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Sample records for ablative radiotherapy sabr

  1. Stereotactic ablative body radiotherapy (SABR) for primary and secondary lung tumours

    PubMed Central

    Gaya, Andrew

    2012-01-01

    Abstract Stereotactic ablative body radiotherapy (SABR) represents a technological breakthrough in radiotherapy technique, with proven benefits to patients in terms of improved tumour control and overall survival. The key components of SABR are described. The current evidence base for SABR for the treatment of primary and secondary lung tumours is appraised, and key ongoing trials are identified. PMID:23023165

  2. Survey of stereotactic ablative body radiotherapy in the UK by the QA group on behalf of the UK SABR Consortium

    PubMed Central

    Baker, A; Scott, A J D; Webster, G J

    2014-01-01

    Objective: To ascertain the progress being made towards the implementation of stereotactic ablative body radiotherapy (SABR) treatment in the UK, to obtain details of current practice in centres with an active treatment programme and to assess the projected future provision. Methods: In August 2012, an online questionnaire was sent to all 65 UK radiotherapy institutions. The included questions covered the current number of patients being treated and the intended number of patients for each clinical site; immobilization and motion management methods; CT scanning protocols; target and organ-at-risk delineation; treatment planning; image-guidance and treatment protocols; and quality assurance methods. Results: 48/65 (74%) institutions responded by the end of November 2012, with 15 indicating an active SABR programme. A further four centres indicated that a SABR protocol had been established but was not yet in clinical use. 14 of the 29 remaining responses stated an intention to develop a SABR programme in the next 2 years. Conclusion: The survey responses confirm that SABR provision in the UK is increasing and that this should be expected to continue in the next 2 years. A projection of the future uptake would suggest that by the end of 2014, UK SABR provision will be broadly in line with international practice. PMID:24620840

  3. [Current Status of Stereotactic Ablative Radiotherapy (SABR) for Early-stage 
Non-small Cell Lung Cancer].

    PubMed

    Shi, Anhui; Zhu, Guangying

    2016-06-20

    High level evidence from randomized studies comparing stereotactic ablative radiotherapy (SABR) to surgery is lacking. Although the results of pooled analysis of two randomized trials for STARS and ROSEL showed that SABR is better tolerated and might lead to better overall survival than surgery for operable clinical stage I non-small cell lung cancer (NSCLC), SABR, however, is only recommended as a preferred treatment option for early stage NSCLC patients who cannot or will not undergo surgery. We, therefore, are waiting for the results of the ongoing randomized studies [Veterans affairs lung cancer surgery or stereotactic radiotherapy in the US (VALOR) and the SABRTooth study in the United Kingdom (SABRTooths)]. Many retrospective and case control studies showed that SABR is safe and effective (local control rate higher than 90%, 5 years survival rate reached 70%), but there are considerable variations in the definitions and staging of lung cancer, operability determination, and surgical approaches to operable lung cancer (open vs video-assisted). Therefore, it is difficult to compare the superiority of radiotherapy and surgery in the treatment of early staged lung cancer. Most studies demonstrated that the efficacy of the two modalities for early staged lung cancer is equivalent; however, due to the limited data, the conclusions from those studies are difficult to be evidence based. Therefore, the controversies will be focusing on the safety and invasiveness of the two treatment modalities. This article will review the ongoing debate in light of these goals. PMID:27335303

  4. Surgery versus stereotactic ablative radiotherapy (SABR) for early-stage non-small cell lung cancer: less is not more.

    PubMed

    White, Abby; Swanson, Scott J

    2016-04-01

    High level evidence from randomized studies comparing surgery to stereotactic ablative radiotherapy (SABR) is lacking and available retrospective cohort and case control studies are highly variable in how thoroughly they define and stage lung cancer, in how they determine operability, and in the offered surgical approaches to operable lung cancer (open vs. video-assisted). This makes it difficult to compare best radiotherapy and best surgery approaches to treatment and to be confident in conclusions of equipoise between the two modalities. What has become clear from the controversy surrounding surgery versus SABR for early stage lung cancer is the desire to optimize treatment efficacy while minimizing invasiveness and morbidity. This review highlights the ongoing debate in light of these goals. PMID:27195137

  5. Surgery versus stereotactic ablative radiotherapy (SABR) for early-stage non-small cell lung cancer: less is not more

    PubMed Central

    Swanson, Scott J.

    2016-01-01

    High level evidence from randomized studies comparing surgery to stereotactic ablative radiotherapy (SABR) is lacking and available retrospective cohort and case control studies are highly variable in how thoroughly they define and stage lung cancer, in how they determine operability, and in the offered surgical approaches to operable lung cancer (open vs. video-assisted). This makes it difficult to compare best radiotherapy and best surgery approaches to treatment and to be confident in conclusions of equipoise between the two modalities. What has become clear from the controversy surrounding surgery versus SABR for early stage lung cancer is the desire to optimize treatment efficacy while minimizing invasiveness and morbidity. This review highlights the ongoing debate in light of these goals. PMID:27195137

  6. Recommendations for dose calculations of lung cancer treatment plans treated with stereotactic ablative body radiotherapy (SABR)

    NASA Astrophysics Data System (ADS)

    Devpura, S.; Siddiqui, M. S.; Chen, D.; Liu, D.; Li, H.; Kumar, S.; Gordon, J.; Ajlouni, M.; Movsas, B.; Chetty, I. J.

    2014-03-01

    The purpose of this study was to systematically evaluate dose distributions computed with 5 different dose algorithms for patients with lung cancers treated using stereotactic ablative body radiotherapy (SABR). Treatment plans for 133 lung cancer patients, initially computed with a 1D-pencil beam (equivalent-path-length, EPL-1D) algorithm, were recalculated with 4 other algorithms commissioned for treatment planning, including 3-D pencil-beam (EPL-3D), anisotropic analytical algorithm (AAA), collapsed cone convolution superposition (CCC), and Monte Carlo (MC). The plan prescription dose was 48 Gy in 4 fractions normalized to the 95% isodose line. Tumors were classified according to location: peripheral tumors surrounded by lung (lung-island, N=39), peripheral tumors attached to the rib-cage or chest wall (lung-wall, N=44), and centrally-located tumors (lung-central, N=50). Relative to the EPL-1D algorithm, PTV D95 and mean dose values computed with the other 4 algorithms were lowest for "lung-island" tumors with smallest field sizes (3-5 cm). On the other hand, the smallest differences were noted for lung-central tumors treated with largest field widths (7-10 cm). Amongst all locations, dose distribution differences were most strongly correlated with tumor size for lung-island tumors. For most cases, convolution/superposition and MC algorithms were in good agreement. Mean lung dose (MLD) values computed with the EPL-1D algorithm were highly correlated with that of the other algorithms (correlation coefficient =0.99). The MLD values were found to be ~10% lower for small lung-island tumors with the model-based (conv/superposition and MC) vs. the correction-based (pencil-beam) algorithms with the model-based algorithms predicting greater low dose spread within the lungs. This study suggests that pencil beam algorithms should be avoided for lung SABR planning. For the most challenging cases, small tumors surrounded entirely by lung tissue (lung-island type), a Monte

  7. Improved survival with stereotactic ablative radiotherapy (SABR) over lobectomy for early stage non-small cell lung cancer (NSCLC): addressing the fallout of disruptive randomized data

    PubMed Central

    Kavanagh, Brian D.; Karam, Sana D.

    2015-01-01

    The gold-standard therapy for early stage non-small cell lung cancer (esNSCLC) has historically been lobectomy with mediastinal lymph node dissection. However, up to one-third of patients with esNSCLC are considered medically-inoperable due to factors such as advanced age and comorbid illnesses. The past decade has witnessed a dramatic increase in the use of high-dose conformal radiotherapy delivered over 1-5 fractions, synonymously termed stereotactic ablative radiotherapy (SABR) or stereotactic body radiation therapy (SBRT). High rates of tumor control and favorable toxicity profiles have led to the adoption of SABR as the treatment of choice for medically-inoperable patients. Limited but growing data exist using SABR for medically-operable patients who are also candidates for lobectomy. A recent pooled analysis of two multicenter prospective randomized trials, the STARS (NCT00840749) and ROSEL (NCT00687986) protocols, published by Chang and colleagues (PMID 25981812) reported improved overall survival (OS) and reduced toxicity with SABR over lobectomy for medically-operable patients with esNSCLC. In this article we review the outcomes of this analysis in the context of existing radiotherapy and surgical data for NSCLC. Further, we discuss the potential causes and implications of these provocative results, including the shifting balance between oncologic control and treatment-related mortality in comparisons of SABR and surgical resection, termed the Head Start Effect. PMID:26244136

  8. Early prediction of tumor recurrence based on CT texture changes after stereotactic ablative radiotherapy (SABR) for lung cancer

    SciTech Connect

    Mattonen, Sarah A.; Palma, David A.; Haasbeek, Cornelis J. A.; Senan, Suresh; Ward, Aaron D.

    2014-03-15

    Purpose: Benign computed tomography (CT) changes due to radiation induced lung injury (RILI) are common following stereotactic ablative radiotherapy (SABR) and can be difficult to differentiate from tumor recurrence. The authors measured the ability of CT image texture analysis, compared to more traditional measures of response, to predict eventual cancer recurrence based on CT images acquired within 5 months of treatment. Methods: A total of 24 lesions from 22 patients treated with SABR were selected for this study: 13 with moderate to severe benign RILI, and 11 with recurrence. Three-dimensional (3D) consolidative and ground-glass opacity (GGO) changes were manually delineated on all follow-up CT scans. Two size measures of the consolidation regions (longest axial diameter and 3D volume) and nine appearance features of the GGO were calculated: 2 first-order features [mean density and standard deviation of density (first-order texture)], and 7 second-order texture features [energy, entropy, correlation, inverse difference moment (IDM), inertia, cluster shade, and cluster prominence]. For comparison, the corresponding response evaluation criteria in solid tumors measures were also taken for the consolidation regions. Prediction accuracy was determined using the area under the receiver operating characteristic curve (AUC) and two-fold cross validation (CV). Results: For this analysis, 46 diagnostic CT scans scheduled for approximately 3 and 6 months post-treatment were binned based on their recorded scan dates into 2–5 month and 5–8 month follow-up time ranges. At 2–5 months post-treatment, first-order texture, energy, and entropy provided AUCs of 0.79–0.81 using a linear classifier. On two-fold CV, first-order texture yielded 73% accuracy versus 76%–77% with the second-order features. The size measures of the consolidative region, longest axial diameter and 3D volume, gave two-fold CV accuracies of 60% and 57%, and AUCs of 0.72 and 0.65, respectively

  9. Stereotactic ablative body radiotherapy (SABR): an alternative to surgery in stage I-II non-small-cell cancer of the lung?

    PubMed

    Mirimanoff, René-Olivier

    2015-12-01

    For decades, surgery was considered to be the only standard therapy for early-stage non-small cell lung cancer (NSCLC). However stereotactic ablative body radiotherapy (SABR) has been used in a growing number of patients and institutions since the early 2000's. Initially this technique was intended mainly for patients who were deemed to be medically inoperable due to co-morbidities or who refused surgery, but more recently it has been applied to operable patients as well. Strict criteria for treatment planning, the use of high-technology equipment and the appropriate selection of dose based on tumor size and location are of paramount importance for a proper application of SABR. Under these conditions, SABR offers high control rates with a moderate risk of severe toxicity, quite comparable to those of modern surgery. This article reviews the basic principles of SABR, its practical aspects, the definition of biologically equivalent doses, the results in terms of tumor control, survival and toxicity and an attempt will be made to compare the results of SABR with those of surgery. PMID:26730754

  10. Long term survival with stereotactic ablative radiotherapy (SABR) versus thoracoscopic sublobar lung resection in elderly people: national population based study with propensity matched comparative analysis

    PubMed Central

    Paul, Subroto; Lee, Paul C; Mao, Jialin; Isaacs, Abby J

    2016-01-01

    Objectives To compare cancer specific survival after thoracoscopic sublobar lung resection and stereotactic ablative radiotherapy (SABR) for tumors ≤2 cm in size and thoracoscopic resection (sublobar resection or lobectomy) and SABR for tumors ≤5 cm in size. Design National population based retrospective cohort study with propensity matched comparative analysis. Setting Surveillance, Epidemiology, and End Results (SEER) registry linked with Medicare database in the United States. Participants Patients aged ≥66 with lung cancer undergoing SABR or thoracoscopic lobectomy or sublobar resection from 1 Oct 2007 to 31 June 2012 and followed up to 31 December 2013. Main outcome measures Cancer specific survival after SABR or thoracoscopic surgery for lung cancer. Results 690 (275 (39.9%) SABR and 415 (60.1%) thoracoscopic sublobar lung resection) and 2967 (714 (24.1%) SABR and 2253 (75.9%) thoracoscopic resection) patients were included in primary and secondary analyses. The average age of the entire cohort was 76. Follow-up of the entire cohort ranged from 0 to 6.25 years, with an average of three years. In the primary analysis of patients with tumors sized ≤2 cm, 37 (13.5%) undergoing SABR and 44 (10.6%) undergoing thoracoscopic sublobar resection died from lung cancer, respectively. The cancer specific survival diverged after one year, but in the matched analysis (201 matched patients in each group) there was no significant difference between the groups (SABR v sublobar lung resection mortality: hazard ratio 1.32, 95% confidence interval 0.77 to 2.26; P=0.32). Estimated cancer specific survival at three years after SABR and thoracoscopic sublobar lung resection was 82.6% and 86.4%, respectively. The secondary analysis (643 matched patients in each group) showed that thoracoscopic resection was associated with improved cancer specific survival over SABR in patients with tumors sized ≤5 cm (SABR v resection mortality: hazard ratio 2.10, 1.52 to 2.89; P<0

  11. Quantification of interplay and gradient effects for lung stereotactic ablative radiotherapy (SABR) treatments.

    PubMed

    Tyler, Madelaine K

    2016-01-01

    This study quantified the interplay and gradient effects on GTV dose coverage for 3D CRT, dMLC IMRT, and VMAT SABR treatments for target amplitudes of 5-30 mm using 3DVH v3.1 software incorporating 4D Respiratory MotionSim (4D RMS) module. For clinically relevant motion periods (5 s), the interplay effect was small, with deviations in the minimum dose covering the target volume (D99%) of less than ± 2.5% for target amplitudes up to 30 mm. Increasing the period to 60 s resulted in interplay effects of up to ± 15.0% on target D99% dose coverage. The gradient effect introduced by target motion resulted in deviations of up to ± 3.5% in D99% target dose coverage. VMAT treatments showed the largest deviation in dose metrics, which was attributed to the long delivery times in comparison to dMLC IMRT. Retrospective patient analysis indicated minimal interplay and gradient effects for patients treated with dMLC IMRT at the NCCI. PMID:26894347

  12. Radiation-induced second primary cancer risks from modern external beam radiotherapy for early prostate cancer: impact of stereotactic ablative radiotherapy (SABR), volumetric modulated arc therapy (VMAT) and flattening filter free (FFF) radiotherapy

    NASA Astrophysics Data System (ADS)

    Murray, Louise J.; Thompson, Christopher M.; Lilley, John; Cosgrove, Vivian; Franks, Kevin; Sebag-Montefiore, David; Henry, Ann M.

    2015-02-01

    Risks of radiation-induced second primary cancer following prostate radiotherapy using 3D-conformal radiotherapy (3D-CRT), intensity-modulated radiotherapy (IMRT), volumetric modulated arc therapy (VMAT), flattening filter free (FFF) and stereotactic ablative radiotherapy (SABR) were evaluated. Prostate plans were created using 10 MV 3D-CRT (78 Gy in 39 fractions) and 6 MV 5-field IMRT (78 Gy in 39 fractions), VMAT (78 Gy in 39 fractions, with standard flattened and energy-matched FFF beams) and SABR (42.7 Gy in 7 fractions with standard flattened and energy-matched FFF beams). Dose-volume histograms from pelvic planning CT scans of three prostate patients, each planned using all 6 techniques, were used to calculate organ equivalent doses (OED) and excess absolute risks (EAR) of second rectal and bladder cancers, and pelvic bone and soft tissue sarcomas, using mechanistic, bell-shaped and plateau models. For organs distant to the treatment field, chamber measurements recorded in an anthropomorphic phantom were used to calculate OEDs and EARs using a linear model. Ratios of OED give relative radiation-induced second cancer risks. SABR resulted in lower second cancer risks at all sites relative to 3D-CRT. FFF resulted in lower second cancer risks in out-of-field tissues relative to equivalent flattened techniques, with increasing impact in organs at greater distances from the field. For example, FFF reduced second cancer risk by up to 20% in the stomach and up to 56% in the brain, relative to the equivalent flattened technique. Relative to 10 MV 3D-CRT, 6 MV IMRT or VMAT with flattening filter increased second cancer risks in several out-of-field organs, by up to 26% and 55%, respectively. For all techniques, EARs were consistently low. The observed large relative differences between techniques, in absolute terms, were very low, highlighting the importance of considering absolute risks alongside the corresponding relative risks, since when absolute

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

    SciTech Connect

    Mestrovic, A; Fortin, D; Alexander, A

    2014-08-15

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

  14. TU-F-BRE-07: In Vivo Neutron Detection in Patients Undergoing Stereotactic Ablative Radiotherapy (SABR) for Primary Kidney Cancer Using 6Li and 7Li Enriched TLD Pairs

    SciTech Connect

    Lonski, P; Kron, T; Franich, R; Keehan, S; Siva, S; Taylor, M

    2014-06-15

    Purpose: Stereotactic ablative radiotherapy (SABR) for primary kidney cancer often involves the use of high-energy photons combined with a large number of monitor units. While important for risk assessment, the additional neutron dose to untargeted healthy tissue is not accounted for in treatment planning. This work aims to detect out-of-field neutrons in vivo for patients undergoing SABR with high-energy (>10 MV) photons and provides preliminary estimates of neutron effective dose. Methods: 3 variations of high-sensitivity LiF:Mg,Cu,P thermoluminescent dosimeter (TLD) material, each with varying {sup 6}Li / {sup 7}Li concentrations, were used in custom-made Perspex holders for in vivo measurements. The variation in cross section for thermal neutrons between Li isotopes was exploited to distinguish neutron from photon signal. Measurements were made out-of-field for 7 patients, each undergoing 3D-conformal SABR treatment for primary kidney cancer on a Varian 21iX linear accelerator. Results: In vivo measurements show increased signal for the {sup 6}Li enriched material for patients treated with 18 MV photons. Measurements on one SABR patient treated using only 6 MV showed no difference between the 3 TLD materials. The out-of-field photon signal decreased exponentially with distance from the treatment field. The neutron signal, taken as the difference between {sup 6}Li enriched and {sup 7}Li enriched TLD response, remains almost constant up to 50 cm from the beam central axis. Estimates of neutron effective dose from preliminary TLD calibration suggest between 10 and 30 mSv per 1000 MU delivered at 18 MV for the 7 patients. Conclusion: TLD was proven to be a useful tool for the purpose of in vivo neutron detection at out-of-field locations. Further work is required to understand the relationship between TL signal and neutron dose. Dose estimates based on preliminary TLD calibration in a neutron beam suggest the additional neutron dose was <30 mSv per 1000 MU at 18 MV.

  15. Stereotactic Ablative Radiotherapy for the Treatment of Clinically Localized Renal Cell Carcinoma

    PubMed Central

    Campbell, Scott P.; Song, Daniel Y.; Pierorazio, Phillip M.; Allaf, Mohamad E.; Gorin, Michael A.

    2015-01-01

    Thermal ablation is currently the most studied treatment option for medically inoperable patients with clinically localized renal cell carcinoma (RCC). Recent evidence suggests that stereotactic ablative radiotherapy (SABR) may offer an effective noninvasive alternative for these patients. In this review, we explore the current literature on SABR for the primary treatment of RCC and make recommendations for future studies so that an accurate comparison between SABR and other ablative therapies may be conducted. PMID:26640488

  16. Stereotactic Ablative Radio Therapy (SABR) followed by immunotherapy a challenge for individualized treatment of metastatic solid tumours.

    PubMed

    Masucci, Giuseppe V; Wersäll, Peter; Kiessling, Rolf; Lundqvist, Andreas; Lewensohn, Rolf

    2012-01-01

    Combination strategies surely play a crucial role in treatment of cancer. Stereotactic ablative radiotherapy (SABR) has been described to induce abscopal effects particularly in renal cell cancer metastases. This effect is a reaction induced following irradiation of tumour tissue and occurring in another metastatic location outside the treatment field. However, this effect is limited and occurs sparsely in about 1-5% of patient. We are planning to improve the clinical outcome of this treatment in metastatic solid tumours by combining SABR with sequential immunotherapeutic treatments including vaccination strategies, adoptive cell therapy, cytokine therapy, or anti-CTLA-4 therapy. PMID:22616654

  17. Stereotactic Ablative Radio Therapy (SABR) followed by immunotherapy a challenge for individualized treatment of metastatic solid tumours

    PubMed Central

    2012-01-01

    Combination strategies surely play a crucial role in treatment of cancer. Stereotactic ablative radiotherapy (SABR) has been described to induce abscopal effects particularly in renal cell cancer metastases. This effect is a reaction induced following irradiation of tumour tissue and occurring in another metastatic location outside the treatment field. However, this effect is limited and occurs sparsely in about 1-5% of patient. We are planning to improve the clinical outcome of this treatment in metastatic solid tumours by combining SABR with sequential immunotherapeutic treatments including vaccination strategies, adoptive cell therapy, cytokine therapy, or anti-CTLA-4 therapy. PMID:22616654

  18. Stereotactic Ablative Radiotherapy for Oligometastatic Disease in Liver

    PubMed Central

    Kim, Myungsoo; Son, Seok Hyun; Won, Yong Kyun; Kay, Chul Seung

    2014-01-01

    Liver metastasis in solid tumors, including colorectal cancer, is the most frequent and lethal complication. The development of systemic therapy has led to prolonged survival. However, in selected patients with a finite number of discrete lesions in liver, defined as oligometastatic state, additional local therapies such as surgical resection, radiofrequency ablation, cryotherapy, and radiotherapy can lead to permanent local disease control and improve survival. Among these, an advance in radiation therapy made it possible to deliver high dose radiation to the tumor more accurately, without impairing the liver function. In recent years, the introduction of stereotactic ablative radiotherapy (SABR) has offered even more intensive tumor dose escalation in a few fractions with reduced dose to the adjacent normal liver. Many studies have shown that SABR for oligometastases is effective and safe, with local control rates widely ranging from 50% to 100% at one or two years. And actuarial survival at one and two years has been reported ranging from 72% to 94% and from 30% to 62%, respectively, without severe toxicities. In this paper, we described the definition and technical aspects of SABR, clinical outcomes including efficacy and toxicity, and related parameters after SABR in liver oligometastases from colorectal cancer. PMID:24868526

  19. Stereotactic ablative radiotherapy for oligometastatic disease in liver.

    PubMed

    Kim, Myungsoo; Son, Seok Hyun; Won, Yong Kyun; Kay, Chul Seung

    2014-01-01

    Liver metastasis in solid tumors, including colorectal cancer, is the most frequent and lethal complication. The development of systemic therapy has led to prolonged survival. However, in selected patients with a finite number of discrete lesions in liver, defined as oligometastatic state, additional local therapies such as surgical resection, radiofrequency ablation, cryotherapy, and radiotherapy can lead to permanent local disease control and improve survival. Among these, an advance in radiation therapy made it possible to deliver high dose radiation to the tumor more accurately, without impairing the liver function. In recent years, the introduction of stereotactic ablative radiotherapy (SABR) has offered even more intensive tumor dose escalation in a few fractions with reduced dose to the adjacent normal liver. Many studies have shown that SABR for oligometastases is effective and safe, with local control rates widely ranging from 50% to 100% at one or two years. And actuarial survival at one and two years has been reported ranging from 72% to 94% and from 30% to 62%, respectively, without severe toxicities. In this paper, we described the definition and technical aspects of SABR, clinical outcomes including efficacy and toxicity, and related parameters after SABR in liver oligometastases from colorectal cancer. PMID:24868526

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

    PubMed

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

    2015-06-01

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

  1. Commissioning and initial stereotactic ablative radiotherapy experience with Vero.

    PubMed

    Solberg, Timothy D; Medin, Paul M; Ramirez, Ezequiel; Ding, Chuxiong; Foster, Ryan D; Yordy, John

    2014-01-01

    The purpose of this study is to describe the comprehensive commissioning process and initial clinical performance of the Vero linear accelerator, a new radiotherapy device recently installed at UT Southwestern Medical Center specifically developed for delivery of image-guided stereotactic ablative radiotherapy (SABR). The Vero system utilizes a ring gantry to integrate a beam delivery platform with image guidance systems. The ring is capable of rotating ± 60° about the vertical axis to facilitate noncoplanar beam arrangements ideal for SABR delivery. The beam delivery platform consists of a 6 MV C-band linac with a 60 leaf MLC projecting a maximum field size of 15 × 15 cm² at isocenter. The Vero planning and delivery systems support a range of treatment techniques, including fixed beam conformal, dynamic conformal arcs, fixed gantry IMRT in either SMLC (step-and-shoot) or DMLC (dynamic) delivery, and hybrid arcs, which combines dynamic conformal arcs and fixed beam IMRT delivery. The accelerator and treatment head are mounted on a gimbal mechanism that allows the linac and MLC to pivot in two dimensions for tumor tracking. Two orthogonal kV imaging subsystems built into the ring facilitate both stereoscopic and volumetric (CBCT) image guidance. The system is also equipped with an always-active electronic portal imaging device (EPID). We present our commissioning process and initial clinical experience focusing on SABR applications with the Vero, including: (1) beam data acquisition; (2) dosimetric commissioning of the treatment planning system, including evaluation of a Monte Carlo algorithm in a specially-designed anthropomorphic thorax phantom; (3) validation using the Radiological Physics Center thorax, head and neck (IMRT), and spine credentialing phantoms; (4) end-to-end evaluation of IGRT localization accuracy; (5) ongoing system performance, including isocenter stability; and (6) clinical SABR applications. PMID:24710458

  2. Mathematical modelling of tumour volume dynamics in response to stereotactic ablative radiotherapy for non-small cell lung cancer

    NASA Astrophysics Data System (ADS)

    Tariq, Imran; Humbert-Vidan, Laia; Chen, Tao; South, Christopher P.; Ezhil, Veni; Kirkby, Norman F.; Jena, Rajesh; Nisbet, Andrew

    2015-05-01

    This paper reports a modelling study of tumour volume dynamics in response to stereotactic ablative radiotherapy (SABR). The main objective was to develop a model that is adequate to describe tumour volume change measured during SABR, and at the same time is not excessively complex as lacking support from clinical data. To this end, various modelling options were explored, and a rigorous statistical method, the Akaike information criterion, was used to help determine a trade-off between model accuracy and complexity. The models were calibrated to the data from 11 non-small cell lung cancer patients treated with SABR. The results showed that it is feasible to model the tumour volume dynamics during SABR, opening up the potential for using such models in a clinical environment in the future.

  3. Measuring the Population Impact of Introducing Stereotactic Ablative Radiotherapy for Stage I Non-Small Cell Lung Cancer in Canada

    PubMed Central

    Rodrigues, George B.; Palma, David A.; Senan, Suresh

    2014-01-01

    Background. The Cancer Risk Management Model (CRMM) was used to estimate the health and economic impact of introducing stereotactic ablative radiotherapy (SABR) for stage I non-small cell lung cancer (NSCLC) in Canada. Methods. The CRMM uses Monte Carlo microsimulation representative of all Canadians. Lung cancer outputs were previously validated internally (Statistics Canada) and externally (Canadian Cancer Registry). We updated costs using the Ontario schedule of fees and benefits or the consumer price index to calculate 2013 Canadian dollars, discounted at a 3% rate. The reference model assumed that for stage I NSCLC, 75% of patients undergo surgery (lobectomy, sublobar resection, or pneumonectomy), 12.5% undergo radiotherapy (RT), and 12.5% undergo best supportive care (BSC). SABR was introduced in 2008 as an alternative to sublobar resection, RT, and BSC at rates reflective of the literature. Incremental cost effectiveness ratios (ICERs) were calculated; a willingness-to-pay threshold of $100,000 (all amounts are in Canadian dollars) per quality-adjusted life-year (QALY) was used from the health care payer perspective. Results. The total cost for 25,085 new cases of lung cancer in 2013 was calculated to be $608,002,599. Mean upfront costs for the 4,318 stage I cases were $7,646.98 for RT, $8,815.55 for SABR, $12,161.17 for sublobar resection, $16,266.12 for lobectomy, $22,940.59 for pneumonectomy, and $14,582.87 for BSC. SABR dominated (higher QALY, lower cost) RT, sublobar resection, and BSC. RT had lower initial costs than SABR that were offset by subsequent costs associated with recurrence. Lobectomy was cost effective when compared with SABR, with an ICER of $55,909.06. Conclusion. The use of SABR for NSCLC in Canada is projected to result in significant cost savings and survival gains. PMID:24951606

  4. Increasing the Therapeutic Ratio of Stereotactic Ablative Radiotherapy by Individualized Isotoxic Dose Prescription.

    PubMed

    Zindler, Jaap D; Thomas, Charles R; Hahn, Stephen M; Hoffmann, Aswin L; Troost, Esther G C; Lambin, Philippe

    2016-02-01

    To obtain a favorable tradeoff between treatment benefits and morbidity ("therapeutic ratio"), radiotherapy (RT) dose is prescribed according to the tumor volume, with the goal of controlling the disease while respecting normal tissue tolerance levels. We propose a new paradigm for tumor dose prescription in stereotactic ablative radiotherapy (SABR) based on organ-at-risk (OAR) tolerance levels called isotoxic dose prescription (IDP), which is derived from experiences and limitations of conventionally fractionated radiotherapy. With IDP, the radiation dose is prescribed based on the predefined level of normal tissue complication probability of a nearby dose-limiting OAR at a prespecified dose-volume constraint. Simultaneously, the prescribed total tumor dose (TTD) is maximized to the technically highest achievable level in order to increase the local tumor control probability (TCP). IDP is especially relevant for tumors located at eloquent locations or for large tumors in which severe toxicity has been described. IDP will result in a lower RT dose or a treatment scheduled with more fractions if the OAR tolerance level is exceeded, and potential dose escalation occurs when the OAR tolerance level allows it and when it is expected to be beneficial (if TCP < 90%). For patients with small tumors at noneloquent sites, the current SABR dose prescription already results in high rates of local control at low toxicity rates. In this review, the concept of IDP is described in the context of SABR. PMID:26476075

  5. Stereotactic ablative radiotherapy with CyberKnife for advanced thymic carcinoma: a case report

    PubMed Central

    Fan, C.Y.; Huang, W.Y.; Jen, Y.M.; Lin, M.J.; Lin, K.T.

    2015-01-01

    Thymic carcinoma is a rare but lethal mediastinal cancer. The optimal treatment for advanced thymic carcinoma is not yet established. This report is the first known of stereotactic ablative radiotherapy (sabr) with CyberKnife (Accuray, Sunnyvale, CA, U.S.A.) as definitive therapy for thymic carcinoma. The patient, a 70-year-old woman with thymic carcinoma, invasion into neighboring organs, and pleural metastases—underwent CyberKnife sabr at 40 Gy in 5 fractions for two lesions, one in the thymus and one in the right paraspinal pleura. After 61 months of observation, a partial response was observed in the irradiated fields. However, disease progression in the non-irradiated pleura was noted. The patient underwent salvage CyberKnife sabr for the four initially nonirradiated pleural lesions. Computed tomography images obtained 10 months after the salvage therapy revealed a partial response. The patient is living, with progression-free irradiated lesions and no radiation-related toxicity. CyberKnife sabr is feasible for patients who are unable to undergo either surgery or conventionally fractionated radiation therapy. PMID:26628883

  6. Stereotactic Ablative Radiotherapy Should Be Combined With a Hypoxic Cell Radiosensitizer

    SciTech Connect

    Brown, J. Martin; Diehn, Maximilian; Loo, Billy W.

    2010-10-01

    Purpose: To evaluate the effect of tumor hypoxia on the expected level of cell killing by regimens of stereotactic ablative radiotherapy (SABR) and to determine the extent to which the negative effect of hypoxia could be prevented using a clinically available hypoxic cell radiosensitizer. Results and Discussion: We have calculated the expected level of tumor cell killing from regimens of SABR, both with and without the assumption that 20% of the tumor cells are hypoxic, using the standard linear quadratic model and the universal survival curve modification. We compare the results obtained with our own clinical data for lung tumors of different sizes and with published data from other studies. We also have calculated the expected effect on cell survival of adding the hypoxic cell sensitizer etanidazole at clinically achievable drug concentrations. Modeling tumor cell killing with any of the currently used regimens of SABR produces results that are inconsistent with the majority of clinical findings if tumor hypoxia is not considered. However, with the assumption of tumor hypoxia, the expected level of cell killing is consistent with clinical data. For only some of the smallest tumors are the clinical data consistent with no tumor hypoxia, but there could be other reasons for the sensitivity of these tumors. The addition of etanidazole at clinically achievable tumor concentrations produces a large increase in the expected level of tumor cell killing from the large radiation doses used in SABR. Conclusions: The presence of tumor hypoxia is a major negative factor in limiting the curability of tumors by SABR at radiation doses that are tolerable to surrounding normal tissues. However, this negative effect of hypoxia could be overcome by the addition of clinically tolerable doses of the hypoxic cell radiosensitizer etanidazole.

  7. Stereotactic ablative radiotherapy for early stage non-small cell lung cancer: a word of caution.

    PubMed

    Varela, Gonzalo; Gómez-Hernández, María Teresa

    2016-02-01

    Recently published data from pooled randomised trials conclude that stereotactic ablative radiotherapy (SABR) can be considered the treatment of choice in operable lung cancer patients fit for lobectomy. This conclusion comes for comparable 3-year survival and much lower risk of early severe morbidity and mortality. In this editorial comment we discuss the validity of the conclusions due to the prematurity of the survival analysis and to the poor accuracy of patients' staging leading to higher rates of regional relapse in the SABR arm. Besides, therapy-related mortality and morbidity in the pooled cohort is much higher that the internationally accepted standards maybe because surgery was not performed according to the best approaches and procedures currently available. The effectiveness of SABR as the sole therapy for resectable lung cancer is still awaiting for sound evidences. It could be adopted for individual cases only in two situations: (I) the patient does not accept surgical treatment; and (II) in cases were the risk of surgical related mortality is considered to exceed the probability of long-term survival after lung resection. For this, a multidisciplinary team (MDT) assessment, including surgeons and oncologists, is mandatory. PMID:26958502

  8. Stereotactic ablative radiotherapy for early stage non-small cell lung cancer: a word of caution

    PubMed Central

    Gómez-Hernández, María Teresa

    2016-01-01

    Recently published data from pooled randomised trials conclude that stereotactic ablative radiotherapy (SABR) can be considered the treatment of choice in operable lung cancer patients fit for lobectomy. This conclusion comes for comparable 3-year survival and much lower risk of early severe morbidity and mortality. In this editorial comment we discuss the validity of the conclusions due to the prematurity of the survival analysis and to the poor accuracy of patients’ staging leading to higher rates of regional relapse in the SABR arm. Besides, therapy-related mortality and morbidity in the pooled cohort is much higher that the internationally accepted standards maybe because surgery was not performed according to the best approaches and procedures currently available. The effectiveness of SABR as the sole therapy for resectable lung cancer is still awaiting for sound evidences. It could be adopted for individual cases only in two situations: (I) the patient does not accept surgical treatment; and (II) in cases were the risk of surgical related mortality is considered to exceed the probability of long-term survival after lung resection. For this, a multidisciplinary team (MDT) assessment, including surgeons and oncologists, is mandatory. PMID:26958502

  9. Tumor Volume-Adapted Dosing in Stereotactic Ablative Radiotherapy of Lung Tumors

    SciTech Connect

    Trakul, Nicholas; Chang, Christine N.; Harris, Jeremy; Chapman, Christopher; Rao, Aarti; Shen, John; Quinlan-Davidson, Sean; Filion, Edith J.; Wakelee, Heather A.; Colevas, A. Dimitrios; Whyte, Richard I.; and others

    2012-09-01

    Purpose: Current stereotactic ablative radiotherapy (SABR) protocols for lung tumors prescribe a uniform dose regimen irrespective of tumor size. We report the outcomes of a lung tumor volume-adapted SABR dosing strategy. Methods and Materials: We retrospectively reviewed the outcomes in 111 patients with a total of 138 primary or metastatic lung tumors treated by SABR, including local control, regional control, distant metastasis, overall survival, and treatment toxicity. We also performed subset analysis on 83 patients with 97 tumors treated with a volume-adapted dosing strategy in which small tumors (gross tumor volume <12 mL) received single-fraction regimens with biologically effective doses (BED) <100 Gy (total dose, 18-25 Gy) (Group 1), and larger tumors (gross tumor volume {>=}12 mL) received multifraction regimens with BED {>=}100 Gy (total dose, 50-60 Gy in three to four fractions) (Group 2). Results: The median follow-up time was 13.5 months. Local control for Groups 1 and 2 was 91.4% and 92.5%, respectively (p = 0.24) at 12 months. For primary lung tumors only (excluding metastases), local control was 92.6% and 91.7%, respectively (p = 0.58). Regional control, freedom from distant metastasis, and overall survival did not differ significantly between Groups 1 and 2. Rates of radiation pneumonitis, chest wall toxicity, and esophagitis were low in both groups, but all Grade 3 toxicities developed in Group 2 (p = 0.02). Conclusion: A volume-adapted dosing approach for SABR of lung tumors seems to provide excellent local control for both small- and large-volume tumors and may reduce toxicity.

  10. The Role of Stereotactic Ablative Radiotherapy for Early-Stage and Oligometastatic Non-small Cell Lung Cancer: Evidence for Changing Paradigms

    PubMed Central

    Dahele, Max

    2011-01-01

    A compelling body of non-randomized evidence has established stereotactic ablative lung radiotherapy (SABR) as a standard of care for medically inoperable patients with peripheral early-stage non-small cell lung cancer (NSCLC). This convenient outpatient therapy, which is typically delivered in 3-8 fractions, is also well tolerated by elderly and frail patients, makes efficient use of resources and is feasible using standard commercial equipment. The introduction of lung SABR into large populations has led to an increased utilization of radiotherapy, a reduction in the proportion of untreated patients and an increase in overall survival. In selected patients, the same ablative technology can now achieve durable local control of NSCLC metastases in a variety of common locations including the adrenal glands, bone, brain, and liver. At the same time as this, advances in prognostic molecular markers and targeted systemic therapies mean that there is now a subgroup of patients with stage IV NSCLC and a median survival of around 2 years. This creates opportunities for new trials that incorporate SABR and patient-specific systemic strategies. This selective mini-review focuses on the emerging role of SABR in patients with early-stage and oligometastatic NSCLC. PMID:21811422

  11. Outcomes of Stereotactic Ablative Radiotherapy in Patients With Potentially Operable Stage I Non-Small Cell Lung Cancer

    SciTech Connect

    Lagerwaard, Frank J.; Verstegen, Naomi E.; Haasbeek, Cornelis J.A.; Slotman, Ben J.; Paul, Marinus A.; Smit, Egbert F.; Senan, Suresh

    2012-05-01

    Background: Approximately two-thirds of patients with early-stage non-small-cell lung cancer (NSCLC) in The Netherlands currently undergo surgical resection. As an increasing number of fit patients have elected to undergo stereotactic ablative radiotherapy (SABR) in recent years, we studied outcomes after SABR in patients with potentially operable stage I NSCLC. Methods and Materials: In an institutional prospective database collected since 2003, 25% of lung SABR cases (n = 177 patients) were found to be potentially operable when the following patients were excluded: those with (1) synchronous lung tumors or other malignancy, (2) prior high-dose radiotherapy/pneumonectomy, (3) chronic obstructive pulmonary disease with a severity score of 3-4 according to the Global initiative for Obstructive Lung Disease classification. (4) a performance score of {>=}3, and (5) other comorbidity precluding surgery. Study patients included 101 males and 76 females, with a median age of 76 years old, 60% of whom were staged as T1 and 40% of whom were T2. Median Charlson comorbidity score was 2 (range, 0-5). A SABR dose of 60 Gy was delivered using a risk-adapted scheme in 3, 5, or 8 fractions, depending on tumor size and location. Follow-up chest computed tomography scans were obtained at 3, 6, and 12 months and yearly thereafter. Results: Median follow-up was 31.5 months; and median overall survival (OS) was 61.5 months, with 1- and 3-year survival rates of 94.7% and 84.7%, respectively. OS rates at 3 years in patients with (n = 59) and without (n = 118) histological diagnosis did not differ significantly (96% versus 81%, respectively, p = 0.39). Post-SABR 30-day mortality was 0%, while predicted 30-day mortality for a lobectomy, derived using the Thoracoscore predictive model (Falcoz PE et al. J Thorac Cardiovasc Surg 2007;133:325-332), would have been 2.6%. Local control rates at 1 and 3 years were 98% and 93%, respectively. Regional and distant failure rates at 3 years were each

  12. Severe Chest Wall Toxicity From Cryoablation in the Setting of Prior Stereotactic Ablative Radiotherapy.

    PubMed

    Chaudhuri, Aadel A; Binkley, Michael S; Aggarwal, Sonya; Qian, Yushen; Carter, Justin N; Shah, Rajesh; Loo, Billy W

    2016-01-01

    We present the case of a 42-year-old woman with metastatic synovial sarcoma of parotid origin, treated definitively with chemoradiation, who subsequently developed oligometastatic disease limited to the lungs. She underwent multiple left and right lung wedge resections and left lower lobectomy, followed by right lower lobe stereotactic ablative radiotherapy (SABR), 54 Gy in three fractions to a right lower lobe lesion abutting the chest wall. Two years later, she was treated with cryoablation for a separate right upper lobe nodule abutting the chest wall. Two months later, she presented with acute shortness of breath, pleuritic chest pain, decreased peripheral blood O2 saturation, and productive cough. A computed tomography (CT) scan demonstrated severe chest wall necrosis in the area of recent cryoablation that, in retrospect, also received a significant radiation dose from her prior SABR. This case demonstrates that clinicians should exercise caution in using cryoablation when treating lung tumors abutting a previously irradiated chest wall. Note: Drs. Loo and Shah contributed equally as co-senior authors. PMID:27004154

  13. Severe Chest Wall Toxicity From Cryoablation in the Setting of Prior Stereotactic Ablative Radiotherapy

    PubMed Central

    Chaudhuri, Aadel A; Binkley, Michael S; Aggarwal, Sonya; Qian, Yushen; Carter, Justin N; Shah, Rajesh

    2016-01-01

    We present the case of a 42-year-old woman with metastatic synovial sarcoma of parotid origin, treated definitively with chemoradiation, who subsequently developed oligometastatic disease limited to the lungs. She underwent multiple left and right lung wedge resections and left lower lobectomy, followed by right lower lobe stereotactic ablative radiotherapy (SABR), 54 Gy in three fractions to a right lower lobe lesion abutting the chest wall. Two years later, she was treated with cryoablation for a separate right upper lobe nodule abutting the chest wall. Two months later, she presented with acute shortness of breath, pleuritic chest pain, decreased peripheral blood O2 saturation, and productive cough. A computed tomography (CT) scan demonstrated severe chest wall necrosis in the area of recent cryoablation that, in retrospect, also received a significant radiation dose from her prior SABR. This case demonstrates that clinicians should exercise caution in using cryoablation when treating lung tumors abutting a previously irradiated chest wall. Note: Drs. Loo and Shah contributed equally as co-senior authors. PMID:27004154

  14. Stereotactic ablative radiotherapy versus lobectomy for operable stage I non-small-cell lung cancer: a pooled analysis of two randomised trials

    PubMed Central

    Chang, Joe Y; Senan, Suresh; Paul, Marinus A; Mehran, Reza J; Louie, Alexander V; Balter, Peter; Groen, Harry J M; McRae, Stephen E; Widder, Joachim; Feng, Lei; van den Borne, Ben E E M; Munsell, Mark F; Hurkmans, Coen; Berry, Donald A; van Werkhoven, Erik; Kresl, John J; Dingemans, Anne-Marie; Dawood, Omar; Haasbeek, Cornelis J A; Carpenter, Larry S; De Jaeger, Katrien; Komaki, Ritsuko; Slotman, Ben J; Smit, Egbert F; Roth, Jack A

    2015-01-01

    Summary Background The standard of care for operable, stage I, non-small-cell lung cancer (NSCLC) is lobectomy with mediastinal lymph node dissection or sampling. Stereotactic ablative radiotherapy (SABR) for inoperable stage I NSCLC has shown promising results, but two independent, randomised, phase 3 trials of SABR in patients with operable stage I NSCLC (STARS and ROSEL) closed early due to slow accrual. We aimed to assess overall survival for SABR versus surgery by pooling data from these trials. Methods Eligible patients in the STARS and ROSEL studies were those with clinical T1–2a (<4 cm), N0M0, operable NSCLC. Patients were randomly assigned in a 1:1 ratio to SABR or lobectomy with mediastinal lymph node dissection or sampling. We did a pooled analysis in the intention-to-treat population using overall survival as the primary endpoint. Both trials are registered with ClinicalTrials.gov (STARS: NCT00840749; ROSEL: NCT00687986). Findings 58 patients were enrolled and randomly assigned (31 to SABR and 27 to surgery). Median follow-up was 40.2 months (IQR 23.0–47.3) for the SABR group and 35.4 months (18.9–40.7) for the surgery group. Six patients in the surgery group died compared with one patient in the SABR group. Estimated overall survival at 3 years was 95% (95% CI 85–100) in the SABR group compared with 79% (64–97) in the surgery group (hazard ratio [HR] 0.14 [95% CI 0.017–1.190], log-rank p=0.037). Recurrence-free survival at 3 years was 86% (95% CI 74–100) in the SABR group and 80% (65–97) in the surgery group (HR 0.69 [95% CI 0.21–2.29], log-rank p=0.54). In the surgery group, one patient had regional nodal recurrence and two had distant metastases; in the SABR group, one patient had local recurrence, four had regional nodal recurrence, and one had distant metastases. Three (10%) patients in the SABR group had grade 3 treatment-related adverse events (three [10%] chest wall pain, two [6%] dyspnoea or cough, and one [3%] fatigue and rib

  15. Residual {sup 18}F-FDG-PET Uptake 12 Weeks After Stereotactic Ablative Radiotherapy for Stage I Non-Small-Cell Lung Cancer Predicts Local Control

    SciTech Connect

    Bollineni, Vikram Rao; Widder, Joachim; Pruim, Jan; Langendijk, Johannes A.; Wiegman, Erwin M.

    2012-07-15

    Purpose: To investigate the prognostic value of [{sup 18}F]fluorodeoxyglucose positron emission tomography (FDG-PET) uptake at 12 weeks after stereotactic ablative radiotherapy (SABR) for stage I non-small-cell lung cancer (NSCLC). Methods and Materials: From November 2006 to February 2010, 132 medically inoperable patients with proven Stage I NSCLC or FDG-PET-positive primary lung tumors were analyzed retrospectively. SABR consisted of 60 Gy delivered in 3 to 8 fractions. Maximum standardized uptake value (SUV{sub max}) of the treated lesion was assessed 12 weeks after SABR, using FDG-PET. Patients were subsequently followed at regular intervals using computed tomography (CT) scans. Association between post-SABR SUV{sub max} and local control (LC), mediastinal failure, distant failure, overall survival (OS), and disease-specific survival (DSS) was examined. Results: Median follow-up time was 17 months (range, 3-40 months). Median lesion size was 25 mm (range, 9-70 mm). There were 6 local failures: 15 mediastinal failures, 15 distant failures, 13 disease-related deaths, and 16 deaths from intercurrent diseases. Glucose corrected post-SABR median SUV{sub max} was 3.0 (range, 0.55-14.50). Using SUV{sub max} 5.0 as a cutoff, the 2-year LC was 80% versus 97.7% for high versus low SUV{sub max}, yielding an adjusted subhazard ratio (SHR) for high post-SABR SUV{sub max} of 7.3 (95% confidence interval [CI], 1.4-38.5; p = 0.019). Two-year DSS rates were 74% versus 91%, respectively, for high and low SUV{sub max} values (SHR, 2.2; 95% CI, 0.8-6.3; p = 0.113). Two-year OS was 62% versus 81% (hazard ratio [HR], 1.6; 95% CI, 0.7-3.7; p = 0.268). Conclusions: Residual FDG uptake (SUV{sub max} {>=}5.0) 12 weeks after SABR signifies increased risk of local failure. A single FDG-PET scan at 12 weeks could be used to tailor further follow-up according to the risk of failure, especially in patients potentially eligible for salvage surgery.

  16. PD-1 Restrains Radiotherapy-Induced Abscopal Effect.

    PubMed

    Park, Sean S; Dong, Haidong; Liu, Xin; Harrington, Susan M; Krco, Christopher J; Grams, Michael P; Mansfield, Aaron S; Furutani, Keith M; Olivier, Kenneth R; Kwon, Eugene D

    2015-06-01

    We investigated the influence of PD-1 expression on the systemic antitumor response (abscopal effect) induced by stereotactic ablative radiotherapy (SABR) in preclinical melanoma and renal cell carcinoma models. We compared the SABR-induced antitumor response in PD-1-expressing wild-type (WT) and PD-1-deficient knockout (KO) mice and found that PD-1 expression compromises the survival of tumor-bearing mice treated with SABR. None of the PD-1 WT mice survived beyond 25 days, whereas 20% of the PD-1 KO mice survived beyond 40 days. Similarly, PD-1-blocking antibody in WT mice was able to recapitulate SABR-induced antitumor responses observed in PD-1 KO mice and led to increased survival. The combination of SABR plus PD-1 blockade induced near complete regression of the irradiated primary tumor (synergistic effect), as opposed to SABR alone or SABR plus control antibody. The combination of SABR plus PD-1 blockade therapy elicited a 66% reduction in size of nonirradiated, secondary tumors outside the SABR radiation field (abscopal effect). The observed abscopal effect was tumor specific and was not dependent on tumor histology or host genetic background. The CD11a(high) CD8(+) T-cell phenotype identifies a tumor-reactive population, which was associated in frequency and function with a SABR-induced antitumor immune response in PD-1 KO mice. We conclude that SABR induces an abscopal tumor-specific immune response in both the irradiated and nonirradiated tumors, which is potentiated by PD-1 blockade. The combination of SABR and PD-1 blockade has the potential to translate into a potent immunotherapy strategy in the management of patients with metastatic cancer. PMID:25701325

  17. Dosimetric comparison of a 6-MV flattening-filter and a flattening-filter-free beam for lung stereotactic ablative radiotherapy treatment

    NASA Astrophysics Data System (ADS)

    Kim, Yon-Lae; Chung, Jin-Beom; Kim, Jae-Sung; Lee, Jeong-Woo; Kim, Jin-Young; Kang, Sang-Won; Suh, Tae-Suk

    2015-11-01

    The purpose of this study was to test the feasibility of clinical usage of a flattening-filter-free (FFF) beam for treatment with lung stereotactic ablative radiotherapy (SABR). Ten patients were treated with SABR and a 6-MV FFF beam for this study. All plans using volumetric modulated arc therapy (VMAT) were optimized in the Eclipse treatment planning system (TPS) by using the Acuros XB (AXB) dose calculation algorithm and were delivered by using a Varian TrueBeam ™ linear accelerator equipped with a high-definition (HD) multi-leaf collimator. The prescription dose used was 48 Gy in 4 fractions. In order to compare the plan using a conventional 6-MV flattening-filter (FF) beam, the SABR plan was recalculated under the condition of the same beam settings used in the plan employing the 6-MV FFF beam. All dose distributions were calculated by using Acuros XB (AXB, version 11) and a 2.5-mm isotropic dose grid. The cumulative dosevolume histograms (DVH) for the planning target volume (PTV) and all organs at risk (OARs) were analyzed. Technical parameters, such as total monitor units (MUs) and the delivery time, were also recorded and assessed. All plans for target volumes met the planning objectives for the PTV ( i.e., V95% > 95%) and the maximum dose ( i.e., Dmax < 110%) revealing adequate target coverage for the 6-MV FF and FFF beams. Differences in DVH for target volumes (PTV and clinical target volume (CTV)) and OARs on the lung SABR plans from the interchange of the treatment beams were small, but showed a marked reduction (52.97%) in the treatment delivery time. The SABR plan with a FFF beam required a larger number of MUs than the plan with the FF beam, and the mean difference in MUs was 4.65%. This study demonstrated that the use of the FFF beam for lung SABR plan provided better treatment efficiency relative to 6-MV FF beam. This strategy should be particularly beneficial for high dose conformity to the lung and decreased intra-fraction movements because of

  18. Stereotactic ablative radiotherapy in the treatment of hepatocellular carcinoma >3 cm.

    PubMed

    Guarneri, Alessia; Franco, Pierfrancesco; Trino, Elisabetta; Campion, Daniela; Faletti, Riccardo; Mirabella, Stefano; Gaia, Silvia; Ragona, Riccardo; Diotallevi, Margherita; Saracco, Giorgio; Salizzoni, Mauro; Ricardi, Umberto; Carucci, Patrizia

    2016-10-01

    Stereotactic ablative radiotherapy (SABR) is a safe treatment approach for hepatocellular carcinoma (HCC) with comparable results to other local therapies. For lesions larger than 3 cm, no definitive standard treatment is present and several options are available. We retrospectively review local control (LC) and survival results of SABR in patients with HCC lesions >3 cm. Between 2012 and 2015, we treated 29 patients (39 lesions) having histological or radiological diagnosis of HCC and at least one lesion sized >3 cm. Patients were prescribed 36-48 Gy in 3-5 fractions (mainly 16 Gy × 3 fractions or 8 Gy × 5 fractions), in 3-5 consecutive days. A total of 15 lesions (52 %) had complete, while 10 (34 %) had partial remission; 3 (11 %) had a stable disease. Mean time for CR achievement was 5.8 months (range 1-17). One- and two-year actuarial LC was 100 %. Moreover, 1- and 2-year progression-free (PFS), cancer-specific and overall survival were 57.9 % [standard error (SE) 0.09; 95 % CI 36.9-74.2] and 41.2 % (SE 0.12; 95 % CI 17.7-63.5), 80.7 % (SE 0.08; 95 % CI 59.6-91.5) and 63.3 % (SE 0.11; 95 % CI 38.4-80.3), 71.7 % (SE 0.08; 95 % CI 51.2-84.7) and 56.2 % (SE 0.10; 95 % CI 33.8-73.6). On multivariate analysis, achieving a CR within the target lesion had a borderline significance with respect to PFS (HR 0.83; SE = 0.014; z -1.15; p = 0.095; 95 % CI 0.71-7.45). Time between HCC diagnosis and SABR delivery (< vs >12 months) was significantly correlated with OS (HR 16.5; SE 21.5; z = 2.14; p = 0.032; 95 % CI 1.27-213.3) as CLIP score (score: 0-1 vs 2) (HR 5.6; SE 4.6; z = 2.10; p = 0.036; 95 % CI 1.11-27.8). A total of 6 major toxic events (G3-G4) were recorded (20 %). In 2 patients (6 %), a radiation-induced liver disease was seen. In conclusion, SABR provided LC and survival rates comparable to other local therapies for patients with HCC lesion sized >3 cm, with acceptable toxicity profile. PMID:27566310

  19. Hypofractionated ablative radiotherapy for locally advanced pancreatic cancer

    PubMed Central

    Crane, Christopher H.

    2016-01-01

    The role of radiation in locally advanced unresectable pancreatic cancer (LAPC) is controversial. Randomized trials evaluating standard doses of chemoradiation have not shown a significant benefit from the use of consolidative radiation. Results from non-randomized studies of 3–5-fraction stereotactic body radiotherapy (SBRT) have been similar to standard chemoradiation, but with less toxicity and a shorter treatment time. Doses of SBRT have been reduced to subablative levels for the sake of tolerability. The benefit of both options is unclear. In contrast, ablative doses can be delivered using an SBRT technique in 15–28 fractions. The keys to the delivery of ablative doses are computed tomography (CT) image guidance and respiratory gating. Higher doses have resulted in encouraging long-term survival results. In this review, we present a comprehensive solution to achieving ablative doses for selected patients with pancreatic tumors by using a combination of classical, modern and novel concepts of radiotherapy: fractionation, CT image guidance, respiratory gating, intentional dose heterogeneity, and simultaneous integrated protection. PMID:27029741

  20. Clinical outcome of hypofractionated breath-hold image-guided SABR of primary lung tumors and lung metastases

    PubMed Central

    2014-01-01

    Background Stereotactic Ablative RadioTherapy (SABR) of lung tumors/metastases has been shown to be an effective treatment modality with low toxicity. Outcome and toxicity were retrospectively evaluated in a unique single-institution cohort treated with intensity-modulated image-guided breath-hold SABR (igSABR) without external immobilization. The dose–response relationship is analyzed based on Biologically Equivalent Dose (BED). Patients and methods 50 lesions in 43 patients with primary NSCLC (n = 27) or lung-metastases of various primaries (n = 16) were consecutively treated with igSABR with Active-Breathing-Coordinator (ABC®) and repeat-breath-hold cone-beam-CT. After an initial dose-finding/-escalation period, 5x12 Gy for peripheral lesions and single doses of 5 Gy to varying dose levels for central lesions were applied. Overall-survival (OS), progression-free-survival (PFS), progression pattern, local control (LC) and toxicity were analyzed. Results The median BED2 was 83 Gy. 12 lesions were treated with a BED2 of <80 Gy, and 38 lesions with a BED2 of >80 Gy. Median follow-up was 15 months. Actuarial 1- and 2-year OS were 67% and 43%; respectively. Cause of death was non-disease-related in 27%. Actuarial 1- and 2-year PFS was 42% and 28%. Progression site was predominantly distant. Actuarial 1- and 2 year LC was 90% and 85%. LC showed a trend for a correlation to BED2 (p = 0.1167). Pneumonitis requiring conservative treatment occurred in 23%. Conclusion Intensity-modulated breath-hold igSABR results in high LC-rates and low toxicity in this unfavorable patient cohort with inoperable lung tumors or metastases. A BED2 of <80 Gy was associated with reduced local control. PMID:24401323

  1. Effect of different breathing patterns in the same patient on stereotactic ablative body radiotherapy dosimetry for primary renal cell carcinoma: A case study

    SciTech Connect

    Pham, Daniel; Kron, Tomas; Foroudi, Farshad; Siva, Shankar

    2013-10-01

    Stereotactic ablative body radiotherapy (SABR) for primary renal cell carcinoma (RCC) targets requires motion management strategies to verify dose delivery. This case study highlights the effect of a change in patient breathing amplitude on the dosimetry to organs at risk and target structures. A 73-year-old male patient was planned for receiving 26 Gy of radiation in 1 fraction of SABR for a left primary RCC. The patient was simulated with four-dimensional computed tomography (4DCT) and the tumor internal target volume (ITV) was delineated using the 4DCT maximum intensity projection. However, the initially planned treatment was abandoned at the radiation oncologist's discretion after pretreatment cone-beam CT (CBCT) motion verification identified a greater than 50% reduction in superior to inferior diaphragm motion as compared with the planning 4DCT. This patient was resimulated with respiratory coaching instructions. To assess the effect of the change in breathing on the dosimetry to the target, each plan was recalculated on the data set representing the change in breathing condition. A change from smaller to larger breathing showed a 46% loss in planning target volume (PTV) coverage, whereas a change from larger breathing to smaller breathing resulted in an 8% decrease in PTV coverage. ITV coverage was similarly reduced by 8% in both scenarios. This case study highlights the importance of tools to verify breathing motion prior to treatment delivery. 4D image guided radiation therapy verification strategies should focus on not only verifying ITV margin coverage but also the effect on the surrounding organs at risk.

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

    PubMed

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

    2016-07-01

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

  3. Successful treatment of hepatic oligometastases with stereotactic ablative radiotherapy and radiofrequency ablation in an anaplastic lymphoma kinase fusion-positive lung cancer patient.

    PubMed

    Weber, Britta; Liu, Mitchell; Sobkin, Paul; Morris, Stephan W; Hout, David; van der Westhuizen, Nicholas; Tonseth, R Petter; Saltman, David L

    2016-03-01

    Local ablative therapy with stereotactic ablative radiotherapy may improve survival in oncogene-addicted lung cancer patients with extracranial oligometastatic disease treated with targeted therapies. There is limited data on the use of radiofrequency ablation (RFA) in this same setting. We present a case of an anaplastic lymphoma kinase (ALK)-positive lung cancer patient with hepatic oligometastatic progression who was successfully treated with both stereotactic ablative radiation and RFA while continuing with an ALK inhibitor. PMID:27087977

  4. SU-E-J-207: Assessing the Validity of 4D-CT Based Target Volumes and Free Breathing CBCT Localization in Lung Stereotactic Ablative Radiation Therapy (SABR)

    SciTech Connect

    Badkul, R; Pokhrel, D; Jiang, H; Park, J; Wang, F; Kumar, P

    2014-06-01

    Purpose: Four-dimensional-computed-tomography(4D-CT) imaging for target-volume delineation and cone-beam-tomography(CBCT) for treatment localization are widely utilized in lung-SABR.Aim of this study was to perform a quantitative-assessment and inter-comparison of Internal-targetvolumes( ITV) drawn on various phases of breathing-cycle 4D-CT-scans, Maximum-intensity-projection(MIP), average-intensity-projection(AIP)and static CT-scans of lung-motion-phantom to simulate lung-SABR patient geometry. We also analyzed and compared the ITVs drawn on freebreathing- CBCT. Materials and Methods: 4D-CT-scans were acquired on Philips big-bore 16slice CT and Bellows-respiratory monitoring-system using retrospective phase-binning method. Each respiratory cycle divided into 10-phases. Quasar-Phantom with lung-inserts and 3cm-diameter nylonball to simulate tumor and was placed on respiratory-motion-platform for 4D-CT and CBCT-acquisition. Amplitudes of motions: 0.5,1.0,2.0,3.0cm in superior-inferior direction with breathing-cycle time of 6,5,4,6sec, respectively used.4D-CTs with 10-phases(0%to90%)for each excursion-set and 3D-CT for static-phantom exported to iPlan treatment-planningsystem( TPS).Tumor-volumes delineated in all phases of 4D-CT, MIP,AIP,CBCT scans using fixed-HU-threshold(−500to1000)values automatically.For each 4D-dataset ITV obtained by unifying the tumorcontours on all phases.CBCT-ITV-volumes were drawn in Eclipse-TPS. Results: Mean volume of tumor contours for all phases compared with static 3D-CT were 0.62±0.08%, 1.67±0.26%, 4.77±0.54% and 9.27±1.23% for 0.5cm,1cm,2cm,3cm excursions respectively. Differences of mean Union-ITV with MIP-ITV were close(≤2.4%).Mean Union-ITV from expected-theoretical values differed from −4.9% to 3.8%.Union-ITV and MIP-ITV were closer within 2.3%. AIP-ITVs were underestimated from 14 to 32% compared to union-ITV for all motion datasets. Differences of −5.9% to −44% and −5% to 6.7% for CBCT-ITV from MIP-ITV and AIP

  5. Pulmonary imaging after stereotactic radiotherapy-does RECIST still apply?

    PubMed

    Mattonen, Sarah A; Ward, Aaron D; Palma, David A

    2016-09-01

    The use of stereotactic ablative radiotherapy (SABR) for the treatment of primary lung cancer and metastatic disease is rapidly increasing. However, the presence of benign fibrotic changes on CT imaging makes response assessment following SABR a challenge, as these changes develop with an appearance similar to tumour recurrence. Misclassification of benign fibrosis as local recurrence has resulted in unnecessary interventions, including biopsy and surgical resection. Response evaluation criteria in solid tumours (RECIST) are widely used as a universal set of guidelines to assess tumour response following treatment. However, in the context of non-spherical and irregular post-SABR fibrotic changes, the RECIST criteria can have several limitations. Positron emission tomography can also play a role in response assessment following SABR; however, false-positive results in regions of inflammatory lung post-SABR can be a major clinical issue and optimal standardized uptake values to distinguish fibrosis and recurrence have not been determined. Although validated CT high-risk features show a high sensitivity and specificity for predicting recurrence, most recurrences are not detected until more than 1-year post-treatment. Advanced quantitative radiomic analysis on CT imaging has demonstrated promise in distinguishing benign fibrotic changes from local recurrence at earlier time points, and more accurately, than physician assessment. Overall, the use of RECIST alone may prove inferior to novel metrics of assessing response. PMID:27245137

  6. Technical advances in external radiotherapy for hepatocellular carcinoma

    PubMed Central

    Park, Shin-Hyung; Kim, Jae-Chul; Kang, Min Kyu

    2016-01-01

    Radiotherapy techniques have substantially improved in the last two decades. After the introduction of 3-dimensional conformal radiotherapy, radiotherapy has been increasingly used for the treatment of hepatocellular carcinoma (HCC). Currently, more advanced techniques, including intensity-modulated radiotherapy (IMRT), stereotactic ablative body radiotherapy (SABR), and charged particle therapy, are used for the treatment of HCC. IMRT can escalate the tumor dose while sparing the normal tissue even though the tumor is large or located near critical organs. SABR can deliver a very high radiation dose to small HCCs in a few fractions, leading to high local control rates of 84%-100%. Various advanced imaging modalities are used for radiotherapy planning and delivery to improve the precision of radiotherapy. These advanced techniques enable the delivery of high dose radiotherapy for early to advanced HCCs without increasing the radiation-induced toxicities. However, as there have been no effective tools for the prediction of the response to radiotherapy or recurrences within or outside the radiation field, future studies should focus on selecting the patients who will benefit from radiotherapy. PMID:27621577

  7. Technical advances in external radiotherapy for hepatocellular carcinoma.

    PubMed

    Park, Shin-Hyung; Kim, Jae-Chul; Kang, Min Kyu

    2016-08-28

    Radiotherapy techniques have substantially improved in the last two decades. After the introduction of 3-dimensional conformal radiotherapy, radiotherapy has been increasingly used for the treatment of hepatocellular carcinoma (HCC). Currently, more advanced techniques, including intensity-modulated radiotherapy (IMRT), stereotactic ablative body radiotherapy (SABR), and charged particle therapy, are used for the treatment of HCC. IMRT can escalate the tumor dose while sparing the normal tissue even though the tumor is large or located near critical organs. SABR can deliver a very high radiation dose to small HCCs in a few fractions, leading to high local control rates of 84%-100%. Various advanced imaging modalities are used for radiotherapy planning and delivery to improve the precision of radiotherapy. These advanced techniques enable the delivery of high dose radiotherapy for early to advanced HCCs without increasing the radiation-induced toxicities. However, as there have been no effective tools for the prediction of the response to radiotherapy or recurrences within or outside the radiation field, future studies should focus on selecting the patients who will benefit from radiotherapy. PMID:27621577

  8. A feasibility study evaluating the relationship between dose and focal liver reaction in stereotactic ablative radiotherapy for liver cancer based on intensity change of Gd-EOB-DTPA-enhanced magnetic resonance images

    PubMed Central

    Jung, Sang Hoon; Yu, Jeong Il; Lim, Do Hoon; Han, Youngyih

    2016-01-01

    Purpose In order to evaluate the relationship between the dose to the liver parenchyma and focal liver reaction (FLR) after stereotactic ablative body radiotherapy (SABR), we suggest a novel method using a three-dimensional dose distribution and change in signal intensity of gadoxetate disodium-gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) hepatobiliary phase images. Materials and Methods In our method, change of the signal intensity between the pretreatment and follow-up hepatobiliary phase images of Gd-EOB-DTPA-enhanced MRI was calculated and then threshold dose (TD) for developing FLR was obtained from correlation of dose with the change of the signal intensity. For validation of the method, TDs for six patients, who had been treated for liver cancer with SABR with 45–60 Gy in 3 fractions, were calculated using the method, and we evaluated concordance between volume enclosed by isodose of TD by the method and volume identified as FLR by a physician. Results The dose to normal liver was correlated with change in signal intensity between pretreatment and follow-up MRI with a median R2 of 0.935 (range, 0.748 to 0.985). The median TD by the method was 23.5 Gy (range, 18.3 to 39.4 Gy). The median value of concordance was 84.5% (range, 44.7% to 95.9%). Conclusion Our method is capable of providing a quantitative evaluation of the relationship between dose and intensity changes on follow-up MRI, as well as determining individual TD for developing FLR. We expect our method to provide better information about the individual relationship between dose and FLR in radiotherapy for liver cancer. PMID:27104169

  9. Survival and Quality of Life After Stereotactic or 3D-Conformal Radiotherapy for Inoperable Early-Stage Lung Cancer

    SciTech Connect

    Widder, Joachim; Postmus, Douwe; Ubbels, Jan F.; Wiegman, Erwin M.; Langendijk, Johannes A.

    2011-11-15

    Purpose: To investigate survival and local recurrence after stereotactic ablative radiotherapy (SABR) or three-dimensional conformal radiotherapy (3D-CRT) administered for early-stage primary lung cancer and to investigate longitudinal changes of health-related quality of life (HRQOL) parameters after either treatment. Methods and Materials: Two prospective cohorts of inoperable patients with T1-2N0M0 primary lung tumors were analyzed. Patients received 70 Gy in 35 fractions with 3D-CRT or 60 Gy in three to eight fractions with SABR. Global quality of life (GQOL), physical functioning (PF), and patient-rated dyspnea were assessed using the respective dimensions of European Organization for Research and Treatment of Cancer Core Questionnaire-C30 and LC13. HRQOL was analyzed using multivariate linear mixed-effects modeling, survival and local control (LC) using the Kaplan-Meier method, Cox proportional hazards analysis, and Fine and Gray multivariate competing risk analysis as appropriate. Results: Overall survival (OS) was better after SABR compared with 3D-CRT with a HR of 2.6 (95% confidence interval [CI]: 1.5-4.8; p < 0.01). 3D-CRT conferred a subhazard ratio for LC of 5.0 (95% CI: 1.7-14.7; p < 0.01) compared with SABR. GQOL and PF were stable after SABR (p = 0.21 and p = 0.62, respectively). Dyspnea increased after SABR by 3.2 out of 100 points (95% CI: 1.0-5.3; p < 0.01), which is clinically insignificant. At 1 year, PF decreased by an excess of 8.7 out of 100 points (95% CI: 2.8-14.7; p < 0.01) after 3D-CRT compared with SABR. Conclusion: In this nonrandomized comparison of two prospective cohorts of medically inoperable patients with Stage I lung cancer, OS and LC were better after SABR. GQOL, PF, and patient-rated dyspnea were stable after SABR, whereas PF decreased after 3D-CRT approaching clinical significance already at 1 year.

  10. New Strategies in Stereotactic Radiotherapy for Oligometastases.

    PubMed

    Palma, David A; Louie, Alexander V; Rodrigues, George B

    2015-12-01

    Patients with metastatic solid tumors are usually treated with palliative intent. Systemic therapy and palliative radiation are often used, with the goals of prolonging survival or maintaining quality of life, but not of cure. In contrast to this paradigm, the theory of oligometastasis suggests that some patients who have a small number of metastases may be amenable to cure if all lesions can be eradicated. Aggressive treatment of patients with oligometastases, using either surgery or radiotherapy, has become more common in the past decade, yet in most situations, no randomized evidence is available to support such an approach. Stereotactic ablative radiotherapy (SABR) is a novel treatment for oligometastases, delivering large doses of radiotherapy in only a few treatments, with excellent rates of local control, and appears to be an excellent noninvasive alternative to surgical resection of metastases. This article reviews recent biologic and clinical data that support the existence of the oligometastatic state and discusses gaps in this evidence base. The emerging role for SABR in the management of this challenging patient population is discussed with a focus on ongoing clinical trials in an attempt to improve overall survival, delay progression, or induce immunologic anticancer effects through the abscopal effect. PMID:26626571

  11. Early prediction of lung cancer recurrence after stereotactic radiotherapy using second order texture statistics

    NASA Astrophysics Data System (ADS)

    Mattonen, Sarah A.; Palma, David A.; Haasbeek, Cornelis J. A.; Senan, Suresh; Ward, Aaron D.

    2014-03-01

    Benign radiation-induced lung injury is a common finding following stereotactic ablative radiotherapy (SABR) for lung cancer, and is often difficult to differentiate from a recurring tumour due to the ablative doses and highly conformal treatment with SABR. Current approaches to treatment response assessment have shown limited ability to predict recurrence within 6 months of treatment. The purpose of our study was to evaluate the accuracy of second order texture statistics for prediction of eventual recurrence based on computed tomography (CT) images acquired within 6 months of treatment, and compare with the performance of first order appearance and lesion size measures. Consolidative and ground-glass opacity (GGO) regions were manually delineated on post-SABR CT images. Automatic consolidation expansion was also investigated to act as a surrogate for GGO position. The top features for prediction of recurrence were all texture features within the GGO and included energy, entropy, correlation, inertia, and first order texture (standard deviation of density). These predicted recurrence with 2-fold cross validation (CV) accuracies of 70-77% at 2- 5 months post-SABR, with energy, entropy, and first order texture having leave-one-out CV accuracies greater than 80%. Our results also suggest that automatic expansion of the consolidation region could eliminate the need for manual delineation, and produced reproducible results when compared to manually delineated GGO. If validated on a larger data set, this could lead to a clinically useful computer-aided diagnosis system for prediction of recurrence within 6 months of SABR and allow for early salvage therapy for patients with recurrence.

  12. Treatment Plan Technique and Quality for Single-Isocenter Stereotactic Ablative Radiotherapy of Multiple Lung Lesions with Volumetric-Modulated Arc Therapy or Intensity-Modulated Radiosurgery

    PubMed Central

    Quan, Kimmen; Xu, Karen M.; Lalonde, Ron; Horne, Zachary D.; Bernard, Mark E.; McCoy, Chuck; Clump, David A.; Burton, Steven A.; Heron, Dwight E.

    2015-01-01

    The aim of this study is to provide a practical approach to the planning technique and evaluation of plan quality for the multi-lesion, single-isocenter stereotactic ablative radiotherapy (SABR) of the lung. Eleven patients with two or more lung lesions underwent single-isocenter volumetric-modulated arc therapy (VMAT) radiosurgery or IMRS. All plans were normalized to the target maximum dose. For each plan, all targets were treated to the same dose. Plan conformity and dose gradient were maximized with dose-control tuning structures surrounding targets. For comparison, multi-isocenter plans were retrospectively created for four patients. Conformity index (CI), homogeneity index (HI), gradient index (GI), and gradient distance (GD) were calculated for each plan. V5, V10, and V20 of the lung and organs at risk (OARs) were collected. Treatment time and total monitor units (MUs) were also recorded. One patient had four lesions and the remainder had two lesions. Six patients received VMAT and five patients received intensity-modulated radiosurgery (IMRS). For those treated with VMAT, two patients received 3-arc VMAT and four received 2-arc VMAT. For those treated with IMRS, two patients were treated with 10 and 11 beams, respectively, and the rest received 12 beams. Prescription doses ranged from 30 to 54 Gy in three to five fractions. The median prescribed isodose line was 84% (range: 80–86%). The median maximum dose was 57.1 Gy (range: 35.7–65.1 Gy). The mean combined PTV was 49.57 cm3 (range: 14.90–87.38 cm3). For single-isocenter plans, the median CI was 1.15 (range: 0.97–1.53). The median HI was 1.19 (range: 1.16–1.28). The median GI was 4.60 (range: 4.16–7.37). The median maximum radiation dose (Dmax) to total lung was 55.6 Gy (range: 35.7–62.0 Gy). The median mean radiation dose to the lung (Dmean) was 4.2 Gy (range: 1.1–9.3 Gy). The median lung V5 was 18.7% (range: 3.8–41.3%). There was no significant difference in CI, HI, GI

  13. SU-E-T-131: Dosimetric Impact and Evaluation of Different Heterogenity Algorithm in Volumetric Modulated Arc Therapy Plan for Stereotactic Ablative Radiotherapy Lung Treatment with the Flattening Filter Free Beam

    SciTech Connect

    Chung, J; Kim, J; Lee, J; Kim, Y

    2014-06-01

    Purpose: The present study aimed to investigate the dosimetric impacts of the anisotropic analytic algorithm (AAA) and the Acuros XB (AXB) plan for lung stereotactic ablative radiation therapy using flattening filter-free (FFF) beam. We retrospectively analyzed 10 patients. Methods: We retrospectively analyzed 10 patients. The dosimetric parameters for the target and organs at risk (OARs) from the treatment plans calculated with these dose calculation algorithms were compared. The technical parameters, such as the computation times and the total monitor units (MUs), were also evaluated. Results: A comparison of DVHs from AXB and AAA showed that the AXB plan produced a high maximum PTV dose by average 4.40% with a statistical significance but slightly lower mean PTV dose by average 5.20% compared to the AAA plans. The maximum dose to the lung was slightly higher in the AXB compared to the AAA. For both algorithms, the values of V5, V10 and V20 for ipsilateral lung were higher in the AXB plan more than those of AAA. However, these parameters for contralateral lung were comparable. The differences of maximum dose for the spinal cord and heart were also small. The computation time of AXB was found fast with the relative difference of 13.7% than those of AAA. The average of monitor units (MUs) for all patients was higher in AXB plans than in the AAA plans. These results indicated that the difference between AXB and AAA are large in heterogeneous region with low density. Conclusion: The AXB provided the advantages such as the accuracy of calculations and the reduction of the computation time in lung stereotactic ablative radiotherapy (SABR) with using FFF beam, especially for VMAT planning. In dose calculation with the media of different density, therefore, the careful attention should be taken regarding the impacts of different heterogeneity correction algorithms. The authors report no conflicts of interest.

  14. The Potential Role of Respiratory Motion Management and Image Guidance in the Reduction of Severe Toxicities Following Stereotactic Ablative Radiation Therapy for Patients with Centrally Located Early Stage Non-Small Cell Lung Cancer or Lung Metastases

    PubMed Central

    Chi, Alexander; Nguyen, Nam Phong; Komaki, Ritsuko

    2014-01-01

    Image guidance allows delivery of very high doses of radiation over a few fractions, known as stereotactic ablative radiotherapy (SABR). This treatment is associated with excellent outcome for early stage non-small cell lung cancer and metastases to the lungs. In the delivery of SABR, central location constantly poses a challenge due to the difficulty of adequately sparing critical thoracic structures that are immediately adjacent to the tumor if an ablative dose of radiation is to be delivered to the tumor target. As of current, various respiratory motion management and image guidance strategies can be used to ensure accurate tumor target localization prior and/or during daily treatment, which allows for maximal and safe reduction of set up margins. The incorporation of both may lead to the most optimal normal tissue sparing and the most accurate SABR delivery. Here, the clinical outcome, treatment related toxicities, and the pertinent respiratory motion management/image guidance strategies reported in the current literature on SABR for central lung tumors are reviewed. PMID:25009800

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

    SciTech Connect

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

    2011-09-01

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

  16. A critical review of recent developments in radiotherapy for non-small cell lung cancer.

    PubMed

    Baker, Sarah; Dahele, Max; Lagerwaard, Frank J; Senan, Suresh

    2016-01-01

    Lung cancer is the leading cause of cancer mortality, and radiotherapy plays a key role in both curative and palliative treatments for this disease. Recent advances include stereotactic ablative radiotherapy (SABR), which is now established as a curative-intent treatment option for patients with peripheral early-stage NSCLC who are medically inoperable, or at high risk for surgical complications. Improved delivery techniques have facilitated studies evaluating the role of SABR in oligometastatic NSCLC, and encouraged the use of high-technology radiotherapy in some palliative settings. Although outcomes in locally advanced NSCLC remain disappointing for many patients, future progress may come about from an improved understanding of disease biology and the development of radiotherapy approaches that further reduce normal tissue irradiation. At the moment, the benefits, if any, of radiotherapy technologies such as proton beam therapy remain unproven. This paper provides a critical review of selected aspects of modern radiotherapy for lung cancer, highlights the current limitations in our understanding and treatment approaches, and discuss future treatment strategies for NSCLC. PMID:27600665

  17. Microsimulation Model Predicts Survival Benefit of Radiofrequency Ablation and Stereotactic Body Radiotherapy Versus Radiotherapy for Treating Inoperable Stage I Non–Small Cell Lung Cancer

    PubMed Central

    Tramontano, Angela C.; Cipriano, Lauren E.; Kong, Chung Yin; Shepard, Jo-Anne O.; Lanuti, Michael; Gazelle, G. Scott; McMahon, Pamela M.

    2013-01-01

    OBJECTIVE A subset of patients with stage IA and IB non–small cell lung cancer (NSCLC) is ineligible for surgical resection and undergoes radiation therapy. Radiofrequency ablation (RFA) and stereotactic body radiotherapy are newer potentially attractive alternative therapies. MATERIALS AND METHODS We added RFA and stereotactic body radiotherapy treatment modules to a microsimulation model that simulates lung cancer’s natural history, detection, and treatment. Natural history parameters were previously estimated via calibration against tumor registry data and cohort studies; the model was validated with screening study and cohort data. RFA model parameters were calibrated against 2-year survival from the Radiofrequency Ablation of Pulmonary Tumor Response Evaluation (RAPTURE) study, and stereotactic body radiotherapy model parameters were calibrated against 3-year survival from a phase 2 prospective trial. We simulated lifetime histories of identical patients with early-stage NSCLC who were ineligible for resection, who were treated with radiation therapy, RFA, or stereotactic body radiotherapy under a range of scenarios. From 5,000,000 simulated individuals, we selected a cohort of patients with stage I medically inoperable cancer for analysis (n = 2056 per treatment scenario). Main outcomes were life expectancy gains. RESULTS RFA or stereotactic body radiotherapy treatment in patients with peripheral stage IA or IB NSCLC who were nonoperative candidates resulted in life expectancy gains of 1.71 and 1.46 life-years, respectively, compared with universal radiation therapy. A strategy where patients with central tumors underwent stereotactic body radiotherapy and those with peripheral tumors underwent RFA resulted in a gain of 2.02 life-years compared with universal radiation therapy. Findings were robust with respect to changes in model parameters. CONCLUSION Microsimulation modeling results suggest that RFA and stereotactic body radiotherapy could provide life

  18. Intermittent androgen ablation in patients with biochemical failure after pelvic radiotherapy for localized prostate cancer

    SciTech Connect

    Cury, Fabio L.B.; Souhami, Luis . E-mail: luis.souhami@muhc.mcgill.ca; Rajan, Raghu; Tanguay, Simon; Gagnon, Bruno; Duclos, Marie; Shenouda, George; Faria, Sergio L.; David, Marc; Freeman, Carolyn R.

    2006-03-01

    Purpose: To assess the efficacy of intermittent androgen ablation (IAA) in patients with biochemical failure after radiotherapy for prostate cancer. Methods and Materials: Thirty-nine patients received a luteinizing hormone-releasing hormone analog every 2 months for a total of 4 doses. IAA was then discontinued if serum prostate-specific antigen (PSA) fell to a normal level with a castrate level of testosterone. Therapy was restarted when the serum PSA level reached {>=}10 ng/mL and was discontinued if hormone resistance or unacceptable toxicity occurred. Results: Median PSA was 9.1 ng/mL at the time of first IAA. The median time between the first and the second cycles was 20.1 months, decreasing to 15.5 months between the third and fourth cycles. Two patients discontinued the treatment because of severe hot flushes. Four patients developed hormone resistance. With a median follow-up of 56.4 months, 5-year survival is 92.3%. Three patients died of unrelated causes. The incidence of distant metastasis is 6.8%. Conclusions: The use of IAA seems to be a safe and effective treatment for patients with biochemical failure post radiotherapy and no evidence of metastatic disease. The use of IAA limits hormone-related side effects and health care costs without an apparent increase in the risk for the development of metastatic disease.

  19. Stereotactic Ablative Radiosurgery for Locally Advanced or Recurrent Skull Base Malignancies with Prior External Beam Radiation Therapy

    PubMed Central

    Xu, Karen M.; Quan, Kimmen; Clump, David A.; Ferris, Robert L.; Heron, Dwight E.

    2015-01-01

    Purpose: Stereotactic ablative radiotherapy (SABR) is an attractive modality to treat malignancies invading the skull base as it can deliver a highly conformal dose with minimal toxicity. However, variation exists in the prescribed dose and fractionation. The purpose of our study is to examine the local control, survival, and toxicities in SABR for the treatment of previously irradiated malignant skull base tumors. Materials and methods: A total of 31 patients and 40 locally advanced or recurrent head and neck malignancies involving the skull base treated with a common SABR regimen, which delivers a radiation dose of 44 Gy in 5 fractions from January 1st, 2004 to December 31st, 2013, were retrospectively reviewed. The local control rate (LC), progression-free survival rate, overall survival (OS) rate, and toxicities were reported. Results: The median follow-up time of all patients was 11.4 months (range: 0.6–67.2 months). The median tumor volume was 27 cm3 (range: 2.4–205 cm3). All patients received prior external beam radiation therapy with a median radiation dose of 64 Gy (range: 24–75.6 Gy) delivered in 12–42 fractions. Twenty patients had surgeries prior to SABR. Nineteen patients received chemotherapy. Specifically, eight patients received concurrent cetuximab (Erbitux™) with SABR. The median time-to-progression (TTP) was 3.3 months (range: 0–16.9 months). For the 29 patients (93.5%) who died, the median time from the end of first SABR to death was 10.3 months (range: 0.5–41.4 months). The estimated 1-year OS rate was 35%. The estimated 2-year OS rate was 12%. Treatment was well-tolerated without grade 4 or 5 treatment-related toxicities. Conclusion: Stereotactic ablative radiotherapy has been shown to achieve low toxicities in locally advanced or recurrent, previously irradiated head and neck malignancies invading the skull base. PMID:25853093

  20. Texture analysis of automatic graph cuts segmentations for detection of lung cancer recurrence after stereotactic radiotherapy

    NASA Astrophysics Data System (ADS)

    Mattonen, Sarah A.; Palma, David A.; Haasbeek, Cornelis J. A.; Senan, Suresh; Ward, Aaron D.

    2015-03-01

    Stereotactic ablative radiotherapy (SABR) is a treatment for early-stage lung cancer with local control rates comparable to surgery. After SABR, benign radiation induced lung injury (RILI) results in tumour-mimicking changes on computed tomography (CT) imaging. Distinguishing recurrence from RILI is a critical clinical decision determining the need for potentially life-saving salvage therapies whose high risks in this population dictate their use only for true recurrences. Current approaches do not reliably detect recurrence within a year post-SABR. We measured the detection accuracy of texture features within automatically determined regions of interest, with the only operator input being the single line segment measuring tumour diameter, normally taken during the clinical workflow. Our leave-one-out cross validation on images taken 2-5 months post-SABR showed robustness of the entropy measure, with classification error of 26% and area under the receiver operating characteristic curve (AUC) of 0.77 using automatic segmentation; the results using manual segmentation were 24% and 0.75, respectively. AUCs for this feature increased to 0.82 and 0.93 at 8-14 months and 14-20 months post SABR, respectively, suggesting even better performance nearer to the date of clinical diagnosis of recurrence; thus this system could also be used to support and reinforce the physician's decision at that time. Based on our ongoing validation of this automatic approach on a larger sample, we aim to develop a computer-aided diagnosis system which will support the physician's decision to apply timely salvage therapies and prevent patients with RILI from undergoing invasive and risky procedures.

  1. Three-Dimensional Conformal Radiotherapy for Hepatocellular Carcinoma in Patients Unfit for Resection, Ablation, or Chemotherapy: A Retrospective Study

    PubMed Central

    Mosa, Eftychia; Georgakopoulos, John; Platoni, Kalliopi; Brountzos, Ilias; Zygogianni, Anna; Kosmidis, Paraskevas; Mystakidou, Kyriaki; Tolia, Maria; Beli, Ivelina; Gouliamos, Athanasios; Kouvaris, John; Kelekis, Nikoalos

    2013-01-01

    Purpose. The purpose is to evaluate the feasibility, efficacy, and the toxicity of three-dimensional conformal radiotherapy (3DCRT) in patients with advanced hepatocelluar carcinoma (HCC) and inferior vena cava tumor thrombosis (IVCTT). Methods. Between 2007 and 2012, in a retrospective way, 9 patients (median age 69 years) with advanced HCC and IVCTT unfit for surgery, radiofrequency ablation, embolization, or chemotherapy were treated with three-dimensional conformal radiotherapy (3DCRT). The radiotherapy volume included both primary tumor and IVTT. The radiotherapy schedule was 50–52 Gy in 2 Gy fractions. Overall survival (OS), response to radiotherapy, visual analogue scale (VAS), and toxicity were assessed. Results. All patients demonstrated a response rate up to 60%. During radiotherapy, 3 patients experienced grade 1 nausea/vomit toxicity. All patients demonstrated an elevation of the liver enzymes (3 patients with grade 1 and 6 patients with grade 2). The mean VAS-score was decreased from 6.11 to 3.11, while the median overall survival was 24 months. Conclusion. 3DCRT achieves a very high local control rate and is suitable for patients with HCC and IVTT, while the documented radiation induced toxicity is moderate. It can be recommended for palliation in patients unable to undergo curative therapies. PMID:24379750

  2. Skylon Aerodynamics and SABRE Plumes

    NASA Technical Reports Server (NTRS)

    Mehta, Unmeel; Afosmis, Michael; Bowles, Jeffrey; Pandya, Shishir

    2015-01-01

    An independent partial assessment is provided of the technical viability of the Skylon aerospace plane concept, developed by Reaction Engines Limited (REL). The objectives are to verify REL's engineering estimates of airframe aerodynamics during powered flight and to assess the impact of Synergetic Air-Breathing Rocket Engine (SABRE) plumes on the aft fuselage. Pressure lift and drag coefficients derived from simulations conducted with Euler equations for unpowered flight compare very well with those REL computed with engineering methods. The REL coefficients for powered flight are increasingly less acceptable as the freestream Mach number is increased beyond 8.5, because the engineering estimates did not account for the increasing favorable (in terms of drag and lift coefficients) effect of underexpanded rocket engine plumes on the aft fuselage. At Mach numbers greater than 8.5, the thermal environment around the aft fuselage is a known unknown-a potential design and/or performance risk issue. The adverse effects of shock waves on the aft fuselage and plumeinduced flow separation are other potential risks. The development of an operational reusable launcher from the Skylon concept necessitates the judicious use of a combination of engineering methods, advanced methods based on required physics or analytical fidelity, test data, and independent assessments.

  3. A Case of Metastatic Low-Grade Endometrial Stromal Sarcoma Treated with Letrozole after Ovarian Ablation by Radiotherapy

    PubMed Central

    Yang, Kyung Ho; Shin, Jung A; Jung, Joo Hyuk; Jung, Hae Won; Lee, Hye Ran; Chang, Sunhee; Park, Ji Yeon; Yi, Seong Yoon

    2015-01-01

    A 50-year-old woman was admitted to our hospital due to multiple lung nodules detected incidentally on a chest X-ray. A video-assisted thoracoscopic lung biopsy revealed low-grade endometrial stromal sarcoma (LG-ESS). She had undergone a simple hysterectomy 1 year earlier owing to a diagnosis of adenomyosis. A review of her previous hysterectomy specimen showed not endometriosis but LG-ESS. According to the patient’s levels of serum follicle stimulating hormone and estradiol, she was in the premenopausal state with retained and normally functioning ovaries. She then underwent ovarian ablation by radiotherapy, after which she was administered 2.5 mg of letrozole once per day. Three months later, the size of the metastatic nodules in both lungs had decreased. The patient was followed up for 24 months while continuing on letrozole, and maintained a partial remission. We report herein on a case of metastatic LG-ESS treated with letrozole after ovarian ablation by radiotherapy. PMID:25715770

  4. Frontal linear scieroderma (en Coup de Sabre): a case report.

    PubMed

    Pekiner, Filiz Namdar; Yücelten, Deniz; Gümrü, Birsay; Sinanoğlu, Enver Alper

    2006-01-01

    En coup de sabre is a type of linear scleroderma which presents on the frontal or frontoparietal scalp. En coup de sabre in children is associated with asymmetric growth and progressive facial disfigurement. The purpose of this report was to present the case of a 4-year-old girl with a 2-year history of en coup de sabre. The clinical presentation and radiographic findings are discussed. PMID:17367036

  5. Complete PSA Response Following Stereotactic Ablative Radiotherapy for a Bony Metastasis in the Setting of Castrate-Resistant Prostate Cancer.

    PubMed

    Lukovic, Jelena; Rodrigues, George

    2015-01-01

    A majority of patients with castrate-resistant prostate cancer ultimately develop distant metastases, with bone being the most common site of spread. Classically, systemic therapy has been considered the standard of care for patients with metastatic cancer. Emerging evidence, however, suggests that an intermediate oligometastatic state, between limited disease and widespread metastases, exists; theoretically, with locally ablative treatment, patients may be curable. We describe a complete PSA response following aggressive management, using stereotactic body radiotherapy (SBRT), of an oligometastatic spine lesion in the setting of castrate-resistant prostate cancer (CRPC). This case report supports the use of SBRT in oligometastatic CRPC and suggests that management of limited metastases may provide good long-term outcomes in well-selected patients. PMID:26623220

  6. Complete PSA Response Following Stereotactic Ablative Radiotherapy for a Bony Metastasis in the Setting of Castrate-Resistant Prostate Cancer

    PubMed Central

    Rodrigues, George

    2015-01-01

    A majority of patients with castrate-resistant prostate cancer ultimately develop distant metastases, with bone being the most common site of spread. Classically, systemic therapy has been considered the standard of care for patients with metastatic cancer. Emerging evidence, however, suggests that an intermediate oligometastatic state, between limited disease and widespread metastases, exists; theoretically, with locally ablative treatment, patients may be curable. We describe a complete PSA response following aggressive management, using stereotactic body radiotherapy (SBRT), of an oligometastatic spine lesion in the setting of castrate-resistant prostate cancer (CRPC). This case report supports the use of SBRT in oligometastatic CRPC and suggests that management of limited metastases may provide good long-term outcomes in well-selected patients. PMID:26623220

  7. Differential response to ablative ionizing radiation in genetically distinct non-small cell lung cancer cells.

    PubMed

    Oweida, Ayman; Sharifi, Zeinab; Halabi, Hani; Xu, Yaoxian; Sabri, Siham; Abdulkarim, Bassam

    2016-04-01

    Stereotactic ablative radiotherapy (SABR) has emerged as a highly promising treatment for medically inoperable early-stage non-small cell lung cancer patients. Treatment outcomes after SABR have been excellent compared to conventional fractionated radiotherapy (CFRT). However, the biological determinants of the response to ablative doses of radiation remain poorly characterized. Furthermore, there's little data on the cellular and molecular response of genetically distinct NSCLC subtypes to radiation. We assessed the response of 3 genetically distinct lung adenocarcinoma cell lines to ablative and fractionated ionizing radiation (AIR and FIR). We studied clonogenic survival, cell proliferation, migration, invasion, apoptosis and senescence. We also investigated the effect of AIR and FIR on the expression of pro-invasive proteins, epithelial-to-mesenchymal transition (EMT), extracellular signal-regulated kinases (ERK1/2) and the transmembrane receptor cMET. Our findings reveal that AIR significantly reduced cell proliferation and clonogenic survival compared to FIR in A549 cells only. This differential response was not observed in HCC827 or H1975 cells. AIR significantly enhanced the invasiveness of A549 cells, but not HCC827 or H1975 cells compared to FIR. Molecular analysis of pathways involved in cell proliferation and invasion revealed that AIR significantly reduced phosphorylation of ERK1/2 and upregulated cMET expression in A549 cells. Our results show a differential proliferative and invasive response to AIR that is dependent on genetic subtype and independent of intrinsic radioresistance. Further examination of these findings in a larger panel of NSCLC cell lines and in pre-clinical models is warranted for identification of biomarkers of tumor response to AIR. PMID:27096542

  8. SU-C-BRA-07: Virtual Bronchoscopy-Guided IMRT Planning for Mapping and Avoiding Radiation Injury to the Airway Tree in Lung SAbR

    SciTech Connect

    Sawant, A; Modiri, A; Bland, R; Yan, Y; Ahn, C; Timmerman, R

    2015-06-15

    Purpose: Post-treatment radiation injury to central and peripheral airways is a potentially important, yet under-investigated determinant of toxicity in lung stereotactic ablative radiotherapy (SAbR). We integrate virtual bronchoscopy technology into the radiotherapy planning process to spatially map and quantify the radiosensitivity of bronchial segments, and propose novel IMRT planning that limits airway dose through non-isotropic intermediate- and low-dose spillage. Methods: Pre- and ∼8.5 months post-SAbR diagnostic-quality CT scans were retrospectively collected from six NSCLC patients (50–60Gy in 3–5 fractions). From each scan, ∼5 branching levels of the bronchial tree were segmented using LungPoint, a virtual bronchoscopic navigation system. The pre-SAbR CT and the segmented bronchial tree were imported into the Eclipse treatment planning system and deformably registered to the planning CT. The five-fraction equivalent dose from the clinically-delivered plan was calculated for each segment using the Universal Survival Curve model. The pre- and post-SAbR CTs were used to evaluate radiation-induced segmental collapse. Two of six patients exhibited significant segmental collapse with associated atelectasis and fibrosis, and were re-planned using IMRT. Results: Multivariate stepwise logistic regression over six patients (81 segments) showed that D0.01cc (minimum point dose within the 0.01cc receiving highest dose) was a significant independent factor associated with collapse (odds-ratio=1.17, p=0.010). The D0.01cc threshold for collapse was 57Gy, above which, collapse rate was 45%. In the two patients exhibiting segmental collapse, 22 out of 32 segments showed D0.01cc >57Gy. IMRT re-planning reduced D0.01cc below 57Gy in 15 of the 22 segments (68%) while simultaneously achieving the original clinical plan objectives for PTV coverage and OAR-sparing. Conclusion: Our results indicate that the administration of lung SAbR can Result in significant injury to

  9. Endometrial ablation

    MedlinePlus

    Hysteroscopy-endometrial ablation; Laser thermal ablation; Endometrial ablation-radiofrequency; Endometrial ablation-thermal balloon ablation; Rollerball ablation; Hydrothermal ablation; Novasure ablation

  10. Monte Carlo calculation of dose distributions in oligometastatic patients planned for spine stereotactic ablative radiotherapy

    NASA Astrophysics Data System (ADS)

    Moiseenko, V.; Liu, M.; Loewen, S.; Kosztyla, R.; Vollans, E.; Lucido, J.; Fong, M.; Vellani, R.; Popescu, I. A.

    2013-10-01

    Dosimetric consequences of plans optimized using the analytical anisotropic algorithm (AAA) implemented in the Varian Eclipse treatment planning system for spine stereotactic body radiotherapy were evaluated by re-calculating with BEAMnrc/DOSXYZnrc Monte Carlo. Six patients with spinal vertebral metastases were planned using volumetric modulated arc therapy. The planning goal was to cover at least 80% of the planning target volume with a prescribed dose of 35 Gy in five fractions. Tissue heterogeneity-corrected AAA dose distributions for the planning target volume and spinal canal planning organ-at-risk volume were compared against those obtained from Monte Carlo. The results showed that the AAA overestimated planning target volume coverage with the prescribed dose by up to 13.5% (mean 8.3% +/- 3.2%) when compared to Monte Carlo simulations. Maximum dose to spinal canal planning organ-at-risk volume calculated with Monte Carlo was consistently smaller than calculated with the treatment planning system and remained under spinal cord dose tolerance. Differences in dose distribution appear to be related to the dosimetric effects of accounting for body composition in Monte Carlo simulations. In contrast, the treatment planning system assumes that all tissues are water-equivalent in their composition and only differ in their electron density.

  11. F-86 Sabre on lakebed, front view

    NASA Technical Reports Server (NTRS)

    1954-01-01

    With the NACA High-Speed Flight Station (HSFS) main building (4800) in the background the North American F-86F (Serial #52-5426) Sabre sits on the Rogers Dry lakebed just off the NACA ramp in 1954. This was soon after the National Advisory Committee for Aeronautics unit moved from South Base at Edwards Air Force Base to the new building that still houses the NASA Dryden Flight Research Center, successor to the HSFS. The F-86F performed both pitch-up research and duties as a chase aircraft for the D-558-2. Its stay at the HSFS was brief. It arrived on June 23, 1954, and left on September 10 the same year. The F-86 had a 35 degree sweptwing and a wing span of 37 feet 1 inch with a General Electric J47-GE engine. It was the first U.S. sweptwing fighter and saw extensive action in the Korean War. It could slightly exceed Mach 1 in a dive.

  12. LIGHT-SABRE enables efficient in-magnet catalytic hyperpolarization

    NASA Astrophysics Data System (ADS)

    Theis, Thomas; Truong, Milton; Coffey, Aaron M.; Chekmenev, Eduard Y.; Warren, Warren S.

    2014-11-01

    Nuclear spin hyperpolarization overcomes the sensitivity limitations of traditional NMR and MRI, but the most general method demonstrated to date (dynamic nuclear polarization) has significant limitations in scalability, cost, and complex apparatus design. As an alternative, signal amplification by reversible exchange (SABRE) of parahydrogen on transition metal catalysts can hyperpolarize a variety of substrates, but to date this scheme has required transfer of the sample to low magnetic field or very strong RF irradiation. Here we demonstrate "Low-Irradiation Generation of High Tesla-SABRE" (LIGHT-SABRE) which works with simple pulse sequences and low power deposition; it should be usable at any magnetic field and for hyperpolarization of many different nuclei. This approach could drastically reduce the cost and complexity of producing hyperpolarized molecules.

  13. Radiotherapy.

    PubMed

    Adamietz, Irenaus A

    2010-01-01

    The intrathoracic growth of the tumor causes several severe symptoms as cough, dyspnea, chest pain, hemoptysis, hoarseness, anorexia/nausea, and dysphagia. In patients with manifest or threatening symptoms radiotherapy (RT) as an effective measure should be implemented into the management concept. Palliative RT radiotherapy prefers short hypofractionated schemas (e.g. 10 x 3 Gy, 4 x 5 Gy, 2 x 8 Gy, 1 x 10 Gy). Careful radiation planning supports the precision of palliative RT and reduces significantly the complication rate. A good response and prolonged palliation effects (6-12 months) can be achieved in many cases. However, the minimum biologically equivalent dose should not be less than 35 Gy. RT produces a good outcome in all types of metastases of lung carcinoma. In emergencies like VCSS or spinal cord compression RT should be initiated immediately. The selection of the optimal therapy for locally advanced lung carcinoma with malignant airway obstruction is difficult. Both brachytherapy and percutaneous irradiation are effective, however published results including local a sum of response, functionality and life quality demonstrates more benefit by percutaneous RT. Due to different physical properties of these two methods the combination of brachytherapy and external beam irradiation may be advantageous. PMID:19955803

  14. The role of stereotactic ablative radiotherapy in oncological and non-oncological clinical settings: highlights from the 7th Meeting of AIRO--Young Members Working Group (AIRO Giovani).

    PubMed

    Franco, Pierfrancesco; De Bari, Berardino; Ciammella, Patrizia; Fiorentino, Alba; Chiesa, Silvia; Amelio, Dante; Pinzi, Valentina; Bonomo, Pierluigi; Vagge, Stefano; Fiore, Michele; Comito, Tiziana; Cecconi, Agnese; Mortellaro, Gianluca; Bruni, Alessio; Trovò, Marco; Filippi, Andrea Riccardo; Greto, Daniela; Alongi, Filippo

    2014-01-01

    Stereotactic ablative radiotherapy is a modern cancer treatment strategy able to deliver highly focused radiation in one or a few fractions with a radical intent in several clinical settings. Young radiation oncologists need a constant and tailored update in this context to improve patient care in daily clinical practice. A recent meeting of AIRO Giovani (AIRO--Young Members Working Group) was specifically addressed to this topic, presenting state-of-the-art knowledge, based on the latest evidence in this field. Highlights of the congress are summarized and presented in this report, including thorough contributions of the speakers dealing with the role of stereotactic ablative radiotherapy in both oncological and non-oncological diseases, divided according to anatomical and clinical scenarios: intra-cranial settings (brain malignant primary tumors, metastases, benign tumors and functional disorders) and extra-cranial indications (lung primary tumors and metastases, thoracic re-irradiation, liver, lymph node and bone metastases, prostate cancer). With literature data discussed during the congress as a background, stereotactic ablative radiotherapy has proved to be a consolidated treatment approach in specific oncological and non-oncological scenarios, as well as a promising option in other clinical settings, requiring a further prospective validation in the near future. We herein present an updated overview of stereotactic ablative radiotherapy use in the clinic. PMID:25688503

  15. En coup de sabre accompanied by pachydermoperiostosis: a case report.

    PubMed

    Ozdemir, M; Yildirim, S; Mevlitoğlu, I

    2007-01-01

    Scleroderma en coup de sabre, a variant of localized scleroderma is a disorder characterized by fibrosis of connective tissue. We report a 21-year-old female with scleroderma en coup de sabre accompanied by pachydermoperiostosis. She was born to consanguineous parents and her older sister also had pachydermoperiostosis characterized by clubbing of the digits, enlargement of distal parts of the extremities. The two disorders were diagnosed by clinical examination, histological and x-ray findings. In contrast to scleroderma, pachydermoperiostosis is a hypertrophic process characterized by periosteal proliferation of the tubuler bones and hypertrophic skin changes. We discuss this interesting coexistence and review the literature. PMID:17543162

  16. CHARACTERIZING THE MICROBIAL COMMUNITY IN SABRE MICROCOSM STUDIES (ABSTRACT ONLY)

    EPA Science Inventory

    The SABRE (Source Area BioREmediation) project will evaluate accelerated anaerobic bioremediation of chlorinated solvents in areas of high concentration, such as DNAPL source areas. In preparation for a field scale pilot test, laboratory microcosm and column studies were conducte...

  17. METRICS OF PERFORMANCE FOR THE SABRE MICROCOSM STUDY (ABSTRACT ONLY)

    EPA Science Inventory

    The SABRE (Source Area BioREmediation) project will evaluate accelerated anaerobic bioremediation of chlorinated solvents in areas of high concentration, such as DNAPL source areas. In preparation for a field scale pilot test, a laboratory microcosm study was conducted to provide...

  18. Repair of "coup de sabre," a linear form of scleroderma.

    PubMed

    Sengezer, M; Deveci, M; Selmanpakoglu, N

    1996-10-01

    A case of coup de sabre, a linear form of scleroderma, is presented. Treatment consisted of soft-tissue expansion and autologous bone grafting to the forehead, a composite graft for alar reconstruction, and a scalp graft for eyebrow reconstruction. None of the linear scleroderma cases reported in the literature consisted of bony reconstruction. PMID:8905054

  19. Developing SABRE as an analytical tool in NMR

    NASA Astrophysics Data System (ADS)

    Lloyd, Lyrelle Stacey

    Work presented in this thesis centres around the application of the new hyperpolarisation technique, SABRE, within nuclear magnetic resonance spectroscopy, focusing on optimisation of the technique to characterise small organic molecules. While pyridine was employed as a model substrate, studies on a range of molecules are investigated including substituted pyridines, quinolines, thiazoles and indoles are detailed. Initial investigations explored how the properties of the SABRE catalyst effect the extent of polarisation transfer exhibited. The most important of these properties proved to be the rate constants for loss of pyridine and hydrides as these define the contact time of pyridine with the parahydrogen derived hydride ligands in the metal template. The effect of changing the temperature, solvent or concentration of substrate or catalyst are rationalised. For instance, the catalyst ICy(a) exhibits relatively slow ligand exchange rates and increasing the temperature during hyperpolarisation increases the observed signal enhancements. These studies have revealed a second polarisation transfer template can be used with SABRE in which two substrate molecules are bound. This allows the possibility of investigation of larger substrates which might otherwise be too sterically encumbered to bind. Another significant advance relates to the first demonstration that SABRE can be used in conjunction with an automated system designed with Bruker allowing the acquisition of scan averaged, phase cycled and traditional 2D spectra. The system also allowed investigations into the effect of the polarisation transfer field and application of that knowledge to collect single-scan 13C data for characterisation. The successful acquisition of 1H NOESY, 1H-1H COSY, 1H-13C 2D and ultrafast 1H-1H COSY NMR sequences is detailed for a 10 mM concentration sample, with 1H data collected for a 1 mM sample. A range of studies which aim to demonstrate the applicability of SABRE to the

  20. Solutions that enable ablative radiotherapy for large liver tumors: Fractionated dose painting, simultaneous integrated protection, motion management, and computed tomography image guidance.

    PubMed

    Crane, Christopher H; Koay, Eugene J

    2016-07-01

    The emergence and success of stereotactic body radiation therapy (SBRT) for the treatment of lung cancer have led to its rapid adoption for liver cancers. SBRT can achieve excellent results for small liver tumors. However, the vast majority of physicians interpret SBRT as meaning doses of radiation (range, 4-20 Gray [Gy]) that may not be ablative but are delivered within about 1 week (ie, in 3-6 fractions). Adherence to this approach has limited the effectiveness of SBRT for large liver tumors (>7 cm) because of the need to reduce doses to meet organ constraints. The prognosis for patients who present with large liver tumors is poor, with a median survival ≤12 months, and most of these patients die from tumor-related liver failure. Herein, the authors present a comprehensive solution to achieve ablative SBRT doses for patients with large liver tumors by using a combination of classic, modern, and novel concepts of radiotherapy: fractionation, dose painting, motion management, image guidance, and simultaneous integrated protection. The authors discuss these concepts in the context of large, inoperable liver tumors and review how this approach can substantially prolong survival for patients, most of whom otherwise have a very poor prognosis and few effective treatment options. Cancer 2016;122:1974-86. © 2016 American Cancer Society. PMID:26950735

  1. Arabidopsis  SABRE and CLASP interact to stabilize cell division plane orientation and planar polarity

    PubMed Central

    Pietra, Stefano; Gustavsson, Anna; Kiefer, Christian; Kalmbach, Lothar; Hörstedt, Per; Ikeda, Yoshihisa; Stepanova, Anna N.; Alonso, Jose M.; Grebe, Markus

    2013-01-01

    The orientation of cell division and the coordination of cell polarity within the plane of the tissue layer (planar polarity) contribute to shape diverse multicellular organisms. The root of Arabidopsis thaliana displays regularly oriented cell divisions, cell elongation and planar polarity providing a plant model system to study these processes. Here we report that the SABRE protein, which shares similarity with proteins of unknown function throughout eukaryotes, has important roles in orienting cell division and planar polarity. SABRE localizes at the plasma membrane, endomembranes, mitotic spindle and cell plate. SABRE stabilizes the orientation of CLASP-labelled preprophase band microtubules predicting the cell division plane, and of cortical microtubules driving cell elongation. During planar polarity establishment, sabre is epistatic to clasp at directing polar membrane domains of Rho-of-plant GTPases. Our findings mechanistically link SABRE to CLASP-dependent microtubule organization, shedding new light on the function of SABRE-related proteins in eukaryotes. PMID:24240534

  2. Scleroderma en coup de sabre treated with polymethylmethacrylate - Case report.

    PubMed

    Franco, Joanna Pimenta de Araujo; Serra, Márcio Soares; Lima, Ricardo Barbosa; D'Acri, Antônio Macedo; Martins, Carlos José

    2016-04-01

    The scleroderma en coup de sabre is a variant of localized scleroderma that occurs preferentially in children. The disease progresses with a proliferative and inflammatory phase and later atrophy and residual deformity, which are treated with surgical techniques such as injectable fillers, transplanted or autologous fat grafting and resection of the lesion. Among the most widely used fillers is hyaluronic acid. However, there are limitations that motivate the search for alternatives, such as polymethylmethacrylate, a permanent filler that is biocompatible, non-toxic, non-mutagenic and immunologically inert. In order to illustrate its application, a case of scleroderma en coup de sabre in a 17-year-old patient, who was treated with polymethylmethacrylate with excellent aesthetic results, is reported. PMID:27192521

  3. Scleroderma en coup de sabre treated with polymethylmethacrylate - Case report*

    PubMed Central

    Franco, Joanna Pimenta de Araujo; Serra, Márcio Soares; Lima, Ricardo Barbosa; D’Acri, Antônio Macedo; Martins, Carlos José

    2016-01-01

    The scleroderma en coup de sabre is a variant of localized scleroderma that occurs preferentially in children. The disease progresses with a proliferative and inflammatory phase and later atrophy and residual deformity, which are treated with surgical techniques such as injectable fillers, transplanted or autologous fat grafting and resection of the lesion. Among the most widely used fillers is hyaluronic acid. However, there are limitations that motivate the search for alternatives, such as polymethylmethacrylate, a permanent filler that is biocompatible, non-toxic, non-mutagenic and immunologically inert. In order to illustrate its application, a case of scleroderma en coup de sabre in a 17-year-old patient, who was treated with polymethylmethacrylate with excellent aesthetic results, is reported. PMID:27192521

  4. Developments and advances concerning the hyperpolarisation technique SABRE.

    PubMed

    Mewis, Ryan E

    2015-10-01

    To overcome the inherent sensitivity issue in NMR and MRI, hyperpolarisation techniques are used. Signal Amplification By Reversible Exchange (SABRE) is a hyperpolarisation technique that utilises parahydrogen, a molecule that possesses a nuclear singlet state, as the source of polarisation. A metal complex is required to break the singlet order of parahydrogen and, by doing so, facilitates polarisation transfer to analyte molecules ligated to the same complex through the J-coupled network that exists. The increased signal intensities that the analyte molecules possess as a result of this process have led to investigations whereby their potential as MRI contrast agents has been probed and to understand the fundamental processes underpinning the polarisation transfer mechanism. As well as discussing literature relevant to both of these areas, the chemical structure of the complex, the physical constraints of the polarisation transfer process and the successes of implementing SABRE at low and high magnetic fields are discussed. PMID:26264565

  5. Ablative Radiotherapy Doses Lead to a Substantial Prolongation of Survival in Patients With Inoperable Intrahepatic Cholangiocarcinoma: A Retrospective Dose Response Analysis

    PubMed Central

    Tao, Randa; Krishnan, Sunil; Bhosale, Priya R.; Javle, Milind M.; Aloia, Thomas A.; Shroff, Rachna T.; Kaseb, Ahmed O.; Bishop, Andrew J.; Swanick, Cameron W.; Koay, Eugene J.; Thames, Howard D.; Hong, Theodore S.; Das, Prajnan

    2016-01-01

    Purpose Standard therapies for localized inoperable intrahepatic cholangiocarcinoma (IHCC) are ineffective. Advances in radiotherapy (RT) techniques and image guidance have enabled ablative doses to be delivered to large liver tumors. This study evaluated the effects of RT dose escalation in the treatment of IHCC. Patients and Methods Seventy-nine consecutive patients with inoperable IHCC were identified and treated with definitive RT from 2002 to 2014. At diagnosis, the median tumor size was 7.9 cm (range, 2.2 to 17 cm). Seventy patients (89%) received systemic chemotherapy before RT. RT doses were 35 to 100 Gy (median, 58.05 Gy) in three to 30 fractions for a median biologic equivalent dose (BED) of 80.5 Gy (range, 43.75 to 180 Gy). Results Median follow-up time for patients alive at time of analysis was 33 months (range, 11 to 93 months). Median overall survival (OS) time after diagnosis was 30 months; 3-year OS rate was 44%. Radiation dose was the single most important prognostic factor; higher doses correlated with an improved local control (LC) rate and OS. The 3-year OS rate for patients receiving BED greater than 80.5 Gy was 73% versus 38% for those receiving lower doses (P = .017); 3-year LC rate was significantly higher (78%) after a BED greater than 80.5 Gy than after lower doses (45%, P = .04). BED as a continuous variable significantly affected LC (P = .009) and OS (P = .004). There were no significant treatment-related toxicities. Conclusion Delivery of higher doses of RT improves LC and OS in inoperable IHCC. A BED greater than 80.5 Gy seems to be an ablative dose of RT for large IHCCs, with long-term survival rates that compare favorably with resection. PMID:26503201

  6. Cost-Effectiveness Analysis of Stereotactic Body Radiotherapy and Radiofrequency Ablation for Medically Inoperable, Early-Stage Non-Small Cell Lung Cancer

    SciTech Connect

    Sher, David J.

    2011-12-01

    Purpose: The standard management of medically inoperable Stage I non-small-cell lung cancer (NSCLC) conventionally has been fractionated three-dimensional conformal radiation therapy (3D-CRT). The relatively poor local control rate and inconvenience associated with this therapy have prompted the development of stereotactic body radiotherapy (SBRT), a technique that delivers very high doses of irradiation typically over 3 to 5 sessions. Radiofrequency ablation (RFA) has also been investigated as a less costly, single-day therapy that thermally ablates small, peripheral tumors. The cost-effectiveness of these three techniques has never been compared. Methods and Materials: We developed a Markov model to describe health states of 65-year-old men with medically inoperable NSCLC after treatment with 3D-CRT, SBRT, and RFA. Given their frail state, patients were assumed to receive supportive care after recurrence. Utility values, recurrence risks, and costs were adapted from the literature. Sensitivity analyses were performed to model uncertainty in these parameters. Results: The incremental cost-effectiveness ratio for SBRT over 3D-CRT was $6,000/quality-adjusted life-year, and the incremental cost-effectiveness ratio for SBRT over RFA was $14,100/quality-adjusted life-year. One-way sensitivity analysis showed that the results were robust across a range of tumor sizes, patient utility values, and costs. This result was confirmed with probabilistic sensitivity analyses that varied local control rates and utilities. Conclusion: In comparison to 3D-CRT and RFA, SBRT was the most cost-effective treatment for medically inoperable NSCLC over a wide range of treatment and disease assumptions. On the basis of efficacy and cost, SBRT should be the primary treatment approach for this disease.

  7. MDM2 Inhibition Sensitizes Prostate Cancer Cells to Androgen Ablation and Radiotherapy in a p53-Dependent Manner12

    PubMed Central

    Feng, Felix Y.; Zhang, Yu; Kothari, Vishal; Evans, Joseph R.; Jackson, William C.; Chen, Wei; Johnson, Skyler B.; Luczak, Connor; Wang, Shaomeng; Hamstra, Daniel A.

    2016-01-01

    PURPOSE: Increased murine double minute 2 (MDM2) expression, independent of p53 status, is associated with increased cancer-specific mortality for men with prostate cancer treated with radiotherapy. We assessed MI-219, a small molecule inhibitor of MDM2 with improved pharmacokinetics over nutlin-3, for sensitization of prostate cancer cells to radiotherapy and androgen deprivation therapy, a standard treatment option for men with high-risk prostate cancer. EXPERIMENTAL DESIGN: The effect of MDM2 inhibition by MI-219 was assessed in vitro and in vivo with mouse xenograft models across multiple prostate cancer cell lines containing varying p53 functional status. RESULTS: MDM2 inhibition by MI-219 resulted in dose- and time-dependent p53 activation and decreased clonogenic cell survival after radiation in a p53-dependent manner. Mechanistically, radiosensitization following inhibition of MDM2 was largely the result of p53-dependent increases in apoptosis and DNA damage as evidenced by Annexin V flow cytometry and γ-H2AX foci immunofluorescence. Similarly, treatment with MI-219 enhanced response to antiandrogen therapy via a p53-dependent increase in apoptotic cell death. Lastly, triple therapy with radiation, androgen deprivation therapy, and MI-219 decreased xenograft tumor growth compared with any single- or double-agent treatment. CONCLUSION: MDM2 inhibition with MI-219 results in p53-dependent sensitization of prostate cancer cells to radiation, antiandrogen therapy, and the combination. These findings support MDM2 small molecule inhibitor therapy as a therapy intensification strategy to improve clinical outcomes in high-risk localized prostate cancer. TRANSLATIONAL RELEVANCE: The combination of radiotherapy and androgen deprivation therapy is a standard treatment option for men with high-risk prostate cancer. Despite improvements in outcomes when androgen deprivation therapy is added to radiation, men with high-risk prostate cancer have significant risk for

  8. Spin polarization transfer mechanisms of SABRE: A magnetic field dependent study

    NASA Astrophysics Data System (ADS)

    Pravdivtsev, Andrey N.; Ivanov, Konstantin L.; Yurkovskaya, Alexandra V.; Petrov, Pavel A.; Limbach, Hans-Heinrich; Kaptein, Robert; Vieth, Hans-Martin

    2015-12-01

    We have investigated the magnetic field dependence of Signal Amplification By Reversible Exchange (SABRE) arising from binding of para-hydrogen (p-H2) and a substrate to a suitable transition metal complex. The magnetic field dependence of the amplification of the 1H Nuclear Magnetic Resonance (NMR) signals of the released substrates and dihydrogen, and the transient transition metal dihydride species shows characteristic patterns, which is explained using the theory presented here. The generation of SABRE is most efficient at low magnetic fields due to coherent spin mixing at nuclear spin Level Anti-Crossings (LACs) in the SABRE complexes. We studied two Ir-complexes and have shown that the presence of a 31P atom in the SABRE complex doubles the number of LACs and, consequently, the number of peaks in the SABRE field dependence. Interestingly, the polarization of SABRE substrates is always accompanied by the para-to-ortho conversion in dihydride species that results in enhancement of the NMR signal of free (H2) and catalyst-bound H2 (Ir-HH). The field dependences of hyperpolarized H2 and Ir-HH by means of SABRE are studied here, for the first time, in detail. The field dependences depend on the chemical shifts and coupling constants of Ir-HH, in which the polarization transfer takes place. A negative coupling constant of -7 Hz between the two chemically equivalent but magnetically inequivalent hydride nuclei is determined, which indicates that Ir-HH is a dihydride with an HH distance larger than 2 Å. Finally, the field dependence of SABRE at high fields as found earlier has been investigated and attributed to polarization transfer to the substrate by cross-relaxation. The present study provides further evidence for the key role of LACs in the formation of SABRE-derived polarization. Understanding the spin dynamics behind the SABRE method opens the way to optimizing its performance and overcoming the main limitation of NMR, its notoriously low sensitivity.

  9. 15N Hyperpolarization by Reversible Exchange Using SABRE-SHEATH

    PubMed Central

    2016-01-01

    NMR signal amplification by reversible exchange (SABRE) is a NMR hyperpolarization technique that enables nuclear spin polarization enhancement of molecules via concurrent chemical exchange of a target substrate and parahydrogen (the source of spin order) on an iridium catalyst. Recently, we demonstrated that conducting SABRE in microtesla fields provided by a magnetic shield enables up to 10% 15N-polarization (Theis, T.; et al. J. Am. Chem. Soc.2015, 137, 1404). Hyperpolarization on 15N (and heteronuclei in general) may be advantageous because of the long-lived nature of the hyperpolarization on 15N relative to the short-lived hyperpolarization of protons conventionally hyperpolarized by SABRE, in addition to wider chemical shift dispersion and absence of background signal. Here we show that these unprecedented polarization levels enable 15N magnetic resonance imaging. We also present a theoretical model for the hyperpolarization transfer to heteronuclei, and detail key parameters that should be optimized for efficient 15N-hyperpolarization. The effects of parahydrogen pressure, flow rate, sample temperature, catalyst-to-substrate ratio, relaxation time (T1), and reversible oxygen quenching are studied on a test system of 15N-pyridine in methanol-d4. Moreover, we demonstrate the first proof-of-principle 13C-hyperpolarization using this method. This simple hyperpolarization scheme only requires access to parahydrogen and a magnetic shield, and it provides large enough signal gains to enable one of the first 15N images (2 × 2 mm2 resolution). Importantly, this method enables hyperpolarization of molecular sites with NMR T1 relaxation times suitable for biomedical imaging and spectroscopy. PMID:25960823

  10. Changes in the Secretory Profile of NSCLC-Associated Fibroblasts after Ablative Radiotherapy: Potential Impact on Angiogenesis and Tumor Growth1

    PubMed Central

    Hellevik, Turid; Pettersen, Ingvild; Berg, Vivian; Bruun, Jack; Bartnes, Kristian; Busund, Lill-Tove; Chalmers, Anthony; Bremnes, Roy; Martinez-Zubiaurre, Iñigo

    2013-01-01

    In the context of radiotherapy, collateral effects of ablative doses of ionizing radiation (AIR) on stromal components of tumors remains understudied. In this work, cancer-associated fibroblasts (CAFs) isolated from freshly resected human lung tumors were exposed to AIR (1x 18 Gy) and analyzed for their release of paracrine factors. Inflammatory mediators and regulators of angiogenesis and tumor growth were analyzed by multiplex protein assays in conditioned medium (CM) from irradiated and non-irradiated CAFs. Additionally, the profile of secreted proteins was examined by proteomics. In functional assays, effects of CAF-CM on proliferative and migratory capacity of lung tumor cells (H-520/H-522) and human umbilical vein endothelial cells (HUVECs) and their tube-forming capacity were assessed. Our data show that exposure of CAFs to AIR results in 1) downregulated release of angiogenic molecules such as stromal cell-derived factor-1, angiopoietin, and thrombospondin-2 (TSP-2); 2) upregulated release of basic fibroblast growth factor from most donors; and 3) unaffected expression levels of hepatocyte growth factor, interleukin-6 (IL-6), IL-8, IL-1β, and tumor necrosis factor-α. CM from irradiated and control CAFs did not affect differently the proliferative or migratory capacity of tumor cells (H-520/H-522), whereas migratory capacity of HUVECs was partially reduced in the presence of irradiated CAF-CM. Overall, we conclude that AIR mediates a transformation on the secretory profile of CAFs that could influence the behavior of other cells in the tumor tissue and hence guide therapeutic outcomes. Downstream consequences of the changes observed in this study merits further investigations. PMID:23418618

  11. Brain cavernomas associated with en coup de sabre linear scleroderma: Two case reports

    PubMed Central

    2011-01-01

    Linear scleroderma is a form of localized scleroderma that primarily affects the pediatric population. When it occurs on the scalp or forehead, it is termed "en coup de sabre". In the en coup de sabre subtype, many extracutaneous associations, mostly neurological, have been described. A patient with linear scleroderma en coup de sabre was noted to have ipsilateral brain cavernomas by magnetic resonance imaging. Using a worldwide pediatric rheumatology electronic list-serve, another patient with the same 2 conditions was identified. These two patients are reported in this study. Consideration of neuroimaging studies to disclose abnormal findings in patients with linear scleroderma en coup de sabre is important for potentially preventing and treating neurological manifestations associated with this condition. PMID:21801349

  12. SABRE MULTI-LAB, STATISTICALLY-BASED MICROCOSM STUDY FOR TCE SOURCE ZONE REMEDIATION (ABSTRACT ONLY)

    EPA Science Inventory

    SABRE (source area bioremediation) is a public/private consortium of twelve companies, two government agencies, and three research institutions whose charter is to determine if enhanced anaerobic bioremediation can result in effective and quantifiable treatment of chlorinated sol...

  13. Stereotactic Ablative Body Radiation Therapy for Octogenarians With Non-Small Cell Lung Cancer

    SciTech Connect

    Takeda, Atsuya; Sanuki, Naoko; Eriguchi, Takahisa; Kaneko, Takeshi; Morita, Satoshi; Handa, Hiroshi; Aoki, Yousuke; Oku, Yohei; Kunieda, Etsuo

    2013-06-01

    Purpose: To retrospectively investigate treatment outcomes of stereotactic ablative body radiation therapy (SABR) for octogenarians with non-small cell lung cancer (NSCLC). Methods and Materials: Between 2005 and 2012, 109 patients aged ≥80 years with T1-2N0M0 NSCLC were treated with SABR: 47 patients had histology-unproven lung cancer; 62 patients had pathologically proven NSCLC. The prescribed doses were either 50 Gy/5 fractions for peripheral tumors or 40 Gy/5 fractions for centrally located tumors. The treatment outcomes, toxicities, and the correlating factors for overall survival (OS) were evaluated. Results: The median follow-up duration after SABR was 24.2 (range, 3.0-64.6) months. Only limited toxicities were observed, except for 1 grade 5 radiation pneumonitis. The 3-year local, regional, and distant metastasis-free survival rates were 82.3%, 90.1%, and 76.8%, respectively. The OS and lung cancer-specific survival rates were 53.7% and 70.8%, respectively. Multivariate analysis revealed that medically inoperable, low body mass index, high T stage, and high C-reactive protein were the predictors for short OS. The OS for the operable octogenarians was significantly better than that for inoperable (P<.01). Conclusions: Stereotactic ablative body radiation therapy for octogenarians was feasible, with excellent OS. Multivariate analysis revealed that operability was one of the predictors for OS. For medically operable octogenarians with early-stage NSCLC, SABR should be prospectively compared with resection.

  14. Spin polarization transfer mechanisms of SABRE: A magnetic field dependent study.

    PubMed

    Pravdivtsev, Andrey N; Ivanov, Konstantin L; Yurkovskaya, Alexandra V; Petrov, Pavel A; Limbach, Hans-Heinrich; Kaptein, Robert; Vieth, Hans-Martin

    2015-12-01

    We have investigated the magnetic field dependence of Signal Amplification By Reversible Exchange (SABRE) arising from binding of para-hydrogen (p-H2) and a substrate to a suitable transition metal complex. The magnetic field dependence of the amplification of the (1)H Nuclear Magnetic Resonance (NMR) signals of the released substrates and dihydrogen, and the transient transition metal dihydride species shows characteristic patterns, which is explained using the theory presented here. The generation of SABRE is most efficient at low magnetic fields due to coherent spin mixing at nuclear spin Level Anti-Crossings (LACs) in the SABRE complexes. We studied two Ir-complexes and have shown that the presence of a (31)P atom in the SABRE complex doubles the number of LACs and, consequently, the number of peaks in the SABRE field dependence. Interestingly, the polarization of SABRE substrates is always accompanied by the para-to-ortho conversion in dihydride species that results in enhancement of the NMR signal of free (H2) and catalyst-bound H2 (Ir-HH). The field dependences of hyperpolarized H2 and Ir-HH by means of SABRE are studied here, for the first time, in detail. The field dependences depend on the chemical shifts and coupling constants of Ir-HH, in which the polarization transfer takes place. A negative coupling constant of -7Hz between the two chemically equivalent but magnetically inequivalent hydride nuclei is determined, which indicates that Ir-HH is a dihydride with an HH distance larger than 2Å. Finally, the field dependence of SABRE at high fields as found earlier has been investigated and attributed to polarization transfer to the substrate by cross-relaxation. The present study provides further evidence for the key role of LACs in the formation of SABRE-derived polarization. Understanding the spin dynamics behind the SABRE method opens the way to optimizing its performance and overcoming the main limitation of NMR, its notoriously low sensitivity. PMID

  15. Stereotactic Ablative Radiation Therapy as First Local Therapy for Lung Oligometastases From Colorectal Cancer: A Single-Institution Cohort Study

    SciTech Connect

    Filippi, Andrea Riccardo; Badellino, Serena; Ceccarelli, Manuela; Guarneri, Alessia; Franco, Pierfrancesco; Monagheddu, Chiara; Spadi, Rosella; Ragona, Riccardo; Racca, Patrizia; Ricardi, Umberto

    2015-03-01

    Purpose: To estimate stereotactic ablative radiation therapy (SABR) efficacy and its potential role as an alternative to surgery for the treatment of lung metastases from colorectal cancer. Methods and Materials: Forty consecutive patients who received SABR as first local therapy at the time of lung progression were included, from 2004 to 2014. The primary study endpoint was overall survival. Secondary endpoints were progression-free survival and safety. Results: A single nodule was treated in 26 patients (65%), 2 nodules in 10 patients (25%), 3 in 3 patients (7.5%), and 4 in 1 patient (2.5%), for a total of 59 lesions. The median delivered biological effective dose was 96 Gy, in 1 to 8 daily fractions. Median follow-up time was 20 months (range, 3-72 months). Overall survival rates at 1, 2, and 5 years were, respectively, 84%, 73%, and 39%, with 14 patients (35%) dead. Median overall survival was 46 months. Progression occurred in 25 patients (62.5%), at a median interval of 8 months; failure at SABR site was observed in 3 patients (7.5%). Progression-free survival rates were 49% and 27% at 1 and 2 years, respectively. Discussion: The results of this retrospective exploratory analysis suggest safety and efficacy of SABR in patients affected with colorectal cancer lung oligometastases and urge inclusion of SABR in prospective clinical trials.

  16. SABRE: WIMP modulation detection in the northern and southern hemisphere

    NASA Astrophysics Data System (ADS)

    Froborg, F.; SABRE Collaboration

    2016-05-01

    Measuring an annual modulation in a direct Dark Matter detection experiment is not only a proof of the existence of WIMPs but can also tell us more about their interaction with standard matter and maybe even their density and velocity in the halo. Such a modulation has been measured by the DAMA/LIBRA experiment in NaI(Tl) crystals. However, the interpretation as WIMP signal is controversial due to contradicting results by other experiments. The SABRE experiment aims to shed light on this controversy by detecting the annual modulation in the same target material as DAMA with twin detectors at LNGS in Italy and at SUPL in Australia. The two locations in the northern and southern hemisphere allow to verify if other seasonal effects or the site have an influence on the measurement, thus reducing systematic effects. This paper will give an overview on the experimental design, the current status of the proof of principle phase mainly devoted to high-purity crystal growing, and an outlook on future plans.

  17. Definitive Management of Oligometastatic Melanoma in a Murine Model Using Combined Ablative Radiation Therapy and Viral Immunotherapy

    PubMed Central

    Blanchard, Miran; Shim, Kevin G.; Grams, Michael P.; Rajani, Karishma; Diaz, Rosa M.; Furutani, Keith M.; Thompson, Jill; Olivier, Kenneth R.; Park, Sean S.; Markovic, Svetomir N.; Pandha, Hardev; Melcher, Alan; Harrington, Kevin; Zaidi, Shane; Vile, Richard

    2016-01-01

    Purpose The oligometastatic state is an intermediate state between a malignancy that can be completely eradicated with conventional modalities and one in which a palliative approach is undertaken. Clinically, high rates of local tumor control are possible with stereotactic ablative radiation therapy (SABR), using precisely targeted, high-dose, low-fraction radiation therapy. However, in oligometastatic melanoma, virtually all patients develop progression systemically at sites not initially treated with ablative radiation therapy that cannot be managed with conventional chemotherapy and immunotherapy. We have demonstrated in mice that intravenous administration of vesicular stomatitis virus (VSV) expressing defined tumor-associated antigens (TAAs) generates systemic immune responses capable of clearing established tumors. Therefore, in the present preclinical study, we tested whether the combination of systemic VSV-mediated antigen delivery and SABR would be effective against oligometastatic disease. Methods and Materials We generated a model of oligometastatic melanoma in C57BL/6 immunocompetent mice and then used a combination of SABR and systemically administered VSV-TAA viral immunotherapy to treat both local and systemic disease. Results Our data showed that SABR generates excellent control or cure of local, clinically detectable, and accessible tumor through direct cell ablation. Also, the immunotherapeutic activity of systemically administered VSV-TAA generated T-cell responses that cleared subclinical metastatic tumors. We also showed that SABR induced weak T-cell-mediated tumor responses, which, particularly if boosted by VSV−TAA, might contribute to control of local and systemic disease. In addition, VSV−TAA therapy alone had significant effects on control of both local and metastatic tumors. Conclusions We have shown in the present preliminary murine study using a single tumor model that this approach represents an effective, complementary combination

  18. Lung Volume Reduction After Stereotactic Ablative Radiation Therapy of Lung Tumors: Potential Application to Emphysema

    SciTech Connect

    Binkley, Michael S.; Shrager, Joseph B.; Leung, Ann N.; Popat, Rita; Trakul, Nicholas; Atwood, Todd F.; Chaudhuri, Aadel; Maxim, Peter G.; Diehn, Maximilian; Loo, Billy W.

    2014-09-01

    Purpose: Lung volume reduction surgery (LVRS) improves dyspnea and other outcomes in selected patients with severe emphysema, but many have excessive surgical risk for LVRS. We analyzed the dose-volume relationship for lobar volume reduction after stereotactic ablative radiation therapy (SABR) of lung tumors, hypothesizing that SABR could achieve therapeutic volume reduction if applied in emphysema. Methods and Materials: We retrospectively identified patients treated from 2007 to 2011 who had SABR for 1 lung tumor, pre-SABR pulmonary function testing, and ≥6 months computed tomographic (CT) imaging follow-up. We contoured the treated lobe and untreated adjacent lobe(s) on CT before and after SABR and calculated their volume changes relative to the contoured total (bilateral) lung volume (TLV). We correlated lobar volume reduction with the volume receiving high biologically effective doses (BED, α/β = 3). Results: 27 patients met the inclusion criteria, with a median CT follow-up time of 14 months. There was no grade ≥3 toxicity. The median volume reduction of the treated lobe was 4.4% of TLV (range, −0.4%-10.8%); the median expansion of the untreated adjacent lobe was 2.6% of TLV (range, −3.9%-11.6%). The volume reduction of the treated lobe was positively correlated with the volume receiving BED ≥60 Gy (r{sup 2}=0.45, P=.0001). This persisted in subgroups determined by high versus low pre-SABR forced expiratory volume in 1 second, treated lobe CT emphysema score, number of fractions, follow-up CT time, central versus peripheral location, and upper versus lower lobe location, with no significant differences in effect size between subgroups. Volume expansion of the untreated adjacent lobe(s) was positively correlated with volume reduction of the treated lobe (r{sup 2}=0.47, P<.0001). Conclusions: We identified a dose-volume response for treated lobe volume reduction and adjacent lobe compensatory expansion after lung tumor SABR, consistent across

  19. Predicting Overall Survival After Stereotactic Ablative Radiation Therapy in Early-Stage Lung Cancer: Development and External Validation of the Amsterdam Prognostic Model

    SciTech Connect

    Louie, Alexander V.; Haasbeek, Cornelis J.A.; Mokhles, Sahar; Rodrigues, George B.; Stephans, Kevin L.; Lagerwaard, Frank J.; Palma, David A.; Videtic, Gregory M.M.; Warner, Andrew; Takkenberg, Johanna J.M.; Reddy, Chandana A.; Maat, Alex P.W.M.; Woody, Neil M.; Slotman, Ben J.; Senan, Suresh

    2015-09-01

    Purpose: A prognostic model for 5-year overall survival (OS), consisting of recursive partitioning analysis (RPA) and a nomogram, was developed for patients with early-stage non-small cell lung cancer (ES-NSCLC) treated with stereotactic ablative radiation therapy (SABR). Methods and Materials: A primary dataset of 703 ES-NSCLC SABR patients was randomly divided into a training (67%) and an internal validation (33%) dataset. In the former group, 21 unique parameters consisting of patient, treatment, and tumor factors were entered into an RPA model to predict OS. Univariate and multivariate models were constructed for RPA-selected factors to evaluate their relationship with OS. A nomogram for OS was constructed based on factors significant in multivariate modeling and validated with calibration plots. Both the RPA and the nomogram were externally validated in independent surgical (n=193) and SABR (n=543) datasets. Results: RPA identified 2 distinct risk classes based on tumor diameter, age, World Health Organization performance status (PS) and Charlson comorbidity index. This RPA had moderate discrimination in SABR datasets (c-index range: 0.52-0.60) but was of limited value in the surgical validation cohort. The nomogram predicting OS included smoking history in addition to RPA-identified factors. In contrast to RPA, validation of the nomogram performed well in internal validation (r{sup 2}=0.97) and external SABR (r{sup 2}=0.79) and surgical cohorts (r{sup 2}=0.91). Conclusions: The Amsterdam prognostic model is the first externally validated prognostication tool for OS in ES-NSCLC treated with SABR available to individualize patient decision making. The nomogram retained strong performance across surgical and SABR external validation datasets. RPA performance was poor in surgical patients, suggesting that 2 different distinct patient populations are being treated with these 2 effective modalities.

  20. Achieving 1% NMR polarization in water in less than 1 min using SABRE

    PubMed Central

    Zeng, Haifeng; Xu, Jiadi; McMahon, Michael T.; Lohman, Joost A.B.; van Zijl, Peter C.M.

    2015-01-01

    The development of biocompatible hyperpolarized media is a crucial step towards application of hyperpolarization in vivo. This article describes the achievement of 1% hyperpolarization of 3-amino-1,2,4-triazine protons in water using the parahydrogen induced polarization technique based on signal amplification by reversible exchange (SABRE). Polarization was achieved in less than 1 min. PMID:25123540

  1. Characterizing The Microbial Community In A TCE DNAPL Site: SABRE Column And Field Studies

    EPA Science Inventory

    The SABRE (Source Area BioREmediation) project is evaluating accelerated anaerobic bioremediation of chlorinated solvents in areas of high concentration, such as DNAPL source areas. In support of a field scale pilot test, column studies were conducted to design the system and ob...

  2. Spatial And Temporal Distribution Of Microbial Communities In A TCE DNAPL Site: SABRE Field Studies

    EPA Science Inventory

    The SABRE (Source Area BioREmediation) project was conducted to evaluate accelerated anaerobic bioremediation of chlorinated solvents in areas of high concentration, such as DNAPL source areas. To study performance of this technology, a test cell was constructed with a longitudi...

  3. RF-SABRE: A Way to Continuous Spin Hyperpolarization at High Magnetic Fields.

    PubMed

    Pravdivtsev, Andrey N; Yurkovskaya, Alexandra V; Vieth, Hans-Martin; Ivanov, Konstantin L

    2015-10-29

    A new technique is developed that allows one to carry out the signal amplification by reversible exchange (SABRE) experiments at high magnetic field. SABRE is a hyperpolarization method, which utilizes transfer of spin order from para-hydrogen to the spins of a substrate in transient iridium complexes. Previously, it has been thought that such a transfer of spin order is only efficient at low magnetic fields, notably, at level anti-crossing (LAC) regions. Here it is demonstrated that LAC conditions can also be fulfilled at high fields under the action of a RF field. The high-field RF-SABRE experiment can be implemented using commercially available nuclear magnetic resonance (NMR) and magnetic resonance imaging (MRI) machines and does not require technically demanding field-cycling. The achievable NMR enhancements are around 100 for several substrates as compared to their NMR signals at thermal equilibrium conditions at 4.7 T. The frequency dependence of RF-SABRE is comprised of well pronounced peaks and dips, whose position and amplitude are conditioned solely by the magnetic resonance parameters such as chemical shifts and scalar coupling of the spin system involved in the polarization transfer and by the amplitude of the RF field. Thus, the proposed method can serve as a new sensitive tool for probing transient complexes. Simulations of the dependence of magnetization transfer (i.e., NMR signal amplifications) on the frequency and amplitude of the RF field are in good agreement with the developed theoretical approach. Furthermore, the method enables continuous re-hyperpolarization of the SABRE substrate over a long period of time, giving a straightforward way to repetitive NMR experiments. PMID:25970807

  4. SabR enhances nikkomycin production via regulating the transcriptional level of sanG, a pathway-specific regulatory gene in Streptomyces ansochromogenes

    PubMed Central

    2011-01-01

    Background sabR is a pleiotropic regulatory gene which has been shown to positively regulate the nikkomycin biosynthesis and negatively affect the sporulation of Streptomyces ansochromogenes. In this study, we investigate the mechanism of SabR on modulating nikkomycin production in Streptomyces ansochromogenes. Results The transcription start point of sabR was determined by high-resolution S1 nuclease mapping and localized at the nucleotide T at position 37 bp upstream of the potential sabR translation start codon (GTG). Disruption of sabR enhanced its own transcription, but retarded the nikkomycin production. Over-expression of sabR enhanced nikkomycin biosynthesis in Streptomyces ansochromogenes. EMSA analysis showed that SabR bound to the upstream region of sanG, but it did not bind to the upstream region of its encoding gene (sabR), sanF and the intergenic region between sanN and sanO. DNase 1 footprinting assays showed that the SabR-binding site upstream of sanG was 5'-CTTTAAGTCACCTGGCTCATTCGCGTTCGCCCAGCT-3' which was designated as SARE. Deletion of SARE resulted in the delay of nikkomycin production that was similar to that of sabR disruption mutant. Conclusions These results indicated that SabR modulated nikkomycin biosynthesis as an enhancer via interaction with the promoter region of sanG, and expanded our understanding about regulatory cascade in nikkomycin biosynthesis. PMID:21771341

  5. WE-E-BRE-02: BEST IN PHYSICS (THERAPY) - Stereotactic Radiotherapy for Renal Sympathetic Ablation for the Treatment of Refractory Hypertension

    SciTech Connect

    Maxim, P; Wheeler, M; Loo, B; Maguire, P

    2014-06-15

    Purpose: To determine the safety and efficacy of stereotactic radiotherapy as a novel treatment for patients with refractory hypertension in a swine model. Uncontrolled hypertension is a significant contributor to morbidity and mortality, substantially increasing the risk of ischemic stroke, ischemic heart disease, and kidney failure. Methods: High-resolution computed tomography (CT) images of anesthetized pigs were acquired and treatment plans for each renal artery and nerve were developed using our clinically implemented treatment planning system. Stereotactic radiotherapy, 40Gy in single fraction was delivered bilaterally to the renal nerves using a state-of-the-art medical linear accelerator under image guidance utilizing dynamic conformal arcs. Dose to nearby critical organs was evaluated by dosevolume histogram analysis and correlated to toxicity data obtained through follow up pathology analysis. The animals were observed for six months with serial measurements of blood pressure, urine analysis, serum laboratories, and overall clinical and behavioral status. Results: All animals survived to the follow-up point without evidence of renal dysfunction (stable serum creatinine), skin changes, or behavioral changes that might suggest animal discomfort. Plasma norepinephrine levels (ng/ml) were followed monthly for 6 months. The average reduction observed was 63%, with the median reduction at 73.5%. Microscopic evaluation 4–6 weeks after treatment showed evidence of damage to the nerves around treated renal arteries. Considerable attenuation in pan neurofilament expression by immunohistochemistry was observed with some vacuolar changes indicative of injury. There was no histological or immunohistochemical evidence of damage to nearby spinal cord or spinal nerve root structures. Conclusion: Our preclinical studies have shown stereotactic radiotherapy to the renal sympathetic plexus to be safe and effective in reducing blood pressure, thus this approach holds great

  6. Dynamical Safety Analysis of the SABR Fusion-Fission Hybrid Reactor

    NASA Astrophysics Data System (ADS)

    Sumner, Tyler; Stacey, Weston; Ghiaassian, Seyed

    2009-11-01

    A hybrid fusion-fission reactor for the transmutation of spent nuclear fuel is being developed at Georgia Tech. The Subcritical Advanced Burner Reactor (SABR) is a 3000 MWth sodium-cooled, metal TRU-Zr fueled fast reactor driven by a tokamak fusion neutron source based on ITER physics and technology. We are investigating the accident dynamics of SABR's coupled fission, fusion and heat removal systems to explore the safety characteristics of a hybrid reactor. Possible accident scenarios such as loss of coolant mass flow (LOFA), of power (LOPA) and of heat sink (LOHSA), as well as inadvertent reactivity insertions and fusion source excursion are being analyzed using the RELAP5-3D code, the ATHENA version of which includes liquid metal coolants.

  7. Ablative system

    NASA Technical Reports Server (NTRS)

    Gray, V. H. (Inventor)

    1973-01-01

    A carrier liquid containing ablative material bodies is connected to a plenum chamber wall with openings to a high temperature environment. The liquid and bodies pass through the openings of the wall to form a self replacing ablative surface. The wall is composed of honeycomb layers, spheres containing ablative whiskers or wads, and a hardening catalyst for the carrier liquid. The wall also has woven wicks of ablative material fibers that extend through the wall openings and into plenum chamber which contains the liquid.

  8. Nuclear spin hyperpolarization of the solvent using signal amplification by reversible exchange (SABRE).

    PubMed

    Moreno, Karlos X; Nasr, Khaled; Milne, Mark; Sherry, A Dean; Goux, Warren J

    2015-08-01

    Here we report the polarization of the solvent OH protons by SABRE using standard iridium-based catalysts under slightly acidic conditions. Solvent polarization was observed in the presence of a variety of structurally similar N-donor substrates while no solvent enhancement was observed in the absence of substrate or para-hydrogen (p-H2). Solvent polarization was sensitive to the polarizing field and catalyst:substrate ratio in a manner similar to that of substrate protons. SABRE experiments with pyridine-d5 suggest a mechanism where hyperpolarization is transferred from the free substrate to the solvent by chemical exchange while measured hyperpolarization decay times suggest a complimentary mechanism which occurs by direct coordination of the solvent to the catalytic complex. We found the solvent hyperpolarization to decay nearly 3 times more slowly than its characteristic spin-lattice relaxation time suggesting that the hyperpolarized state of the solvent may be sufficiently long lived (∼20s) to hyperpolarize biomolecules having exchangeable protons. This route may offer future opportunities for SABRE to impact metabolic imaging. PMID:26037136

  9. Improving radiotherapy planning, delivery accuracy, and normal tissue sparing using cutting edge technologies

    PubMed Central

    Glide-Hurst, Carri K.

    2014-01-01

    In the United States, more than half of all new invasive cancers diagnosed are non-small cell lung cancer, with a significant number of these cases presenting at locally advanced stages, resulting in about one-third of all cancer deaths. While the advent of stereotactic ablative radiation therapy (SABR, also known as stereotactic body radiotherapy, or SBRT) for early-staged patients has improved local tumor control to >90%, survival results for locally advanced stage lung cancer remain grim. Significant challenges exist in lung cancer radiation therapy including tumor motion, accurate dose calculation in low density media, limiting dose to nearby organs at risk, and changing anatomy over the treatment course. However, many recent technological advancements have been introduced that can meet these challenges, including four-dimensional computed tomography (4DCT) and volumetric cone-beam computed tomography (CBCT) to enable more accurate target definition and precise tumor localization during radiation, respectively. In addition, advances in dose calculation algorithms have allowed for more accurate dosimetry in heterogeneous media, and intensity modulated and arc delivery techniques can help spare organs at risk. New delivery approaches, such as tumor tracking and gating, offer additional potential for further reducing target margins. Image-guided adaptive radiation therapy (IGART) introduces the potential for individualized plan adaptation based on imaging feedback, including bulky residual disease, tumor progression, and physiological changes that occur during the treatment course. This review provides an overview of the current state of the art technology for lung cancer volume definition, treatment planning, localization, and treatment plan adaptation. PMID:24688775

  10. Sci—Thur AM: YIS - 05: 10X-FFF VMAT for Lung SABR: an Investigation of Peripheral Dose

    SciTech Connect

    Mader, J; Mestrovic, A

    2014-08-15

    Flattening Filter Free (FFF) beams exhibit high dose rates, reduced head scatter, leaf transmission and leakage radiation. For VMAT lung SABR, treatment time can be significantly reduced using high dose rate FFF beams while maintaining plan quality and accuracy. Another possible advantage offered by FFF beams for VMAT lung SABR is the reduction in peripheral dose. The focus of this study was to investigate and quantify the reduction of peripheral dose offered by FFF beams for VMAT lung SABR. The peripheral doses delivered by VMAT Lung SABR treatments using FFF and flattened beams were investigated for the Varian Truebeam linac. This study was conducted in three stages, (1): ion chamber measurement of peripheral dose for various plans, (2): validation of AAA, Acuros XB and Monte Carlo for peripheral dose using measured data, and (3): using the validated Monte Carlo model to evaluate peripheral doses for 6 VMAT lung SABR treatments. Three energies, 6X, 10X, and 10X-FFF were used for all stages. Measured data indicates that 10X-FFF delivers the lowest peripheral dose of the three energies studied. AAA and Acuros XB dose calculation algorithms were identified as inadequate, and Monte Carlo was validated for accurate peripheral dose prediction. The Monte Carlo-calculated VMAT lung SABR plans show a significant reduction in peripheral dose for 10X-FFF plans compared to the standard 6X plans, while no significant reduction was showed when compared to 10X. This reduction combined with shorter treatment time makes 10X-FFF beams the optimal choice for superior VMAT lung SABR treatments.

  11. Predicting Radiation Pneumonitis After Stereotactic Ablative Radiation Therapy in Patients Previously Treated With Conventional Thoracic Radiation Therapy

    SciTech Connect

    Liu Hui; Zhang Xu; Vinogradskiy, Yevgeniy Y.; Swisher, Stephen G.; Komaki, Ritsuko; Chang, Joe Y.

    2012-11-15

    Purpose: To determine the incidence of and risk factors for radiation pneumonitis (RP) after stereotactic ablative radiation therapy (SABR) to the lung in patients who had previously undergone conventional thoracic radiation therapy. Methods and Materials: Seventy-two patients who had previously received conventionally fractionated radiation therapy to the thorax were treated with SABR (50 Gy in 4 fractions) for recurrent disease or secondary parenchymal lung cancer (T <4 cm, N0, M0, or Mx). Severe (grade {>=}3) RP and potential predictive factors were analyzed by univariate and multivariate logistic regression analyses. A scoring system was established to predict the risk of RP. Results: At a median follow-up time of 16 months after SABR (range, 4-56 months), 15 patients had severe RP (14 [18.9%] grade 3 and 1 [1.4%] grade 5) and 1 patient (1.4%) had a local recurrence. In univariate analyses, Eastern Cooperative Oncology Group performance status (ECOG PS) before SABR, forced expiratory volume in 1 second (FEV1), and previous planning target volume (PTV) location were associated with the incidence of severe RP. The V{sub 10} and mean lung dose (MLD) of the previous plan and the V{sub 10}-V{sub 40} and MLD of the composite plan were also related to RP. Multivariate analysis revealed that ECOG PS scores of 2-3 before SABR (P=.009), FEV1 {<=}65% before SABR (P=.012), V{sub 20} {>=}30% of the composite plan (P=.021), and an initial PTV in the bilateral mediastinum (P=.025) were all associated with RP. Conclusions: We found that severe RP was relatively common, occurring in 20.8% of patients, and could be predicted by an ECOG PS score of 2-3, an FEV1 {<=}65%, a previous PTV spanning the bilateral mediastinum, and V{sub 20} {>=}30% on composite (previous RT+SABR) plans. Prospective studies are needed to validate these predictors and the scoring system on which they are based.

  12. Endometrial ablation

    MedlinePlus

    ... can be seen on the video screen. Small tools can be used through the scope to remove abnormal growths or tissue for examination. Ablation uses heat, cold, or electricity to destroy the lining of the womb. The ...

  13. Ablation article and method

    NASA Technical Reports Server (NTRS)

    Erickson, W. D.; Sullivan, E. M. (Inventor)

    1973-01-01

    An ablation article, such as a conical heat shield, having an ablating surface is provided with at least one discrete area of at least one seed material, such as aluminum. When subjected to ablation conditions, the seed material is ablated. Radiation emanating from the ablated seed material is detected to analyze ablation effects without disturbing the ablation surface. By providing different seed materials having different radiation characteristics, the ablating effects on various areas of the ablating surface can be analyzed under any prevailing ablation conditions. The ablating article can be provided with means for detecting the radiation characteristics of the ablated seed material to provide a self-contained analysis unit.

  14. In Situ and Ex Situ Low-Field NMR Spectroscopy and MRI Endowed by SABRE Hyperpolarization**

    PubMed Central

    Barskiy, Danila A.; Kovtunov, Kirill V.; Koptyug, Igor V.; He, Ping; Groome, Kirsten A.; Best, Quinn A.; Shi, Fan; Goodson, Boyd M.; Shchepin, Roman V.; Truong, Milton L.; Coffey, Aaron M.; Waddell, Kevin W.; Chekmenev, Eduard Y.

    2015-01-01

    By using 5.75 and 47.5 mT nuclear magnetic resonance (NMR) spectroscopy, up to 105-fold sensitivity enhancement through signal amplification by reversible exchange (SABRE) was enabled, and subsecond temporal resolution was used to monitor an exchange reaction that resulted in the buildup and decay of hyperpolarized species after parahydrogen bubbling. We demonstrated the high-resolution low-field proton magnetic resonance imaging (MRI) of pyridine in a 47.5 mT magnetic field endowed by SABRE. Molecular imaging (i.e. imaging of dilute hyperpolarized substances rather than the bulk medium) was conducted in two regimes: in situ real-time MRI of the reaction mixture (in which pyridine was hyperpolarized), and ex situ MRI (in which hyperpolarization decays) of the liquid hyperpolarized product. Low-field (milli-Tesla range, e.g. 5.75 and 47.5 mT used in this study) parahydrogen-enhanced NMR and MRI, which are free from the limitations of high-field magnetic resonance (including susceptibility-induced gradients of the static magnetic field at phase interfaces), potentially enables new imaging applications as well as differentiation of hyperpolarized chemical species on demand by exploiting spin manipulations with static and alternating magnetic fields. PMID:25367202

  15. A Standardized Tool for Assessing the Quality of Classroom-Based Shared Reading: Systematic Assessment of Book Reading (SABR)

    ERIC Educational Resources Information Center

    Pentimonti, Jill M.; Zucker, Tricia A.; Justice, Laura M.; Petscher, Yaacov; Piasta, Shayne B.; Kaderavek, Joan N.

    2012-01-01

    Participation in shared-reading experiences is associated with children's language and literacy outcomes, yet few standardized assessments of shared-reading quality exist. The purpose of this study was to describe the psychometric characteristics of the Systematic Assessment of Book Reading (SABR), an observational tool designed to characterize…

  16. Reconstruction of coup de sabre deformity (linear localized scleroderma) by using galeal frontalis muscle flap and demineralized bone matrix combination.

    PubMed

    Cavusoglu, Tarik; Yazici, Ilker; Vargel, Ibrahim; Karakaya, Esen Ibrahim

    2011-01-01

    In this clinical report, we are presenting the combination of demineralized bone matrix combined with bilateral galea frontalis flaps. Based on our 6-month results, this seems to be a reasonable combination to accomplish long-lasting restoration of forehead defects related to en coup de sabre linear localized scleroderma. PMID:21233742

  17. Optimization of SABRE for polarization of the tuberculosis drugs pyrazinamide and isoniazid

    NASA Astrophysics Data System (ADS)

    Zeng, Haifeng; Xu, Jiadi; Gillen, Joseph; McMahon, Michael T.; Artemov, Dmitri; Tyburn, Jean-Max; Lohman, Joost A. B.; Mewis, Ryan E.; Atkinson, Kevin D.; Green, Gary G. R.; Duckett, Simon B.; van Zijl, Peter C. M.

    2013-12-01

    Hyperpolarization produces nuclear spin polarization that is several orders of magnitude larger than that achieved at thermal equilibrium thus providing extraordinary contrast and sensitivity. As a parahydrogen induced polarization (PHIP) technique that does not require chemical modification of the substrate to polarize, Signal Amplification by Reversible Exchange (SABRE) has attracted a lot of attention. Using a prototype parahydrogen polarizer, we polarize two drugs used in the treatment of tuberculosis, namely pyrazinamide and isoniazid. We examine this approach in four solvents, methanol-d4, methanol, ethanol and DMSO and optimize the polarization transfer magnetic field strength, the temperature as well as intensity and duration of hydrogen bubbling to achieve the best overall signal enhancement and hence hyperpolarization level.

  18. Creating a hyperpolarised pseudo singlet state through polarisation transfer from parahydrogen under SABRE.

    PubMed

    Olaru, Alexandra M; Roy, Soumya S; Lloyd, Lyrelle S; Coombes, Steven; Green, Gary G R; Duckett, Simon B

    2016-06-14

    The creation of magnetic states that have long lifetimes has been the subject of intense investigation, in part because of their potential to survive the time taken to travel from the point of injection in a patient to the point where a clinically diagnostic MRI trace is collected. We show here that it is possible to harness the signal amplification by reversible exchange (SABRE) process to create such states in a hyperpolarised form that improves their detectability in seconds without the need for any chemical change by reference to the model substrate 2-aminothiazole. We achieve this by transferring Zeeman derived polarisation that is 1500 times larger than that normally available at 400 MHz with greater than 90% efficiency into the new state, which in this case has a 27 second lifetime. PMID:27242264

  19. Method and apparatus for shadow aperture backscatter radiography (SABR) system and protocol

    NASA Technical Reports Server (NTRS)

    Shedlock, Daniel (Inventor); Jacobs, Alan M. (Inventor); Jacobs, Sharon Auerback (Inventor); Dugan, Edward (Inventor)

    2010-01-01

    A shadow aperture backscatter radiography (SABR) system includes at least one penetrating radiation source for providing a penetrating radiation field, and at least one partially transmissive radiation detector, wherein the partially transmissive radiation detector is interposed between an object region to be interrogated and the radiation source. The partially transmissive radiation detector transmits a portion of the illumination radiation field. A shadow aperture having a plurality of radiation attenuating regions having apertures therebetween is disposed between the radiation source and the detector. The apertures provide illumination regions for the illumination radiation field to reach the object region, wherein backscattered radiation from the object is detected and generates an image by the detector in regions of the detector that are shadowed by the radiation attenuation regions.

  20. Lichen sclerosus et atrophicans, scleroderma en coup de sabre and Lyme borreliosis

    PubMed Central

    Gubertini, Nicoletta; Bonin, Serena; Trevisan, Giusto

    2011-01-01

    Lichen sclerosus et atrophicans (LSA) is a chronic, inflammatory skin disease of unknown etiology, characterized by atrophy. We report a case of LSA with frontoparietal distribution, mimicking scleroderma en coup de sabre, causing scarring alopecia. The case was associated with Borrelia infection. The lesion improved with 2 cycles of antibiotic therapy with ceftriaxone 2 gr/day i.v for 21 days associated with UVA-1 therapy and local and systemic vitamin E supply (400 mg 2x/day per os for 3 months). This case stresses the importance of identifying clinical manifestations associated with Lyme disease and the use of tissue PCR to detect borrelial DNA in patients with these lesions, but characterized by negative serology for Borrelia. PMID:25386279

  1. Validation of the subtle and blatant racism scale for Asian American college students (SABR-A(2)).

    PubMed

    Yoo, Hyung Chol; Steger, Michael F; Lee, Richard M

    2010-07-01

    This investigation describes the validation of a measure of perceived racism developed to assess racial experiences of Asian American college students. In three studies across two different regions of the United States, there was strong evidence for the validation of the 8-item Subtle and Blatant Racism Scale for Asian American College Students (SABR-A2). The subtle racism subscale refers to instances of discrimination attributable implicitly to racial bias or stereotype, whereas the blatant racism subscale refers to instances of discrimination attributable explicitly to racial bias or stereotype. The two-subscale structure of the SABR-A2 was supported by exploratory and confirmatory factor analyses and demonstrated discriminant, convergent, and incremental validity, as well as internal reliability and stability over 2 weeks. PMID:20658875

  2. SABR: Photochemical Dose-Response Bead Screening in Droplets.

    PubMed

    Price, Alexander K; MacConnell, Andrew B; Paegel, Brian M

    2016-03-01

    With the potential for each droplet to act as a unique reaction vessel, droplet microfluidics is a powerful tool for high-throughput discovery. Any attempt at compound screening miniaturization must address the significant scaling inefficiencies associated with library handling and distribution. Eschewing microplate-based compound collections for one-bead-one-compound (OBOC) combinatorial libraries, we have developed hνSABR (Light-Induced and -Graduated High-Throughput Screening After Bead Release), a microfluidic architecture that integrates a suspension hopper for compound library bead introduction, droplet generation, microfabricated waveguides to deliver UV light to the droplet flow for photochemical compound dosing, incubation, and laser-induced fluorescence for assay readout. Avobenzone-doped PDMS (0.6% w/w) patterning confines UV exposure to the desired illumination region, generating intradroplet compound concentrations (>10 μM) that are reproducible between devices. Beads displaying photochemically cleavable pepstatin A were distributed into droplets and exposed with five different UV intensities to demonstrate dose-response screening in an HIV-1 protease activity assay. This microfluidic architecture introduces a new analytical approach for OBOC library screening, and represents a key component of a next-generation distributed small molecule discovery platform. PMID:26815064

  3. SABR: Photochemical Dose–Response Bead Screening in Droplets

    PubMed Central

    2016-01-01

    With the potential for each droplet to act as a unique reaction vessel, droplet microfluidics is a powerful tool for high-throughput discovery. Any attempt at compound screening miniaturization must address the significant scaling inefficiencies associated with library handling and distribution. Eschewing microplate-based compound collections for one-bead-one-compound (OBOC) combinatorial libraries, we have developed hνSABR (Light-Induced and -Graduated High-Throughput Screening After Bead Release), a microfluidic architecture that integrates a suspension hopper for compound library bead introduction, droplet generation, microfabricated waveguides to deliver UV light to the droplet flow for photochemical compound dosing, incubation, and laser-induced fluorescence for assay readout. Avobenzone-doped PDMS (0.6% w/w) patterning confines UV exposure to the desired illumination region, generating intradroplet compound concentrations (>10 μM) that are reproducible between devices. Beads displaying photochemically cleavable pepstatin A were distributed into droplets and exposed with five different UV intensities to demonstrate dose–response screening in an HIV-1 protease activity assay. This microfluidic architecture introduces a new analytical approach for OBOC library screening, and represents a key component of a next-generation distributed small molecule discovery platform. PMID:26815064

  4. Frontal linear scleroderma en coup de sabre associated with epileptic seizure.

    PubMed

    Inci, Rahime; Inci, Mehmet Fatih; Ozkan, Fuat; Oztürk, Perihan

    2012-01-01

    Linear scleroderma is a rare variant of localised scleroderma, which is usually seen in childhood and during the adolescent period, and can cause severe functional morbidity as well as cosmetic and psychological problems. Although its ethiopathogenesis is yet obscure, autoimmunity, local ischaemia and injuries, vaccination, irradiation, vitamin K injections, Borrelia burgdorferi and Varicella infections have been incriminated. A 4-year-old girl who had been followed up for about 18 months with diagnosis of epilepsy had a colour discolouration and depression that first appeared 1 year ago and then progressed on her left frontal region. Her CT scan showed a thinning in the frontal bone and depression in the frontal region. These findings are described as 'en coup de sabre' a rare form of linear scleroderma localised at the frontal region of the scalp. In this paper, we present clinical and radiological findings of a 4-year-old girl with epileptic seizures that started 1 year before the onset of the lesion of linear scleroderma. PMID:23230261

  5. [Hepatic tumors and radiotherapy].

    PubMed

    Rio, E; Mornex, F; Peiffert, D; Huertas, A

    2016-09-01

    Recent technological developments led to develop the concept of focused liver radiation therapy. We must distinguish primary and secondary tumors as the indications are restricted and must be discussed as an alternative to surgical or medical treatments. For hepatocellular carcinoma 5 to 10cm (or more), a conformational radiation with or without intensity modulation is performed. Stereotactic body radiotherapy (SBRT) is being evaluated and is increasingly proposed as an alternative to radiofrequency ablative treatment for primary or secondary tumors (typically less than 5cm). Tumor (and liver) movements induced by respiratory motions must be taken into account. Strict dosimetric criteria must be met with particular attention to the dose-volume histograms to liver and the hollow organs, including cases of SBRT. PMID:27521035

  6. SU-E-J-153: Reconstructing 4D Cone Beam CT Images for Clinical QA of Lung SABR Treatments

    SciTech Connect

    Beaudry, J; Bergman, A; Cropp, R

    2015-06-15

    Purpose: To verify that the planned Primary Target Volume (PTV) and Internal Gross Tumor Volume (IGTV) fully enclose a moving lung tumor volume as visualized on a pre-SABR treatment verification 4D Cone Beam CT. Methods: Daily 3DCBCT image sets were acquired immediately prior to treatment for 10 SABR lung patients using the on-board imaging system integrated into a Varian TrueBeam (v1.6: no 4DCBCT module available). Respiratory information was acquired during the scan using the Varian RPM system. The CBCT projections were sorted into 8 bins offline, both by breathing phase and amplitude, using in-house software. An iterative algorithm based on total variation minimization, implemented in the open source reconstruction toolkit (RTK), was used to reconstruct the binned projections into 4DCBCT images. The relative tumor motion was quantified by tracking the centroid of the tumor volume from each 4DCBCT image. Following CT-CBCT registration, the planning CT volumes were compared to the location of the CBCT tumor volume as it moves along its breathing trajectory. An overlap metric quantified the ability of the planned PTV and IGTV to contain the tumor volume at treatment. Results: The 4DCBCT reconstructed images visibly show the tumor motion. The mean overlap between the planned PTV (IGTV) and the 4DCBCT tumor volumes was 100% (94%), with an uncertainty of 5% from the 4DCBCT tumor volume contours. Examination of the tumor motion and overlap metric verify that the IGTV drawn at the planning stage is a good representation of the tumor location at treatment. Conclusion: It is difficult to compare GTV volumes from a 4DCBCT and a planning CT due to image quality differences. However, it was possible to conclude the GTV remained within the PTV 100% of the time thus giving the treatment staff confidence that SABR lung treatements are being delivered accurately.

  7. SU-E-J-84: Quantitative Dosimetry Assessment of the Impact of Image Artifacts of Metal Implants in Spinal SABR Treatment

    SciTech Connect

    Chen, T; Zhang, M; Hanft, S; Green, R; Yue, N; Goyal, S

    2015-06-15

    Purpose: Metal rods are frequently used to stabilize the spine in patients with metastatic disease. The high Z material causes imaging artifacts in the surrounding tissue in CT scans, which introduces dosimetric uncertainty when inhomogeneity correction is enabled for radiation treatment planning. The purpose of this study is to quantify the dosimetric deviations caused by the imaging artifacts and to evaluate the effectiveness of using Hounsfield units (HU) overwriting to reduce dosimetric uncertainties. Methods: We retrospectively reviewed treatment plans for 4 patients with metal implants who received stereotactic ablative radiation therapy (SABR) for metastatic disease to the spine on Tomotherapy HiArt. For all four patients, the region of imaging artifact surrounding the metal implants was contoured and the pixel HU’s were overwritten to be water equivalent. We then generated adaptive treatment plans for these patients using the MVCT pretreatment set up images and batched beamlets in the original treatment plans. The dosimetry deviation between the adaptive and original plans were compared and quantitatively analyzed. Results: For three out of four patient, the major OAR (spinal cord) dose (0.35cc or 10% according to protocols and fractionation) increased (2.7%, 5.5%, 0%, 3.9%, mean=3.0±2.3%, p=0.04), and the PTV dose (D90 or D95 as per prescription) increased for all four patients ( 2%, 5%, 0.7%, 3.6%, mean=2.8±1.9%, p=0.03) in the adaptive plan with HU overwriting. The average point dose deviation of the Tomotherapy DQA for the same patients was −1.0±1.0%. For plans without HU overwriting, the dose deviation from the treatment plan will increase. Conclusion: The metal implant and the imaging artifacts may cause a significant dosimetric impact on radiation treatment plans for spinal disease. The dose to the PTV and the spinal cord was under-calculated in treatment plans without considering the imaging artifacts. HU overwriting can reduce the dosimetry

  8. Salt Bridge Rearrangement (SaBRe) Explains the Dissociation Behavior of Noncovalent Complexes.

    PubMed

    Loo, Rachel R Ogorzalek; Loo, Joseph A

    2016-06-01

    Native electrospray ionization-mass spectrometry, with gas-phase activation and solution compositions that partially release subcomplexes, can elucidate topologies of macromolecular assemblies. That so much complexity can be preserved in gas-phase assemblies is remarkable, although a long-standing conundrum has been the differences between their gas- and solution-phase decompositions. Collision-induced dissociation of multimeric noncovalent complexes typically distributes products asymmetrically (i.e., by ejecting a single subunit bearing a large percentage of the excess charge). That unexpected behavior has been rationalized as one subunit "unfolding" to depart with more charge. We present an alternative explanation based on heterolytic ion-pair scission and rearrangement, a mechanism that inherently partitions charge asymmetrically. Excessive barriers to dissociation are circumvented in this manner, when local charge rearrangements access a lower-barrier surface. An implication of this ion pair consideration is that stability differences between high- and low-charge state ions usually attributed to Coulomb repulsion may, alternatively, be conveyed by attractive forces from ion pairs (salt bridges) stabilizing low-charge state ions. Should the number of ion pairs be roughly inversely related to charge, symmetric dissociations would be favored from highly charged complexes, as observed. Correlations between a gas-phase protein's size and charge reflect the quantity of restraining ion pairs. Collisionally-facilitated salt bridge rearrangement (SaBRe) may explain unusual size "contractions" seen for some activated, low charge state complexes. That some low-charged multimers preferentially cleave covalent bonds or shed small ions to disrupting noncovalent associations is also explained by greater ion pairing in low charge state complexes. Graphical Abstract ᅟ. PMID:27052739

  9. A scrutiny of heterogeneity at the TCE Source Area BioREmediation (SABRE) test site

    NASA Astrophysics Data System (ADS)

    Rivett, M.; Wealthall, G. P.; Mcmillan, L. A.; Zeeb, P.

    2015-12-01

    A scrutiny of heterogeneity at the UK's Source Area BioREmediation (SABRE) test site is presented to better understand how spatial heterogeneity in subsurface properties and process occurrence may constrain performance of enhanced in-situ bioremediation (EISB). The industrial site contained a 25 to 45 year old trichloroethene (TCE) dense non-aqueous phase liquid (DNAPL) that was exceptionally well monitored via a network of multilevel samplers and high resolution core sampling. Moreover, monitoring was conducted within a 3-sided sheet-pile cell that allowed a controlled streamtube of flow to be drawn through the source zone by an extraction well. We primarily focus on the longitudinal transect of monitoring along the length of the cell that provides a 200 groundwater point sample slice along the streamtube of flow through the DNAPL source zone. TCE dechlorination is shown to be significant throughout the cell domain, but spatially heterogeneous in occurrence and progress of dechlorination to lesser chlorinated ethenes - it is this heterogeneity in dechlorination that we primarily scrutinise. We illustrate the diagnostic use of the relative occurrence of TCE parent and daughter compounds to confirm: dechlorination in close proximity to DNAPL and enhanced during the bioremediation; persistent layers of DNAPL into which gradients of dechlorination products are evident; fast flowpaths through the source zone where dechlorination is less evident; and, the importance of underpinning flow regime understanding on EISB performance. Still, even with such spatial detail, there remains uncertainty over the dataset interpretation. These includes poor closure of mass balance along the cell length for the multilevel sampler based monitoring and points to needs to still understand lateral flows (even in the constrained cell), even greater spatial resolution of point monitoring and potentially, not easily proven, ethene degradation loss.

  10. Strategies for the Hyperpolarization of Acetonitrile and Related Ligands by SABRE

    PubMed Central

    2014-01-01

    We report on a strategy for using SABRE (signal amplification by reversible exchange) for polarizing 1H and 13C nuclei of weakly interacting ligands which possess biologically relevant and nonaromatic motifs. We first demonstrate this via the polarization of acetonitrile, using Ir(IMes)(COD)Cl as the catalyst precursor, and confirm that the route to hyperpolarization transfer is via the J-coupling network. We extend this work to the polarization of propionitrile, benzylnitrile, benzonitrile, and trans-3-hexenedinitrile in order to assess its generality. In the 1H NMR spectrum, the signal for acetonitrile is enhanced 8-fold over its thermal counterpart when [Ir(H)2(IMes)(MeCN)3]+ is the catalyst. Upon addition of pyridine or pyridine-d5, the active catalyst changes to [Ir(H)2(IMes)(py)2(MeCN)]+ and the resulting acetonitrile 1H signal enhancement increases to 20- and 60-fold, respectively. In 13C NMR studies, polarization transfers optimally to the quaternary 13C nucleus of MeCN while the methyl 13C is hardly polarized. Transfer to 13C is shown to occur first via the 1H–1H coupling between the hydrides and the methyl protons and then via either the 2J or 1J couplings to the respective 13Cs, of which the 2J route is more efficient. These experimental results are rationalized through a theoretical treatment which shows excellent agreement with experiment. In the case of MeCN, longitudinal two-spin orders between pairs of 1H nuclei in the three-spin methyl group are created. Two-spin order states, between the 1H and 13C nuclei, are also created, and their existence is confirmed for Me13CN in both the 1H and 13C NMR spectra using the Only Parahydrogen Spectroscopy protocol. PMID:25539423

  11. Salt Bridge Rearrangement (SaBRe) Explains the Dissociation Behavior of Noncovalent Complexes

    NASA Astrophysics Data System (ADS)

    Loo, Rachel R. Ogorzalek; Loo, Joseph A.

    2016-04-01

    Native electrospray ionization-mass spectrometry, with gas-phase activation and solution compositions that partially release subcomplexes, can elucidate topologies of macromolecular assemblies. That so much complexity can be preserved in gas-phase assemblies is remarkable, although a long-standing conundrum has been the differences between their gas- and solution-phase decompositions. Collision-induced dissociation of multimeric noncovalent complexes typically distributes products asymmetrically (i.e., by ejecting a single subunit bearing a large percentage of the excess charge). That unexpected behavior has been rationalized as one subunit "unfolding" to depart with more charge. We present an alternative explanation based on heterolytic ion-pair scission and rearrangement, a mechanism that inherently partitions charge asymmetrically. Excessive barriers to dissociation are circumvented in this manner, when local charge rearrangements access a lower-barrier surface. An implication of this ion pair consideration is that stability differences between high- and low-charge state ions usually attributed to Coulomb repulsion may, alternatively, be conveyed by attractive forces from ion pairs (salt bridges) stabilizing low-charge state ions. Should the number of ion pairs be roughly inversely related to charge, symmetric dissociations would be favored from highly charged complexes, as observed. Correlations between a gas-phase protein's size and charge reflect the quantity of restraining ion pairs. Collisionally-facilitated salt bridge rearrangement (SaBRe) may explain unusual size "contractions" seen for some activated, low charge state complexes. That some low-charged multimers preferentially cleave covalent bonds or shed small ions to disrupting noncovalent associations is also explained by greater ion pairing in low charge state complexes.

  12. Salt Bridge Rearrangement (SaBRe) Explains the Dissociation Behavior of Noncovalent Complexes

    NASA Astrophysics Data System (ADS)

    Loo, Rachel R. Ogorzalek; Loo, Joseph A.

    2016-06-01

    Native electrospray ionization-mass spectrometry, with gas-phase activation and solution compositions that partially release subcomplexes, can elucidate topologies of macromolecular assemblies. That so much complexity can be preserved in gas-phase assemblies is remarkable, although a long-standing conundrum has been the differences between their gas- and solution-phase decompositions. Collision-induced dissociation of multimeric noncovalent complexes typically distributes products asymmetrically (i.e., by ejecting a single subunit bearing a large percentage of the excess charge). That unexpected behavior has been rationalized as one subunit "unfolding" to depart with more charge. We present an alternative explanation based on heterolytic ion-pair scission and rearrangement, a mechanism that inherently partitions charge asymmetrically. Excessive barriers to dissociation are circumvented in this manner, when local charge rearrangements access a lower-barrier surface. An implication of this ion pair consideration is that stability differences between high- and low-charge state ions usually attributed to Coulomb repulsion may, alternatively, be conveyed by attractive forces from ion pairs (salt bridges) stabilizing low-charge state ions. Should the number of ion pairs be roughly inversely related to charge, symmetric dissociations would be favored from highly charged complexes, as observed. Correlations between a gas-phase protein's size and charge reflect the quantity of restraining ion pairs. Collisionally-facilitated salt bridge rearrangement (SaBRe) may explain unusual size "contractions" seen for some activated, low charge state complexes. That some low-charged multimers preferentially cleave covalent bonds or shed small ions to disrupting noncovalent associations is also explained by greater ion pairing in low charge state complexes.

  13. Local Ablative Strategies for Ductal Pancreatic Cancer (Radiofrequency Ablation, Irreversible Electroporation): A Review

    PubMed Central

    Paiella, Salvatore; Salvia, Roberto; Ramera, Marco; Girelli, Roberto; Frigerio, Isabella; Giardino, Alessandro; Allegrini, Valentina; Bassi, Claudio

    2016-01-01

    Pancreatic ductal adenocarcinoma (PDAC) has still a dismal prognosis. Locally advanced pancreatic cancer (LAPC) accounts for the 40% of the new diagnoses. Current treatment options are based on chemo- and radiotherapy regimens. Local ablative techniques seem to be the future therapeutic option for stage-III patients with PDAC. Radiofrequency Ablation (RFA) and Irreversible Electroporation (IRE) are actually the most emerging local ablative techniques used on LAPC. Initial clinical studies on the use of these techniques have already demonstrated encouraging results in terms of safety and feasibility. Unfortunately, few studies on their efficacy are currently available. Even though some reports on the overall survival are encouraging, randomized studies are still required to corroborate these findings. This study provides an up-to-date overview and a thematic summary of the current available evidence on the application of RFA and IRE on PDAC, together with a comparison of the two procedures. PMID:26981115

  14. Local Ablative Strategies for Ductal Pancreatic Cancer (Radiofrequency Ablation, Irreversible Electroporation): A Review.

    PubMed

    Paiella, Salvatore; Salvia, Roberto; Ramera, Marco; Girelli, Roberto; Frigerio, Isabella; Giardino, Alessandro; Allegrini, Valentina; Bassi, Claudio

    2016-01-01

    Pancreatic ductal adenocarcinoma (PDAC) has still a dismal prognosis. Locally advanced pancreatic cancer (LAPC) accounts for the 40% of the new diagnoses. Current treatment options are based on chemo- and radiotherapy regimens. Local ablative techniques seem to be the future therapeutic option for stage-III patients with PDAC. Radiofrequency Ablation (RFA) and Irreversible Electroporation (IRE) are actually the most emerging local ablative techniques used on LAPC. Initial clinical studies on the use of these techniques have already demonstrated encouraging results in terms of safety and feasibility. Unfortunately, few studies on their efficacy are currently available. Even though some reports on the overall survival are encouraging, randomized studies are still required to corroborate these findings. This study provides an up-to-date overview and a thematic summary of the current available evidence on the application of RFA and IRE on PDAC, together with a comparison of the two procedures. PMID:26981115

  15. Laser-ablation processes

    SciTech Connect

    Dingus, R.S.

    1992-01-01

    The various mechanisms by which ablation of materials can be induced with lasers are discussed in this paper. The various ablation processes and potential applications are reviewed from the threshold for ablation up to fluxes of about 10{sup 13} W/cm{sup 2}, with emphasis on three particular processes; namely, front-surface spallation, two-dimensional blowoff, and contained vaporization.

  16. Laser ablation of blepharopigmentation

    SciTech Connect

    Tanenbaum, M.; Karas, S.; McCord, C.D. Jr. )

    1988-01-01

    This article discusses laser ablation of blepharopigmentation in four stages: first, experimentally, where pigment vaporization is readily achieved with the argon blue-green laser; second, in the rabbit animal model, where eyelid blepharopigmentation markings are ablated with the laser; third, in human subjects, where the argon blue-green laser is effective in the ablation of implanted eyelid pigment; and fourth, in a case report, where, in a patient with improper pigment placement in the eyelid, the laser is used to safely and effectively ablate the undesired pigment markings. This article describes in detail the new technique of laser ablation of blepharopigmentation. Potential complications associated with the technique are discussed.

  17. Determination of long-range scalar (1)H-(1)H coupling constants responsible for polarization transfer in SABRE.

    PubMed

    Eshuis, Nan; Aspers, Ruud L E G; van Weerdenburg, Bram J A; Feiters, Martin C; Rutjes, Floris P J T; Wijmenga, Sybren S; Tessari, Marco

    2016-04-01

    SABRE (Signal Amplification By Reversible Exchange) nuclear spin hyperpolarization method can provide strongly enhanced NMR signals as a result of the reversible association of small molecules with para-hydrogen (p-H2) at an iridium metal complex. The conversion of p-H2 singlet order to enhanced substrate proton magnetization within such complex is driven by the scalar coupling interactions between the p-H2 derived hydrides and substrate nuclear spins. In the present study these long-range homonuclear couplings are experimentally determined for several SABRE substrates using an NMR pulse sequence for coherent hyperpolarization transfer at high magnetic field. Pyridine and pyrazine derivatives appear to have a similar ∼1.2Hz (4)J coupling to p-H2 derived hydrides for their ortho protons, and a much lower (5)J coupling for their meta protons. Interestingly, the (4)J hydride-substrate coupling for five-membered N-heterocyclic substrates is well below 1Hz. PMID:26859865

  18. Determination of long-range scalar 1H-1H coupling constants responsible for polarization transfer in SABRE

    NASA Astrophysics Data System (ADS)

    Eshuis, Nan; Aspers, Ruud L. E. G.; van Weerdenburg, Bram J. A.; Feiters, Martin C.; Rutjes, Floris P. J. T.; Wijmenga, Sybren S.; Tessari, Marco

    2016-04-01

    SABRE (Signal Amplification By Reversible Exchange) nuclear spin hyperpolarization method can provide strongly enhanced NMR signals as a result of the reversible association of small molecules with para-hydrogen (p-H2) at an iridium metal complex. The conversion of p-H2 singlet order to enhanced substrate proton magnetization within such complex is driven by the scalar coupling interactions between the p-H2 derived hydrides and substrate nuclear spins. In the present study these long-range homonuclear couplings are experimentally determined for several SABRE substrates using an NMR pulse sequence for coherent hyperpolarization transfer at high magnetic field. Pyridine and pyrazine derivatives appear to have a similar ∼1.2 Hz 4J coupling to p-H2 derived hydrides for their ortho protons, and a much lower 5J coupling for their meta protons. Interestingly, the 4J hydride-substrate coupling for five-membered N-heterocyclic substrates is well below 1 Hz.

  19. Treatment of "en coup de sabre" deformity with adipose-derived regenerative cell-enriched fat graft.

    PubMed

    Karaaltin, Mehmet Veli; Akpinar, Ali Cem; Baghaki, Semih; Akpinar, Fatma

    2012-03-01

    Linear scleroderma "en coup de sabre" is characterized by atrophy and furrowing of the skin of the front parietal region above the level of the eyebrow. In most cases, it occurs as a single paramedian line that may be associated with hypoplasia of underlying structures and hemiatrophy of the face. The affected region is a depression that may be associated with hypoplasia of the underlying soft tissues and bone that results in facial hemiatrophy. If the lesion is narrow, it can be resected and directly sutured; in the case of a wide lesion, many different reconstructive techniques, directed at augmentation of deficient soft tissue volume, have been proposed such as autologous tissue grafts, biomaterials, pedicled flaps, and free flaps. Adipose-derived regenerative cells (ADRCs) can be easily processed from lipoaspirated fat and can provide a significant quantity of multipotent cells for a variety of therapeutic regenerative medicine therapies. There is an increasing interest in a possible therapeutic role of ADRCs from processed lipoaspirate for many applications, including their use as soft-tissue fillers. We introduce the application of a successful ADRC therapy for a linear scleroderma en coup de sabre deformity. PMID:22446436

  20. Colorectal Histology Is Associated With an Increased Risk of Local Failure in Lung Metastases Treated With Stereotactic Ablative Radiation Therapy

    SciTech Connect

    Binkley, Michael S.; Trakul, Nicholas; Jacobs, Lisa Rose; Eyben, Rie von; Le, Quynh-Thu; Maxim, Peter G.; Loo, Billy W.; Shultz, David Benjamin; Diehn, Maximilian

    2015-08-01

    Purpose: Stereotactic ablative radiation therapy (SABR) is increasingly used to treat lung oligometastases. We set out to determine the safety and efficacy of this approach and to identify factors associated with outcomes. Methods and Materials: We conducted a retrospective study of patients treated with SABR for metastatic lung tumors at our institution from 2003 to 2014. We assessed the association between various patient and treatment factors with local failure (LF), progression, subsequent treatment, systemic treatment, and overall survival (OS), using univariate and multivariate analyses. Results: We identified 122 tumors in 77 patients meeting inclusion criteria for this study. Median follow-up was 22 months. The 12- and 24-month cumulative incidence rates of LF were 8.7% and 16.2%, respectively; the 24-month cumulative incidence rates of progression, subsequent treatment, and subsequent systemic treatment were 75.2%, 64.5%, and 35.1%, respectively. Twenty-four-month OS was 74.6%, and median OS was 36 months. Colorectal metastases had a significantly higher cumulative incidence of LF at 12 and 24 months (25.5% and 42.2%, respectively), than all other histologies (4.4% and 9.9%, respectively; P<.0004). The 24-month cumulative incidences of LF for colorectal metastases treated with a biologically effective dose at α/β = 10 (BED{sub 10}) of <100 Gy versus BED{sub 10} of ≥100 Gy were 62.5% and 16.7%, respectively (P=.08). Toxicity was minimal, with only a single grade 3 or higher event observed. Conclusions: SABR for metastatic lung tumors appears to be safe and effective with excellent local control, treatment-free intervals, and OS. An exception is metastases from colorectal cancer, which have a high LF rate consistent with a radioresistant phenotype, suggesting a potential role for dose escalation.

  1. Nonequilibrium Ablation of Phenolic Impregnated Carbon Ablator

    NASA Technical Reports Server (NTRS)

    Milos, Frank S.; Chen, Yih K.; Gokcen, Tahir

    2012-01-01

    In previous work, an equilibrium ablation and thermal response model for Phenolic Impregnated Carbon Ablator was developed. In general, over a wide range of test conditions, model predictions compared well with arcjet data for surface recession, surface temperature, in-depth temperature at multiple thermocouples, and char depth. In this work, additional arcjet tests were conducted at stagnation conditions down to 40 W/sq cm and 1.6 kPa. The new data suggest that nonequilibrium effects become important for ablation predictions at heat flux or pressure below about 80 W/sq cm or 10 kPa, respectively. Modifications to the ablation model to account for nonequilibrium effects are investigated. Predictions of the equilibrium and nonequilibrium models are compared with the arcjet data.

  2. Renal Ablation Update

    PubMed Central

    Khiatani, Vishal; Dixon, Robert G.

    2014-01-01

    Thermal ablative technologies have evolved considerably in the recent past and are now an important component of current clinical guidelines for the treatment of small renal masses. Both radiofrequency ablation and cryoablation have intermediate-term oncologic control that rivals surgical options, with favorable complication profiles. Studies comparing cryoablation and radiofrequency ablation show no significant difference in oncologic control or complication profile between the two modalities. Early data from small series with microwave ablation have shown similar promising results. Newer technologies including irreversible electroporation and high-intensity–focused ultrasound have theoretical advantages, but will require further research before becoming a routine part of the ablation armamentarium. The purpose of this review article is to discuss the current ablative technologies available, briefly review their mechanisms of action, discuss technical aspects of each, and provide current data supporting their use. PMID:25049445

  3. Renal ablation update.

    PubMed

    Khiatani, Vishal; Dixon, Robert G

    2014-06-01

    Thermal ablative technologies have evolved considerably in the recent past and are now an important component of current clinical guidelines for the treatment of small renal masses. Both radiofrequency ablation and cryoablation have intermediate-term oncologic control that rivals surgical options, with favorable complication profiles. Studies comparing cryoablation and radiofrequency ablation show no significant difference in oncologic control or complication profile between the two modalities. Early data from small series with microwave ablation have shown similar promising results. Newer technologies including irreversible electroporation and high-intensity-focused ultrasound have theoretical advantages, but will require further research before becoming a routine part of the ablation armamentarium. The purpose of this review article is to discuss the current ablative technologies available, briefly review their mechanisms of action, discuss technical aspects of each, and provide current data supporting their use. PMID:25049445

  4. Radiofrequency Ablation of Cancer

    PubMed Central

    Friedman, Marc; Mikityansky, Igor; Kam, Anthony; Libutti, Steven K.; Walther, McClellan M.; Neeman, Ziv; Locklin, Julia K.; Wood, Bradford J.

    2008-01-01

    Radiofrequency ablation (RFA) has been used for over 18 years for treatment of nerve-related chronic pain and cardiac arrhythmias. In the last 10 years, technical developments have increased ablation volumes in a controllable, versatile, and relatively inexpensive manner. The host of clinical applications for RFA have similarly expanded. Current RFA equipment, techniques, applications, results, complications, and research avenues for local tumor ablation are summarized. PMID:15383844

  5. Radiofrequency Ablation of Cancer

    SciTech Connect

    Friedman, Marc; Mikityansky, Igor; Kam, Anthony; Libutti, Steven K.; Walther, McClellan M.; Neeman, Ziv; Locklin, Julia K.; Wood, Bradford J.

    2004-09-15

    Radiofrequency ablation (RFA) has been used for over 18 years for treatment of nerve-related chronic pain and cardiac arrhythmias. In the last 10 years, technical developments have increased ablation volumes in a controllable, versatile, and relatively inexpensive manner. The host of clinical applications for RFA have similarly expanded. Current RFA equipment, techniques, applications, results, complications, and research avenues for local tumor ablation are summarized.

  6. Synergistic Effects of Gold Nanocages in Hyperthermia and Radiotherapy Treatment

    NASA Astrophysics Data System (ADS)

    Zhang, Ai-wei; Guo, Wei-hua; Qi, Ya-fei; Wang, Jian-zhen; Ma, Xiang-xing; Yu, De-xin

    2016-06-01

    Gold nanocages (GNCs) are a promising material that not only converts near infrared (NIR) light to heat for the ablation of tumors but also acts as a radiosensitizer. The combination of hyperthermia and radiotherapy has a synergistic effect that can lead to significant tumor cell necrosis. In the current study, we synthesized GNCs that offered the combined effects of hyperthermia and radiotherapy. This combination strategy resulted in increased tumor cell apoptosis and significant tumor tissue necrosis. We propose that GNCs can be used for clinical treatment and to potentially overcome resistance to radiotherapy by clearly increasing the antitumor effect.

  7. Synergistic Effects of Gold Nanocages in Hyperthermia and Radiotherapy Treatment.

    PubMed

    Zhang, Ai-Wei; Guo, Wei-Hua; Qi, Ya-Fei; Wang, Jian-Zhen; Ma, Xiang-Xing; Yu, De-Xin

    2016-12-01

    Gold nanocages (GNCs) are a promising material that not only converts near infrared (NIR) light to heat for the ablation of tumors but also acts as a radiosensitizer. The combination of hyperthermia and radiotherapy has a synergistic effect that can lead to significant tumor cell necrosis. In the current study, we synthesized GNCs that offered the combined effects of hyperthermia and radiotherapy. This combination strategy resulted in increased tumor cell apoptosis and significant tumor tissue necrosis. We propose that GNCs can be used for clinical treatment and to potentially overcome resistance to radiotherapy by clearly increasing the antitumor effect. PMID:27255899

  8. Lung Ablation: Whats New?

    PubMed

    Xiong, Lillian; Dupuy, Damian E

    2016-07-01

    Lung cancer had an estimated incidence of 221,200 in 2015, making up 13% of all cancer diagnoses. Tumor ablation is an important treatment option for nonsurgical lung cancer and pulmonary metastatic patients. Radiofrequency ablation has been used for over a decade with newer modalities, microwave ablation, cryoablation, and irreversible electroporation presenting as additional and possibly improved treatment options for patients. This minimally invasive therapy is best for small primary lesions or favorably located metastatic tumors. These technologies can offer palliation and sometimes cure of thoracic malignancies. This article discusses the current available technologies and techniques available for tumor ablation. PMID:27050331

  9. Ablative Thermal Protection System Fundamentals

    NASA Technical Reports Server (NTRS)

    Beck, Robin A. S.

    2013-01-01

    This is the presentation for a short course on the fundamentals of ablative thermal protection systems. It covers the definition of ablation, description of ablative materials, how they work, how to analyze them and how to model them.

  10. Microwave Ablation of Hepatic Malignancy

    PubMed Central

    Lubner, Meghan G.; Brace, Christopher L.; Ziemlewicz, Tim J.; Hinshaw, J. Louis; Lee, Fred T.

    2013-01-01

    Microwave ablation is an extremely promising heat-based thermal ablation modality that has particular applicability in treating hepatic malignancies. Microwaves can generate very high temperatures in very short time periods, potentially leading to improved treatment efficiency and larger ablation zones. As the available technology continues to improve, microwave ablation is emerging as a valuable alternative to radiofrequency ablation in the treatment of hepatic malignancies. This article reviews the current state of microwave ablation including technical and clinical considerations. PMID:24436518

  11. Image-Guided Percutaneous Ablation of Bone and Soft Tissue Tumors

    PubMed Central

    Kurup, A. Nicholas; Callstrom, Matthew R.

    2010-01-01

    Image-guided percutaneous ablation of bone and soft tissue tumors is an effective minimally invasive alternative to conventional therapies, such as surgery and external beam radiotherapy. Proven applications include treatment of benign primary bone tumors, particularly osteoid osteoma, as well as palliation of painful bone metastases. Use of percutaneous ablation in combination with cementoplasty can provide stabilization of metastases at risk for fracture. Local control of oligometastatic disease and treatment of desmoid tumors are emerging applications. PMID:22550367

  12. Monte Carlo validation of the TrueBeam 10XFFF phase–space files for applications in lung SABR

    SciTech Connect

    Teke, Tony; Duzenli, Cheryl; Bergman, Alanah; Viel, Francis; Atwal, Parmveer; Gete, Ermias

    2015-12-15

    Purpose: To establish the clinical acceptability of universal Monte Carlo phase–space data for the 10XFFF (flattening filter free) photon beam on the Varian TrueBeam Linac, including previously unreported data for small fields, output factors, and inhomogeneous media. The study was particularly aimed at confirming the suitability for use in simulations of lung stereotactic ablative radiotherapy treatment plans. Methods: Monte Carlo calculated percent depth doses (PDDs), transverse profiles, and output factors for the TrueBeam 10 MV FFF beam using generic phase–space data that have been released by the Varian MC research team were compared with in-house measurements and published data from multiple institutions (ten Linacs from eight different institutions). BEAMnrc was used to create field size specific phase–spaces located underneath the jaws. Doses were calculated with DOSXYZnrc in a water phantom for fields ranging from 1 × 1 to 40 × 40 cm{sup 2}. Particular attention was paid to small fields (down to 1 × 1 cm{sup 2}) and dose per pulse effects on dosimeter response for high dose rate 10XFFF beams. Ion chamber measurements were corrected for changes in ion collection efficiency (P{sub ion}) with increasing dose per pulse. MC and ECLIPSE ANISOTROPIC ANALYTICAL ALGORITHM (AAA) calculated PDDs were compared to Gafchromic film measurement in inhomogeneous media (water, bone, lung). Results: Measured data from all machines agreed with Monte Carlo simulations within 1.0% and 1.5% for PDDs and in-field transverse profiles, respectively, for field sizes >1 × 1 cm{sup 2} in a homogeneous water phantom. Agreements in the 80%–20% penumbra widths were better than 2 mm for all the fields that were compared. For all the field sizes considered, the agreement between their measured and calculated output factors was within 1.1%. Monte Carlo results for dose to water at water/bone, bone/lung, and lung/water interfaces as well as within lung agree with film

  13. Long-Term Results of a Prospective, Phase II Study of Long-Term Androgen Ablation, Pelvic Radiotherapy, Brachytherapy Boost, and Adjuvant Docetaxel in Patients With High-Risk Prostate Cancer

    SciTech Connect

    DiBiase, Steven J.; Hussain, Arif; Kataria, Ritesh; Amin, Pradip; Bassi, Sunakshi; Dawson, Nancy; Kwok, Young

    2011-11-01

    Purpose: We report the long-term results of a prospective, Phase II study of long-term androgen deprivation (AD), pelvic radiotherapy (EBRT), permanent transperineal prostate brachytherapy boost (PB), and adjuvant docetaxel in patients with high-risk prostate cancer. Methods and Materials: Eligibility included biopsy-proven prostate adenocarcinoma with the following: prostate-specific antigen (PSA) > 20 ng/ml; or Gleason score of 7 and a PSA >10 ng/ml; or any Gleason score of 8 to 10; or stage T2b to T3 irrespective of Gleason score or PSA. Treatment consisted of 45 Gy of pelvic EBRT, followed 1 month later by PB with either iodine-125 or Pd-103. One month after PB, patients received three cycles of docetaxel chemotherapy (35 mg/m{sup 2} per week, Days 1, 8, and 15 every 28 days). All patients received 2 years of AD. Biochemical failure was defined as per the Phoenix definition (PSA nadir + 2). Results: From August 2000 to March 2004, 42 patients were enrolled. The median overall and active follow-ups were 5.6 years (range, 0.9-7.8 years) and 6.3 years (range, 4-7.8 years), respectively. Grade 2 and 3 acute genitourinary (GU) and gastrointestinal (GI) toxicities were 50.0% and 14.2%, respectively, with no Grade 4 toxicities noted. Grade 3 and 4 acute hematologic toxicities were 19% and 2.4%, respectively. Of the patients, 85.7% were able to complete the planned multimodality treatment. The 5- and 7-year actuarial freedom from biochemical failures rates were 89.6% and 86.5%, and corresponding rates for disease-free survival were 76.2% and 70.4%, respectively. The 5- and 7-year actuarial overall survival rates were 83.3% and 80.1%, respectively. The 5- and 7-year actuarial rates of late Grade 2 GI/GU toxicity (no Grade 3-5) was 7.7%. Conclusions: The trimodality approach of using 2 years of AD, external radiation, brachytherapy, and upfront docetaxel in high-risk prostate cancer is well tolerated, produces encouraging long-term results, and should be validated in a

  14. Convergent ablator performance measurements

    SciTech Connect

    Hicks, D. G.; Spears, B. K.; Braun, D. G.; Sorce, C. M.; Celliers, P. M.; Collins, G. W.; Landen, O. L.; Olson, R. E.

    2010-10-15

    The velocity and remaining ablator mass of an imploding capsule are critical metrics for assessing the progress toward ignition of an inertially confined fusion experiment. These and other convergent ablator performance parameters have been measured using a single streaked x-ray radiograph. Traditional Abel inversion of such a radiograph is ill-posed since backlighter intensity profiles and x-ray attenuation by the ablated plasma are unknown. To address this we have developed a regularization technique which allows the ablator density profile {rho}(r) and effective backlighter profile I{sub 0}(y) at each time step to be uniquely determined subject to the constraints that {rho}(r) is localized in radius space and I{sub 0}(y) is delocalized in object space. Moments of {rho}(r) then provide the time-resolved areal density, mass, and average radius (and thus velocity) of the remaining ablator material. These results are combined in the spherical rocket model to determine the ablation pressure and mass ablation rate during the implosion. The technique has been validated on simulated radiographs of implosions at the National Ignition Facility [Miller et al., Nucl. Fusion 44, 228 (2004)] and implemented on experiments at the OMEGA laser facility [Boehly et al., Opt. Commun. 133, 495 (1997)].

  15. Tumor Ablation and Nanotechnology

    PubMed Central

    Manthe, Rachel L.; Foy, Susan P.; Krishnamurthy, Nishanth; Sharma, Blanka; Labhasetwar, Vinod

    2010-01-01

    Next to surgical resection, tumor ablation is a commonly used intervention in the treatment of solid tumors. Tumor ablation methods include thermal therapies, photodynamic therapy, and reactive oxygen species (ROS) producing agents. Thermal therapies induce tumor cell death via thermal energy and include radiofrequency, microwave, high intensity focused ultrasound, and cryoablation. Photodynamic therapy and ROS producing agents cause increased oxidative stress in tumor cells leading to apoptosis. While these therapies are safe and viable alternatives when resection of malignancies is not feasible, they do have associated limitations that prevent their widespread use in clinical applications. To improve the efficacy of these treatments, nanoparticles are being studied in combination with nonsurgical ablation regimens. In addition to better thermal effect on tumor ablation, nanoparticles can deliver anticancer therapeutics that show synergistic anti-tumor effect in the presence of heat and can also be imaged to achieve precision in therapy. Understanding the molecular mechanism of nanoparticle-mediated tumor ablation could further help engineer nanoparticles of appropriate composition and properties to synergize the ablation effect. This review aims to explore the various types of nonsurgical tumor ablation methods currently used in cancer treatment and potential improvements by nanotechnology applications. PMID:20866097

  16. Convergent ablator performance measurements

    NASA Astrophysics Data System (ADS)

    Hicks, D. G.; Spears, B. K.; Braun, D. G.; Olson, R. E.; Sorce, C. M.; Celliers, P. M.; Collins, G. W.; Landen, O. L.

    2010-10-01

    The velocity and remaining ablator mass of an imploding capsule are critical metrics for assessing the progress toward ignition of an inertially confined fusion experiment. These and other convergent ablator performance parameters have been measured using a single streaked x-ray radiograph. Traditional Abel inversion of such a radiograph is ill-posed since backlighter intensity profiles and x-ray attenuation by the ablated plasma are unknown. To address this we have developed a regularization technique which allows the ablator density profile ρ(r ) and effective backlighter profile I0(y) at each time step to be uniquely determined subject to the constraints that ρ(r ) is localized in radius space and I0(y) is delocalized in object space. Moments of ρ(r ) then provide the time-resolved areal density, mass, and average radius (and thus velocity) of the remaining ablator material. These results are combined in the spherical rocket model to determine the ablation pressure and mass ablation rate during the implosion. The technique has been validated on simulated radiographs of implosions at the National Ignition Facility [Miller et al., Nucl. Fusion 44, 228 (2004)] and implemented on experiments at the OMEGA laser facility [Boehly et al., Opt. Commun. 133, 495 (1997)].

  17. Navigation Systems for Ablation

    PubMed Central

    Wood, B. J.; Kruecker, J.; Abi-Jaoudeh, N; Locklin, J.; Levy, E.; Xu, S.; Solbiati, L.; Kapoor, A.; Amalou, H.; Venkatesan, A.

    2010-01-01

    Navigation systems, devices and intra-procedural software are changing the way we practice interventional oncology. Prior to the development of precision navigation tools integrated with imaging systems, thermal ablation of hard-to-image lesions was highly dependent upon operator experience, spatial skills, and estimation of positron emission tomography-avid or arterial-phase targets. Numerous navigation systems for ablation bring the opportunity for standardization and accuracy that extends our ability to use imaging feedback during procedures. Existing systems and techniques are reviewed, and specific clinical applications for ablation are discussed to better define how these novel technologies address specific clinical needs, and fit into clinical practice. PMID:20656236

  18. Ablation of kidney tumors.

    PubMed

    Karam, Jose A; Ahrar, Kamran; Matin, Surena F

    2011-04-01

    While surgical excision remains the gold standard for curative treatment of small renal cell carcinomas, ablative therapy has a place as a minimally invasive, kidney function-preserving therapy in carefully selected patients who are poor candidates for surgery. Although laparoscopic cryoablation and percutaneous radiofrequency ablation (RFA) are commonly performed, percutaneous cryoablation and laparoscopic RFA are reportedly being performed with increasing frequency. The renal function and complication profiles following ablative therapy are favorable, while oncologic outcomes lag behind those of surgery, thus reinforcing the need for careful patient selection. PMID:21377587

  19. Clinical Implementation of Intrafraction Cone Beam Computed Tomography Imaging During Lung Tumor Stereotactic Ablative Radiation Therapy

    SciTech Connect

    Li, Ruijiang; Han, Bin; Meng, Bowen; Maxim, Peter G.; Xing, Lei; Koong, Albert C.; Diehn, Maximilian; Loo, Billy W.

    2013-12-01

    Purpose: To develop and clinically evaluate a volumetric imaging technique for assessing intrafraction geometric and dosimetric accuracy of stereotactic ablative radiation therapy (SABR). Methods and Materials: Twenty patients received SABR for lung tumors using volumetric modulated arc therapy (VMAT). At the beginning of each fraction, pretreatment cone beam computed tomography (CBCT) was used to align the soft-tissue tumor position with that in the planning CT. Concurrent with dose delivery, we acquired fluoroscopic radiograph projections during VMAT using the Varian on-board imaging system. Those kilovolt projections acquired during millivolt beam-on were automatically extracted, and intrafraction CBCT images were reconstructed using the filtered backprojection technique. We determined the time-averaged target shift during VMAT by calculating the center of mass of the tumor target in the intrafraction CBCT relative to the planning CT. To estimate the dosimetric impact of the target shift during treatment, we recalculated the dose to the GTV after shifting the entire patient anatomy according to the time-averaged target shift determined earlier. Results: The mean target shift from intrafraction CBCT to planning CT was 1.6, 1.0, and 1.5 mm; the 95th percentile shift was 5.2, 3.1, 3.6 mm; and the maximum shift was 5.7, 3.6, and 4.9 mm along the anterior-posterior, left-right, and superior-inferior directions. Thus, the time-averaged intrafraction gross tumor volume (GTV) position was always within the planning target volume. We observed some degree of target blurring in the intrafraction CBCT, indicating imperfect breath-hold reproducibility or residual motion of the GTV during treatment. By our estimated dose recalculation, the GTV was consistently covered by the prescription dose (PD), that is, V100% above 0.97 for all patients, and minimum dose to GTV >100% PD for 18 patients and >95% PD for all patients. Conclusions: Intrafraction CBCT during VMAT can provide

  20. Stereotactic Ablative Radiation Therapy for Subcentimeter Lung Tumors: Clinical, Dosimetric, and Image Guidance Considerations

    SciTech Connect

    Louie, Alexander V.; Senan, Suresh; Dahele, Max; Slotman, Ben J.; Verbakel, Wilko F.A.R.

    2014-11-15

    Purpose: Use of stereotactic ablative radiation therapy (SABR) for subcentimeter lung tumors is controversial. We report our outcomes for tumors with diameter ≤1 cm and their visibility on cone beam computed tomography (CBCT) scans and retrospectively evaluate the planned dose using a deterministic dose calculation algorithm (Acuros XB [AXB]). Methods and Materials: We identified subcentimeter tumors from our institutional SABR database. Tumor size was remeasured on an artifact-free phase of the planning 4-dimensional (4D)-CT. Clinical plan doses were generated using either a pencil beam convolution or an anisotropic analytic algorithm (AAA). All AAA plans were recalculated using AXB, and differences among D95 and mean dose for internal target volume (ITV) and planning target volume (PTV) on the average intensity CT dataset, as well as for gross tumor volume (GTV) on the end respiratory phases were reported. For all AAA patients, CBCT scans acquired during each treatment fraction were evaluated for target visibility. Progression-free and overall survival rates were calculated using the Kaplan-Meier method. Results: Thirty-five patients with 37 subcentimeter tumors were eligible for analysis. For the 22 AAA plans recalculated using AXB, Mean D95 ± SD values were 2.2 ± 4.4% (ITV) and 2.5 ± 4.8% (PTV) lower using AXB; whereas mean doses were 2.9 ± 4.9% (ITV) and 3.7 ± 5.1% (PTV) lower. Calculated AXB doses were significantly lower in one patient (difference in mean ITV and PTV doses, as well as in mean ITV and PTV D95 ranged from 22%-24%). However, the end respiratory phase GTV received at least 95% of the prescription dose. Review of 92 CBCT scans from all AAA patients revealed that the tumor was visualized in 82 images, and its position could be inferred in other images. The 2-year local progression-free survival was 100%. Conclusions: Patients with subcentimeter lung tumors are good candidates for SABR, given the dosimetry, ability to localize

  1. Clinical Implementation of Intrafraction Cone Beam Computed Tomography Imaging During Lung Tumor Stereotactic Ablative Radiation Therapy

    PubMed Central

    Li, Ruijiang; Han, Bin; Meng, Bowen; Maxim, Peter G.; Xing, Lei; Koong, Albert C.; Diehn, Maximilian; Loo, Billy W.

    2013-01-01

    Purpose To develop and clinically evaluate a volumetric imaging technique for assessing intrafraction geometric and dosimetric accuracy of stereotactic ablative radiation therapy (SABR). Methods and Materials Twenty patients received SABR for lung tumors using volumetric modulated arc therapy (VMAT). At the beginning of each fraction, pretreatment cone beam computed tomography (CBCT) was used to align the soft-tissue tumor position with that in the planning CT. Concurrent with dose delivery, we acquired fluoroscopic radiograph projections during VMAT using the Varian on-board imaging system. Those kilovolt projections acquired during megavolt beam-on were automatically extracted, and intrafraction CBCT images were reconstructed using the filtered backprojection technique. We determined the time-averaged target shift during VMAT by calculating the center of mass of the tumor target in the intrafraction CBCT relative to the planning CT. To estimate the dosimetric impact of the target shift during treatment, we recalculated the dose to the GTV after shifting the entire patient anatomy according to the time-averaged target shift determined earlier. Results The mean target shift from intrafraction CBCT to planning CT was 1.6, 1.0, and 1.5 mm; the 95th percentile shift was 5.2, 3.1, 3.6 mm; and the maximum shift was 5.7, 3.6, and 4.9 mm along the anterior-posterior, left-right, and superior-inferior directions. Thus, the time-averaged intrafraction gross tumor volume (GTV) position was always within the planning target volume. We observed some degree of target blurring in the intrafraction CBCT, indicating imperfect breath-hold reproducibility or residual motion of the GTV during treatment. By our estimated dose recalculation, the GTV was consistently covered by the prescription dose (PD), that is, V100% above 0.97 for all patients, and minimum dose to GTV >100% PD for 18 patients and >95% PD for all patients. Conclusions Intrafraction CBCT during VMAT can provide

  2. Prostate Stereotactic Ablative Radiation Therapy Using Volumetric Modulated Arc Therapy to Dominant Intraprostatic Lesions

    SciTech Connect

    Murray, Louise J.; Lilley, John; Thompson, Christopher M.; Cosgrove, Vivian; Mason, Josh; Sykes, Jonathan; Franks, Kevin; Sebag-Montefiore, David; Henry, Ann M.

    2014-06-01

    Purpose: To investigate boosting dominant intraprostatic lesions (DILs) in the context of stereotactic ablative radiation therapy (SABR) and to examine the impact on tumor control probability (TCP) and normal tissue complication probability (NTCP). Methods and Materials: Ten prostate datasets were selected. DILs were defined using T2-weighted, dynamic contrast-enhanced and diffusion-weighted magnetic resonance imaging. Four plans were produced for each dataset: (1) no boost to DILs; (2) boost to DILs, no seminal vesicles in prescription; (3) boost to DILs, proximal seminal vesicles (proxSV) prescribed intermediate dose; and (4) boost to DILs, proxSV prescribed higher dose. The prostate planning target volume (PTV) prescription was 42.7 Gy in 7 fractions. DILs were initially prescribed 115% of the PTV{sub Prostate} prescription, and PTV{sub DIL} prescriptions were increased in 5% increments until organ-at-risk constraints were reached. TCP and NTCP calculations used the LQ-Poisson Marsden, and Lyman-Kutcher-Burman models respectively. Results: When treating the prostate alone, the median PTV{sub DIL} prescription was 125% (range: 110%-140%) of the PTV{sub Prostate} prescription. Median PTV{sub DIL} D50% was 55.1 Gy (range: 49.6-62.6 Gy). The same PTV{sub DIL} prescriptions and similar PTV{sub DIL} median doses were possible when including the proxSV within the prescription. TCP depended on prostate α/β ratio and was highest with an α/β ratio = 1.5 Gy, where the additional TCP benefit of DIL boosting was least. Rectal NTCP increased with DIL boosting and was considered unacceptably high in 5 cases, which, when replanned with an emphasis on reducing maximum dose to 0.5 cm{sup 3} of rectum (Dmax{sub 0.5cc}), as well as meeting existing constraints, resulted in considerable rectal NTCP reductions. Conclusions: Boosting DILs in the context of SABR is technically feasible but should be approached with caution. If this therapy is adopted, strict rectal

  3. Ablative skin resurfacing.

    PubMed

    Agrawal, Nidhi; Smith, Greg; Heffelfinger, Ryan

    2014-02-01

    Ablative laser resurfacing has evolved as a safe and effective treatment for skin rejuvenation. Although traditional lasers were associated with significant thermal damage and lengthy recovery, advances in laser technology have improved safety profiles and reduced social downtime. CO2 lasers remain the gold standard of treatment, and fractional ablative devices capable of achieving remarkable clinical improvement with fewer side effects and shorter recovery times have made it a more practical option for patients. Although ablative resurfacing has become safer, careful patient selection and choice of suitable laser parameters are essential to minimize complications and optimize outcomes. This article describes the current modalities used in ablative laser skin resurfacing and examines their efficacy, indications, and possible side effects. PMID:24488638

  4. Moldable cork ablation material

    NASA Technical Reports Server (NTRS)

    1977-01-01

    A successful thermal ablative material was manufactured. Moldable cork sheets were tested for density, tensile strength, tensile elongation, thermal conductivity, compression set, and specific heat. A moldable cork sheet, therefore, was established as a realistic product.

  5. Cardiac ablation procedures

    MedlinePlus

    ... Accessory pathway, such as Wolff-Parkinson-White Syndrome Atrial fibrillation and atrial flutter Ventricular tachycardia ... consensus statement on catheter and surgical ablation of atrial fibrillation: ... for personnel, policy, procedures and follow-up. ...

  6. Laser ablation of concrete.

    SciTech Connect

    Savina, M.

    1998-10-05

    Laser ablation is effective both as an analytical tool and as a means of removing surface coatings. The elemental composition of surfaces can be determined by either mass spectrometry or atomic emission spectroscopy of the atomized effluent. Paint can be removed from aircraft without damage to the underlying aluminum substrate, and environmentally damaged buildings and sculptures can be restored by ablating away deposited grime. A recent application of laser ablation is the removal of radioactive contaminants from the surface and near-surface regions of concrete. We present the results of ablation tests on concrete samples using a high power pulsed Nd:YAG laser with fiber optic beam delivery. The laser-surface interaction was studied on various model systems consisting of Type I Portland cement with varying amounts of either fine silica or sand in an effort to understand the effect of substrate composition on ablation rates and mechanisms. A sample of non-contaminated concrete from a nuclear power plant was also studied. In addition, cement and concrete samples were doped with non-radioactive isotopes of elements representative of cooling waterspills, such as cesium and strontium, and analyzed by laser-resorption mass spectrometry to determine the contamination pathways. These samples were also ablated at high power to determine the efficiency with which surface contaminants are removed and captured. The results show that the neat cement matrix melts and vaporizes when little or no sand or aggregate is present. Surface flows of liquid material are readily apparent on the ablated surface and the captured aerosol takes the form of glassy beads up to a few tens of microns in diameter. The presence of sand and aggregate particles causes the material to disaggregate on ablation, with intact particles on the millimeter size scale leaving the surface. Laser resorption mass spectrometric analysis showed that cesium and potassium have similar chemical environments in the

  7. Threshold Doses for Focal Liver Reaction After Stereotactic Ablative Body Radiation Therapy for Small Hepatocellular Carcinoma Depend on Liver Function: Evaluation on Magnetic Resonance Imaging With Gd-EOB-DTPA

    SciTech Connect

    Sanuki, Naoko; Takeda, Atsuya; Oku, Yohei; Eriguchi, Takahisa; Nishimura, Shuichi; Aoki, Yosuke; Mizuno, Tomikazu; Iwabuchi, Shogo; Kunieda, Etsuo

    2014-02-01

    Purpose: Focal liver reaction (FLR) appears on radiographic images after stereotactic ablative body radiation therapy (SABR) in patients with hepatocellular carcinoma (HCC) and chronic liver disease. We investigated the threshold dose (TD) of FLR and possible factors affecting the TD on gadoxetate acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI). Methods and Materials: In 50 patients who were treated with SABR for small HCC and followed up by MRI for >6 months, FLR, seen as a hypointense area, was evaluated on the hepatobiliary phase of Gd-EOB-DTPA-enhanced MRI. The follow-up MRI with the largest extent of FLR was fused to the planning computed tomography (CT) image, and patients with good image fusion concordance were eligible. After delineating the border of the FLR manually, a dose–volume histogram was used to identify the TD for the FLR. Clinical and volumetric factors were analyzed for correlation with the TD. Results: A total of 45 patients were eligible for analysis with a median image fusion concordance of 84.9% (range, 71.6-95.4%). The median duration between SABR and subsequent hepatobiliary phase MRI with the largest extent of FLR was 3 months (range, 1-6 months). The median TD for FLR was 28.0 Gy (range, 22.3-36.4 Gy). On univariate analysis, pre-treatment Child-Pugh (CP) score and platelet count were significantly correlated with the TD. On multiple linear regression analysis, CP score was the only parameter that predicted TD. Median TDs were 30.5 Gy (range, 26.2.3-36.4 Gy) and 25.2 Gy (range, 22.3-27.5 Gy) for patients with CP-A and CP-B disease, respectively. Conclusion: The TD was significantly correlated with baseline liver function. We propose 30 Gy for CP-A disease and 25 Gy for CP-B disease in 5 fractions as TDs for FLR after SABR for patients with HCC and chronic liver disease. Use of these TDs will help to predict potential loss of liver tissue after SABR.

  8. Ablation of the locally advanced pancreatic cancer: An introduction and brief summary of techniques.

    PubMed

    Petrou, Athanasios; Moris, Demetrios; Paul Tabet, Patrick; David Wensley Richards, Brian; Kourounis, Georgios

    2016-01-01

    Pancreatic ductal adenocarcinoma is a lethal and late presenting malignancy with dismal survival rates. An estimated total of 330,000 people died from this malignancy in 2012. Although there have been improvements in diagnostic and treatment methods, the survival of late stage pancreatic cancer has not shown significant improvement in the past 4 decades. Multiple treatment approaches are available including chemotherapy, radiotherapy, and immunotherapy, but to this day surgical resection remains the only curative treatment option. Ablative techniques use various forms of energy to cause local tissue destruction through necrosis or apoptosis. They are relevant in pancreatic ductal adenocarcinoma as they are a treatment option in non-resectable tumors where their use ranges from symptom control to reducing tumor size for resection. In this narrative review we have grouped and outlined the various ablative methods, classifying them into thermal (Radiofrequency ablation, Microwave ablation, High Intensity Focused Ultrasound ablation, Cryoablation), and non-thermal ablative methods (Irreversible Electroporation (NanoKnife®), Photodynamic Therapy). This is followed by a description and review of the available evidence on survival and complications for each of these ablative methods. According to the literature, thermal ablative methods appear to be more accessible but are implicated with more complications than non thermal ablative methods which show the most promise. PMID:27569086

  9. Ablative therapies for renal tumors

    PubMed Central

    Ramanathan, Rajan; Leveillee, Raymond J.

    2010-01-01

    Owing to an increased use of diagnostic imaging for evaluating patients with other abdominal conditions, incidentally discovered kidney masses now account for a majority of renal tumors. Renal ablative therapy is assuming a more important role in patients with borderline renal impairment. Renal ablation uses heat or cold to bring about cell death. Radiofrequency ablation and cryoablation are two such procedures, and 5-year results are now emerging from both modalities. Renal biopsy at the time of ablation is extremely important in order to establish tissue diagnosis. Real-time temperature monitoring at the time of radiofrequency ablation is very useful to ensure adequacy of ablation. PMID:21789083

  10. Atrial fibrillation ablation.

    PubMed

    Pappone, Carlo; Santinelli, Vincenzo

    2012-06-01

    Atrial fibrillation is the commonest cardiac arrhythmia, with significant morbidity related to symptoms, heart failure, and thromboembolism, which is associated with excess mortality. Over the past 10 years, many centers worldwide have reported high success rates and few complications after a single ablation procedure in patients with paroxysmal atrial fibrillation. Recent studies indicate a short-term and long-term superiority of catheter ablation as compared with conventional antiarrhythmic drug therapy in terms of arrhythmia recurrence, quality of life, and arrhythmia progression. As a result, catheter ablation is evolving to a front-line therapy in many patients with atrial fibrillation. However, in patients with persistent long-standing atrial fibrillation catheter ablation strategy is more complex and time-consuming, frequently requiring repeat procedures to achieve success rates as high as in paroxysmal atrial fibrillation. In the near future, however, with growing experience and evolving technology, catheter ablation of atrial fibrillation may be extended also to patients with long-standing atrial fibrillation. PMID:22541284

  11. Infrared laser bone ablation

    SciTech Connect

    Nuss, R.C.; Fabian, R.L.; Sarkar, R.; Puliafito, C.A.

    1988-01-01

    The bone ablation characteristics of five infrared lasers, including three pulsed lasers (Nd:YAG, lambda = 1064 micron; Hol:YSGG, lambda = 2.10 micron; and Erb:YAG, lambda = 2.94 micron) and two continuous-wave lasers (Nd:YAG, lambda = 1.064 micron; and CO/sub 2/, lambda = 10.6 micron), were studied. All laser ablations were performed in vitro, using moist, freshly dissected calvarium of guinea pig skulls. Quantitative etch rates of the three pulsed lasers were calculated. Light microscopy of histologic sections of ablated bone revealed a zone of tissue damage of 10 to 15 micron adjacent to the lesion edge in the case of the pulsed Nd:YAG and the Erb:YAG lasers, from 20 to 90 micron zone of tissue damage for bone ablated by the Hol:YSGG laser, and 60 to 135 micron zone of tissue damage in the case of the two continuous-wave lasers. Possible mechanisms of bone ablation and tissue damage are discussed.

  12. Transient Ablation of Teflon Hemispheres

    NASA Technical Reports Server (NTRS)

    Arai, Norio; Karashima, Kei-ichi; Sato, Kiyoshi

    1997-01-01

    For high-speed entry of space vehicles into atmospheric environments, ablation is a practical method for alleviating severe aerodynamic heating. Several studies have been undertaken on steady or quasi-steady ablation. However, ablation is a very complicated phenomenon in which a nonequilibrium chemical process is associated with an aerodynamic process that involves changes in body shape with time. Therefore, it seems realistic to consider that ablation is an unsteady phenomenon. In the design of an ablative heat-shield system, since the ultimate purpose of the heat shield is to keep the internal temperature of the space vehicle at a safe level during entry, the transient heat conduction characteristics of the ablator may be critical in the selection of the material and its thickness. This note presents an experimental study of transient ablation of Teflon, with particular emphasis on the change in body shape, the instantaneous internal temperature distribution, and the effect of thermal expansion on ablation rate.

  13. Tumour ablation: technical aspects

    PubMed Central

    Bodner, Gerd; Bale, Reto

    2009-01-01

    Abstract Image-guided percutaneous radiofrequency ablation (RFA) is a minimally invasive, relatively low-risk procedure for tumour treatment. Local recurrence and survival rates depend on the rate of complete ablation of the entire tumour including a sufficient margin of surrounding healthy tissue. Currently a variety of different RFA devices are available. The interventionalist must be able to predict the configuration and extent of the resulting ablation necrosis. Accurate planning and execution of RFA according to the size and geometry of the tumour is essential. In order to minimize complications, individualized treatment strategies may be necessary for tumours close to vital structures. This review examines the state-of-the art of different device technologies, approaches, and treatment strategies for percutaneous RFA of liver tumours. PMID:19965296

  14. Advanced Ablative TPS

    NASA Technical Reports Server (NTRS)

    Gasch, Matthew J.

    2011-01-01

    Early NASA missions (Gemini, Apollo, Mars Viking) employed new ablative TPS that were tailored for the entry environment. After 40 years, heritage ablative TPS materials using Viking or Pathfinder era materials are at or near their performance limits and will be inadequate for future exploration missions. Significant advances in TPS materials technology are needed in order to enable any subsequent human exploration missions beyond Low Earth Orbit. This poster summarizes some recent progress at NASA in developing families of advanced rigid/conformable and flexible ablators that could potentially be used for thermal protection in planetary entry missions. In particular the effort focuses technologies required to land heavy (approx.40 metric ton) masses on Mars to facilitate future exploration plans.

  15. Narcissus, the Beam, and lung cancer.

    PubMed

    Rocco, Gaetano

    2016-08-01

    In the management of lung cancer, the rules of engagement of stereotactic ablative radiotherapy (SABR) are not clearly defined. The potential for SABR to affect to an unprecedented level current protocols and in all disease stages emerges vehemently from the literature. However, in a time when the role of surgery is being reassessed, surgeons need to take a closer look at the evidence for the use of SABR in lung cancer patients and clearly define their indisputable role within the context of multidisciplinary teams. The myth of Narcissus exemplified in the absolute masterpiece by Caravaggio seems to represent an ideal metaphor to explain the ever-evolving interaction between surgery and SABR in lung cancer management. PMID:27209014

  16. Shuttle subscale ablative nozzle tests

    NASA Technical Reports Server (NTRS)

    Powers, L. B.; Bailey, R. L.

    1980-01-01

    Recent subscale nozzle tests have identified new and promising carbon phenolic nozzle ablatives which utilize staple rayon, PAN, and pitch based carbon cloth. A 4-inch throat diameter submerged test nozzle designed for the 48-inch Jet Propulsion Laboratory char motor was used to evaluate five different designs incorporating 20 candidate ablatives. Test results indicate that several pitch and PAN-based carbon phenolic ablatives can provide erosion and char performance equivalent or superior to the present continuous rayon-based SRM ablative.

  17. Ablative thermal protection systems

    NASA Technical Reports Server (NTRS)

    Vaniman, J.; Fisher, R.; Wojciechowski, C.; Dean, W.

    1983-01-01

    The procedures used to establish the TPS (thermal protection system) design of the SRB (solid rocket booster) element of the Space Shuttle vehicle are discussed. A final evaluation of the adequacy of this design will be made from data obtained from the first five Shuttle flights. Temperature sensors installed at selected locations on the SRB structure covered by the TPS give information as a function of time throughout the flight. Anomalies are to be investigated and computer design thermal models adjusted if required. In addition, the actual TPS ablator material loss is to be measured after each flight and compared with analytically determined losses. The analytical methods of predicting ablator performance are surveyed.

  18. Gold Nanoparticle Hyperthermia Reduces Radiotherapy Dose

    PubMed Central

    Lin, Lynn; Slatkin, Daniel N.; Dilmanian, F. Avraham; Vadas, Timothy M.; Smilowitz, Henry M.

    2014-01-01

    Gold nanoparticles can absorb near infrared light, resulting in heating and ablation of tumors. Gold nanoparticles have also been used for enhancing the dose of X-rays in tumors during radiotherapy. The combination of hyperthermia and radiotherapy is synergistic, importantly allowing a reduction in X-ray dose with improved therapeutic results. Here we intratumorally infused small 15 nm gold nanoparticles engineered to be transformed from infrared-transparent to infrared-absorptive by the tumor, which were then heated by infrared followed by X-ray treatment. Synergy was studied using a very radioresistant subcutaneous squamous cell carcinoma (SCCVII) in mice. It was found that the dose required to control 50% of the tumors, normally 55 Gy, could be reduced to <15 Gy (a factor of >3.7). Gold nanoparticles therefore provide a method to combine hyperthermia and radiotherapy to drastically reduce the X-ray radiation needed, thus sparing normal tissue, reducing the side effects, and making radiotherapy more effective. PMID:24990355

  19. Reduction of radiation dose during facet joint injection using the new image guidance system SabreSource™: a prospective study in 60 patients

    PubMed Central

    Proschek, Dirk; Kafchitsas, K.; Rauschmann, M. A.; Kurth, A. A.; Vogl, T. J.

    2008-01-01

    Interventional procedures are associated with high radiation doses for both patients and surgeons. To reduce the risk from ionizing radiation, it is essential to minimize radiation dose. This prospective study was performed to evaluate the effectiveness in reducing radiation dose during facet joint injection in the lumbar spine and to evaluate the feasibility and possibilities of the new real time image guidance system SabreSource™. A total of 60 patients, treated with a standardized injection therapy of the facet joints L4–L5 or L5–S1, were included in this study. A total of 30 patients were treated by fluoroscopy guidance alone, the following 30 patients were treated using the new SabreSource™ system. Thus a total of 120 injections to the facet joints were performed. Pain, according to the visual analogue scale (VAS), was documented before and 6 h after the intervention. Radiation dose, time of radiation and the number of exposures needed to place the needle were recorded. No significant differences concerning age (mean age 60.5 years, range 51–69), body mass index (mean BMI 26.2, range 22.2–29.9) and preoperative pain (VAS 7.9, range 6–10) were found between the two groups. There was no difference in pain reduction between the two groups (60 vs. 61.5%; P = 0.001) but the radiation dose was significantly smaller with the new SabreSource™ system (reduction of radiation dose 32.7%, P = 0.01; reduction of mean entrance surface dose 32.3%, P = 0.01). The SabreSource™ System significantly reduced the radiation dose received during the injection therapy of the lumbar facet joints. With minimal effort for the setup at the beginning of a session, the system is easy to handle and can be helpful for other injection therapies (e.g. nerve root block therapies). PMID:19082641

  20. Therapeutic stimulation versus ablation.

    PubMed

    Hariz, Marwan I; Hariz, Gun-Marie

    2013-01-01

    The renaissance of functional stereotactic neurosurgery was pioneered in the mid 1980s by Laitinen's introduction of Leksell's posteroventral pallidotomy for Parkinson´s disease (PD). This ablative procedure experienced a worldwide spread in the 1990s, owing to its excellent effect on dyskinesias and other symptoms of post-l-dopa PD. Modern deep brain stimulation (DBS), pioneered by Benabid and Pollak in 1987 for the treatment of tremor, first became popular when it was applied to the subthalamic nucleus (STN) in the mid 1990s, where it demonstrated a striking effect on all cardinal symptoms of advanced PD, and permitted reduced dosages of medication. DBS, as a nondestructive, adaptable, and reversible procedure that is proving safe in bilateral surgery on basal ganglia, has great appeal to clinicians and patients alike, despite the fact that it is expensive, laborious, and relies on very strict patient selection criteria, especially for STN DBS. Psychiatric surgery has experienced the same phenomenon, with DBS supplanting completely stereotactic ablative procedures. This chapter discusses the pros and cons of ablation versus stimulation and investigates the reasons why DBS has overshadowed proven efficient ablative procedures such as pallidotomy for PD, and capsulotomy and cingulotomy for obsessive-compulsive disorder and depression. PMID:24112885

  1. Advanced Rigid Ablative TPS

    NASA Technical Reports Server (NTRS)

    Gasch, Matthew J.

    2011-01-01

    NASA Exploration Systems Mission Directorate s (ESMD) Entry, Descent, and Landing (EDL) Technology Development Project (TDP) and the NASA Aeronautics Research Mission Directorate s (ARMD) Hypersonics Project are developing new advanced rigid ablators in an effort to substantially increase reliability, decrease mass, and reduce life cycle cost of rigid aeroshell-based entry systems for multiple missions. Advanced Rigid Ablators combine ablation resistant top layers capable of high heat flux entry and enable high-speed EDL with insulating mass-efficient bottom that, insulate the structure and lower the areal weight. These materials may benefit Commercial Orbital Transportation Services (COTS) vendors and may potentially enable new NASA missions for higher velocity returns (e.g. asteroid, Mars). The materials have been thermally tested to 400-450 W/sq cm at the Laser Hardened Materials Evaluation Lab (LHMEL), Hypersonics Materials Evaluation Test System (HyMETS) and in arcjet facilities. Tested materials exhibit much lower backface temperatures and reduced recession over the baseline materials (PICA). Although the EDL project is ending in FY11, NASA in-house development of advanced ablators will continue with a focus on varying resin systems and fiber/resin interactions.

  2. New Ablation Technologies and Techniques

    PubMed Central

    Berte, Benjamin; Yamashita, Seigo; Derval, Nicolas; Denis, Arnaud; Shah, Ashok; Amraoui, Sana; Hocini, Meleze; Haissaguerre, Michel; Jais, Pierre; Sacher, Frederic

    2014-01-01

    Catheter ablation is an established treatment strategy for a range of different cardiac arrhythmias. Over the past decade two major areas of expansion have been ablation of atrial fibrillation (AF) and ventricular tachycardia (VT) in the context of structurally abnormal hearts. In parallel with the expanding role of catheter ablation for AF and VT, multiple novel technologies have been developed which aim to increase safety and procedural success. Areas of development include novel catheter designs, novel navigation technologies and higher resolution imaging techniques. The aim of the present review is to provide an overview of novel developments in AF ablation and VT ablation in patients with of structural cardiac diseases. PMID:26835075

  3. New Ablation Technologies and Techniques.

    PubMed

    Mahida, Saagar; Berte, Benjamin; Yamashita, Seigo; Derval, Nicolas; Denis, Arnaud; Shah, Ashok; Amraoui, Sana; Hocini, Meleze; Haissaguerre, Michel; Jais, Pierre; Sacher, Frederic

    2014-08-01

    Catheter ablation is an established treatment strategy for a range of different cardiac arrhythmias. Over the past decade two major areas of expansion have been ablation of atrial fibrillation (AF) and ventricular tachycardia (VT) in the context of structurally abnormal hearts. In parallel with the expanding role of catheter ablation for AF and VT, multiple novel technologies have been developed which aim to increase safety and procedural success. Areas of development include novel catheter designs, novel navigation technologies and higher resolution imaging techniques. The aim of the present review is to provide an overview of novel developments in AF ablation and VT ablation in patients with of structural cardiac diseases. PMID:26835075

  4. Percutaneous Ablation of Adrenal Tumors

    PubMed Central

    Venkatesan, Aradhana M.; Locklin, Julia; Dupuy, Damian E.; Wood, Bradford J.

    2010-01-01

    Adrenal tumors comprise a broad spectrum of benign and malignant neoplasms, and include functional adrenal adenomas, pheochromocytomas, primary adrenocortical carcinoma and adrenal metastases. Percutaneous ablative approaches that have been described and used in the treatment of adrenal tumors include percutaneous radiofrequency ablation (RFA), cryoablation, microwave ablation and chemical ablation. Local tumor ablation in the adrenal gland presents unique challenges, secondary to the adrenal gland’s unique anatomic and physiologic features. The results of clinical series employing percutaneous ablative techniques in the treatment of adrenal tumors are reviewed in this article. Clinical and technical considerations unique to ablation in the adrenal gland are presented, including approaches commonly used in our practices, and risks and potential complications are discussed. PMID:20540918

  5. Radiofrequency ablation: a safe and economical modality in treatment of Brooke-Spiegler syndrome.

    PubMed

    Chaudhary, Savita; Dayal, Surabhi

    2012-08-01

    Brooke-Spiegler syndrome is an uncommon disease. Patients have a predisposition to develop cutaneous adnexal neoplasms such as cylindromas, trichoepitheliomas, spiradenomas, trichoblastomas, basal cell carcinomas, follicular cysts, and organoid nevi. Malignant transformation of preexisting tumors also occurs in these individuals. Various techniques have been used for the treatment of trichoepitheliomas and cylindromas including excision, electrocautery, carbon dioxide laser ablation, cryosurgery, and radiotherapy. In our case, cylindromas were ablated by radiofrequency in multiple sittings. Trichoepitheliomas were ablated using coagulation mode with power # 3 to 3.5. Cosmetically acceptable results were obtained in 100 percent of the cylindromas and 70 percent of the trichoepitheliomas (Visual Analog Scale). The radiofrequency ablation technique under different modes can be used in both large tumors as well as smaller ones, especially in developing countries because it is very cost effective and easily accessible. PMID:22948057

  6. Radiofrequency Ablation of Metastatic Pheochromocytoma

    PubMed Central

    Venkatesan, Aradhana M.; Locklin, Julia; Lai, Edwin W.; Adams, Karen T.; Fojo, Antonio Tito; Pacak, Karel; Wood, Bradford J.

    2013-01-01

    In the present report on the preliminary safety and effectiveness of radiofrequency (RF) ablation for pheochromocytoma metastases, seven metastases were treated in six patients (mean size, 3.4 cm; range, 2.2–6 cm). α- and β-adrenergic and catecholamine synthesis inhibition and intraprocedural anesthesia monitoring were used. Safety was assessed by recording ablation-related complications. Complete ablation was defined as a lack of enhancement within the ablation zone on follow-up computed tomography. No serious adverse sequelae were observed. Complete ablation was achieved in six of seven metastases (mean follow-up, 12.3 months; range, 2.5–28 months). In conclusion, RF ablation may be safely performed for metastatic pheochromocytoma given careful attention to peri-procedural management. PMID:19875067

  7. OCDR guided laser ablation device

    DOEpatents

    Dasilva, Luiz B.; Colston, Jr., Bill W.; James, Dale L.

    2002-01-01

    A guided laser ablation device. The device includes a mulitmode laser ablation fiber that is surrounded by one or more single mode optical fibers that are used to image in the vicinity of the laser ablation area to prevent tissue damage. The laser ablation device is combined with an optical coherence domain reflectometry (OCDR) unit and with a control unit which initializes the OCDR unit and a high power laser of the ablation device. Data from the OCDR unit is analyzed by the control unit and used to control the high power laser. The OCDR images up to about 3 mm ahead of the ablation surface to enable a user to see sensitive tissue such as a nerve or artery before damaging it by the laser.

  8. Multiple target laser ablation system

    DOEpatents

    Mashburn, Douglas N.

    1996-01-01

    A laser ablation apparatus and method are provided in which multiple targets consisting of material to be ablated are mounted on a movable support. The material transfer rate is determined for each target material, and these rates are stored in a controller. A position detector determines which target material is in a position to be ablated, and then the controller controls the beam trigger timing and energy level to achieve a desired proportion of each constituent material in the resulting film.

  9. Multiple target laser ablation system

    DOEpatents

    Mashburn, D.N.

    1996-01-09

    A laser ablation apparatus and method are provided in which multiple targets consisting of material to be ablated are mounted on a movable support. The material transfer rate is determined for each target material, and these rates are stored in a controller. A position detector determines which target material is in a position to be ablated, and then the controller controls the beam trigger timing and energy level to achieve a desired proportion of each constituent material in the resulting film. 3 figs.

  10. [Radiotherapy for Thyroid Cancer].

    PubMed

    Jingu, Keiichi; Maruoka, Shin; Umezawa, Rei; Takahashi, Noriyoshi

    2015-06-01

    Radioactive 131I therapy for differentiated thyroid cancer has been used since the 1940s and is an established and effective treatment. In contrast, external beam radiotherapy (EBRT) was considered to be effective for achieving local control but not for prolonging survival. Although clinicians were hesitant to administer EBRT owing to the potential radiation-induced adverse effects of 2 dimensional (2D)-radiotherapy until 2000, it is expected that adverse effects will be reduced and treatment efficacy improved through the introduction of more advanced techniques for delivering radiation (eg, 3D-radiotherapy and intensity modulated radiotherapy [IMRT]). The prognosis of undifferentiated thyroid cancer is known to be extremely bad, although in very rare cases, multimodality therapy (total or subtotal resection, chemotherapy, and radiotherapy) has allowed long-term survival. Here, we report the preliminary results of using hypofractionated radiotherapy for undifferentiated thyroid cancer in our institution. PMID:26199238

  11. Whole body radiotherapy: A TBI-guideline

    PubMed Central

    Quast, Ulrich

    2006-01-01

    Total Body Irradiation (TBI) is one main component in the interdisciplinary treatment of widely disseminated malignancies predominantly of haematopoietic diseases. Combined with intensive chemotherapy, TBI enables myeloablative high dose therapy and immuno-ablative conditioning treatment prior to subsequent transplantation of haematopoietic stem cells: bone marrow stem cells or peripheral blood progenitor stem cells. Jointly prepared by DEGRO and DGMP, the German Society of Radio-Oncology, and the German Association of Medical Physicists, this DEGRO/DGMP-Leitlinie Ganzkoerper-Strahlenbehandlung - DEGRO/DGMP Guideline Whole Body Radiotherapy, summarises the concepts, principles, facts and common methods of Total Body Irradiation and poses a set of recommendations for reliable and successful application of high dose large-field radiotherapy as essential part of this interdisciplinary, multi-modality treatment concept. The guideline is geared towards radio-oncologists, medical physicists, haematooncolo-gists, and all contributing to Whole Body Radiotherapy. To guide centres intending to start or actualise TBI criteria are included. The relevant treatment parameters are defined and a sample of a form is given for reporting TBI to international registries. PMID:21206634

  12. Radiotherapy of Cervical Cancer.

    PubMed

    Vordermark, Dirk

    2016-01-01

    Curative-intent radical radiotherapy of cervical cancer consists of external-beam radiotherapy, brachytherapy, and concomitant chemotherapy with cisplatin. For each element, new developments aim to improve tumor control rates or treatment tolerance. Intensity-modulated radiotherapy (IMRT) has been shown to reduce gastrointestinal toxicity and can be used to selectively increase the radiotherapy dose. Individualized, image-guided brachytherapy enables better adaptation of high-dose volumes to the tumor extension. Intensification of concomitant or sequential systemic therapy is under evaluation. PMID:27614991

  13. Quality Assurance in Radiotherapy

    NASA Astrophysics Data System (ADS)

    Mckenzie, Alan

    A common feature of the Radiotherapy Centres where there have been major accidents involving incorrect radiotherapy treatment is that they did not operate good Quality Assurance systems. A Quality Assurance system is sometimes called a Quality Management system, and it is designed to give assurance that quality standards are being met. One of the "spin offs" from operating a Quality Management system is that it reduces the likelihood of a radiotherapy accident. A detailed account of how to set up a quality system in radiotherapy has been given in an ESTRO booklet.2

  14. SABRE: A search for dark matter and a test of the DAMA/LIBRA annual-modulation result using thallium-doped sodium-iodide scintillation detectors

    NASA Astrophysics Data System (ADS)

    Shields, Emily Kathryn

    Ample evidence has been gathered demonstrating that the majority of the mass in the universe is composed of non-luminous, non-baryonic matter. Though the evidence for dark matter is unassailable, its nature and properties remain unknown. A broad effort has been undertaken by the physics community to detect dark-matter particles through direct-detection techniques. For over a decade, the DAMA/LIBRA experiment has observed a highly significant (9.3sigma) modulation in the scintillation event rate in their highly pure NaI(Tl) detectors, which they use as the basis of a claim for the discovery of dark-matter particles. However, the dark-matter interpretation of the DAMA/LIBRA modulation remains unverified. While there have been some recent hints of dark matter in the form of a light Weakly-Interacting Massive Particle (WIMP) from the CoGeNT and CDMS-Si experiments, when assuming a WIMP dark-matter model, several other experiments, including the LUX and XENON noble-liquid experiments, the KIMS CsI(Tl) experiment, and several bubble chamber experiments, conflict with DAMA/LIBRA. However, these experiments use different dark-matter targets and cannot be compared with DAMA/LIBRA in a model-independent way. The uncertainty surrounding the dark-matter model, astrophysical model, and nuclear-physics effects makes it necessary for a new NaI(Tl) experiment to directly test the DAMA/LIBRA result. The Sodium-iodide with Active Background REjection (SABRE) experiment seeks to provide a much-needed model-independent test of the DAMA/LIBRA modulation by developing highly pure crystal detectors with very low radioactivity and deploying them in an active veto detector that can reject key backgrounds in a dark-matter measurement. This work focuses on the efforts put forward by the SABRE collaboration in developing low-background, low-threshold crystal detectors, designing and fabricating a liquid-scintillator veto detector, and simulating the predicted background spectrum for a dark

  15. High temperature ablative foam

    NASA Technical Reports Server (NTRS)

    Liu, Matthew T. (Inventor)

    1992-01-01

    An ablative foam composition is formed of approximately 150 to 250 parts by weight polymeric isocyanate having an isocyanate functionality of 2.6 to 3.2; approximately 15 to 30 parts by weight reactive flame retardant having a hydroxyl number range from 200-260; approximately 10 to 40 parts by weight non-reactive flame retardant; approximately 10 to 40 parts by weight nonhydrolyzable silicone copolymer having a hydroxyl number range from 75-205; and approximately 3 to 16 parts by weight amine initiated polyether resin having an isocyanate functionality greater than or equal to 3.0 and a hydroxyl number range from 400-800.

  16. LASER ABLATION STUDIES OF CONCRETE

    EPA Science Inventory

    Laser ablation was studied as a means of removing radioactive contaminants from the surface and near-surface regions of concrete. We present the results of ablation tests on cement and concrete samples using a 1.6 kW pulsed Nd:YAG laser with fiber optic beam delivery. The laser-s...

  17. [Radiotherapy of skin cancers].

    PubMed

    Hennequin, C; Rio, E; Mahé, M-A

    2016-09-01

    The indications of radiotherapy for skin cancers are not clearly defined because of the lack of randomised trials or prospective studies. For basal cell carcinomas, radiotherapy frequently offers a good local control, but a randomized trial showed that surgery is more efficient and less toxic. Indications of radiotherapy are contra-indications of surgery for patients older than 60, non-sclerodermiform histology and occurring in non-sensitive areas. Adjuvant radiotherapy could be proposed to squamous cell carcinomas, in case of poor prognostic factors. Dose of 60 to 70Gy are usually required, and must be modulated to the size of the lesions. Adjuvant radiotherapy seems beneficial for desmoplastic melanomas but not for the other histological types. Prophylactic nodal irradiation (45 to 50Gy), for locally advanced tumours (massive nodal involvement), decreases the locoregional failure rate but do not increase survival. Adjuvant radiotherapy (50 to 56Gy) for Merckel cell carcinomas increases also the local control rate, as demonstrated by meta-analysis and a large epidemiological study. Nodal areas must be included, if there is no surgical exploration (sentinel lymph node dissection). Kaposi sarcomas are radiosensitive and could be treated with relatively low doses (24 to 30Gy). Also, cutaneous lymphomas are good indications for radiotherapy: B lymphomas are electively treated with limited fields. The role of total skin electron therapy for T-lymphomas is still discussed; but palliative radiotherapy is very efficient in case of cutaneous nodules. PMID:27522189

  18. Planning National Radiotherapy Services

    PubMed Central

    Rosenblatt, Eduardo

    2014-01-01

    Countries, states, and island nations often need forward planning of their radiotherapy services driven by different motives. Countries without radiotherapy services sponsor patients to receive radiotherapy abroad. They often engage professionals for a feasibility study in order to establish whether it would be more cost-beneficial to establish a radiotherapy facility. Countries where radiotherapy services have developed without any central planning, find themselves in situations where many of the available centers are private and thus inaccessible for a majority of patients with limited resources. Government may decide to plan ahead when a significant exodus of cancer patients travel to another country for treatment, thus exposing the failure of the country to provide this medical service for its citizens. In developed countries, the trigger has been the existence of highly visible waiting lists for radiotherapy revealing a shortage of radiotherapy equipment. This paper suggests that there should be a systematic and comprehensive process of long-term planning of radiotherapy services at the national level, taking into account the regulatory infrastructure for radiation protection, planning of centers, equipment, staff, education programs, quality assurance, and sustainability aspects. Realistic budgetary and cost considerations must also be part of the project proposal or business plan. PMID:25505730

  19. 3.4 Radiotherapy

    NASA Astrophysics Data System (ADS)

    Kramer, H.-M.; Selbach, H.-J.; Vatnitsky, S.

    This document is part of Subvolume A 'Fundamentals and Data in Radiobiology, Radiation Biophysics, Dosimetry and Medical Radiological Protection' of Volume 7 'Medical Radiological Physics' of Landolt-Börnstein - Group VIII 'Advanced Materials and Technologies'. It contains the Section '3.4 Radiotherapy' of the Chapter '3 Dosimetry in Diagnostic Radiology and Radiotherapy' with the contents:

  20. Thermal response and ablation characteristics of light weight ceramic ablators

    NASA Technical Reports Server (NTRS)

    Tran, Huy K.; Rasky, Daniel J.; Esfahani, Lili

    1993-01-01

    An account is given of the thermal performance and ablation characteristics of the NASA-Ames Lightweight Ceramic Ablators (LCAs) in supersonic, high-enthalpy convective environments, which use low density ceramic or carbon fiber matrices as substrates for main structural support, with organic resin fillers. LCA densities are in the 0.224-1.282 g/cu cm range. In-depth temperature data have been obtained to determine thermal penetration depths and conductivity. The addition of SiC and PPMA is noted to significantly improve the ablation performance of LCAs with silica substrates. Carbon-based LCAs are the most mass-efficient at high flux levels.

  1. Ultrasonic characterization of laser ablation

    NASA Astrophysics Data System (ADS)

    Smith, J. A.; Telschow, K. L.

    When a pulsed laser beam strikes the surface of an absorbing material, ultrasonic waves are generated due to thermoelectric expansion and, at higher laser power densities, ablation of the material. These sound generation mechanisms have been the subject of numerous theoretical and experimental studies and are now fairly well understood. In particular, it has been established that at low power densities the thermoelastic mechanism is well described by a surface center of expansion. This mechanism produces a characteristic waveform whose amplitude is proportional to the energy absorbed from the laser pulse and also dependent on the thermal and elastic properties of the material. The ablation ultrasonic source can be described by a point normal force acting on the material surface. For laser power densities near the ablation onset, the time dependence of the source is that of the laser pulse. The resultant waveform recorded on epicenter (source and detector collinear) has a sharp peak determined by the momentum impulse delivered to the material by the ablation process. Particularly in the near ablation onset region, this ultrasonic displacement peak can be used to characterize the ablation process occurring at the material surface. The onset power density for ablation and subsequent ablation dependence on power density are material dependent and thought to be a function of the heat capacity and thermal conductivity of the material. With this in mind, it is possible that these ablation signals could be used to characterize material microstructures, and perhaps material mechanical properties such as hardness, through microstructural changes of the material thermal parameters. This paper explores this question for samples of Type 304 stainless steel with microstructures controlled through work hardening and annealing.

  2. Ablative heat shield design for space shuttle

    NASA Technical Reports Server (NTRS)

    Seiferth, R. W.

    1973-01-01

    Ablator heat shield configuration optimization studies were conducted for the orbiter. Ablator and reusable surface insulation (RSI) trajectories for design studies were shaped to take advantage of the low conductance of ceramic RSI and high temperature capability of ablators. Comparative weights were established for the RSI system and for direct bond and mechanically attached ablator systems. Ablator system costs were determined for fabrication, installation and refurbishment. Cost penalties were assigned for payload weight penalties, if any. The direct bond ablator is lowest in weight and cost. A mechanically attached ablator using a magnesium subpanel is highly competitive for both weight and cost.

  3. Advances in Atrial Fibrillation Ablation

    PubMed Central

    Darge, Alicia; Reynolds, Matthew R.; Germano, Joseph J.

    2009-01-01

    Atrial Fibrillation (AF) is an increasingly common and costly medical problem.1–3 Given the disappointing efficacy and side effects associated with pharmacological therapy for AF, new treatment options are needed. Over the last decade, advances in our understanding of the mechanisms of AF, coupled with iterative improvements in catheter ablation techniques, have spurred the evolution of catheter ablation for AF from an experimental procedure to an increasingly important treatment option.4 This paper will review recent advances in the approaches and outcomes of AF ablation. PMID:19411729

  4. Epicardial Ablation For Ventricular Tachycardia

    PubMed Central

    Maccabelli, Giuseppe; Mizuno, Hiroya; Della Bella, Paolo

    2012-01-01

    Epicardial ablation has lately become a necessary tool to approach some ventricular tachycardias in different types of cardiomyopathy. Its diffusion is now limited to a few high volume centers not because of the difficulty of the pericardial puncture but since it requires high competence not only in the VT ablation field but also in knowing and recognizing the possible complications each of which require a careful treatment. This article will review the state of the art of epicardial ablation with special attention to the procedural aspects and to the possible selection criteria of the patients PMID:23233758

  5. [Percutaneous ablation of renal tumors: radiofrequency ablation or cryoablation?].

    PubMed

    Buy, X; Lang, H; Garnon, J; Gangi, A

    2011-09-01

    Percutaneous ablation of renal tumors, including radiofrequency ablation and cryoablation, are increasingly being used for small tumors as an alternative to surgery for poor surgical candidates. Compared to radiofrequency ablation, cryoablation has several advantages: improved volume control and preservation of adjacent structures due to the excellent depiction of the ice ball on CT and MRI; better protection of the collecting system for central tumor with reduced risk of postprocedural urinary fistula. The main pitfall of cryoablation is the higher cost. Therefore, cryoablation should be reserved for the treatment of complex tumors. In this article, we will review the different steps of percutaneous renal tumor ablation procedures including patient selection, technical considerations, and follow-up imaging. PMID:21944236

  6. Chinese expert consensus workshop report: Guidelines for thermal ablation of primary and metastatic lung tumors.

    PubMed

    Ye, Xin; Fan, Weijun; Chen, Jun-Hui; Feng, Wei-Jian; Gu, Shan-Zhi; Han, Yue; Huang, Guang-Hui; Lei, Guang-Yan; Li, Xiao-Guang; Li, Yu-Liang; Li, Zhen-Jia; Lin, Zheng-Yu; Liu, Bao-Dong; Liu, Ying; Peng, Zhong-Min; Wang, Hui; Yang, Wu-Wei; Yang, Xia; Zhai, Bo; Zhang, Jun

    2015-01-01

    Although surgical resection is the primary means of curing both primary and metastatic lung cancers, about 80% of lung cancers cannot be removed by surgery. As most patients with unresectable lung cancer receive only limited benefits from traditional radiotherapy and chemotherapy, many new local treatment methods have emerged, including local ablation therapy. The Minimally Invasive and Comprehensive Treatment of Lung Cancer Branch, Professional Committee of Minimally Invasive Treatment of Cancer of the Chinese Anti-Cancer Association has organized multidisciplinary experts to develop guidelines for this treatment modality. These guidelines aim at standardizing thermal ablation procedures and criteria for selecting treatment candidates and assessing outcomes; and for preventing and managing post-ablation complications. PMID:26273346

  7. Chinese expert consensus workshop report: Guidelines for thermal ablation of primary and metastatic lung tumors

    PubMed Central

    Ye, Xin; Fan, Weijun; Chen, Jun-hui; Feng, Wei-jian; Gu, Shan-zhi; Han, Yue; Huang, Guang-hui; Lei, Guang-yan; Li, Xiao-guang; Li, Yu-liang; Li, Zhen-jia; Lin, Zheng-yu; Liu, Bao-dong; Liu, Ying; Peng, Zhong-min; Wang, Hui; Yang, Wu-wei; Yang, Xia; Zhai, Bo; Zhang, Jun

    2015-01-01

    Although surgical resection is the primary means of curing both primary and metastatic lung cancers, about 80% of lung cancers cannot be removed by surgery. As most patients with unresectable lung cancer receive only limited benefits from traditional radiotherapy and chemotherapy, many new local treatment methods have emerged, including local ablation therapy. The Minimally Invasive and Comprehensive Treatment of Lung Cancer Branch, Professional Committee of Minimally Invasive Treatment of Cancer of the Chinese Anti-Cancer Association has organized multidisciplinary experts to develop guidelines for this treatment modality. These guidelines aim at standardizing thermal ablation procedures and criteria for selecting treatment candidates and assessing outcomes; and for preventing and managing post-ablation complications. PMID:26273346

  8. Ion acceleration enhanced by target ablation

    SciTech Connect

    Zhao, S.; Lin, C. Wang, H. Y.; Lu, H. Y.; He, X. T.; Yan, X. Q.; Chen, J. E.; Cowan, T. E.

    2015-07-15

    Laser proton acceleration can be enhanced by using target ablation, due to the energetic electrons generated in the ablation preplasma. When the ablation pulse matches main pulse, the enhancement gets optimized because the electrons' energy density is highest. A scaling law between the ablation pulse and main pulse is confirmed by the simulation, showing that for given CPA pulse and target, proton energy improvement can be achieved several times by adjusting the target ablation.

  9. TPS Ablator Technologies for Interplanetary Spacecraft

    NASA Technical Reports Server (NTRS)

    Curry, Donald M.

    2004-01-01

    This slide presentation reviews the status of Thermal Protection System (TPS) Ablator technologies and the preparation for use in interplanetary spacecraft. NASA does not have adequate TPS ablatives and sufficient selection for planned missions. It includes a comparison of shuttle and interplanetary TPS requirements, the status of mainline TPS charring ablator materials, a summary of JSC SBIR accomplishments in developing advanced charring ablators and the benefits of SBIR Ablator/fabrication technology.

  10. Cryoballoon Ablation for Atrial Fibrillation

    PubMed Central

    Andrade, Jason G; Dubuc, Marc; Guerra, Peter G; Macle, Laurent; Rivard, Lena; Roy, Denis; Talajic, Mario; Thibault, Bernard; Khairy, Paul

    2012-01-01

    Focal point-by-point radiofrequency catheter ablation has shown considerable success in the treatment of paroxysmal atrial fibrillation. However, it is not without limitations. Recent clinical and preclinical studies have demonstrated that cryothermal ablation using a balloon catheter (Artic Front©, Medtronic CryoCath LP) provides an effective alternative strategy to treating atrial fibrillation. The objective of this article is to review efficacy and safety data surrounding cryoballoon ablation for paroxysmal and persistent atrial fibrillation. In addition, a practical step-by-step approach to cryoballoon ablation is presented, while highlighting relevant literature regarding: 1) the rationale for adjunctive imaging, 2) selection of an appropriate cryoballoon size, 3) predictors of efficacy, 4) advanced trouble-shooting techniques, and 5) strategies to reduce procedural complications, such as phrenic nerve palsy. PMID:22557842

  11. Recruitment in Radiotherapy

    ERIC Educational Resources Information Center

    Deeley, T. J.; And Others

    1976-01-01

    The Faculty Board of Radiotherapy and Oncology of the Royal College of Radiobiologists surveyed the factors thought to influence recruitment into the specialty. Possible factors listed in replies of 36 questionnaires are offered. (LBH)

  12. Laser ablation in analytical chemistry.

    PubMed

    Russo, Richard E; Mao, Xianglei; Gonzalez, Jhanis J; Zorba, Vassilia; Yoo, Jong

    2013-07-01

    In 2002, we wrote an Analytical Chemistry feature article describing the Physics of Laser Ablation in Microchemical Analysis. In line with the theme of the 2002 article, this manuscript discusses current issues in fundamental research, applications based on detecting photons at the ablation site (LIBS and LAMIS) and by collecting particles for excitation in a secondary source (ICP), and directions for the technology. PMID:23614661

  13. Bone and Soft Tissue Ablation

    PubMed Central

    Foster, Ryan C.B.; Stavas, Joseph M.

    2014-01-01

    Bone and soft tissue tumor ablation has reached widespread acceptance in the locoregional treatment of various benign and malignant musculoskeletal (MSK) lesions. Many principles of ablation learned elsewhere in the body are easily adapted to the MSK system, particularly the various technical aspects of probe/antenna design, tumoricidal effects, selection of image guidance, and methods to reduce complications. Despite the common use of thermal and chemical ablation procedures in bone and soft tissues, there are few large clinical series that show longitudinal benefit and cost-effectiveness compared with conventional methods, namely, surgery, external beam radiation, and chemotherapy. Percutaneous radiofrequency ablation of osteoid osteomas has been evaluated the most and is considered a first-line treatment choice for many lesions. Palliation of painful metastatic bone disease with thermal ablation is considered safe and has been shown to reduce pain and analgesic use while improving quality of life for cancer patients. Procedure-related complications are rare and are typically easily managed. Similar to all interventional procedures, bone and soft tissue lesions require an integrated approach to disease management to determine the optimum type of and timing for ablation techniques within the context of the patient care plan. PMID:25053865

  14. Bone and soft tissue ablation.

    PubMed

    Foster, Ryan C B; Stavas, Joseph M

    2014-06-01

    Bone and soft tissue tumor ablation has reached widespread acceptance in the locoregional treatment of various benign and malignant musculoskeletal (MSK) lesions. Many principles of ablation learned elsewhere in the body are easily adapted to the MSK system, particularly the various technical aspects of probe/antenna design, tumoricidal effects, selection of image guidance, and methods to reduce complications. Despite the common use of thermal and chemical ablation procedures in bone and soft tissues, there are few large clinical series that show longitudinal benefit and cost-effectiveness compared with conventional methods, namely, surgery, external beam radiation, and chemotherapy. Percutaneous radiofrequency ablation of osteoid osteomas has been evaluated the most and is considered a first-line treatment choice for many lesions. Palliation of painful metastatic bone disease with thermal ablation is considered safe and has been shown to reduce pain and analgesic use while improving quality of life for cancer patients. Procedure-related complications are rare and are typically easily managed. Similar to all interventional procedures, bone and soft tissue lesions require an integrated approach to disease management to determine the optimum type of and timing for ablation techniques within the context of the patient care plan. PMID:25053865

  15. Radiofrequency Ablation to Prevent Sudden Cardiac Death

    PubMed Central

    Atoui, Moustapha; Gunda, Sampath; Lakkireddy, Dhanunjaya; Mahapatra, Srijoy

    2015-01-01

    Radiofrequency ablation may prevent or treat atrial and ventricular arrhythmias. Since some of these arrhythmias are associated with sudden cardiac death, it has been hypothesized that ablation may prevent sudden death in certain cases. We performed a literature search to better understand under which circumstances ablation may prevent sudden death and found little randomized data demonstrating the long-term effects of ablation. Current literature shows that ablation clearly prevents symptoms of arrhythmia and may reduce the incidence of sudden cardiac death in select patients, although data does not indicate improved mortality. Ongoing clinical trials are needed to better define the role of ablation in preventing sudden cardiac death. PMID:26306130

  16. Stereotactic body radiation therapy in stage I inoperable lung cancer: from palliative to curative options.

    PubMed

    Boujelbene, Noureddine; Elloumi, Fatma; Kamel, Mohamed E; Abeidi, Hamdi; Matzinger, Oscar; Mirimanoff, René-Olivier; Khanfir, Kaouthar

    2013-01-01

    Surgery has historically been the standard of care for operable stage I non-small cell lung cancer (NSCLC). However, nearly one-quarter of patients with stage I NSCLC will not undergo surgery because of medical comorbidity or other factors. Stereotactic ablative radiotherapy (SABR) is the new standard of care for these patients. SABR offers high local tumour control rates rivalling the historical results of surgery and is generally well tolerated by patients with both peripheral and centrally located tumours. This article reviews the history of SABR for stage I NSCLC, summarises the currently available data on efficacy and toxicity, and describes some of the currently controversial aspects of this treatment. PMID:23740331

  17. Current Hot Potatoes in Atrial Fibrillation Ablation

    PubMed Central

    Roten, Laurent; Derval, Nicolas; Pascale, Patrizio; Scherr, Daniel; Komatsu, Yuki; Shah, Ashok; Ramoul, Khaled; Denis, Arnaud; Sacher, Frédéric; Hocini, Mélèze; Haïssaguerre, Michel; Jaïs, Pierre

    2012-01-01

    Atrial fibrillation (AF) ablation has evolved to the treatment of choice for patients with drug-resistant and symptomatic AF. Pulmonary vein isolation at the ostial or antral level usually is sufficient for treatment of true paroxysmal AF. For persistent AF ablation, drivers and perpetuators outside of the pulmonary veins are responsible for AF maintenance and have to be targeted to achieve satisfying arrhythmia-free success rate. Both complex fractionated atrial electrogram (CFAE) ablation and linear ablation are added to pulmonary vein isolation for persistent AF ablation. Nevertheless, ablation failure and necessity of repeat ablations are still frequent, especially after persistent AF ablation. Pulmonary vein reconduction is the main reason for arrhythmia recurrence after paroxysmal and to a lesser extent after persistent AF ablation. Failure of persistent AF ablation mostly is a consequence of inadequate trigger ablation, substrate modification or incompletely ablated or reconducting linear lesions. In this review we will discuss these points responsible for AF recurrence after ablation and review current possibilities on how to overcome these limitations. PMID:22920482

  18. Thermal response and ablation characteristics of lightweight ceramic ablators

    SciTech Connect

    Tran, H.K.; Rasky, D.J.; Esfahani, L.

    1994-11-01

    This paper presents the thermal performance and ablation characteristics of the newly developed lightweight ceramic ablators (LCAs) in a supersonic, high-enthalpy convective environment. Lightweight ceramic ablators were recently conceived and developed at NASA Ames using low-density ceramic or carbon fibrous matrices as substrates for main structural support and organic resins as fillers. These LCAs were successfully produced with densities ranging from approximately 0.224 to 1.282 g/cu cm. Several infiltrants with different char yields were used to study the effect on surface recession. Tests were conducted in the NASA Ames arc-jet facilities. Material thermal performance was evaluated at cold-wall heat fluxes from 113.5 to 1634 W/sq cm, and stagnation pressures of 0.018 to 0.331 atm. Conventional ablators such as SLA-561, Avcoat 5026-39HC, MA-25S, and balsa wood were tested at the same heat fluxes for direct comparison. Surface temperature was measured using optical pyrometers, and the recession rates were obtained from the high-speed films. In-depth temperature data were obtained to determine the thermal penetration depths and conductivity. Preliminary results indicated that most LCAs performed comparably to or better than conventional ablators. At low flux levels (less than 454 W/sq cm), the addition of silicon carbide and polymethyl methacrylate significantly improved the ablation performance of silica substrates. The carbon-based LCAs were the most mass-efficient at high flux levels (greater than 454 W/sq cm). 16 refs.

  19. Fragmentation and ablation during entry

    SciTech Connect

    Canavan, G.H.

    1997-09-01

    This note discusses objects that both fragment and ablate during entry, using the results of previous reports to describe the velocity, pressure, and fragmentation of entering objects. It shows that the mechanisms used there to describe the breakup of non-ablating objects during deceleration remain valid for most ablating objects. It treats coupled fragmentation and ablation during entry, building on earlier models that separately discuss the entry of objects that are hard, whose high heat of ablation permits little erosion, and those who are strong whose strength prevents fragmentation, which are discussed in ``Radiation from Hard Objects,`` ``Deceleration and Radiation of Strong, Hard, Asteroids During Atmospheric Impact,`` and ``Meteor Signature Interpretation.`` This note provides a more detailed treatment of the further breakup and separation of fragments during descent. It replaces the constraint on mass per unit area used earlier to determine the altitude and magnitude of peak power radiation with a detailed analytic solution of deceleration. Model predictions are shown to be in agreement with the key features of numerical calculations of deceleration. The model equations are solved for the altitudes of maximum radiation, which agree with numerical integrations. The model is inverted analytically to infer object size and speed from measurements of peak power and altitude to provide a complete model for the approximate inversion of meteor data.

  20. Laser ablation studies of concrete

    SciTech Connect

    Savina, M.; Xu, Z.; Wang, Y.; Reed, C.; Pellin, M.

    1999-10-20

    Laser ablation was studied as a means of removing radioactive contaminants from the surface and near-surface regions of concrete. The authors present the results of ablation tests on cement and concrete samples using a 1.6 kW pulsed Nd:YAG laser with fiber optic beam delivery. The laser-surface interaction was studied using cement and high density concrete as targets. Ablation efficiency and material removal rates were determined as functions of irradiance and pulse overlap. Doped samples were also ablated to determine the efficiency with which surface contaminants were removed and captured in the effluent. The results show that the cement phase of the material melts and vaporizes, but the aggregate portion (sand and rock) fragments. The effluent consists of both micron-size aerosol particles and chunks of fragmented aggregate material. Laser-induced optical emission spectroscopy was used to analyze the surface during ablation. Analysis of the effluent showed that contaminants such as cesium and strontium were strongly segregated into different regions of the particle size distribution of the aerosol.

  1. Femtosecond laser ablation of enamel

    NASA Astrophysics Data System (ADS)

    Le, Quang-Tri; Bertrand, Caroline; Vilar, Rui

    2016-06-01

    The surface topographical, compositional, and structural modifications induced in human enamel by femtosecond laser ablation is studied. The laser treatments were performed using a Yb:KYW chirped-pulse-regenerative amplification laser system (560 fs and 1030 nm) and fluences up to 14 J/cm2. The ablation surfaces were studied by scanning electron microscopy, grazing incidence x-ray diffraction, and micro-Raman spectroscopy. Regardless of the fluence, the ablation surfaces were covered by a layer of resolidified material, indicating that ablation is accompanied by melting of hydroxyapatite. This layer presented pores and exploded gas bubbles, created by the release of gaseous decomposition products of hydroxyapatite (CO2 and H2O) within the liquid phase. In the specimen treated with 1-kHz repetition frequency and 14 J/cm2, thickness of the resolidified material is in the range of 300 to 900 nm. The micro-Raman analysis revealed that the resolidified material contains amorphous calcium phosphate, while grazing incidence x-ray diffraction analysis allowed detecting traces of a calcium phosphate other than hydroxyapatite, probably β-tricalcium phosphate Ca3), at the surface of this specimen. The present results show that the ablation of enamel involves melting of enamel's hydroxyapatite, but the thickness of the altered layer is very small and thermal damage of the remaining material is negligible.

  2. [Radiotherapy of larynx cancers].

    PubMed

    Pointreau, Y; Lafond, C; Legouté, F; Trémolières, P; Servagi-Vernat, S; Giraud, P; Maingon, P; Calais, G; Lapeyre, M

    2016-09-01

    Intensity-modulated radiotherapy is the gold standard in the treatment of larynx cancers (except T1 glottic tumour). Early T1 and T2 tumours may be treated by exclusive radiation or surgery. For tumours requiring total laryngectomy (T2 or T3), induction chemotherapy followed by exclusive radiotherapy or concurrent chemoradiotherapy is possible. For T4 tumour, surgery must be proposed. The treatment of lymph nodes is based on the initial treatment of the primary tumour. In non-surgical procedure, in case of sequential radiotherapy, the curative dose is 70Gy and the prophylactic dose is 50Gy. An integrated simultaneous boost radiotherapy is allowed (70Gy in 2Gy per fraction and 56Gy in 1.8Gy per fraction or 70Gy in 2.12Gy per fraction). Postoperatively, radiotherapy is used in locally advanced cancer with dose levels based on pathologic criteria (66Gy for R1 resection, 50 to 54Gy for complete resection). Volume delineation was based on guidelines. PMID:27521037

  3. Radiotherapy of malignant melanoma

    SciTech Connect

    Cooper, J.S.

    1985-04-01

    The role of radiotherapy in the treatment of malignant melanoma is limited, and surgery generally forms the mainstay of medical practice. However, there are some circumstances in which radiotherapy should be considered the treatment of choice. Symptomatic metastatic lesions in bone or brain can effectively be palliated in a substantial proportion of instances. At the current stage of our knowledge, conventionally fractionated treatment of such lesions forms the standard against which other treatments should be measured. In contrast, metastatic lesions to skin or lymph nodes that do not overlie critical normal structures probably are better treated by high-dose-per-fraction techniques. Radiotherapy may play a definitive role in the treatment of lentigo maligna. The precise optimal energy of the beam to be used remains to be defined. Slightly more penetrating radiation appears to be required for lentigo maligna melanomas. Here, too, the optimal energy remains to be defined. The treatment of nonlentigenous melanomas primarily by radiotherapy is unproved in my opinion. Certainly, the data from the Princess Margaret Hospital is exciting, but I believe it must be corroborated by a well-designed trial before it can be accepted without question. Future directions in treatment of malignant melanoma are likely to include further trials of unconventional fractionation and the use of radiosensitizing agents in conjunction with radiotherapy. The time for dermatologists and radiation therapists to cooperate in such studies is at hand.

  4. [Prostate cancer external beam radiotherapy].

    PubMed

    de Crevoisier, R; Pommier, P; Latorzeff, I; Chapet, O; Chauvet, B; Hennequin, C

    2016-09-01

    The prostate external beam radiotherapy techniques are described, when irradiating the prostate or after prostatectomy, with and without pelvic lymph nodes. The following parts are presented: indications of radiotherapy, total dose and fractionation, planning CT image acquisition, volume of interest delineation (target volumes and organs at risk) and margins, Intensity modulated radiotherapy planning and corresponding dose-volume constraints, and finally Image guided radiotherapy. PMID:27516051

  5. Radiotherapy of inoperable lung cancer

    SciTech Connect

    Namer, M.; Lalanne, C.M.; Boublil, J.L.; Hery, M.; Chauvel, P.; Verschoore, J.; Aubanel, J.M.; Bruneton, J.N.

    1980-08-01

    Evaluation of loco-regional results obtained by radiotherapy for 31 patients with inoperable epidermoid lung cancer revealed objective remission (over 50%) in only 25% of patients. These results emphasize the limited effectiveness of radiotherapy in such cases and point out the need for increased research in radiotherapy techniques if survival rates are to be improved.

  6. A Review of Mitral Isthmus Ablation

    PubMed Central

    Wong, Kelvin CK; Betts, Timothy R

    2012-01-01

    Mitral isthmus ablation forms part of the electrophysiologist’s armoury in the catheter ablation treatment of atrial fibrillation. It is well recognised however, that mitral isthmus ablation is technically challenging and incomplete ablation may be pro-arrhythmic, leading some to question its role. This article first reviews the evidence for the use of adjunctive mitral isthmus ablation and its association with the development of macroreentrant perimitral flutter. It then describes the practical techniques of mitral isthmus ablation, with particular emphasis on the assessment of bi-directional mitral isthmus block. The anatomy of the mitral isthmus is also discussed in order to understand the possible obstacles to successful ablation. Finally, novel techniques which may facilitate mitral isthmus ablation are reviewed. PMID:22912536

  7. [Radiotherapy for brain metastases].

    PubMed

    Latorzeff, I; Antoni, D; Gaudaire-Josset, S; Feuvret, L; Tallet-Richard, A; Truc, G; Noël, G

    2016-09-01

    Radiotherapy for brain metastases has become more multifaceted. Indeed, with the improvement of the patient's life expectancy, side effects must be undeniably avoided and the retreatments or multiple treatments are common. The cognitive side effects should be warned and the most modern techniques of radiation therapy are used regularly to reach this goal. The new classifications of patients with brain metastases help guiding treatment more appropriately. Stereotactic radiotherapy has supplanted whole brain radiation therapy both for patients with metastases in place and for those who underwent surgery. Hippocampus protection is possible with intensity-modulated radiotherapy. Its relevance in terms of cognitive functioning should be more clearly demonstrated but the requirement, for using it, is increasingly strong. While addressing patients in palliative phase, the treatment of brain metastases is one of the localisations where technical thinking is the most challenging. PMID:27523410

  8. [Radiotherapy in Europe].

    PubMed

    Verheij, M; Slotman, B J

    2016-01-01

    Radiotherapy plays an important part in the curing of cancer patients and is an effective treatment for tumour-related symptoms. However, in many countries the level of access to this treatment modality is unacceptably low due to shortage of infrastructure, modern apparatus and trained staff. In Europe it is mainly the Eastern European countries that are behind in the provision of and accessibility to radiotherapy. Worldwide investment to narrow the gap would put an end to these undesirable differences. In addition, these investments would deliver economic benefits, especially in low-to-middle income countries. In this article, on the basis of a number of recently published reports, we discuss the differences that exist in the geographical spread of radiotherapy departments and the availability of apparatus within Europe. In conclusion we also take a short look at the Dutch situation. PMID:27334085

  9. Femtosecond lasers for machining of transparent, brittle materials: ablative vs. non-ablative femtosecond laser processing

    NASA Astrophysics Data System (ADS)

    Hendricks, F.; Matylitsky, V. V.

    2016-03-01

    This paper focuses on precision machining of transparent materials by means of ablative and non-ablative femtosecond laser processing. Ablation technology will be compared with a newly developed patent pending non-ablative femtosecond process, ClearShapeTM, using the Spectra-Physics Spirit industrial femtosecond laser.

  10. Microwave ablation of hepatocellular carcinoma

    PubMed Central

    Poggi, Guido; Tosoratti, Nevio; Montagna, Benedetta; Picchi, Chiara

    2015-01-01

    Although surgical resection is still the optimal treatment option for early-stage hepatocellular carcinoma (HCC) in patients with well compensated cirrhosis, thermal ablation techniques provide a valid non-surgical treatment alternative, thanks to their minimal invasiveness, excellent tolerability and safety profile, proven efficacy in local disease control, virtually unlimited repeatability and cost-effectiveness. Different energy sources are currently employed in clinics as physical agents for percutaneous or intra-surgical thermal ablation of HCC nodules. Among them, radiofrequency (RF) currents are the most used, while microwave ablations (MWA) are becoming increasingly popular. Starting from the 90s’, RF ablation (RFA) rapidly became the standard of care in ablation, especially in the treatment of small HCC nodules; however, RFA exhibits substantial performance limitations in the treatment of large lesions and/or tumors located near major heat sinks. MWA, first introduced in the Far Eastern clinical practice in the 80s’, showing promising results but also severe limitations in the controllability of the emitted field and in the high amount of power employed for the ablation of large tumors, resulting in a poor coagulative performance and a relatively high complication rate, nowadays shows better results both in terms of treatment controllability and of overall coagulative performance, thanks to the improvement of technology. In this review we provide an extensive and detailed overview of the key physical and technical aspects of MWA and of the currently available systems, and we want to discuss the most relevant published data on MWA treatments of HCC nodules in regard to clinical results and to the type and rate of complications, both in absolute terms and in comparison with RFA. PMID:26557950

  11. Surgical Ablation of Atrial Fibrillation.

    PubMed

    Ramlawi, Basel; Abu Saleh, Walid K

    2015-01-01

    The Cox-maze procedure for the restoration of normal sinus rhythm, initially developed by Dr. James Cox, underwent several iterations over the years. The main concept consists of creating a series of transmural lesions in the right and left atria that disrupt re-entrant circuits responsible for propagating the abnormal atrial fibrillation rhythm. The left atrial appendage is excluded as a component of the Maze procedure. For the first three iterations of the Cox- maze procedure, these lesions were performed using a surgical cut-and-sew approach that ensured transmurality. The Cox-Maze IV is the most currently accepted iteration. It achieves the same lesion set of the Cox- maze III but uses alternative energy sources to create the transmural lesions, potentially in a minimally invasive approach on the beating heart. High-frequency ultrasound, microwave, and laser energy have all been used with varying success in the past. Today, bipolar radiofrequency heat or cryotherapy cooling are the most accepted sources for creating linear lesions with consistent safety and transmurality. The robust and reliable nature of these energy delivery methods has yielded a success rate reaching 90% freedom from atrial fibrillation at 12 months. Such approaches offer a significant long-term advantage over catheter-based ablation, especially in patients having longstanding, persistent atrial fibrillation with characteristics such as dilated left atrial dimensions, poor ejection fraction, and failed catheter ablation. Based on these improved results, there currently is significant interest in developing a hybrid ablation strategy that incorporates the superior transmural robust lesions of surgical ablation, the reliable stroke prevention potential of epicardial left atrial appendage exclusion, and sophisticated mapping and confirmatory catheter-based ablation technology. Such a minimally invasive hybrid strategy for ablation may lead to the development of multidisciplinary "Afib teams" to

  12. Thermal Ablation of Lung Tumors

    PubMed Central

    Sonntag, P. David; Hinshaw, J. Louis; Lubner, Meghan G.; Brace, Christopher L.; Lee, Fred T.

    2011-01-01

    Lung cancer remains the leading cause of cancer death in the United States, accounting for an estimated 29% of cancer deaths in 2009.1 Pneumonectomy or lobectomy with hilar and mediastinal lymph node sampling is the gold standard treatment and offers the best option for cure of stage 1/2 nonsmall cell lung cancer (NSCLC).2 Unfortunately, only 15% of patients present with stage 1/2 disease, and many of these patients do not meet the pulmonary physiologic guidelines for lobar resection.3 In addition to lung cancer, pulmonary metastases are present in 25% to 30% of patients dying from all types of cancer.4 For some patients with oligometastatic pulmonary disease, metastectomy is associated with an improvement in survival.5 External beam radiation traditionally has been offered as the alternative to surgical resection for NSCLC or pulmonary metastatic disease. Unfortunately, the 5-year survival following radiation for stage 1 and 2 NSCLC remains low at 15% to 20%, with local recurrence being the most common mode of failure.6,7 Thermal ablation offers an intriguing therapeutic option to increase local tumor control and survival in patients with early stage NSCLC or with limited metastatic disease from nonlung primaries who are not surgical candidates because of poor cardiopulmonary reserve, anatomic constraints limiting resection, failure of traditional therapies, or refusal of operative approaches. Thermal ablation has been shown to be effective in treating tumors in bone, kidney, and liver.8–11 Most preclinical and clinical trials have focused on demonstrating the feasibility of three modalities for pulmonary thermal ablation, namely radiofrequency (RF) ablation, microwave (MW) ablation, and cryoablation. This article discusses the unique challenges of performing thermal ablation in lung tissue and reviews the current literature regarding RF, MW, and cryoablation in the lung. PMID:21377589

  13. Microwave ablation of hepatocellular carcinoma.

    PubMed

    Poggi, Guido; Tosoratti, Nevio; Montagna, Benedetta; Picchi, Chiara

    2015-11-01

    Although surgical resection is still the optimal treatment option for early-stage hepatocellular carcinoma (HCC) in patients with well compensated cirrhosis, thermal ablation techniques provide a valid non-surgical treatment alternative, thanks to their minimal invasiveness, excellent tolerability and safety profile, proven efficacy in local disease control, virtually unlimited repeatability and cost-effectiveness. Different energy sources are currently employed in clinics as physical agents for percutaneous or intra-surgical thermal ablation of HCC nodules. Among them, radiofrequency (RF) currents are the most used, while microwave ablations (MWA) are becoming increasingly popular. Starting from the 90s', RF ablation (RFA) rapidly became the standard of care in ablation, especially in the treatment of small HCC nodules; however, RFA exhibits substantial performance limitations in the treatment of large lesions and/or tumors located near major heat sinks. MWA, first introduced in the Far Eastern clinical practice in the 80s', showing promising results but also severe limitations in the controllability of the emitted field and in the high amount of power employed for the ablation of large tumors, resulting in a poor coagulative performance and a relatively high complication rate, nowadays shows better results both in terms of treatment controllability and of overall coagulative performance, thanks to the improvement of technology. In this review we provide an extensive and detailed overview of the key physical and technical aspects of MWA and of the currently available systems, and we want to discuss the most relevant published data on MWA treatments of HCC nodules in regard to clinical results and to the type and rate of complications, both in absolute terms and in comparison with RFA. PMID:26557950

  14. Radiotherapy for lung cancer

    SciTech Connect

    Bleehen, N.M.; Cox, J.D.

    1985-05-01

    The role of radiation therapy in the management of lung cancer was reviewed at a workshop held in Cambridge, England, in June 1984. It was concluded that there was a continuing role for radiation therapy in the primary management of small cell lung cancer, including the loco-regional treatment for patients with limited disease. Radical radiotherapy for patients with non-small cell carcinoma could be curative for a proportion of patients with limited disease. Careful planning and quality control was essential. Palliative radiotherapy provided useful treatment for many other patients. Other related aspects of treatment are also presented.

  15. Transhemangioma Ablation of Hepatocellular Carcinoma

    SciTech Connect

    Pua, Uei

    2012-12-15

    Radiofrequency ablation (RFA) is a well-established treatment modality in the treatment of early hepatocellular carcinoma (HCC) [1]. Safe trajectory of the RFA probe is crucial in decreasing collateral tissue damage and unwarranted probe transgression. As a percutaneous technique, however, the trajectory of the needle is sometimes constrained by the available imaging plane. The presence of a hemangioma beside an HCC is uncommon but poses the question of safety related to probe transgression. We hereby describe a case of transhemangioma ablation of a dome HCC.

  16. Laser ablation of human tooth

    NASA Astrophysics Data System (ADS)

    Franklin, Sushmita R.; Chauhan, P.; Mitra, A.; Thareja, R. K.

    2005-05-01

    We report the measurements of ablation threshold of human tooth in air using photo-thermal deflection technique. A third harmonic (355nm) of Nd:YAG (yttrium aluminum garnet) laser was used for irradiation and a low power helium neon laser as a probe beam. The experimental observations of ablation threshold in conjunction with theoretical model based on heat conduction equations for simulating the interaction of a laser radiation with a calcified tissue are used to estimate the absorption coefficient of human tooth.

  17. Tektite ablation - Some confirming calculations.

    NASA Technical Reports Server (NTRS)

    O'Keefe, J. A., III; Silver, A. D.; Cameron, W. S.; Adams , E. W.; Warmbrod, J. D.

    1973-01-01

    The calculation of tektite ablation has been redone, taking into account transient effects, internal radiation, melting and nonequilibrium vaporization of the glass, and the drag effect of the flanges. It is found that the results confirm the earlier calculations of Chapman and his group and of Adams and his co-workers. The general trend of the results is not sensitive to reasonable changes of the physical parameters. The ablation is predominantly by melting rather than by vaporization at all velocities up to 11 km/sec; this is surprising in view of the lack of detectable melt flow in most tektites. Chemical effects have not been considered.

  18. Ablative Therapies for Barrett's Esophagus

    PubMed Central

    Garman, Katherine S.; Shaheen, Nicholas J.

    2011-01-01

    Barrett's esophagus has gained increased clinical attention because of its association with esophageal adenocarcinoma, a cancer with increasing incidence and poor survival rates. The goals of ablating Barrett's esophagus are to decrease esophageal cancer rates and to improve overall survival and quality of life. Different techniques have been developed and tested for their effectiveness eradicating Barrett's epithelium. This review assesses the literature associated with different ablative techniques. The safety and efficacy of different techniques are discussed. This review concludes with recommendations for the clinician, including specific strategies for patient care decisions for patients with Barrett's esophagus with varying degrees of dysplasia. PMID:21373836

  19. Laser ablation based fuel ignition

    DOEpatents

    Early, J.W.; Lester, C.S.

    1998-06-23

    There is provided a method of fuel/oxidizer ignition comprising: (a) application of laser light to a material surface which is absorptive to the laser radiation; (b) heating of the material surface with the laser light to produce a high temperature ablation plume which emanates from the heated surface as an intensely hot cloud of vaporized surface material; and (c) contacting the fuel/oxidizer mixture with the hot ablation cloud at or near the surface of the material in order to heat the fuel to a temperature sufficient to initiate fuel ignition. 3 figs.

  20. Laser ablation based fuel ignition

    DOEpatents

    Early, James W.; Lester, Charles S.

    1998-01-01

    There is provided a method of fuel/oxidizer ignition comprising: (a) application of laser light to a material surface which is absorptive to the laser radiation; (b) heating of the material surface with the laser light to produce a high temperature ablation plume which emanates from the heated surface as an intensely hot cloud of vaporized surface material; and (c) contacting the fuel/oxidizer mixture with the hot ablation cloud at or near the surface of the material in order to heat the fuel to a temperature sufficient to initiate fuel ignition.

  1. Atrial Fibrillation Ablation and Stroke.

    PubMed

    Aagaard, Philip; Briceno, David; Csanadi, Zoltan; Mohanty, Sanghamitra; Gianni, Carola; Trivedi, Chintan; Nagy-Baló, Edina; Danik, Stephan; Barrett, Conor; Santoro, Francesco; Burkhardt, J David; Sanchez, Javier; Natale, Andrea; Di Biase, Luigi

    2016-05-01

    Catheter ablation has become a widely available and accepted treatment to restore sinus rhythm in atrial fibrillation patients who fail antiarrhythmic drug therapy. Although generally safe, the procedure carries a non-negligible risk of complications, including periprocedural cerebral insults. Uninterrupted anticoagulation, maintenance of an adequate ACT during the procedure, and measures to avoid and detect thrombus build-up on sheaths and atheters during the procedure, appears useful to reduce the risk of embolic events. This is a review of the incidence, mechanisms, impact, and methods to reduce catheter ablation related cerebral insults. PMID:27150179

  2. Radiofrequency ablation during continuous saline infusion can extend ablation margins

    PubMed Central

    Ishikawa, Toru; Kubota, Tomoyuki; Horigome, Ryoko; Kimura, Naruhiro; Honda, Hiroki; Iwanaga, Akito; Seki, Keiichi; Honma, Terasu; Yoshida, Toshiaki

    2013-01-01

    AIM: To determine whether fluid injection during radiofrequency ablation (RFA) can increase the coagulation area. METHODS: Bovine liver (1-2 kg) was placed on an aluminum tray with a return electrode affixed to the base, and the liver was punctured by an expandable electrode. During RFA, 5% glucose; 50% glucose; or saline fluid was infused continuously at a rate of 1.0 mL/min through the infusion line connected to the infusion port. The area and volume of the thermocoagulated region of bovine liver were determined after RFA. The Joule heat generated was determined from the temporal change in output during the RFA experiment. RESULTS: No liquid infusion was 17.3 ± 1.6 mL, similar to the volume of a 3-cm diameter sphere (14.1 mL). Mean thermocoagulated volume was significantly larger with continuous infusion of saline (29.3 ± 3.3 mL) than with 5% glucose (21.4 ± 2.2 mL), 50% glucose (16.5 ± 0.9 mL) or no liquid infusion (17.3 ± 1.6 mL). The ablated volume for RFA with saline was approximately 1.7-times greater than for RFA with no liquid infusion, representing a significant difference between these two conditions. Total Joule heat generated during RFA was highest with saline, and lowest with 50% glucose. CONCLUSION: RFA with continuous saline infusion achieves a large ablation zone, and may help inhibit local recurrence by obtaining sufficient ablation margins. RFA during continuous saline infusion can extend ablation margins, and may be prevent local recurrence. PMID:23483097

  3. Percutaneous Tumor Ablation with Radiofrequency

    PubMed Central

    Wood, Bradford J.; Ramkaransingh, Jeffrey R.; Fojo, Tito; Walther, McClellan M.; Libutti, Stephen K.

    2008-01-01

    BACKGROUND Radiofrequency thermal ablation (RFA) is a new minimally invasive treatment for localized cancer. Minimally invasive surgical options require less resources, time, recovery, and cost, and often offer reduced morbidity and mortality, compared with more invasive methods. To be useful, image-guided, minimally invasive, local treatments will have to meet those expectations without sacrificing efficacy. METHODS Image-guided, local cancer treatment relies on the assumption that local disease control may improve survival. Recent developments in ablative techniques are being applied to patients with inoperable, small, or solitary liver tumors, recurrent metachronous hereditary renal cell carcinoma, and neoplasms in the bone, lung, breast, and adrenal gland. RESULTS Recent refinements in ablation technology enable large tumor volumes to be treated with image-guided needle placement, either percutaneously, laparoscopically, or with open surgery. Local disease control potentially could result in improved survival, or enhanced operability. CONCLUSIONS Consensus indications in oncology are ill-defined, despite widespread proliferation of the technology. A brief review is presented of the current status of image-guided tumor ablation therapy. More rigorous scientific review, long-term follow-up, and randomized prospective trials are needed to help define the role of RFA in oncology. PMID:11900230

  4. Modern Advances in Ablative TPS

    NASA Technical Reports Server (NTRS)

    Venkatapathy, Ethiraj

    2013-01-01

    Topics covered include: Physics of Hypersonic Flow and TPS Considerations. Destinations, Missions and Requirements. State of the Art Thermal Protection Systems Capabilities. Modern Advances in Ablative TPS. Entry Systems Concepts. Flexible TPS for Hypersonic Inflatable Aerodynamic Decelerators. Conformal TPS for Rigid Aeroshell. 3-D Woven TPS for Extreme Entry Environment. Multi-functional Carbon Fabric for Mechanically Deployable.

  5. Photochemical Ablation of Organic Solids

    NASA Astrophysics Data System (ADS)

    Garrison, Barbara

    2004-03-01

    As discovered by Srinivasan in 1982, irradiation of materials by far UV laser light can lead to photochemical ablation, a process distinct from normal thermal ablation in which the laser primarily heats the material. A versatile mesoscopic model for molecular dynamics simulations of the laser ablation phenomena is presented. The model incorporates both the thermal and photochemical events, that is, both heating of the system and UV induced bond-cleavage followed by abstraction and radical-radical recombination reactions. The results from the simulations are compared to experimental data and the basic physics and chemistry for each irradiation regime are discussed. Initial results from polymer ablation simulations will be presented. L. V. Zhigilei, P. B. S. Kodali and B. J. Garrison, J. Phys. Chem. B, 102, 2845-2853 (1998); L. V. Zhigilei and B. J. Garrison, Journal of Applied Physics, 88, 1281-1298 (2000). Y. G. Yingling, L. V. Zhigilei and B. J. Garrison, J. Photochemistry and Photobiology A: Chemistry, 145, 173-181 (2001); Y. G. Yingling and B. J. Garrison, Chem. Phys. Lett., 364, 237-243 (2002).

  6. Electron Beam Ablation of Metals

    NASA Astrophysics Data System (ADS)

    Kovaleski, S. D.; Gilgenbach, R. M.; Rintamaki, J. I.; Ang, L. K.; Spindler, H. L.; Cohen, W. E.; Lau, Y. Y.; Lash, J. S.

    1996-10-01

    An experiment has recently been devised for material ablation using a channelspark electron beam. The ultimate goal of this experiment is to deposit thin films by electron beam ablation. The channelspark is a pseudospark device developed by Forschungszentrum Karlsruhe (G. Muller, C. Schultheiss, Proc. of Beams, 2, 833(1994)) for production of high current, low energy electron beams. The channelspark has the following operating parameters: a 15-20kV accelerating potential and measured source current of <2000A. Initial experiments have concentrated on characterizing ion-focused electron beam current transport through the necessary background fill gas (typically 5-50 mTorr of Argon). Ablation of Al, Fe, and Ti is being studied with spectroscopy and electron beam current diagnostics. Physical beam target damage is also being investigated and compared to laser ablated targets. Simulations of electron transport and energy deposition are being conducted via the ITS-TIGER code (Sandia Report No. SAND 91-1634) developed at Sandia National Laboratory.

  7. Photophysical ablation of porous silicon

    NASA Astrophysics Data System (ADS)

    Aksenov, Valerii P.; Mikhailova, G. N.

    2004-07-01

    Laser ablation of porous silicon as a function of laser wavelength and width of silicon nanowires was studied in our experiments. The time-resolved evolution of the cloud of the porous silicon particles produced by laser ablation is studied in situ by the analysis of the kinetics of photoluminescence signal. The laser ablation of porous silicon produced by pulses of 532 nm or 337 nm radiation with addition of synchronized power pulses of 1064 nm radiation. The cloud of the nanometer-sized silicon crystallites had the high enhancement of luminescence quantum efficiency in the red region of spectra. The slow PL kinetics component, which is due to the localized carriers, decays on a millisecond time scale. The squeezed electron-hole plasma heating by IR-laser radiation may produce a damage of silicon nanowires. The fragments of nanowires in cloud must be smaller, than the critical length. The energy of excitation of e-h pair in fragment with contribution of longitude quantum modes must be lower than energy of the excited photons. Particles with lesser length don't absorb excited laser radiation and don't damage. For this case we may speak about the quantum mechanism of laser ablation of nanowires.

  8. Cold Atmospheric Plasma for Selectively Ablating Metastatic Breast Cancer Cells

    PubMed Central

    Wang, Mian; Holmes, Benjamin; Cheng, Xiaoqian; Zhu, Wei; Keidar, Michael; Zhang, Lijie Grace

    2013-01-01

    Traditional breast cancer treatments such as surgery and radiotherapy contain many inherent limitations with regards to incomplete and nonselective tumor ablation. Cold atomospheric plasma (CAP) is an ionized gas where the ion temperature is close to room temperature. It contains electrons, charged particles, radicals, various excited molecules, UV photons and transient electric fields. These various compositional elements have the potential to either enhance and promote cellular activity, or disrupt and destroy them. In particular, based on this unique composition, CAP could offer a minimally-invasive surgical approach allowing for specific cancer cell or tumor tissue removal without influencing healthy cells. Thus, the objective of this research is to investigate a novel CAP-based therapy for selectively bone metastatic breast cancer treatment. For this purpose, human metastatic breast cancer (BrCa) cells and bone marrow derived human mesenchymal stem cells (MSCs) were separately treated with CAP, and behavioral changes were evaluated after 1, 3, and 5 days of culture. With different treatment times, different BrCa and MSC cell responses were observed. Our results showed that BrCa cells were more sensitive to these CAP treatments than MSCs under plasma dose conditions tested. It demonstrated that CAP can selectively ablate metastatic BrCa cells in vitro without damaging healthy MSCs at the metastatic bone site. In addition, our study showed that CAP treatment can significantly inhibit the migration and invasion of BrCa cells. The results suggest the great potential of CAP for breast cancer therapy. PMID:24040051

  9. Esophageal papilloma: Flexible endoscopic ablation by radiofrequency

    PubMed Central

    del Genio, Gianmattia; del Genio, Federica; Schettino, Pietro; Limongelli, Paolo; Tolone, Salvatore; Brusciano, Luigi; Avellino, Manuela; Vitiello, Chiara; Docimo, Giovanni; Pezzullo, Angelo; Docimo, Ludovico

    2015-01-01

    Squamous papilloma of the esophagus is a rare benign lesion of the esophagus. Radiofrequency ablation is an established endoscopic technique for the eradication of Barrett esophagus. No cases of endoscopic ablation of esophageal papilloma by radiofrequency ablation (RFA) have been reported. We report a case of esophageal papilloma successfully treated with a single session of radiofrequency ablation. Endoscopic ablation of the lesion was achieved by radiofrequency using a new catheter inserted through the working channel of endoscope. The esophageal ablated tissue was removed by a specifically designed cup. Complete ablation was confirmed at 3 mo by endoscopy with biopsies. This case supports feasibility and safety of as a new potential indication for BarrxTM RFA in patients with esophageal papilloma. PMID:25789102

  10. Role of radiotherapy in the management of hepatocellular carcinoma: A systematic review

    PubMed Central

    Kalogeridi, Maria-Aggeliki; Zygogianni, Anna; Kyrgias, George; Kouvaris, John; Chatziioannou, Sofia; Kelekis, Nikolaos; Kouloulias, Vassilis

    2015-01-01

    Many patients with hepatocellular carcinoma (HCC) present with advanced disease, not amenable to curative therapies such as surgery, transplantation or radiofrequency ablation. Treatment options for this group of patients include transarterial chemoembolization (TACE) and radiation therapy. Especially TACE, delivering a highly concentrated dose of chemotherapy to tumor cells while minimizing systemic toxicity of chemotherapy, has given favorable results on local control and survival. Radiotherapy, as a therapeutic modality of internal radiation therapy with radioisotopes, has also achieved efficacious tumor control in advanced disease. On the contrary, the role of external beam radiotherapy for HCC has been limited in the past, due to the low tolerance of surrounding normal liver parenchyma. However, technological innovations in the field of radiotherapy treatment planning and delivery, have provided the means of delivering radical doses to the tumor, while sparing normal tissues. Advanced and highly conformal radiotherapy approaches such as stereotactic body radiotherapy and proton therapy, evaluated for efficacy and safety for HCC, report encouraging results. In this review, we present the role of radiotherapy in hepatocellular carcinoma patients not suitable for radical treatment. PMID:25625001

  11. Stereotactic Ablative Radiation Therapy for Centrally Located Early Stage or Isolated Parenchymal Recurrences of Non-Small Cell Lung Cancer: How to Fly in a “No Fly Zone”

    SciTech Connect

    Chang, Joe Y.; Li, Qiao-Qiao; Xu, Qing-Yong; Allen, Pamela K.; Rebueno, Neal; Gomez, Daniel R.; Balter, Peter; Komaki, Ritsuko; Mehran, Reza; Swisher, Stephen G.; Roth, Jack A.

    2014-04-01

    Purpose: We extended our previous experience with stereotactic ablative radiation therapy (SABR; 50 Gy in 4 fractions) for centrally located non-small cell lung cancer (NSCLC); explored the use of 70 Gy in 10 fractions for cases in which dose-volume constraints could not be met with the previous regimen; and suggested modified dose-volume constraints. Methods and Materials: Four-dimensional computed tomography (4DCT)-based volumetric image-guided SABR was used for 100 patients with biopsy-proven, central T1-T2N0M0 (n=81) or isolated parenchymal recurrence of NSCLC (n=19). All disease was staged with positron emission tomography/CT; all tumors were within 2 cm of the bronchial tree, trachea, major vessels, esophagus, heart, pericardium, brachial plexus, or vertebral body. Endpoints were toxicity, overall survival (OS), local and regional control, and distant metastasis. Results: At a median follow-up time of 30.6 months, median OS time was 55.6 months, and the 3-year OS rate was 70.5%. Three-year cumulative actuarial local, regional, and distant control rates were 96.5%, 87.9%, and 77.2%, respectively. The most common toxicities were chest-wall pain (18% grade 1, 13% grade 2) and radiation pneumonitis (11% grade 2 and 1% grade 3). No patient experienced grade 4 or 5 toxicity. Among the 82 patients receiving 50 Gy in 4 fractions, multivariate analyses showed mean total lung dose >6 Gy, V{sub 20} >12%, or ipsilateral lung V{sub 30} >15% to independently predict radiation pneumonitis; and 3 of 9 patients with brachial plexus D{sub max} >35 Gy experienced brachial neuropathy versus none of 73 patients with brachial D{sub max} <35 Gy (P=.001). Other toxicities were analyzed and new dose-volume constraints are proposed. Conclusions: SABR for centrally located lesions produces clinical outcomes similar to those for peripheral lesions when normal tissue constraints are respected.

  12. Radiation Therapy for Oligometastatic Non-Small Cell Lung Cancer: Theory and Practice.

    PubMed

    Rusthoven, Chad G; Yeh, Norman; Gaspar, Laurie E

    2015-01-01

    Management paradigms for metastatic non-small cell lung cancer (mNSCLC) are evolving. Locally ablative therapies are now being increasingly integrated into combined-modality treatment strategies for mNSCLC patients with limited burdens of metastatic foci, termed oligometastases. Concurrently, techniques allowing for precise high-dose radiotherapy delivered over 1 to 5 total treatments, termed stereotactic body radiation therapy (SBRT) or stereotactic ablative radiation therapy (SABR), have emerged as a powerful means of noninvasive tumor ablation with broad patient candidacy. Strong rationale exists for ablative therapy in the setting of oligometastatic NSCLC, including patterns-of-failure analyses and data supporting local ablation of oligoprogressive disease for patients with oncogene-addicted mNSCLC treated with tyrosine kinase inhibitors. In this article, we examine the theoretical basis for ablation of oligometastatic NSCLC and review the growing clinical literature of mNSCLC patients treated with ablative radiation therapy. PMID:26389766

  13. [Catheter ablation of persistent atrial fibrillation : pulmonary vein isolation, ablation of fractionated electrograms, stepwise approach or rotor ablation?].

    PubMed

    Scherr, D

    2015-02-01

    Catheter ablation is an established treatment option for patients with atrial fibrillation (AF). In paroxysmal AF ablation, pulmonary vein isolation alone is a well-defined procedural endpoint, leading to success rates of up to 80% with multiple procedures over 5 years of follow-up. The success rate in persistent AF ablation is significantly more limited. This is partly due to the rudimentary understanding of the substrate maintaining persistent AF. Three main pathophysiological concepts for this arrhythmia exist: the multiple wavelet hypothesis, the concept of focal triggers, mainly located in the pulmonary veins and the rotor hypothesis. However, the targets and endpoints of persistent AF ablation are ill-defined and there is no consensus on the optimal ablation strategy in these patients. Based on these concepts, several ablation approaches for persistent AF have emerged: pulmonary vein isolation, the stepwise approach (i.e. pulmonary vein isolation, ablation of fractionated electrograms and linear ablation), magnetic resonance imaging (MRI) and rotor-based approaches. Currently, persistent AF ablation is a second-line therapy option to restore and maintain sinus rhythm. Several factors, such as the presence of structural heart disease, duration of persistent AF and dilatation and possibly also the degree of fibrosis of the left atrium should influence the decision to perform persistent AF ablation. PMID:25687615

  14. Microwave Ablation Compared with Radiofrequency Ablation for Breast Tissue in an Ex Vivo Bovine Udder Model

    SciTech Connect

    Tanaka, Toshihiro; Westphal, Saskia; Isfort, Peter; Braunschweig, Till; Penzkofer, Tobias Bruners, Philipp; Kichikawa, Kimihiko; Schmitz-Rode, Thomas Mahnken, Andreas H.

    2012-08-15

    Purpose: To compare the effectiveness of microwave (MW) ablation with radiofrequency (RF) ablation for treating breast tissue in a nonperfused ex vivo model of healthy bovine udder tissue. Materials and Methods: MW ablations were performed at power outputs of 25W, 35W, and 45W using a 915-MHz frequency generator and a 2-cm active tip antenna. RF ablations were performed with a bipolar RF system with 2- and 3-cm active tip electrodes. Tissue temperatures were continuously monitored during ablation. Results: The mean short-axis diameters of the coagulation zones were 1.34 {+-} 0.14, 1.45 {+-} 0.13, and 1.74 {+-} 0.11 cm for MW ablation at outputs of 25W, 35W, and 45W. For RF ablation, the corresponding values were 1.16 {+-} 0.09 and 1.26 {+-} 0.14 cm with electrodes having 2- and 3-cm active tips, respectively. The mean coagulation volumes were 2.27 {+-} 0.65, 2.85 {+-} 0.72, and 4.45 {+-} 0.47 cm{sup 3} for MW ablation at outputs of 25W, 35W, and 45W and 1.18 {+-} 0.30 and 2.29 {+-} 0.55 cm{sup 3} got RF ablation with 2- and 3-cm electrodes, respectively. MW ablations at 35W and 45W achieved significantly longer short-axis diameters than RF ablations (P < 0.05). The highest tissue temperature was achieved with MW ablation at 45W (P < 0.05). On histological examination, the extent of the ablation zone in MW ablations was less affected by tissue heterogeneity than that in RF ablations. Conclusion: MW ablation appears to be advantageous with respect to the volume of ablation and the shape of the margin of necrosis compared with RF ablation in an ex vivo bovine udder.

  15. Surgical Ablation of Atrial Fibrillation

    PubMed Central

    Ramlawi, Basel; Abu Saleh, Walid K.

    2015-01-01

    The Cox-maze procedure for the restoration of normal sinus rhythm, initially developed by Dr. James Cox, underwent several iterations over the years. The main concept consists of creating a series of transmural lesions in the right and left atria that disrupt re-entrant circuits responsible for propagating the abnormal atrial fibrillation rhythm. The left atrial appendage is excluded as a component of the Maze procedure. For the first three iterations of the Cox- maze procedure, these lesions were performed using a surgical cut-and-sew approach that ensured transmurality. The Cox-Maze IV is the most currently accepted iteration. It achieves the same lesion set of the Cox- maze III but uses alternative energy sources to create the transmural lesions, potentially in a minimally invasive approach on the beating heart. High-frequency ultrasound, microwave, and laser energy have all been used with varying success in the past. Today, bipolar radiofrequency heat or cryotherapy cooling are the most accepted sources for creating linear lesions with consistent safety and transmurality. The robust and reliable nature of these energy delivery methods has yielded a success rate reaching 90% freedom from atrial fibrillation at 12 months. Such approaches offer a significant long-term advantage over catheter-based ablation, especially in patients having longstanding, persistent atrial fibrillation with characteristics such as dilated left atrial dimensions, poor ejection fraction, and failed catheter ablation. Based on these improved results, there currently is significant interest in developing a hybrid ablation strategy that incorporates the superior transmural robust lesions of surgical ablation, the reliable stroke prevention potential of epicardial left atrial appendage exclusion, and sophisticated mapping and confirmatory catheter-based ablation technology. Such a minimally invasive hybrid strategy for ablation may lead to the development of multidisciplinary “Afib teams

  16. Sci—Sat AM: Stereo — 04: Evaluation of VMAT interplay effect for lung SABR using TrueBeam 10XFFF beam

    SciTech Connect

    Huang, V; Thomas, SD; Teke, T

    2014-08-15

    During a VMAT treatment delivery, the interplay effect between the moving target and varying machine parameters result in dose distributions that are different from those initially planned. In this work, we investigate this effect for lung SABR by using 4D dose calculation derived from the Varian TrueBeam trajectory log file. The impact of treatment start phase is also evaluated. A QUASAR™ respiratory motion phantom was scanned with motion amplitudes of 0.4, 1, 2 and 3 cm with a 4 second period. MIP and the average dataset were generated from the 4DCT. A static CT was also acquired with the tumor in its centre position. Plans were optimized with 10X FFF beam until PTV and fictitious critical structures met the dose constraints. Ten temporally interleaved plans were constructed with the temporal machine parameter information from the trajectory log file. Ten plans were calculated with isocentre shifts to simulate respiratory motion and then summed. For each motion amplitude, three separate sum plans were created with various phase shifts (no phase shift, maximum inhalation and maximum exhalation) to assess the impact of treatment start phase. For all the phase shifts investigated, the DVH for PTV demonstrated good dose coverage. However, a careful review of slice by slice plan comparison indicates dose “holes” are observed within PTV. The PTV dose difference between various treatment start phases can be as high as 19%. This assumes all treatment fractions have identical treatment start phase. Our future work includes evaluation of interplay effect for various breathing periods.

  17. Vista Sabre II: integration of helmet-mounted tracker/display and high off-boresight missile seeker into F-15 aircraft

    NASA Astrophysics Data System (ADS)

    Merryman, Ron F. K.

    1994-06-01

    Future air battles will increasingly rely on aircraft capable of directing their advanced weapons with greater accuracy and at larger off-boresight angles. Analysis of current threats indicate that potential adversaries include this enhanced technology in their aircraft today. Helmet-mounted Tracker/Displays (HMT/D) provide a ready and capable response to that threat. These pilot- friendly systems allow the pilot to lock-on to targets and fire missiles at much greater angles than normally allowed in the head up display (HUD). Vista Sabre II is a congressionally mandated special project to evaluate a helmet-mounted display in an operational environment. The program effort involves the installation of two helmet-mounted tracker/display systems on two operational F-15C aircraft for demonstrating the capabilities of this technology in air-to-air combat. The system will provide the pilot with weapon status, targeting information, and other important, time critical, information necessary for effective air-to-air engagements at any head orientation without having to look into the cockpit or through the head up display (HUD). Also integrated into the system is a Navy high off-boresight missile seeker (HOBS) with extended range capability to track targets at high angles off the aircraft's boresight. The helmet display and HOBS will help the pilot lock a missile faster and simulate the missile launch. During the period of demonstration flights, the system will be evaluated through all aspects of the close-in, visual air-to-air combat arena, as well as investigating the human factors issues unique to helmet-mounted systems.

  18. WE-E-17A-02: Predictive Modeling of Outcome Following SABR for NSCLC Based On Radiomics of FDG-PET Images

    SciTech Connect

    Li, R; Aguilera, T; Shultz, D; Rubin, D; Diehn, M; Loo, B

    2014-06-15

    Purpose: This study aims to develop predictive models of patient outcome by extracting advanced imaging features (i.e., Radiomics) from FDG-PET images. Methods: We acquired pre-treatment PET scans for 51 stage I NSCLC patients treated with SABR. We calculated 139 quantitative features from each patient PET image, including 5 morphological features, 8 statistical features, 27 texture features, and 100 features from the intensity-volume histogram. Based on the imaging features, we aim to distinguish between 2 risk groups of patients: those with regional failure or distant metastasis versus those without. We investigated 3 pattern classification algorithms: linear discriminant analysis (LDA), naive Bayes (NB), and logistic regression (LR). To avoid the curse of dimensionality, we performed feature selection by first removing redundant features and then applying sequential forward selection using the wrapper approach. To evaluate the predictive performance, we performed 10-fold cross validation with 1000 random splits of the data and calculated the area under the ROC curve (AUC). Results: Feature selection identified 2 texture features (homogeneity and/or wavelet decompositions) for NB and LR, while for LDA SUVmax and one texture feature (correlation) were identified. All 3 classifiers achieved statistically significant improvements over conventional PET imaging metrics such as tumor volume (AUC = 0.668) and SUVmax (AUC = 0.737). Overall, NB achieved the best predictive performance (AUC = 0.806). This also compares favorably with MTV using the best threshold at an SUV of 11.6 (AUC = 0.746). At a sensitivity of 80%, NB achieved 69% specificity, while SUVmax and tumor volume only had 36% and 47% specificity. Conclusion: Through a systematic analysis of advanced PET imaging features, we are able to build models with improved predictive value over conventional imaging metrics. If validated in a large independent cohort, the proposed techniques could potentially aid in

  19. Laser Ablation Propulsion A Study

    NASA Astrophysics Data System (ADS)

    Irfan, Sayed A.; Ugalatad, Akshata C.

    Laser Ablation Propulsion (LAP) will serve as an alternative propulsion system for development of microthrusters. The principle of LAP is that when a laser (pulsed or continuous wave) with sufficient energy (more than the vaporization threshold energy of material) is incident on material, ablation or vaporization takes place which leads to the generation of plasma. The generated plasma has the property to move away from the material hence pressure is generated which leads to the generation of thrust. Nowadays nano satellites are very common in different space and defence applications. It is important to build micro thruster which are useful for orienting and re-positioning small aircraft (like nano satellites) above the atmosphere. modelling of LAP using MATLAB and Mathematica. Schematic is made for the suitable optical configuration of LAP. Practical experiments with shadowgraphy and self emission techniques and the results obtained are analysed taking poly (vinyl-chloride) (PVC) as propellant to study the

  20. Laser Ablation Molecular Isotopic Spectrometry

    NASA Astrophysics Data System (ADS)

    Russo, Richard E.; Bol'shakov, Alexander A.; Mao, Xianglei; McKay, Christopher P.; Perry, Dale L.; Sorkhabi, Osman

    2011-02-01

    A new method of performing optical isotopic analysis of condensed samples in ambient air and at ambient pressure has been developed: Laser Ablation Molecular Isotopic Spectrometry (LAMIS). The technique uses radiative transitions from molecular species either directly vaporized from a sample or formed by associative mechanisms of atoms or ions in a laser ablation plume. This method is an advanced modification of a known atomic emission technique called laser-induced breakdown spectroscopy (LIBS). The new method — LAMIS — can determine not only chemical composition but also isotopic ratios of elements in the sample. Isotopic measurements are enabled by significantly larger isotopic shifts found in molecular spectra relative to atomic spectra. Analysis can be performed from a distance and in real time. No sample preparation or pre-treatment is required. Detection of the isotopes of hydrogen, boron, carbon, and oxygen are discussed to illustrate the technique.

  1. Electron Beam Ablation and Deposition

    NASA Astrophysics Data System (ADS)

    Kovaleski, S. D.; Gilgenbach, R. M.; Ang, L. K.; Lau, Y. Y.

    1997-11-01

    Ablation of fused silica, titanium nitride, and boron nitride with a channel spark electron beam is being studied. The channel spark is a low energy (15-20kV), high current (1600A) electron beam source developed at KFK(G. Muller and C. Schultheiss, Proc. of Beams `94, Vol. II, p833). This is a pseudospark device which operates in the ion focused regime of electron beam transport. For this reason, a low pressure (10-15mTorr of Ar) background gas is used to provide electron beam focusing. Plume composition and excitation has been studied via optical emission spectroscopy. Ablation has also been imaged photographically. Electron density gradients and densities are being studied through laser deflection. Film deposition experiments are also being performed. Electron transport and energy deposition in metals are being simulated in the ITS-TIGER code(Sandia Report No. SAND 91-1634).

  2. Artificial meteor ablation studies: Olivine

    NASA Technical Reports Server (NTRS)

    Blanchard, M. B.; Cunningham, G. G.

    1973-01-01

    Artificial meteor ablation was performed on a Mg-rich olivine sample using an arc-heated plasma of ionized air. Experimental conditions simulated a meteor traveling about 12 km/sec at an altitude of 70 km. The mineral content of the original olivine sample was 98% olivine (including traces of olivine alteration products) and 2% chromite. Forsterite content of the original olivine was Fo-89. After ablation, the forsterite content had increased to Fo-94 in the recrystallized olivine. In addition, lamella-like intergrowths of magnetite were prevalent constituents. Wherever magnetite occurred, there was an increase in Mg and a corresponding decrease in Fe for the recrystallized olivine. The Allende fusion crust consisted of a recrystallized olivine, which was more Mg-rich and Fe-deficient than the original meteorite's olivine, and abundant magnetite grains. Although troilite and pentlandite were the common opaque mineral constituents in this meteorite, magnetite was the principal opaque mineral found in the fusion crust.

  3. Caries selective ablation: the handpiece

    NASA Astrophysics Data System (ADS)

    Hennig, Thomas; Rechmann, Peter; Holtermann, Andreas

    1995-05-01

    Caries selective ablation is fixed to a window of fluences predicted by the ablation thresholds of carious and healthy dentin, respectively. The aim of the study was to develop a dental handpiece which guarantees homogeneous fluence at the irradiated tooth surface. Furthermore the point of treatment should be cooled down without energy losses due to the cooling system. We suggest the direct coupling of the laser radiation into a laminar stream of liquid, which acts in turn as a lengthened beam guide. The impacts of the laser radiation and of the cooling medium fall exactly into the same point. Hot ablation debris is removed out of the crater by the flush of the water jet. Fluences are constant if the handpiece is used in contact mode or at a distance. Normally the surface of a bare fiber working in contact mode is destroyed after a few shots. Coupling the laser radiation into a stream of liquid prevents this destruction. Putting together the benefits of this special handpiece short overall treatment times seem to be possible. High average power can be applied to the tooth without the threat of thermal damage. Furthermore no time consuming cutting of the fiber prolongs the treatment time.

  4. Excimer laser ablation of ferrites

    NASA Astrophysics Data System (ADS)

    Tam, A. C.; Leung, W. P.; Krajnovich, D.

    1991-02-01

    Laser etching of ferrites was previously done by scanning a focused continuous-wave laser beam on a ferrite sample in a chemical environment. We study the phenomenon of photo-ablation of Ni-Zn or Mn-Zn ferrites by pulsed 248-nm KrF excimer laser irradiation. A transfer lens system is used to project a grating pattern of a mask irradiated by the pulsed KrF laser onto the ferrite sample. The threshold fluence for ablation at the ferrite surface is about 0.3 J/cm2. A typical fluence of 1 J/cm2 is used. The etched grooves produced are typically 20-50 μm wide, with depths achieved as deep as 70 μm . Groove straightness is good as long as a sharp image is projected onto the sample surface. The wall angle is steeper than 60 degrees. Scanning electron microscopy of the etched area shows a ``glassy'' skin with extensive microcracks and solidified droplets being ejected that is frozen in action. We found that this skin can be entirely removed by ultrasonic cleaning. A fairly efficient etching rate of about 10 nm/pulse for a patterned area of about 2 mm×2 mm is obtained at a fluence of 1 J/cm2. This study shows that projection excimer laser ablation is useful for micromachining of ferrite ceramics, and indicates that a hydrodynamic sputtering mechanism involving droplet emission is a cause of material removal.

  5. The Osteosarcoradionecrosis as an Unfavorable Result Following Head and Neck Tumor Ablation and Microsurgical Reconstruction.

    PubMed

    Al Deek, Nidal Farhan; Wei, Fu-Chan

    2016-10-01

    Osteoradionecrosis is preferably called osteosarcoradionecrosis to adequately cover the scope of the problem: multitissue necrosis. The changes following radiotherapy and leading to necrosis are further classified into 2 phases based on improved understanding of the underlying mechanisms. The reversible-damage phase could respond to the medical treatment, while the irreversible damage phase or osteosarcoradionecrosis may benefit from complete resection and free flap reconstruction. The role of ablation and reconstruction in paving the road for the development of osteosarcoradionecrosis is discussed, a case study provided, and a refined reconstructive approach proposed. PMID:27601399

  6. Image-guided ablation for hepatocellular carcinoma.

    PubMed

    Lencioni, Riccardo; Crocetti, Laura

    2013-01-01

    Image-guided ablation is accepted as the best therapeutic choice for patients with early-stage hepatocellular carcinoma (HCC) when surgical options-including resection and transplantation-are precluded. The term image-guided tumor ablation is defined as the direct application of chemical substances or sources of energy to a focal tumor in an attempt to achieve eradication or substantial tumor destruction. Over the past 25 years, several methods for local tumor destruction have been developed and clinically tested. Radiofrequency ablation (RFA) has shown superior anticancer effect and greater survival benefit with respect to the seminal percutaneous technique, ethanol injection, in meta-analyses of randomized controlled trials, and is currently established as the standard ablative modality. Nevertheless, novel thermal and nonthermal techniques for tumor ablation-including microwave ablation and irreversible electroporation-seem to have potential to improve the efficacy of RFA and are currently undergoing clinical investigation. PMID:22941021

  7. Laser Ablation of Alumina in Water

    SciTech Connect

    Musaev, O.; Midgley, A; Wrobel, J; Kruger, M

    2010-01-01

    Bulk {alpha}-alumina immersed in distilled water was ablated by pulsed UV laser radiation. The resulting colloidal solution contained micron and submicron size particles. X-ray diffraction and Raman spectra of the ablated and original material are similar. Hence, most of the ablated material is {alpha}-alumina. From transmission electron microscope images, most of the submicron and all of the micron-sized particles have sharp edges and do not have spherical shapes, indicating that the dominant ablation mechanism is due to crack propagation. Some spherical particles of diameter less than 100 nm are observed, indicating that they were formed from the liquid state.

  8. Ablative therapies in renal cell carcinoma.

    PubMed

    Chan, A A; Ahrar, K; Matin, S F

    2011-09-01

    We reviewed the use of ablative therapies in the management of renal cell carcinoma. We performed a PubMed search of the English language literature using the keywords "ablation" and "renal carcinoma." Pertinent articles specific to the technologic advancement of ablative therapy and clinical outcomes were selected for review. Intermediate-term oncologic outcomes of cryoablation and radiofrequency ablation are acceptable but are not quite as good as for surgical excision based nearly all on retrospective studies. No randomized studies have been performed comparing excisional and ablative therapies. Careful selection of patients and tumor characteristics results in improved outcomes. Diagnostic biopsy for tissue confirmation is mandatory and should even be considered post therapy after 6-12 months in patients with a concern about recurrence. Ablative therapies are associated with decreased morbidity, less severe complication rates, and excellent preservation of renal function in comparison with surgical excision. The majority of recurrences occur early, but long-term surveillance is required as delayed recurrences are also possible and the long-term oncologic efficacy is not yet established. Ablation can be delivered percutaneously or laparoscopically, and the superiority of one over the other remains controversial. The percutaneous approach is more cost effective and causes less perinephric desmoplasia. Nearly all data on ablation are retrospective and, with few exceptions, from single institutions. Ablative therapy is an appealing option for the management of small renal tumors shown to be renal cell carcinoma on biopsy in patients who are unsuitable candidates for surgical extirpation. PMID:21993322

  9. Plasma-mediated ablation of biofilm contamination

    NASA Astrophysics Data System (ADS)

    Guo, Zhixiong; Wang, Xiaoliang; Huang, Huan

    2010-12-01

    Ultra-short pulsed laser removal of thin biofilm contamination on different substrates has been conducted via the use of plasma-mediated ablation. The biofilms were formed using sheep whole blood. The ablation was generated using a 1.2 ps ultra-short pulsed laser with wavelength centered at 1552 nm. The blood contamination was transformed into plasma and collected with a vacuum system. The single line ablation features have been measured. The ablation thresholds of blood contamination and bare substrates were determined. It is found that the ablation threshold of the blood contamination is lower than those of the beneath substrates including the glass slide, PDMS, and human dermal tissues. The ablation effects of different laser parameters (pulse overlap rate and pulse energy) were studied and ablation efficiency was measured. Proper ablation parameters were found to efficiently remove contamination with maximum efficiency and without damage to the substrate surface for the current laser system. Complete removal of blood contaminant from the glass substrate surface and freeze-dried dermis tissue surface was demonstrated by the USP laser ablation with repeated area scanning. No obvious thermal damage was found in the decontaminated glass and tissue samples.

  10. Analysis of iodinated contrast delivered during thermal ablation: is material trapped in the ablation zone?

    NASA Astrophysics Data System (ADS)

    Wu, Po-hung; Brace, Chris L.

    2016-08-01

    Intra-procedural contrast-enhanced CT (CECT) has been proposed to evaluate treatment efficacy of thermal ablation. We hypothesized that contrast material delivered concurrently with thermal ablation may become trapped in the ablation zone, and set out to determine whether such an effect would impact ablation visualization. CECT images were acquired during microwave ablation in normal porcine liver with: (A) normal blood perfusion and no iodinated contrast, (B) normal perfusion and iodinated contrast infusion or (C) no blood perfusion and residual iodinated contrast. Changes in CT attenuation were analyzed from before, during and after ablation to evaluate whether contrast was trapped inside of the ablation zone. Visualization was compared between groups using post-ablation contrast-to-noise ratio (CNR). Attenuation gradients were calculated at the ablation boundary and background to quantitate ablation conspicuity. In Group A, attenuation decreased during ablation due to thermal expansion of tissue water and water vaporization. The ablation zone was difficult to visualize (CNR  =  1.57  ±  0.73, boundary gradient  =  0.7  ±  0.4 HU mm‑1), leading to ablation diameter underestimation compared to gross pathology. Group B ablations saw attenuation increase, suggesting that iodine was trapped inside the ablation zone. However, because the normally perfused liver increased even more, Group B ablations were more visible than Group A (CNR  =  2.04  ±  0.84, boundary gradient  =  6.3  ±  1.1 HU mm‑1) and allowed accurate estimation of the ablation zone dimensions compared to gross pathology. Substantial water vaporization led to substantial attenuation changes in Group C, though the ablation zone boundary was not highly visible (boundary gradient  =  3.9  ±  1.1 HU mm‑1). Our results demonstrate that despite iodinated contrast being trapped in the ablation zone, ablation visibility

  11. Analysis of iodinated contrast delivered during thermal ablation: is material trapped in the ablation zone?

    PubMed

    Wu, Po-Hung; Brace, Chris L

    2016-08-21

    Intra-procedural contrast-enhanced CT (CECT) has been proposed to evaluate treatment efficacy of thermal ablation. We hypothesized that contrast material delivered concurrently with thermal ablation may become trapped in the ablation zone, and set out to determine whether such an effect would impact ablation visualization. CECT images were acquired during microwave ablation in normal porcine liver with: (A) normal blood perfusion and no iodinated contrast, (B) normal perfusion and iodinated contrast infusion or (C) no blood perfusion and residual iodinated contrast. Changes in CT attenuation were analyzed from before, during and after ablation to evaluate whether contrast was trapped inside of the ablation zone. Visualization was compared between groups using post-ablation contrast-to-noise ratio (CNR). Attenuation gradients were calculated at the ablation boundary and background to quantitate ablation conspicuity. In Group A, attenuation decreased during ablation due to thermal expansion of tissue water and water vaporization. The ablation zone was difficult to visualize (CNR  =  1.57  ±  0.73, boundary gradient  =  0.7  ±  0.4 HU mm(-1)), leading to ablation diameter underestimation compared to gross pathology. Group B ablations saw attenuation increase, suggesting that iodine was trapped inside the ablation zone. However, because the normally perfused liver increased even more, Group B ablations were more visible than Group A (CNR  =  2.04  ±  0.84, boundary gradient  =  6.3  ±  1.1 HU mm(-1)) and allowed accurate estimation of the ablation zone dimensions compared to gross pathology. Substantial water vaporization led to substantial attenuation changes in Group C, though the ablation zone boundary was not highly visible (boundary gradient  =  3.9  ±  1.1 HU mm(-1)). Our results demonstrate that despite iodinated contrast being trapped in the ablation zone, ablation visibility

  12. [Stereotactic radiotherapy in brain metastases].

    PubMed

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

    2015-02-01

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

  13. Immediate functional loading of an implant-supported fixed prosthesis at the time of ablative surgery and mandibular reconstruction for squamous cell carcinoma.

    PubMed

    Odin, Guillaume; Balaguer, Thierry; Savoldelli, Charles; Scortecci, Gérard

    2010-01-01

    The authors describe a case of squamous cell carcinoma of the oral cavity managed by ablative surgery, mandibular reconstruction with a fibula free flap, and implant placement during the same session. Immediate functional implant loading, respecting the principles of basal implantology, was performed 48 hours later using a highly rigid, screw-secured fixed prosthesis that served as an external fixator for the implants and grafted bone. Implant loading before external beam radiotherapy improves flap stability, bone consolidation, and quality of life. Functional and esthetic outcomes were evaluated 2 years after radiotherapy was completed. PMID:20553177

  14. Possible Role for Cryoballoon Ablation of Right Atrial Appendage Tachycardia when Conventional Ablation Fails

    PubMed Central

    Kilic, Ayhan

    2015-01-01

    Focal atrial tachycardia arising from the right atrial appendage usually responds well to radiofrequency ablation; however, successful ablation in this anatomic region can be challenging. Surgical excision of the right atrial appendage has sometimes been necessary to eliminate the tachycardia and prevent or reverse the resultant cardiomyopathy. We report the case of a 48-year-old man who had right atrial appendage tachycardia resistant to multiple attempts at ablation with use of conventional radiofrequency energy guided by means of a 3-dimensional mapping system. The condition led to cardiomyopathy in 3 months. The arrhythmia was successfully ablated with use of a 28-mm cryoballoon catheter that had originally been developed for catheter ablation of paroxysmal atrial fibrillation. To our knowledge, this is the first report of cryoballoon ablation without isolation of the right atrial appendage. It might also be an alternative to epicardial ablation or surgery when refractory atrial tachycardia originates from the right atrial appendage. PMID:26175651

  15. Testing and evaluation of light ablation decontamination

    SciTech Connect

    Demmer, R.L.; Ferguson, R.L.

    1994-10-01

    This report details the testing and evaluation of light ablation decontamination. It details WINCO contracted research and application of light ablation efforts by Ames Laboratory. Tests were conducted with SIMCON (simulated contamination) coupons and REALCON (actual radioactive metal coupons) under controlled conditions to compare cleaning effectiveness, speed and application to plant process type equipment.

  16. PULSED LASER ABLATION OF CEMENT AND CONCRETE

    EPA Science Inventory

    Laser ablation was investigated as a means of removing radioactive contaminants from the surface and near-surface regions of concrete from nuclear facilities. We present the results of ablation tests on cement and concrete samples using a pulsed Nd:YAG laser with fiber optic beam...

  17. Percutaneous Local Ablative Therapy for Hepatocellular Carcinoma

    PubMed Central

    Lau, W. Y.; Leung, Thomas W. T.; Yu, Simon C. H.; Ho, Stephen K. W.

    2003-01-01

    Objective To review and compare treatment result for percutaneous local ablative therapy (PLAT) with surgical resection in the treatment of small hepatocellular carcinoma (HCC). Summary Background Data PLAT is indicated for small unresectable HCC localized to the liver. From the use of ethanol to the latest technology of radiofrequency ablation, ablative techniques have been refined and their role in the management of HCC established. This review aims to give an overview of various ablative methods, including their efficacy, indications, and limitations, and also tries to look into the future of clinical trials in PLAT. Methods The authors reviewed recent papers in the English medical literature about the use of local ablative therapy for HCC. Focus was given to the results of treatment in terms of local control, progression-free survival, and overall survival, and to compare treatment results with those of surgery. Results PLAT for small HCC (<5 cm) with thermal ablation (radiofrequency ablation or microwave coagulation) can achieve effective local control of disease and is superior to ethanol injection. Progressive disease in untreated areas is a common reason for failure. Overall progression-free survival is similar to that of surgical resection. Conclusions Thermal ablation gives good local control of small HCC, is superior to ethanol, and may be comparable to surgical resection in long-term outcome. PMID:12560774

  18. Excimer laser ablation of the lens.

    PubMed

    Nanevicz, T M; Prince, M R; Gawande, A A; Puliafito, C A

    1986-12-01

    Ablation of the bovine crystalline lens was studied using radiation from an excimer laser at four ultraviolet wave lengths as follows: 193 nm (argon fluoride), 248 nm (krypton fluoride), 308 nm (xenon chloride), and 351 nm (xenon fluoride). The ablation process was quantitated by measuring mass ablated with an electronic balance, and characterized by examining ablation craters with scanning electron microscopy. The highest ablation rate was observed at 248 nm with lower rates at 193 and 308 nm. No ablation was observed at 351 nm. Scanning electron microscopy revealed the smoothest craters at 193 nm while at 248 nm there was vacuolization in the crater walls and greater disruption of surrounding tissue. The craters made at 308 nm did not have as smooth a contour as the 193-nm lesions. The spectral absorbance of the bovine lens was calculated at the wavelengths used for ablation and correlated with ablation rates and thresholds. High peak-power, pulsed ultraviolet laser radiation may have a role in surgical removal of the lens. PMID:3789982

  19. Local Ablation for Hepatocellular Carcinoma in Taiwan

    PubMed Central

    Lin, Shi-Ming

    2013-01-01

    Hepatocellular carcinoma (HCC) is the second commonest cancer in Taiwan. The national surveillance program can detect HCC in its early stages, and various curative modalities (including surgical resection, orthotopic liver transplantation, and local ablation) are employed for the treatment of small HCC. Local ablation therapies are currently advocated for early-stage HCC that is unresectable because of co-morbidities, the need to preserve liver function, or refusal of resection. Among the various local ablation therapies, the most commonly used modalities include percutaneous ethanol injection and radiofrequency ablation (RFA); percutaneous acetic acid injection and microwave ablation are used less often. RFA is more commonly employed than other local ablative modalities in Taiwan because the technique is highly effective, minimally invasive, and requires fewer sessions. RFA is therefore advocated in Taiwan as the first-line curative therapy for unresectable HCC or even for resectable HCC. However, current RFA procedures are less effective against tumors that are in high-risk or difficult-to-ablate locations, are poorly visualized on ultrasonography (US), or are large. Recent advancements in RFA in Taiwan can resolve these issues by the creation of artificial ascites or pleural effusion, application of real-time virtual US assistance, use of combination therapy before RFA, or use of switching RF controllers with multiple electrodes. This review article provides updates on the clinical outcomes and advances in local ablative modalities (mostly RFA) for HCC in Taiwan. PMID:24159599

  20. Imaging in radiotherapy

    NASA Astrophysics Data System (ADS)

    Calandrino, R.; Del Maschio, A.; Cattaneo, G. M.; Castiglioni, I.

    2009-09-01

    The diagnostic methodologies used for the radiotherapy planning have undergone great developments in the last 30 years. Since the 1980s, after the introduction of the CT scanner, the modality for the planning moved beyond the planar 2D assessment to approach a real and more realistic volumetric 3D definition. Consequently the dose distribution, previously obtained by means of an overly simple approximation, became increasingly complex, better tailoring the true shape of the tumour. The final therapeutic improvement has been obtained by a parallel increase in the complexity of the irradiating units: the Linacs for therapy have, in fact, been equipped with a full accessory set capable to modulate the fluence (IMRT) and to check the correct target position continuously during the therapy session (IMRT-IGRT). The multimodal diagnostic approach, which integrates diagnostic information, from images of the patient taken with CT, NMR, PET and US, further improves the data for a biological and topological optimization of the radiotherapy plan and consequently of the dose distribution in the Planning Target Volume. Proteomic and genomic analysis will be the next step in tumour diagnosis. These methods will provide the planners with further information, for a true personalization of the treatment regimen and the assessment of the predictive essays for each tumour and each patient.

  1. Lung Cancer Ablation: Technologies and Techniques

    PubMed Central

    Alexander, Erica S.; Dupuy, Damian E.

    2013-01-01

    The incidence of lung cancers in 2012 is estimated to reach 226,160 new cases, with only a third of patients suitable surgical candidates. Tumor ablation has emerged as an important and efficacious treatment option for nonsurgical lung cancer patients. This localized minimally invasive therapy is best suited for small oligonodular lesions or favorably located metastatic tumors. Radiofrequency ablation has been in use for over a decade, and newer modalities including microwave ablation, cryoablation, and irreversible electroporation have emerged as additional treatment options for patients. Ablation therapies can offer patients and clinicians a repeatable and effective therapy for palliation and, in some cases, cure of thoracic malignancies. This article discusses the available technologies and techniques available for tumor ablation of thoracic malignancies including patient selection, basic aspects of procedure technique, imaging follow-up, treatment outcomes, and comparisons between various therapies. PMID:24436530

  2. Epicardial Ventricular Tachycardia Ablation for Which Patients?

    PubMed Central

    Roten, Laurent; Sacher, Frédéric; Daly, Matthew; Pascale, Patrizio; Komatsu, Yuki; Ramoul, Khaled; Scherr, Daniel; Chaumeil, Arnaud; Shah, Ashok; Denis, Arnaud; Derval, Nicolas; Hocini, Mélèze; Haïssaguerre, Michel; Jaïs, Pierre

    2012-01-01

    With the widespread use of implantable cardioverter-defibrillators, an increasing number of patients present with ventricular tachycardia (VT). Large multicentre studies have shown that ablation of VT successfully reduces recurrent VT and this procedure is being performed by an increasing number of centres. However, for a number of reasons, many patients experience VT recurrence after ablation. One important reason for VT recurrence is the presence of an epicardial substrate involved in the VT circuit which is not affected by endocardial ablation. Epicardial access and ablation is now frequently performed either after failed endocardial VT ablation or as first-line treatment in selected patients. This review will focus on the available evidence for identifying VT of epicardial origin, and discuss in which patients an epicardial approach would be benefitial. PMID:26835028

  3. Pulsed Laser Ablation of Soft Biological Tissues

    NASA Astrophysics Data System (ADS)

    Vogel, Alfred; Venugopalan, Vasan

    In this chapter we focus on the key elements that form our current understanding of the mechanisms of pulsed laser ablation of soft biological tissues. We present a conceptual framework providing mechanistic links between various ablation applications and the underlying thermodynamic and phase change processes [1]. We define pulsed laser ablation as the use of laser pulses with duration of ~1 ms or less for the incision or removal of tissue regardless of the photophysical or photochemical processes involved. However, we will confine this presentation to pulsed ablation performed on a tissue level that does not involve laser-induced plasma formation. Ablation processes within transparent tissues or cells resulting from non-linear absorption have been considered in reviews by Vogel and Venugopalan [1] and by Vogel and co-workers [2].

  4. RF Field Visualization of RF Ablation at the Larmor Frequency

    PubMed Central

    Stang, Pascal; Kerr, Adam; Pauly, John; Scott, Greig

    2012-01-01

    Radiofrequency ablation is an effective minimally invasive treatment for tumors. One primary source of difficulty is monitoring and controlling the ablation region. Currently, RF ablation is performed at 460 kHz, for which MRI could play a role given its capability for temperature monitoring and tumor visualization. If instead the ablation were to be performed at the MRI Larmor frequency, then the MR capability for B1 field mapping could be used to directly visualize the RF fields created by the ablation currents. Visualizing the RF fields may enable better control of the ablation currents, enabling better control of lesion shape and size and improving repeatability. We demonstrate the feasibility of performing RF ablations at 64 MHz and show preliminary results from imaging the RF fields from the ablation. The post-ablation RF fields show an increase in current density in the ablated region, consistent with an increase in conductivity of the ablated tissue. PMID:21775256

  5. Radiofrequency ablation for hepatocellular carcinoma.

    PubMed

    Nishikawa, Hiroki; Kimura, Toru; Kita, Ryuichi; Osaki, Yukio

    2013-09-01

    Hepatocellular carcinoma (HCC) is one of the most common causes of cancer-related mortality worldwide. Unfortunately, only 20% of HCC patients are amenable to curative therapy (liver transplantation or surgical resection). Locoregional therapies such as radiofrequency ablation (RFA), percutaneous ethanol injection, microwave coagulation therapy, and transcatheter arterial chemoembolisation play a key role in the management of HCC. The choice of the treatment modality depends on the size of the tumour, tumour location, anatomic considerations and the number of tumours present and liver function. RFA therapy for HCC can be performed safely using a percutaneous, laparoscopic, or an open approach, even in patients with poor functional reserve. Since the introduction of RFA, several randomised controlled trials and non-randomised studies comparing RFA and other therapies for HCC have been conducted. In addition, in the last decade there have been technical advances in RFA therapy for HCC, resulting in significant improvement in the prognosis of HCC patients treated with this modality. In this review, we primarily focus on percutaneous RFA therapy for HCC and refer to current knowledge and future perspectives for this therapy. We also discuss new emerging ablation techniques. PMID:23937321

  6. Stellar Ablation of Planetary Atmospheres

    NASA Technical Reports Server (NTRS)

    Moore, Thomas E.; Horwitz, J. L.

    2007-01-01

    We review observations and theories of the solar ablation of planetary atmospheres, focusing on the terrestrial case where a large magnetosphere holds off the solar wind, so that there is little direct atmospheric impact, but also couples the solar wind electromagnetically to the auroral zones. We consider the photothermal escape flows known as the polar wind or refilling flows, the enhanced mass flux escape flows that result from localized solar wind energy dissipation in the auroral zones, and the resultant enhanced neutral atom escape flows. We term these latter two escape flows the "auroral wind." We review observations and theories of the heating and acceleration of auroral winds, including energy inputs from precipitating particles, electromagnetic energy flux at magnetohydrodynamic and plasma wave frequencies, and acceleration by parallel electric fields and by convection pickup processes also known as "centrifugal acceleration." We consider also the global circulation of ionospheric plasmas within the magnetosphere, their participation in magnetospheric disturbances as absorbers of momentum and energy, and their ultimate loss from the magnetosphere into the downstream solar wind, loading reconnection processes that occur at high altitudes near the magnetospheric boundaries. We consider the role of planetary magnetization and the accumulating evidence of stellar ablation of extrasolar planetary atmospheres. Finally, we suggest and discuss future needs for both the theory and observation of the planetary ionospheres and their role in solar wind interactions, to achieve the generality required for a predictive science of the coupling of stellar and planetary atmospheres over the full range of possible conditions.

  7. Ablative shielding for hypervelocity projectiles

    NASA Technical Reports Server (NTRS)

    Rucker, Michelle A. (Inventor)

    1993-01-01

    A hypervelocity projectile shield which includes a hollow semi-flexible housing fabricated from a plastic like, or otherwise transparent membrane which is filled with a fluid (gas or liquid) is presented. The housing has a inlet valve, similar to that on a tire or basketball, to introduce an ablating fluid into the housing. The housing is attached by a Velcro mount or double-sided adhesive tape to the outside surface of a structure to be protected. The housings are arrayed in a side-by-side relationship for complete coverage of the surface to be protected. In use, when a hypervelocity projectile penetrates the outer wall of a housing it is broken up and then the projectile is ablated as it travels through the fluid, much like a meteorite 'burns up' as it enters the earth's atmosphere, and the housing is deflated. The deflated housing can be easily spotted for replacement, even from a distance. Replacement is then accomplished by simply pulling a deflated housing off the structure and installing a new housing.

  8. Study of 201 Non-Small Cell Lung Cancer Patients Given Stereotactic Ablative Radiation Therapy Shows Local Control Dependence on Dose Calculation Algorithm

    SciTech Connect

    Latifi, Kujtim; Oliver, Jasmine; Baker, Ryan; Dilling, Thomas J.; Stevens, Craig W.; Kim, Jongphil; Yue, Binglin; DeMarco, MaryLou; Zhang, Geoffrey G.; Moros, Eduardo G.; Feygelman, Vladimir

    2014-04-01

    Purpose: Pencil beam (PB) and collapsed cone convolution (CCC) dose calculation algorithms differ significantly when used in the thorax. However, such differences have seldom been previously directly correlated with outcomes of lung stereotactic ablative body radiation (SABR). Methods and Materials: Data for 201 non-small cell lung cancer patients treated with SABR were analyzed retrospectively. All patients were treated with 50 Gy in 5 fractions of 10 Gy each. The radiation prescription mandated that 95% of the planning target volume (PTV) receive the prescribed dose. One hundred sixteen patients were planned with BrainLab treatment planning software (TPS) with the PB algorithm and treated on a Novalis unit. The other 85 were planned on the Pinnacle TPS with the CCC algorithm and treated on a Varian linac. Treatment planning objectives were numerically identical for both groups. The median follow-up times were 24 and 17 months for the PB and CCC groups, respectively. The primary endpoint was local/marginal control of the irradiated lesion. Gray's competing risk method was used to determine the statistical differences in local/marginal control rates between the PB and CCC groups. Results: Twenty-five patients planned with PB and 4 patients planned with the CCC algorithms to the same nominal doses experienced local recurrence. There was a statistically significant difference in recurrence rates between the PB and CCC groups (hazard ratio 3.4 [95% confidence interval: 1.18-9.83], Gray's test P=.019). The differences (Δ) between the 2 algorithms for target coverage were as follows: ΔD99{sub GITV} = 7.4 Gy, ΔD99{sub PTV} = 10.4 Gy, ΔV90{sub GITV} = 13.7%, ΔV90{sub PTV} = 37.6%, ΔD95{sub PTV} = 9.8 Gy, and ΔD{sub ISO} = 3.4 Gy. GITV = gross internal tumor volume. Conclusions: Local control in patients receiving who were planned to the same nominal dose with PB and CCC algorithms were statistically significantly different. Possible alternative

  9. Radiotherapy planning using MRI

    NASA Astrophysics Data System (ADS)

    Schmidt, Maria A.; Payne, Geoffrey S.

    2015-11-01

    The use of magnetic resonance imaging (MRI) in radiotherapy (RT) planning is rapidly expanding. We review the wide range of image contrast mechanisms available to MRI and the way they are exploited for RT planning. However a number of challenges are also considered: the requirements that MR images are acquired in the RT treatment position, that they are geometrically accurate, that effects of patient motion during the scan are minimized, that tissue markers are clearly demonstrated, that an estimate of electron density can be obtained. These issues are discussed in detail, prior to the consideration of a number of specific clinical applications. This is followed by a brief discussion on the development of real-time MRI-guided RT.

  10. Subpicosecond laser ablation of dental enamel

    NASA Astrophysics Data System (ADS)

    Rode, A. V.; Gamaly, E. G.; Luther-Davies, B.; Taylor, B. T.; Dawes, J.; Chan, A.; Lowe, R. M.; Hannaford, P.

    2002-08-01

    Laser ablation of dental enamel with subpicosecond laser pulses has been studied over the intensity range of (0.1-1.4) x1014 W/cm2 using 95 and 150 fs pulses at a pulse repetition rate of 1 kHz. The experimentally determined ablation threshold of 2.2plus-or-minus0.1 J/cm2 was in good agreement with theoretical predictions based on an electrostatic ablation model. The ablation rate increased linearly with the laser fluence for up to 15 times the ablation threshold. The absence of collateral damage was observed using optical and scanning electron microscopy. Pulpal temperature measurements showed an increase of about 10 degC during the 200 s course of ablation. However, air cooling at a rate of 5 l/min resulted in the intrapulpal temperature being maintained below the pulpal damage threshhold of 5.5 degC. The material removal rates for subpicosecond precision laser ablation of dental enamel are compared with other techniques.

  11. Neural Ablation and Regeneration in Pain Practice.

    PubMed

    Choi, Eun Ji; Choi, Yun Mi; Jang, Eun Jung; Kim, Ju Yeon; Kim, Tae Kyun; Kim, Kyung Hoon

    2016-01-01

    A nerve block is an effective tool for diagnostic and therapeutic methods. If a diagnostic nerve block is successful for pain relief and the subsequent therapeutic nerve block is effective for only a limited duration, the next step that should be considered is a nerve ablation or modulation. The nerve ablation causes iatrogenic neural degeneration aiming only for sensory or sympathetic denervation without motor deficits. Nerve ablation produces the interruption of axonal continuity, degeneration of nerve fibers distal to the lesion (Wallerian degeneration), and the eventual death of axotomized neurons. The nerve ablation methods currently available for resection/removal of innervation are performed by either chemical or thermal ablation. Meanwhile, the nerve modulation method for interruption of innervation is performed using an electromagnetic field of pulsed radiofrequency. According to Sunderland's classification, it is first and foremost suggested that current neural ablations produce third degree peripheral nerve injury (PNI) to the myelin, axon, and endoneurium without any disruption of the fascicular arrangement, perineurium, and epineurium. The merit of Sunderland's third degree PNI is to produce a reversible injury. However, its shortcoming is the recurrence of pain and the necessity of repeated ablative procedures. The molecular mechanisms related to axonal regeneration after injury include cross-talk between axons and glial cells, neurotrophic factors, extracellular matrix molecules, and their receptors. It is essential to establish a safe, long-standing denervation method without any complications in future practices based on the mechanisms of nerve degeneration as well as following regeneration. PMID:26839664

  12. On the Ablation Models of Fuel Pellets

    SciTech Connect

    Rozhansky, V.A.; Senichenkov, I.Yu.

    2005-12-15

    The neutral gas shielding model and neutral-gas-plasma shielding model are analyzed qualitatively. The main physical processes that govern the formation of the shielding gas cloud and, consequently, the ablation rate are considered. For the neutral gas shielding model, simple formulas relating the ablation rate and cloud parameters to the parameters of the pellet and the background plasma are presented. The estimates of the efficiency of neutral gas shielding and plasma shielding are compared. It is shown that the main portion of the energy flux of the background electrons is released in the plasma cloud. Formulas for the ablation rate and plasma parameters are derived in the neutral-gas-plasma shielding model. The question is discussed as to why the neutral gas shielding model describes well the ablation rate of the pellet material, although it does not take into account the ionization effects and the effects associated with the interaction of ionized particles with the magnetic field. The reason is that the ablation rate depends weakly on the energy flux of hot electrons; as a result, the attenuation of this flux by the electrostatic shielding and plasma shielding has little effect on the ablation rate. This justifies the use of the neutral gas shielding model to estimate the ablation rate (to within a factor of about 2) over a wide range of parameters of the pellet and the background plasma.

  13. Neural Ablation and Regeneration in Pain Practice

    PubMed Central

    Choi, Eun Ji; Choi, Yun Mi; Jang, Eun Jung; Kim, Ju Yeon; Kim, Tae Kyun

    2016-01-01

    A nerve block is an effective tool for diagnostic and therapeutic methods. If a diagnostic nerve block is successful for pain relief and the subsequent therapeutic nerve block is effective for only a limited duration, the next step that should be considered is a nerve ablation or modulation. The nerve ablation causes iatrogenic neural degeneration aiming only for sensory or sympathetic denervation without motor deficits. Nerve ablation produces the interruption of axonal continuity, degeneration of nerve fibers distal to the lesion (Wallerian degeneration), and the eventual death of axotomized neurons. The nerve ablation methods currently available for resection/removal of innervation are performed by either chemical or thermal ablation. Meanwhile, the nerve modulation method for interruption of innervation is performed using an electromagnetic field of pulsed radiofrequency. According to Sunderland's classification, it is first and foremost suggested that current neural ablations produce third degree peripheral nerve injury (PNI) to the myelin, axon, and endoneurium without any disruption of the fascicular arrangement, perineurium, and epineurium. The merit of Sunderland's third degree PNI is to produce a reversible injury. However, its shortcoming is the recurrence of pain and the necessity of repeated ablative procedures. The molecular mechanisms related to axonal regeneration after injury include cross-talk between axons and glial cells, neurotrophic factors, extracellular matrix molecules, and their receptors. It is essential to establish a safe, long-standing denervation method without any complications in future practices based on the mechanisms of nerve degeneration as well as following regeneration. PMID:26839664

  14. Chemically assisted laser ablation ICP mass spectrometry.

    PubMed

    Hirata, Takafumi

    2003-01-15

    A new laser ablation technique combined with a chemical evaporation reaction has been developed for elemental ratio analysis of solid samples using an inductively coupled plasma mass spectrometer (ICPMS). Using a chemically assisted laser ablation (CIA) technique developed in this study, analytical repeatability of the elemental ratio measurement was successively improved. To evaluate the reliability of the CLA-ICPMS technique, Pb/U isotopic ratios were determined for zircon samples that have previously been analyzed by other techniques. Conventional laser ablation for Pb/U shows a serious elemental fractionation during ablation mainly due to the large difference in elemental volatility between Pb and U. In the case of Pb/U ratio measurement, a Freon R-134a gas (1,1,1,2-tetrafluoroethane) was introduced into the laser cell as a fluorination reactant. The Freon gas introduced into the laser cell reacts with the ablated sample U, and refractory U compounds are converted to a volatile U fluoride compound (UF6) under the high-temperature condition at the ablation site. This avoids the redeposition of U around the ablation pits. Although not all the U is reacted with Freon, formation of volatile UF compounds improves the transmission efficiency of U. Typical precision of the 206Pb/238U ratio measurement is 3-5% (2sigma) for NIST SRM 610 and Nancy 91500 zircon standard, and the U-Pb age data obtained here show good agreement within analytical uncertainties with the previously reported values. Since the observed Pb/U ratio for solid samples is relatively insensitive to laser power and ablation time, optimization of ablation conditions or acquisition parameters no longer needs to be performed on a sample-to-sample basis. PMID:12553756

  15. Thermal infrared images to quantify thermal ablation effects of acid and base on target tissues

    NASA Astrophysics Data System (ADS)

    Liu, Ran; Wang, Jia; Liu, Jing

    2015-07-01

    Hyperthermia (42-46°C), treatment of tumor tissue through elevated temperature, offers several advantages including high cost-effectiveness, highly targeted ablation and fewer side effects and hence higher safety level over traditional therapies such as chemotherapy and radiotherapy. Recently, hyperthermia using heat release through exothermic acid-base neutralization comes into view owing to its relatively safe products of salt and water and highly confined ablation. However, lack of quantitative understanding of the spatial and temporal temperature profiles that are produced by simultaneous diffusion of liquid chemical and its chemical reaction within tumor tissue impedes the application of this method. This article is dedicated to quantify thermal ablation effects of acid and base both individually and as in neutralization via infrared captured thermal images. A theoretical model is used to approximate specific heat absorption rate (SAR) based on experimental measurements that contrast two types of tissue, normal pork and pig liver. According to the computation, both pork and liver tissue has a higher ability in absorbing hydrochloric acid (HCl) than sodium hydroxide, hence suggesting that a reduced dosage for HCl is appropriate in a surgery. The heating effect depends heavily on the properties of tissue types and amount of chemical reagents administered. Given thermal parameters such as SAR for different tissues, a computational model can be made in predicting temperature transitions which will be helpful in planning and optimizing surgical hyperthermia procedures.

  16. Thermal infrared images to quantify thermal ablation effects of acid and base on target tissues

    SciTech Connect

    Liu, Ran E-mail: liuran@tsinghua.edu.cn; Liu, Jing E-mail: liuran@tsinghua.edu.cn; Wang, Jia

    2015-07-15

    Hyperthermia (42-46°C), treatment of tumor tissue through elevated temperature, offers several advantages including high cost-effectiveness, highly targeted ablation and fewer side effects and hence higher safety level over traditional therapies such as chemotherapy and radiotherapy. Recently, hyperthermia using heat release through exothermic acid-base neutralization comes into view owing to its relatively safe products of salt and water and highly confined ablation. However, lack of quantitative understanding of the spatial and temporal temperature profiles that are produced by simultaneous diffusion of liquid chemical and its chemical reaction within tumor tissue impedes the application of this method. This article is dedicated to quantify thermal ablation effects of acid and base both individually and as in neutralization via infrared captured thermal images. A theoretical model is used to approximate specific heat absorption rate (SAR) based on experimental measurements that contrast two types of tissue, normal pork and pig liver. According to the computation, both pork and liver tissue has a higher ability in absorbing hydrochloric acid (HCl) than sodium hydroxide, hence suggesting that a reduced dosage for HCl is appropriate in a surgery. The heating effect depends heavily on the properties of tissue types and amount of chemical reagents administered. Given thermal parameters such as SAR for different tissues, a computational model can be made in predicting temperature transitions which will be helpful in planning and optimizing surgical hyperthermia procedures.

  17. Thermal protection system ablation sensor

    NASA Technical Reports Server (NTRS)

    Gorbunov, Sergey (Inventor); Martinez, Edward R. (Inventor); Scott, James B. (Inventor); Oishi, Tomomi (Inventor); Fu, Johnny (Inventor); Mach, Joseph G. (Inventor); Santos, Jose B. (Inventor)

    2011-01-01

    An isotherm sensor tracks space vehicle temperatures by a thermal protection system (TPS) material during vehicle re-entry as a function of time, and surface recession through calibration, calculation, analysis and exposed surface modeling. Sensor design includes: two resistive conductors, wound around a tube, with a first end of each conductor connected to a constant current source, and second ends electrically insulated from each other by a selected material that becomes an electrically conductive char at higher temperatures to thereby complete an electrical circuit. The sensor conductors become shorter as ablation proceeds and reduced resistance in the completed electrical circuit (proportional to conductor length) is continually monitored, using measured end-to-end voltage change or current in the circuit. Thermocouple and/or piezoelectric measurements provide consistency checks on local temperatures.

  18. High geocentric velocity meteor ablation

    NASA Astrophysics Data System (ADS)

    Hill, K. A.; Rogers, L. A.; Hawkes, R. L.

    2005-12-01

    Interstellar origin meteoroids have now been detected using radar, image intensified video, large aperture radar and space dust impact techniques. Dynamical and radiation production mechanisms will eject some meteoroids from other planetary systems into orbits which will impact Earth with high geocentric velocities. In this paper we numerically model the ablation of high geocentric velocity (71 to 500~km s-1) meteors in order to predict the heights, light curves and trail lengths to be expected. We modeled three compositions and structures: asteroidal, cometary and porous cometary. Meteoroid masses ranging from 10-6 to 10-13~kg were used in the model. As expected, these high geocentric velocity meteors, when compared to other meteors, ablate higher in the atmosphere. For example a 300~km s-1 cometary structure meteor of mass 10-9~kg will have a peak luminosity at about 190 km. They will also have significantly longer trail lengths. The same 300~km s-1, 10-9~kg cometary meteor would be within 2 mag of its peak brightness for a vertical displacement of 60 km if incident at a zenith angle of 45°. The peak light intensity of these high geocentric velocity meteors changes only slowly with velocity. Although the incident kinetic energy per unit time increases dramatically, this is largely offset by a decrease in the optical luminous efficiency in this velocity regime according to our luminous efficiency model. The 300~km s-1, 10-9~kg cometary meteor would have an absolute meteor magnitude at peak luminosity of about +8.5 mag. Our results suggest that at least those high geocentric velocity meteors larger than about 10-8~kg should be observable with current meteor electro-optical technology although there may be observational biases against their detection. The results of this paper can be used to help optimize a search strategy for these very high geocentric velocity meteors.

  19. Atrioventricular Junction Ablation for Atrial Fibrillation.

    PubMed

    Patel, Dilesh; Daoud, Emile G

    2016-04-01

    Atrioventricular junction (AVJ) ablation is an effective therapy in patients with symptomatic atrial fibrillation who are intolerant to or unsuccessfully managed with rhythm control or medical rate control strategies. A drawback is that the procedure mandates a pacing system. Overall, the safety and efficacy of AVJ ablation is high with a majority of the patients reporting significant improvement in symptoms and quality-of-life measures. Risk of sudden cardiac death after device implantation is low, especially with an appropriate postprocedure pacing rate. Mortality benefit with AVJ ablation has been shown in patients with heart failure and cardiac resynchronization therapy devices. PMID:26968669

  20. Atrioventricular junction ablation for atrial fibrillation.

    PubMed

    Patel, Dilesh; Daoud, Emile G

    2014-11-01

    Atrioventricular junction (AVJ) ablation is an effective therapy in patients with symptomatic atrial fibrillation who are intolerant to or unsuccessfully managed with rhythm control or medical rate control strategies. A drawback is that the procedure mandates a pacing system. Overall, the safety and efficacy of AVJ ablation is high with a majority of the patients reporting significant improvement in symptoms and quality-of-life measures. Risk of sudden cardiac death after device implantation is low, especially with an appropriate postprocedure pacing rate. Mortality benefit with AVJ ablation has been shown in patients with heart failure and cardiac resynchronization therapy devices. PMID:25443238

  1. Diamond Ablators for Inertial Confinement Fusion

    SciTech Connect

    Biener, J; Mirkarimi, P B; Tringe, J W; Baker, S L; Wang, Y M; Kucheyev, S O; Teslich, N E; Wu, K J; Hamza, A V; Wild, C; Woerner, E; Koidl, P; Bruehne, K; Fecht, H

    2005-06-21

    Diamond has a unique combination of physical properties for the inertial confinement fusion ablator application, such as appropriate optical properties, high atomic density, high yield strength, and high thermal conductivity. Here, we present a feasible concept to fabricate diamond ablator shells. The fabrication of diamond capsules is a multi-step process, which involves diamond chemical vapor deposition on silicon mandrels followed by polishing, microfabrication of holes, and removing of the silicon mandrel by an etch process. We also discuss the pros and cons of coarse-grained optical quality and nanocrystalline chemical vapor deposition diamond films for the ablator application.

  2. Catheter ablation of inappropriate sinus tachycardia.

    PubMed

    Gianni, Carola; Di Biase, Luigi; Mohanty, Sanghamitra; Gökoğlan, Yalçın; Güneş, Mahmut F; Horton, Rodney; Hranitzky, Patrick M; Burkhardt, J David; Natale, Andrea

    2016-06-01

    Catheter ablation for inappropriate sinus tachycardia (IST) is recommended for patients symptomatic for palpitations and refractory to other treatments. The current approach consists in sinus node modification (SNM), achieved by ablation of the cranial part of the sinus node to eliminate faster sinus rates while trying to preserve chronotropic competence. This approach has a limited efficacy, with a very modest long-term clinical success. To overcome this, proper patient selection is crucial and an epicardial approach should always be considered. This brief review will discuss the current role and limitations of catheter ablation in the management of patients with IST. PMID:26310299

  3. Investigation of different liquid media and ablation times on pulsed laser ablation synthesis of aluminum nanoparticles

    NASA Astrophysics Data System (ADS)

    Baladi, Arash; Sarraf Mamoory, Rasoul

    2010-10-01

    Aluminum nanoparticles were synthesized by pulsed laser ablation of Al targets in ethanol, acetone, and ethylene glycol. Transmission Electron Microscope (TEM) and Scanning Electron Microscope (SEM) images, Particle size distribution diagram from Laser Particle Size Analyzer (LPSA), UV-visible absorption spectra, and weight changes of targets were used for the characterization and comparison of products. The experiments demonstrated that ablation efficiency in ethylene glycol is too low, in ethanol is higher, and in acetone is highest. Comparison between ethanol and acetone clarified that acetone medium leads to finer nanoparticles (mean diameter of 30 nm) with narrower size distribution (from 10 to 100 nm). However, thin carbon layer coats some of them, which was not observed in ethanol medium. It was also revealed that higher ablation time resulted in higher ablated mass, but lower ablation rate. Finer nanoparticles, moreover, were synthesized in higher ablation times.

  4. Indications for Salivary Gland Radiotherapy.

    PubMed

    Thomson, David J; Slevin, Nick J; Mendenhall, William M

    2016-01-01

    There is an established role for post-operative radiotherapy in the treatment of benign and malignant salivary gland tumours. For benign disease, the addition of radiotherapy improves local tumour control in cases with incomplete excision, involved surgical margins or multi-focal disease recurrence. After capsule rupture or spillage alone, surveillance should usually be advised. For malignant disease, post-operative radiotherapy is recommended for an advanced tumour stage, high-grade tumour, perineural or lympho-vascular invasion, close or positive resection margins, extra-parotid extension or lymph node involvement. The main benefit is increased loco-regional tumour control, although this may translate into a modest improvement in survival. The possible late side effects of parotid bed irradiation include skin changes, chronic otitis externa, sensorineural hearing loss, osteoradionecrosis and secondary malignancy. Severe complications are rare, but patients should be counselled carefully about the risks. Primary radiotherapy is unlikely to be curative and is reserved to cases in which resection would cause unacceptable functional or cosmetic morbidity or would likely result in subtotal resection (R2) or to patients with distant metastases to gain local tumour control. There are provisional data on the use of charged particle radiotherapy in this setting. Some patients may benefit from synchronous chemotherapy with radiotherapy, but this group is not defined, and data from comparative prospective studies are required before routine clinical use of this treatment. PMID:27093301

  5. Current Tumor Ablation Technologies: Basic Science and Device Review

    PubMed Central

    Saldanha, David F.; Khiatani, Vishal L.; Carrillo, Tami C.; Yap, Felix Y.; Bui, James T.; Knuttinen, M. Grace; Owens, Charles A.; Gaba, Ron C.

    2010-01-01

    Image-guided tumor ablation is an increasingly utilized tool to treat focal malignancy. Tumor ablation can be divided into two large categories, thermal and chemical ablation. The authors provide an overview of the current methods used to achieve thermal and chemical ablation of tumors, specifically addressing the basic science behind the ablation methods as well as providing a brief synopsis of the commercial devices currently available for use in the United States. PMID:22550363

  6. Dual beam optical system for pulsed laser ablation film deposition

    DOEpatents

    Mashburn, D.N.

    1996-09-24

    A laser ablation apparatus having a laser source outputting a laser ablation beam includes an ablation chamber having a sidewall, a beam divider for dividing the laser ablation beam into two substantially equal halves, and a pair of mirrors for converging the two halves on a surface of the target from complementary angles relative to the target surface normal, thereby generating a plume of ablated material emanating from the target. 3 figs.

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

    PubMed

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

    2016-01-01

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

  8. Femtosecond laser ablation of dentin and enamel: relationship between laser fluence and ablation efficiency

    NASA Astrophysics Data System (ADS)

    Chen, Hu; Liu, Jing; Li, Hong; Ge, Wenqi; Sun, Yuchun; Wang, Yong; Lü, Peijun

    2015-02-01

    The objective was to study the relationship between laser fluence and ablation efficiency of a femtosecond laser with a Gaussian-shaped pulse used to ablate dentin and enamel for prosthodontic tooth preparation. A diode-pumped thin-disk femtosecond laser with wavelength of 1025 nm and pulse width of 400 fs was used for the ablation of dentin and enamel. The laser spot was guided in a line on the dentin and enamel surfaces to form a groove-shaped ablation zone under a series of laser pulse energies. The width and volume of the ablated line were measured under a three-dimensional confocal microscope to calculate the ablation efficiency. Ablation efficiency for dentin reached a maximum value of 0.020 mm3/J when the laser fluence was set at 6.51 J/cm2. For enamel, the maximum ablation efficiency was 0.009 mm3/J at a fluence of 7.59 J/cm2. Ablation efficiency of the femtosecond laser on dentin and enamel is closely related to the laser fluence and may reach a maximum when the laser fluence is set to an appropriate value.

  9. How to Improve Therapeutic Ratio in Radiotherapy of HCC

    PubMed Central

    Tsai, Chiao-Ling; Hsu, Feng-Ming; Cheng, Jason Chia-Hsien

    2016-01-01

    Background During the past two decades, external-beam radiation technology has substantially changed from traditional two-dimensional to conformal three-dimensional to intensity-modulated planning and stereotactic body radiotherapy (SBRT). Summary Modern techniques of radiotherapy (RT) are highly focused and capable of delivering an ablative dose to targeted hepatocellular carcinoma (HCC) tumors. SBRT is an option for selected patients with limited tumor volume and non-eligibility for other invasive treatments. Moreover, RT combined with a radiation sensitizer (RS) to increase the therapeutic ratio has shown promising results in select studies, prompting further investigation of this combination. With the undetermined role of RT in treatment guidelines and variation in patterns of treatment failure after RT in patient with HCC, useful biomarkers to guide RT decision-making and selection of patients are needed and emerging. Key Message The objective of this review is to summarize the current RS with SBRT schemes and biomarkers for patient selection used to maximize the effect of RT on HCC. PMID:27493896

  10. Femtosecond laser ablation of the stapes

    PubMed Central

    McCaughey, Ryan G.; Sun, Hui; Rothholtz, Vanessa S.; Juhasz, Tibor; Wong, Brian J. F.

    2014-01-01

    A femtosecond laser, normally used for LASIK eye surgery, is used to perforate cadaveric human stapes. The thermal side effects of bone ablation are measured with a thermocouple in an inner ear model and are found to be within acceptable limits for inner ear surgery. Stress and acoustic events, recorded with piezoelectric film and a microphone, respectively, are found to be negligible. Optical microscopy, scanning electron microscopy, and optical coherence tomography are used to confirm the precision of the ablation craters and lack of damage to the surrounding tissue. Ablation is compared to that from an Er:YAG laser, the current laser of choice for stapedotomy, and is found to be superior. Ultra-short-pulsed lasers offer a precise and efficient ablation of the stapes, with minimal thermal and negligible mechanical and acoustic damage. They are, therefore, ideal for stapedotomy operations. PMID:19405768

  11. [Ablation of supraventricular tachycardias : Complications and emergencies].

    PubMed

    Sawan, N; Eitel, C; Thiele, H; Tilz, R

    2016-06-01

    Catheter ablation is an established treatment of supraventricular tachycardias (SVT) with high success rates of > 95 %. Complication rates range from 3 to 5 %, with serious complications occurring in about 0.8 %. There are general complications caused either by the vascular access or the catheters (e. g. hematomas, hemo-pneumothorax, embolism, thrombosis and aspiration) und specific ablation related complications (e. g. AV block during ablation of the slow pathway). The complication risk is elevated in elderly and multimorbid patients. Furthermore, the experience of the treating physician and the respective team plays an essential role. The purpose of this article is to give an overview on incidences, causes and management as well as prevention strategies of complications associated with catheter ablation of SVT. PMID:27206630

  12. Femtosecond laser ablation of the stapes

    NASA Astrophysics Data System (ADS)

    McCaughey, Ryan G.; Sun, Hui; Rothholtz, Vanessa S.; Juhasz, Tibor; Wong, Brian J. F.

    2009-03-01

    A femtosecond laser, normally used for LASIK eye surgery, is used to perforate cadaveric human stapes. The thermal side effects of bone ablation are measured with a thermocouple in an inner ear model and are found to be within acceptable limits for inner ear surgery. Stress and acoustic events, recorded with piezoelectric film and a microphone, respectively, are found to be negligible. Optical microscopy, scanning electron microscopy, and optical coherence tomography are used to confirm the precision of the ablation craters and lack of damage to the surrounding tissue. Ablation is compared to that from an Er:YAG laser, the current laser of choice for stapedotomy, and is found to be superior. Ultra-short-pulsed lasers offer a precise and efficient ablation of the stapes, with minimal thermal and negligible mechanical and acoustic damage. They are, therefore, ideal for stapedotomy operations.

  13. Optical Effects on Laser Ablated Polymer Surfaces

    NASA Astrophysics Data System (ADS)

    Prabhu, R. D.; Govinthasamy, R.; Murthy, N. S.

    2006-03-01

    Laser ablation of poly (ethylene terephthalate) and polyimide films were investigated using Excimer-UV laser. SEM analyses indicate the presence of rings for a wide range of ablation parameters (fluence, frequency and number of pulses). It is proposed that the particles present in the plasma plume could cause the incident laser light to diffract, similar to the optical effects observed in the femtosecond laser ablation of solids. The polymer surface provides a perfect medium to register the optical signatures as seen in the SEM images. The fringe-spacings observed in the images are compared with the theoretical diffraction patterns and the height of the plasma particles above the surface is estimated using an optimization scheme. The results of the analysis are consistent with experimentally observed dynamics of the plasma plume. It is proposed that such optical effects could be a routine feature in the laser ablation of polymers. The significance of such artifacts for lithography is discussed.

  14. Laser ablation in analytical chemistry - A review

    SciTech Connect

    Russo, Richard E.; Mao, Xianglei; Liu, Haichen; Gonzalez, Jhanis; Mao, Samuel S.

    2001-10-10

    Laser ablation is becoming a dominant technology for direct solid sampling in analytical chemistry. Laser ablation refers to the process in which an intense burst of energy delivered by a short laser pulse is used to sample (remove a portion of) a material. The advantages of laser ablation chemical analysis include direct characterization of solids, no chemical procedures for dissolution, reduced risk of contamination or sample loss, analysis of very small samples not separable for solution analysis, and determination of spatial distributions of elemental composition. This review describes recent research to understand and utilize laser ablation for direct solid sampling, with emphasis on sample introduction to an inductively coupled plasma (ICP). Current research related to contemporary experimental systems, calibration and optimization, and fractionation is discussed, with a summary of applications in several areas.

  15. Photodynamic therapy toward selective endometrial ablation

    NASA Astrophysics Data System (ADS)

    Tadir, Yona; Tromberg, Bruce J.; Krasieva, Tatiana B.; Berns, Michael W.

    1993-05-01

    Potential applications of photodynamic therapy for endometrial disease are discussed. Experimental models that may lead to diagnosis and treatment of endometriosis as well as selective endometrial ablation are summarized.

  16. Left Atrial Anatomy Relevant to Catheter Ablation

    PubMed Central

    Sánchez-Quintana, Damián; Cabrera, José Angel; Saremi, Farhood

    2014-01-01

    The rapid development of interventional procedures for the treatment of arrhythmias in humans, especially the use of catheter ablation techniques, has renewed interest in cardiac anatomy. Although the substrates of atrial fibrillation (AF), its initiation and maintenance, remain to be fully elucidated, catheter ablation in the left atrium (LA) has become a common therapeutic option for patients with this arrhythmia. Using ablation catheters, various isolation lines and focal targets are created, the majority of which are based on gross anatomical, electroanatomical, and myoarchitectual patterns of the left atrial wall. Our aim was therefore to review the gross morphological and architectural features of the LA and their relations to extracardiac structures. The latter have also become relevant because extracardiac complications of AF ablation can occur, due to injuries to the phrenic and vagal plexus nerves, adjacent coronary arteries, or the esophageal wall causing devastating consequences. PMID:25057427

  17. Laser ablation inductively coupled plasma mass spectrometry

    SciTech Connect

    Durrant, S.F.

    1996-07-01

    Laser ablation for solid sample introduction to inductively coupled plasma mass spectrometry for bulk and spatially-resolved elemental analysis is briefly reviewed. {copyright} {ital 1996 American Institute of Physics.}

  18. Thermal Ablation Modeling for Silicate Materials

    NASA Technical Reports Server (NTRS)

    Chen, Yih-Kanq

    2016-01-01

    A general thermal ablation model for silicates is proposed. The model includes the mass losses through the balance between evaporation and condensation, and through the moving molten layer driven by surface shear force and pressure gradient. This model can be applied in the ablation simulation of the meteoroid and the glassy ablator for spacecraft Thermal Protection Systems. Time-dependent axisymmetric computations are performed by coupling the fluid dynamics code, Data-Parallel Line Relaxation program, with the material response code, Two-dimensional Implicit Thermal Ablation simulation program, to predict the mass lost rates and shape change. The predicted mass loss rates will be compared with available data for model validation, and parametric studies will also be performed for meteoroid earth entry conditions.

  19. Nanoscale ablation through optically trapped microspheres

    NASA Astrophysics Data System (ADS)

    Fardel, Romain; McLeod, Euan; Tsai, Yu-Cheng; Arnold, Craig B.

    2010-10-01

    The ability to directly create patterns with size scales below 100 nm is important for many applications where the production or repair of high resolution and density features is needed. Laser-based direct-write methods have the benefit of being able to quickly and easily modify and create structures on existing devices, but ablation can negatively impact the overall technique. In this paper we show that self-positioning of near-field objectives through the optical trap assisted nanopatterning (OTAN) method allows for ablation without harming the objective elements. Small microbeads are positioned in close proximity to a substrate where ablation is initiated. Upon ablation, these beads are temporarily displaced from the trap but rapidly return to the initial position. We analyze the range of fluence values for which this process occurs and find that there exists a critical threshold beyond which the beads are permanently ejected.

  20. Cisplatin-tethered gold nanospheres for multimodal chemo-radiotherapy of glioblastoma.

    PubMed

    Setua, Sonali; Ouberai, Myriam; Piccirillo, Sara G; Watts, Colin; Welland, Mark

    2014-09-21

    Glioblastoma multiforme (GBM) remains the most aggressive and challenging brain tumour to treat. We report the first successful chemo-radiotherapy on patient derived treatment resistant GBM cells using a cisplatin-tethered gold nanosphere. After intracellular uptake, the nanosphere effects DNA damage which initiates caspase-mediated apoptosis in those cells. In the presence of radiation, both gold and platinum of cisplatin, serve as high atomic number radiosensitizers leading to the emission of ionizing photoelectrons and Auger electrons. This resulted in enhanced synergy between cisplatin and radiotherapy mediated cytotoxicity, and photo/Auger electron mediated radiosensitisation leading to complete ablation of the tumour cells in an in vitro model system. This study demonstrates the potential of designed nanoparticles to target aggressive cancers in the patient derived cell lines providing a platform to move towards treatment strategies. PMID:25117686

  1. [Stereotactic radiotherapy is established treatment in localized non-small cell lung cancer].

    PubMed

    Sailas, Liisa; Virsunen, Heli

    2016-01-01

    Surgery has been the standard treatment in localized non-small cell lung cancer. Some of the early stage lung cancer patients are not suitable for surgery owing to associated diseases or refusing surgery. Ninety percent of untreated patients die within five years. Stereotactic ablative radiotherapy is a technique in which highly focused radiation treatment is given at a couple of high single doses to the tumor region. The treatment results in an average of 90% local control of the cancer, and the adverse effects are minor. Treatment outcome is equivalent to those of surgical therapy and is better than obtained with conventional external radiation therapy. PMID:27132296

  2. Photogrammetric recession measurements of an ablating surface

    NASA Technical Reports Server (NTRS)

    Schairer, Edward T. (Inventor); Heineck, James T. (Inventor)

    2012-01-01

    An instrument and method for measuring the time history of recession of an ablating surface of a test article during testing in a high enthalpy thermal test facility, such as an arcjet. The method advances prior art by providing time-history data over the full ablating surface without targets and without any modifications to the test article. The method is non-intrusive, simple to implement, requires no external light source, and does not interfere with normal operations of the arcjet facility.

  3. Resonant laser ablation: Mechanisms and applications

    SciTech Connect

    Anderson, J.E.; Allen, T.M.; Garrett, A.W.; Gill, C.G.; Hemberger, P.H.; Kelly, P.B.; Nogar, N.S.

    1997-01-01

    We will report on aspects of resonant laser ablation (RLA) behavior for a number of sample types: metals, alloys, thin films, zeolites and soil. The versatility of RLA is demonstrated, with results on a variety of samples and in several mass spectrometers. In addition, the application to depth profiling of thin films is described; absolute removal rates and detection limits are also displayed. A discussion of possible mechanisms for low-power ablation are presented. {copyright} {ital 1997 American Institute of Physics.}

  4. Catheter Ablation of Arrhythmia During Pregnancy.

    PubMed

    Driver, Kevin; Chisholm, Christian A; Darby, Andrew E; Malhotra, Rohit; Dimarco, John P; Ferguson, John D

    2015-06-01

    Cardiac arrhythmia as a complication of pregnancy can be problematic to maternal health and fetal life and development. Catheter ablation of tachyarrhythmias during pregnancy has been successfully performed in selected patients with limited experience. Techniques to limit maternal and fetal radiation exposure, including intracardiac echo and electroanatomic mapping systems, are particularly important in this setting. Specific accommodations are necessary in the care of the gravid patient during catheter ablation. PMID:25828853

  5. Flexible Ablators: Applications and Arcjet Testing

    NASA Technical Reports Server (NTRS)

    Arnold, James O.; Venkatapathy, Ethiraj; Beck, Robin A S.; Mcguire, Kathy; Prabhu, Dinesh K.; Gorbunov, Sergey

    2011-01-01

    Flexible ablators were conceived in 2009 to meet the technology pull for large, human Mars Exploration Class, 23 m diameter hypersonic inflatable aerodynamic decelerators. As described elsewhere, they have been recently undergoing initial technical readiness (TRL) advancement by NASA. The performance limits of flexible ablators in terms of maximum heat rates, pressure and shear remain to be defined. Further, it is hoped that this emerging technology will vastly expand the capability of future NASA missions involving atmospheric entry systems. This paper considers four topics of relevance to flexible ablators: (1) Their potential applications to near/far term human and robotic missions (2) Brief consideration of the balance between heat shield diameter, flexible ablator performance limits, entry vehicle controllability and aft-body shear layer impingement of interest to designers of very large entry vehicles, (3) The approach for developing bonding processes of flexible ablators for use on rigid entry bodies and (4) Design of large arcjet test articles that will enable the testing of flexible ablators in flight-like, combined environments (heat flux, pressure, shear and structural tensile loading). Based on a review of thermal protection system performance requirements for future entry vehicles, it is concluded that flexible ablators have broad applications to conventional, rigid entry body systems and are enabling to large deployable (both inflatable and mechanical) heat shields. Because of the game-changing nature of flexible ablators, it appears that NASA's Office of the Chief Technologist (OCT) will fund a focused, 3-year TRL advancement of the new materials capable of performance in heat fluxes in the range of 200-600 W/sq. cm. This support will enable the manufacture and use of the large-scale arcjet test designs that will be a key element of this OCT funded activity.

  6. Percutaneous ablation of colorectal lung metastases

    PubMed Central

    Solomon, Stephen B.

    2015-01-01

    Lung metastasectomy can prolong survival in patients with metastatic colorectal carcinoma. Thermal ablation offers a potential solution with similar reported survival outcomes. It has minimal effect on pulmonary function, or quality of life, can be repeated, and may be considered more acceptable to patients because of the associated shorter hospital stay and recovery. This review describes the indications, technique, reported outcomes, complications and radiologic appearances after thermal ablation of colorectal lung metastases. PMID:26697202

  7. Radiofrequency Ablation in the Management of Advanced Stage Thymomas: A Case Report on a Novel Multidisciplinary Therapeutic Approach

    PubMed Central

    Pala, Carlo; Versace, Renato

    2014-01-01

    We describe in this report a case of successful radiofrequency ablation of an unresectable stage III-type B3 thymoma, and we discuss the role of this novel approach in the management of patients with advanced stage thymoma. The patient, a 59-year-old Caucasian male underwent neoadjuvant chemotherapy with only a slight reduction of the mass. Subsequently, an explorative sternotomy and debulking were performed; before closing the thorax, radiofrequency ablation of the residual tumor was carried out and a partial necrosis of the mass was achieved. A further percutaneous radiofrequency ablation was performed subsequently, obtaining complete necrosis of the lesion. Successively, the patient underwent adjuvant radiotherapy. As a result of this multidisciplinary treatment, complete and stable response was obtained. It is hard to say which of the single treatments had the major impact on cure; nevertheless, the results obtained suggest that radiofrequency ablation must be taken into account for the treatment of advanced stage thymomas, and its effectiveness must be further assessed in future studies. PMID:25574416

  8. Therapeutic effects of ablative radiation on local tumor require CD8+ T cells: changing strategies for cancer treatment

    PubMed Central

    Lee, Youjin; Auh, Sogyong L.; Wang, Yugang; Burnette, Byron; Wang, Yang; Meng, Yuru; Beckett, Michael; Sharma, Rohit; Chin, Robert; Tu, Tony

    2009-01-01

    Patients with locally advanced cancer or distant metastasis frequently receive prolonged treatment with chemotherapy and/or fractionated radiotherapy (RT). Despite the initial clinical response, treatment resistance frequently develops and cure in these patients is uncommon. Developments in RT technology allow for the use of high-dose (or ablative) RT to target local tumors, with limited damage to the surrounding normal tissue. We report that reduction of tumor burden after ablative RT depends largely on T-cell responses. Ablative RT dramatically increases T-cell priming in draining lymphoid tissues, leading to reduction/eradication of the primary tumor or distant metastasis in a CD8+ T cell–dependent fashion. We further demonstrate that ablative RT-initiated immune responses and tumor reduction are abrogated by conventional fractionated RT or adjuvant chemotherapy but greatly amplified by local immunotherapy. Our study challenges the rationale for current RT/chemotherapy strategies and highlights the importance of immune activation in preventing tumor relapse. Our findings emphasize the need for new strategies that not only reduce tumor burden but also enhance the role of antitumor immunity. PMID:19349616

  9. Exploiting tumor shrinkage through temporal optimization of radiotherapy

    NASA Astrophysics Data System (ADS)

    Unkelbach, Jan; Craft, David; Hong, Theodore; Papp, Dávid; Ramakrishnan, Jagdish; Salari, Ehsan; Wolfgang, John; Bortfeld, Thomas

    2014-06-01

    In multi-stage radiotherapy, a patient is treated in several stages separated by weeks or months. This regimen has been motivated mostly by radiobiological considerations, but also provides an approach to reduce normal tissue dose by exploiting tumor shrinkage. The paper considers the optimal design of multi-stage treatments, motivated by the clinical management of large liver tumors for which normal liver dose constraints prohibit the administration of an ablative radiation dose in a single treatment. We introduce a dynamic tumor model that incorporates three factors: radiation induced cell kill, tumor shrinkage, and tumor cell repopulation. The design of multi-stage radiotherapy is formulated as a mathematical optimization problem in which the total dose to the normal tissue is minimized, subject to delivering the prescribed dose to the tumor. Based on the model, we gain insight into the optimal administration of radiation over time, i.e. the optimal treatment gaps and dose levels. We analyze treatments consisting of two stages in detail. The analysis confirms the intuition that the second stage should be delivered just before the tumor size reaches a minimum and repopulation overcompensates shrinking. Furthermore, it was found that, for a large range of model parameters, approximately one-third of the dose should be delivered in the first stage. The projected benefit of multi-stage treatments in terms of normal tissue sparing depends on model assumptions. However, the model predicts large dose reductions by more than a factor of 2 for plausible model parameters. The analysis of the tumor model suggests that substantial reduction in normal tissue dose can be achieved by exploiting tumor shrinkage via an optimal design of multi-stage treatments. This suggests taking a fresh look at multi-stage radiotherapy for selected disease sites where substantial tumor regression translates into reduced target volumes.

  10. Femtosecond laser lithotripsy: feasibility and ablation mechanism

    NASA Astrophysics Data System (ADS)

    Qiu, Jinze; Teichman, Joel M. H.; Wang, Tianyi; Neev, Joseph; Glickman, Randolph D.; Chan, Kin Foong; Milner, Thomas E.

    2010-03-01

    Light emitted from a femtosecond laser is capable of plasma-induced ablation of various materials. We tested the feasibility of utilizing femtosecond-pulsed laser radiation (λ=800 nm, 140 fs, 0.9 mJ/pulse) for ablation of urinary calculi. Ablation craters were observed in human calculi of greater than 90% calcium oxalate monohydrate (COM), cystine (CYST), or magnesium ammonium phosphate hexahydrate (MAPH). Largest crater volumes were achieved on CYST stones, among the most difficult stones to fragment using Holmium:YAG (Ho:YAG) lithotripsy. Diameter of debris was characterized using optical microscopy and found to be less than 20 μm, substantially smaller than that produced by long-pulsed Ho:YAG ablation. Stone retropulsion, monitored by a high-speed camera system with a spatial resolution of 15 μm, was negligible for stones with mass as small as 0.06 g. Peak shock wave pressures were less than 2 bars, measured by a polyvinylidene fluoride (PVDF) needle hydrophone. Ablation dynamics were visualized and characterized with pump-probe imaging and fast flash photography and correlated to shock wave pressures. Because femtosecond-pulsed laser ablates urinary calculi of soft and hard compositions, with micron-sized debris, negligible stone retropulsion, and small shock wave pressures, we conclude that the approach is a promising candidate technique for lithotripsy.

  11. Laser Ablation for Small Hepatocellular Carcinoma

    PubMed Central

    Pacella, Claudio Maurizio; Francica, Giampiero; Di Costanzo, Giovanni Giuseppe

    2011-01-01

    Hepatocellular carcinoma (HCC) is one of the most common malignancies worldwide and is increasingly detected at small size (<5 cm) owing to surveillance programmes in high-risk patients. For these cases, curative therapies such as resection, liver transplantation, or percutaneous ablation have been proposed. When surgical options are precluded, image-guided tumor ablation is recommended as the most appropriate therapeutic choice in terms of tumor local control, safety, and improvement in survival. Laser ablation (LA) represents one of currently available loco-ablative techniques: light is delivered via flexible quartz fibers of diameter from 300 to 600 μm inserted into tumor lesion through either fine needles (21g Chiba needles) or large-bore catheters. The thermal destruction of tissue is achieved through conversion of absorbed light (usually infrared) into heat. A range of different imaging modalities have been used to guide percutaneous laser ablation, but ultrasound and magnetic resonance imaging are most widely employed, according to local experience and resource availability. Available clinical data suggest that LA is highly effective in terms of tumoricidal capability with an excellent safety profile; the best results in terms of long-term survival are obtained in early HCC so that LA can be proposed not only in unresectable cases but, not differently from radiofrequency ablation, also as the first-line treatment. PMID:22191028

  12. Basic ablation phenomena during laser thrombolysis

    NASA Astrophysics Data System (ADS)

    Sathyam, Ujwal S.; Shearin, Alan; Prahl, Scott A.

    1997-05-01

    This paper presents studies of microsecond ablation phenomena that take place during laser thrombolysis. The main goals were to optimize laser parameters for efficient ablation, and to investigate the ablation mechanism. Gelatin containing an absorbing dye was used as the clot model. A parametric study was performed to identify the optimal wavelength, spot size, pulse energies, and repetition rate for maximum material removal. The minimum radiant exposures to achieve ablation at any wavelength were measured. The results suggest that most visible wavelengths were equally efficient at removing material at radiant exposures above threshold. Ablation was initiated at surface temperatures just above 100 degrees Celsius. A vapor bubble was formed during ablation. Less than 5% of the total pulse energy is coupled into the bubble energy. A large part of the delivered energy is unaccounted for and is likely released partly as acoustic transients from the vapor expansion and partly wasted as heat. The current laser and delivery systems may not be able to completely remove large clot burden that is sometimes encountered in heart attacks. However, laser thrombolysis may emerge as a favored treatment for strokes where the occlusion is generally smaller and rapid recanalization is of paramount importance. A final hypothesis is that laser thrombolysis should be done at radiant exposures close to threshold to minimize any damaging effects of the bubble dynamics on the vessel wall.

  13. Novel Laser Ablation Technology for Surface Decontamination

    SciTech Connect

    Cheng, Chung H.

    2004-06-01

    Laser ablation for surface cleaning has been pursued for the removal of paint on airplanes. It has also been pursued for the cleaning of semiconductor surfaces. However, all these approaches have been pursued by laser ablation in air. For highly contaminated surface, laser ablation in air can easily cause secondary contamination. Thus it is not suitable to apply to achieve surface decontamination for DOE facilities since many of these facilities have radioactive contaminants on the surface. Any secondary contamination will be a grave concern. The objective of this project is to develop a novel technology for laser ablation in liquid for surface decontamination. It aims to achieve more efficient surface decontamination without secondary contamination and to evaluate the economic feasibility for large scale surface decontamination with laser ablation in liquid. When laser ablation is pursued in the solution, all the desorbed contaminants will be confined in liquid. The contaminants can be precipitated and subsequently contained in a small volume for disposal. It can reduce the risk of the decontamination workers. It can also reduce the volume of contaminants dramatically.

  14. Lung Cancer Ablation: What Is the Evidence?

    PubMed Central

    de Baere, Thierry; Farouil, Geoffroy; Deschamps, Frederic

    2013-01-01

    Percutaneous ablation of small non-small cell lung cancer (NSCLC) has been demonstrated to be both feasible and safe in nonsurgical candidates. Radiofrequency ablation (RFA), the most commonly used technique for ablation, has a reported rate of complete ablation of ~90%, with best results obtained in tumors <2 to 3 cm in diameter. The best reported 1-, 3-, and 5-year overall survival rates after RFA of NSCLC are 97.7%, 72.9%, and 55.7%, respectively. It is noteworthy that in most studies, cancer-specific survival is greater than overall survival due to severe comorbidities in patients treated with RFA for NSCLC. Aside from tumor size and tumor stage, these comorbidities are predictive of survival. Other ablation techniques such as microwave and irreversible electroporation may in the future prove to overcome some of the limitations of RFA, namely for large tumors or tumors close to large vessels. Stereotactic body radiation therapy has also been demonstrated to be highly efficacious in treating small lung tumors and will need to be compared with percutaneous ablation. This article reviews the current evidence regarding RFA for lung cancer. PMID:24436531

  15. Cisplatin-tethered gold nanospheres for multimodal chemo-radiotherapy of glioblastoma

    NASA Astrophysics Data System (ADS)

    Setua, Sonali; Ouberai, Myriam; Piccirillo, Sara G.; Watts, Colin; Welland, Mark

    2014-08-01

    Glioblastoma multiforme (GBM) remains the most aggressive and challenging brain tumour to treat. We report the first successful chemo-radiotherapy on patient derived treatment resistant GBM cells using a cisplatin-tethered gold nanosphere. After intracellular uptake, the nanosphere effects DNA damage which initiates caspase-mediated apoptosis in those cells. In the presence of radiation, both gold and platinum of cisplatin, serve as high atomic number radiosensitizers leading to the emission of ionizing photoelectrons and Auger electrons. This resulted in enhanced synergy between cisplatin and radiotherapy mediated cytotoxicity, and photo/Auger electron mediated radiosensitisation leading to complete ablation of the tumour cells in an in vitro model system. This study demonstrates the potential of designed nanoparticles to target aggressive cancers in the patient derived cell lines providing a platform to move towards treatment strategies.Glioblastoma multiforme (GBM) remains the most aggressive and challenging brain tumour to treat. We report the first successful chemo-radiotherapy on patient derived treatment resistant GBM cells using a cisplatin-tethered gold nanosphere. After intracellular uptake, the nanosphere effects DNA damage which initiates caspase-mediated apoptosis in those cells. In the presence of radiation, both gold and platinum of cisplatin, serve as high atomic number radiosensitizers leading to the emission of ionizing photoelectrons and Auger electrons. This resulted in enhanced synergy between cisplatin and radiotherapy mediated cytotoxicity, and photo/Auger electron mediated radiosensitisation leading to complete ablation of the tumour cells in an in vitro model system. This study demonstrates the potential of designed nanoparticles to target aggressive cancers in the patient derived cell lines providing a platform to move towards treatment strategies. Electronic supplementary information (ESI) available: Additional figures. See DOI: 10.1039/c

  16. [Postoperative radiotherapy of prostate cancer].

    PubMed

    Guérif, S; Latorzeff, I; Lagrange, J-L; Hennequin, C; Supiot, S; Garcia, A; François, P; Soulié, M; Richaud, P; Salomon, L

    2014-10-01

    Between 10 and 40% of patients who have undergone a radical prostatectomy may have a biologic recurrence. Local or distant failure represents the possible patterns of relapse. Patients at high-risk for local relapse have extraprostatic disease, positive surgical margins or seminal vesicles infiltration or high Gleason score at pathology. Three phase-III randomized clinical trials have shown that, for these patients, adjuvant irradiation reduces the risk of tumoral progression without higher toxicity. Salvage radiotherapy for late relapse allows a disease control in 60-70% of the cases. Several research in order to improve the therapeutic ratio of the radiotherapy after prostatectomy are evaluate in the French Groupe d'Étude des Tumeurs Urogénitales (Gétug) and of the French association of urology (Afu). The Gétug-Afu 17 trial will provide answers to the question of the optimal moment for postoperative radiotherapy for pT3-4 R1 pN0 Nx patients, with the objective of comparing an immediate treatment to a differed early treatment initiated at biological recurrence. The Gétug-Afu 22 questions the place of a short hormonetherapy combined with image-guided, intensity-modulated radiotherapy (IMRT) in adjuvant situation for a detectable prostate specific antigen (PSA). The implementation of a multicenter quality control within the Gétug-Afu in order to harmonize a modern postoperative radiotherapy will allow the development of a dose escalation IMRT after surgery. PMID:25195116

  17. Small animal radiotherapy research platforms

    NASA Astrophysics Data System (ADS)

    Verhaegen, Frank; Granton, Patrick; Tryggestad, Erik

    2011-06-01

    Advances in conformal radiation therapy and advancements in pre-clinical radiotherapy research have recently stimulated the development of precise micro-irradiators for small animals such as mice and rats. These devices are often kilovolt x-ray radiation sources combined with high-resolution CT imaging equipment for image guidance, as the latter allows precise and accurate beam positioning. This is similar to modern human radiotherapy practice. These devices are considered a major step forward compared to the current standard of animal experimentation in cancer radiobiology research. The availability of this novel equipment enables a wide variety of pre-clinical experiments on the synergy of radiation with other therapies, complex radiation schemes, sub-target boost studies, hypofractionated radiotherapy, contrast-enhanced radiotherapy and studies of relative biological effectiveness, to name just a few examples. In this review we discuss the required irradiation and imaging capabilities of small animal radiation research platforms. We describe the need for improved small animal radiotherapy research and highlight pioneering efforts, some of which led recently to commercially available prototypes. From this, it will be clear that much further development is still needed, on both the irradiation side and imaging side. We discuss at length the need for improved treatment planning tools for small animal platforms, and the current lack of a standard therein. Finally, we mention some recent experimental work using the early animal radiation research platforms, and the potential they offer for advancing radiobiology research.

  18. Release of monocyte migration signals by breast cancer cell lines after ablative and fractionated γ-irradiation

    PubMed Central

    2014-01-01

    Background Radiotherapy, administered in fractionated as well as ablative settings, is an essential treatment component for breast cancer. Besides the direct tumor cell death inducing effects, there is growing evidence that immune mechanisms contribute - at least in part - to its therapeutic success. The present study was designed to characterize the type and the extent of cell death induced by fractionated and ablative radiotherapy as well as its impact on the release of monocyte migration stimulating factors by dying breast cancer cells. Methods Cell death and senescence assays were employed to characterize the response of a panel of breast cancer cell lines with different receptor and p53 status towards γ-irradiation applied in a fractionated (daily doses of 2 Gy) or ablative setting (single dose of 20 Gy). Cell-free culture supernatants were examined for their monocyte migration stimulating potential in transwell migration and 2D chemotaxis/chemokinesis assays. Irradiation-induced transcriptional responses were analyzed by qRT-PCR, and CD39 surface expression was measured by flow cytometry. Results Fast proliferating, hormone receptor negative breast cancer cell lines with defective p53 predominantly underwent primary necrosis in response to γ-irradiation when applied at a single, ablative dose of 20 Gy, whereas hormone receptor positive, p53 wildtype cells revealed a combination of apoptosis, primary, and secondary (post-apoptotic) necrosis. During necrosis the dying tumor cells released apyrase-sensitive nucleotides, which effectively stimulated monocyte migration and chemokinesis. In hormone receptor positive cells with functional p53 this was hampered by irradiation-induced surface expression of the ectonucleotidase CD39. Conclusions Our study shows that ablative radiotherapy potently induces necrosis in fast proliferating, hormone receptor negative breast cancer cell lines with mutant p53, which in turn release monocyte migration and chemokinesis

  19. Plans and status of the Beryllium ablator campaign on NIF

    NASA Astrophysics Data System (ADS)

    Kline, J. L.; Yi, S. A.; Simakov, A. N.; Wilson, D. C.; Olson, R. E.; Krasheninnikova, N. S.; Kyrala, G. A.; Perry, T. S.; Batha, S. H.; Dewald, E. L.; Edwards, M. J.; MacKinnon, A. J.; Meezan, N. B.

    2014-10-01

    Beryllium has long been known to have excellent properties for indirectly driven ICF implosions including enhanced ablation pressure, implosion velocity, and mass ablation rate. The high ablation velocity leads to stabilization of ablative hydrodynamic instabilities and higher ablation pressures. Recent ``high foot'' experiments have shown ablative Rayleigh-Taylor to be a leading cause of degraded performance for ICF implosions. While Beryllium ablators have these advantages, there are also risks associated with Beryllium target designs. A campaign is underway to design and to test these advantages for comparison with other ablator options and determine which provides the best path forward for ICF. Experiments using Beryllium ablators are expected to start in the late summer of 2014. This presentation will discuss the status of the experiments and layout the plans/goals for the campaign. This work is supported by the US DOE.

  20. Magnetocardiographically-guided catheter ablation.

    PubMed

    Fenici, R R; Covino, M; Cellerino, C; Di Lillo, M; De Filippo, M C; Melillo, G

    1995-12-01

    After more than 30 years since the first magnetocardiographic (MCG) recording was carried out with induction coils, MCG is now approaching the threshold of clinical use. During the last 5 years, in fact, there has been a growing interest of clinicians in this new method which provides an unrivalled accuracy for noninvasive, three-dimensional localization of intracardiac source. An increasing number of laboratories are reporting data validating the use of MCG as an effective method for preoperative localization of arrhythmogenic substrates and for planning the best catheter ablation approach for different arrhythmogenic substrates. In this article, available data from literature have been reviewed. We consider the clinical use of MCG to localize arrhythmogenic substrates in patients with Wolff-Parkinson-White syndrome and in patients with ventricular tachycardia in order to assess the state-of-the-art of the method on a large number of patients. This article also addresses some suggestions for industrial development of more compact, medically oriented MCG equipments at reasonable cost. PMID:10159774

  1. Lip Reconstruction after Tumor Ablation

    PubMed Central

    Ebrahimi, Ali; Kalantar Motamedi, Mohammad Hossein; Ebrahimi, Azin; Kazemi, Mohammad; Shams, Amin; Hashemzadeh, Haleh

    2016-01-01

    Approximately 25% of all oral cavity carcinomas involve the lips, and the primary management of these lesions is complete surgical resection. Loss of tissue in the lips after resection is treated with a variety of techniques, depending on the extension and location of the defect. Here we review highly accepted techniques of lip reconstruction and some of new trials with significant clinical results. Reconstruction choice is primarily depend to size of the defect, localization of defect, elasticity of tissues. But patient’s age, comorbidities, and motivation are also important. According to the defect location and size, different reconstruction methods can be used. For defects involved less than 30% of lips, primary closures are sufficient. In defects with 35–70% lip involvement, the Karapandzic, Abbe, Estlander, McGregor or Gillies’ fan flaps or their modifications can be used. When lip remaining tissues are insufficient, cheek tissue can be used in Webster and Bernard advancement flaps and their various modifications. Deltopectoral or radial forearm free flaps can be options for large defects of the lip extending to the Jaws. To achieve best functional and esthetic results, surgeons should be able to choose most appropriate reconstruction method. Considering defects’ size and location, patients’ expects and surgeon’s ability and knowledge, a variety of flaps are presented in order to reconstruct defects resulted from tumor ablation. It’s necessary for surgeons to trace the recent innovations in lip reconstruction to offer best choices to patients. PMID:27308236

  2. Dust Ablation in Pluto's Atmosphere

    NASA Astrophysics Data System (ADS)

    Horanyi, M.; Poppe, A. R.; Sternovsky, Z.

    2015-12-01

    Based on measurements by in situ dust detectors onboard the Pioneer and New Horizon spacecraft the total production rate of dust particles born in the Kuiper belt can be estimated to be on the order of 5 x 10 ^3 kg/s in the approximate size range of 1 - 10 micron. These particles slowly migrate inward due to Poynting - Robertson drag and their spatial distribution is shaped by mean motion resonances with the gas giant planets in the outer solar system. The expected mass influx into Pluto's atmosphere is on the order of 50 kg/day, and the arrival speed of the incoming particles is on the order of 3 - 4 km/s. We have followed the ablation history as function of speed and size of dust particles in Pluto's atmosphere, and found that, if the particles are rich in volatiles, they can fully sublimate due to drag heating and deposit their mass in a narrow layer. This deposition might promote the formation of the haze layers observed by the New Horizons spacecraft. This talk will explore the constraints on the composition of the dust particles, as well as on our newly developed models of Pluto's atmosphere that can be learned by matching the altitude where haze layers could be formed.

  3. Dust ablation in Pluto's atmosphere

    NASA Astrophysics Data System (ADS)

    Horanyi, Mihaly; Poppe, Andrew; Sternovsky, Zoltan

    2016-04-01

    Based on measurements by dust detectors onboard the Pioneer 10/11 and New Horizons spacecraft the total production rate of dust particles born in the Edgeworth Kuiper Belt (EKB) has been be estimated to be on the order of 5 ṡ 103 kg/s in the approximate size range of 1 - 10 μm. Dust particles are produced by collisions between EKB objects and their bombardment by both interplanetary and interstellar dust particles. Dust particles of EKB origin, in general, migrate towards the Sun due to Poynting-Robertson drag but their distributions are further sculpted by mean-motion resonances as they first approach the orbit of Neptune and later the other planets, as well as mutual collisions. Subsequently, Jupiter will eject the vast majority of them before they reach the inner solar system. The expected mass influx into Pluto atmosphere is on the order of 200 kg/day, and the arrival speed of the incoming particles is on the order of 3 - 4 km/s. We have followed the ablation history as function of speed and size of dust particles in Pluto's atmosphere, and found that volatile rich particles can fully sublimate due to drag heating and deposit their mass in narrow layers. This deposition might promote the formation of the haze layers observed by the New Horizons spacecraft. This talk will explore the constraints on the composition of the dust particles by comparing the altitude of the deposition layers to the observed haze layers.

  4. A systematic review of surgical ablation versus catheter ablation for atrial fibrillation

    PubMed Central

    Kearney, Katherine; Stephenson, Rowan; Phan, Kevin; Chan, Wei Yen; Huang, Min Yin

    2014-01-01

    Background Atrial fibrillation (AF) is an increasingly prevalent condition in the ageing population, with significantly associated morbidity and mortality. Surgical and catheter ablative strategies both aim to reduce mortality and morbidity through freedom from AF. This review consolidates all currently available comparative data to evaluate these two interventions. Methods A systematic search was conducted across MEDLINE, PubMed, Embase, Cochrane Central Register of Controlled Trials and the Cochrane Database of Systematic Reviews from January 2000 until August 2013. All studies were critically appraised and only those directly comparing surgical and catheter ablation were included. Results Seven studies were deemed suitable for analysis according to the inclusion criteria. Freedom from AF was significantly higher in the surgical ablation group versus the catheter ablation group at 6-month, 12-month and study endpoint follow-up periods. Subgroup analysis demonstrated similar trends, with higher freedom from AF in the surgical ablation group for paroxysmal AF patients. The incidence of pacemaker implantation was higher, while no difference in stroke or cardiac tamponade was demonstrated for the surgical versus catheter ablation groups. Conclusions Current evidence suggests that epicardial ablative strategies are associated with higher freedom from AF, higher pacemaker implantation rates and comparable neurological complications and cardiac tamponade incidence to catheter ablative treatment. Other complications and risks were poorly reported, which warrants further randomized controlled trials (RCTs) of adequate power and follow-up duration. PMID:24516794

  5. Quantification and controllability study of minimally invasive exothermic chemo-ablation therapy for tumor ablation.

    PubMed

    Liu, Ran; Huang, Yu; Liu, Jing

    2009-01-01

    The recently proposed exothermic chemical reaction based tumor hyperthermia method presented a new way of realizing truly minimally invasive treatment for tumor. This method utilizes heat generated from the reaction between acid and alkali solutions to allow for tumor ablation. Successful clinical implementation of this method requires a clearer understanding and quantification of the ablation area such that a more controllable operation can be made. A number of in-vitro and in-vivo experiments are designed to examine the features of thermal chemo-ablation therapy which include micro and macro characteristics of ablated tissue and temperature change during the ablation process. A Quantitative study on the relationship between velocity and ablation volume as well as a Graphical User Interface in Matlab for computerized ablation area analysis are also presented in this article. We present in here two instrument designs for thermal chemo-ablation and have completed the prototype design for the injection pump which has been tested and successfully applied in ex-vivo and vivo experiments. PMID:19963802

  6. Fractionated beam radiotherapy is a special case of continuous beam radiotherapy when irradiation time is small.

    PubMed

    Biswas, Jayanta; Rajguru, Tapan K; Choudhury, Krishnangshu B; Dutta, Sumita; Sharma, Shyam; Sarkar, Aniruddha

    2013-01-01

    Fractionated beam radiotherapy, in other terms, external beam radiotherapy (EBRT) and continuous beam radiotherapy or Brachytherapy are two modes of radiotherapy techniques. Although in many ways, they appear to be different, radiobiologically, with the help of mathematics, it can be proved that the biological effective dose (BED) of EBRT is similar to BED of Brachytherapy, when irradiation time is small. Here an attempt is made to correlate these two predominant modes of radiotherapy techniques. PMID:24125964

  7. Factors Limiting Complete Tumor Ablation by Radiofrequency Ablation

    SciTech Connect

    Paulet, Erwan Aube, Christophe; Pessaux, Patrick; Lebigot, Jerome; Lhermitte, Emilie; Oberti, Frederic; Ponthieux, Anne; Cales, Paul; Ridereau-Zins, Catherine; Pereira, Philippe L.

    2008-01-15

    The purpose of this study was to determine radiological or physical factors to predict the risk of residual mass or local recurrence of primary and secondary hepatic tumors treated by radiofrequency ablation (RFA). Eighty-two patients, with 146 lesions (80 hepatocellular carcinomas, 66 metastases), were treated by RFA. Morphological parameters of the lesions included size, location, number, ultrasound echogenicity, computed tomography density, and magnetic resonance signal intensity were obtained before and after treatment. Parameters of the generator were recorded during radiofrequency application. The recurrence-free group was statistically compared to the recurrence and residual mass groups on all these parameters. Twenty residual masses were detected. Twenty-nine lesions recurred after a mean follow-up of 18 months. Size was a predictive parameter. Patients' sex and age and the echogenicity and density of lesions were significantly different for the recurrence and residual mass groups compared to the recurrence-free group (p < 0.05). The presence of an enhanced ring on the magnetic resonance control was more frequent in the recurrence and residual mass groups. In the group of patients with residual lesions, analysis of physical parameters showed a significant increase (p < 0.05) in the time necessary for the temperature to rise. In conclusion, this study confirms risk factors of recurrence such as the size of the tumor and emphasizes other factors such as a posttreatment enhanced ring and an increase in the time necessary for the rise in temperature. These factors should be taken into consideration when performing RFA and during follow-up.

  8. Ultraviolet femtosecond and nanosecond laser ablation of silicon: Ablation efficiency and laser-induced plasma expansion

    SciTech Connect

    Zeng, Xianzhong; Mao, Xianglei; Greif, Ralph; Russo, Richard E.

    2004-03-23

    Femtosecond laser ablation of silicon in air was studied and compared with nanosecond laser ablation at ultraviolet wavelength (266 nm). Laser ablation efficiency was studied by measuring crater depth as a function of pulse number. For the same number of laser pulses, the fs-ablated crater was about two times deeper than the ns-crater. The temperature and electron number density of the pulsed laser-induced plasma were determined from spectroscopic measurements. The electron number density and temperature of fs-pulse plasmas decreased faster than ns-pulse plasmas due to different energy deposition mechanisms. Images of the laser-induced plasma were obtained with femtosecond time-resolved laser shadowgraph imaging. Plasma expansion in both the perpendicular and the lateral directions to the laser beam were compared for femtosecond and nanosecond laser ablation.

  9. Ablation enhancement of silicon by ultrashort double-pulse laser ablation

    SciTech Connect

    Zhao, Xin; Shin, Yung C.

    2014-09-15

    In this study, the ultrashort double-pulse ablation of silicon is investigated. An atomistic simulation model is developed to analyze the underlying physics. It is revealed that the double-pulse ablation could significantly increase the ablation rate of silicon, compared with the single pulse ablation with the same total pulse energy, which is totally different from the case of metals. In the long pulse delay range (over 1 ps), the enhancement is caused by the metallic transition of melted silicon with the corresponding absorption efficiency. At ultrashort pulse delay (below 1 ps), the enhancement is due to the electron excitation by the first pulse. The enhancement only occurs at low and moderate laser fluence. The ablation is suppressed at high fluence due to the strong plasma shielding effect.

  10. Expanding global access to radiotherapy.

    PubMed

    Atun, Rifat; Jaffray, David A; Barton, Michael B; Bray, Freddie; Baumann, Michael; Vikram, Bhadrasain; Hanna, Timothy P; Knaul, Felicia M; Lievens, Yolande; Lui, Tracey Y M; Milosevic, Michael; O'Sullivan, Brian; Rodin, Danielle L; Rosenblatt, Eduardo; Van Dyk, Jacob; Yap, Mei Ling; Zubizarreta, Eduardo; Gospodarowicz, Mary

    2015-09-01

    Radiotherapy is a critical and inseparable component of comprehensive cancer treatment and care. For many of the most common cancers in low-income and middle-income countries, radiotherapy is essential for effective treatment. In high-income countries, radiotherapy is used in more than half of all cases of cancer to cure localised disease, palliate symptoms, and control disease in incurable cancers. Yet, in planning and building treatment capacity for cancer, radiotherapy is frequently the last resource to be considered. Consequently, worldwide access to radiotherapy is unacceptably low. We present a new body of evidence that quantifies the worldwide coverage of radiotherapy services by country. We show the shortfall in access to radiotherapy by country and globally for 2015-35 based on current and projected need, and show substantial health and economic benefits to investing in radiotherapy. The cost of scaling up radiotherapy in the nominal model in 2015-35 is US$26·6 billion in low-income countries, $62·6 billion in lower-middle-income countries, and $94·8 billion in upper-middle-income countries, which amounts to $184·0 billion across all low-income and middle-income countries. In the efficiency model the costs were lower: $14·1 billion in low-income, $33·3 billion in lower-middle-income, and $49·4 billion in upper-middle-income countries-a total of $96·8 billion. Scale-up of radiotherapy capacity in 2015-35 from current levels could lead to saving of 26·9 million life-years in low-income and middle-income countries over the lifetime of the patients who received treatment. The economic benefits of investment in radiotherapy are very substantial. Using the nominal cost model could produce a net benefit of $278·1 billion in 2015-35 ($265·2 million in low-income countries, $38·5 billion in lower-middle-income countries, and $239·3 billion in upper-middle-income countries). Investment in the efficiency model would produce in the same period an even

  11. Voice following radiotherapy.

    PubMed

    Stoicheff, M L

    1975-04-01

    This study was undertaken to provide information on the voice of patients following radiotherapy for glottic cancer. Part I presents findings from questionnaires returned by 227 of 235 patients successfully irradiated for glottic cancer from 1960 through 1971. Part II presents preliminary findings on the speaking fundamental frequencies of 22 irradiated patients. Normal to near-normal voice was reported by 83 percent of the 227 patients; however, 80 percent did indicate persisting vocal difficulties such as fatiguing of voice with much usage, inability to sing, reduced loudness, hoarse voice quality and inability to shout. Amount of talking during treatments appeared to affect length of time for voice to recover following treatments in those cases where it took from nine to 26 weeks; also, with increasing years since treatment, patients rated their voices more favorably. Smoking habits following treatments improved significantly with only 27 percent smoking heavily as compared with 65 percent prior to radiation therapy. No correlation was found between smoking (during or after treatments) and vocal ratings or between smoking and length of time for voice to recover. There was no relationship found between reported vocal ratings and stage of the disease. Data on mean speaking fundamental frequency seem to indicate a trend toward lower frequencies in irradiated patients as compared with normals. A trend was also noted in both irradidated and control groups for lower speaking fundamental frequencies in heavy smokers compared with non-smokers or previous smokers. These trends would indicate some vocal cord thickening or edema in irradiated patients and in heavy smokers. It is suggested that the study of irradiated patients' voices before, during and following treatments by means of audio, aerodynamic and acoustic instrumentation would yield additional information of diagnostic value on recovery of laryngeal function. It is also suggested that the voice pathologist could

  12. Radiotherapy for ocular tumours.

    PubMed

    Stannard, C; Sauerwein, W; Maree, G; Lecuona, K

    2013-02-01

    Ocular tumours present a therapeutic challenge because of the sensitive tissues involved and the necessity to destroy the tumour while minimising visual loss. Radiotherapy (RT) is one of several modalites used apart from surgery, laser, cryotherapy, and chemotherapy. Both external beam RT (EBRT) and brachytherapy are used. Tumours of the bulbar conjunctiva, squamous carcinoma and malignant melanoma, can be treated with a radioactive plaque: strontium-90, ruthenium-106 (Ru-106), or iodine-125 (I-125), after excision. If the tumour involves the fornix or tarsal conjunctiva, proton therapy can treat the conjunctiva and spare most of the eye. Alternatively, an I-125 interstitial implant can be used with shielding of the cornea and lens. Conjunctival mucosal-associated lymphoid tissue lymphoma can be treated with an anterior electron field with lens shielding and 25-30 Gray (Gy) in 2 Gy fractions. Discrete retinoblastoma (RB), too large for cryotherapy or thermolaser, or recurrent after these modalities, can be treated with plaque therapy, I-125, or Ru-106. For large RB, multiple tumours, or vitreous seeds the whole eye can be treated with an I-125 applicator, sparing the bony orbit, or with EBRT, under anaesthetic, using X-rays or proton therapy with vacuum contact lenses to fix the eyes in the required position. Post-enucleated orbits at risk for recurrent RB can be treated with an I-125 implant with shielding to reduce the dose to the bony orbit. Uveal malignant melanomas can be treated with plaque or proton therapy with excellent local control. Preservation of vision will depend on the initial size and location of the tumour. PMID:23174750

  13. Radiotherapy for ocular tumours

    PubMed Central

    Stannard, C; Sauerwein, W; Maree, G; Lecuona, K

    2013-01-01

    Ocular tumours present a therapeutic challenge because of the sensitive tissues involved and the necessity to destroy the tumour while minimising visual loss. Radiotherapy (RT) is one of several modalites used apart from surgery, laser, cryotherapy, and chemotherapy. Both external beam RT (EBRT) and brachytherapy are used. Tumours of the bulbar conjunctiva, squamous carcinoma and malignant melanoma, can be treated with a radioactive plaque: strontium-90, ruthenium-106 (Ru-106), or iodine-125 (I-125), after excision. If the tumour involves the fornix or tarsal conjunctiva, proton therapy can treat the conjunctiva and spare most of the eye. Alternatively, an I-125 interstitial implant can be used with shielding of the cornea and lens. Conjunctival mucosal-associated lymphoid tissue lymphoma can be treated with an anterior electron field with lens shielding and 25–30 Gray (Gy) in 2 Gy fractions. Discrete retinoblastoma (RB), too large for cryotherapy or thermolaser, or recurrent after these modalities, can be treated with plaque therapy, I-125, or Ru-106. For large RB, multiple tumours, or vitreous seeds the whole eye can be treated with an I-125 applicator, sparing the bony orbit, or with EBRT, under anaesthetic, using X-rays or proton therapy with vacuum contact lenses to fix the eyes in the required position. Post-enucleated orbits at risk for recurrent RB can be treated with an I-125 implant with shielding to reduce the dose to the bony orbit. Uveal malignant melanomas can be treated with plaque or proton therapy with excellent local control. Preservation of vision will depend on the initial size and location of the tumour. PMID:23174750

  14. Catheter Ablation of Fascicular Ventricular Tachycardia

    PubMed Central

    Liu, Yaowu; Fang, Zhen; Yang, Bing; Kojodjojo, Pipin; Chen, Hongwu; Ju, Weizhu; Cao, Kejiang; Chen, Minglong

    2015-01-01

    Background— Fascicular ventricular tachycardia (FVT) is a common form of sustained idiopathic left ventricular tachycardia with an Asian preponderance. This study aimed to prospectively investigate long-term clinical outcomes of patients undergoing ablation of FVT and identify predictors of arrhythmia recurrence. Methods and Results— Consecutive patients undergoing FVT ablation at a single tertiary center were enrolled. Activation mapping was performed to identify the earliest presystolic Purkinje potential during FVT that was targeted by radiofrequency ablation. Follow-up with clinic visits, ECG, and Holter monitoring was performed at least every 6 months. A total of 120 consecutive patients (mean age, 29.3±12.7 years; 82% men; all patients with normal ejection fraction) were enrolled. FVT involved left posterior fascicle and left anterior fascicle in 118 and 2 subjects, respectively. VT was noninducible in 3 patients, and ablation was acutely successful in 117 patients. With a median follow-up of 55.7 months, VT of a similar ECG morphology recurred in 17 patients, and repeat procedure confirmed FVT recurrence involving the same fascicle. Shorter VT cycle length was the only significant predictor of FVT recurrence (P=0.03). Six other patients developed new-onset upper septal FVT that was successfully ablated. Conclusions— Ablation of FVT guided by activation mapping is associated with a single procedural success rate without the use of antiarrhythmic drugs of 80.3%. Arrhythmia recurrences after an initially successful ablation were caused by recurrent FVT involving the same fascicle in two thirds of patients or new onset of upper septal FVT in the remainder. PMID:26386017

  15. Photoacoustic characterization of radiofrequency ablation lesions

    NASA Astrophysics Data System (ADS)

    Bouchard, Richard; Dana, Nicholas; Di Biase, Luigi; Natale, Andrea; Emelianov, Stanislav

    2012-02-01

    Radiofrequency ablation (RFA) procedures are used to destroy abnormal electrical pathways in the heart that can cause cardiac arrhythmias. Current methods relying on fluoroscopy, echocardiography and electrical conduction mapping are unable to accurately assess ablation lesion size. In an effort to better visualize RFA lesions, photoacoustic (PA) and ultrasonic (US) imaging were utilized to obtain co-registered images of ablated porcine cardiac tissue. The left ventricular free wall of fresh (i.e., never frozen) porcine hearts was harvested within 24 hours of the animals' sacrifice. A THERMOCOOLR Ablation System (Biosense Webster, Inc.) operating at 40 W for 30-60 s was used to induce lesions through the endocardial and epicardial walls of the cardiac samples. Following lesion creation, the ablated tissue samples were placed in 25 °C saline to allow for multi-wavelength PA imaging. Samples were imaged with a VevoR 2100 ultrasound system (VisualSonics, Inc.) using a modified 20-MHz array that could provide laser irradiation to the sample from a pulsed tunable laser (Newport Corp.) to allow for co-registered photoacoustic-ultrasound (PAUS) imaging. PA imaging was conducted from 750-1064 nm, with a surface fluence of approximately 15 mJ/cm2 maintained during imaging. In this preliminary study with PA imaging, the ablated region could be well visualized on the surface of the sample, with contrasts of 6-10 dB achieved at 750 nm. Although imaging penetration depth is a concern, PA imaging shows promise in being able to reliably visualize RF ablation lesions.

  16. Radioiodine Remnant Ablation: A Critical Review

    PubMed Central

    Bal, Chandra Sekhar; Padhy, Ajit Kumar

    2015-01-01

    Radioiodine remnant ablation (RRA) is considered a safe and effective method for eliminating residual thyroid tissue, as well as microscopic disease if at all present in thyroid bed following thyroidectomy. The rationale of RRA is that in the absence of thyroid tissue, serum thyroglobulin (Tg) measurement can be used as an excellent tumor marker. Other considerations are like the presence of significant remnant thyroid tissue makes detection and treatment of nodal or distant metastases difficult. Rarely, microscopic disease in the thyroid bed if not ablated, in the future, could be a source of anaplastic transformation. On the other hand, microscopic tumor emboli in distant sites could be the cause of distant metastasis too. The ablation of remnant tissue would in all probability eliminate these theoretical risks. It may be noted that all these are unproven contentious issues except postablation serum Tg estimation that could be a good tumor marker for detecting early biochemical recurrence in long-term follow-up strategy. Radioactive iodine is administered as a form of “adjuvant therapy” for remnant ablation. There have been several reports with regard to the administered dose for remnant ablation. The first report of a prospective randomized clinical trial was published from India by a prospective randomized study conducted at the All India Institute of Medical Sciences, New Delhi in the year 1996. The study reported that increasing the empirical 131I initial dose to more than 50 mCi results in plateauing of the dose-response curve and thus, conventional high-dose remnant ablation needs critical evaluation. Recently, two important studies were published: One from French group and the other from UK on a similar line. Interestingly, all three studies conducted in three different geographical regions of the world showed exactly similar conclusion. The new era of low-dose remnant ablation has taken a firm scientific footing across the continents. PMID:26420983

  17. Subsurface ablation of atherosclerotic plaque using ultrafast laser pulses

    PubMed Central

    Lanvin, Thomas; Conkey, Donald B.; Frobert, Aurelien; Valentin, Jeremy; Goy, Jean-Jacques; Cook, Stéphane; Giraud, Marie-Noelle; Psaltis, Demetri

    2015-01-01

    We perform subsurface ablation of atherosclerotic plaque using ultrafast pulses. Excised mouse aortas containing atherosclerotic plaque were ablated with ultrafast near-infrared (NIR) laser pulses. Optical coherence tomography (OCT) was used to observe the ablation result, while the physical damage was inspected in histological sections. We characterize the effects of incident pulse energy on surface damage, ablation hole size, and filament propagation. We find that it is possible to ablate plaque just below the surface without causing surface damage, which motivates further investigation of ultrafast ablation for subsurface atherosclerotic plaque removal. PMID:26203381

  18. Clinical quality standards for radiotherapy

    PubMed Central

    2012-01-01

    Aim of the study The technological progress that is currently being witnessed in the areas of diagnostic imaging, treatment planning systems and therapeutic equipment has caused radiotherapy to become a high-tech and interdisciplinary domain involving staff of various backgrounds. This allows steady improvement in therapy results, but at the same time makes the diagnostic, imaging and therapeutic processes more complex and complicated, requiring every stage of those processes to be planned, organized, controlled and improved so as to assure high quality of services provided. The aim of this paper is to present clinical quality standards for radiotherapy as developed by the author. Material and methods In order to develop the quality standards, a comparative analysis was performed between European and Polish legal acts adopted in the period of 1980-2006 and the universal industrial ISO 9001:2008 standard, defining requirements for quality management systems, and relevant articles published in 1984-2009 were reviewed, including applicable guidelines and recommendations of American, international, European and Polish bodies, such as the American Association of Physicists in Medicine (AAPM), the European Society for Radiotherapy & Oncology (ESTRO), the International Atomic Energy Agency (IAEA), and the Organisation of European Cancer Institutes (OECI) on quality assurance and management in radiotherapy. Results As a result, 352 quality standards for radiotherapy were developed and categorized into the following three groups: 1 – organizational standards; 2 – physico-technical standards and 3 – clinical standards. Conclusion Proposed clinical quality standards for radiotherapy can be used by any institution using ionizing radiation for medical purposes. However, standards are of value only if they are implemented, reviewed, audited and improved, and if there is a clear mechanism in place to monitor and address failure to meet agreed standards. PMID:23788854

  19. Clinical Significance of Additional Ablation of Atrial Premature Beats after Catheter Ablation for Atrial Fibrillation

    PubMed Central

    Kim, In-Soo; Yang, Pil-Sung; Kim, Tae-Hoon; Park, Junbeum; Park, Jin-Kyu; Uhm, Jae Sun; Joung, Boyoung; Lee, Moon Hyoung

    2016-01-01

    Purpose The clinical significance of post-procedural atrial premature beats immediately after catheter ablation for atrial fibrillation (AF) has not been clearly determined. We hypothesized that the provocation of immediate recurrence of atrial premature beats (IRAPB) and additional ablation improves the clinical outcome of AF ablation. Materials and Methods We enrolled 200 patients with AF (76.5% males; 57.4±11.1 years old; 64.3% paroxysmal AF) who underwent catheter ablation. Post-procedure IRAPB was defined as frequent atrial premature beats (≥6/min) under isoproterenol infusion (5 µg/min), monitored for 10 min after internal cardioversion, and we ablated mappable IRAPBs. Post-procedural IRAPB provocations were conducted in 100 patients. We compared the patients who showed IRAPB with those who did not. We also compared the IRAPB provocation group with 100 age-, sex-, and AF-type-matched patients who completed ablation without provocation (No-Test group). Results 1) Among the post-procedural IRAPB provocation group, 33% showed IRAPB and required additional ablation with a longer procedure time (p=0.001) than those without IRAPB, without increasing the complication rate. 2) During 18.0±6.6 months of follow-up, the patients who showed IRAPB had a worse clinical recurrence rate than those who did not (27.3% vs. 9.0%; p=0.016), in spite of additional IRAPB ablation. 3) However, the clinical recurrence rate was significantly lower in the IRAPB provocation group (15.0%) than in the No-Test group (28.0%; p=0.025) without lengthening of the procedure time or raising complication rate. Conclusion The presence of post-procedural IRAPB was associated with a higher recurrence rate after AF ablation. However, IRAPB provocation and additional ablation might facilitate a better clinical outcome. A further prospective randomized study is warranted. PMID:26632385

  20. Ablation threshold and ablation mechanism transition of polyoxymethylene irradiated by CO2 laser.

    PubMed

    Li, Gan; Cheng, Mousen; Li, Xiaokang

    2016-09-01

    Polyoxymethylene (POM) decomposes gradually as it is heated up by the irradiation of CO2 laser; the long-chain molecules of POM are broken into short chains, which leads to the lowering of the melting point and the critical temperature of the ablation products. When the product temperature is above the melting point, ablation comes up in the way of vaporization; when the product temperature is higher than the critical temperature, all liquid products are transformed into gas instantly and the ablation mechanism is changed. The laser fluence at which significant ablation is observed is defined as the ablation threshold, and the fluence corresponding to the ablation mechanism changing is denoted as the flyover threshold. In this paper, random pyrolysis is adopted to describe the pyrolytic decomposition of POM, and consequently, the components of the pyrolysis products under different pyrolysis rates are acquired. The Group Contribution method is used to count the thermodynamic properties of the pyrolysis products, and the melting point and the critical temperature of the product mixture are obtained by the Mixing Law. The Knudsen layer relationship is employed to evaluate the ablation mass removal when the product temperature is below the critical temperature. The gas dynamics conservation laws associated with the Jouguet condition are used to calculate the mass removal when the product temperature is higher than the critical temperature. Based on the model, a set of simulations for various laser intensities and lengths are carried out to generalize the relationships between the thresholds and the laser parameters. Besides the ablated mass areal density, which fits the experimental data quite well, the ablation temperature, pyrolysis rate, and product components are also discussed for a better understanding of the ablation mechanism of POM. PMID:27607281

  1. Radiotherapy. Gazing at the crystal ball of European radiotherapy.

    PubMed

    Overgaard, Jens

    2015-01-01

    Although radiotherapy is a key component of cancer treatment, provision of this modality is not immune to limits placed on health-care expenditure. Recent studies suggest European radiation oncology resources will generally be insufficient to meet future, and in some cases current, needs. This challenge and how it might be addressed is discussed herein. PMID:25421280

  2. Effect of Laser Wavelength and Ablation Time on Pulsed Laser Ablation Synthesis of AL Nanoparticles in Ethanol

    NASA Astrophysics Data System (ADS)

    Baladi, A.; Mamoory, R. Sarraf

    Aluminum nanoparticles were synthesized by pulsed laser ablation of Al targets in ethanol for 5-15 minutes using the 1064 and 533 nm wavelengths of a Nd:YAG laser with energies of 280-320 mJ per pulse. It has been found that higher wavelength leads to significantly higher ablation efficiency, and finer spherical nanoparticles are also synthesized. Besides, it was obvious that higher ablation time resulted in higher ablated mass, while lower ablation rate was observed. Finer nanoparticles, moreover, are synthesized in higher ablation times.

  3. Fracture in Phenolic Impregnated Carbon Ablator

    NASA Technical Reports Server (NTRS)

    Agrawal, Parul; Chavez-Garcia, Jose; Pham, John

    2013-01-01

    This paper describes the development of a novel technique to understand the failure mechanisms inside thermal protection materials. The focus of this research is on the class of materials known as phenolic impregnated carbon ablators. It has successfully flown on the Stardust spacecraft and is the thermal protection system material chosen for the Mars Science Laboratory and SpaceX Dragon spacecraft. Although it has good thermal properties, structurally, it is a weak material. To understand failure mechanisms in carbon ablators, fracture tests were performed on FiberForm(Registered TradeMark) (precursor), virgin, and charred ablator materials. Several samples of these materials were tested to investigate failure mechanisms at a microstructural scale. Stress-strain data were obtained simultaneously to estimate the tensile strength and toughness. It was observed that cracks initiated and grew in the FiberForm when a critical stress limit was reached such that the carbon fibers separated from the binder. However, both for virgin and charred carbon ablators, crack initiation and growth occurred in the matrix (phenolic) phase. Both virgin and charred carbon ablators showed greater strength values compared with FiberForm samples, confirming that the presence of the porous matrix helps in absorbing the fracture energy.

  4. Design Calculations for NIF Convergent Ablator Experiments

    NASA Astrophysics Data System (ADS)

    Olson, R. E.; Callahan, D. A.; Hicks, D. G.; Landen, O. L.; Langer, S. H.; Meezan, N. B.; Spears, B. K.; Widmann, K.; Kline, J. L.; Wilson, D. C.; Petrasso, R. D.; Leeper, R. J.

    2010-11-01

    Design calculations for NIF convergent ablator experiments will be described. The convergent ablator experiments measure the implosion trajectory, velocity, and ablation rate of an x-ray driven capsule and are a important component of the U. S. National Ignition Campaign at NIF. The design calculations are post-processed to provide simulations of the key diagnostics -- 1) Dante measurements of hohlraum x-ray flux and spectrum, 2) streaked radiographs of the imploding ablator shell, 3) wedge range filter measurements of D-He3 proton output spectra, and 4) GXD measurements of the imploded core. The simulated diagnostics will be compared to the experimental measurements to provide an assessment of the accuracy of the design code predictions of hohlraum radiation temperature, capsule ablation rate, implosion velocity, shock flash areal density, and x-ray bang time. Post-shot versions of the design calculations are used to enhance the understanding of the experimental measurements and will assist in choosing parameters for subsequent shots and the path towards optimal ignition capsule tuning. *SNL, LLNL, and LANL are operated under US DOE contracts DE-AC04-94AL85000. DE-AC52-07NA27344, and DE-AC04-94AL85000.

  5. Design calculations for NIF convergent ablator experiments.

    SciTech Connect

    Callahan, Debra; Leeper, Ramon Joe; Spears, B. K.; Zylstra, A.; Seguin, F.; Landen, Otto L.; Petrasso, R. D.; Rinderknecht, H.; Kline, J. L.; Frenje, J.; Wilson, D. C.; Langer, S. H.; Widmann, K.; Meezan, Nathan B.; Hicks, Damien G.; Olson, Richard Edward

    2010-11-01

    Design calculations for NIF convergent ablator experiments will be described. The convergent ablator experiments measure the implosion trajectory, velocity, and ablation rate of an x-ray driven capsule and are a important component of the U. S. National Ignition Campaign at NIF. The design calculations are post-processed to provide simulations of the key diagnostics: (1) Dante measurements of hohlraum x-ray flux and spectrum, (2) streaked radiographs of the imploding ablator shell, (3) wedge range filter measurements of D-He3 proton output spectra, and (4) GXD measurements of the imploded core. The simulated diagnostics will be compared to the experimental measurements to provide an assessment of the accuracy of the design code predictions of hohlraum radiation temperature, capsule ablation rate, implosion velocity, shock flash areal density, and x-ray bang time. Post-shot versions of the design calculations are used to enhance the understanding of the experimental measurements and will assist in choosing parameters for subsequent shots and the path towards optimal ignition capsule tuning.

  6. Improved laser ablation model for asteroid deflection

    NASA Astrophysics Data System (ADS)

    Vasile, Massimiliano; Gibbings, Alison; Watson, Ian; Hopkins, John-Mark

    2014-10-01

    This paper presents an improved laser ablation model and compares the performance - momentum coupling and deflection system mass - of laser ablation against contactless deflection methods based on ion-propulsion. The deflection of an asteroid through laser ablation is achieved by illuminating the surface of the asteroid with high intensity laser light. The absorbed energy induces the sublimation of the surface material and the generation of a plume of gas and ejecta. Similar to a rocket engine, the flow of expelled material produces a continuous and controllable thrust that could be used to modify the trajectory and tumbling motion of the asteroid. Recent results gained from a series of laser ablation experiments were used to improve the sublimation and deflection models. In each experiment a terrestrial olivine sample was ablated, under vacuum, with a 90 W continuous wave laser. The paper presents a model that better fits the outcomes of the experimental campaign, in particular in terms of mass flow rate and spot temperature.

  7. [Which rules apply to hypofractionated radiotherapy?].

    PubMed

    Supiot, S; Clément-Colmou, K; Paris, F; Corre, I; Chiavassa, S; Delpon, G

    2015-10-01

    Hypofractionated radiotherapy is now more widely prescribed due to improved targeting techniques (intensity modulated radiotherapy, image-guided radiotherapy and stereotactic radiotherapy). Low dose hypofractionated radiotherapy is routinely administered mostly for palliative purposes. High or very high dose hypofractionated irradiation must be delivered according to very strict procedures since every minor deviation can lead to major changes in dose delivery to the tumor volume and organs at risk. Thus, each stage of the processing must be carefully monitored starting from the limitations and the choice of the hypofractionation technique, tumour contouring and dose constraints prescription, planning and finally dose calculation and patient positioning verification. PMID:26321647

  8. Intraoperative radiotherapy: the Japanese experience. [Betatron

    SciTech Connect

    Abe, M.; Takahashi, M.

    1981-07-01

    Clinical results of intraoperative radiotherapy (IOR) which have been obtained since 1964 in Japan were reviewed. In this radiotherapy a cancerocidal dose can be delivered safely to the lesions, since critical organs are shifted from the field so that the lesions may be exposed directly to radiation. Intraoperative radiotherapy has spread in Japan and the number of institutions in which this radiotherapy is performed has continued to increase to a total of 26 in 1979. The total number of patients treated was 717. It has been demonstrated that intraoperative radiotherapy has definite effects on locally advanced abdominal neoplasms and unresectable radioresistant tumors.

  9. Effects of material composition on the ablation performance of low density elastomeric ablators

    NASA Technical Reports Server (NTRS)

    Tompkins, S. S.; Kabana, W. P.

    1973-01-01

    The ablation performance of materials composed of various concentrations of nylon, hollow silica spheres, hollow phenolic spheres, and four elastomeric resins was determined. Both blunt-body and flat-panel specimens were used, the cold-wall heating-rate ranges being 0.11 to 0.8 MW/sq m, respectively. The corresponding surface pressure ranges for these tests were 0.017 to 0.037 atmosphere and 0.004 to 0.005 atmosphere. Some of the results show that (1) the addition of nylon significantly improved the ablation performance, but the nylon was not compatible with one resin system; (2) panel and blunt-body specimen data do not show the same effect of phenolic sphere content on ablation effectiveness; and (3) there appears to be an optimum concentration of hollow silica spheres for good ablation performance. The composition of an efficient, nonproprietary ablator for lifting body application is identified and the ablation performance of this ablator is compared with the performance of three commercially available materials.

  10. Microwave ablation versus laser ablation in occluding lateral veins in goats.

    PubMed

    Wang, Xu-hong; Wang, Xiao-ping; Su, Wen-juan; Yuan, Yuan

    2016-02-01

    Increasing number of endovenous techniques are available for the treatment of saphenous vein reflux and endovenous laser ablation (EVLA) is a frequently used method. A newly developed alternative, based on thermal therapy, is endovenous microwave ablation (EMA). This study evaluated the effect of the two procedures, in terms of coagulation and histological changes, in occluding lateral veins in goats. Twelve animals were randomized into two group, with 6 treated with EMA (EMA group), and the rest 6 with EVLA (EVLA group). Results of coagulation, including coagulation, fibrinolysis and platelet activation, were assessed at three or four different time points: before, immediately after, 24 h (and 48 h) after ablation. The diameter change, a measure of efficacy, was ultrasonographically measured before and 1 month after the ablation. Histological changes were grossly and microscopically evaluated immediately, 1 and 3 month(s) after the ablation. The length of the ablated vein and preoperative average diameter were comparable between the two groups. In both EMA and EVLA groups, several coagulation parameters, fibrinolysis and platelet activation parameters only underwent slight changes. Ultrasound imaging displayed that the diameter reduction of the veins treated by EMA was significantly larger than by EVLA, in consistent with the results of macroscopic examination. Microscopic examination revealed necrosis and thickening of the vein wall, and occlusion of the lumen within 3 months after ablation in both EMA and EVLA groups. It is concluded that EMA is a minimally invasive therapy, which appears to be safe and effective for treatment of lateral veins in goats. PMID:26838749

  11. Radiofrequency catheter ablation in pediatric patients with supraventricular arrhythmias.

    PubMed

    Rhodes, L A; Lobban, J H; Schmidt, S B

    1995-01-01

    Radiofrequency (RF) ablation of foci leading to abnormal cardiac rhythms is rapidly becoming the procedure of choice in the management of arrhythmias in adults. This report reviews our initial experience with RF ablation in the pediatric population. PMID:8533398

  12. Radiotherapy T1 glottic carcinoma

    SciTech Connect

    Zablow, A.I.; Erba, P.S.; Sanfillippo, L.J.

    1989-11-01

    From 1970 to 1985, curative radiotherapy was administered to 63 patients with stage I carcinoma of the true vocal cords. Precision radiotherapeutic technique yields cure rates comparable to surgical results. Good voice quality was preserved in a high percentage of patients.

  13. Pancreatic cancer: chemotherapy and radiotherapy

    PubMed Central

    Andrén-Sandberg, Åke

    2011-01-01

    Pancreatic cancer in many cases appears in a non-curatively resectable stage when the diagnosis is made. Palliative treatment become an option in the patients with advanced stage. The present article reviewed chemotherapy and radiotherapy in various advanced stage of pancreatic cancer. PMID:22540056

  14. Preoperative radiotherapy for colorectal cancer.

    PubMed Central

    Higgins, G A; Conn, J H; Jordan, P H; Humphrey, E W; Roswit, B; Keehn, R J

    1975-01-01

    In a prospective randomized trial, 700 patients with a confirmed histological diagnosis of adenocarcinoma of the rectum or rectosigmoid were randomized to receive radiotherapy prior to operation (2000 to 2500 rads in two weeks) or surgery alone. Five year observed survival in the 453 patients on whom "curative" resection was possible was 48.5% in the X-ray treated group compared with 38.8% in controls, while in the 305 having low lying lesions requiring abdominoperineal resection, survival in the treated group was 46.9% compared with 34.3% in controls. Although suggestive of a treatment benefit, neither is considered statistically significant. Histologically positive lymph nodes were found in 41.2% of the control group and in only 27.8% of the patients receiving radiotherapy. Reveiw of all patients who died during the study shows a consistently lower death rate from cancer in the radiotherapy group. Although this study suggests a treatment benefit from preoperative radiotherapy, further studies now in progress by this group and others are necessary to determine the optimal dose regimen. PMID:805571

  15. Simulation of Double-Pulse Laser Ablation

    SciTech Connect

    Povarnitsyn, Mikhail E.; Khishchenko, Konstantin V.; Levashov, Pavel R.; Itina, Tatian E.

    2010-10-08

    We investigate the physical reasons of a strange decrease in the ablation depth observed in femtosecond double-pulse experiments with increasing delay between the pulses. Two ultrashort pulses of the same energy produce the crater which is less than that created by a single pulse. Hydrodynamic simulation shows that the ablation mechanism is suppressed when the delay between the pulses exceeds the electron-ion relaxation time. In this case, the interaction of the second laser pulse with the expanding target material leads to the formation of the second shock wave suppressing the rarefaction wave created by the first pulse. The modeling of the double-pulse ablation for different delays between pulses confirms this explanation.

  16. Deep Dive Topic: Choosing between ablators

    SciTech Connect

    Hurricane, O. A.; Thomas, C.; Olson, R.

    2015-07-14

    Recent data on implosions using identical hohlraums and very similar laser drives underscores the conundrum of making a clear choice of one ablator over another. Table I shows a comparison of Be and CH in a nominal length, gold, 575 μm-diameter, 1.6 mg/cc He gas-fill hohlraum while Table II shows a comparison of undoped HDC and CH in a +700 length, gold, 575 μm diameter, 1.6 mg/cc He gas fill hohlraum. As can be seen in the tables, the net integrated fusion performance of these ablators is the same to within error bars. In the case of the undoped HDC and CH ablators, the hot spot shapes of the implosions were nearly indistinguishable for the experiments listed in Table II.

  17. Image-Guided Spinal Ablation: A Review.

    PubMed

    Tsoumakidou, Georgia; Koch, Guillaume; Caudrelier, Jean; Garnon, Julien; Cazzato, Roberto Luigi; Edalat, Faramarz; Gangi, Afshin

    2016-09-01

    The image-guided thermal ablation procedures can be used to treat a variety of benign and malignant spinal tumours. Small size osteoid osteoma can be treated with laser or radiofrequency. Larger tumours (osteoblastoma, aneurysmal bone cyst and metastasis) can be addressed with radiofrequency or cryoablation. Results on the literature of spinal microwave ablation are scarce, and thus it should be used with caution. A distinct advantage of cryoablation is the ability to monitor the ice-ball by intermittent CT or MRI. The different thermal insulation, temperature and electrophysiological monitoring techniques should be applied. Cautious pre-procedural planning and intermittent intra-procedural monitoring of the ablation zone can help reduce neural complications. Tumour histology, patient clinical-functional status and life-expectancy should define the most efficient and least disabling treatment option. PMID:27329231

  18. Laser ablated hard coating for microtools

    DOEpatents

    McLean, II, William; Balooch, Mehdi; Siekhaus, Wigbert J.

    1998-05-05

    Wear-resistant coatings composed of laser ablated hard carbon films, are deposited by pulsed laser ablation using visible light, on instruments such as microscope tips and micro-surgical tools. Hard carbon, known as diamond-like carbon (DLC), films produced by pulsed laser ablation using visible light enhances the abrasion resistance, wear characteristics, and lifetimes of small tools or instruments, such as small, sharp silicon tips used in atomic probe microscopy without significantly affecting the sharpness or size of these devices. For example, a 10-20 nm layer of diamond-like carbon on a standard silicon atomic force microscope (AFM) tip, enables the useful operating life of the tip to be increased by at least twofold. Moreover, the low inherent friction coefficient of the DLC coating leads to higher resolution for AFM tips operating in the contact mode.

  19. Radiofrequency ablation technique eradicating palpebral margin neoplasm

    PubMed Central

    Jiang, Tian-Yu; Wang, Xing-Lin; Suo, Wei; He, Qing-Hua; Xiao, Hong-Yu

    2011-01-01

    AIM To report the study on radiofrequency ablation technique for eradication of palpebral margin neoplasm and its clinical effects. METHODS One hundred and six cases with the palpebral margin neoplasm were performed surgical removal with radiofrequency ablation technique. The 1-2 months postoperative follow-up was investigated and the lost cases were excluded from statistics. The continuing follow-up lasted about 6-16months. RESULTS One hundred cases underwent one treatment and 6 cases underwent two treatments. Six cases were missed. All the cases followed up healed well without pigmentation or scar left, nor eyelash loss or palpebral margin deformation. No case was recurrent. CONCLUSION Radiofrequency ablation has significant efficiency in eradicating the palpebral margin neoplasm. PMID:22553639

  20. Caries-selective ablation: the second threshold

    NASA Astrophysics Data System (ADS)

    Hennig, Thomas; Rechmann, Peter; Jeitner, Peter; Kaufmann, Raimund

    1993-07-01

    The aim of the study was to describe the appropriate fluence necessary for the effective removal of dental decay by ablation processes without or with at least minimal removal of healthy dentin. The experiments were conducted at two wavelengths [355 nm (frequency tripled, Q-switched Nd:YAG-laser) and 377 nm (frequency doubled, gain-switched Alexandrite-laser)] found to be close to the maximum of preferential absorption of carious dentin over healthy dentin. Optoacoustic techniques were applied to determine the ablation thresholds of healthy and carious dentin. The ablation efficiencies at characteristic fluences were determined using non-tactile microtopography. During all experiments a fiber optic delivery system was engaged.

  1. Thermal Ablation Modeling for Silicate Materials

    NASA Technical Reports Server (NTRS)

    Chen, Yih-Kanq

    2016-01-01

    A thermal ablation model for silicates is proposed. The model includes the mass losses through the balance between evaporation and condensation, and through the moving molten layer driven by surface shear force and pressure gradient. This model can be applied in ablation simulations of the meteoroid or glassy Thermal Protection Systems for spacecraft. Time-dependent axi-symmetric computations are performed by coupling the fluid dynamics code, Data-Parallel Line Relaxation program, with the material response code, Two-dimensional Implicit Thermal Ablation simulation program, to predict the mass lost rates and shape change. For model validation, the surface recession of fused amorphous quartz rod is computed, and the recession predictions reasonably agree with available data. The present parametric studies for two groups of meteoroid earth entry conditions indicate that the mass loss through moving molten layer is negligibly small for heat-flux conditions at around 1 MW/cm(exp. 2).

  2. Numerical Modeling of Ablation Heat Transfer

    NASA Technical Reports Server (NTRS)

    Ewing, Mark E.; Laker, Travis S.; Walker, David T.

    2013-01-01

    A unique numerical method has been developed for solving one-dimensional ablation heat transfer problems. This paper provides a comprehensive description of the method, along with detailed derivations of the governing equations. This methodology supports solutions for traditional ablation modeling including such effects as heat transfer, material decomposition, pyrolysis gas permeation and heat exchange, and thermochemical surface erosion. The numerical scheme utilizes a control-volume approach with a variable grid to account for surface movement. This method directly supports implementation of nontraditional models such as material swelling and mechanical erosion, extending capabilities for modeling complex ablation phenomena. Verifications of the numerical implementation are provided using analytical solutions, code comparisons, and the method of manufactured solutions. These verifications are used to demonstrate solution accuracy and proper error convergence rates. A simple demonstration of a mechanical erosion (spallation) model is also provided to illustrate the unique capabilities of the method.

  3. Advances in Imaging for Atrial Fibrillation Ablation

    PubMed Central

    D'Silva, Andrew; Wright, Matthew

    2011-01-01

    Over the last fifteen years, our understanding of the pathophysiology of atrial fibrillation (AF) has paved the way for ablation to be utilized as an effective treatment option. With the aim of gaining more detailed anatomical representation, advances have been made using various imaging modalities, both before and during the ablation procedure, in planning and execution. Options have flourished from procedural fluoroscopy, electroanatomic mapping systems, preprocedural computed tomography (CT), magnetic resonance imaging (MRI), ultrasound, and combinations of these technologies. Exciting work is underway in an effort to allow the electrophysiologist to assess scar formation in real time. One advantage would be to lessen the learning curve for what are very complex procedures. The hope of these developments is to improve the likelihood of a successful ablation procedure and to allow more patients access to this treatment. PMID:22091384

  4. Laser ablated hard coating for microtools

    DOEpatents

    McLean, W. II; Balooch, M.; Siekhaus, W.J.

    1998-05-05

    Wear-resistant coatings composed of laser ablated hard carbon films, are deposited by pulsed laser ablation using visible light, on instruments such as microscope tips and micro-surgical tools. Hard carbon, known as diamond-like carbon (DLC), films produced by pulsed laser ablation using visible light enhances the abrasion resistance, wear characteristics, and lifetimes of small tools or instruments, such as small, sharp silicon tips used in atomic probe microscopy without significantly affecting the sharpness or size of these devices. For example, a 10--20 nm layer of diamond-like carbon on a standard silicon atomic force microscope (AFM) tip, enables the useful operating life of the tip to be increased by at least twofold. Moreover, the low inherent friction coefficient of the DLC coating leads to higher resolution for AFM tips operating in the contact mode. 12 figs.

  5. Specific Impulse Definition for Ablative Laser Propulsion

    NASA Technical Reports Server (NTRS)

    Herren, Kenneth A.; Gregory, Don A.

    2004-01-01

    The term "specific impulse" is so ingrained in the field of rocket propulsion that it is unlikely that any fundamental argument would be taken seriously for its removal. It is not an ideal measure but it does give an indication of the amount of mass flow (mass loss/time), as in fuel rate, required to produce a measured thrust over some time period This investigation explores the implications of being able to accurately measure the ablation rate and how the language used to describe the specific impulse results may have to change slightly, and recasts the specific impulse as something that is not a time average. It is not currently possible to measure the ablation rate accurately in real time so it is generally just assumed that a constant amount of material will be removed for each laser pulse delivered The specific impulse dependence on the ablation rate is determined here as a correction to the classical textbook definition.

  6. Laser systems for ablative fractional resurfacing.

    PubMed

    Paasch, Uwe; Haedersdal, Merete

    2011-01-01

    Ablative fractional resurfacing (AFR) creates microscopic vertical ablated channels that are surrounded by a thin layer of coagulated tissue, constituting the microscopic treatment zones (MTZs). AFR induces epidermal and dermal remodeling, which raises new possibilities for the treatment of a variety of skin conditions, primarily chronically photodamaged skin, but also acne and burn scars. In addition, it is anticipated that AFR can be utilized in the laser-assisted delivery of topical drugs. Clinical efficacy coupled with minimal downtime has driven the development of various fractional ablative laser systems. Fractionated CO(2) (10,600-nm), erbium yttrium aluminum garnet, 2940-nm and yttrium scandium gallium garnet, 2790-nm lasers are available. In this article, we present an overview of AFR technology, devices and histopathology, and we summarize the current clinical possibilities with AFR incorporating our personal experience. AFR is still in the exploratory era, and systematic investigations of clinical outcomes related to various system settings are needed. PMID:21158542

  7. Performance of Conformable Ablators in Aerothermal Environments

    NASA Technical Reports Server (NTRS)

    Thornton, J.; Fan, W.; Skokova, K.; Stackpoole, M.; Beck, R.; Chavez-Garcia, J.

    2012-01-01

    Conformable Phenolic Impregnated Carbon Ablator, a cousin of Phenolic Impregnated Carbon Ablator (PICA), was developed at NASA Ames Research Center as a lightweight thermal protection system under the Fundamental Aeronautics Program. PICA is made using a brittle carbon substrate, which has a very low strain to failure. Conformable PICA is made using a flexible carbon substrate, a felt in this case. The flexible felt significantly increases the strain to failure of the ablator. PICA is limited by its thermal mechanical properties. Future NASA missions will require heatshields that are more fracture resistant than PICA and, as a result, NASA Ames is working to improve PICAs performance by developing conformable PICA to meet these needs. Research efforts include tailoring the chemistry of conformable PICA with varying amounts of additives to enhance mechanical properties and testing them in aerothermal environments. This poster shows the performance of conformable PICA variants in arc jets tests. Some mechanical and thermal properties will also be presented.

  8. Tumor Ablation: Common Modalities and General Practices

    PubMed Central

    Knavel, Erica M.; Brace, Christopher L.

    2014-01-01

    Tumor ablation is a minimally invasive technique that is commonly used in the treatment of tumors of the liver, kidney, bone, and lung. During tumor ablation, thermal energy is used to heat or cool tissue to cytotoxic levels (less than −40°C or more than 60°C). An additional technique is being developed that targets the permeability of the cell membrane and is ostensibly nonthermal. Within the classification of tumor ablation, there are several modalities used worldwide: radiofrequency, microwave, laser, high-intensity focused ultrasound, cryoablation, and irreversible electroporation. Each technique, although similar in purpose, has specific and optimal indications. This review serves to discuss general principles and technique, reviews each modality, and discusses modality selection. PMID:24238374

  9. Excimer laser ablation of ferrite ceramics

    NASA Astrophysics Data System (ADS)

    Tam, A. C.; Leung, W. P.; Krajnovich, D.

    We study the ablation of Ni-Zn or Mn-7n ferrites by 248-nm KrF excimer laser irradiation for high-resolution patterning. A transfer lens system is used to project the image of a mask irradiated by the pulsed KrF laser onto the ferrite sample. The threshold fluente for ablation of the ferrite surface is about 0.3 J/cm2. A typical fluente of 1 J/cm2 is used to produce good-quality patterning. Scanning electron microscopy of the ablated area shows a "glassy" skin with extensive microcracks and solidified droplets being ejected that is frozen in action. This skin can be removed by ultrasonic cleaning.

  10. Ablative Rocket Deflector Testing and Computational Modeling

    NASA Technical Reports Server (NTRS)

    Allgood, Daniel C.; Lott, Jeffrey W.; Raines, Nickey

    2010-01-01

    A deflector risk mitigation program was recently conducted at the NASA Stennis Space Center. The primary objective was to develop a database that characterizes the behavior of industry-grade refractory materials subjected to rocket plume impingement conditions commonly experienced on static test stands. The program consisted of short and long duration engine tests where the supersonic exhaust flow from the engine impinged on an ablative panel. Quasi time-dependent erosion depths and patterns generated by the plume impingement were recorded for a variety of different ablative materials. The erosion behavior was found to be highly dependent on the material s composition and corresponding thermal properties. For example, in the case of the HP CAST 93Z ablative material, the erosion rate actually decreased under continued thermal heating conditions due to the formation of a low thermal conductivity "crystallization" layer. The "crystallization" layer produced near the surface of the material provided an effective insulation from the hot rocket exhaust plume. To gain further insight into the complex interaction of the plume with the ablative deflector, computational fluid dynamic modeling was performed in parallel to the ablative panel testing. The results from the current study demonstrated that locally high heating occurred due to shock reflections. These localized regions of shock-induced heat flux resulted in non-uniform erosion of the ablative panels. In turn, it was observed that the non-uniform erosion exacerbated the localized shock heating causing eventual plume separation and reversed flow for long duration tests under certain conditions. Overall, the flow simulations compared very well with the available experimental data obtained during this project.

  11. Thermal Ablation for Benign Thyroid Nodules: Radiofrequency and Laser

    PubMed Central

    Lee, Jeong Hyun; Valcavi, Roberto; Pacella, Claudio M.; Rhim, Hyunchul; Na, Dong Gyu

    2011-01-01

    Although ethanol ablation has been successfully used to treat cystic thyroid nodules, this procedure is less effective when the thyroid nodules are solid. Radiofrequency (RF) ablation, a newer procedure used to treat malignant liver tumors, has been valuable in the treatment of benign thyroid nodules regardless of the extent of the solid component. This article reviews the basic physics, techniques, applications, results, and complications of thyroid RF ablation, in comparison to laser ablation. PMID:21927553

  12. Ablation driven by hot electrons in shock ignition

    NASA Astrophysics Data System (ADS)

    Piriz, A. R.; Rodriguez Prieto, G.; Tahir, N. A.; Zhao, Y. T.

    2016-03-01

    An analytical model for the ablation driven by hot electrons is developed. The hot electrons are assumed to carry on the totality of the absorbed laser energy. Efficient energy coupling requires to keep the critical surface sufficiently close to the ablation front. To achieve this goal for high laser intensities a short enough laser wavelength is required. Scaling laws for the ablation pressure and the other relevant magnitudes of the ablation cloud are found in terms of the laser and target parameters.

  13. Indirect-drive ablative Richtmyer Meshkov node scaling

    NASA Astrophysics Data System (ADS)

    Landen, O. L.; Baker, K. L.; Clark, D. S.; Goncharov, V. N.; Hammel, B. A.; Ho, D. D.; Hurricane, O. A.; Lindl, J. D.; Loomis, E. N.; Masse, L.; Mauche, C.; Milovich, J. L.; Peterson, J. L.; Smalyuk, V. A.; Yi, S. A.; Velikovich, A. L.; Weber, C.

    2016-05-01

    The ablation front Rayleigh Taylor hydroinstability growth dispersion curve for indirect-drive implosions has been shown to be dependent on the Richtmyer Meshkov growth during the first shock transit phase. In this paper, a simplified treatment of the first shock ablative Richtmyer-Meshkov (ARM) growth dispersion curve is used to extract differences in ablation front perturbation growth behavior as function of foot pulse shape and ablator material for comparing the merits of various ICF design option.

  14. Subcellular analysis by laser ablation electrospray ionization mass spectrometry

    DOEpatents

    Vertes, Akos; Stolee, Jessica A; Shrestha, Bindesh

    2014-12-02

    In various embodiments, a method of laser ablation electrospray ionization mass spectrometry (LAESI-MS) may generally comprise micro-dissecting a cell comprising at least one of a cell wall and a cell membrane to expose at least one subcellular component therein, ablating the at least one subcellular component by an infrared laser pulse to form an ablation plume, intercepting the ablation plume by an electrospray plume to form ions, and detecting the ions by mass spectrometry.

  15. Testing of Advanced Conformal Ablative TPS

    NASA Technical Reports Server (NTRS)

    Gasch, Matthew; Agrawal, Parul; Beck, Robin

    2013-01-01

    In support of the CA250 project, this paper details the results of a test campaign that was conducted at the Ames Arcjet Facility, wherein several novel low density thermal protection (TPS) materials were evaluated in an entry like environment. The motivation for these tests was to investigate whether novel conformal ablative TPS materials can perform under high heat flux and shear environment as a viable alternative to rigid ablators like PICA or Avcoat for missions like MSL and beyond. A conformable TPS over a rigid aeroshell has the potential to solve a number of challenges faced by traditional rigid TPS materials (such as tiled Phenolic Impregnated Carbon Ablator (PICA) system on MSL, and honeycomb-based Avcoat on the Orion Multi Purpose Crew Vehicle (MPCV)). The compliant (high strain to failure) nature of the conformable ablative materials will allow better integration of the TPS with the underlying aeroshell structure and enable monolithic-like configuration and larger segments to be used in fabrication.A novel SPRITE1 architecture, developed by the researchers at NASA Ames was used for arcjet testing. This small probe like configuration with 450 spherecone, enabled us to test the materials in a combination of high heat flux, pressure and shear environment. The heat flux near the nose were in the range of 500-1000 W/sq cm whereas in the flank section of the test article the magnitudes were about 50 of the nose, 250-500W/sq cm range. There were two candidate conformable materials under consideration for this test series. Both test materials are low density (0.28 g/cu cm) similar to Phenolic Impregnated Carbon Ablator (PICA) or Silicone Impregnated Refractory Ceramic Ablator (SIRCA) and are comprised of: A flexible carbon substrate (Carbon felt) infiltrated with an ablative resin system: phenolic (Conformal-PICA) or silicone (Conformal-SICA). The test demonstrated a successful performance of both the conformable ablators for heat flux conditions between 50

  16. Radiofrequency Ablation Complicated by Skin Burn

    PubMed Central

    Huffman, S.D.; Huffman, N.P.; Lewandowski, Robert J.; Brown, Daniel B.

    2011-01-01

    Radiofrequency (RF) ablation has been increasingly utilized as a minimally invasive treatment for primary and metastatic liver tumors, as well as tumors in the kidneys, bones, and adrenal glands. The development of high-current RF ablation has subsequently led to an increased risk of thermal skin injuries at the grounding pad site. The incidence of skin burns in recent studies ranges from 0.1–3.2% for severe skin burns (second-/third-degree), and from 5–33% for first-degree burns.1–3 PMID:22654258

  17. High throughput solar cell ablation system

    SciTech Connect

    Harley, Gabriel; Pass, Thomas; Cousins, Peter John; Viatella, John

    2014-10-14

    A solar cell is formed using a solar cell ablation system. The ablation system includes a single laser source and several laser scanners. The laser scanners include a master laser scanner, with the rest of the laser scanners being slaved to the master laser scanner. A laser beam from the laser source is split into several laser beams, with the laser beams being scanned onto corresponding wafers using the laser scanners in accordance with one or more patterns. The laser beams may be scanned on the wafers using the same or different power levels of the laser source.

  18. High throughput solar cell ablation system

    SciTech Connect

    Harley, Gabriel; Pass, Thomas; Cousins, Peter John; Viatella, John

    2012-09-11

    A solar cell is formed using a solar cell ablation system. The ablation system includes a single laser source and several laser scanners. The laser scanners include a master laser scanner, with the rest of the laser scanners being slaved to the master laser scanner. A laser beam from the laser source is split into several laser beams, with the laser beams being scanned onto corresponding wafers using the laser scanners in accordance with one or more patterns. The laser beams may be scanned on the wafers using the same or different power levels of the laser source.

  19. General Model for Multicomponent Ablation Thermochemistry

    NASA Technical Reports Server (NTRS)

    Milos, Frank S.; Marschall, Jochen; Rasky, Daniel J. (Technical Monitor)

    1994-01-01

    A previous paper (AIAA 94-2042) presented equations and numerical procedures for modeling the thermochemical ablation and pyrolysis of thermal protection materials which contain multiple surface species. This work describes modifications and enhancements to the Multicomponent Ablation Thermochemistry (MAT) theory and code for application to the general case which includes surface area constraints, rate limited surface reactions, and non-thermochemical mass loss (failure). Detailed results and comparisons with data are presented for the Shuttle Orbiter reinforced carbon-carbon oxidation protection system which contains a mixture of sodium silicate (Na2SiO3), silica (SiO2), silicon carbide (SiC), and carbon (C).

  20. Effects of Laser Wavelength on Ablator Testing

    NASA Technical Reports Server (NTRS)

    White, Susan M.

    2014-01-01

    Wavelength-dependent or spectral radiation effects are potentially significant for thermal protection materials. NASA atmospheric entry simulations include trajectories with significant levels of shock layer radiation which is concentrated in narrow spectral lines. Tests using two different high powered lasers, the 10.6 micron LHMEL I CO2 laser and the near-infrared 1.07 micron fiber laser, on low density ablative thermal protection materials offer a unique opportunity to evaluate spectral effects. Test results indicated that the laser wavelength can impact the thermal response of an ablative material, in terms of bond-line temperatures, penetration times, mass losses, and char layer thicknesses.

  1. Difficulties with Ablation for Arrhythmias in Children

    PubMed Central

    Asirvatham, Samuel J

    2008-01-01

    Radiofrequency ablation procedures in children present unique challenges for the electrophysiologist. At times, obtaining vascular access to reach the heart is a problem. If this first step is accomplished, the small size of the child's heart, arrhythmias relatively unique to the pediatric population, and the presence of congenital heart disease add to the complexity. In this manuscript, a review of commonly encountered problems and suggested solutions based on practice are presented. Precise mapping of the arrhythmogenic substrate, techniques to access excluded portions of the atrium from prior surgery, and the basis for electrophysiology maneuvers important in pediatric ablation are highlighted. PMID:18478062

  2. Experimental measurement of ablation effects in plasma armature railguns

    SciTech Connect

    Parker, J.V.; Parsons, W.M.

    1986-01-01

    Experimental evidence supporting the importance of ablation in plasma armature railguns is presented. Experiments conducted using the HYVAX and MIDI-2 railguns are described. Several indirect effects of ablation are identified from the experimental results. An improved ablation model of plasma armature dynamics is proposed which incorporates the restrike process.

  3. Sensors measure surface ablation rate of reentry vehicle heat shield

    NASA Technical Reports Server (NTRS)

    Russel, J. M., III

    1966-01-01

    Sensors measure surface erosion rate of ablating material in reentry vehicle heat shield. Each sensor, which is placed at precise depths in the heat shield is activated when the ablator surface erodes to the location of a sensing point. Sensor depth and activation time determine ablator surface erosion rate.

  4. Experimental measurement of ablation effects in plasma armature railguns

    NASA Astrophysics Data System (ADS)

    Parker, J. V.; Parsons, W. M.

    Experimental evidence supporting the importance of ablation in plasma armature railguns is presented. Experiments conducted using the HYVAX and MIDI-2 railguns are described. Several indirect effects of ablation are identified from the experimental results. An improved ablation model of plasma armature dynamics is proposed which incorporates the restrike process.

  5. Ablation techniques for primary and metastatic liver tumors.

    PubMed

    Ryan, Michael J; Willatt, Jonathon; Majdalany, Bill S; Kielar, Ania Z; Chong, Suzanne; Ruma, Julie A; Pandya, Amit

    2016-01-28

    Ablative treatment methods have emerged as safe and effective therapies for patients with primary and secondary liver tumors who are not surgical candidates at the time of diagnosis. This article reviews the current literature and describes the techniques, complications and results for radiofrequency ablation, microwave ablation, cryoablation, and irreversible electroporation. PMID:26839642

  6. Ablation techniques for primary and metastatic liver tumors

    PubMed Central

    Ryan, Michael J; Willatt, Jonathon; Majdalany, Bill S; Kielar, Ania Z; Chong, Suzanne; Ruma, Julie A; Pandya, Amit

    2016-01-01

    Ablative treatment methods have emerged as safe and effective therapies for patients with primary and secondary liver tumors who are not surgical candidates at the time of diagnosis. This article reviews the current literature and describes the techniques, complications and results for radiofrequency ablation, microwave ablation, cryoablation, and irreversible electroporation. PMID:26839642

  7. Palliative radiotherapy: current status and future directions.

    PubMed

    Sharma, Sonam; Hertan, Lauren; Jones, Joshua

    2014-12-01

    For nearly 100 years, palliative radiotherapy has been a time-efficient, effective treatment for patients with metastatic or advanced cancer in any area where local tumors are causing symptoms. Short courses including a single fraction of radiotherapy may be effective for symptom relief with minimal side effects and maximization of convenience for patient and family. With recent advances in imaging, surgery, and other local therapies as well as systemic cancer therapies, palliative radiotherapy has been used frequently in patients who may not yet have symptoms of advanced or metastatic cancer. In this setting, more prolonged radiotherapy courses and advanced radiotherapy techniques including intensity-modulated radiotherapy (IMRT) or stereotactic radiotherapy (SRT) may be useful in obtaining local control and durable palliative responses. This review will explore the use of radiotherapy across the spectrum of patients with advanced and metastatic cancer and delineate an updated, rational approach for the use of palliative radiotherapy that incorporates symptoms, prognosis, and other factors into the delivery of palliative radiotherapy. PMID:25499634

  8. [The incidence of ventricular arrhythmia following direct current ablation, high-frequency current ablation and laser photo-ablation].

    PubMed

    Hindricks, G; Haverkamp, W; Dute, U; Gülker, H

    1988-11-01

    Incidence and severity of ventricular arrhythmias (VA) following transvenous catheter ablation have so far not been fully elucidated. In the present study we evaluated the comparative incidence of postablation ventricular arrhythmias following high voltage-direct current electrical ablation (DCA), radiofrequency-ablation (RFA), and laser-photoablation (LPA). Experiments were performed on a total of 26 anesthetized mongrel dogs (BW: 20-30 kg). DCA (n = 14; 150-200 J) and RFA (n = 7; 38.5-72.5 J) were performed unipolarly via a 6F USCI catheter, LPA (n = 5; 40-80 J) was delivered through a quarz core fiber (diameter 0.4 mm) housed within a special designed catheter. Energies were delivered to various sites of free wall and apical endocardium of the left ventricle. Immediately after DCA fast runs of ventricular tachycardia (VT) developed in 13 out of 14 dogs degenerating into ventricular fibrillation in two animals. Mean cycle length of induced VT was 298 +/- 86 ms. Persistent VA, morphologically mainly characterized by an accelerated idioventricular rhythm interrupted by runs of ventricular salvoes, occurred in 12 animals (mean rate: 78 +/- 13 VPB/min 3 h after ablation). During VT early endocardial activations were recorded from the ablation site. No significant correlation between total applied energy (150-550 J) and incidence of arrhythmogenic effects was observed. RFA and LPA induced ventricular salvoes and runs of non-sustained ventricular tachycardia, in one animal ventricular fibrillation occurred during RFA; however, no persistent arrhythmic activity developed after RFA and LPA, respectively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3213137

  9. Harnessing the immunomodulatory effect of thermal and non-thermal ablative therapies for cancer treatment.

    PubMed

    Bastianpillai, Christopher; Petrides, Neophytos; Shah, Taimur; Guillaumier, Stephanie; Ahmed, Hashim U; Arya, Manit

    2015-12-01

    Minimally invasive interventional therapies are evolving rapidly and their use for the treatment of solid tumours is becoming more extensive. The in situ destruction of solid tumours by such therapies is thought to release antigens that can prime an antitumour immune response. In this review, we offer an overview of the current evidence for immune response activation associated with the utilisation of the main thermal and non-thermal ablation therapies currently in use today. This is followed by an assessment of the hypothesised mechanisms behind this immune response priming and by a discussion of potential methods of harnessing this specific response, which may subsequently be applicable in the treatment of cancer patients. References were identified through searches of PubMed/MEDLINE and Cochrane databases to identify peer-reviewed original articles, meta-analyses and reviews. Papers were searched from 1850 until October 2014. Articles were also identified through searches of the authors' files. Only papers published in English were reviewed. Thermal and non-thermal therapies have the potential to stimulate antitumour immunity although the current body of evidence is based mostly on murine trials or small-scale phase 1 human trials. The evidence for this immune-modulatory response is currently the strongest in relation to cryotherapy and radiotherapy, although data is accumulating for related ablative treatments such as high-intensity focused ultrasound, radiofrequency ablation and irreversible electroporation. This effect may be greatly enhanced by combining these therapies with other immunostimulatory interventions. Evidence is emerging into the immunomodulatory effect associated with thermal and non-thermal ablative therapies used in cancer treatment in addition to the mechanism behind this effect and how it may be harnessed for therapeutic use. A potential exists for treatment approaches that combine ablation of the primary tumour with control and possible

  10. Survival outcomes after stereotactic body radiotherapy for 79 Japanese patients with hepatocellular carcinoma.

    PubMed

    Yamashita, Hideomi; Onishi, Hiroshi; Murakami, Naoya; Matsumoto, Yasuo; Matsuo, Yukinori; Nomiya, Takuma; Nakagawa, Keiichi

    2015-05-01

    Stereotactic body radiotherapy (SBRT) is a relatively new treatment for liver tumor. Outcomes of SBRT for liver tumors unsuitable for ablation or surgical resection were evaluated. A total of 79 patients treated with SBRT for primary hepatocellular carcinoma (HCC) between 2004 and 2012 in six Japanese institutions were studied retrospectively. Patients treated with SBRT preceded by trans-arterial chemoembolization were eligible. Their median age was 73 years, 76% were males, and their Child-Pugh scores were Grades A (85%) and B (11%) before SBRT. The median biologically effective dose (α/β = 10 Gy) was 96.3 Gy. The median follow-up time was 21.0 months for surviving patients. The 2-year overall survival (OS), progression-free survival (PFS), and distant metastasis-free survival were 53%, 40% and 76%, respectively. Sex and serum PIVKA-II values were significant predictive factors for OS. Hypovascular or hypervascular types of HCC, sex and clinical stage were significant predictive factors for PFS. The 2-year PFS was 66% in Stage I vs 18% in Stages II-III. Multivariate analysis indicated that clinical stage was the only significant predictive factor for PFS. No Grade 3 laboratory toxicities in the acute, sub-acute, and chronic phases were observed. PFS after SBRT for liver tumor was satisfactory, especially for Stage I HCC, even though these patients were unsuitable for resection and ablation. SBRT is safe and might be an alternative to resection and ablation. PMID:25691453

  11. Survival outcomes after stereotactic body radiotherapy for 79 Japanese patients with hepatocellular carcinoma

    PubMed Central

    Yamashita, Hideomi; Onishi, Hiroshi; Murakami, Naoya; Matsumoto, Yasuo; Matsuo, Yukinori; Nomiya, Takuma; Nakagawa, Keiichi

    2015-01-01

    Stereotactic body radiotherapy (SBRT) is a relatively new treatment for liver tumor. Outcomes of SBRT for liver tumors unsuitable for ablation or surgical resection were evaluated. A total of 79 patients treated with SBRT for primary hepatocellular carcinoma (HCC) between 2004 and 2012 in six Japanese institutions were studied retrospectively. Patients treated with SBRT preceded by trans-arterial chemoembolization were eligible. Their median age was 73 years, 76% were males, and their Child–Pugh scores were Grades A (85%) and B (11%) before SBRT. The median biologically effective dose (α/β = 10 Gy) was 96.3 Gy. The median follow-up time was 21.0 months for surviving patients. The 2-year overall survival (OS), progression-free survival (PFS), and distant metastasis-free survival were 53%, 40% and 76%, respectively. Sex and serum PIVKA-II values were significant predictive factors for OS. Hypovascular or hypervascular types of HCC, sex and clinical stage were significant predictive factors for PFS. The 2-year PFS was 66% in Stage I vs 18% in Stages II–III. Multivariate analysis indicated that clinical stage was the only significant predictive factor for PFS. No Grade 3 laboratory toxicities in the acute, sub-acute, and chronic phases were observed. PFS after SBRT for liver tumor was satisfactory, especially for Stage I HCC, even though these patients were unsuitable for resection and ablation. SBRT is safe and might be an alternative to resection and ablation. PMID:25691453

  12. UV laser ablation patterns in intraocular lenses

    NASA Astrophysics Data System (ADS)

    Lagiou, D. P.; Evangelatos, Ch.; Apostolopoulos, A.; Spyratou, E.; Bacharis, C.; Makropoulou, M.; Serafetinides, A. A.

    2013-03-01

    The aim of this work is to investigate the effect of UV solid state laser radiation on intraocular lens (IOL) polymer surfaces as an alternative method to conventional surface shaping techniques for IOLs customization. Laser ablation experiments were performed on PMMA plates and commercially available hydrophobic and hydrophilic acrylic IOLs with the 5th harmonic of a Q-switched Nd:YAG laser (λ=213 nm). Circular arrays of holes were drilled on the polymer surface, covering the centre and the peripheries of the IOL. The morphology of the ablated IOL surface was examined with a conventional optical microscope (Leitz GMBH Wetzlar) and with a scanning electron microscope (SEM, Fei - Innova Nanoscope) at various laser parameters. Quantitative measurements of ablation rates were performed with a contact profilometer (Dektak-150), in which a mechanical stylus scanned across the surface of gold-coated IOLs (after SEM imaging) to measure variationsF in surface height. Laser interaction with IOLs depends on optical and mechanical material properties, in addition to laser radiation parameters. The exact ablation mechanism is discussed. Some polymer materials, depending on their properties, are more susceptible to the photothermal mechanism than the photochemical one or vice versa. In summary, every IOL polymer exhibits specific attributes in its interaction with the 5th harmonic of Nd:YAG laser.

  13. Ablation Resistant Zirconium and Hafnium Ceramics

    NASA Technical Reports Server (NTRS)

    Bull, Jeffrey (Inventor); White, Michael J. (Inventor); Kaufman, Larry (Inventor)

    1998-01-01

    High temperature ablation resistant ceramic composites have been made. These ceramics are composites of zirconium diboride and zirconium carbide with silicon carbide, hafnium diboride and hafnium carbide with silicon carbide and ceramic composites which contain mixed diborides and/or carbides of zirconium and hafnium. along with silicon carbide.

  14. Innovative Laser Ablation Technology for Surface Decontamination

    SciTech Connect

    Chen, Winston C. H.

    2003-06-01

    The objective of this project is to develop a novel laser ablation in liquid for surface decontamination. It aims to achieve more efficient surface decontamination without secondary contamination. Another aim is to make this surface decontamination technology becomes economically feasible for large scale decontamination.

  15. Reflecting ablating heat shields for planetary entry.

    NASA Technical Reports Server (NTRS)

    Peterson, D. L.; Nachtsheim, P. R.; Howe, J. T.

    1972-01-01

    Heat shielding for planetary entry probes of future Jovian and Venusian missions will encounter heating levels well beyond those previously experienced. These entries are typically dominated by radiative heating from the shock layer. This paper demonstrates the potential of reflecting this incident radiation diffusely from an ablating material. This technique contrasts with the absorption experienced by char-forming or graphitic ablators. Two dielectric materials, Teflon (polytetra-fluoroethylene) and boron nitride, are examined for their ablative performance, including reflection, in a combined convective- and radiative-heating environment. For Teflon, at the conditions obtained, superimposition of radiative heating upon a convective stream causes no additional increase in surface recession over the convective only results. For boron nitride, an excellent room-temperature reflector in the visible spectrum, a decrease in reflectivity from 90 to 55 percent is experienced when the surface undergoes sublimation at high temperatures. The process of reflection in each of these materials is described in terms of backscattering from crystals. The significance of a sizable reflection as a mode of energy accommodation is demonstrated for Venusian entries as a potential reduction in mass loss due to ablation.

  16. Femtosecond laser ablation of bovine cortical bone

    NASA Astrophysics Data System (ADS)

    Cangueiro, Liliana T.; Vilar, Rui; Botelho do Rego, Ana M.; Muralha, Vania S. F.

    2012-12-01

    We study the surface topographical, structural, and compositional modifications induced in bovine cortical bone by femtosecond laser ablation. The tests are performed in air, with a Yb:KYW chirped-pulse-regenerative amplification laser system (500 fs, 1030 nm) at fluences ranging from 0.55 to 2.24 J/cm2. The ablation process is monitored by acoustic emission measurements. The topography of the laser-treated surfaces is studied by scanning electron microscopy, and their constitution is characterized by glancing incidence x-ray diffraction, x-ray photoelectron spectroscopy, Fourier transform infrared spectroscopy, and micro-Raman spectroscopy. The results show that femtosecond laser ablation allows removing bone without melting, carbonization, or cracking. The structure and composition of the remaining tissue are essentially preserved, the only constitutional changes observed being a reduction of the organic material content and a partial recrystallization of hydroxyapatite in the most superficial region of samples. The results suggest that, within this fluence range, ablation occurs by a combination of thermal and electrostatic mechanisms, with the first type of mechanism predominating at lower fluences. The associated thermal effects explain the constitutional changes observed. We show that femtosecond lasers are a promising tool for delicate orthopaedic surgeries, where small amounts of bone must be cut with negligible damage, thus minimizing surgical trauma.

  17. Noninvasive mapping to guide atrial fibrillation ablation.

    PubMed

    Lim, Han S; Zellerhoff, Stephan; Derval, Nicolas; Denis, Arnaud; Yamashita, Seigo; Berte, Benjamin; Mahida, Saagar; Hooks, Darren; Aljefairi, Nora; Shah, Ashok J; Sacher, Frédéric; Hocini, Meleze; Jais, Pierre; Haissaguerre, Michel

    2015-03-01

    Atrial fibrillation (AF) is a dynamic rhythm. Noninvasive mapping overcomes many previous barriers to mapping such a dynamic rhythm, by providing a beat-to-beat, biatrial, panoramic view of the AF process. Catheter ablation of AF drivers guided by noninvasive mapping has yielded promising clinical results and has advanced understanding of the underlying pathophysiologic processes of this common heart rhythm disorder. PMID:25784025

  18. Resonant laser ablation: Mechanisms and applications

    SciTech Connect

    Anderson, J.E.; Bodla, R.; Eiden, G.C.; Nogar, N.S.; Smith, C.H.

    1994-06-01

    Ever since the first report of laser action, it has been recognized that laser ablation (evaporation/volatilization) may provide a useful sampling mechanism for chemical analysis. In particular, laser ablation is rapidly gaining popularity as a method of sample introduction for mass spectrometry. While most laser ablation/mass spectrometry has been performed with fixed frequency lasers operating at relatively high intensities/fluences ({ge}10{sup 8} W/cm{sup 2}, {ge}1 J/cm{sup 2}), there has been some recent interest in the use of tunable lasers to enhance the ionization yield of selected components in an analytical sample. This process has been termed resonant laser ablation (RLA), and typically relies on irradiation of a sample in a mass spectrometer with modest intensity laser pulses tuned to a one- or two-photon resonant transition in the analyte of interest. Potential advantages of RLA include: (1) simplification of the mass spectrum, by enhancement of signal from the analyte of interest; (2) improvement of the absolute detection limits by improving the ionization efficiency, and (3) improvement in relative sensitivity. The sensitivity enhancement results from reduction of spurious signal, and accompanying noise, in the detection channel. This spurious signal may be due to bleed through from adjacent mass channels, or from isobaric interferences. RLA tends to produce higher mass resolution because of minimal spatial spread in the ion source and small space charge effects. In this manuscript we present a survey of RLA attributes and applications.

  19. Laboratory Micrometeroid/Dust Ablation Studies

    NASA Astrophysics Data System (ADS)

    Thomas, E.; Horanyi, M.; Janches, D.; Munsat, T. L.; Plane, J. M. C.; Simolka, J.; Sternovsky, Z.

    2014-12-01

    Each day, somewhere between 5-270 tonnes of meteoric material ablates in Earth's upper atmosphere. Thisenormous range is significant because the Interplanetary Dust Particle (IDP) input has implications in ourunderstanding of meteor transport in the atmosphere, the formation of layers of metal atoms and ions,nucleation of noctilucent clouds, effects on stratospheric aerosols and O3 chemistry, and dust evolution inour solar system. As the dust ablates, it produces light, as well as a plasma trail of ionized atmosphericatoms and electrons. These meteor signatures are detected by photographic means, or by radar, but thereremain uncertainties in the luminous efficiency and ionization coefficient of meteors - two parameters thatare essential to evaluate densities, masses, height distributions and fluxes. Precise measurements of theseparameters would allow for not only an understanding of the layers of metal atoms and ions and meteoricsmoke particles in the mesosphere and lower thermosphere, but also would allow for the Earth's atmosphereto be used as a dust detector to detect and characterize the dust environment in our solar system. This work discusses the preliminary results of the new dust ablation facility at the 3 MV hypervelocity dust accelerator at the Institute for Modeling Plasma, Atmospheres and Cosmic Dust (IMPACT) at the University of Colorado, which aims to characterize the ionization coefficient and luminous efficiency of ablating micrometeroids.

  20. Combining Electrolysis and Electroporation for Tissue Ablation.

    PubMed

    Phillips, Mary; Rubinsky, Liel; Meir, Arie; Raju, Narayan; Rubinsky, Boris

    2015-08-01

    Electrolytic ablation is a method that operates by delivering low magnitude direct current to the target region over long periods of time, generating electrolytic products that destroy cells. This study was designed to explore the hypothesis stating that electrolytic ablation can be made more effective when the electrolysis-producing electric charges are delivered using electric pulses with field strength typical in reversible electroporation protocols. (For brevity we will refer to tissue ablation protocols that combine electroporation and electrolysis as E(2).) The mechanistic explanation of this hypothesis is related to the idea that products of electrolysis generated by E(2) protocols can gain access to the interior of the cell through the electroporation permeabilized cell membrane and therefore cause more effective cell death than from the exterior of an intact cell. The goal of this study is to provide a first-order examination of this hypothesis by comparing the charge dosage required to cause a comparable level of damage to a rat liver, in vivo, when using either conventional electrolysis or E(2) approaches. Our results show that E(2) protocols produce tissue damage that is consistent with electrolytic ablation. Furthermore, E(2) protocols cause damage comparable to that produced by conventional electrolytic protocols while delivering orders of magnitude less charge to the target tissue over much shorter periods of time. PMID:25416745

  1. Underwater excimer laser ablation of polymers

    NASA Astrophysics Data System (ADS)

    Elaboudi, I.; Lazare, S.; Belin, C.; Talaga, D.; Labrugère, C.

    2008-09-01

    In this paper, we study the photoablation kinetic of poly (ethylene terephthalate) (PET), polycarbonate (PC), polyimide (PI) and polystyrene (PS) in both air and water. Compared to the results obtained in air, we highlight the decrease of the ablation threshold (AT) of polyesters in contact with water as a function of polymer chemical structure. In order to check the expected hydrolytic reaction of polyesters near the ablation threshold, the chemical modification of the polymer surfaces, as well the composition of the ablation products, were investigated after irradiation near the fluence of ablation threshold in air (air- F t ) by X-ray photoelectron spectroscopy (XPS) and confocal Raman microspectroscopy. The morphology of polymers obtained by underwater irradiation and near the air- F t was also examined using scanning electron microscopy (SEM). To understand the process and its dynamics in contact with water, we consider the model of temperature at the polymer-water interface based on the semi-analytical solution of the transit heat-diffusion equation.

  2. NOVEL LASER ABLATION TECHNOLOGY FOR SURFACE DECONTAMINATION

    EPA Science Inventory

    The objective of this project is to develop a novel Laser Ablation Decontamination in Liquid (LADIL) technology for surface decontamination and safe removal of radioactive and/or toxic contaminants. It aims to achieve more efficient surface decontamination without secondary conta...

  3. Intumescent-ablator coatings using endothermic fillers

    NASA Technical Reports Server (NTRS)

    Sawko, P. M.; Riccitiello, S. R. (Inventor)

    1978-01-01

    An intumescent-ablator coating composition which contains the ammonium salt of 1,4-nitroaniline-2-sulfonic acid or 4,4 dinitrosul fanilide, a polymeric binder system and about 5 to 30% weight of an endothermic filler is reported. The filler has a decomposition temperature about or within the exothermic region of the intumescent agent.

  4. Plume collimation for laser ablation electrospray ionization mass spectrometry

    DOEpatents

    Vertes, Akos; Stolee, Jessica A.

    2016-06-07

    In various embodiments, a device may generally comprise a capillary having a first end and a second end; a laser to emit energy at a sample in the capillary to ablate the sample and generate an ablation plume in the capillary; an electrospray apparatus to generate an electrospray plume to intercept the ablation plume to produce ions; and a mass spectrometer having an ion transfer inlet to capture the ions. The ablation plume may comprise a collimated ablation plume. The device may comprise a flow cytometer. Methods of making and using the same are also described.

  5. Plume collimation for laser ablation electrospray ionization mass spectrometry

    SciTech Connect

    Vertes, Akos; Stolee, Jessica A.

    2014-09-09

    In various embodiments, a device may generally comprise a capillary having a first end and a second end; a laser to emit energy at a sample in the capillary to ablate the sample and generate an ablation plume in the capillary; an electrospray apparatus to generate an electrospray plume to intercept the ablation plume to produce ions; and a mass spectrometer having an ion transfer inlet to capture the ions. The ablation plume may comprise a collimated ablation plume. The device may comprise a flow cytometer. Methods of making and using the same are also described.

  6. Stereotactic body radiotherapy for the treatment of medically inoperable primary renal cell carcinoma: Current evidence and future directions

    PubMed Central

    Swaminath, Anand; Chu, William

    2015-01-01

    The incidence of renal cell carcinoma (RCC) is steadily rising due to an aging population and more frequent imaging of the abdomen for other medical conditions. While surgery remains the standard of care treatment for localized disease, many patients are unfit due to their advanced age and medical comorbidities. In these patients, an active surveillance strategy or ablative therapies, including radiofrequency/microwave ablation or cryotherapy, can be offered. Such options have limitations particularly with fast growing, or larger tumors. A promising ablative therapy option to consider is stereo-tactic body radiotherapy (SBRT). SBRT refers to high dose, focally ablative radiation delivered in a short time (3–5 fractions), and is safe and effective in many other cancer sites, including lung, liver and spine. SBRT offers potential advantages in the primary kidney cancer setting due to its ablative dosing (overcoming the notion of “radio-resistance”), short treatment duration (important in an elderly population), low toxicity profile (enabling SBRT to treat larger RCCs than other ablative modalities), and non-invasiveness. To date, there is limited long-term prospective data on the outcomes of SBRT in primary RCC. However, early evidence is intriguing with respect to excellent local control and low toxicity; however, most studies vary in terms of technique and radiation dosing used. Well-designed prospective cohort studies with clearly defined and standardized techniques, dosing, follow-up, and integration of quality of life outcomes will be essential to further establish the role of SBRT in management of inoperable, localized RCC. PMID:26316914

  7. Thermochemical Ablation Analysis of the Orion Heatshield

    NASA Technical Reports Server (NTRS)

    Sixel, William

    2015-01-01

    The Orion Multi-Purpose Crew Vehicle will one day carry astronauts to the Moon and beyond, and Orion's heatshield is a critical component in ensuring their safe return to Earth. The Orion heatshield is the structural component responsible for absorbing the intense heating environment caused by re-entry to Earth's atmosphere. The heatshield is primarily composed of Avcoat, an ablative material that is consumed during the re-entry process. Ablation is primarily characterized by two processes: pyrolysis and recession. The decomposition of in-depth virgin material is known as pyrolysis. Recession occurs when the exposed surface of the heatshield reacts with the surrounding flow. The Orion heatshield design was changed from an individually filled Avcoat honeycomb to a molded block Avcoat design. The molded block Avcoat heatshield relies on an adhesive bond to keep it attached to the capsule. In some locations on the heatshield, the integrity of the adhesive bond cannot be verified. For these locations, a mechanical retention device was proposed. Avcoat ablation was modelled in CHAR and the in-depth virgin material temperatures were used in a Thermal Desktop model of the mechanical retention device. The retention device was analyzed and shown to cause a large increase in the maximum bondline temperature. In order to study the impact of individual ablation modelling parameters on the heatshield sizing process, a Monte Carlo simulation of the sizing process was proposed. The simulation will give the sensitivity of the ablation model to each of its input parameters. As part of the Monte Carlo simulation, statistical uncertainties on material properties were required for Avcoat. Several properties were difficult to acquire uncertainties for: the pyrolysis gas enthalpy, non-dimensional mass loss rate (B´c), and Arrhenius equation parameters. Variability in the elemental composition of Avcoat was used as the basis for determining the statistical uncertainty in pyrolysis gas

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

    SciTech Connect

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

    2013-05-15

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

  9. Ablation of Atrial Fibrillation: Patient Selection, Periprocedural Anticoagulation, Techniques, and Preventive Measures After Ablation.

    PubMed

    Link, Mark S; Haïssaguerre, Michel; Natale, Andrea

    2016-07-26

    Atrial fibrillation (AF) is the most common arrhythmia encountered by cardiologists and is a major cause of morbidity and mortality. Risk factors for AF include age, male sex, genetic predisposition, hypertension, diabetes mellitus, sleep apnea, obesity, excessive alcohol, smoking, hyperthyroidism, pulmonary disease, air pollution, heart failure, and possibly excessive exercise. The management of AF involves decisions about rate versus rhythm control. Asymptomatic patients are generally managed with rate control and anticoagulation. Symptomatic patients will desire rhythm control. Rhythm control options are either antiarrhythmic agents or ablation, with each having its own risks and benefits. Ablation of AF has evolved from a rare and complex procedure to a common electrophysiological technique. Selection of patients to undergo ablation is an important aspect of AF care. Patients with the highest success rates of ablation are those with normal structural hearts and paroxysmal AF, although those with congestive heart failure have the greatest potential benefit of the procedure. Although pulmonary vein isolation of any means/energy source is the approach generally agreed on for those with paroxysmal AF, optimal techniques for the ablation of nonparoxysmal AF are not yet clear. Anticoagulation reduces thromboembolic complications; the newer anticoagulants have eased management for both the patient and the cardiologist. Aggressive management of modifiable risk factors (hypertension, diabetes mellitus, sleep apnea, obesity, excessive alcohol, smoking, hyperthyroidism, pulmonary disease, air pollution, and possibly excessive exercise) after ablation reduces the odds of recurrent AF and is an important element of care. PMID:27462054

  10. Nd:YAG laser cleaning of ablation debris from excimer-laser-ablated polyimide

    NASA Astrophysics Data System (ADS)

    Gu, Jianhui; Low, Jason; Lim, Puay K.; Lim, Pean

    2001-10-01

    In the processing of excimer laser ablation of nozzles on polyimide in air, both gases like CO2, CO and HCN and solid debris including C2 approximately C12 are produced in laser ablation area. In this paper, we reported for the first time a Nd:YAG laser cleaning of ablation debris generated in excimer laser ablation of polyimide. It demonstrated effective cleaning with the advantages of shortening cleaning cycle time and simplifying cleaning process. The laser used for the cleaning was a Q-switched and frequency doubled Nd:YAG laser with wavelength of 532 nm and repetition rate of 10 Hz. The laser cleaning effect was compared with conventional plasma ashing. AFM measurement showed that the Nd:YAG laser cleaning had no damage to the substrate. XPS results indicated that the polyimide surface cleaned with laser beam had a lower oxygen/carbon ratio than that of plasma ashing. The study shows that frequency doubled Nd:YAG laser cleaning is effective in ablation debris removal from excimer laser ablated polyimide.

  11. A Retrospective Comparison of Microwave Ablation vs. Radiofrequency Ablation for Colorectal Cancer Hepatic Metastases

    PubMed Central

    Correa-Gallego, Camilo; Fong, Yuman; Gonen, Mithat; D'Angelica, Michael I.; Allen, Peter J.; DeMatteo, Ronald P.; Jarnagin, William R.; Kingham, T. Peter

    2015-01-01

    Background Microwave (MWA) and radiofrequency ablation (RFA) are the most commonly used techniques for ablating colorectal-liver metastases (CRLM). The technical and oncologic differences between these modalities are unclear. Methods We conducted a matched-cohort analysis of patients undergoing open MWA or RFA for CRLM at a tertiary-care center between 2008 and 2011; the primary endpoint was ablation-site recurrence. Tumors were matched by size, clinical-risk score, and arterial-intrahepatic or systemic chemotherapy use. Outcomes were compared using conditional logistic regression and stratified log-rank test. Results We matched 254 tumors (127 per group) from 134 patients. MWA and RFA groups were comparable by age, gender, median number of tumors treated, proximity to major vessels, and postoperative complication rates. Patients in the MWA group had lower ablation-site recurrence rates (6% vs. 20%; P < 0.01). Median follow-up, however, was significantly shorter in the MWA group (18 months [95% confidence interval 17–20] vs. 31 months [95% confidence interval 28–35]; P < 0.001). Kaplan–Meier estimates of ablation-site recurrence at 2 years were significantly lower for the lesions treated with MWA (7% vs. 18%, P: 0.01). Conclusions Ablation-site recurrences of CRLM were lower with MWA compared with RFA in this matched cohort analysis. Longer follow-up time in the MWA may increase the recurrence rate; however, actuarial local failure estimations demonstrated better local control with MWA. PMID:24889486

  12. GPU-based real-time approximation of the ablation zone for radiofrequency ablation.

    PubMed

    Rieder, Christian; Kröger, Tim; Schumann, Christian; Hahn, Horst K

    2011-12-01

    Percutaneous radiofrequency ablation (RFA) is becoming a standard minimally invasive clinical procedure for the treatment of liver tumors. However, planning the applicator placement such that the malignant tissue is completely destroyed, is a demanding task that requires considerable experience. In this work, we present a fast GPU-based real-time approximation of the ablation zone incorporating the cooling effect of liver vessels. Weighted distance fields of varying RF applicator types are derived from complex numerical simulations to allow a fast estimation of the ablation zone. Furthermore, the heat-sink effect of the cooling blood flow close to the applicator's electrode is estimated by means of a preprocessed thermal equilibrium representation of the liver parenchyma and blood vessels. Utilizing the graphics card, the weighted distance field incorporating the cooling blood flow is calculated using a modular shader framework, which facilitates the real-time visualization of the ablation zone in projected slice views and in volume rendering. The proposed methods are integrated in our software assistant prototype for planning RFA therapy. The software allows the physician to interactively place virtual RF applicator models. The real-time visualization of the corresponding approximated ablation zone facilitates interactive evaluation of the tumor coverage in order to optimize the applicator's placement such that all cancer cells are destroyed by the ablation. PMID:22034298

  13. Burn, freeze, or photo-ablate?: comparative symptom profile in Barrett's dysplasia patients undergoing endoscopic ablation

    NASA Astrophysics Data System (ADS)

    Gill, Kanwar Rupinder S.; Gross, Seth A.; Greenwald, Bruce D.; Hemminger, Lois L.; Wolfsen, Herbert C.

    2009-06-01

    Background: There are few data available comparing endoscopic ablation methods for Barrett's esophagus with high-grade dysplasia (BE-HGD). Objective: To determine differences in symptoms and complications associated with endoscopic ablation. Design: Prospective observational study. Setting: Two tertiary care centers in USA. Patients: Consecutive patients with BE-HGD Interventions: In this pilot study, symptoms profile data were collected for BE-HGD patients among 3 endoscopic ablation methods: porfimer sodium photodynamic therapy, radiofrequency ablation and low-pressure liquid nitrogen spray cryotherapy. Main Outcome Measurements: Symptom profiles and complications from the procedures were assessed 1-8 weeks after treatment. Results: Ten BE-HGD patients were treated with each ablation modality (30 patients total; 25 men, median age: 69 years (range 53-81). All procedures were performed in the clinic setting and none required subsequent hospitalization. The most common symptoms among all therapies were chest pain, dysphagia and odynophagia. More patients (n=8) in the porfimer sodium photodynamic therapy group reported weight loss compared to radio-frequency ablactation (n=2) and cryotherapy (n=0). Four patients in the porfimer sodium photodynamic therapy group developed phototoxicity requiring medical treatment. Strictures, each requiring a single dilation, were found in radiofrequency ablactation (n=1) and porfimer sodium photodynamic therapy (n=2) patients. Limitations: Small sample size, non-randomized study. Conclusions: These three endoscopic therapies are associated with different types and severity of post-ablation symptoms and complications.

  14. Femtosecond laser ablation of brass in air and liquid media

    NASA Astrophysics Data System (ADS)

    Shaheen, M. E.; Gagnon, J. E.; Fryer, B. J.

    2013-06-01

    Laser ablation of brass in air, water, and ethanol was investigated using a femtosecond laser system operating at a wavelength of 785 nm and a pulse width less than 130 fs. Scanning electron and optical microscopy were used to study the efficiency and quality of laser ablation in the three ablation media at two different ablation modes. With a liquid layer thickness of 3 mm above the target, ablation rate was found to be higher in water and ethanol than in air. Ablation under water and ethanol showed cleaner surfaces and less debris re-deposition compared to ablation in air. In addition to spherical particles that are normally formed from re-solidified molten material, micro-scale particles with varying morphologies were observed scattered in the ablated structures (craters and grooves) when ablation was conducted under water. The presence of such particles indicates the presence of a non-thermal ablation mechanism that becomes more apparent when ablation is conducted under water.

  15. Comparison of procedure costs of various percutaneous tumor ablation modalities.

    PubMed

    Astani, Seyed A; Brown, Manuel L; Steusloff, Kay

    2014-01-01

    Microwave ablation, radiofrequency ablation, cryoablation, and irreversible electroporation are percutaneous ablation modalities commonly employed to treat tumors. The procedure cost of treating the same lesion with each of the four modalities is compared. A cost model was created for each ablation modality estimating the cost of treating a tumor based on the number of probes required, which is estimated by the tumor size.Total cost of treating a 3 cm kidney lesion with each modality was individually calculated. There was a strongly positive and statistically significant relationship between estimated cost based on the cost modules and actual cost for all procedures. The number of required probes is the dominant factor in determining the cost of an ablation procedure. The most expensive ablation modalities in decreasing order are irreversible electroporation, cryoablation, and microwave and radiofrequency ablations. PMID:25174139

  16. Lessons from computer simulations of ablation of atrial fibrillation.

    PubMed

    Jacquemet, Vincent

    2016-05-01

    This paper reviews the simulations of catheter ablation in computer models of the atria, from the first attempts to the most recent anatomical models. It describes how postulated substrates of atrial fibrillation can be incorporated into mathematical models, how modelling studies can be designed to test ablation strategies, what their current trade-offs and limitations are, and what clinically relevant lessons can be learnt from these simulations. Drawing a parallel between clinical and modelling studies, six ablation targets are considered: pulmonary vein isolation, linear ablation, ectopic foci, complex fractionated atrial electrogram, rotors and ganglionated plexi. The examples presented for each ablation target illustrate a major advantage of computer models, the ability to identify why a therapy is successful or not in a given atrial fibrillation substrate. The integration of pathophysiological data to create detailed models of arrhythmogenic substrates is expected to solidify the understanding of ablation mechanisms and to provide theoretical arguments supporting substrate-specific ablation strategies. PMID:26846178

  17. Image-Guided Percutaneous Ablation of Hepatic Malignancies

    PubMed Central

    Foltz, Gretchen

    2014-01-01

    The liver is a common site of primary and secondary malignancies, often resulting in significant morbidity and mortality. Evaluating these patients in a multidisciplinary setting allows for optimal utilization of all oncologic therapies including surgery, radiation, systemic chemotherapy, transarterial therapies, and ablation. While surgical intervention often provides the best outcomes when treating most hepatic tumors, many patients are not surgical candidates due to extensive tumor burden, underlying liver disease, or other comorbid conditions. The evolution of imaging and ablation devices has allowed for the increased utilization of percutaneous ablation as definitive and palliative treatment of primary and metastatic hepatic malignancies. Ablation induces tumor necrosis by injection of chemicals (chemical ablation) or temperature modification (thermal ablation). The goal of this review is to provide an overview of different ablation techniques commonly used for hepatic malignancies, discuss the oncologic outcomes of these interventions, and outline the current indications, contraindications, and reported complications of these therapies. PMID:25071304

  18. Intraoperative radiotherapy for breast cancer

    PubMed Central

    Williams, Norman R.; Pigott, Katharine H.; Brew-Graves, Chris

    2014-01-01

    Intra-operative radiotherapy (IORT) as a treatment for breast cancer is a relatively new technique that is designed to be a replacement for whole breast external beam radiotherapy (EBRT) in selected women suitable for breast-conserving therapy. This article reviews twelve reasons for the use of the technique, with a particular emphasis on targeted intra-operative radiotherapy (TARGIT) which uses X-rays generated from a portable device within the operating theatre immediately after the breast tumour (and surrounding margin of healthy tissue) has been removed. The delivery of a single fraction of radiotherapy directly to the tumour bed at the time of surgery, with the capability of adding EBRT at a later date if required (risk-adaptive technique) is discussed in light of recent results from a large multinational randomised controlled trial comparing TARGIT with EBRT. The technique avoids irradiation of normal tissues such as skin, heart, lungs, ribs and spine, and has been shown to improve cosmetic outcome when compared with EBRT. Beneficial aspects to both institutional and societal economics are discussed, together with evidence demonstrating excellent patient satisfaction and quality of life. There is a discussion of the published evidence regarding the use of IORT twice in the same breast (for new primary cancers) and in patients who would never be considered for EBRT because of their special circumstances (such as the frail, the elderly, or those with collagen vascular disease). Finally, there is a discussion of the role of the TARGIT Academy in developing and sustaining high standards in the use of the technique. PMID:25083504

  19. [Palliative Radiotherapy for Bone Metastases].

    PubMed

    Nagakura, Hisayasu

    2015-11-01

    Bone metastasis is associated with many symptoms such as bone pain, pathological fracture, and spinal cord compression. Especially, pain secondary to bone metastases is a serious problem in many patients with metastatic cancer. Radiotherapy can provide remarkable pain relief, reduce the requirement for analgesic drugs, and prevent pathological fracture or spinal cord compression with few complications in most patients. Many randomized controlled trials have shown equivalent extent of pain relief between single-fraction and multiple-fraction regimens. Reirradiation of painful bone metastases is effective for palliation of pain in non-responders or patients with recurrent pain after an initial satisfactory response to a previous radiation therapy. Systemic administration of radioisotopes is an important palliative care option for painful multifocal bone metastases detected on nuclear imaging; however, the application of this option depends on the histologic features of the tumor and distribution of the metastases. Metastatic spinal cord compression is the most frequent oncologic emergency and necessitates timely and appropriate treatment. External beam radiotherapy is commonly used for the treatment of metastatic spinal cord compression. Surgical decompression and stabilization should be considered for metastatic spinal cord compression or pathological fracture in select patients. Postoperative radiotherapy should be administered to patients who have undergone surgical intervention for bone metastases. For patients at a high risk for oncologic emergency, optimal prophylactic management is highly recommended. PMID:26602393

  20. Adjuvant and Definitive Radiotherapy for Adrenocortical Carcinoma

    SciTech Connect

    Sabolch, Aaron; Feng, Mary; Griffith, Kent; Hammer, Gary; Doherty, Gerard; Ben-Josef, Edgar

    2011-08-01

    Purpose: To evaluate the impact of both adjuvant and definitive radiotherapy on local control of adrenocortical carcinoma. Methods and Materials: Outcomes were analyzed from 58 patients with 64 instances of treatment for adrenocortical carcinoma at the University of Michigan's Multidisciplinary Adrenal Cancer Clinic. Thirty-seven of these instances were for primary disease, whereas the remaining 27 were for recurrent disease. Thirty-eight of the treatment regimens involved surgery alone, 10 surgery plus adjuvant radiotherapy, and 16 definitive radiotherapy for unresectable disease. The effects of patient, tumor, and treatment factors were modeled simultaneously using multiple variable Cox proportional hazards regression for associations with local recurrence, distant recurrence, and overall survival. Results: Local failure occurred in 16 of the 38 instances that involved surgery alone, in 2 of the 10 that consisted of surgery plus adjuvant radiotherapy, and in 1 instance of definitive radiotherapy. Lack of radiotherapy use was associated with 4.7 times the risk of local failure compared with treatment regimens that involved radiotherapy (95% confidence interval, 1.2-19.0; p = 0.030). Conclusions: Radiotherapy seems to significantly lower the risk of local recurrence/progression in patients with adrenocortical carcinoma. Adjuvant radiotherapy should be strongly considered after surgical resection.

  1. Osseous oligometastases from thymic carcinoma: a case report suggesting the effectiveness of palliative-intent radiotherapy treatment

    PubMed Central

    Kashima, Jumpei; Horio, Hirotoshi; Okuma, Yusuke; Hosomi, Yukio; Hishima, Tsunekazu

    2016-01-01

    Background Oligometastasis, a recently proposed concept, is defined as an intermediate state of cancer, between localized and systemic disease, that may be well controlled by local ablative treatment. Thymic carcinoma is a rare cancer with a poor prognosis. A definitive management approach has yet to be confirmed by a high level of evidence. Case presentation We present the case of a 41-year-old female who underwent curative-intent surgery for a stage III squamous cell carcinoma of the thymus. Bone metastases were detected 1 year later by magnetic resonance imaging. These were treated with palliative-intent radiotherapy. Disease progression has not been observed in more than 15 years since the achievement of complete radiological remission. Conclusion The treatment outcomes in this and other reported cases suggest that some patients with oligometastatic thymic carcinoma may achieve prolonged survival or even cure with low-dose radiotherapy delivered to the metastases. PMID:27013896

  2. Catheter ablation of atrial fibrillation: Radiofrequency catheter ablation for redo procedures after cryoablation

    PubMed Central

    Kettering, Klaus; Gramley, Felix

    2013-01-01

    AIM: To evaluate the effectiveness of two different strategies using radiofrequency catheter ablation for redo procedures after cryoablation of atrial fibrillation. METHODS: Thirty patients (paroxysmal atrial fibrillation: 22 patients, persistent atrial fibrillation: 8 patients) had to undergo a redo procedure after initially successful circumferential pulmonary vein (PV) isolation with the cryoballoon technique (Arctic Front Balloon, CryoCath Technologies/Medtronic). The redo ablation procedures were performed using a segmental approach or a circumferential ablation strategy (CARTO; Biosense Webster) depending on the intra-procedural findings. After discharge, patients were scheduled for repeated visits at the arrhythmia clinic. A 7-day Holter monitoring was performed at 3, 12 and 24 mo after the ablation procedure. RESULTS: During the redo procedure, a mean number of 2.9 re-conducting pulmonary veins (SD ± 1.0 PVs) were detected (using a circular mapping catheter). In 20 patients, a segmental approach was sufficient to eliminate the residual pulmonary vein conduction because there were only a few recovered pulmonary vein fibres. In the remaining 10 patients, a circumferential ablation strategy was used because of a complete recovery of the PV-LA conduction. All recovered pulmonary veins could be isolated successfully again. At 2-year follow-up, 73.3% of all patients were free from an arrhythmia recurrence (22/30). There were no major complications. CONCLUSION: In patients with an initial circumferential pulmonary vein isolation using the cryoballoon technique, a repeat ablation procedure can be performed safely and effectively using radiofrequency catheter ablation. PMID:24009817

  3. Is surgery still the optimal treatment for stage I non-small cell lung cancer?

    PubMed Central

    Moghanaki, Drew

    2016-01-01

    There is debate about what is the optimal treatment for operable stage I non-small cell lung cancer (NSCLC). Although surgery has been the standard of care for centuries, recent retrospective and prospective randomized studies indicated that stereotactic ablative radiotherapy (SABR) could be an option for this group of patients with similar survival and less toxicities. However, to change the standard of care, more studies are needed and participating ongoing larger randomized studies is the best approach to resolve this controversy. PMID:27183993

  4. Radiative ablation of disks around massive stars

    NASA Astrophysics Data System (ADS)

    Kee, Nathaniel Dylan

    Hot, massive stars (spectral types O and B) have extreme luminosities (10. 4 -10. 6 L?) that drive strong stellar winds through UV line-scattering.Some massive stars also have disks, formed by either decretion from the star (as in the rapidly rotating "Classical Be stars"), or accretion during the star's formation. This dissertation examines the role of stellar radiation in driving (ablating) material away from these circumstellar disks. A key result is that the observed month to year decay of Classical Be disks can be explained by line-driven ablation without, as previously done, appealing to anomalously strong viscous diffusion. Moreover, the higher luminosity of O stars leads to ablation of optically thin disks on dynamical timescales of order a day, providing a natural explanation for the lack of observed Oe stars. In addition to the destruction of Be disks, this dissertation also introduces a model for their formation by coupling observationally inferred non-radial pulsation modes and rapid stellar rotation to launch material into orbiting Keplerian disks of Be-like densities. In contrast to such Be decretion disks, star-forming accretion disks are much denser and so are generally optically thick to continuum processes. To circumvent the computational challenges associated with radiation hydrodynamics through optically thick media, we develop an approximate method for treating continuum absorption in the limit of geometrically thin disks. The comparison of ablation with and without continuum absorption shows that accounting for disk optical thickness leads to less than a 50% reduction in ablation rate, implying that ablation rate depends mainly on stellar properties like luminosity. Finally, we discuss the role of "thin-shell mixing" in reducing X-rays from colliding wind binaries. Laminar, adiabatic shocks produce well understood X-ray emission, but the emission from radiatively cooled shocks is more complex due to thin-shell instabilities. The parameter

  5. Temperature profiles of 980- and 1,470-nm endovenous laser ablation, endovenous radiofrequency ablation and endovenous steam ablation.

    PubMed

    Malskat, W S J; Stokbroekx, M A L; van der Geld, C W M; Nijsten, T E C; van den Bos, R R

    2014-03-01

    Endovenous thermal ablation (EVTA) techniques are very effective for the treatment of varicose veins, but their exact working mechanism is still not well documented. The lack of knowledge of mechanistic properties has led to a variety of EVTA protocols and a commercially driven dissemination of new or modified techniques without robust scientific evidence. The aim of this study is to compare temperature profiles of 980-and 1,470-nm endovenous laser ablation (EVLA), segmental radiofrequency ablation (RFA), and endovenous steam ablation (EVSA). In an experimental setting, temperature measurements were performed using thermocouples; raw potato was used to mimic a vein wall. Two laser wavelengths (980 and 1,470 nm) were used with tulip-tip fibers and 1,470 nm also with a radial-emitting fiber. Different powers and pullback speeds were used to achieve fluences of 30, 60, and 90 J/cm. For segmental RFA, 1 cycle of 20 s was analyzed. EVSA was performed with two and three pulses of steam per centimeter. Maximum temperature increase, time span of relevant temperature increase, and area under the curve of the time of relevant temperature increase were measured. In all EVLA settings, temperatures increased and decreased rapidly. High fluence is associated with significantly higher temperatures and increased time span of temperature rise. Temperature profiles of 980- and 1,470-nm EVLA with tulip-tip fibers did not differ significantly. Radial EVLA showed significantly higher maximum temperatures than tulip-tip EVLA. EVSA resulted in mild peak temperatures for longer durations than EVLA. Maximum temperatures with three pulses per centimeter were significantly higher than with two pulses. RFA temperature rises were relatively mild, resulting in a plateau-shaped temperature profile, similar to EVSA. Temperature increase during EVLA is fast with a high-peak temperature for a short time, where EVSA and RFA have longer plateau phases and lower maximum temperatures. PMID

  6. Automated planning of ablation targets in atrial fibrillation treatment

    NASA Astrophysics Data System (ADS)

    Keustermans, Johannes; De Buck, Stijn; Heidbüchel, Hein; Suetens, Paul

    2011-03-01

    Catheter based radio-frequency ablation is used as an invasive treatment of atrial fibrillation. This procedure is often guided by the use of 3D anatomical models obtained from CT, MRI or rotational angiography. During the intervention the operator accurately guides the catheter to prespecified target ablation lines. The planning stage, however, can be time consuming and operator dependent which is suboptimal both from a cost and health perspective. Therefore, we present a novel statistical model-based algorithm for locating ablation targets from 3D rotational angiography images. Based on a training data set of 20 patients, consisting of 3D rotational angiography images with 30 manually indicated ablation points, a statistical local appearance and shape model is built. The local appearance model is based on local image descriptors to capture the intensity patterns around each ablation point. The local shape model is constructed by embedding the ablation points in an undirected graph and imposing that each ablation point only interacts with its neighbors. Identifying the ablation points on a new 3D rotational angiography image is performed by proposing a set of possible candidate locations for each ablation point, as such, converting the problem into a labeling problem. The algorithm is validated using a leave-one-out-approach on the training data set, by computing the distance between the ablation lines obtained by the algorithm and the manually identified ablation points. The distance error is equal to 3.8+/-2.9 mm. As ablation lesion size is around 5-7 mm, automated planning of ablation targets by the presented approach is sufficiently accurate.

  7. Radiofrequency ablation of abdominal wall endometrioma.

    PubMed

    Carrafiello, Gianpaolo; Fontana, Federico; Pellegrino, Carlo; Mangini, Monica; Cabrini, Luca; Mariani, Davide; Piacentino, Filippo; Cuffari, Salvatore; Laganà, Domenico; Fugazzola, Carlo

    2009-11-01

    Extraperitoneal endometriosis is the presence of ectopic, functional endometrium outside the peritoneal cavity, and its occurrence is exceedingly rare. Diagnostic imaging--including ultrasound, duplex ultrasonography, and magnetic resonance imaging--in the preoperative assessment of patients with suspected abdominal wall endometriosis (AWE) is helpful for detection and accurate determination of the extent of disease. The treatment of choice for AWE is surgical excision. In addition, medical therapies can be used. We present one case of AWE treated with percutaneous radiofrequency ablation under ultrasound guidance. There were no major complications, and the patient's symptoms improved. In selected patients, radiofrequency ablation can be used safely for the treatment of AWE; however, further studies are needed to confirm this hypothesis. PMID:19184197

  8. Palliative Radiofrequency Ablation for Recurrent Prostate Cancer

    SciTech Connect

    Jindal, Gaurav; Friedman, Marc; Locklin, Julia Wood, Bradford J.

    2006-06-15

    Percutaneous radiofrequency ablation (RFA) is a minimally invasive local therapy for cancer. Its efficacy is now becoming well documented in many different organs, including liver, kidney, and lung. The goal of RFA is typically complete eradication of a tumor in lieu of an invasive surgical procedure. However, RFA can also play an important role in the palliative care of cancer patients. Tumors which are surgically unresectable and incompatible for complete ablation present the opportunity for RFA to be used in a new paradigm. Cancer pain runs the gamut from minor discomfort relieved with mild pain medication to unrelenting suffering for the patient, poorly controlled by conventional means. RFA is a tool which can potentially palliate intractable cancer pain. We present here a case in which RFA provided pain relief in a patient with metastatic prostate cancer with pain uncontrolled by conventional methods.

  9. Radiofrequency thermal ablation of renal tumors.

    PubMed

    De Filippo, Massimo; Bozzetti, Francesca; Martora, Rosa; Zagaria, Raffaella; Ferretti, Stefania; Macarini, Luca; Brunese, Luca; Rotondo, Antonio; Rossi, Cristina

    2014-07-01

    Percutaneous radiofrequency ablation (PRFA) of renal malignancies is currently a therapeutic option for patients who are not able to undergo surgery. Some authors consider PRFA as the therapeutic standard in the treatment of renal neoplasms in non-operable patients due to comorbid conditions and in patients with mild-moderate renal failure, to preserve residual renal functionality. The use of PRFA has become more and more widespread due to a rise in the incidental detection of renal cell carcinomas with the ever-increasing use of Imaging for the study of abdominal diseases. Clinical studies indicate that RF ablation is an effective therapy with a low level of risk of complications, which provides good results in selected patients over short and medium term periods of time, however up to now few long-term studies have been carried out which can confirm the effectiveness of PRFA. PMID:25024061

  10. Particle analysis using laser ablation mass spectroscopy

    DOEpatents

    Parker, Eric P.; Rosenthal, Stephen E.; Trahan, Michael W.; Wagner, John S.

    2003-09-09

    The present invention provides a method of quickly identifying bioaerosols by class, even if the subject bioaerosol has not been previously encountered. The method begins by collecting laser ablation mass spectra from known particles. The spectra are correlated with the known particles, including the species of particle and the classification (e.g., bacteria). The spectra can then be used to train a neural network, for example using genetic algorithm-based training, to recognize each spectra and to recognize characteristics of the classifications. The spectra can also be used in a multivariate patch algorithm. Laser ablation mass specta from unknown particles can be presented as inputs to the trained neural net for identification as to classification. The description below first describes suitable intelligent algorithms and multivariate patch algorithms, then presents an example of the present invention including results.

  11. Sepsis-Induced Osteoblast Ablation Causes Immunodeficiency.

    PubMed

    Terashima, Asuka; Okamoto, Kazuo; Nakashima, Tomoki; Akira, Shizuo; Ikuta, Koichi; Takayanagi, Hiroshi

    2016-06-21

    Sepsis is a host inflammatory response to severe infection associated with high mortality that is caused by lymphopenia-associated immunodeficiency. However, it is unknown how lymphopenia persists after the accelerated lymphocyte apoptosis subsides. Here we show that sepsis rapidly ablated osteoblasts, which reduced the number of common lymphoid progenitors (CLPs). Osteoblast ablation or inducible deletion of interleukin-7 (IL-7) in osteoblasts recapitulated the lymphopenic phenotype together with a lower CLP number without affecting hematopoietic stem cells (HSCs). Pharmacological activation of osteoblasts improved sepsis-induced lymphopenia. This study demonstrates a reciprocal interaction between the immune and bone systems, in which acute inflammation induces a defect in bone cells resulting in lymphopenia-associated immunodeficiency, indicating that bone cells comprise a therapeutic target in certain life-threatening immune reactions. PMID:27317262

  12. A rare complication following radiofrequency ablation.

    PubMed

    Rajakulasingam, Ramyah; Francis, Rohin; Ghuran, Azad

    2013-01-01

    Atrial-oesophageal fistula (AOF) formation is a rare but often fatal complication post radio frequency ablation (RFA). Mortality ranges from 67% to 100%, with a rapid progression from symptom onset to death. We report a case of a healthy man in his early 40s who presented with a Glasgow Coma Scale  of 5/15, clinical evidence of sepsis and Streptococcus viridans bacteraemia, 14 days following uncomplicated RFA for atrial fibrillation. Establishing a diagnosis of AOF can be difficult, as patients may have bacteraemia, but are consequently misdiagnosed with infective endocarditis, as in this case. One should have a high-index of suspicion for AOF in patients presenting with the aforementioned constellation of symptoms following ablation. There are no established predictors of mortality, but prompt detection, emergent operative intervention and prolonged antibiotic therapy are vital for survival. PMID:23420721

  13. Nozzle designs with pitch precursor ablatives

    NASA Technical Reports Server (NTRS)

    Blevins, H. R.; Bedard, R. J.

    1976-01-01

    Recent developments in carbon phenolic ablatives for solid rocket motor nozzles have yielded a pitch precursor carbon fiber offering significant raw material availability and cost saving advantages as compared to conventional rayon precursor material. This paper discusses the results of an experimental program conducted to assess the thermal performance and characterize the thermal properties of pitch precursor carbon phenolic ablatives. The end result of this program is the complete thermal characterization of pitch fabric, pitch mat, hybrid pitch/rayon fabric and pitch mat molding compound. With these properties determined an analytic capability now exists for predicting the thermal performance of these materials in rocket nozzle liner applications. Further planned efforts to verify material performance and analytical prediction procedures through actual rocket motor firings are also discussed.

  14. 3D Multifunctional Ablative Thermal Protection System

    NASA Technical Reports Server (NTRS)

    Feldman, Jay; Venkatapathy, Ethiraj; Wilkinson, Curt; Mercer, Ken

    2015-01-01

    NASA is developing the Orion spacecraft to carry astronauts farther into the solar system than ever before, with human exploration of Mars as its ultimate goal. One of the technologies required to enable this advanced, Apollo-shaped capsule is a 3-dimensional quartz fiber composite for the vehicle's compression pad. During its mission, the compression pad serves first as a structural component and later as an ablative heat shield, partially consumed on Earth re-entry. This presentation will summarize the development of a new 3D quartz cyanate ester composite material, 3-Dimensional Multifunctional Ablative Thermal Protection System (3D-MAT), designed to meet the mission requirements for the Orion compression pad. Manufacturing development, aerothermal (arc-jet) testing, structural performance, and the overall status of material development for the 2018 EM-1 flight test will be discussed.

  15. Magnetic Colloids By Pulsed Laser Ablation

    NASA Astrophysics Data System (ADS)

    Pandey, B. K.; Singh, M. K.; Agarwal, A.; Gopal, R.

    2011-06-01

    Colloidal magnetic nanoparticles have been successfully synthesized by nano second pules laser ablation of a cobalt slice immersed in liquid (distilled water) medium. The focused output of 1064 nm wavelength of pulsed Nd: YAG laser operating at 40 mJ/pulse is used for ablation. The liquid enviorment allows formation of colloids with nanoparticles in uniform particle diameter. Synchrotron X-ray powder diffraction (XRD) is used for the study of structural property of synthesized nanoparticles. The magnetic properties of cobalt nanoparticles are also investigated. The coercivity of is found to be 73 Oe. The optical properties have been determined by UV-visible absorption spectroscopy and band gap found to be 2.16 and 3.60 eV.

  16. Simulation of ablation in Earth atmospheric entry

    NASA Technical Reports Server (NTRS)

    Keenan, James A.; Candler, Graham V.

    1993-01-01

    The process of ablation for Earth atmospheric entry is simulated using a computational approach that allows thermo-chemical nonequilibrium of the flow field and ablation gases. The heat pulse into the heat shield is modeled. The flowfield and graphite heat shield are coupled through surface mass and energy balances. The surface thermochemistry involves the oxidation of graphite and allows for catalytic recombination of diatomic oxygen. Steady-state simulations are performed on a one meter nose radius sphere at an altitude of 65/km and at freestream velocities of 8 km/s and 10 km/s. A transient simulation is performed at 65 km altitude and a freestream velocity of 10 km/s.

  17. Ablative Therapies for Colorectal Polyps and Malignancy

    PubMed Central

    Hochwald, Steven N.; Nurkin, Steven

    2014-01-01

    Endoscopic techniques are gaining popularity in the management of colorectal polyps and occasionally superficial cancers. While their use is in many times palliative, they have proven to be curative in carefully selected patients with polyps or malignancies, with less morbidity than radical resection. However, one should note that data supporting local and ablative therapies for colorectal cancer is scarce and may be subject to publication bias. Therefore, for curative intent, these techniques should only be considered in highly select cases as higher rates of local recurrences have also been reported. The aim of this review is to explain the different modalities of local and ablative therapies specific to colorectal neoplasia and explain the indications and circumstances where they have been most successful. PMID:25089281

  18. A Review of Laser Ablation Propulsion

    SciTech Connect

    Phipps, Claude; Bohn, Willy; Lippert, Thomas; Sasoh, Akihiro; Schall, Wolfgang; Sinko, John

    2010-10-08

    Laser Ablation Propulsion is a broad field with a wide range of applications. We review the 30-year history of laser ablation propulsion from the transition from earlier pure photon propulsion concepts of Oberth and Saenger through Kantrowitz's original laser ablation propulsion idea to the development of air-breathing 'Lightcraft' and advanced spacecraft propulsion engines. The polymers POM and GAP have played an important role in experiments and liquid ablation fuels show great promise. Some applications use a laser system which is distant from the propelled object, for example, on another spacecraft, the Earth or a planet. Others use a laser that is part of the spacecraft propulsion system on the spacecraft. Propulsion is produced when an intense laser beam strikes a condensed matter surface and produces a vapor or plasma jet. The advantages of this idea are that exhaust velocity of the propulsion engine covers a broader range than is available from chemistry, that it can be varied to meet the instantaneous demands of the particular mission, and that practical realizations give lower mass and greater simplicity for a payload delivery system. We review the underlying theory, buttressed by extensive experimental data. The primary problem in laser space propulsion theory has been the absence of a way to predict thrust and specific impulse over the transition from the vapor to the plasma regimes. We briefly discuss a method for combining two new vapor regime treatments with plasma regime theory, giving a smooth transition from one regime to the other. We conclude with a section on future directions.

  19. Stability analysis of unsteady ablation fronts

    SciTech Connect

    Betti, R.; McCrory, R.L.; Verdon, C.P.

    1993-08-01

    The linear stability analysis of unsteady ablation fronts, is carried out for a semi-infinite uniform medium. For a laser accelerated target, it is shown that a properly selected modulation of the laser intensity can lead to the dynamic stabilization or growth-rate reduction of a large portion of the unstable spectrum. The theory is in qualitative agreement with the numerical results obtained by using the two-dimensional hydrodynamic code ORCHID.

  20. Stability analysis of unsteady ablation fronts

    SciTech Connect

    Betti, R.; McCrory, R.L.; Verdon, C.P. )

    1993-11-08

    The linear stability analysis of unsteady ablation fronts is carried out for a semi-infinite uniform medium. For a laser accelerated target, it is shown that a properly selected modulation of the laser intensity can lead to the dynamic stabilization or growth-rate reduction of a large portion of the unstable spectrum. The theory is in qualitative agreement with the numerical results obtained by using the two-dimensional hydrodynamic code ORCHID.

  1. Stability analysis of unsteady ablation fronts

    NASA Astrophysics Data System (ADS)

    Betti, R.; McCrory, R. L.; Verdon, C. P.

    1993-11-01

    The linear stability analysis of unsteady ablation fronts is carried out for a semi-infinite uniform medium. For a laser accelerated target, it is shown that a properly selected modulation of the laser intensity can lead to the dynamic stabilization or growth-rate reduction of a large portion of the unstable spectrum. The theory is in qualitative agreement with the numerical results obtained by using the two-dimensional hydrodynamic code orchid.

  2. Stability analysis of unsteady ablation fronts

    NASA Astrophysics Data System (ADS)

    Betti, R.; McCrory, R. L.; Verdon, C. P.

    1993-08-01

    The linear stability analysis of unsteady ablation fronts is carried out for a semi-infinite uniform medium. For a laser accelerated target, it is shown that a properly selected modulation of the laser intensity can lead to the dynamic stabilization or growth-rate reduction of a large portion of the unstable spectrum. The theory is in qualitative agreement with the numerical results obtained by using the two-dimensional hydrodynamic code ORCHID.

  3. Resolving Bias in Laser Ablation Geochronology

    NASA Astrophysics Data System (ADS)

    Bowring, James; Horstwood, Matthew; Gehrels, George

    2013-06-01

    Increasingly, scientific investigations requiring geochronology utilize laser ablation (LA)-inductively coupled plasma mass spectrometry (ICPMS), taking advantage of the efficiency and throughput possible for uranium-thorium-lead (U-Th-Pb) dating. A number of biases exist when comparing data among laboratories and an ongoing community-based effort is working to resolve and eliminate these biases to improve the accuracy of scientific interpretation based on these data.

  4. Study of the ablative effects on tektite

    NASA Technical Reports Server (NTRS)

    Chen, K. K.

    1975-01-01

    The tumbling and surface roughness effects on the trajectory of entry tektite are studied in both free molecular and continuum flows. It was concluded that, while surface roughness has negligible effect on trajectory, the tumbling may play an important role in tektite trajectory and the consequent ablation, provided the body shape is different from a sphere. A shape factor was a good parameter for correlations between body shape and tumbling effects.

  5. Design Calculations For NIF Convergent Ablator Experiments

    SciTech Connect

    Olson, R E; Hicks, D G; Meezan, N B; Callahan, D A; Landen, O L; Jones, O S; Langer, S H; Kline, J L; Wilson, D C; Rinderknecht, H; Zylstra, A; Petrasso, R D

    2011-10-25

    The NIF convergent ablation tuning effort is underway. In the early experiments, we have discovered that the design code simulations over-predict the capsule implosion velocity and shock flash rhor, but under-predict the hohlraum x-ray flux measurements. The apparent inconsistency between the x-ray flux and radiography data implies that there are important unexplained aspects of the hohlraum and/or capsule behavior.

  6. Innovative radiotherapy of sarcoma: Proton beam radiation.

    PubMed

    DeLaney, Thomas F; Haas, Rick L M

    2016-07-01

    This review on proton beam radiotherapy (PBT) focusses on an historical overview, cost-effectiveness, techniques, acute and late toxicities and clinical results of PBT for sarcoma patients. PBT has gained its place among the armamentarium of modern radiotherapy techniques. For selected patients, it can be cost-effective. PMID:27258968

  7. Microcystic adnexal carcinoma following radiotherapy in childhood

    SciTech Connect

    Borenstein, A.; Seidman, D.S.; Trau, H.; Tsur, H. )

    1991-04-01

    A 36-year-old man was treated by radiotherapy for tinea capitis many years before discovery of microcystic adnexal carcinoma (MAC). Because of patient's refusal of any surgical intervention, we were able to follow the natural course of this tumor for 13 years. This case emphasizes the typical slow development of (MAC). The implication of the association of MAC and radiotherapy are discussed.

  8. KTP-532 laser ablation of urethral strictures

    NASA Astrophysics Data System (ADS)

    Malloy, Terrence R.

    1991-07-01

    In 1988, the KTP-532 laser was used to ablate a series of benign urethral strictures. Rather than using a single incision, as in urethrotomy, strictures were treated with a 360$DEG contact photoradiation. Thirty-one males, average age 53.2 years, received 37 treatments. Six patients underwent a second laser treatment. Stricture etiology was commonly iatrogenic (32%), traumatic (16%), and post-gonococcal (10%). Stricture location included mainly bulbar (49%), membranous (20%), and penile (12%) areas. The surgical technique consisted of a circumferential ablation followed by foley catheter placement (mean 10 days). Follow-up on 29 of 31 patients ranged from 1 to 16 months (mean 9.7) Complete success occurred in 17 patients (59%) who had no further symptoms or instrumentation. Partial success was seen in 6 patients (20.5%) with symptoms but no stricture recurrence. Six patients (20.5%) failed therapy requiring additional surgery or regular dilatations. No complications were encountered. Although longer assessment is required, KTP-532 laser ablation of urethral strictures appears efficacious.

  9. Interactive Volumetry Of Liver Ablation Zones.

    PubMed

    Egger, Jan; Busse, Harald; Brandmaier, Philipp; Seider, Daniel; Gawlitza, Matthias; Strocka, Steffen; Voglreiter, Philip; Dokter, Mark; Hofmann, Michael; Kainz, Bernhard; Hann, Alexander; Chen, Xiaojun; Alhonnoro, Tuomas; Pollari, Mika; Schmalstieg, Dieter; Moche, Michael

    2015-01-01

    Percutaneous radiofrequency ablation (RFA) is a minimally invasive technique that destroys cancer cells by heat. The heat results from focusing energy in the radiofrequency spectrum through a needle. Amongst others, this can enable the treatment of patients who are not eligible for an open surgery. However, the possibility of recurrent liver cancer due to incomplete ablation of the tumor makes post-interventional monitoring via regular follow-up scans mandatory. These scans have to be carefully inspected for any conspicuousness. Within this study, the RF ablation zones from twelve post-interventional CT acquisitions have been segmented semi-automatically to support the visual inspection. An interactive, graph-based contouring approach, which prefers spherically shaped regions, has been applied. For the quantitative and qualitative analysis of the algorithm's results, manual slice-by-slice segmentations produced by clinical experts have been used as the gold standard (which have also been compared among each other). As evaluation metric for the statistical validation, the Dice Similarity Coefficient (DSC) has been calculated. The results show that the proposed tool provides lesion segmentation with sufficient accuracy much faster than manual segmentation. The visual feedback and interactivity make the proposed tool well suitable for the clinical workflow. PMID:26482818

  10. Status of the Ablative Laser Propulsion Studies

    NASA Technical Reports Server (NTRS)

    Herren, Kenneth A.; Lin, Jun; Cohen, Tinothy; Pakhomov, Andrew V.; Thompson, M. Shane

    2004-01-01

    We present a short review of our laser-propulsion research as well as some of the current results of the Ablative Laser Propulsion (ALP) studies currently underway at the University of Alabama in Huntsville. It has been shown that direct surface ablation of a solid material produces high specific impulse (Isp) at relatively high energy conversion efficiency (20 - 40%). We detail measurements of specific impulse, thrust and coupling coefficients for elemental target materials both with single and with double pulse laser shots. We also present measurements taken using three independent methods for determination of Isp. The three methods produce consistent values from ion time-of-flight technique, impulse measurements and imaging of the expansion front of plasma plume. We present a demonstration of our ALP lightcraft, a small free-flying micro-vehicle that is propelled by ablation. For ALP lightcraft we use a subscale thin shell of nickel replicated over a diamond turned mandrel that produces a highly polished self-focusing, truncated at the focus parabolic mirror. The mass of the lightcraft is 54 mg and it is driven by 100-ps wide, 35-mJ laser pulses at 532 nm wavelength. This is an ongoing research. We also present the latest work on laserdriven micro-thrusters and detail some the near term goals of our program.

  11. Thermal Convection on an Ablating Target

    NASA Astrophysics Data System (ADS)

    Mehmedagic, Igbal; Thangam, Siva

    2015-11-01

    Modeling and analysis of thermal convection of a metallic targets subject to radiative flux is of relevance to various manufacturing processes as well as for the development of protective shields. The present work involves the computational modeling of metallic targets subject to high heat fluxes that are both steady and pulsed. Modeling of the ablation and associated fluid dynamics when metallic surfaces are exposed to high intensity pulsed laser fluence at normal atmospheric conditions is considered. The incident energy from the laser is partly absorbed and partly reflected by the surface during ablation and subsequent vaporization of the convecting melt also participates in the radiative exchange. The energy distribution during the process between the bulk and vapor phase strongly depends on optical and thermodynamic properties of the irradiated material, radiation wavelength, and laser pulse intensity and duration. Computational findings based on effective representation and prediction of the heat transfer, melting and vaporization of the targeting material as well as plume formation and expansion are presented and discussed in the context of various ablation mechanisms, variable thermo-physical and optical properties, plume expansion and surface geometry. Funded in part by U. S. Army ARDEC, Picatinny Arsenal, NJ.

  12. Calcified lesion modeling for excimer laser ablation

    NASA Astrophysics Data System (ADS)

    Scott, Holly A.; Archuleta, Andrew; Splinter, Robert

    2009-06-01

    Objective: Develop a representative calcium target model to evaluate penetration of calcified plaque lesions during atherectomy procedures using 308 nm Excimer laser ablation. Materials and Methods: An in-vitro model representing human calcified plaque was analyzed using Plaster-of-Paris and cement based composite materials as well as a fibrinogen model. The materials were tested for mechanical consistency. The most likely candidate(s) resulting from initial mechanical and chemical screening was submitted for ablation testing. The penetration rate of specific multi-fiber catheter designs and a single fiber probe was obtained and compared to that in human cadaver calcified plaque. The effects of lasing parameters and catheter tip design on penetration speed in a representative calcified model were verified against the results in human cadaver specimens. Results: In Plaster of Paris, the best penetration was obtained using the single fiber tip configuration operating at 100 Fluence, 120 Hz. Calcified human lesions are twice as hard, twice as elastic as and much more complex than Plaster of Paris. Penetration of human calcified specimens was highly inconsistent and varied significantly from specimen to specimen and within individual specimens. Conclusions: Although Plaster of Paris demonstrated predictable increases in penetration with higher energy density and repetition rate, it can not be considered a totally representative laser ablation model for calcified lesions. This is in part due to the more heterogeneous nature and higher density composition of cadaver intravascular human calcified occlusions. Further testing will require a more representative model of human calcified lesions.

  13. Investigating Age Resolution in Laser Ablation Geochronology

    NASA Astrophysics Data System (ADS)

    Horstwood, Matt; Kosler, Jan; Jackson, Simon; Pearson, Norman; Sylvester, Paul

    2009-02-01

    Workshop on Data Handling in LA-ICP-MS U-Th-Pb Geochronology; Vancouver, British Columbia, Canada, 12-13 July 2008; Laser ablation inductively coupled plasma mass spectrometry (LA-ICP-MS) uranium-thorium-lead (U-Th-Pb) dating is an increasingly popular approach for determining the age of mineral grains and the timing of geological events. The spatial resolution offered by this technique allows detailed investigations of complex igneous and metamorphic processes, and the speed of data capture allows vast amounts of information to be gathered rapidly. Laser ablation U-Th-Pb dating is therefore becoming an increasingly influential technique to the geochronology community, providing cost-effective and ready access to age data for laboratories and end users worldwide. However, complications in acquiring, processing, and interpreting data can lead to inaccurate age information entering the literature. With the numbers of practitioners expanding rapidly, the need to standardize approaches and resolve difficulties (particularly involving the subjectivity in processing laser ablation U-Th-Pb data) is becoming important.

  14. Femtosecond laser ablation elemental mass spectrometry.

    PubMed

    Hergenröder, Roland; Samek, Ota; Hommes, Vanja

    2006-01-01

    Laser ablation mass spectrometry (LA-MS) has always been an interesting method for the elemental analysis of solid samples. Chemical analysis with a laser requires small amounts of material. Depending on the analytical detection system, subpicogram quantities may be sufficient. In addition, a focused laser beam permits the spatial characterization of heterogeneity in solid samples typically with micrometer resolution in terms of lateral and depth dimensions. With the advent of high-energy, ultra-short pulse lasers, new possibilities arise. The task of this review is to discuss the principle differences between the ablation process of short (>1 ps) and ultra-short (<1 ps) pulses. Based on the timescales and the energy balance of the process that underlies an ablation event, it will be shown that ultra-short pulses are less thermal and cause less collateral damages than longer pulses. The confinement of the pulse energy to the focal region guarantees a better spatial resolution in all dimensions and improves the analytical figures of merit (e.g., fractionation). Applications that demonstrate these features and that will be presented are in-depth profiling of multi-layer samples and the elemental analysis of biological materials. PMID:16477613

  15. KTP-532 laser ablation of urethral strictures.

    PubMed

    Turek, P J; Malloy, T R; Cendron, M; Carpiniello, V L; Wein, A J

    1992-10-01

    In 1988 the KTP-532 laser was used to ablate a series of benign urethral strictures. Rather than using a single incision as in urethrotomy, strictures were treated with 360-degree contact photoradiation. Thirty-one male patients, average age 53.2 years, received thirty-seven treatments; 6 patients underwent a second laser treatment. Stricture etiology was commonly iatrogenic (32%), traumatic (16%), and postgonococcal (10%). Stricture location included mainly bulbar (49%), membranous (20%), and penile (12%) areas. The surgical technique consisted of circumferential ablation, followed by Foley catheter placement (mean, 10 days). Follow-up on 29 of 31 patients ranged from one to sixteen months (mean 9.7). Complete success occurred in 17 patients (59%) who had no further symptoms or instrumentation. Partial success was seen in 6 patients (20.5%) with symptom, but not stricture, recurrence. Six patients (20.5%) failed therapy, requiring additional surgery or regular dilations. No complications were seen. Although longer assessment is required, KTP-532 laser ablation of urethral strictures appears efficacious. PMID:1413350

  16. Atrial Fibrillation Ablation without Interruption of Anticoagulation.

    PubMed

    Santangeli, Pasquale; Di Biase, Luigi; Sanchez, Javier E; Horton, Rodney; Natale, Andrea

    2011-01-01

    Atrial fibrillation (AF) can be cured by pulmonary vein antrum isolation (PVAI) in a substantial proportion of patients. The high efficacy of PVAI is partially undermined by a small but concrete periprocedural risk of complications, such as thromboembolic events and bleeding. A correct management of anticoagulation is essential to prevent such complications. Performing PVAI without interruption of oral anticoagulation has been demonstrated feasible by our group in previous studies. Recently, we reported that continuation of therapeutic warfarin during radiofrequency catheter ablation consistently reduces the risk of periprocedural stroke/transient ischemic attack without increasing the risk of hemorrhagic events. Of note, interrupting warfarin anticoagulation may actually increase the risk of stroke even when bridged with heparin. The latter strategy is also associated with an increased risk of minor bleeding. With regard to major bleeding, we found no significant difference between patients with a therapeutic INR and those who were bridged with heparin. Therefore, continuation of therapeutic warfarin during ablation of AF appears to be the best anticoagulation strategy. In this paper we summarize our experience with AF ablation without interruption of anticoagulation. PMID:21577267

  17. Interactive Volumetry Of Liver Ablation Zones

    NASA Astrophysics Data System (ADS)

    Egger, Jan; Busse, Harald; Brandmaier, Philipp; Seider, Daniel; Gawlitza, Matthias; Strocka, Steffen; Voglreiter, Philip; Dokter, Mark; Hofmann, Michael; Kainz, Bernhard; Hann, Alexander; Chen, Xiaojun; Alhonnoro, Tuomas; Pollari, Mika; Schmalstieg, Dieter; Moche, Michael

    2015-10-01

    Percutaneous radiofrequency ablation (RFA) is a minimally invasive technique that destroys cancer cells by heat. The heat results from focusing energy in the radiofrequency spectrum through a needle. Amongst others, this can enable the treatment of patients who are not eligible for an open surgery. However, the possibility of recurrent liver cancer due to incomplete ablation of the tumor makes post-interventional monitoring via regular follow-up scans mandatory. These scans have to be carefully inspected for any conspicuousness. Within this study, the RF ablation zones from twelve post-interventional CT acquisitions have been segmented semi-automatically to support the visual inspection. An interactive, graph-based contouring approach, which prefers spherically shaped regions, has been applied. For the quantitative and qualitative analysis of the algorithm’s results, manual slice-by-slice segmentations produced by clinical experts have been used as the gold standard (which have also been compared among each other). As evaluation metric for the statistical validation, the Dice Similarity Coefficient (DSC) has been calculated. The results show that the proposed tool provides lesion segmentation with sufficient accuracy much faster than manual segmentation. The visual feedback and interactivity make the proposed tool well suitable for the clinical workflow.

  18. Radiofrequency ablation of hepatocellular carcinoma: Current status

    PubMed Central

    Minami, Yasunori; Kudo, Masatoshi

    2010-01-01

    Ablation therapy is one of the best curative treatment options for malignant liver tumors, and can be an alternative to resection. Radiofrequency ablation (RFA) of primary and secondary liver cancers can be performed safely using percutaneous, laparoscopic, or open surgical techniques, and RFA has markedly changed the treatment strategy for small hepatocellular carcinoma (HCC). Percutaneous RFA can achieve the same overall and disease-free survival as surgical resection for patients with small HCC. The use of a laparoscopic or open approach allows repeated placements of RFA electrodes at multiple sites to ablate larger tumors. RFA combined with transcatheter arterial chemoembolization will make the treatment of larger tumors a clinically viable treatment alternative. However, an accurate evaluation of treatment response is very important to secure successful RFA therapy. Since a sufficient safety margin (at least 0.5 cm) can prevent local tumor recurrences, an accurate evaluation of treatment response is very important to secure successful RFA therapy. To minimize complications of RFA, clinicians should be familiar with the imaging features of each type of complication. Appropriate management of complications is essential for successful RFA treatment. PMID:21179308

  19. Interactive Volumetry Of Liver Ablation Zones

    PubMed Central

    Egger, Jan; Busse, Harald; Brandmaier, Philipp; Seider, Daniel; Gawlitza, Matthias; Strocka, Steffen; Voglreiter, Philip; Dokter, Mark; Hofmann, Michael; Kainz, Bernhard; Hann, Alexander; Chen, Xiaojun; Alhonnoro, Tuomas; Pollari, Mika; Schmalstieg, Dieter; Moche, Michael

    2015-01-01

    Percutaneous radiofrequency ablation (RFA) is a minimally invasive technique that destroys cancer cells by heat. The heat results from focusing energy in the radiofrequency spectrum through a needle. Amongst others, this can enable the treatment of patients who are not eligible for an open surgery. However, the possibility of recurrent liver cancer due to incomplete ablation of the tumor makes post-interventional monitoring via regular follow-up scans mandatory. These scans have to be carefully inspected for any conspicuousness. Within this study, the RF ablation zones from twelve post-interventional CT acquisitions have been segmented semi-automatically to support the visual inspection. An interactive, graph-based contouring approach, which prefers spherically shaped regions, has been applied. For the quantitative and qualitative analysis of the algorithm’s results, manual slice-by-slice segmentations produced by clinical experts have been used as the gold standard (which have also been compared among each other). As evaluation metric for the statistical validation, the Dice Similarity Coefficient (DSC) has been calculated. The results show that the proposed tool provides lesion segmentation with sufficient accuracy much faster than manual segmentation. The visual feedback and interactivity make the proposed tool well suitable for the clinical workflow. PMID:26482818

  20. Radiotherapy for Head and Neck Cancer

    PubMed Central

    Yeh, Shyh-An

    2010-01-01

    Treatment for patients with head and neck cancer requires a multidisciplinary approach. Radiotherapy is employed as a primary treatment or as an adjuvant to surgery. Each specific subsite dictates the appropriate radiotherapy techniques, fields, dose, and fractionation scheme. Quality of life is also an important issue in the management of head and neck cancer. The radiation-related complications have a tremendous impact on the quality of life. Modern radiotherapy techniques, such as intensity-modulated radiotherapy and image-guided radiotherapy, can offer precise radiation delivery and reduce the dose to the surrounding normal tissues without compromise of target coverage. In the future, efforts should be made in the exploration of novel strategies to improve treatment outcome in patients with head and neck cancer. PMID:22550433

  1. Persistent atrial fibrillation ablation: conventional versus driver-guided strategy.

    PubMed

    Lim, Han S; Sacher, Frédéric; Zellerhoff, Stephan; Jesel, Laurence; Shah, Ashok J; Komatsu, Yuki; Daly, Matthew; Denis, Arnaud; Derval, Nicolas; Hocini, Mélèze; Jaïs, Pierre; Haïssaguerre, Michel

    2015-01-01

    While pulmonary vein isolation for paroxysmal atrial fibrillation (AF) is highly effective, catheter ablation for persistent AF remains a challenge with varying clinical success reported. Several ablation techniques have been proposed to target persistent AF, with the additional ablation of complex fractionated electrograms and linear lesions shown to provide incremental success to pulmonary vein isolation alone. Recently, several studies have suggested the presence of localized drivers (re-entrant or focal) in AF. By targeting these drivers, clinical outcomes may be maintained while minimizing the extent of ablation. This article will focus on the conventional stepwise ablation approach for persistent AF versus driver-guided ablation with the use of newer mapping technologies. PMID:26610158

  2. Modeling CO{sub 2} Laser Ablative Impulse with Polymers

    SciTech Connect

    Sinko, John E.; Phipps, Claude R.; Sasoh, Akihiro

    2010-10-08

    Laser ablation vaporization models have usually ignored the spatial dependence of the laser beam. Here, we consider effects from modeling using a Gaussian beam for both photochemical and photothermal conditions. The modeling results are compared to experimental and literature data for CO{sub 2} laser ablation of the polymer polyoxymethylene under vacuum, and discussed in terms of the ablated mass areal density and momentum coupling coefficient. Extending the scope of discussion, laser ablative impulse generation research has lacked a cohesive strategy for linking the vaporization and plasma regimes. Existing models, mostly formulated for ultraviolet laser systems or metal targets, appear to be inappropriate or impractical for applications requiring CO{sub 2} laser ablation of polymers. A recently proposed method for linking the vaporization and plasma regimes for analytical modeling is addressed here along with the implications of its use. Key control parameters are considered, along with the major propulsion parameters needed for laser ablation propulsion modeling.

  3. Successful radiotherapy of facial angiosarcoma.

    PubMed

    Gkalpakiotis, S; Arenberger, P; Vohradnikova, O; Arenbergerova, M

    2008-11-01

    Cutaneous angiosarcoma of the face and scalp is a rare malignant vascular tumor that affects mostly Caucasian elderly males. At present, connections concerning the etiology of this neoplasm with radiation therapy, exposure to environmental carcinogens and chronic lymphedema have been described. Due to the difficult histologic evaluation, high local recurrence and tendency to early metastasing, angiosarcoma poses generally a very poor prognosis. We report the case of an 80-year-old patient who experienced successful removal of large, exophytic growing angiosarcoma of the face achieved with radiotherapy with long-term relapse-free survival. PMID:18986458

  4. Convergent ablation measurements of plastic ablators in gas-filled rugby hohlraums on OMEGA

    NASA Astrophysics Data System (ADS)

    Casner, A.; Jalinaud, T.; Masse, L.; Galmiche, D.

    2015-10-01

    Indirect-drive implosions experiments were conducted on the Omega Laser Facility to test the performance of uniformly doped plastic ablators for Inertial Confinement Fusion. The first convergent ablation measurements in gas-filled rugby hohlraums are reported. Ignition relevant limb velocities in the range from 150 to 300 μm .n s-1 have been reached by varying the laser drive energy and the initial capsule aspect ratio. The measured capsule trajectory and implosion velocity are in good agreement with 2D integrated simulations and a zero-dimensional modeling of the implosions. We demonstrate experimentally the scaling law for the maximum implosion velocity predicted by the improved rocket model [Y. Saillard, Nucl. Fusion 46, 1017 (2006)] in the high-ablation regime case.

  5. Macrophages loaded with gold nanoshells for photothermal ablation of glioma: An in vitro model

    NASA Astrophysics Data System (ADS)

    Makkouk, Amani Riad

    The current median survival of patients with glioblastoma multiforme (GBM), the most common type of glioma, remains at 14.6 months despite multimodal treatments (surgery, radiotherapy and chemotherapy). This research aims to study the feasibility of photothermal ablation of glioma using gold nanoshells that are heated upon laser irradiation at their resonance wavelength. The novelty of our approach lies in improving nanoshell tumor delivery by loading them in macrophages, which are known to be recruited to gliomas via tumor-released chemoattractive agents. Ferumoxides, superparamagnetic iron oxide (SPIO) nanoparticles, are needed as an additional macrophage load in order to visualize macrophage accumulation in the tumor with magnetic resonance imaging (MRI) prior to laser irradiation. The feasibility of this approach was studied in an in vitro model of glioma spheroids with the use of continuous wave (CW) laser light for ablation. The optimal loading of both murine and rat macrophages with Ferumoxides was determined using inductively coupled plasma atomic emission spectroscopy (ICP-AES). Higher concentrations of SPIO were observed in rat macrophages, and the optimal concentration was chosen at 100 microg Fe/ml. Macrophages were found to be very sensitive to near infra-red (NIR) laser irradiation, and their use as vehicles was thus not expected to hinder the function of loaded nanoshells as tumor-ablating tools. The intracellular presence of gold nanoshells in macrophages was confirmed with TEM imaging. Next, the loading of both murine and rat macrophages with gold nanoshells was studied using UV/Vis spectrophotometry, where higher nanoshell uptake was found in rat macrophages. Incubation of loaded murine and rat macrophages with rat C-6 and human ACBT spheroids, respectively, resulted in their infiltration of the spheroids. Subsequent laser irradiation at 55 W/cm2 for 10 min and follow-up of spheroid average diameter size over 14 days post-irradiation showed that

  6. Laser-ablation processes (Invited Paper)

    NASA Astrophysics Data System (ADS)

    Dingus, Ronald S.

    1992-06-01

    The physical mechanisms associated with ablation of matter by laser irradiation are quite different in different regions of parameter space. The important parameters are the laser wavelength; the laser flux versus time, position, and angle of incidence at the target; and the target properties as well as the properties of the laser-transport medium adjacent to the irradiated target surface. Important target properties include surface contour, laser reflectivity and absorption depth, thermal diffusively, vaporization energy, Gruneisen coefficient, spall strength, ionization energies and plasma opacity versus temperature and density. As the flux increases, the process becomes less dependent on most of these target properties. Depending on the values of these various parameters, at relatively low fluxes targets can be vaporized and these vapors can be transparent to the laser beam. If a transparent liquid or solid transport medium exists in front of the vaporized target material, then a complicated contained- vaporization process takes place and the work done on the target by the vapors can be several orders of magnitude larger than with a gas or vacuum transport medium; the degree of work enhancement can depend strongly on the vapor condensability and condensed matter thermal conductivity. For short-pulselength irradiations of semi-transparent targets with a low- acoustic-impedance-laser-transport medium adjacent to the target, ablation needs to be a vacuum in order for the beam to be able to propagate to the target. For targets in a vacuum exposed to fluxes of this order (and considerably higher) and for long pulselengths, most of the laser energy will be absorbed (before reaching the critical surface) by inverse bremsstrahlung in material blown off from the target; at higher fluxes, the beam will be stopped at the critical surface producing localized absorption along with much higher energy densities and non-thermal equilibrium behavior. When the combination of

  7. Ablation by ultrashort laser pulses: Atomistic and thermodynamic analysis of the processes at the ablation threshold

    SciTech Connect

    Upadhyay, Arun K.; Inogamov, Nail A.; Rethfeld, Baerbel; Urbassek, Herbert M.

    2008-07-15

    Ultrafast laser irradiation of solids may ablate material off the surface. We study this process for thin films using molecular-dynamics simulation and thermodynamic analysis. Both metals and Lennard-Jones (LJ) materials are studied. We find that despite the large difference in thermodynamical properties between these two classes of materials--e.g., for aluminum versus LJ the ratio T{sub c}/T{sub tr} of critical to triple-point temperature differs by more than a factor of 4--the values of the ablation threshold energy E{sub abl} normalized to the cohesion energy, {epsilon}{sub abl}=E{sub abl}/E{sub coh}, are surprisingly universal: all are near 0.3 with {+-}30% scattering. The difference in the ratio T{sub c}/T{sub tr} means that for metals the melting threshold {epsilon}{sub m} is low, {epsilon}{sub m}<{epsilon}{sub abl}, while for LJ it is high, {epsilon}{sub m}>{epsilon}{sub abl}. This thermodynamical consideration gives a simple explanation for the difference between metals and LJ. It explains why despite the universality in {epsilon}{sub abl}, metals thermomechanically ablate always from the liquid state. This is opposite to LJ materials, which (near threshold) ablate from the solid state. Furthermore, we find that immediately below the ablation threshold, the formation of large voids (cavitation) in the irradiated material leads to a strong temporary expansion on a very slow time scale. This feature is easily distinguished from the acoustic oscillations governing the material response at smaller intensities, on the one hand, and the ablation occurring at larger intensities, on the other hand. This finding allows us to explain the puzzle of huge surface excursions found in experiments at near-threshold laser irradiation.

  8. Percutaneous ablation therapies of inoperable pancreatic cancer: a systematic review

    PubMed Central

    Ierardi, Anna Maria; Lucchina, Natalie; Bacuzzi, Alessandro; Marco, De Chiara; Bracchi, Elena; Cocozza, Eugenio; Dionigi, Gianlorenzo; Tsetis, Dimitrios; Floridi, Chiara; Carrafiello, Gianpaolo

    2015-01-01

    Initial studies about ablation therapies of the pancreas were associated with significant morbidity and mortality, which limited widespread adoption. Development of techniques with high quality imaging used as guidance improve outcomes reducing complications. Moreover, only few experiences of percutaneous pancreatic ablations are reported. They are performed by very skilled operators in highly specialized centers. This review presents the current status of percutaneous local ablative therapies in the treatment of advanced pancreatic cancer. PMID:26424487

  9. Is ventricular ectopy a legitimate target for ablation?

    PubMed Central

    Gumbrielle, T; Bourke, J P; Furniss, S S

    1994-01-01

    Radiofrequency ablation has an established role in the treatment of non-ischaemic ventricular tachycardia. A few patients present with symptomatic but benign ventricular ectopy that can be mapped to the right ventricular outflow tract. The successful use of radiofrequency ablation in a patient with drug resistant, symptomatic ventricular ectopy is reported. Radiofrequency ablation may have a useful role in more benign arrhythmias. PMID:7818971

  10. A rare complication of radiofrequency ablation: skin burn.

    PubMed

    Ertuğrul, İlker; Karagöz, Tevfik; Aykan, Hayrettin H

    2015-10-01

    Radiofrequency ablation is the first-line treatment for arrhythmias with high success and low complication rates. Skin burns have been reported rarely after electrophysiological procedures, especially procedures in which higher-power energy is used and multiple ablations are performed. Here, we report a case of skin burn that developed after radiofrequency ablation for ventricular tachycardia originating from the right ventricular outflow tract. PMID:25613639

  11. Radiofrequency Ablation of Thyroid Nodules: Basic Principles and Clinical Application

    PubMed Central

    Shin, Ji Hoon; Baek, Jung Hwan; Ha, Eun Ju; Lee, Jeong Hyun

    2012-01-01

    Radiofrequency (RF) ablation has been gaining popularity as a minimally invasive treatment for benign thyroid nodules regardless of the extent of the solid component. RF ablation of benign nodules demonstrated volume reductions of 33–58% after one month and 51–85% after six months, while solving nodule-related clinical problems. RF ablation has recently shown positive short-term results for locoregional control as well as symptom improvement in patients with recurrent thyroid cancers. This paper reviews the basic physics, indications, patient preparation, devices, procedures, clinical results, and complications of RF ablation. PMID:23133449

  12. Streaked radiography measurements of convergent ablator performance (invited)

    SciTech Connect

    Hicks, D. G.; Spears, B. K.; Braun, D. G.; Olson, R. E.; Sorce, C. M.; Celliers, P. M.; Collins, G. W.; Landen, O. L.

    2010-10-15

    The velocity and remaining ablator mass of an imploding capsule are critical metrics for assessing the progress toward ignition of an inertially confined fusion experiment. These and other ablator rocket parameters have been measured using a single streaked x-ray radiograph. A regularization technique has been used to determine the ablator density profile {rho}(r) at each time step; moments of {rho}(r) then provide the areal density, average radius, and mass of the unablated, or remaining, ablator material, with the velocity determined from the time derivative of the average radius. The technique has been implemented on experiments at the OMEGA laser facility.

  13. Osteoid Osteoma: Experience with Laser- and Radiofrequency-Induced Ablation

    SciTech Connect

    Gebauer, Bernhard Tunn, Per-Ulf; Gaffke, Gunnar; Melcher, Ingo; Felix, Roland; Stroszczynski, Christian

    2006-04-15

    The purpose of this study was to analyze the clinical outcome of osteoid osteoma treated by thermal ablation after drill opening. A total of 17 patients and 20 procedures were included. All patients had typical clinical features (age, pain) and a typical radiograph showing a nidus. In 5 cases, additional histological specimens were acquired. After drill opening of the osteoid osteoma nidus, 12 thermal ablations were induced by laser interstitial thermal therapy (LITT) (9F Power-Laser-Set; Somatex, Germany) and 8 ablations by radiofrequency ablation (RFA) (RITA; StarBurst, USA). Initial clinical success with pain relief has been achieved in all patients after the first ablation. Three patients had an osteoid osteoma recurrence after 3, 9, and 10 months and were successfully re-treated by thermal ablation. No major complication and one minor complication (sensible defect) were recorded. Thermal ablation is a safe and minimally invasive therapy option for osteoid osteoma. Although the groups are too small for a comparative analysis, we determined no difference between laser- and radiofrequency-induced ablation in clinical outcome after ablation.

  14. Image-Guided Tumor Ablation: Emerging Technologies and Future Directions

    PubMed Central

    McWilliams, Justin P.; Lee, Edward W.; Yamamoto, Shota; Loh, Christopher T.; Kee, Stephen T.

    2010-01-01

    As the trend continues toward the decreased invasiveness of medical procedures, image-guided percutaneous ablation has begun to supplant surgery for the local control of small tumors in the liver, kidney, and lung. New ablation technologies, and refinements of existing technologies, will enable treatment of larger and more complex tumors in these and other organs. At the same time, improvements in intraprocedural imaging promise to improve treatment accuracy and reduce complications. In this review, the latest advancements in clinical and experimental ablation technologies will be summarized, and new applications of image-guided tumor ablation will be discussed. PMID:22550370

  15. Radiofrequency catheter ablation of accessory pathways in infants.

    PubMed Central

    Benito, F.; Sánchez, C.

    1997-01-01

    OBJECTIVE: To evaluate the indications, results and complications of radiofrequency catheter ablation in small infants with supraventricular tachycardia due to an accessory atrioventricular pathway. METHODS: Five infants less than 9 months old underwent radiofrequency catheter ablation of accessory pathways. Ablation was done for medically refractory tachyarrhythmia associated with aborted sudden death in two patients, left ventricular dysfunction in one, failure of antiarrhythmic drugs in one, and planned cardiac surgery in one. All five patients underwent a single successful procedure. Three left free wall pathways were ablated by transseptal approach, a right posteroseptal pathway was ablated from the inferior vena cava, and a left posteroseptal pathway was approached from the inferior vena cava into the coronary sinus. A deflectable 5F bipolar electrode catheter with a 3 mm tip was used. RESULTS: A sudden increment in impedance indicative of coagulum formation was observed in two procedures. One patient developed a transient ischaemic complication after ablation of a left lateral accessory pathway by transseptal approach. This patient had mild pericardial effusion after the procedure. Moderate pericardial effusion was also noted in another patient. After a mean follow up of 18.4 months all patients are symptom free without treatment. CONCLUSIONS: Radiofrequency catheter ablation can be performed successfully in infants. Temperature monitoring in 5F ablation catheters would be desirable to prevent the development of coagulum. Echocardiography must be performed after the ablation procedure to investigate pericardial effusion. Images PMID:9326990

  16. Nanochemical effects in femtosecond laser ablation of metals

    SciTech Connect

    Vorobyev, A. Y.; Guo, Chunlei

    2013-02-18

    We study chemical energy released from the oxidation of aluminum in multipulse femtosecond laser ablation in air and oxygen. Our study shows that the released chemical energy amounts to about 13% of the incident laser energy, and about 50% of the ablated material is oxidized. The ablated material mass per laser pulse is measured to be on the nanogram scale. Our study indicates that femtosecond laser ablation is capable of inducing nanochemical reactions since the femtosecond laser pulse can controllably produce nanoparticles, clusters, and atoms from a solid target.

  17. Is radiation-induced ovarian ablation in breast cancer an obsolete procedure? Results of a meta-analysis

    PubMed Central

    Asiri, Mushabbab Al; Tunio, Mutahir A; Abdulmoniem, Reham

    2016-01-01

    Background A meta-analysis was conducted to assess the impact of radiation-induced ovarian ablation (RT-OA) on amenorrhea cessation rates, progression-free survival, and overall survival in pre/perimenopausal women with breast cancer. Materials and methods The Medline, CANCERLIT, and Cochrane Library databases and search engines were searched to identify randomized controlled studies comparing RT-OA with control for early or metastatic breast cancer. Further, radiotherapy doses, techniques, and associated side effects were evaluated. Results Six controlled trials with a total patient population of 3,317 were identified. Pooled results from these trials showed significant amenorrhea rates (P<0.00001) and increase in progression-free survival in patients treated with RT-OA (P<0.00001). However, there was no difference in overall survival (P=0.37). The majority of patients were treated with larger field sizes with parallel-opposed anteroposterior and posteroanterior pelvic fields. RT-OA was generally well tolerated. Radiotherapy doses of 1,500 cGy in five fractions, 1,500 cGy in four fractions, 1,600 cGy in four fractions, and 2,000 cGy in ten fractions were associated with excellent amenorrhea rates. The resultant funnel plot showed no publication bias (Egger test P=0.16). Conclusion RT-OA is cost-effective and can safely be used in pre/perimenopausal women with metastatic breast cancer, or if luteinizing hormone-releasing hormone analogs are contraindicated, or in patients in whom fertility preservation is not an issue. Radiation dose of 1,500 cGy in five fractions, 1,500 cGy in four fractions, 1,600 cGy in four fractions, and 2,000 cGy in ten fractions showed more efficacies. However, further studies incorporating three-dimensional conformal radiotherapy and intensity-modulated radiotherapy are warranted. PMID:27307764

  18. Ion-induced nuclear radiotherapy

    DOEpatents

    Horn, K.M.; Doyle, B.L.

    1996-08-20

    Ion-induced Nuclear Radiotherapy (INRT) is a technique for conducting radiosurgery and radiotherapy with a very high degree of control over the spatial extent of the irradiated volume and the delivered dose. Based upon the concept that low energy, ion induced atomic and nuclear reactions can be used to produce highly energetic reaction products at the site of a tumor, the INRT technique is implemented through the use of a conduit-needle or tube which conducts a low energy ion beam to a position above or within the intended treatment area. At the end of the conduit-needle or tube is a specially fabricated target which, only when struck by the ion beam, acts as a source of energetic radiation products. The inherent limitations in the energy, and therefore range, of the resulting reaction products limits the spatial extent of irradiation to a pre-defined volume about the point of reaction. Furthermore, since no damage is done to tissue outside this irradiated volume, the delivered dose may be made arbitrarily large. INRT may be used both as a point-source of radiation at the site of a small tumor, or as a topical bath of radiation to broad areas of diseased tissue. 25 figs.

  19. Ion-induced nuclear radiotherapy

    DOEpatents

    Horn, Kevin M.; Doyle, Barney L.

    1996-01-01

    Ion-induced Nuclear Radiotherapy (INRT) is a technique for conducting radiosurgery and radiotherapy with a very high degree of control over the spatial extent of the irradiated volume and the delivered dose. Based upon the concept that low energy, ion induced atomic and nuclear reactions can be used to produce highly energetic reaction products at the site of a tumor, the INRT technique is implemented through the use of a conduit-needle or tube which conducts a low energy ion beam to a position above or within the intended treatment area. At the end of the conduit-needle or tube is a specially fabricated target which, only when struck by the ion beam, acts as a source of energetic radiation products. The inherent limitations in the energy, and therefore range, of the resulting reaction products limits the spatial extent of irradiation to a pre-defined volume about the point of reaction. Furthermore, since no damage is done to tissue outside this irradiated volume, the delivered dose may be made arbitrarily large. INRT may be used both as a point-source of radiation at the site of a small tumor, or as a topical bath of radiation to broad areas of diseased tissue.

  20. CT-guided Bipolar and Multipolar Radiofrequency Ablation (RF Ablation) of Renal Cell Carcinoma: Specific Technical Aspects and Clinical Results

    SciTech Connect

    Sommer, C. M.; Lemm, G.; Hohenstein, E.; Bellemann, N.; Stampfl, U.; Goezen, A. S.; Rassweiler, J.; Kauczor, H. U.; Radeleff, B. A.; Pereira, P. L.

    2013-06-15

    Purpose. This study was designed to evaluate the clinical efficacy of CT-guided bipolar and multipolar radiofrequency ablation (RF ablation) of renal cell carcinoma (RCC) and to analyze specific technical aspects between both technologies. Methods. We included 22 consecutive patients (3 women; age 74.2 {+-} 8.6 years) after 28 CT-guided bipolar or multipolar RF ablations of 28 RCCs (diameter 2.5 {+-} 0.8 cm). Procedures were performed with a commercially available RF system (Celon AG Olympus, Berlin, Germany). Technical aspects of RF ablation procedures (ablation mode [bipolar or multipolar], number of applicators and ablation cycles, overall ablation time and deployed energy, and technical success rate) were analyzed. Clinical results (local recurrence-free survival and local tumor control rate, renal function [glomerular filtration rate (GFR)]) and complication rates were evaluated. Results. Bipolar RF ablation was performed in 12 procedures and multipolar RF ablation in 16 procedures (2 applicators in 14 procedures and 3 applicators in 2 procedures). One ablation cycle was performed in 15 procedures and two ablation cycles in 13 procedures. Overall ablation time and deployed energy were 35.0 {+-} 13.6 min and 43.7 {+-} 17.9 kJ. Technical success rate was 100 %. Major and minor complication rates were 4 and 14 %. At an imaging follow-up of 15.2 {+-} 8.8 months, local recurrence-free survival was 14.4 {+-} 8.8 months and local tumor control rate was 93 %. GFR did not deteriorate after RF ablation (50.8 {+-} 16.6 ml/min/1.73 m{sup 2} before RF ablation vs. 47.2 {+-} 11.9 ml/min/1.73 m{sup 2} after RF ablation; not significant). Conclusions. CT-guided bipolar and multipolar RF ablation of RCC has a high rate of clinical success and low complication rates. At short-term follow-up, clinical efficacy is high without deterioration of the renal function.