated in this work present usefulness as a new tool in prostate brachytherapy treatments, and the methodology employed in this work may be applied for other radiation sources, or treatments. (authors)

  14. Specific autoantibody slows the rapid plasma clearance of 125I-SS-B (La) in mice.

    PubMed Central

    Schrieber, L; Melsom, R D; Venables, P J; McCarthy, D A; Maini, R N

    1984-01-01

    In BALB/c mice the plasma clearance of intravenously (i.v.) injected 125I-SS-B (La) (T 1/2 = 3 min) is markedly delayed when complexed in vitro to specific autoantibody (T 1/2 = 60 min) and is associated with diminished hepatic and renal uptake. The in vivo behaviour of 11S 125I-SS-B-IgG-anti-SS-B complexes was similar to that of 20-30S 125I-heat-aggregated IgG. The presence of anti-SS-B antibodies in systemic lupus erythematosus and Sjögren's syndrome could similarly result in persistence of SS-B containing immune complexes and provide a mechanism which may perpetuate autoimmunity. PMID:6611229

  15. Simulation of 125I induced DNA strand breaks in a CAP-DNA complex.

    PubMed

    Li, W; Friedland, W; Jacob, P; Paretzke, H G; Panyutin, I; Neumann, R D

    2002-01-01

    The E. coli catabolite gene activator protein (CAP)-DNA complex with 125I located at the position of the H5 atom of the cytosine near the centre was incorporated into the PARTRAC track structure code. DNA strand breaks due to irradiation were calculated by track structure and radical attack simulations; strand breaks due to neutralisation of the highly charged 125Te ion were derived from a semi-empirical distribution. According to the calculations, the neutralisation effect dominates the strand breakage frequency at 2 bases away from the 125I decay site on both strands. The first breakage distribution counted from a 32P labelled end on the strand with 125I agreed well with experimental data, but on the opposite strand, the calculated distribution is more concentrated around the decay site and its yield is about 20% larger than the measured data.

  16. Non-Repairable Strand Breaks Induced by 125I Incorporated into Mammalian DNA

    PubMed Central

    Painter, R. B.; Young, B. R.; Burki, H. J.

    1974-01-01

    When 125I is incorporated into Chinese hamster DNA (via 125I-labeled iododeoxyuridine) and the cells are stored at 77°K, the resulting decays of the isotope cause 4 to 5 breaks/single-strand per disintegration. On the average, about 50% of these breaks are repaired. In contrast, under the same conditions of storage and in the same range of total strand breaks/cell, 70-100% of the breaks induced by x-radiation are repaired. Thus, the extreme toxicity of 125I when incorporated into DNA is correlated with the unrepaired breaks caused by decay of this isotope. These results suggest that unrepaired DNA strand breaks may be important in cell killing after treatments which damage DNA. PMID:4531021

  17. Two-dimensional dose distribution around a commercial 125I seed.

    PubMed

    Burns, G S; Raeside, D E

    1988-01-01

    The Monte Carlo method was used to investigate the dose distribution around a 3M Company model 6711 125I seed immersed in a water phantom. Dose rate per unit activity data are presented as a matrix of 63 points surrounding the seed. Relative dose data are presented graphically for two mutually perpendicular directions and compared with the corresponding data for the only other 125I seed currently available, the 3M Company model 6702 125I seed. The 6711 relative dose distribution decreases more rapidly with distance from the seed than does the 6702 relative dose distribution. Uncertainties in the 6711 seed dose distribution produced by end-weld thickness variations were investigated and found to be substantial at certain points.

  18. Inulin-125I-tyramine, an improved residualizing label for studies on sites of catabolism of circulating proteins

    SciTech Connect

    Maxwell, J.L.; Baynes, J.W.; Thorpe, S.R.

    1988-10-05

    Residualizing labels for protein, such as dilactitol-125I-tyramine (125I-DLT) and cellobiitol-125I-tyramine, have been used to identify the tissue and cellular sites of catabolism of long-lived plasma proteins, such as albumin, immunoglobulins, and lipoproteins. The radioactive degradation products formed from labeled proteins are relatively large, hydrophilic, resistant to lysosomal hydrolases, and accumulate in lysosomes in the cells involved in degradation of the carrier protein. However, the gradual loss of the catabolites from cells (t1/2 approximately 2 days) has limited the usefulness of residualizing labels in studies on longer lived proteins. We describe here a higher molecular weight (Mr approximately 5000), more efficient residualizing glycoconjugate label, inulin-125I-tyramine (125I-InTn). Attachment of 125I-InTn had no effect on the plasma half-life or tissue sites of catabolism of asialofetuin, fetuin, or rat serum albumin in the rat. The half-life for hepatic retention of degradation products from 125I-InTn-labeled asialofetuin was 5 days, compared to 2.3 days for 125I-DLT-labeled asialofetuin. The whole body half-lives for radioactivity from 125I-InTn-, 125I-DLT-, and 125I-labeled rat serum albumin were 7.5, 4.3, and 2.2 days, respectively. The tissue distribution of degradation products from 125I-InTn-labeled proteins agreed with results of previous studies using 125I-DLT, except that a greater fraction of total degradation products was recovered in tissues. Kinetic analyses indicated that the average half-life for retention of 125I-InTn degradation products in tissues is approximately 5 days and suggested that in vivo there are both slow and rapid routes for release of degradation products from cells.

  19. Binding of 125I-insulin to the isolated glomeruli of rat kidney.

    PubMed Central

    Kurokawa, K; Silverblatt, F J; Klein, K L; Wang, M S; Lerner, R L

    1979-01-01

    To investigate a possible action of insulin on the glomerulus, the binding 125I-insulin to the isolated glomeruli prepared from rat kidney was examined. When incubated at 22 degrees C, 125I-insulin binding proceeded with time and reached a steady state at 45 min at which time nonspecific binding was less than 25% of total binding. A small fraction of 125I-insulin was degraded during incubation. This binding was specific to insulin in that it was inhibited by unlabeled porcine and beef insulins and to a lesser extent by porcine proinsulin and desalanine-desasparagine insulin, but not by glucagon, parathyroid hormone, vasopressin, calcitonin, and angiotensin II. Increasing concentrations of nonlabeled insulin displaced 125I-insulin binding in a dose-dependent fashion. Scatchard plot of the data was curvilinear consistent with either two classes of receptors with different affinities or a single class of receptors that demonstrate negative cooperativity. The addition of excess nonlabeled insulin to the glomeruli preincubated with 125I-insulin resulted in a rapid dissociation of approximately or equal to 70% of bound 125I-insulin. Insulin decreased the increments in glomerular cyclic AMP levels by epinephrine and by prostaglandin E2, but not those by histamine. These data showed the presence of specific insulin receptors in the glomeruli, and that insulin action may be, at least in part, through modulation of glomerular cyclic AMP concentrations. Such action of insulin may underlie the alteration in glomerular ultrafiltration and the glomerular ultrafiltration and the development of glomerular lesions in diabetes mellitus, a disease in which insulin deficiency or the tissue resistance to insulin exists. PMID:500816

  20. Binding of 125I-insulin to the isolated glomeruli of rat kidney.

    PubMed

    Kurokawa, K; Silverblatt, F J; Klein, K L; Wang, M S; Lerner, R L

    1979-11-01

    To investigate a possible action of insulin on the glomerulus, the binding 125I-insulin to the isolated glomeruli prepared from rat kidney was examined. When incubated at 22 degrees C, 125I-insulin binding proceeded with time and reached a steady state at 45 min at which time nonspecific binding was less than 25% of total binding. A small fraction of 125I-insulin was degraded during incubation. This binding was specific to insulin in that it was inhibited by unlabeled porcine and beef insulins and to a lesser extent by porcine proinsulin and desalanine-desasparagine insulin, but not by glucagon, parathyroid hormone, vasopressin, calcitonin, and angiotensin II. Increasing concentrations of nonlabeled insulin displaced 125I-insulin binding in a dose-dependent fashion. Scatchard plot of the data was curvilinear consistent with either two classes of receptors with different affinities or a single class of receptors that demonstrate negative cooperativity. The addition of excess nonlabeled insulin to the glomeruli preincubated with 125I-insulin resulted in a rapid dissociation of approximately or equal to 70% of bound 125I-insulin. Insulin decreased the increments in glomerular cyclic AMP levels by epinephrine and by prostaglandin E2, but not those by histamine. These data showed the presence of specific insulin receptors in the glomeruli, and that insulin action may be, at least in part, through modulation of glomerular cyclic AMP concentrations. Such action of insulin may underlie the alteration in glomerular ultrafiltration and the glomerular ultrafiltration and the development of glomerular lesions in diabetes mellitus, a disease in which insulin deficiency or the tissue resistance to insulin exists.

  1. Use of 2-(/sup 125/I)iodomelatonin to characterize melatonin binding sites in chicken retina

    SciTech Connect

    Dubocovich, M.L.; Takahashi, J.S.

    1987-06-01

    2-(/sup 125/I)Iodomelatonin binds with high affinity to a site possessing the pharmacological characteristics of a melatonin receptor in chicken retinal membranes. The specific binding of 2-(/sup 125/I)iodomelatonin is stable, saturable, and reversible. Saturation experiments indicated that 2-(/sup 125/I)iodomelatonin labeled a single class of sites with an affinity constant (Kd) of 434 +/- 56 pM and a total number of binding sites (Bmax) of 74.0 +/- 13.6 fmol/mg of protein. The affinity constant obtained from kinetic analysis was in close agreement with that obtained in saturation experiments. Competition experiments showed a monophasic reduction of 2-(/sup 125/I)iodomelatonin binding with a pharmacological order of indole amine affinities characteristic of a melatonin receptor: 2-iodomelatonin greater than 6-chloromelatonin greater than or equal to melatonin greater than or equal to 6,7-dichloro-2-methylmelatonin greater than 6-hydroxymelatonin greater than or equal to 6-methoxymelatonin much greater than N-acetyltryptamine greater than N-acetyl-5-hydroxytryptamine greater than 5-methoxytryptamine greater than 5-hydroxytryptamine (inactive). The affinities of these melatonin analogs in competing for 2-(/sup 125/I)iodomelatonin binding sites were correlated closely with their potencies for inhibition of the calcium-dependent release of (3H)dopamine from chicken and rabbit retinas, indicating association of the binding site with a functional response regulated by melatonin. The results indicate that 2-(/sup 125/I)iodomelatonin is a selective, high-affinity radioligand for the identification and characterization of melatonin receptor sites.

  2. Increased /sup 125/I-labelled concanavalin A binding to erythrocytes in diabetes mellitus

    SciTech Connect

    Okada, Y.; Arima, T.; Okazaki, S.; Nakata, K.; Nagashima, H.; Yamabuki, T.

    1982-03-01

    Percentage binding of /sup 125/I-labelled concanavalin A to erythrocytes in diabetic patients was significantly higher than that in normal subjects (12.2 +- 2.8 versus 8.1 +- 1.8%, mean +- SD, p < 0.001). Insulin-dependent diabetic patients showed significantly higher concanavalin A binding than non-insulin-dependent diabetic subjects (15.0 +- 1.4 versus 11.4 +- 2.5%, p < 0.01). There was a highly significant correlation between percentage binding of /sup 125/I-labelled concanavalin A and glycosylated haemoglobin.

  3. p-( sup 125 I)iodoclonidine is a partial agonist at the alpha 2-adrenergic receptor

    SciTech Connect

    Gerhardt, M.A.; Wade, S.M.; Neubig, R.R. )

    1990-08-01

    The binding properties of p-(125I)iodoclonidine (( 125I)PIC) to human platelet membranes and the functional characteristics of PIC are reported. (125I)PIC bound rapidly and reversibly to platelet membranes, with a first-order association rate constant (kon) at room temperature of 8.0 +/- 2.7 x 10(6) M-1 sec-1 and a dissociation rate constant (koff) of 2.0 +/- 0.8 x 10(-3) sec-1. Scatchard plots of specific (125I)PIC binding (0.1-5 nM) were linear, with a Kd of 1.2 +/- 0.1 nM. (125I)PIC bound to the same number of high affinity sites as the alpha 2-adrenergic receptor (alpha 2-AR) full agonist (3H) bromoxidine (UK14,304), which represented approximately 40% of the sites bound by the antagonist (3H)yohimbine. Guanosine 5'-(beta, gamma-imido)triphosphate greatly reduced the amount of (125I)PIC bound (greater than 80%), without changing the Kd of the residual binding. In competition experiments, the alpha 2-AR-selective ligands yohimbine, bromoxidine, oxymetazoline, clonidine, p-aminoclonidine, (-)-epinephrine, and idazoxan all had Ki values in the low nanomolar range, whereas prazosin, propranolol, and serotonin yielded Ki values in the micromolar range. Epinephrine competition for (125I)PIC binding was stereoselective. Competition for (3H)bromoxidine binding by PIC gave a Ki of 1.0 nM (nH = 1.0), whereas competition for (3H)yohimbine could be resolved into high and low affinity components, with Ki values of 3.7 and 84 nM, respectively. PIC had minimal agonist activity in inhibiting adenylate cyclase in platelet membranes, but it potentiated platelet aggregation induced by ADP with an EC50 of 1.5 microM. PIC also inhibited epinephrine-induced aggregation, with an IC50 of 5.1 microM. Thus, PIC behaves as a partial agonist in a human platelet aggregation assay. (125I)PIC binds to the alpha 2B-AR in NG-10815 cell membranes with a Kd of 0.5 +/- 0.1 nM.

  4. 2-([sup 125]I) iodomelatonin binding sites in rat adrenals: Pharmacological characteristics and subcellular distribution

    SciTech Connect

    Persengiev, S.P. )

    1992-01-01

    Specific binding sites for 2-[[sup 125]I] iodomelatonin, a selective radiolabeled melatonin receptor ligand, were detected and characterized in rat adrenal membranes. Saturation studies demonstrated that 2-[[sup 125]I]iodomelatonin binds to a single class of sites with an affinity constant (Kd) of 541 pM and a total binding capacity (Bmax) of 3.23 fmol/mg protein. Competition experiments revealed that the relative order of potency of compounds tested was as follows: 6-chloromelatonin > 2-iodomelatonin > melatonin > 5-methoxytryptamine > 5-methoxytryptophol. The highest density of binding sites was found in membranes from nuclear and mitochondrial subcellular fractions.

  5. Detection of glycosaminoglycans at the one-nanogram level by 125I-cytochrome c

    SciTech Connect

    Sampson, P.M.; Heimer, R.; Fishman, A.P.

    1985-12-01

    The basic protein cytochrome c forms stable ionic complexes with all known glycosaminoglycans. When labeled with 125I, cytochrome c is capable of detecting exceptionally small quantities of glycosaminoglycans. Subsequent to electrophoresis on cellulose acetate strips using pyridine formate buffer at pH 3, followed by ethanol fixation, and treatment with 125I-cytochrome c, all the known glycosaminoglycans are detected at minimum levels of 1 ng/0.25-microliter application. The method can be used for quantification of glycosaminoglycans in other electrophoretic buffer systems also.

  6. A modern Monte Carlo investigation of the TG-43 dosimetry parameters for an {sup 125}I seed already having AAPM consensus data

    SciTech Connect

    Aryal, Prakash; Molloy, Janelle A.; Rivard, Mark J.

    2014-02-15

    Purpose: To investigate potential causes for differences in TG-43 brachytherapy dosimetry parameters in the existent literature for the model IAI-125A{sup 125}I seed and to propose new standard dosimetry parameters. Methods: The MCNP5 code was used for Monte Carlo (MC) simulations. Sensitivity of dose distributions, and subsequently TG-43 dosimetry parameters, was explored to reproduce historical methods upon which American Association of Physicists in Medicine (AAPM) consensus data are based. Twelve simulation conditions varying{sup 125}I coating thickness, coating mass density, photon interaction cross-section library, and photon emission spectrum were examined. Results: Varying{sup 125}I coating thickness, coating mass density, photon cross-section library, and photon emission spectrum for the model IAI-125A seed changed the dose-rate constant by up to 0.9%, about 1%, about 3%, and 3%, respectively, in comparison to the proposed standard value of 0.922 cGy h{sup −1} U{sup −1}. The dose-rate constant values by Solberg et al. [“Dosimetric parameters of three new solid core {sup 125}I brachytherapy sources,” J. Appl. Clin. Med. Phys. 3, 119–134 (2002)], Meigooni et al. [“Experimental and theoretical determination of dosimetric characteristics of IsoAid ADVANTAGE™ {sup 125}I brachytherapy source,” Med. Phys. 29, 2152–2158 (2002)], and Taylor and Rogers [“An EGSnrc Monte Carlo-calculated database of TG-43 parameters,” Med. Phys. 35, 4228–4241 (2008)] for the model IAI-125A seed and Kennedy et al. [“Experimental and Monte Carlo determination of the TG-43 dosimetric parameters for the model 9011 THINSeed™ brachytherapy source,” Med. Phys. 37, 1681–1688 (2010)] for the model 6711 seed were +4.3% (0.962 cGy h{sup −1} U{sup −1}), +6.2% (0.98 cGy h{sup −1} U{sup −1}), +0.3% (0.925 cGy h{sup −1} U{sup −1}), and −0.2% (0.921 cGy h{sup −1} U{sup −1}), respectively, in comparison to the proposed standard

  7. A modern Monte Carlo investigation of the TG-43 dosimetry parameters for an {sup 125}I seed already having AAPM consensus data

    SciTech Connect

    Aryal, Prakash; Molloy, Janelle A.; Rivard, Mark J.

    2014-02-15

    Purpose: To investigate potential causes for differences in TG-43 brachytherapy dosimetry parameters in the existent literature for the model IAI-125A{sup 125}I seed and to propose new standard dosimetry parameters. Methods: The MCNP5 code was used for Monte Carlo (MC) simulations. Sensitivity of dose distributions, and subsequently TG-43 dosimetry parameters, was explored to reproduce historical methods upon which American Association of Physicists in Medicine (AAPM) consensus data are based. Twelve simulation conditions varying{sup 125}I coating thickness, coating mass density, photon interaction cross-section library, and photon emission spectrum were examined. Results: Varying{sup 125}I coating thickness, coating mass density, photon cross-section library, and photon emission spectrum for the model IAI-125A seed changed the dose-rate constant by up to 0.9%, about 1%, about 3%, and 3%, respectively, in comparison to the proposed standard value of 0.922 cGy h{sup −1} U{sup −1}. The dose-rate constant values by Solberg et al. [“Dosimetric parameters of three new solid core {sup 125}I brachytherapy sources,” J. Appl. Clin. Med. Phys. 3, 119–134 (2002)], Meigooni et al. [“Experimental and theoretical determination of dosimetric characteristics of IsoAid ADVANTAGE™ {sup 125}I brachytherapy source,” Med. Phys. 29, 2152–2158 (2002)], and Taylor and Rogers [“An EGSnrc Monte Carlo-calculated database of TG-43 parameters,” Med. Phys. 35, 4228–4241 (2008)] for the model IAI-125A seed and Kennedy et al. [“Experimental and Monte Carlo determination of the TG-43 dosimetric parameters for the model 9011 THINSeed™ brachytherapy source,” Med. Phys. 37, 1681–1688 (2010)] for the model 6711 seed were +4.3% (0.962 cGy h{sup −1} U{sup −1}), +6.2% (0.98 cGy h{sup −1} U{sup −1}), +0.3% (0.925 cGy h{sup −1} U{sup −1}), and −0.2% (0.921 cGy h{sup −1} U{sup −1}), respectively, in comparison to the proposed standard

  8. Highly efficient method for (125)I-radiolabeling of biomolecules using inverse-electron-demand Diels-Alder reaction.

    PubMed

    Choi, Mi Hee; Shim, Ha Eun; Yun, Seong-Jae; Kim, Hye Rim; Mushtaq, Sajid; Lee, Chang Heon; Park, Sang Hyun; Choi, Dae Seong; Lee, Dong-Eun; Byun, Eui-Baek; Jang, Beom-Su; Jeon, Jongho

    2016-04-19

    In this report, we present a rapid and highly efficient method for radioactive iodine labeling of trans-cyclooctene group conjugated biomolecules using inverse-electron-demand Diels-Alder reaction. Radioiodination reaction of the tetrazine structure was carried out using the stannylated precursor 2 to give (125)I-labeled azide ([(125)I]1) with high radiochemical yield (65±8%) and radiochemical purity (>99%). For radiolabeling application of [(125)I]1, trans-cyclooctene derived cRGD peptide and human serum albumin were prepared. These substrated were reacted with [(125)I]1 under mild condition to provide the radiolabeled products [(125)I]6 and [(125)I]8, respectively, with excellent radiochemical yields. The biodistribution study of [(125)I]8 in normal ICR mice showed significantly lower thyroid uptake values than that of (125)I-labeled human serum albumin prepared by a traditional radiolabeling method. Therefore [(125)I]8 will be a useful radiolabeled tracer in various molecular imaging and biological studies. Those results clearly demonstrate that [(125)I]1 will be used as a valuable prosthetic group for radiolabeling of biomolecules. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. Labelled dyes, a new 125I-indomonocarbocyanine and 125I-BSP, in the exploration of experimental cholestasis and steatosis in the rat.

    PubMed Central

    Lapalus, F.; Moreau, M. F.; Meyniel, G.

    1981-01-01

    A new dye, an indomonocarbocyanine labelled with radioactive iodine, was studied in normal rats and in rats with experimental diseases. After i.v. injection, the cyanine was selectively concentrated in the liver and eliminated in the bile; urinary excretion was found to be minimal but increased in rats with ligated bile duct. In addition, the blood clearance kinetics of the labelled dyes were significantly modified in cases of hepatic cholestasis or steatosis. A comparative study was carried out with 125I-BSP; the results showed that these 2 dyes may be considered as complementary in the exploration of liver function. PMID:7225289

  10. Image guided Brachytherapy: The paradigm of Gynecologic and Partial Breast HDR Brachytherapy

    NASA Astrophysics Data System (ADS)

    Diamantopoulos, S.; Kantemiris, I.; Konidari, A.; Zaverdinos, P.

    2015-09-01

    High dose rate (HDR) brachytherapy uses high strength radioactive sources and temporary interstitial implants to conform the dose to target and minimize the treatment time. The advances of imaging technology enable accurate reconstruction of the implant and exact delineation of high-risk CTV and the surrounding critical structures. Furthermore, with sophisticated treatment planning systems, applicator devices and stepping source afterloaders, brachytherapy evolved to a more precise, safe and individualized treatment. At the Radiation Oncology Department of Metropolitan Hospital Athens, MRI guided HDR gynecologic (GYN) brachytherapy and accelerated partial breast irradiation (APBI) with brachytherapy are performed routinely. Contouring and treatment planning are based on the recommendations of the GEC - ESTRO Working group. The task of this presentation is to reveal the advantages of 3D image guided brachytherapy over 2D brachytherapy. Thus, two patients treated at our department (one GYN and one APBI) will be presented. The advantage of having adequate dose coverage of the high risk CTV and simultaneous low doses to the OARs when using 3D image- based brachytherapy will be presented. The treatment techniques, equipment issues, as well as implantation, imaging and treatment planning procedures will be described. Quality assurance checks will be treated separately.

  11. In vitro root caries progression measured by /sup 125/I absorptiometry: comparison with chemical analysis

    SciTech Connect

    Almqvist, H.; Wefel, J.S.; Lagerloef, F.E.; Ekstrand, J.; Henrikson, C.O.

    1988-09-01

    Radiation from a /sup 125/I source and a non-image-forming detector was used for non-destructive measurements of root caries progression. Blocks were cut parallel to the cementum surface of unexposed human roots. These blocks were then individually demineralized in under-saturated calcium phosphate solutions over an 84-hour period. In order for the in vitro root surface demineralization to be followed, the changes in transmission (delta T) through the blocks were measured, by /sup 125/I absorptiometry, eight times during the course of the experiment. Chemical analyses of the calcium output (delta Ca) from the blocks into the demineralizing solutions were also performed, and the rate of demineralization (Vdem) was calculated from these values. The precision of /sup 125/I absorptiometry was calculated from 176 duplicate transmission measurements, and the coefficient of variation was found to be 0.20%. The correlation coefficient between delta T and total delta Ca for each of 22 cementum/dentin blocks ranged between r = 0.934 and r = 0.998. The progression of root hard-tissue lesions observed by these two methods and by the calculated Vdem was found to be proportional to the square and cubic roots of time. The study shows that /sup 125/I absorptiometry can be used for continuous non-destructive measurements of root hard-tissue demineralization in vitro.

  12. Uptake and modification of 125I-lipopolysaccharide by isolated rat Kupffer cells.

    PubMed

    Fox, E S; Thomas, P; Broitman, S A

    1988-01-01

    While it is generally believed that hepatic clearance of lipopolysaccharide involves Kupffer cells, the mechanism involved has not been fully elucidated. This study assesses this phenomenon in terms of in vitro uptake and post-uptake modification experiments with an 125I-labeled Salmonella minnesota lipopolysaccharide. 125I-Lipopolysaccharide was added to Kupffer cells in suspension cultures under a variety of conditions. In vitro uptake of 125I-Lipopolysaccharide was not saturable up to concentrations of 33.33 micrograms per ml. Kinetics experiments performed at 16.67 micrograms per ml demonstrated that Kupffer cells were unsaturable after 60 min of incubation. The kinetics of uptake could be inhibited, however, by incubation in the presence of a 10-fold excess of unlabeled lipopolysaccharide, indicating that a component of the uptake process may be limited. Energy dependence in this process was demonstrated by incubation in the presence of 1 mM 2-deoxyglucose which inhibited 125I-lipopolysaccharide uptake by approximately 30%. Pretreatment with 7.5 x 10(-5) M colchicine had no effect on kinetics, implying no role for the cell cytoskeleton in lipopolysaccharide uptake. These results are inconsistent with a receptor-mediated process as previously suggested. Modification of internalized label has been demonstrated by changes in buoyant density in CsCl isopyknic density gradients following overnight incubation with Kupffer cells. These results indicate that Kupffer cells clear bacterial endotoxin in vitro and post-uptake degradation occurs within 20 hr of incubation.

  13. Use of immunoaffinity chromatography for purification of /sup 125/I-labeled human prolactin

    SciTech Connect

    Stuart, M.C.; Boscato, L.M.; Underwood, P.A.

    1983-02-01

    Researchers assessed a simple method for purifying /sup 125/I-labeled human prolactin, taking advantage of the abundant supplies of monoclonal antibodies available. /sup 125/I-labeled human prolactin purified by immunoaffinity chromatography is compared with that purified by gel filtration on Sephadex G-100. Researchers used monoclonal antibodies to prolactin to prepare the affinity chromatography columns. Prolactin was radiolabeled by the Chloramine T method, purified by each of the above procedures, and the binding and displacement characteristics were studied in radioimmunoassays in which either monoclonal antibodies or a rabbit anti-prolactin serum was the first antibody. A nonimmune fraction of /sup 125/I-labeled prolactin that co-eluted with the immunoreactive hormone from Sephadex G-100 was removed by affinity chromatography, which increased the antibody binding of /sup 125/I-labeled prolactin in the radioimmunoassay in the absence of unlabeled antigen (B/T0, in percent) twofold or more, increased the assay sensitivity, and increased the slope of antigen displacement measured by the 50% intercept. Several advantages make this the purification method of choice.

  14. [Shielding property of different prosthetic materials to shield radiation of (125)I seed].

    PubMed

    Bai, Yang; Wang, Yan-yi; Zhang, Lei; Bu, Rong-fa

    2011-08-01

    To investigation the shielding property to (125)I of several different prosthetic materials used in clinical when prostheses are used as carriers of (125)I seed in tumor treatment. (125)I seeds were taken as the radiation sources to establish a model in vitro and the radiation doses were measured by thermoluminescent dosemeters (TLD). The shielding property of titanium plate, cochrome plate, and poly methyl methacrylate (PMMA) plate were detected, calculated and compared with that of plumbum plate in the control group. The radiation doses of the radiation source at 10 mm distance through the following materials were measured, and the results are 2.805 mGy (0.09 mm thick titanium plate), 1.082 mGy (0.48 thick titanium plate), 0.390 mGy (0.41 mm thick cochrome plate), and 0.261 mGy (0.67 mm's cochrome plate), and 2.885 mGy (1.685 mm thick PMMA plate). The shield property of cochrome is optimal. The poly methyl methacrylate behaves to some extend as a shield to the (125)I seed which can shield the radiation as the effects of plumbum when adopted together with the 0.557 mm's (or more) titanium plate.

  15. Absolute intensity of internal bremsstrahlung from the electron capture decay of {sup 125}I

    SciTech Connect

    Hindi, M.M.; Kozub, R.L.; Robinson, S.J.

    1995-11-01

    The absolute intensity of the internal bremsstrahlung spectrum accompanying the electron capture decay of {sup 125}I has been measured and compared to the recent calculation of Suric {ital et} {ital al}. The measured intensity above the 1{ital s} end point is found to be (86{plus_minus}10)% of the calculated intensity.

  16. Solid-phase receptor binding assay for /sup 125/I-hCG

    SciTech Connect

    Bortolussi, M.; Selmin, O.; Colombatti, A.

    1987-01-01

    A solid-phase radioligand-receptor assay (RRA) to measure the binding of /sup 125/I-labelled human chorionic gonadotropin (/sup 125/I-hCG) to target cell membranes has been developed. The binding of /sup 125/I-hCG to membranes immobilized on the wells of microtitration plates reached a maximum at about 3 hours at 37 degrees C, was saturable, displayed a high affinity (Ka = 2.4 X 10(9) M-1) and was specifically inhibited by unlabelled hCG. In comparison with RRAs carried out with membranes in suspension, the solid-phase RRA is significantly simpler and much faster to perform as it avoids centrifugation or filtration procedures. The solid-phase RRA was adapted profitably to process large numbers of samples at the same time. It proved particularly useful as a screening assay to detect anti-hCG monoclonal antibodies with high inhibitory activity for binding of /sup 125/I-hCG to its receptors.

  17. Photoaffinity labelling of the rat liver nuclear thyroid hormone receptor with (/sup 125/I)triiodothyronine

    SciTech Connect

    David-Inouye, Y.; Somack, R; Nordeen, S.K.; Apriletti, J.W.; Baxter, J.D.; Eberhardt, N.L.

    1982-11-01

    (/sup 125/I)Triiodothyronine (T/sub 3/) was used as a photoreactive probe for the thyroid hormone nuclear receptor in photoaffinity labelling experiments. Autoradiograms of photolysis products electrophoresed on either one or two-dimensional gels showed that (/sup 125/I)T/sub 3/ covalently, but nonspecifically, labelled many proteins in the partially purified receptor preparations used. However, one of these proteins with an estimated molecular weight of 47,000 and an isoelectric point of approximately 6.2 +/- 0.5 pH units appears to be the thyroid hormone receptor, since, in contrast to the other proteins, its photoinduced labelling was blocked by concentrations of T/sub 3/ and thyroxine (T/sub 4/) similar to those that inhibit binding of (/sup 125/I)T/sub 3/ by the receptor in equilibrium binding assays. In addition, the isoelectric point of the photolabelled protein agrees with that determined in separate equilibrium isoelectric focusing studies. These results indicate that (/sup 125/I)T/sub 3/ can serve as a photoreactive probe for the thyroid hormone nuclear receptor, and they suggest that this receptor is a single polypeptide chain of molecular weight 47,000 with an isoelectric point of 6.2 +/- 0.5 pH units.

  18. Dopamine transport sites selectively labeled by a novel photoaffinity probe: 125I-DEEP

    SciTech Connect

    Grigoriadis, D.E.; Wilson, A.A.; Lew, R.; Sharkey, J.S.; Kuhar, M.J. )

    1989-08-01

    The dopamine transporter was labeled using a photosensitive compound related to GBR-12909, {sup 125}I-1-(2-(diphenylmethoxy)ethyl)-4-(2- (4-azido-3-iodophenyl)ethyl)piperazine ({sup 125}I-DEEP). {sup 125}I-DEEP bound reversibly and with high affinity to the dopamine transport protein in the absence of light and could be covalently attached to the protein following exposure to UV light. In rat striatal homogenates, {sup 125}I-DEEP was found to incorporate covalently into a protein with apparent molecular weight of 58,000 Da. The properties of this binding protein were characteristic of the dopamine transporter since covalent attachment could be inhibited by dopamine-uptake blockers with the proper pharmacological rank order of potencies. Covalent binding was also inhibited in a stereospecific manner by (+) and (-) cocaine, as well as other cocaine analogs. The protein was not found in the cerebellum. The dopamine transporter appears to exist in a glycosylated form since photoaffinity-labeled transport sites could adsorb to wheat germ-agglutinin and could be specifically eluted from the column by beta-N-acetylglucosamine.

  19. Clinical observation of 125I-labeled anti-alpha fetoprotein antibody radioimmunotherapy in hepatocellular carcinoma

    PubMed Central

    Wu, Ying-De; Yang, Ke-Zeng; Zhou, De-Nan; Gang, You-Quan; Song, Xiang-Qun; Hu, Xiao-Hua; Huang, Bing-Yan

    1997-01-01

    AIM: To observe the therapeutic effects and toxic side effects of 125I labeled horse anti-human alpha fetoprotein (AFP) polyclonal antibodies in immune targeted therapy against hepatocellular carcinoma (HCC). METHODS: A modified chloramine-T method to produce nuclide 125I labeled horse anti-human AFP polyclonal antibodies was used to treat 22 cases of HCC. Drugs were administered by intravenous drip. The median dose of 125I in the whole group was 289.3 (100.3-708.9) MBq. In this series of 22 cases, 19 were evaluated. HCC cases of the same period treated by 131I anti AFP (A group), anti-cancer drugs and anti AFP conjugates (B group) and chemotherapy alone (C group) were used as controls. RESULTS: The effective rate (CR + PR) was 31.6%, tumor shrinkage rate was 63.2% (12/19), AFP descending rate 64.7% (11/17) and 6 cases became AFP negative. The post treatment 1 year survival rate was 47.1% (8/17). Seven cases are still alive. Five cases survived 14.33 mo, showing good therapeutic tolerance and minimal toxic side effects. CONCLUSION: The therapeutic effect in the treatment group was significantly better than that of the control groups. This may be due to the effect of the continuous radiation of the long half life 125I within the tumor cells. PMID:27006585

  20. Synthesis and biodistribution of [125I]iodo- and [75Se]seleno-ergoline derivatives.

    PubMed

    Sadek, S; Basmadjian, G; Patel, A

    1987-01-01

    (8 beta)-8-([125]Iodomethyl)-6-propylergoline (125I-3) was prepared by refluxing the mesyl analog with Na125I in methyl-ethyl-ketone, followed by HPLC, in a radiochemical yield greater than 70%. [75Se]Selenopergolide (75Se-2) was prepared in 74% yield starting with H75(2) SeO3. The biodistribution studies of the two compounds in male rats show good uptake by the adrenals and the brain. Compound 75Se-2 had higher adrenal uptake and adrenal-to-blood ratios (4.2% dose/g and 70:1) than 125I-3 (3.6% dose/g and 23.8:1) at 15 min post injection. The two compounds had almost equal brain uptake (0.91% dose/g for 75Se-2 and 1.14% dose/g for 125I-3), but 75Se-2 showed higher brain-to-blood ratios (15.2:1 vs 7.3:1) at 15 min post injection. This study indicates that 75Se-2 and 123I-3 may be useful agents for imaging the adrenal and the brain.

  1. Methodology for characterizing seeds under development for brachytherapy by means of radiochromic and photographic films.

    PubMed

    Meira-Belo, L C; Rodrigues, E J T; Grynberg, S E

    2013-04-01

    The development of new medical devices possess a number of challenges, including designing, constructing, and assaying prototypes. In the case of new brachytherapy seeds, this is also true. In this paper, a methodology for rapid dosimetric characterization of (125)I brachytherapy seeds during the early stages of their development is introduced. The characterization methodology is based on the joint use of radiochromic and personal monitoring photographic films in order to determine the planar anisotropy due to the radiation field produced by the seed under development, by means of isodose curves. To evaluate and validate the process, isodose curves were obtained with both types of films after irradiation with a commercial (125)I brachytherapy seed.

  2. Dosimetric analysis of 123I, 125I and 131I in thyroid follicle models

    PubMed Central

    2014-01-01

    Background Radioiodine is routinely used or proposed for diagnostic and therapeutic purposes: 123I, 125I and 131I for diagnostics and 125I and 131I for therapy. When radioiodine-labelled pharmaceuticals are administered to the body, radioiodide might be released into the circulation and taken up by the thyroid gland, which may then be an organ at risk. The aim of this study was to compare dosimetric properties for 123I, 125I and 131I in previously developed thyroid models for man, rat and mouse. Methods Dosimetric calculations were performed using the Monte Carlo code MCNPX 2.6.0 and nuclear decay data from ICRP 107. Only the non-radiative transitions in the decays were considered. The S value was determined for the cell nuclei in species-specific thyroid follicle models for mouse, rat and man for different spatial distributions of radioiodine. Results For the species-specific single follicle models with radioiodine homogeneously within the follicle lumen, the highest S value came from 131I, with the largest contribution from the β particles. When radioiodine was homogeneously distributed within the follicle cells or the follicle cell nucleus, the highest contribution originated from 125I, about two times higher than 123I, with the largest contribution from the Auger electrons. The mean absorbed dose calculated for our human thyroid multiple follicle model, assuming homogenous distribution of for 123I, 125I, or 131I within the follicle lumens and follicle cells, was 9%, 18% and 4% higher, respectively, compared with the mean absorbed dose according to Medical Internal Radiation Dose (MIRD) formalism and nuclear decay data. When radioiodine was homogeneously distributed in the follicle lumens, our calculations gave up to 90% lower mean absorbed dose for 125I compared to MIRD (20% lower for 123I, and 2% lower for 131I). Conclusions This study clearly demonstrates the importance of using more detailed dosimetric methods and models than MIRD formalism for radioiodine

  3. High affinity binding of 125I-angiotensin II to rat glomerular basement membranes.

    PubMed Central

    Sraer, J; Baud, L; Cosyns, J P; Verroust, P; Nivez, M P; Ardaillou, R

    1977-01-01

    125I-angiotensin II (AII) specifically bound to rat glomerular basement membrane (GBM). The kinetics of binding were similar to those obtained with the total glomeruli. The apparent dissociation constant was close to 50 pM with both preparations. The number of sites related to the amount of protein was two times greater with GBM than with total glomeruli. Since the amount of GBM protein extracted from a given amount of glomerular protein was about 10%, it was possible to estimate the share of the GBM binding sites for AII as representing 20% of the total number present in the entire glomerulus. Binding studies at equilibrium as a function of 125I-AII concentration and competitive binding experiments suggested either multiplicity of the binding sites or cooperativity in the binding reaction. Degradation of 125I-AII in the presence of GBM was slight and did not increase with time. The difference in the degrees of degradation of 125I-AII was too small to account for the observed difference in binding when the results obtained with GBM and isolated glomeruli preparations were compared. 125I-AII binding to GBM was increased after treatment of these membranes with collagenase, slightly diminished with neuraminidase, and almost completely abolished with trypsin suggesting the proteic nature of the receptor. 125I-AII binding to GBM was diminished after incubation of GBM with anti-GBM antibodies as a result of a decrease in the number of binding sites. 125I-AII binding was even more diminished in preparations of glomeruli isolated from rats passively immunized with anti-GBM antibodies when compared with glomeruli from control animals. This resulted from both smaller affinity for AII and decrease in the number of the binding sites. The present data provides evidence for specific binding sites for AII localized on GBM. This is noteworthy since receptors for polypeptide hormones are currently observed on the surface of cell membranes. These findings also suggest a new

  4. Retention and degradation of 125I-insulin by perfused livers from diabetic rats.

    PubMed

    Terris, S; Steiner, D F

    1976-04-01

    The retention of degradation of insulin by isolated perfused liver have been examined. Noncyclically perfused livers from streptozotocin-diabetic rats retained 25% and degraded 10% of 125I-insulin administered as a 1-min pulse. On gel filtration (Sephadex G50F), the degradation products released into the vascular effluent eluted in the salt peak. During the 45-min interval after the end of the 125I-insulin infusion, 0.19% of the total dose was excreted in the bile. 60-90% of this material consisted of iodinated, low-molecular-weight degradation products. Inclusion of native insulin with the 125I-insulin in the pulse depressed both the retention and degradation of iodinated material; however, this reflected increased retention and degradation of the total insulin dose (125I-insulin plus native hormone). The log of the total amounts of insulin retained and degraded were linearly related to the log of the total amount of insulin infused at concentrations between 12.7 nM and 2.84 muM. Increasing the amount of native insulin in the infused pulse also depressed the total amount of iodinated material found in the bile and led to the appearance in the bile of intermediate-sized degradation products that did not simultaneously appear in the vascular effluent. Addition of high concentrations of glucagon to the infused 125I-insulin had no effect on the retention or degradation of the labeled hormone, or on the apparent size and amount of iodinated degradation products found in the vascular effluent or in the bile. Preinfusion of concanavalin A inhibited both 125I-insulin retention and degradation. A greater depression by concanavalin A of degradation than binding was also observed with isolated hepatocytes. In contrast to 125I-insulin, the retention and degradation of two iodinated insulin analogues of relative low biological potency, proinsulin and desalanyl-desasparaginyl insulin, were small. The amount of radioactivity appearing in the bile after infusion of these

  5. Ocular Response of Choroidal Melanoma With Monosomy 3 Versus Disomy 3 After Iodine-125 Brachytherapy

    SciTech Connect

    Marathe, Omkar S.; Wu, Jeffrey; Lee, Steve P.; Yu Fei; Burgess, Barry L.; Leu Min; Straatsma, Bradley R.; McCannel, Tara A.

    2011-11-15

    Purpose: To report the ocular response of choroidal melanoma with monosomy 3 vs. disomy 3 after {sup 125}I brachytherapy. Methods and Materials: We evaluated patients with ciliochoroidal melanoma managed with fine needle aspiration biopsy immediately before plaque application for {sup 125}I brachytherapy between January 1, 2005 and December 31, 2008. Patients with (1) cytopathologic diagnosis of melanoma, (2) melanoma chromosome 3 status identified by fluorescence in situ hybridization, and (3) 6 or more months of follow-up after brachytherapy were sorted by monosomy 3 vs. disomy 3 and compared by Kruskal-Wallis test. Results: Among 40 ciliochoroidal melanomas (40 patients), 15 had monosomy 3 and 25 had disomy 3. Monosomy 3 melanomas had a median greatest basal diameter of 12.00 mm and a median tumor thickness of 6.69 mm before brachytherapy; at a median of 1.75 years after brachytherapy, median thickness was 3.10 mm. Median percentage decrease in tumor thickness was 48.3%. Disomy 3 melanomas had a median greatest basal diameter of 10.00 mm and median tumor thickness of 3.19 mm before brachytherapy; at a median of 2.00 years after brachytherapy, median tumor thickness was 2.37 mm. The median percentage decrease in tumor thickness was 22.7%. Monosomy 3 melanomas were statistically greater in size than disomy 3 melanomas (p < 0.001) and showed a greater decrease in tumor thickness after brachytherapy (p = 0.006). Conclusion: In this study, ciliochoroidal melanomas with monosomy 3 were significantly greater in size than disomy 3 melanoma and showed a significantly greater decrease in thickness at a median of 1.75 years after brachytherapy. The greater decrease in monosomy 3 melanoma thickness after brachytherapy is consistent with other malignancies in which more aggressive pathology has been shown to be associated with a greater initial response to radiotherapy.

  6. (R)-N-Methyl-3-(3-125I-pyridin-2-yloxy)-3-phenylpropan-1-amine ([125I]PYINXT) : a novel probe for norepinephrine transporters (NET)

    PubMed Central

    Lakshmi, B.; Kung, M-P.; Lieberman, B.; Zhao, J.; Waterhouse, R.; H.F.Kung

    2008-01-01

    Alterations in the serotonin and norepinephrine neuronal functions have been observed in patients with major depression. Several antidepressants bind to both serotonin transporters (SERT) and norepinephrine transporters (NET). The ability to image NET in the human brain would be a useful step toward understanding how alterations in NET relate to disease. In this study, we report the synthesis and characterization of a new series of derivatives of iodo-nisoxetine (INXT), a known radioiodinated probe. The most promising, (R)-N-methyl-3-(3-iodopyridin-2-yloxy)-3-phenylpropylamine (PYINXT) 9, displayed a high and saturable binding to NET with a Kd value of 0.53 ± 0.03 nM. Biodistribution studies of [125I]PYINXT in rats showed moderate initial brain uptake (0.54 %dose/organ at 2 min) with a relatively fast washout from the brain (0.16 %dose/organ at 2 hr) as compared to [125I]INXT, 7. The hypothalamus (a NET rich region) to striatum (a region devoid of NET) ratio was found to be 2.14 at 4 hr post i.v. injection. The preliminary results suggest that this improved iodinated ligand, when labeled with 123I, may be useful for mapping NET binding sites with SPECT in the living human brain. PMID:18158942

  7. Identification of beta 2-adrenoceptors on guinea pig alveolar macrophages using (-)-3-( sup 125 I)iodocyanopindolol

    SciTech Connect

    Leurs, R.; Beusenberg, F.D.; Bast, A.; Van Amsterdam, J.G.; Timmerman, H. )

    1990-08-01

    The beta-adrenoceptor antagonist (-)-3-({sup 125}I)iodocyanopindolol (({sup 125}I)ICYP) binds with high affinity and in saturable way to membranes of guinea pig alveolar macrophages. The equilibrium dissociation constant for ({sup 125}I)ICYP is 24.3 +/- 1.2 pM, and the number of binding sites is 166.3 +/- 13.7 fmol/mg protein (N = 4, +/- SEM). Displacement studies with selective antagonists showed that ({sup 125}I)ICYP labels beta 2-adrenoceptors on guinea pig alveolar macrophages.

  8. Late side-effects and cosmetic results of accelerated partial breast irradiation with interstitial brachytherapy versus whole-breast irradiation after breast-conserving surgery for low-risk invasive and in-situ carcinoma of the female breast: 5-year results of a randomised, controlled, phase 3 trial.

    PubMed

    Polgár, Csaba; Ott, Oliver J; Hildebrandt, Guido; Kauer-Dorner, Daniela; Knauerhase, Hellen; Major, Tibor; Lyczek, Jaroslaw; Guinot, José Luis; Dunst, Jürgen; Miguelez, Cristina Gutierrez; Slampa, Pavel; Allgäuer, Michael; Lössl, Kristina; Polat, Bülent; Kovács, György; Fischedick, Arnt-René; Fietkau, Rainer; Resch, Alexandra; Kulik, Anna; Arribas, Leo; Niehoff, Peter; Guedea, Ferran; Schlamann, Annika; Pötter, Richard; Gall, Christine; Uter, Wolfgang; Strnad, Vratislav

    2017-02-01

    We previously confirmed the non-inferiority of accelerated partial breast irradiation (APBI) with interstitial brachytherapy in terms of local control and overall survival compared with whole-breast irradiation for patients with early-stage breast cancer who underwent breast-conserving surgery in a phase 3 randomised trial. Here, we present the 5-year late side-effects and cosmetic results of the trial. We did this randomised, controlled, phase 3 trial at 16 centres in seven European countries. Women aged 40 years or older with stage 0-IIA breast cancer who underwent breast-conserving surgery with microscopically clear resection margins of at least 2 mm were randomly assigned 1:1, via an online interface, to receive either whole-breast irradiation of 50 Gy with a tumour-bed boost of 10 Gy or APBI with interstitial brachytherapy. Randomisation was stratified by study centre, menopausal status, and tumour type (invasive carcinoma vs ductal carcinoma in situ), with a block size of ten, according to an automated dynamic algorithm. Patients and investigators were not masked to treatment allocation. The primary endpoint of our initial analysis was ipsilateral local recurrence; here, we report the secondary endpoints of late side-effects and cosmesis. We analysed physician-scored late toxicities and patient-scored and physician-scored cosmetic results from the date of breast-conserving surgery to the date of onset of event. Analysis was done according to treatment received (as-treated population). This trial is registered with ClinicalTrials.gov, number NCT00402519. Between April 20, 2004, and July 30, 2009, we randomly assigned 1328 women to receive either whole-breast irradiation (n=673) or APBI with interstitial brachytherapy (n=655); 1184 patients comprised the as-treated population (551 in the whole-breast irradiation group and 633 in the APBI group). At a median follow-up of 6·6 years (IQR 5·8-7·6), no patients had any grade 4 toxities, and three (<1%) of 484

  9. Increased (/sup 125/I)trypsin-binding in serum from cystic fibrosis patients

    SciTech Connect

    Cox, K.L.; Frates, R.C. Jr.; Sheikholislam, B.M.; Iwahashi-Hosoda, C.K.

    1982-01-01

    The capacities of normal and cystic fibrosis (CF) sera to bind to exogenous human (/sup 125/I)trypsin were compared. Sera from eight older CF patients bound significantly more exogenous human (/sup 125/I)trypsin than did sera from eight normal subjects (p less than 0.001). Disregarding the increased trypsin-binding (TB) of CF sera, serum immunoreactive trypsinogen (SIRT) levels were not detectable in these eight older CF patients. However, when SIRT levels were corrected for TB, four CF patients had normal SIRT concentrations and four had low but detectable SIRT levels. As compared to five normal newborns' sera, serum from a newborn with CF had normal TB and the SIRT levels were very high. In conclusion, increased TB in CF serum lowers results of SIRT assays. Therefore, unless SIRT levels are corrected for TB, results obtained from currently available SIRT kits may be invalid.

  10. Lymphatic flow in humans as indicated by the clearance of /sup 125/I-labeled albumin from the subcutaneous tissue of the leg

    SciTech Connect

    Fernandez, M.J.; Davies, W.T.; Owen, G.M.; Tyler, A.

    1983-08-01

    Since the removal of albumin from the extracellular space and its return to the vascular compartment is the essential function of the lymphatic system, the rate at which it is removed from the interstitial tissue may be regarded as a means of estimating lymphatic efficiency. An objective measure of lymphatic function can be obtained by monitoring the rate of clearance following injection of /sup 125/I-labeled albumin (RIHSA) from the subcutaneous tissue of a limb. The clearance of /sup 125/I-RIHSA from lower limb was monitored in a group of patients with normal limbs, patients with unilateral edema due to deep vein thrombosis, and patients with bilateral edema due to hypoproteinemia. The mean T1/2 in normal legs was 32.7 hr, compared to 23.7 hr in edematous limbs due to deep vein thrombosis and 19.4 in edematous limbs due to hypoproteinemia. There is a clear-cut difference in clearance rate between edematous and nonedematous limbs. This suggests that lymphatic flow is increased in edema due to venous obstruction and hypoproteinemia.

  11. CT-Guided Radioactive {sup 125}I Seed Implantation Therapy of Symptomatic Retroperitoneal Lymph Node Metastases

    SciTech Connect

    Wang, Zhongmin; Lu, Jian; Gong, Ju; Zhang, Liyun; Xu, Yingjia; Song, Shaoli; Chen, Kemin; Liu, Fenju; Gang, Huang

    2013-04-12

    PurposeThis study explored the clinical efficacy of CT-guided radioactive {sup 125}I seed implantation in treating patients with symptomatic retroperitoneal lymph node metastases.MethodsTwenty-five patients with pathologically confirmed malignant tumors received CT-guided radioactive {sup 125}I seed implantation to treat metastatic lymph nodes. The diameter of the metastatic lymph nodes ranged from 1.5 to 4.5 cm. Treatment planning system (TPS) was used to reconstruct the three-dimensional image of the tumor and then calculate the corresponding quantity and distribution of {sup 125}I seeds.ResultsFollow-up period for this group of patients was 2–30 months, and median time was 16 months. Symptoms of refractory pain were significantly resolved postimplantation (P < 0.05), and Karnofsky score rose dramatically (P < 0.05). Most patients reported pain relief 2–5 days after treatment. Follow-up imaging studies were performed 2 months later, which revealed CR in 7 patients, PR in 13 patients, SD in 3 patients, and PD in 2 patients. The overall effective rate (CR + PR) was 80 %. Median survival time was 25.5 months. Seven patients died of recurrent tumor; 16 patients died of multiorgan failure or other metastases. Two patients survived after 30 months follow-up. Two patients reported localized skin erythema 1 week postimplantation, which disappeared after topical treatment.ConclusionsCT-guided radioactive {sup 125}I seed implantation, which showed good palliative pain relief with acceptable short-term effects, has proved in our study to be a new, safe, effective, and relatively uncomplicated treatment option for symptomatic retroperitoneal metastatic lymph nodes.

  12. Effects of hypothyroidism on vascular /sup 125/I-albumin permeation and blood flow in rats

    SciTech Connect

    Tilton, R.G.; Pugliese, G.; Chang, K.; Speedy, A.; Province, M.A.; Kilo, C.; Williamson, J.R.

    1989-05-01

    Effects of hypothyroidism on vascular 125I-albumin permeation and on blood flow were assessed in multiple tissues of male Sprague-Dawley rats rendered hypothyroid by dietary supplementation with 0.5% (wt/wt) 2-thiouracil or by thyroidectomy. In both thiouracil-treated and thyroidectomized rats, body weights, kidney weight, arterial blood pressure, and pulse rate were decreased significantly v age-matched controls. After 10 to 12 weeks of thiouracil treatment, 125I-albumin permeation was increased significantly in the kidney, aorta, eye (anterior uvea, choroid, retina), skin, and new granulation tissue, remained unchanged in brain, sciatic nerve, and heart, and was decreased in forelimb skeletal muscle. A similar pattern was observed in thyroidectomized rats, except that increases in 125I-albumin permeation for all tissues were smaller than those observed in thiouracil-treated rats, and 125I-albumin permeation in retina did not differ from controls. In both thiouracil-treated and thyroidectomized rats, changes in blood flow (assessed with 15-microns, 85Sr-labeled microspheres) relative to the decrease in arterial blood pressure were indicative of a decrease in regional vascular resistance except in the choroid and in the kidney, in which vascular resistance was increased significantly. Glomerular filtration rate was decreased, but filtration fraction and urinary excretion of albumin remained unchanged by thiouracil treatment and thyroidectomy. These results indicate that vascular hemodynamics and endothelial cell barrier functional integrity are modulated in many different tissues by the thyroid. In view of the correspondence of hypothyroid- and diabetes-induced vascular permeability changes, these results raise the possibility that altered thyroid function in diabetes may play a role in the pathogenesis of diabetic vascular disease.

  13. Photoaffinity labelling of the rat liver nuclear thyroid hormone receptor with (/sup 125/I)triiodothyronine

    SciTech Connect

    David-Inouye, Y.; Somack, R.; Nordeen, S.K.; Apriletti, J.W.; Baxter, J.D.; Eberhardt, N.L.

    1982-11-01

    (/sup 125/I)Triiodothyronine (T3) was used as a photoreactive probe for the thyroid hormone nuclear receptor in photoaffinity labelling experiments. Autoradiograms of photolysis products electrophoresed on either one or two-dimensional gels showed that (/sup 125/I)T3 covalently, but nonspecifically, labelled many proteins in the partially purified receptor preparations used. However, one of these proteins with an estimated molecular weight of 47,000 and an isoelectric point of approximately 6.2 +/- 0.5 pH units appears to be the thyroid hormone receptor, since, in contrast to the other proteins, its photoinduced labelling was blocked by concentrations of T3 and thyroxine (T4) similar to those that inhibit binding of (/sup 125/I)T3 by the receptor in equilibrium binding assays. In addition, the isoelectric point of the photolabelled protein agrees with that determined in separate equilibrium isoelectric focusing studies. These results indicate that (/sup 125/)T3 can serve as a photoreactive probe for the thyroid hormone nuclear receptor, and they suggest that this receptor is a single polypeptide chain of molecular weight 47,000 with an isoelectric point of 6.2 +/- 0.5 pH units.

  14. 2( sup 125 I)Iodomelatonin binding sites in spleens of guinea pigs

    SciTech Connect

    Poon, A.M.S. ); Pang, S.F. )

    1992-01-01

    2-({sup 125}I)Iodomelatonin was found to bind specifically to the membrane preparations of the spleens of guinea pigs with high affinity. The binding was rapid, stable, saturable and reversible. Scatchard analysis of the binding assays revealed an equilibrium dissociation constant (Kd) of 49.8{plus minus}4.12 pmol/l and binding site density (Bmax) of 0.69{plus minus}0.082 fmol/mg protein at mid-light. There was no significant change in the Kd or the Bmax at mid-dark. Kinetic analysis showed a Kd of 23.13{plus minus}4.81 pmol/l, in agreement to that derived from the saturation studies. The 2-({sup 125}I)iodomelatonin binding sites have the following order of potency: 2-iodomelatonin > melatonin > 6-chloromelatonin {much gt} N-acetylserotonin, 6-hydroxymelatonin > 5-methoxytryptamine, 5-methoxytryptophol > serotonin, 5-methoxyindole-3-acetic acid > 5-hydroxytryptophol, 3-acetylindole, 1-acetylindole-3-carboxyaldehyde, L-tryptophan > tryptamine, 5-hydroxyindole-3-acetic acid. Differential centrifugation studies showed that the binding sites are localized mainly in the nuclear fraction, the rest are distributed in the microsomal fraction, mitochondrial fraction and cytosolic fraction. The demonstration of 2-({sup 125}I)iodomelatonin binding sites in the spleen suggests the presence of melatonin receptors and a direct mechanism of action of melatonin on the immune system.

  15. Correlation of 125I-LSD autoradiographic labeling with serotonin voltage clamp responses in Aplysia neurons

    SciTech Connect

    Evans, M.L.; Kadan, M.J.; Hartig, P.R.; Carpenter, D.O. )

    1991-05-01

    Autoradiographic receptor binding studies using 125I-LSD (2-(125I)lysergic acid diethyamide) revealed intense labelling on the soma of a symmetrically located pair of cells in the abdominal ganglion of Aplysia californica. This binding was blocked by micromolar concentrations of serotonin and lower concentrations of the serotonergic antagonists, cyproheptadine and mianserin. Electrophysiological investigation of responses to serotonin of neurons in the left upper quadrant, where one of the labeled neurons is located, revealed a range of serotonin responses. Cells L3 and L6 have a K+ conductance increase in response to serotonin that is not blocked by cyproheptadine or mianserin. Cells L2 and L4 have a biphasic response to serotonin: a Na+ conductance increase, which can be blocked by cyproheptadine and mianserin, followed by a voltage dependent Ca2+ conductance which is blocked by Co2+ but not the serotonergic antagonists. Cell L1, and its symmetrical pair, R1, have in addition to the Na+ and Ca2+ responses observed in L2 and L4, a Cl- conductance increase blocked by LSD, cyproheptadine and mianserin. LSD had little effect on the other responses. The authors conclude that the symmetrically located cells L1 and R1 have a Cl- channel linked to a cyproheptadine- and mianserin-sensitive serotonin receptor that is selectively labelled by 125I-LSD. This receptor has many properties in common with the mammalian serotonin 1C receptor.

  16. Glucocorticoid interactions with ethanol effects on synaptic plasma membranes: influence on [125I]calmodulin binding.

    PubMed

    Sze, P Y

    1996-02-01

    Ca(++)-dependent binding of calmodulin (CaM) to brain synaptic plasma membranes is known to be inhibited by ethanol and stimulated by glucocorticoids. These opposite neurochemical actions between ethanol and the steroids in vitro are consistent with glucocorticoid antagonism of ethanol-induced sedation reported to occur in vivo. The present study was undertaken to characterize the interactions of corticosterone with ethanol effects on [125I]CaM binding in synaptic plasma membranes. From the shift of concentration-response curves when corticosterone and ethanol were present in combination, the interaction between steroid stimulation and ethanol inhibition occurred in an additive relationship over the range of their effective concentrations. From Scatchard analyses, ethanol-induced decrease in membrane affinity for [125I]CaM was antagonized by steroid-induced increase in the membrane affinity, indicating that the convergent event in their interaction was the alteration of membrane affinity for CaM. Glucocorticoid antagonism of ethanol inhibition of [125I]CaM binding exhibited a high degree of steroid specificity; steroids with glucocorticoid activity including cortisol, dexamethasone and triamcinolone were effective, whereas gonadal steroids and excitatory neuroactive steroid metabolites were ineffective. The demonstration that glucocorticoids antagonized the inhibition of CaM binding by ethanol provides support for the hypothesis that these steroids are among the endogenous factors that modulate neuronal sensitivity to ethanol.

  17. A Dose–Response Analysis of Biochemical Control Outcomes After {sup 125}I Monotherapy for Patients With Favorable-Risk Prostate Cancer

    SciTech Connect

    Shiraishi, Yutaka; Yorozu, Atsunori; Ohashi, Toshio; Toya, Kazuhito; Saito, Shiro; Nishiyama, Toru; Yagi, Yasuto; Shigematsu, Naoyuki

    2014-12-01

    Purpose: To define the optimal dose for {sup 125}I prostate implants by correlating postimplantation dosimetry findings with biochemical failure and toxicity. Methods and Materials: Between 2003 and 2009, 683 patients with prostate cancer were treated with {sup 125}I prostate brachytherapy without supplemental external beam radiation therapy and were followed up for a median time of 80 months. Implant dose was defined as the D90 (the minimal dose received by 90% of the prostate) on postoperative day 1 and 1 month after implantation. Therefore, 2 dosimetric variables (day 1 D90 and day 30 D90) were analyzed for each patient. We investigated the dose effects on biochemical control and toxicity. Results: The 7-year biochemical failure-free survival (BFFS) rate for the group overall was 96.4% according to the Phoenix definition. A multivariate analysis found day 1 D90 and day 30 D90 to be the most significant factors affecting BFFS. The cutoff points for day 1 D90 and day 30 D90, calculated from ROC curves, were 163 Gy and 175 Gy, respectively. By use of univariate analysis, various dosimetric cutoff points for day 30 D90 were tested. We found that day 30 D90 cutoff points from 130 to 180 Gy appeared to be good for the entire cohort. Greater D90s were associated with an increase in late genitourinary or gastrointestinal toxicity ≥ grade 2, but the increase was not statistically significant. Conclusions: Improvements in BFFS rates were seen with increasing D90 levels. Day 30 D90 doses of 130 to 180 Gy were found to serve as cutoff levels. For low-risk and low-tier intermediate-risk prostate cancer patients, high prostate D90s, even with doses exceeding 180 Gy, achieve better treatment results and are feasible.

  18. Autoradiographic evidence of sup 125 I-. beta. -endorphin binding sites in the articular cartilage of the rat

    SciTech Connect

    Castano, M.T.; Freire-Garabal, M.; Giraldez, M.; Nunez, M.J.; Belmonte, A.; Couceiro, J.; Jorge, J. )

    1991-01-01

    After {sup 125}I-{beta}-endorphin was intravenously injected to rats, an autoradiographic study of distal femur articular cartilage was performed. Results show a specific binding of {sup 125}I-{beta}-endorphin to chondrocytes, suggesting the possible existence of an opiate modulation of articular cartilage.

  19. Testicular shielding in penile brachytherapy

    PubMed Central

    Bindal, Arpita; Tambe, Chandrashekhar M.; Ghadi, Yogesh; Murthy, Vedang; Shrivastava, Shyam Kishore

    2015-01-01

    Purpose Penile cancer, although rare, is one of the common genitourinary cancers in India affecting mostly aged uncircumcised males. For patients presenting with small superficial lesions < 3 cm restricted to glans, surgery, radical external radiation or brachytherapy may be offered, the latter being preferred as it allows organ and function preservation. In patients receiving brachytherapy, testicular morbidity is not commonly addressed. With an aim to minimize and document the doses to testis after adequate shielding during radical interstitial brachytherapy for penile cancers, we undertook this study in 2 patients undergoing brachytherapy and forms the basis of this report. Material and methods Two patients with early stage penile cancer limited to the glans were treated with radical high-dose-rate (HDR) brachytherapy using interstitial implant. A total of 7-8 tubes were implanted in two planes, parallel to the penile shaft. A total dose of 44-48 Gy (55-60 Gy EQD2 doses with α/β = 10) was delivered in 11-12 fractions of 4 Gy each delivered twice daily. Lead sheets adding to 11 mm (4-5 half value layer) were interposed between the penile shaft and scrotum. The testicular dose was measured using thermoluminescent dosimeters. For each patient, dosimetry was done for 3 fractions and mean calculated. Results The cumulative testicular dose to left and right testis was 31.68 cGy and 42.79 cGy for patient A, and 21.96 cGy and 23.28 cGy for patient B. For the same patients, the mean cumulative dose measured at the posterior aspect of penile shaft was 722.15 cGy and 807.72 cGy, amounting to 16.4% and 16.8% of the prescribed dose. Hence, the application of lead shield 11 mm thick reduced testicular dose from 722-808 cGy to 21.96-42.57 cGy, an “absolute reduction” of 95.99 ± 1.5%. Conclusions With the use of a simple lead shield as described, we were able to effectively reduce testicular dose from “spermicidal” range to “oligospermic” range with possible

  20. In vivo binding of /sup 125/I-LSD to serotonin 5-HT/sub 2/ receptors in mouse brain

    SciTech Connect

    Hartig, P.R.; Scheffel, U., Frost, J.J.; Wagner, H.N. Jr.

    1985-08-19

    The binding of /sup 125/I-LSD (2-(/sup 125/I)-lysergic acid diethylamide) was studied in various mouse brain regions following intravenous injection of the radioligand. The high specific activity of /sup 125/I-LSD enabled the injection of low mass doses (14ng/kg), which are well below the threshold for induction of any known physiological effect of the probe. The highest levels of /sup 125/I-LSD binding were found in the frontal cortex, olfactory tubercles, extra-frontal cortex and striatum while the lowest level was found in the cerebellum. Binding was saturable in the frontal cortex but increased linearly in the cerebellum with increasing doses of /sup 125/I-LSD. Serotonergic compounds potently inhibited /sup 125/I-LSD binding in cortical regions, olfactory tubercles, and hypothalamus but had no effect in the cerebellum. Dopaminergic compounds caused partial inhibition of binding in the striatum while adrenergic compounds were inactive. From these studies the authors conclude that /sup 125/I-LSD labels serotonin 5-HT/sub 2/ receptor sites in cortical regions with no indication that other receptor sites are labeled. In the olfactory tubercles and hypothalamus, /sup 125/I-LSD labeling occurs predominantly or entirely at serotonic 5-HT/sub 2/ sites. In the striatum, /sup 125/I-LSD labels approximately equal proportions of serotonergic and dopaminergic sites. These data indicate that /sup 125/I-LSD labels serotonin receptors in vivo and suggests that appropriate derivatives of 2I-LSD may prove useful for tomographic imaging of serotonin 5-HT/sub 2/ receptors in the mammalian cortex.

  1. Direct linkage of /sup 125/I-EGF to cell surface receptors: a useful artifact of chloramine-T treatment

    SciTech Connect

    Comens, P.G.; Simmer, R.L.; Baker, J.B.

    1982-01-01

    A study is presented which shows that /sup 125/I-EGF that was iodinated by lactoperoxidase treatment bound to cells but did not become linked to EGF receptors. /sup 125/I-EGF that was iodinated by chloramine-T treatment or /sup 125/I-EGF that was iodinated by lactoperoxidase treatment and then exposed to chloramine-T, formed linked /sup 125/I-EGF-receptor complexes. Chloramine-T-treated /sup 125/I-EGF remained able to couple to EGF receptors many hours after chloramine-T was removed. These results indicate that chloramine-T ''activates'' /sup 125/I-EGF to a new stable form that couples specifically to EGF receptors. This activation did not occur when Tris middle dot Cl was present during the chloramine-T incubation. Because Tris middle dot Cl is nucleophilic and could moderate the oxidizing effects of chloramine-T, this finding suggests that chloramine-T activates EGF as a result of its ability to oxidize certain amino acid residues in proteins. The specific linkage of chloramine-T-treated /sup 125/I-EGF to EGF receptors provides a convenient, effective method for radiolabeling EGF receptors. The percentage of human fibroblast EGF receptors cross-linked by /sup 125/I-EGF increased to 60% when turnover of EGF receptors at the cell surface was blocked by inhibiting endocytosis with phenylarsine oxide. The linkage of /sup 125/I-thrombin to protease-nexin, a cell-released factor that mediates the binding of /sup 125/I-thrombin to human fibroblasts, is not a chloramine-T artifact. (JMT)

  2. Cervix cancer brachytherapy: high dose rate.

    PubMed

    Miglierini, P; Malhaire, J-P; Goasduff, G; Miranda, O; Pradier, O

    2014-10-01

    Cervical cancer, although less common in industrialized countries, is the fourth most common cancer affecting women worldwide and the fourth leading cause of cancer death. In developing countries, these cancers are often discovered at a later stage in the form of locally advanced tumour with a poor prognosis. Depending on the stage of the disease, treatment is mainly based on a chemoradiotherapy followed by uterovaginal brachytherapy ending by a potential remaining tumour surgery or in principle for some teams. The role of irradiation is crucial to ensure a better local control. It has been shown that the more the delivered dose is important, the better the local results are. In order to preserve the maximum of organs at risk and to allow this dose escalation, brachytherapy (intracavitary and/or interstitial) has been progressively introduced. Its evolution and its progressive improvement have led to the development of high dose rate brachytherapy, the advantages of which are especially based on the possibility of outpatient treatment while maintaining the effectiveness of other brachytherapy forms (i.e., low dose rate or pulsed dose rate). Numerous innovations have also been completed in the field of imaging, leading to a progress in treatment planning systems by switching from two-dimensional form to a three-dimensional one. Image-guided brachytherapy allows more precise target volume delineation as well as an optimized dosimetry permitting a better coverage of target volumes.

  3. Image fusion analysis of volumetric changes after interstitial low-dose-rate iodine-125 irradiation of supratentorial low-grade gliomas.

    PubMed

    Julow, Jeno; Major, Tibor; Mangel, László; Bajzik, Gábor; Viola, Arpad

    2007-04-01

    The aim of this study was to compare the volumes of tumor necrosis, reactive zone and edema with the three-dimensional dose distributions after brachytherapy treatments of gliomas. The investigation was performed an average of 14.2 months after low-dose-rate (125)I interstitial irradiation of 25 inoperable low-grade gliomas. The prescribed dose was 50-60 Gy to the tumor surface. Dose planning and image fusion were performed with the BrainLab-Target 1.19 software. In the CT/ MRI images, the "triple ring" (tumor necrosis, reactive ring and edema) developing after the interstitial irradiation of the brain tumors was examined. The images with the triple ring were fused with the planning images, and the isodose curves were superimposed on them. The volumes of the three regions were measured. The average dose at the necrosis border was determined from the isodose distribution. For quantitative assessment of the dose distributions, the dose nonuniformity ratio (DNR), homogeneity index (HI), coverage index (CI) and conformal index (COIN) were calculated. The relative volumes of the different parts of the triple ring after the interstitial irradiation compared to the reference dose volume were the following: necrosis, 40.9%, reactive zone, 47.1%, and edema, 367%. The tumor necrosis developed at 79.1 Gy on average. The average DNR, HI, CI and COIN were 0.45, 0.24, 0.94 and 0.57, respectively. The image fusion analysis of the volume of tumor necrosis, reactive ring and edema caused by interstitial irradiation and their correlation with the dose distribution provide valuable information for patient follow-up, treatment options, and effects and side effects of radio therapy.

  4. Sequential Comparison of Seed Loss and Prostate Dosimetry of Stranded Seeds With Loose Seeds in {sup 125}I Permanent Implant for Low-Risk Prostate Cancer

    SciTech Connect

    Saibishkumar, Elantholi P.; Borg, Jette; Yeung, Ivan; Cummins-Holder, Cheryl; Landon, Angela; Crook, Juanita

    2009-01-01

    Purpose: To compare stranded seeds (SSs) with loose seeds (LSs) in terms of prostate edema, dosimetry, and seed loss after {sup 125}I brachytherapy. Methods and Materials: Two prospective cohorts of 20 men participated in an institutional review board-approved protocols to study postimplant prostate edema and its effect on dosimetry. The LS cohort underwent brachytherapy between September 2002 and July 2003 and the SS cohort between April 2006 and January 2007. Both cohorts were evaluated sequentially using computed tomography-magnetic resonance imaging fusion-based dosimetry on Days 0, 7, and 30. No hormonal therapy or supplemental beam radiotherapy was used. Results: Prostate edema was less in the SS cohort at all points (p = NS). On Day 0, all the prostate dosimetric factors were greater in the LS group than in the SS group (p = 0.003). However, by Days 7 and 30, the dosimetry was similar between the two cohorts. No seeds migrated to the lung in the SS cohort compared with a total of five seeds in 4 patients in the LS cohort. However, the overall seed loss was greater in the SS cohort (24 seeds in 6 patients; 1.1% of total vs. 0.6% for LSs), with most seeds lost through urine (22 seeds in 5 patients). Conclusion: Despite elimination of venous seed migration, greater seed loss was observed with SSs compared with LSs, with the primary site of loss being the urinary tract. Modification of the technique might be necessary to minimize this. Prostate dosimetry on Days 7 and 30 was similar between the SS and LS cohorts.

  5. Interstitial Nephritis

    MedlinePlus

    ... was contributed by: familydoctor.org editorial staff Tags: acute tubulointerstitial nephritis, AIN, interstitial nephritis, kidney disorders, kidney failure, renal failure, renal infection Men, Seniors, Women December 2004 ...

  6. Preventive effects of 125I seeds on benign restenosis following esophageal stent implantation in a dog model

    PubMed Central

    GAN, ZHEN; JING, JIAN; ZHU, GUANGYU; QIN, YONGLIN; TENG, GAOJUN; GUO, JINHE

    2015-01-01

    The present study aimed to evaluate the effects of iodine-125 (125I) seeds on the proliferation of primary esophageal fibroblasts in dogs, and to assess the safety and preventive efficacy of 125I seed-pre-loaded esophageal stents in benign restenosis following implantation. Primary fibroblasts were cultured with various 125I seed activities, which were then evaluated using cell proliferation and apoptosis assays as well as cell cycle analysis using Annexin V/propidium iodide (PI) double staining and PI staining. Prior to sacrification, animals were submitted to esophageal radiography under digital subtraction angiography. Esophageal tissues were collected and examined for macroscopic, microscopic and pathological alterations. The results demonstrated a significant and dose-dependent inhibition of fibroblast proliferation and increased apoptosis following exposure to 125I seeds. G0/G1 fibroblast populations increased in a dose-dependent manner following treatment with 125I seeds, in contrast to cells in S phase. Four weeks following implantation, α-smooth muscle actin and proliferating cell nuclear antigen expression levels in the experimental group were significantly lower compared with those in the control group; in addition, eight weeks following implantation, esophageal inner diameters were increased in the experimental group. 125I seeds inhibited proliferation of dog esophageal fibroblasts via cell cycle arrest and apoptosis. In conclusion, 125I seed-pre-loaded esophageal stents inhibited benign hyperplasia in the upper edge of the stent to a certain extent, which relieved benign restenosis following implantation with a good safety profile. PMID:25543838

  7. Retrograde axonal transport of /sup 125/I-nerve growth factor in rat ileal mesenteric nerves. Effect of streptozocin diabetes

    SciTech Connect

    Schmidt, R.E.; Plurad, S.B.; Saffitz, J.E.; Grabau, G.G.; Yip, H.K.

    1985-12-01

    The retrograde axonal transport of intravenously (i.v.) administered /sup 125/I-nerve growth factor (/sup 125/I-NGF) was examined in mesenteric nerves innervating the small bowel of rats with streptozocin (STZ) diabetes using methods described in detail in the companion article. The accumulation of /sup 125/I-NGF distal to a ligature on the ileal mesenteric nerves of diabetic animals was 30-40% less than in control animals. The inhibition of accumulation of /sup 125/I-NGF in diabetic animals was greater at a ligature tied 2 h after i.v. administration than at a ligature tied after 14 h, which suggests that the diabetic animals may have a lag in initiation of NGF transport in the terminal axon or retardation of transport at some site along the axon. The /sup 125/I-NGF transport defect was observed as early as 3 days after the induction of diabetes, a time before the development of structural axonal lesions, and did not worsen at later times when dystrophic axonopathy is present. Both the ileal mesenteric nerves, which eventually develop dystrophic axonopathy in experimental diabetes, and the jejunal mesenteric nerves, which never develop comparable structural alterations, showed similar /sup 125/I-NGF transport deficits, suggesting that the existence of the transport abnormality does not predict the eventual development of dystrophic axonal lesions. Autoradiographic localization of /sup 125/I-NGF in the ileal mesenteric nerves of animals that had been diabetic for 11-13 mo demonstrated decreased amounts of /sup 125/I-NGF in transit in unligated paravascular nerve fascicles. There was, however, no evidence for focal retardation of transported /sup 125/I-NGF at the sites of dystrophic axonal lesions.

  8. Relative biologic effectiveness in terms of tumor response of {sup 125}I implants compared with {sup 60}Co gamma rays

    SciTech Connect

    Lehnert, Shirley . E-mail: shirley.lehnert@mcgill.ca; Reniers, Brigitte; Verhaegen, Frank

    2005-09-01

    Purpose: To measure the relative biologic effectiveness (RBE) for {sup 125}I seeds compared with external beam radiotherapy using a clinically relevant in vivo system. Methods and Materials: Photon emission from a detailed source model was simulated using the Monte Carlo code MCNP4C, sampling from a {sup 125}I spectrum. The mouse RIF-1 tumor was treated with either temporary implant of an {sup 125}I seed or with {sup 60}Co gamma rays. The tumors were always the same size at the initiation of treatment, and the endpoint was growth inhibition. Results: The dose-response curve for both modalities was close to linear and was independent of the initial {sup 125}I activity (dose rate) for the range investigated. Calculation of the RBE for tumor response requires assigning a unique value for the tumor dose that is not homogenous but depends on the distance from the {sup 125}I source. Because tumor regrowth will depend on the subpopulation of cells that have the greatest probability of survival (i.e., those at the greatest distance from the {sup 125}I source), one approach is to use the dose to this population. On this basis, the RBE for {sup 125}I compared with {sup 60}Co gamma rays is 1.5. If the {sup 125}I dose is computed as the average dose to the tumor, corrected for the dose that is wasted as overkill in the cell population closest to the center of the {sup 125}I seed, the RBE is 1.4. Conclusion: The result, an RBE of 1.4-1.5 is similar to findings obtained by other methods, supporting the validity of this approach to derive an RBE with validity in a clinical context.

  9. Specific uptake, dissociation, and degradation of /sup 125/I-labeled insulin in isolated turtle (Chrysemys dorbigni) thyroid glands

    SciTech Connect

    Marques, M.; da Silva, R.S.; Turyn, D.; Dellacha, J.M.

    1985-11-01

    Thyroid glands from turtles (Chrysemys dorbigni) pretreated with potassium iodide were incubated with /sup 125/I-insulin in the presence or absence of unlabeled insulin, in order to study its specific uptake. At 24 degrees, the specific uptake reached a plateau at 180 min of incubation. The dose of bovine insulin that inhibited 50% of the /sup 125/I-insulin uptake was 2 micrograms/ml of incubation medium. Most of the radioactive material (71%) extracted from the gland, after 30 min incubation with /sup 125/I-insulin, eluted in the same position as labeled insulin on Sephadex G-50. Only 24% eluted in the salt position. After 240 min incubation, increased amount of radioactivity appeared in the Na/sup 125/I position. When bovine insulin was added together with the labeled hormone, a substantial reduction of radioactivity was observed in the insulin and Na/sup 125/I elution positions. Dissociation studies were performed at 6 degrees in glands preincubated with /sup 125/I-insulin either at 24 or 6 degrees. The percentage of trichloroacetic acid (TCA)-soluble radioactive material in the dissociation medium increased with incubation time at both temperatures. However, the degradation activity was lower at 6 than at 24 degrees. The addition of bovine insulin to the incubation buffer containing /sup 125/I-insulin reduced the radioactive degradation products in the dissociated medium. Chloroquine or bacitracin inhibited the degradation activity. Incubation of thyroid glands with /sup 125/I-hGH or /sup 125/I-BSA showed values of uptake, dissociation, and degradation similar to those experiments in which an excess of bovine insulin was added together with the labeled hormone. Thus, by multiple criteria, such as specific uptake, dissociation, and degradation, the presence of insulin-binding sites in the turtle thyroid gland may be suggested.

  10. Scintillation Studies of the Mouse Mammary Tumor Virus with ^125I

    NASA Astrophysics Data System (ADS)

    Yazdi, Amir; Blue, Eric; Bradley, Eric; Majewski, Stan; Mohammed, Shira; Qian, Jianguo; Saha, Margaret; Schworer, Stephen; Sutton, Jonathan; Weisenberger, Andrew; Welsh, Robert

    2007-10-01

    We have applied the techniques of scintillation imaging to studies of the mouse mammary tumor virus (MMTV). In these studies, Sodium Iodide Symporter (NIS) transfers the radioactive ^125I to the mammary glands of lactating mice and in particular to those mammaries with visible tumors. These studies have principally been carried out using pixellated scintillators coupled to position sensitive photomultiplier tubes (PSPMTs). More recently, we have initiated such studies with a monolithic slab of LaBr3 scintillator coupled to an array of PSPMTs. Several techniques of mapping and measuring the development of such tumors have been employed. These will be discussed in detail and preliminary results will be reported.

  11. Rapid extraction, radioiodination, and in vivo catabolism of 125I-labeled fibrinogen in the horse

    SciTech Connect

    Coyne, C.P.; Hornof, W.J.; Kelly, A.B.; O'Brien, T.R.; DeNardo, S.J.

    1985-12-01

    Two methods were analyzed for the rapid extraction of equine fibrinogen from fresh plasma, using ammonium sulfate-sodium phosphate buffer. Fibrinogen from each of these 2 methods was then radiolabeled with 125I (half-life = 60.2 days, gamma = 35 keV), using monochloroiodine reagent. Mean protein-bound activity was 98.5% and mean clottable radioactivity was 94.1%. Radiolabeled fibrinogen administered IV to 15 horses had an overall mean (+/- SD) plasma half-life of 4.95 +/- 0.44 days.

  12. Double K-shell vacancy production in the electron capture decay of 125I

    NASA Astrophysics Data System (ADS)

    Hindi, M. M.; Kozub, R. L.

    1992-03-01

    We have measured the probability of double K-shell vacancy production in the electron capture decay of 125I to the 35-keV level of 125Te. The probability was deduced from the number of triple coincidences between the Te hypersatellite and satellite x rays produced in filling the double vacancy, and the subsequent normal x ray accompanying the K internal conversion of the 35-keV level. The probability of double K-shell vacancy production per K-shell electron capture (PKK) was found to be (1.35+/-0.15)×10-5.

  13. Ocular penetration of (/sup 125/I)IVDU, a radiolabeled analogue of bromovinyldeoxyuridine

    SciTech Connect

    Maudgal, P.C.; Verbruggen, A.M.; De Clercq, E.; Busson, R.; Bernaerts, R.; de Roo, M.; Ameye, C.; Missotten, L.

    1985-01-01

    Following topical application of (/sup 125/)IVDU, the radiolabeled analogue of bromovinyldeoxyuridine ((E)-5-(2-bromovinyl)-2'-deoxyuridine), as 0.5% or 0.3% eyedrops, to rabbits, (/sup 125/I)IVDU appeared in the anterior chamber fluid at drug levels well above the minimum concentration (0.01 microgram/mL) required for inhibition of herpes simplex virus type 1 replication. These findings are consistent with the efficacy of 0.5% bromovinyldeoxyuridine eyedrops in the topical treatment of herpes simplex uveitis.

  14. Preparation and one-step purification of mono-125I-angiotensin II for radioligand binding assays

    SciTech Connect

    Speth, R.C.; Husain, A.

    1984-04-01

    A one-step purification of mono-/sup 125/I-angiotensin II prepared by the chloramine T procedure is described. The purification is effected on a cellulose cation exchange column with isocratic elution by 50 mM sodium acetate, pH 5.0. The purity of the mono-/sup 125/I-angiotensin II was determined by thin layer chromatography, high pressure liquid chromatography, enzymatic digestion, radioreceptor assay, and radioimmunoassay. Preparation and purification of mono-/sup 125/I-angiotensin II by this procedure offers significant advantages over existing methods for its preparation in terms of purity, simplicity, efficiency, and cost.

  15. A rapid means of separating A14-/sup 125/I-insulin from heterogeneously labeled insulin molecules for biologic studies

    SciTech Connect

    Stentz, F.B.; Wright, R.K.; Kitabchi, A.E.

    1982-12-01

    We have used two methods for the preparation of a highly homogeneous insulin with high specific activity. After iodination with chloramine T, the labeled peptides were retained on a disposable Sep Pak cartridge and subsequently eluted. The eluted labeled insulins were further purified by either DEAE cellulose or high performance liquid chromatography (HPLC) to separate A14-/sup 125/I- from A19-/sup 125/I-insulin. Both methods of chromatography were effective, but HPLC offered the advantage of better resolution in less time and higher yields of A14-/sup 125/I-insulin, which is suitable for biologic studies in various target tissues.

  16. Derivatives of cyclosporin compatible with antibody-based assays. I. The generation of (/sup 125/I)-labeled cyclosporin

    SciTech Connect

    Mahoney, W.C.; Orf, J.W.

    1985-03-01

    The immunosuppressive drug cyclosporin A, has been successfully iodinated to a specific activity of 300 Ci per gram. /sup 125/I-labeled cyclosporin and (/sup 3/H)cyclosporin are nearly equivalent as tracers in a radioimmunoassay in producing standard lines (suppression by unlabeled cyclosporin) and in assigning values to clinical samples. In addition, the (/sup 125/I)-labeled cyclosporin has greater than twice the sensitivity, and it is stable to long-term storage. Use of a (/sup 125/I)-labeled cyclosporin tracer is more convenient, more reproducible, more precise, and easier than the tritiated-cyclosporin alternative in radioimmunoassay of this compound.

  17. [Prostate cancer brachytherapy].

    PubMed

    Pommier, P; Guérif, S; Peiffert, D; Créhange, G; Hannoun-Lévi, J-M; de Crevoisier, R

    2016-09-01

    Prostate brachytherapy techniques are described, concerning both Iodine 125 high dose rate brachytherapy. The following parts are presented: brachytherapy indications, technical description, immediate postoperative management and post-treatment evaluation, and 4 to 6 weeks as well as long-term follow-up. Copyright © 2016. Published by Elsevier SAS.

  18. Radiation pneumonitis caused by a migrated brachytherapy seed lodged in the lung.

    PubMed

    Miura, Noriyoshi; Kusuhara, Yoshito; Numata, Kousaku; Shirato, Akitomi; Hashine, Katsuyoshi; Sumiyoshi, Yoshiteru; Kataoka, Masaaki; Takechi, Shinsuke

    2008-09-01

    We report a case of radiation pneumonitis caused by a migrated seed lodged in the lung after prostate brachytherapy. A 71-year-old man underwent transperineal interstitial permanent prostate brachytherapy for localized prostate cancer. On the day after brachytherapy, a routine postimplant chest X-ray revealed migration of one seed to the lower lobe of the left lung. After 1 month, pulmonary opacities were observed in the left lower lobe but not near the seed. He was diagnosed with bacterial pneumonia, and antibiotic therapy was commenced. Two months after brachytherapy, the patient's symptoms, laboratory data and pulmonary opacities improved; however, an abnormal shadow (consolidation) developed around the migrated seed. Lung consolidation disappeared almost completely 12 months after brachytherapy without any medical treatment. The abnormal shadow probably represented radiation pneumonitis. To the best of our knowledge, this is the first report of radiation pneumonitis caused by a migrated brachytherapy seed in the lung.

  19. Adjuvant brachytherapy in the treatment of soft-tissue sarcomas.

    PubMed

    Crownover, R L; Marks, K E

    1999-06-01

    For many patients with STS, administering adjuvant radiation treatments in the form of interstitial brachytherapy provides an excellent alternative to a protracted course of EBRT. Ideal patients are those with intermediate- or high-grade tumors amenable to en bloc resection. Attractive features of this approach include an untainted pathologic specimen, expeditious completion of treatment, reduction in wound complications, and improved functional outcome. Brachytherapy can permit definitive reirradiation by tightly localizing the high dose radiation exposure. It is also useful in patients who are known to have or be at high risk of metastatic disease, for whom the rapid completion of local treatment allows systemic therapy to begin quickly. Introduction of HDR techniques has shifted the delivery of brachytherapy from inpatient solitary confinement to an outpatient setting. Early reports using HDR brachytherapy for treatment of adult and pediatric STS are quite encouraging. The clinical equivalence between hyperfractionated HDR schedules and traditional LDR techniques is gaining acceptance.

  20. The preparation and properties of purified 125I-labelled antibodies to insulin

    PubMed Central

    Miles, L. E. M.; Hales, C. N.

    1968-01-01

    1. A procedure is described for the preparation of an insulin-immunoadsorbent containing 105–185mg. of insulin/g. of matrix, and with an antibody-binding capacity of 660mg./g. of insulin-immunoadsorbent. 2. Purified non-precipitating 125I-labelled antibodies were prepared by iodination of the antibodies while they were isolated on the insulin-immunoadsorbent in order to protect at least one antigen-binding site. 3. The radioactive antibody was simply and rapidly separated from other radioactive material and damaging reagents, and found to be up to 94% pure as judged by its reaction with insulin-immunoadsorbent and unfixed insulin. 4. The 125I-labelled antibody preparations had iodine contents of 0·5–64atoms/mol. of protein and specific radioactivities of 0·3–125mc/mg. of protein. 5. It is suggested that this is a simple method of producing a useful reagent. PMID:5667273

  1. Search for 17-keV neutrinos in the internal bremsstrahlung spectrum of {sup 125}I

    SciTech Connect

    Kozub, R.L.; Hindi, M.M.; Parker, J.G.; Robinson, S.J.

    1993-10-01

    We have conducted an experiment to search for the signature of a 17-keV neutrino in the internal bremsstrahlung (IB) spectrum of {sup 125}I. Gamma rays from a {approximately} 100 mCi {sup 125}I point source were counted in a planar HPGe detector which is 16 mm in diameter and 10 mm in depth and which has a resolution of 560 eV at 122 keV. The source was counted for 61 d and the background for 17 d. At the start of the counting period the count rate was 650 s{sup -1}; the number of counts 17 keV below the 2p endpoint is 10{sup 6} per keV. Data in the energy interval 120-150.5 keV were fitted with a theoretical spectrum calculated using nonrelativistic Hartree-Fock atomic wavefunctions. The preliminary fits reject the hypothesis of a 0.8% 17-keV neutrino at a confidence level of {ge} 98%. We are in the process of reanalyzing the data using recent relativistic theoretical shapes.

  2. Autoradiographic localization of (/sup 125/I-Tyr4)bombesin-binding sites in rat brain

    SciTech Connect

    Zarbin, M.A.; Kuhar, M.J.; O'Donohue, T.L.; Wolf, S.S.; Moody, T.W.

    1985-02-01

    The binding of (/sup 125/I-Tyr/sub 4/)bombesin to rat brain slices was investigated. Radiolabeled (Tyr/sub 4/)bombesin bound with high affinity (K/sub d/ . 4 nM) to a single class of sites (B/sub max/ . 130 fmol/mg of protein); the ratio of specific to nonspecific binding was 6/1. Also, pharmacology studies indicated that the C-terminal of bombesin was important for the high affinity binding activity. Autoradiographic studies indicated that the (/sup 125/I-Tyr4)bombesin-binding sites were discretely distributed in certain gray but not white matter regions of rat brain. Highest grain densities were present in the olfactory bulb and tubercle, nucleus accumbens, suprachiasmatic and periventricular nuclei of the hypothalamus, central medial thalamic nucleus, medial amygdaloid nucleus, hippocampus, dentate gyrus, subiculum, nucleus of the solitary tract, and substantia gelatinosa. Moderate grain densities were present in the parietal cortex, deep layers of the neocortex, rhinal cortex, caudate putamen, stria terminalis, locus ceruleus, parabrachial nucleus, and facial nucleus. Low grain densities were present in the globus pallidus, lateral thalamus, and midbrain. Negligible grain densities were present in the cerebellum, corpus callosum, and all regions treated with 1 microM unlabeled bombesin. The discrete regional distribution of binding suggests that endogenous bombesin-like peptides may function as important regulatory agents in certain brain loci.

  3. Autoradiographic localization of (/sup 125/I)-angiotensin II binding sites in the rat adrenal gland

    SciTech Connect

    Healy, D.P.; Maciejewski, A.R.; Printz, M.P.

    1985-03-01

    To gain greater insight into sites of action of circulating angiotensin II (Ang II) within the adrenal, we have localized the (/sup 125/I)-Ang II binding site using in vitro autoradiography. Autoradiograms were generated either by apposition of isotope-sensitive film or with emulsion-coated coverslips to slide-mounted adrenal sections labeled in vitro with 1.0 nM (/sup 125/I)-Ang II. Analysis of the autoradiograms showed that Ang II binding sites were concentrated in a thin band in the outer cortex (over the cells of the zona glomerulosa) and in the adrenal medulla, which at higher power was seen as dense patches. Few sites were evident in the inner cortex. The existence of Ang II binding sites in the adrenal medulla was confirmed by conventional homogenate binding techniques which revealed a single class of high affinity Ang II binding site (K/sub d/ . 0.7nM, B/sub max/ . 168.7 fmol/mg). These results suggest that the adrenal medulla may be a target for direct receptor-mediated actions of Ang II.

  4. Autoradiographic distribution of /sup 125/I-galanin binding sites in the rat central nervous system

    SciTech Connect

    Skofitsch, G.; Sills, M.A.; Jacobowitz, D.M.

    1986-11-01

    Galanin (GAL) binding sites in coronal sections of the rat brain were demonstrated using autoradiographic methods. Scatchard analysis of /sup 125/I-GAL binding to slide-mounted tissue sections revealed saturable binding to a single class of receptors with a Kd of approximately 0.2 nM. /sup 125/I-GAL binding sites were demonstrated throughout the rat central nervous system. Dense binding was observed in the following areas: prefrontal cortex, the anterior nuclei of the olfactory bulb, several nuclei of the amygdaloid complex, the dorsal septal area, dorsal bed nucleus of the stria terminalis, the ventral pallidum, the internal medullary laminae of the thalamus, medial pretectal nucleus, nucleus of the medial optic tract, borderline area of the caudal spinal trigeminal nucleus adjacent to the spinal trigeminal tract, the substantia gelatinosa and the superficial layers of the dorsal spinal cord. Moderate binding was observed in the piriform, periamygdaloid, entorhinal, insular cortex and the subiculum, the nucleus accumbens, medial forebrain bundle, anterior hypothalamic, ventromedial, dorsal premamillary, lateral and periventricular thalamic nuclei, the subzona incerta, Forel's field H1 and H2, periventricular gray matter, medial and superficial gray strata of the superior colliculus, dorsal parts of the central gray, peripeduncular area, the interpeduncular nucleus, substantia nigra zona compacta, ventral tegmental area, the dorsal and ventral parabrachial and parvocellular reticular nuclei. The preponderance of GAL-binding in somatosensory as well as in limbic areas suggests a possible involvement of GAL in a variety of brain functions.

  5. Plasma kinetics of sup 125 I beta endorphin turnover in lean and obese Zucker rats

    SciTech Connect

    Rodd, D.; Caston, A.L.; Green M.H.; Farrell, P.A. )

    1990-02-26

    Plasma clearance kinetics for Beta Endorphin (BEP) are not well-defined and no definitive data exist for lean versus obese animals. To determine such kinetic parameters, a bolus of {sup 125}I BEP (1{mu}Ci/kg) was infused into awake lean(L) and obese(O) Zucker rats. Arterial blood samples were withdrawn initially at 20 seconds intervals and less frequently as a 3-hour experimental period progressed. Donor rat blood was infused (venous catheter) to replace withdrawn blood. At 180 minutes approximately 10% of the initial dose remained in the plasma. Clearance kinetics for {sup 125}I BEP were analyzed by compartmental analysis. A 3-component equation (i.e., 3 compartment model) provided the best fit for both L and O groups. Plasma transit times were very rapid; however, plasma fractional catabolic rate was low. Plasma mean residence time was similar for both groups (50 minutes) as was recycle time. These data suggest that BEP kinetics are similar in L and O rats, and that this peptide may undergo extensive recycling into and out of the plasma compartment. The identity of the other two compartments requires further investigation.

  6. Detection by cationized /sup 125/I-cytochrome C of proteoglycans (PG) transferred to nylon

    SciTech Connect

    Heimer, R.; Sampson, P.M.; Fishman, A.P.

    1986-05-01

    Cytochrome c, labeled with /sup 125/I, has been used by us for staining glycosaminoglycans (GAG) separated by electrophoresis on cellulose acetate strips. As GAG between 1-10 ng could be quantified by autoradiography and densitometry, the reagent is approximately 100-fold more sensitive than currently used non-radiolabeled stains. The authors extend now the use of radiolabeled cytochrome c to the quantification of PG transblotted to solid supports subsequent to separation on polyacrylamine slab gels. Dot blotting used for exploring optimal conditions for detecting PG indicated that because of low background positively charged Nylon 66 was superior to nitrocellulose. Increasing the positive charge of the staining reagent by cationization decreased background radiation even further so that 1 ng PG could be seen readily after 5 hrs of autoradiography. Use of cationized /sup 125/I-cytochrome c has been made in detecting PG of bovine fetal epiphyseal cartilage (> 1 x 10/sup 6/ D) and PG of bovine aorta (0.25 x 10/sup 6/ D) following slab gel electrophoresis and electrophoretic transblotting. With effective electrophoretic transfer of the PG to positively charged Nylon 66, the sensitivity of detection of the two PG was increased at least 100-fold over that observed when the gels were stained with toluidine blue, the method in current use.

  7. Receptor binding and cell-mediated metabolism of (/sup 125/I)monoiodoglucagon by isolated canine hepatocytes

    SciTech Connect

    Hagopian, W.A.; Tager, H.S.

    1984-07-25

    A reverse-phase HPLC method has been developed to purify /sup 125/I-labeled products resulting from the chloramine-T-based iodination of glucagon. In addition the products ((/sup 125/I)iodoTyr/sup 10/ /sup 13/)glucagon, ((/sup 125/I)iodoTyr/sup 13/)glucagon, and ((/sup 125/I)iodoTyr/sup 10/)glucagon) have been used to study the receptor binding of glucagon and the cell-mediated metabolism of the hormone by isolated canine hepatocytes. It was concluded that (a) not withstanding apparent differences in affinities exhibited by the three peptides, the interactions with the glucagon receptor are functionally equivalent, and (b) the cell-mediated metabolism of receptor-bound glucagon involves the formation of hormone-derived peptides in which the biologically important NH/sub 2/-terminal region of the hormone has been modified by limited proteolytic cleavage.

  8. Relationship between alveolar bone measured by /sup 125/I absorptiometry with analysis of standardized radiographs: 1. Magiscan

    SciTech Connect

    Hausmann, E.; Ortman, L.F.; McHenry, K.; Fallon, J.

    1982-05-01

    Previous studies have shown that /sup 125/I absorptiometry gives an accurate and sensitive measure of alveolar bone mass. The purpose of this study was to determine the relationship between alveolar bone mass determined by /sup 125/I absorptiometry and bone density obtained by analysis of standardized intraoral radiographs by the Magiscan System. A defect of increasing size was made at one site of the alveolar bone in a human skull. The amount of bone remaining at each step was calculated using /sup 125/I absorptiometry. Standardized radiographs were also taken at each step and the relative density in the area of the defect was determined by the Magiscan System. The Magiscan's System Computer Memory permits analysis of identical areas on a longitudinal series of films of the same alveolar bone location. The results indicate that in estimating amounts of alveolar bone the Magiscan analysis of standardized intraoral radiography is similar in sensitivity and accuracy to /sup 125/I absorptiometry.

  9. Endocytosis and subsequent processing of 125I-labelled immunoglobulin G by guinea pig yolk sac in vitro.

    PubMed Central

    Douglas, G C; King, B F

    1985-01-01

    We have developed conditions for studying the binding, uptake, degradation and transport of 125I-labelled IgG by yolk sac in vitro. Specific binding to tissue at 4 degrees C and to paraformaldehyde-treated tissue at 37 degrees C was time- and temperature-dependent and showed saturation kinetics (Kd,4 degrees C = 2.9 X 10(-6) M, Kd,37 degrees C = 5.3 X 10(-6) M). Uptake was studied at 37 degrees C using untreated tissue (K uptake = 13.3 X 10(-6) M) and was inhibited by preincubation with metabolic poisons but not with cycloheximide. Tissue that had been incubated with 125I-labelled IgG at 37 degrees C released radiolabelled degradation products and intact 125I-labelled IgG into the medium. Experiments with paraformaldehyde-treated and untreated tissue showed that release of intact 125I-labelled IgG was mostly the result of ligand dissociation from surface binding sites. However, more 125I-labelled IgG was released from untreated tissue than could be accounted for solely by loss of surface-bound ligand and the difference was presumed to reflect uptake, transport and exocytosis of 125I-labelled IgG. Degradation of 125I-labelled IgG was inhibited by leupeptin and lysosomotropic amines. These drugs had no detectable effect on 125I-labelled IgG release. The results suggest that degradation and transport of IgG are not intimately related and are consistent with a previously proposed model for IgG transport via coated vesicles which do not fuse with lysosomes and for non-selective uptake into another class of vesicle which does fuse with lysosomes. PMID:4004783

  10. Heterogeneity in mouse seminal vesicle epithelial cells responding to androgen as evaluated by incorporation of (/sup 125/I)iododeoxyuridine

    SciTech Connect

    Terada, N.; Ogasawara, Y.; Yamane, T.; Matsumoto, K.; Kitamura, Y.

    1985-04-01

    When the uptake of 5-(/sup 125/I)iodo-2'-deoxyuridine ((/sup 125/I)IdUrd) into the seminal vesicle of castrated mice was measured 3 days after starting injections of various doses of testosterone propionate (TP), logarithmic values of (/sup 125/I)IdUrd uptake were proportional to the logarithmic doses of TP in the range of 0.04-2 micrograms/g BW. The (/sup 125/I)IdUrd uptake values correlated well with the labeling and mitotic indices of epithelial cells. Since daily injections of 0.4 microgram TP/g BW did not increase significantly the weight or DNA content or protein content of the seminal vesicle, the (/sup 125/I)IdUrd uptake is a sensitive index of androgen action. Moreover, this suggests that low doses of androgen induce division of epithelial cells without resulting in the increase in cell number. The (/sup 125/I)IdUrd radioactivity in the seminal vesicle was measured 2-15 days after the injection of (/sup 125/I)IdUrd, since the value represented the fraction of surviving cells synthesizing DNA at the time of (/sup 125/I)IdUrd injection. When injections of 4 micrograms TP/g BW were continued, the incorporated radioactivity was retained. In contrast, continuous injections of 0.2 microgram TP/g BW did not maintain the radioactivity, of which incorporation was induced by the same dose of TP. Thus, the present result suggests the presence of heterogeneity in androgen-responsive epithelial cells of the seminal vesicle.

  11. O6-3-[125I]iodobenzyl-2'-deoxyguanosine ([125I]IBdG): synthesis and evaluation of its usefulness as an agent for quantification of alkylguanine-DNA alkyltransferase (AGT).

    PubMed

    Shankar, Sriram; Zalutsky, Michael R; Vaidyanathan, Ganesan

    2005-06-02

    The development of O(6)-(3-[(125)I]iodobenzyl)-2'-deoxyguanosine ([(125)I]IBdG), the glycosylated analogue of the O(6)-3-iodobenzylguanine (IBG), as an agent for the in vivo mapping of the DNA repair protein alkylguanine-DNA alkyltransferase (AGT) is described. Synthesis of its tin precursor, O(6)-3-trimethylstannylbenzyl-2'-deoxyguanosine (TBdG) was achieved in four steps from deoxyguanosine. Radioiodination of TBdG in a single step gave [(125)I]IBdG in 70-85% isolated radiochemical yield. [(125)I]IBdG bound specifically to pure AGT with an IC(50) of 7.1 microM. From paired-label assays, [(125)I]IBdG showed a 2- to 3-fold higher cellular uptake than [(131)I]IBG in DAOY medulloblastoma, TE-671 rhabdomyosarcoma, SK-Mel-28 melanoma, and HT-29 colon carcinoma human cell lines. Uptake of both labeled compounds in these cell lines decreased with increasing concentrations of unlabeled O(6)-benzylguanine (BG) when BG was present in the medium during incubation with the labeled compounds. Compared to BG, unlabeled IBdG diminished the uptake of [(125)I]IBdG and [(131)I]IBG in DAOY cells more efficiently (IC(50)<1 microM vs >10 microM for BG). There was no significant change in cell-bound activity of [(125)I]IBdG and [(131)I]IBG when BG was removed from the incubation medium before incubating cells with the tracers, suggesting that only a very small portion of radioactivity taken up by the cells is AGT bound. This was corroborated by gel-electrophoresis performed on extracts from cells treated with varying amounts of BG and then incubated with [(125)I]IBdG in the presence of BG. No radiolabeled AGT band was discernable by phosphor-imaging, signifying low cellular AGT binding of the radiotracer. In contrast, when cell extracts were prepared from BG pre-treated cells and aliquots were incubated with [(125)I]IBdG subsequently, the intensity of radiolabeled AGT band decreased linearly as a function of BG concentration. This suggests that the low level of [(125)I]IBdG that binds

  12. Dynamic rotating-shield brachytherapy

    SciTech Connect

    Liu, Yunlong; Flynn, Ryan T.; Kim, Yusung; Yang, Wenjun; Wu, Xiaodong

    2013-12-15

    Purpose: To present dynamic rotating shield brachytherapy (D-RSBT), a novel form of high-dose-rate brachytherapy (HDR-BT) with electronic brachytherapy source, where the radiation shield is capable of changing emission angles during the radiation delivery process.Methods: A D-RSBT system uses two layers of independently rotating tungsten alloy shields, each with a 180° azimuthal emission angle. The D-RSBT planning is separated into two stages: anchor plan optimization and optimal sequencing. In the anchor plan optimization, anchor plans are generated by maximizing the D{sub 90} for the high-risk clinical-tumor-volume (HR-CTV) assuming a fixed azimuthal emission angle of 11.25°. In the optimal sequencing, treatment plans that most closely approximate the anchor plans under the delivery-time constraint will be efficiently computed. Treatment plans for five cervical cancer patients were generated for D-RSBT, single-shield RSBT (S-RSBT), and {sup 192}Ir-based intracavitary brachytherapy with supplementary interstitial brachytherapy (IS + ICBT) assuming five treatment fractions. External beam radiotherapy doses of 45 Gy in 25 fractions of 1.8 Gy each were accounted for. The high-risk clinical target volume (HR-CTV) doses were escalated such that the D{sub 2cc} of the rectum, sigmoid colon, or bladder reached its tolerance equivalent dose in 2 Gy fractions (EQD2 with α/β= 3 Gy) of 75 Gy, 75 Gy, or 90 Gy, respectively.Results: For the patients considered, IS + ICBT had an average total dwell time of 5.7 minutes/fraction (min/fx) assuming a 10 Ci{sup 192}Ir source, and the average HR-CTV D{sub 90} was 78.9 Gy. In order to match the HR-CTV D{sub 90} of IS + ICBT, D-RSBT required an average of 10.1 min/fx more delivery time, and S-RSBT required 6.7 min/fx more. If an additional 20 min/fx of delivery time is allowed beyond that of the IS + ICBT case, D-RSBT and S-RSBT increased the HR-CTV D{sub 90} above IS + ICBT by an average of 16.3 Gy and 9.1 Gy, respectively

  13. Dynamic rotating-shield brachytherapy

    PubMed Central

    Liu, Yunlong; Flynn, Ryan T.; Kim, Yusung; Yang, Wenjun; Wu, Xiaodong

    2013-01-01

    Purpose: To present dynamic rotating shield brachytherapy (D-RSBT), a novel form of high-dose-rate brachytherapy (HDR-BT) with electronic brachytherapy source, where the radiation shield is capable of changing emission angles during the radiation delivery process. Methods: A D-RSBT system uses two layers of independently rotating tungsten alloy shields, each with a 180° azimuthal emission angle. The D-RSBT planning is separated into two stages: anchor plan optimization and optimal sequencing. In the anchor plan optimization, anchor plans are generated by maximizing the D90 for the high-risk clinical-tumor-volume (HR-CTV) assuming a fixed azimuthal emission angle of 11.25°. In the optimal sequencing, treatment plans that most closely approximate the anchor plans under the delivery-time constraint will be efficiently computed. Treatment plans for five cervical cancer patients were generated for D-RSBT, single-shield RSBT (S-RSBT), and 192Ir-based intracavitary brachytherapy with supplementary interstitial brachytherapy (IS + ICBT) assuming five treatment fractions. External beam radiotherapy doses of 45 Gy in 25 fractions of 1.8 Gy each were accounted for. The high-risk clinical target volume (HR-CTV) doses were escalated such that the D2cc of the rectum, sigmoid colon, or bladder reached its tolerance equivalent dose in 2 Gy fractions (EQD2 with α/β = 3 Gy) of 75 Gy, 75 Gy, or 90 Gy, respectively. Results: For the patients considered, IS + ICBT had an average total dwell time of 5.7 minutes/fraction (min/fx) assuming a 10 Ci192Ir source, and the average HR-CTV D90 was 78.9 Gy. In order to match the HR-CTV D90 of IS + ICBT, D-RSBT required an average of 10.1 min/fx more delivery time, and S-RSBT required 6.7 min/fx more. If an additional 20 min/fx of delivery time is allowed beyond that of the IS + ICBT case, D-RSBT and S-RSBT increased the HR-CTV D90 above IS + ICBT by an average of 16.3 Gy and 9.1 Gy, respectively. Conclusions: For cervical cancer patients, D

  14. Dynamic rotating-shield brachytherapy.

    PubMed

    Liu, Yunlong; Flynn, Ryan T; Kim, Yusung; Yang, Wenjun; Wu, Xiaodong

    2013-12-01

    To present dynamic rotating shield brachytherapy (D-RSBT), a novel form of high-dose-rate brachytherapy (HDR-BT) with electronic brachytherapy source, where the radiation shield is capable of changing emission angles during the radiation delivery process. A D-RSBT system uses two layers of independently rotating tungsten alloy shields, each with a 180° azimuthal emission angle. The D-RSBT planning is separated into two stages: anchor plan optimization and optimal sequencing. In the anchor plan optimization, anchor plans are generated by maximizing the D90 for the high-risk clinical-tumor-volume (HR-CTV) assuming a fixed azimuthal emission angle of 11.25°. In the optimal sequencing, treatment plans that most closely approximate the anchor plans under the delivery-time constraint will be efficiently computed. Treatment plans for five cervical cancer patients were generated for D-RSBT, single-shield RSBT (S-RSBT), and (192)Ir-based intracavitary brachytherapy with supplementary interstitial brachytherapy (IS + ICBT) assuming five treatment fractions. External beam radiotherapy doses of 45 Gy in 25 fractions of 1.8 Gy each were accounted for. The high-risk clinical target volume (HR-CTV) doses were escalated such that the D2cc of the rectum, sigmoid colon, or bladder reached its tolerance equivalent dose in 2 Gy fractions (EQD2 with α∕β = 3 Gy) of 75 Gy, 75 Gy, or 90 Gy, respectively. For the patients considered, IS + ICBT had an average total dwell time of 5.7 minutes∕fraction (min∕fx) assuming a 10 Ci(192)Ir source, and the average HR-CTV D90 was 78.9 Gy. In order to match the HR-CTV D90 of IS + ICBT, D-RSBT required an average of 10.1 min∕fx more delivery time, and S-RSBT required 6.7 min∕fx more. If an additional 20 min∕fx of delivery time is allowed beyond that of the IS + ICBT case, D-RSBT and S-RSBT increased the HR-CTV D90 above IS + ICBT by an average of 16.3 Gy and 9.1 Gy, respectively. For cervical cancer patients, D-RSBT can boost HR-CTV D90

  15. Interstitial keratitis

    MedlinePlus

    ... However, interstitial keratitis accounts for 10% of avoidable blindness in the least developed countries worldwide. ... chap 4.17. World Health Organization. Causes of blindness and visual impairment. Prevention of blindness and visual ...

  16. Interstitial thermoradiotherapy.

    PubMed

    Coughlin, C T; Strohbehn, J W

    1989-05-01

    The more recent engineering and clinical aspects of interstitial hyperthermia a