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Sample records for adaptive radiotherapy art

  1. [Head and neck adaptive radiotherapy].

    PubMed

    Graff, P; Huger, S; Kirby, N; Pouliot, J

    2013-10-01

    Onboard volumetric imaging systems can provide accurate data of the patient's anatomy during a course of head and neck radiotherapy making it possible to assess the actual delivered dose and to evaluate the dosimetric impact of complex daily positioning variations and gradual anatomic changes such as geometric variations of tumors and normal tissues or shrinkage of external contours. Adaptive radiotherapy is defined as the correction of a patient's treatment planning to adapt for individual variations observed during treatment. Strategies are developed to selectively identify patients that require replanning because of an intolerable dosimetric drift. Automated tools are designed to limit time consumption. Deformable image registration algorithms are the cornerstones of these strategies, but a better understanding of their limits of validity is required before adaptive radiotherapy can be safely introduced to daily practice. Moreover, strict evaluation of the clinical benefits is yet to be proven.

  2. SU-E-J-179: Assessment of Tumor Volume Change and Movement During Stereotactic Body Radiotherapy (SBRT) for Lung Cancer: Is Adaptive Radiation Therapy (ART) Necessary?

    SciTech Connect

    Lee, C; Lee, C

    2015-06-15

    Purpose: Delineation of gross tumor volumes (GTVs) is important for stereotactic body radiotherapy (SBRT). However, tumor volume changes during treatment response. Here, we have investigated tumor volume changes and movement during SBRT for lung cancer, as a means of examining the need for adaptive radiation therapy (ART). Methods: Fifteen tumors in 15 patients with lung cancer were treated with SBRT (total dose: 60 Gy in 4 fractions). GTVs were obtained from cone-beam computed tomography scans (CBCT1–4) taken before each of the 4 fractions was administered. GTVs were delineated and measured by radiation oncologists using a treatment planning system. Variance in the tumor position was assessed between the planning CT and the CBCT images. To investigate the dosimetric effects of tumor volume changes, planning CT and CBCT4 treatment plans were compared using the conformity index (CI), homogeneity index (HI), and Paddick’s index (PCI). Results: The GTV on CBCT1 was employed as a baseline for comparisons. GTV had decreased by a mean of 20.4% (range: 0.7% to 47.2%) on CBCT4. Most patients had smaller GTVs on CBCT4 than on CBCT1. The interfractional shifts of the tumor position between the planning CT and CBCT1–4 were as follows: right-left, −0.4 to 1.3 mm; anterior-posterior, −0.8 to 0.5 mm; and superiorinferior, −0.9 to 1.1 mm. Indices for plans from the planning CT and CBCT4 were as follows: CI = 0.94±0.02 and 1.11±0.03; HI= 1.1±0.02 and 1.10±0.03; and PCI = 1.35±0.16 and 1.11±0.02, respectively. Conclusion: CI, HI, and PCI did not differ between the planning CT and CBCTs. However, daily CBCT revealed a significant decrease in the GTV during lung SBRT. Furthermore, there was an obvious interfractional shift in tumor position. Using ART could potentially lead to a reduced GTV margin and improved regional tumor control for lung cancer patients with significantly decreased GTV.

  3. [Adaptative radiotherapy: The case for MRI-guided radiotherapy].

    PubMed

    Maingon, P

    2016-10-01

    The concept of image-guided radiotherapy benefits from the development of magnetic resonance imaging (MRI) associated with different capacities of tissue analyses such as spectroscopy or diffusion analysis. The production of devices allowing the repositioning of patients through MRI represents a strong added value without delivering any additional dose to the patient while the optimization of the adaptative strategies are facilitated by a better contrast of the soft tissues compared to the scanner. The advantages of MRI are well demonstrated for brain tumours, head and neck carcinomas, pelvic tumors, mediastinal malignancies, gastrointestinal tract diseases. Adaptative radiotherapy inaugurates a new area of radiotherapy with different modalities. Several technological solutions are provided or discussed allowing the patients to benefit from thses new technologies as soon as possible.

  4. Adapting radiotherapy to hypoxic tumours

    NASA Astrophysics Data System (ADS)

    Malinen, Eirik; Søvik, Åste; Hristov, Dimitre; Bruland, Øyvind S.; Rune Olsen, Dag

    2006-10-01

    In the current work, the concepts of biologically adapted radiotherapy of hypoxic tumours in a framework encompassing functional tumour imaging, tumour control predictions, inverse treatment planning and intensity modulated radiotherapy (IMRT) were presented. Dynamic contrast enhanced magnetic resonance imaging (DCEMRI) of a spontaneous sarcoma in the nasal region of a dog was employed. The tracer concentration in the tumour was assumed related to the oxygen tension and compared to Eppendorf histograph measurements. Based on the pO2-related images derived from the MR analysis, the tumour was divided into four compartments by a segmentation procedure. DICOM structure sets for IMRT planning could be derived thereof. In order to display the possible advantages of non-uniform tumour doses, dose redistribution among the four tumour compartments was introduced. The dose redistribution was constrained by keeping the average dose to the tumour equal to a conventional target dose. The compartmental doses yielding optimum tumour control probability (TCP) were used as input in an inverse planning system, where the planning basis was the pO2-related tumour images from the MR analysis. Uniform (conventional) and non-uniform IMRT plans were scored both physically and biologically. The consequences of random and systematic errors in the compartmental images were evaluated. The normalized frequency distributions of the tracer concentration and the pO2 Eppendorf measurements were not significantly different. 28% of the tumour had, according to the MR analysis, pO2 values of less than 5 mm Hg. The optimum TCP following a non-uniform dose prescription was about four times higher than that following a uniform dose prescription. The non-uniform IMRT dose distribution resulting from the inverse planning gave a three times higher TCP than that of the uniform distribution. The TCP and the dose-based plan quality depended on IMRT parameters defined in the inverse planning procedure (fields

  5. Adaptive Radiotherapy for an Uncommon Chloroma

    PubMed Central

    Majdoul, Soufya; Colson-Durand, Laurianne; To, Nu Hanh; Belkacemi, Yazid

    2016-01-01

    Granulocytic sarcomas, also referred to as chloromas or myeloid sarcomas, are extramedullary neoplasms that are composed of immature myeloid cells. This uncommon disease is known to be radiosensitive. However, the total dose and dose per fraction are not standardized. In addition, during the course of radiation therapy, significant reduction of the tumor is usually obtained. Thus, target volume reduction may require an intermediate radiotherapy plan evaluation for an adaptive treatment. A second plan at mid-dose is highly recommended. PMID:27920690

  6. State of the art of radiotherapy.

    PubMed

    Garrido, Pilar; Olmedo, Eugenia

    2013-06-01

    Locally advanced or stage III disease accounts for ~30% of patients with non-small-cell lung cancer (NSCLC), which means only in the United States, more than 50,000 new patients each year. Stage III is a very heterogeneous disease, the management of patients is complex and several conditions (performance status, weight loss, comorbidities, characteristics of nodal involvement or resectability) must be considered before selecting the best treatment, which in most cases is chemotherapy (CT) and radiotherapy (RT). In this article, we will review key changes in the management of unresectable stage III during the last decades. Also we will highlight some challenges and areas of active research.

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

    SciTech Connect

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

    2008-07-01

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

  8. Technical Note: DIRART- A software suite for deformable image registration and adaptive radiotherapy research

    SciTech Connect

    Yang Deshan; Brame, Scott; El Naqa, Issam; Aditya, Apte; Wu Yu; Murty Goddu, S.; Mutic, Sasa; Deasy, Joseph O.; Low, Daniel A.

    2011-01-15

    Purpose: Recent years have witnessed tremendous progress in image guide radiotherapy technology and a growing interest in the possibilities for adapting treatment planning and delivery over the course of treatment. One obstacle faced by the research community has been the lack of a comprehensive open-source software toolkit dedicated for adaptive radiotherapy (ART). To address this need, the authors have developed a software suite called the Deformable Image Registration and Adaptive Radiotherapy Toolkit (DIRART). Methods: DIRART is an open-source toolkit developed in MATLAB. It is designed in an object-oriented style with focus on user-friendliness, features, and flexibility. It contains four classes of DIR algorithms, including the newer inverse consistency algorithms to provide consistent displacement vector field in both directions. It also contains common ART functions, an integrated graphical user interface, a variety of visualization and image-processing features, dose metric analysis functions, and interface routines. These interface routines make DIRART a powerful complement to the Computational Environment for Radiotherapy Research (CERR) and popular image-processing toolkits such as ITK. Results: DIRART provides a set of image processing/registration algorithms and postprocessing functions to facilitate the development and testing of DIR algorithms. It also offers a good amount of options for DIR results visualization, evaluation, and validation. Conclusions: By exchanging data with treatment planning systems via DICOM-RT files and CERR, and by bringing image registration algorithms closer to radiotherapy applications, DIRART is potentially a convenient and flexible platform that may facilitate ART and DIR research.

  9. Adapting Arts Activities or Success for All.

    ERIC Educational Resources Information Center

    Carr, Gary R.

    It is possible to adapt art activity to meet the needs of any student regardless of physical and medical challenges. Art activities should allow any child to participate with success. This handbook is about tools and devices adapted for and used by physically handicapped and health impaired students for art activities. The handbook also works on…

  10. Comparison of adaptive radiotherapy techniques for external radiation therapy of canine bladder cancer.

    PubMed

    Nieset, Jessica R; Harmon, Joseph F; Johnson, Thomas E; Larue, Susan M

    2014-01-01

    Daily bladder variations make it difficult to utilize standard radiotherapy as a primary treatment option for muscle-invasive bladder cancer. Our purpose was to develop a model comparing dose distributions of image-guided and adaptive radiotherapy (ART) techniques for canine bladder cancer. Images were obtained retrospectively from cone-beam computed tomography (CBCT) scans used for daily positioning of four dogs undergoing fractionated image-guided radiotherapy (IGRT). Four different treatment plans were modeled for each dog, and dosimetric data were compared. Two plans were developed using planning target volumes based on planning computed tomography (CT) bladder volume. These plans then used bony anatomy or soft tissue anatomy for daily positioning and dosimetric modeling. The third plan type was a hybrid IGRT and ART technique utilizing a library of premade anisotropic planning target volumes using bladder wall motion data and selection of a "plan-of-the-day" determined from positioning CBCT bladder volumes. The fourth plan was an ART technique that constructed a new planning target volume each day based on daily bladder volume as determined by pretreatment CBCT. Dose volume histograms were generated for each plan type and dose distribution for the bladder and rectum were compared between plan types. Irradiated rectal volume decreased and irradiated bladder volume increased as plan conformality increased. ART provided the greatest rectal sparing, with lowest irradiated rectal volume (P < 0.001), and largest bladder volume receiving 95% of the prescription dose (P < 0.001). In our model, adaptive radiotherapy techniques for canine bladder cancer showed significant reduction in rectal volume irradiated when compared to nonadaptive techniques, while maintaining appropriate bladder coverage.

  11. Radiotherapy Adapted to Spatial and Temporal Variability in Tumor Hypoxia

    SciTech Connect

    Sovik, Aste; Malinen, Eirik . E-mail: emalinen@fys.uio.no; Skogmo, Hege K.; Bentzen, Soren M.; Bruland, Oyvind S.; Olsen, Dag Rune

    2007-08-01

    Purpose: To explore the feasibility and clinical potential of adapting radiotherapy to temporal and spatial variations in tumor oxygenation. Methods and Materials: Repeated dynamic contrast enhanced magnetic resonance (DCEMR) images were taken of a canine sarcoma during the course of fractionated radiation therapy. The tumor contrast enhancement was assumed to represent the oxygen distribution. The IMRT plans were retrospectively adapted to the DCEMR images by employing tumor dose redistribution. Optimized nonuniform tumor dose distributions were calculated and compared with a uniform dose distribution delivering the same integral dose to the tumor. Clinical outcome was estimated from tumor control probability (TCP) and normal tissue complication probability (NTCP) modeling. Results: The biologically adapted treatment was found to give a substantial increase in TCP compared with conventional radiotherapy, even when only pretreatment images were used as basis for the treatment planning. The TCP was further increased by repeated replanning during the course of treatment, and replanning twice a week was found to give near optimal TCP. Random errors in patient positioning were found to give a small decrease in TCP, whereas systematic errors were found to reduce TCP substantially. NTCP for the adapted treatment was similar to or lower than for the conventional treatment, both for parallel and serial normal tissue structures. Conclusion: Biologically adapted radiotherapy is estimated to improve treatment outcome of tumors having spatial and temporal variations in radiosensitivity.

  12. Process-based quality management for clinical implementation of adaptive radiotherapy

    SciTech Connect

    Noel, Camille E.; Santanam, Lakshmi; Parikh, Parag J.; Mutic, Sasa

    2014-08-15

    Purpose: Intensity-modulated adaptive radiotherapy (ART) has been the focus of considerable research and developmental work due to its potential therapeutic benefits. However, in light of its unique quality assurance (QA) challenges, no one has described a robust framework for its clinical implementation. In fact, recent position papers by ASTRO and AAPM have firmly endorsed pretreatment patient-specific IMRT QA, which limits the feasibility of online ART. The authors aim to address these obstacles by applying failure mode and effects analysis (FMEA) to identify high-priority errors and appropriate risk-mitigation strategies for clinical implementation of intensity-modulated ART. Methods: An experienced team of two clinical medical physicists, one clinical engineer, and one radiation oncologist was assembled to perform a standard FMEA for intensity-modulated ART. A set of 216 potential radiotherapy failures composed by the forthcoming AAPM task group 100 (TG-100) was used as the basis. Of the 216 failures, 127 were identified as most relevant to an ART scheme. Using the associated TG-100 FMEA values as a baseline, the team considered how the likeliness of occurrence (O), outcome severity (S), and likeliness of failure being undetected (D) would change for ART. New risk priority numbers (RPN) were calculated. Failures characterized by RPN ≥ 200 were identified as potentially critical. Results: FMEA revealed that ART RPN increased for 38% (n = 48/127) of potential failures, with 75% (n = 36/48) attributed to failures in the segmentation and treatment planning processes. Forty-three of 127 failures were identified as potentially critical. Risk-mitigation strategies include implementing a suite of quality control and decision support software, specialty QA software/hardware tools, and an increase in specially trained personnel. Conclusions: Results of the FMEA-based risk assessment demonstrate that intensity-modulated ART introduces different (but not necessarily

  13. Process-based quality management for clinical implementation of adaptive radiotherapy

    PubMed Central

    Noel, Camille E.; Santanam, Lakshmi; Parikh, Parag J.; Mutic, Sasa

    2014-01-01

    Purpose: Intensity-modulated adaptive radiotherapy (ART) has been the focus of considerable research and developmental work due to its potential therapeutic benefits. However, in light of its unique quality assurance (QA) challenges, no one has described a robust framework for its clinical implementation. In fact, recent position papers by ASTRO and AAPM have firmly endorsed pretreatment patient-specific IMRT QA, which limits the feasibility of online ART. The authors aim to address these obstacles by applying failure mode and effects analysis (FMEA) to identify high-priority errors and appropriate risk-mitigation strategies for clinical implementation of intensity-modulated ART. Methods: An experienced team of two clinical medical physicists, one clinical engineer, and one radiation oncologist was assembled to perform a standard FMEA for intensity-modulated ART. A set of 216 potential radiotherapy failures composed by the forthcoming AAPM task group 100 (TG-100) was used as the basis. Of the 216 failures, 127 were identified as most relevant to an ART scheme. Using the associated TG-100 FMEA values as a baseline, the team considered how the likeliness of occurrence (O), outcome severity (S), and likeliness of failure being undetected (D) would change for ART. New risk priority numbers (RPN) were calculated. Failures characterized by RPN ≥ 200 were identified as potentially critical. Results: FMEA revealed that ART RPN increased for 38% (n = 48/127) of potential failures, with 75% (n = 36/48) attributed to failures in the segmentation and treatment planning processes. Forty-three of 127 failures were identified as potentially critical. Risk-mitigation strategies include implementing a suite of quality control and decision support software, specialty QA software/hardware tools, and an increase in specially trained personnel. Conclusions: Results of the FMEA-based risk assessment demonstrate that intensity-modulated ART introduces different (but not necessarily

  14. Dysphagia after radiotherapy: state of the art and prevention.

    PubMed

    Servagi-Vernat, S; Ali, D; Roubieu, C; Durdux, C; Laccourreye, O; Giraud, P

    2015-02-01

    Adjuvant radiotherapy after surgery or exclusive radiotherapy, with or without concurrent chemotherapy is a valuable treatment option in the great majority of patients with head and neck cancer. Recent technical progress in radiotherapy has resulted in a decreased incidence of xerostomia. Another common toxicity of radiotherapy is dysphagia, which alters the nutritional status and quality of life of patients in remission. The objective of this review is to describe the physiology of swallowing function, the pathophysiology of radiation-induced dysphagia and the various strategies currently available to prevent this complication.

  15. Dosimetric evaluation of a three-phase adaptive radiotherapy for nasopharyngeal carcinoma using helical tomotherapy

    SciTech Connect

    Fung, Winky Wing Ki; Wu, Vincent Wing Cheung; Teo, Peter Man Lung

    2012-04-01

    Adaptive radiotherapy (ART) has been introduced to correct the radiation-induced anatomic changes in head and neck cases during a treatment course. This study evaluated the potential dosimetric benefits of applying a 3-phase adaptive radiotherapy protocol in nasopharyngeal carcinoma (NPC) patients compared with the nonadaptive single-phase treatment protocol. Ten NPC patients previously treated with this 3-phase radiation protocol using Hi-Art Tomotherapy were recruited. Two new plans, PII-ART and PIII-ART, were generated based on the up-to-date computed tomography (CT) images and contours and were used for treatment in phase two (PII; after 25th fraction) and phase three (PIII; after 35th fraction), respectively. To simulate the situation of no replanning, 2 hybrid plans denoted as PII-NART and PIII-NART were generated using the original contours pasted on the PII- and PIII-CT sets by CT-CT fusion. Dosimetric comparisons were made between the NART plans and the corresponding ART plans. In both PII- and PIII-NART plans, the doses to 95% of all the target volumes (D{sub 95}) were increased with better dose uniformity, whereas the organs at risk (OARs) received higher doses compared with the corresponding ART plans. Without replanning, the total dose to 1% of brainstem and spinal cord (D{sub 1}) significantly increased 7.87 {+-} 7.26% and 10.69 {+-} 6.72%, respectively (P = 0.011 and 0.001, respectively), in which 3 patients would have these structures overdosed when compared with those with two replannings. The total maximum doses to the optic chiasm and pituitary gland and the mean doses to the left and right parotid glands were increased by 10.50 {+-} 10.51%, 8.59 {+-} 6.10%, 3.03 {+-} 4.48%, and 2.24 {+-} 3.11%, respectively (P = 0.014, 0.003, 0.053, and 0.046, respectively). The 3-phase radiotherapy protocol showed improved dosimetric results to the critical structures while keeping satisfactory target dose coverage, which demonstrated the advantages of ART in

  16. Art therapy using famous painting appreciation maintains fatigue levels during radiotherapy in cancer patients

    PubMed Central

    Koom, Woong Sub; Choi, Mi Yeon; Lee, Jeongshim; Park, Eun Jung; Kim, Ju Hye; Kim, Sun-Hyun; Kim, Yong Bae

    2016-01-01

    Purpose: The purpose of this study was to evaluate the efficacy of art therapy to control fatigue in cancer patients during course of radiotherapy and its impact on quality of life (QoL). Materials and Methods: Fifty cancer patients receiving radiotherapy received weekly art therapy sessions using famous painting appreciation. Fatigue and QoL were assessed using the Brief Fatigue Inventory (BFI) Scale and the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) at baseline before starting radiotherapy, every week for 4 weeks during radiotherapy, and at the end of radiotherapy. Mean changes of scores over time were analyzed using a generalized linear mixed model. Results: Of the 50 patients, 34 (68%) participated in 4 sessions of art therapy. Generalized linear mixed models testing for the effect of time on mean score changes showed no significant changes in scores from baseline for the BFI and FACIT-F. The mean BFI score and FACIT-F total score changed from 3.1 to 2.7 and from 110.7 to 109.2, respectively. Art therapy based on the appreciation of famous paintings led to increases in self-esteem by increasing self-realization and forming social relationships. Conclusion: Fatigue and QoL in cancer patients with art therapy do not deteriorate during a period of radiotherapy. Despite the single-arm small number of participants and pilot design, this study provides a strong initial demonstration that art therapy of appreciation for famous painting is worthy of further study for fatigue and QoL improvement. Further, it can play an important role in routine practice in cancer patients during radiotherapy. PMID:27306778

  17. SU-E-J-206: Adaptive Radiotherapy for Gynecological Malignancies with MRIGuided Cobolt-60 Radiotherapy

    SciTech Connect

    Lamb, J; Kamrava, M; Agazaryan, N; Cao, M; Low, D; Thomas, D; Yang, Y

    2015-06-15

    Purpose: Even in the IMRT era, bowel toxicity and bone marrow irradiation remain concerns with pelvic irradiation. We examine the potential gain from an adaptive radiotherapy workflow for post-operative gynecological patients treated to pelvic targets including lymph nodes using MRI-guided Co-60 radiation therapy. Methods: An adaptive workflow was developed with the intent of minimizing time overhead of adaptive planning. A pilot study was performed using retrospectively analyzed images from one patient’s treatment. The patient’s treated plan was created using conventional PTV margins. Adaptive treatment was simulated on the patient’s first three fractions. The daily PTV was created by removing non-target tissue, including bone, muscle and bowel, from the initial PTV based on the daily MRI. The number of beams, beam angles, and optimization parameters were kept constant, and the plan was re-optimized. Normal tissue contours were not adjusted for the re-optimization, but were adjusted for evaluation of plan quality. Plan quality was evaluated based on PTV coverage and normal tissue DVH points per treatment protocol. Bowel was contoured as the entire bowel bag per protocol at our institution. Pelvic bone marrow was contoured per RTOG protocol 1203. Results: For the clinically treated plan, the volume of bowel receiving 45 Gy was 380 cc, 53% of the rectum received 30 Gy, 35% of the bladder received 45 Gy, and 28% of the pelvic bone marrow received 40 Gy. For the adaptive plans, the volume of bowel receiving 45 Gy was 175–201 cc, 55–62% of the rectum received 30 Gy, 21– 27% of the bladder received 45 Gy, and 13–17% of the pelvic bone marrow received 40 Gy. Conclusion: Adaptive planning led to a large reduction of bowel and bone marrow dose in this pilot study. Further study of on-line adaptive techniques for the radiotherapy of pelvic lymph nodes is warranted. Dr. Low is a member of the scientific advisory board of ViewRay, Inc.

  18. Adaptive Radiotherapy for Head-and-Neck Cancer: Initial Clinical Outcomes From a Prospective Trial

    SciTech Connect

    Schwartz, David L.; Garden, Adam S.; Thomas, Jimmy; Chen Yipei; Zhang Yongbin; Lewin, Jan; Chambers, Mark S.; Dong, Lei

    2012-07-01

    Purpose: To present pilot toxicity and survival outcomes for a prospective trial investigating adaptive radiotherapy (ART) for oropharyngeal squamous cell carcinoma. Methods and Materials: A total of 24 patients were enrolled in an institutional review board-approved clinical trial; data for 22 of these patients were analyzed. Daily CT-guided setup and deformable image registration permitted serial mapping of clinical target volumes and avoidance structures for ART planning. Primary site was base of tongue in 15 patients, tonsil in 6 patient, and glossopharyngeal sulcus in 1 patient. Twenty patients (91%) had American Joint Committee on Cancer (AJCC) Stage IV disease. T stage distribution was 2 T1, 12 T2, 3 T3, 5 T4. N stage distribution was 1 N0, 2 N1, 5 N2a, 12 N2b, and 2 N2c. Of the patients, 21 (95%) received systemic therapy. Results: With a 31-month median follow-up (range, 13-45 months), there has been no primary site failure and 1 nodal relapse, yielding 100% local and 95% regional disease control at 2 years. Baseline tumor size correlated with absolute volumetric treatment response (p = 0.018). Parotid volumetric change correlated with duration of feeding tube placement (p = 0.025). Acute toxicity was comparable to that observed with conventional intensity-modulated radiotherapy (IMRT). Chronic toxicity and functional outcomes beyond 1 year were tabulated. Conclusion: This is the first prospective evaluation of morbidity and survival outcomes in patients with locally advanced head-and-neck cancer treated with automated adaptive replanning. ART can provide dosimetric benefit with only one or two mid-treatment replanning events. Our preliminary clinical outcomes document functional recovery and preservation of disease control at 1-year follow-up and beyond.

  19. A theoretical stochastic control framework for adapting radiotherapy to hypoxia.

    PubMed

    Saberian, Fatemeh; Ghate, Archis; Kim, Minsun

    2016-10-07

    Hypoxia, that is, insufficient oxygen partial pressure, is a known cause of reduced radiosensitivity in solid tumors, and especially in head-and-neck tumors. It is thus believed to adversely affect the outcome of fractionated radiotherapy. Oxygen partial pressure varies spatially and temporally over the treatment course and exhibits inter-patient and intra-tumor variation. Emerging advances in non-invasive functional imaging offer the future possibility of adapting radiotherapy plans to this uncertain spatiotemporal evolution of hypoxia over the treatment course. We study the potential benefits of such adaptive planning via a theoretical stochastic control framework using computer-simulated evolution of hypoxia on computer-generated test cases in head-and-neck cancer. The exact solution of the resulting control problem is computationally intractable. We develop an approximation algorithm, called certainty equivalent control, that calls for the solution of a sequence of convex programs over the treatment course; dose-volume constraints are handled using a simple constraint generation method. These convex programs are solved using an interior point algorithm with a logarithmic barrier via Newton's method and backtracking line search. Convexity of various formulations in this paper is guaranteed by a sufficient condition on radiobiological tumor-response parameters. This condition is expected to hold for head-and-neck tumors and for other similarly responding tumors where the linear dose-response parameter is larger than the quadratic dose-response parameter. We perform numerical experiments on four test cases by using a first-order vector autoregressive process with exponential and rational-quadratic covariance functions from the spatiotemporal statistics literature to simulate the evolution of hypoxia. Our results suggest that dynamic planning could lead to a considerable improvement in the number of tumor cells remaining at the end of the treatment course. Through

  20. A theoretical stochastic control framework for adapting radiotherapy to hypoxia

    NASA Astrophysics Data System (ADS)

    Saberian, Fatemeh; Ghate, Archis; Kim, Minsun

    2016-10-01

    Hypoxia, that is, insufficient oxygen partial pressure, is a known cause of reduced radiosensitivity in solid tumors, and especially in head-and-neck tumors. It is thus believed to adversely affect the outcome of fractionated radiotherapy. Oxygen partial pressure varies spatially and temporally over the treatment course and exhibits inter-patient and intra-tumor variation. Emerging advances in non-invasive functional imaging offer the future possibility of adapting radiotherapy plans to this uncertain spatiotemporal evolution of hypoxia over the treatment course. We study the potential benefits of such adaptive planning via a theoretical stochastic control framework using computer-simulated evolution of hypoxia on computer-generated test cases in head-and-neck cancer. The exact solution of the resulting control problem is computationally intractable. We develop an approximation algorithm, called certainty equivalent control, that calls for the solution of a sequence of convex programs over the treatment course; dose-volume constraints are handled using a simple constraint generation method. These convex programs are solved using an interior point algorithm with a logarithmic barrier via Newton’s method and backtracking line search. Convexity of various formulations in this paper is guaranteed by a sufficient condition on radiobiological tumor-response parameters. This condition is expected to hold for head-and-neck tumors and for other similarly responding tumors where the linear dose-response parameter is larger than the quadratic dose-response parameter. We perform numerical experiments on four test cases by using a first-order vector autoregressive process with exponential and rational-quadratic covariance functions from the spatiotemporal statistics literature to simulate the evolution of hypoxia. Our results suggest that dynamic planning could lead to a considerable improvement in the number of tumor cells remaining at the end of the treatment course

  1. A deformable head and neck phantom with in-vivo dosimetry for adaptive radiotherapy quality assurance

    SciTech Connect

    Graves, Yan Jiang; Smith, Arthur-Allen; Mcilvena, David; Manilay, Zherrina; Lai, Yuet Kong; Rice, Roger; Mell, Loren; Cerviño, Laura E-mail: steve.jiang@utsouthwestern.edu; Jia, Xun; Jiang, Steve B. E-mail: steve.jiang@utsouthwestern.edu

    2015-04-15

    Purpose: Patients’ interfractional anatomic changes can compromise the initial treatment plan quality. To overcome this issue, adaptive radiotherapy (ART) has been introduced. Deformable image registration (DIR) is an important tool for ART and several deformable phantoms have been built to evaluate the algorithms’ accuracy. However, there is a lack of deformable phantoms that can also provide dosimetric information to verify the accuracy of the whole ART process. The goal of this work is to design and construct a deformable head and neck (HN) ART quality assurance (QA) phantom with in vivo dosimetry. Methods: An axial slice of a HN patient is taken as a model for the phantom construction. Six anatomic materials are considered, with HU numbers similar to a real patient. A filled balloon inside the phantom tissue is inserted to simulate tumor. Deflation of the balloon simulates tumor shrinkage. Nonradiopaque surface markers, which do not influence DIR algorithms, provide the deformation ground truth. Fixed and movable holders are built in the phantom to hold a diode for dosimetric measurements. Results: The measured deformations at the surface marker positions can be compared with deformations calculated by a DIR algorithm to evaluate its accuracy. In this study, the authors selected a Demons algorithm as a DIR algorithm example for demonstration purposes. The average error magnitude is 2.1 mm. The point dose measurements from the in vivo diode dosimeters show a good agreement with the calculated doses from the treatment planning system with a maximum difference of 3.1% of prescription dose, when the treatment plans are delivered to the phantom with original or deformed geometry. Conclusions: In this study, the authors have presented the functionality of this deformable HN phantom for testing the accuracy of DIR algorithms and verifying the ART dosimetric accuracy. The authors’ experiments demonstrate the feasibility of this phantom serving as an end

  2. SU-E-J-153: MRI Based, Daily Adaptive Radiotherapy for Rectal Cancer: Contour Adaptation

    SciTech Connect

    Kleijnen, J; Burbach, M; Verbraeken, T; Weggers, R; Zoetelief, A; Reerink, O; Lagendijk, J; Raaymakers, B; Asselen, B

    2014-06-01

    Purpose: A major hurdle in adaptive radiotherapy is the adaptation of the planning MRI's delineations to the daily anatomy. We therefore investigate the accuracy and time needed for online clinical target volume (CTV) adaptation by radiation therapists (RTT), to be used in MRI-guided adaptive treatments on a MRI-Linac (MRL). Methods: Sixteen patients, diagnosed with early stage rectal cancer, underwent a T2-weighted MRI prior to each fraction of short-course radiotherapy, resulting in 4–5 scans per patient. On these scans, the CTV was delineated according to guidelines by an experienced radiation oncologist (RO) and considered to be the gold standard. For each patient, the first MRI was considered as the planning MRI and matched on bony anatomy to the 3–4 daily MRIs. The planning MRI's CTV delineation was rigidly propagated to the daily MRI scans as a proposal for adaptation. Three RTTs in training started the adaptation of the CTV conform guidelines, after a two hour training lecture and a two patient (n=7) training set. To assess the inter-therapist variation, all three RTTs altered delineations of 3 patients (n=12). One RTT altered the CTV delineations (n=53) of the remaining 11 patients. Time needed for adaptation of the CTV to guidelines was registered.As a measure of agreement, the conformity index (CI) was determined between the RTTs' delineations as a group. Dice similarity coefficients were determined between delineations of the RTT and the RO. Results: We found good agreement between RTTs' and RO's delineations (average Dice=0.91, SD=0.03). Furthermore, the inter-observer agreement between the RTTs was high (average CI=0.94, SD=0.02). Adaptation time reduced from 10:33 min (SD= 3:46) to 2:56 min (SD=1:06) between the first and last ten delineations, respectively. Conclusion: Daily CTV adaptation by RTTs, seems a feasible and safe way to introduce daily, online MRI-based plan adaptation for a MRL.

  3. A DVH-guided IMRT optimization algorithm for automatic treatment planning and adaptive radiotherapy replanning

    SciTech Connect

    Zarepisheh, Masoud; Li, Nan; Long, Troy; Romeijn, H. Edwin; Tian, Zhen; Jia, Xun; Jiang, Steve B.

    2014-06-15

    Purpose: To develop a novel algorithm that incorporates prior treatment knowledge into intensity modulated radiation therapy optimization to facilitate automatic treatment planning and adaptive radiotherapy (ART) replanning. Methods: The algorithm automatically creates a treatment plan guided by the DVH curves of a reference plan that contains information on the clinician-approved dose-volume trade-offs among different targets/organs and among different portions of a DVH curve for an organ. In ART, the reference plan is the initial plan for the same patient, while for automatic treatment planning the reference plan is selected from a library of clinically approved and delivered plans of previously treated patients with similar medical conditions and geometry. The proposed algorithm employs a voxel-based optimization model and navigates the large voxel-based Pareto surface. The voxel weights are iteratively adjusted to approach a plan that is similar to the reference plan in terms of the DVHs. If the reference plan is feasible but not Pareto optimal, the algorithm generates a Pareto optimal plan with the DVHs better than the reference ones. If the reference plan is too restricting for the new geometry, the algorithm generates a Pareto plan with DVHs close to the reference ones. In both cases, the new plans have similar DVH trade-offs as the reference plans. Results: The algorithm was tested using three patient cases and found to be able to automatically adjust the voxel-weighting factors in order to generate a Pareto plan with similar DVH trade-offs as the reference plan. The algorithm has also been implemented on a GPU for high efficiency. Conclusions: A novel prior-knowledge-based optimization algorithm has been developed that automatically adjust the voxel weights and generate a clinical optimal plan at high efficiency. It is found that the new algorithm can significantly improve the plan quality and planning efficiency in ART replanning and automatic treatment

  4. Adaptive Radiotherapy for Locally Advanced Non-Small-Cell Lung Cancer Does Not Underdose the Microscopic Disease and has the Potential to Increase Tumor Control

    SciTech Connect

    Guckenberger, Matthias; Richter, Anne; Wilbert, Juergen; Flentje, Michael; Partridge, Mike

    2011-11-15

    Purpose: To evaluate doses to the microscopic disease (MD) in adaptive radiotherapy (ART) for locally advanced non-small-cell lung cancer (NSCLC) and to model tumor control probability (TCP). Methods and Materials: In a retrospective planning study, three-dimensional conformal treatment plans for 13 patients with locally advanced NSCLC were adapted to shape and volume changes of the gross tumor volume (GTV) once or twice during conventionally fractionated radiotherapy with total doses of 66 Gy; doses in the ART plans were escalated using an iso-mean lung dose (MLD) approach compared to non-adapted treatment. Dose distributions to the volumes of suspect MD were simulated for a scenario with synchronous shrinkage of the MD and GTV and for a scenario of a stationary MD despite GTV shrinkage; simulations were performed using deformable image registration. TCP calculations considering doses to the GTV and MD were performed using three different models. Results: Coverage of the MD at 50 Gy was not compromised by ART. Coverage at 60 Gy in the scenario of a stationary MD was significantly reduced from 92% {+-} 10% to 73% {+-} 19% using ART; however, the coverage was restored by iso-MLD dose escalation. Dose distributions in the MD were sufficient to achieve a TCP >80% on average in all simulation experiments, with the clonogenic cell density the major factor influencing TCP. The combined TCP for the GTV and MD was 19.9% averaged over all patients and TCP models in non-adaptive treatment with 66 Gy. Iso-MLD dose escalation achieved by ART increased the overall TCP by absolute 6% (adapting plan once) and by 8.7% (adapting plan twice) on average. Absolute TCP values were significantly different between the TCP models; however, all TCP models suggested very similar TCP increase by using ART. Conclusions: Adaptation of radiotherapy to the shrinking GTV did not compromise dose coverage of volumes of suspect microscopic disease and has the potential to increase TCP by >40

  5. State-of-the-art radiotherapy in the management of clinically localized prostate carcinoma.

    PubMed

    Bermudez, R Scott; Izaguirre, Alejandra; Roach, Mack

    2007-02-01

    Four Phase III trials demonstrating higher prostate-specific antigen control rates in prostate cancer patients treated with higher doses of radiation have changed the standard of care. Emerging on-line technologies, improved imaging and computer algorithms, combined with an improved understanding of how best to apply them, have allowed radiation oncologists to move ever closer to the optimal application of curative radiation. This technology allows a higher dose to be delivered to tumor-bearing areas while minimizing the dose delivered to surrounding normal tissues. Real-time adaptive techniques have made each step more accurate, and commercialization has increasingly moved these advances further into the community setting. Phase III trials have also helped to define the role of hormonal therapy in combination with radiation and the benefits of prophylactic pelvic nodal radiotherapy in subsets of patients. We have also learnt how to optimize the use of prostate-specific antigen to better determine success and failure following radiotherapy.

  6. SU-E-J-245: Is Off-Line Adaptive Radiotherapy Sufficient for Head and Neck Cancer with IGRT?

    SciTech Connect

    Li, Z; Shang, Q; Liu, H; Greskovich, J; Koyfman, S; Xia, P

    2014-06-01

    Purpose: Radiation doses delivered to patients with head and neck cancer (HN) may deviate from the planned doses because of variations in patient setup and anatomy. This study was to evaluate whether off-line Adaptive Radiotherapy (ART) is sufficient. Methods: Ten HN patients, who received IMRT under daily imaging guidance using CT-on-rail/KV-CBCT, were randomly selected for this study. For each patient, the daily treatment setup was corrected with translational only directions. Sixty weekly verification CTs were retrospectively analyzed. On these weekly verification CTs, the tumor volumes and OAR contours were manually delineated by a physician. With the treatment iso-center placed on the verification CTs, according to the recorded clinical shifts, the treatment beams from the original IMRT plans were then applied to these CTs to calculate the delivered doses. The electron density of the planning CTs and weekly CTs were overridden to 1 g/cm3. Results: Among 60 fractions, D99 of the CTVs in 4 fractions decreased more than 5% of the planned doses. The maximum dose of the spinal cord exceeded 10% of the planned values in 2 fractions. A close examination indicated that the dose discrepancy in these 6 fractions was due to patient rotations, especially shoulder rotations. After registering these 6 CTs with the planning CT allowing six degree of freedoms, the maximum rotations around 3 axes were > 1.5° for these fractions. With rotation setup errors removed, 4 out of 10 patients still required off-line ART to accommodate anatomical changes. Conclusion: A significant shoulder rotations were observed in 10% fractions, requiring patient re-setup. Off-line ART alone is not sufficient to correct for random variations of patient position, although ART is effective to adapt to patients' gradual anatomic changes. Re-setup or on-line ART may be considered for patients with large deviations detected early by daily IGRT images. The study is supported in part by Siemens Medical

  7. Molecular PET imaging for biology-guided adaptive radiotherapy of head and neck cancer.

    PubMed

    Hoeben, Bianca A W; Bussink, Johan; Troost, Esther G C; Oyen, Wim J G; Kaanders, Johannes H A M

    2013-10-01

    Integration of molecular imaging PET techniques into therapy selection strategies and radiation treatment planning for head and neck squamous cell carcinoma (HNSCC) can serve several purposes. First, pre-treatment assessments can steer decisions about radiotherapy modifications or combinations with other modalities. Second, biology-based objective functions can be introduced to the radiation treatment planning process by co-registration of molecular imaging with planning computed tomography (CT) scans. Thus, customized heterogeneous dose distributions can be generated with escalated doses to tumor areas where radiotherapy resistance mechanisms are most prevalent. Third, monitoring of temporal and spatial variations in these radiotherapy resistance mechanisms early during the course of treatment can discriminate responders from non-responders. With such information available shortly after the start of treatment, modifications can be implemented or the radiation treatment plan can be adapted tailing the biological response pattern. Currently, these strategies are in various phases of clinical testing, mostly in single-center studies. Further validation in multicenter set-up is needed. Ultimately, this should result in availability for routine clinical practice requiring stable production and accessibility of tracers, reproducibility and standardization of imaging and analysis methods, as well as general availability of knowledge and expertise. Small studies employing adaptive radiotherapy based on functional dynamics and early response mechanisms demonstrate promising results. In this context, we focus this review on the widely used PET tracer (18)F-FDG and PET tracers depicting hypoxia and proliferation; two well-known radiation resistance mechanisms.

  8. Modelling and Bayesian adaptive prediction of individual patients' tumour volume change during radiotherapy.

    PubMed

    Tariq, Imran; Chen, Tao; Kirkby, Norman F; Jena, Rajesh

    2016-03-07

    The aim of this study is to develop a mathematical modelling method that can predict individual patients’ response to radiotherapy, in terms of tumour volume change during the treatment. The main concept is to start from a population-average model, which is subsequently updated from an individual’s tumour volume measurement. The model becomes increasingly personalized and so too does the prediction it produces. This idea of adaptive prediction was realised by using a Bayesian approach for updating the model parameters. The feasibility of the developed method was demonstrated on the data from 25 non-small cell lung cancer patients treated with helical tomotherapy, during which tumour volume was measured from daily imaging as part of the image-guided radiotherapy. The method could provide useful information for adaptive treatment planning and dose scheduling based on the patient’s personalised response.

  9. Potential of Adaptive Radiotherapy to Escalate the Radiation Dose in Combined Radiochemotherapy for Locally Advanced Non-Small Cell Lung Cancer

    SciTech Connect

    Guckenberger, Matthias; Wilbert, Juergen; Richter, Anne; Baier, Kurt; Flentje, Michael

    2011-03-01

    Purpose: To evaluate the potential of adaptive radiotherapy (ART) for advanced-stage non-small cell lung cancer (NSCLC) in terms of lung sparing and dose escalation. Methods and Materials: In 13 patients with locally advanced NSCLC, weekly CT images were acquired during radio- (n = 1) or radiochemotherapy (n = 12) for simulation of ART. Three-dimensional (3D) conformal treatment plans were generated: conventionally fractionated doses of 66 Gy were prescribed to the planning target volume without elective lymph node irradiation (Plan{sub 3}D). Using a surface-based algorithm of deformable image registration, accumulated doses were calculated in the CT images acquired during the treatment course (Plan{sub 4}D). Field sizes were adapted to tumor shrinkage once in week 3 or 5 and twice in weeks 3 and 5. Results: A continuous tumor regression of 1.2% per day resulted in a residual gross tumor volume (GTV) of 49% {+-} 15% after six weeks of treatment. No systematic differences between Plan{sub 3}D and Plan{sub 4}D were observed regarding doses to the GTV, lung, and spinal cord. Plan adaptation to tumor shrinkage resulted in significantly decreased lung doses without compromising GTV coverage: single-plan adaptation in Week 3 or 5 and twice-plan adaptation in Weeks 3 and 5 reduced the mean lung dose by 5.0% {+-} 4.4%, 5.6% {+-} 2.9% and 7.9% {+-} 4.8%, respectively. This lung sparing with twice ART allowed an iso-mean lung dose escalation of the GTV dose from 66.8 Gy {+-} 0.8 Gy to 73.6 Gy {+-} 3.8 Gy. Conclusions: Adaptation of radiotherapy to continuous tumor shrinkage during the treatment course reduced doses to the lung, allowed significant dose escalation and has the potential of increased local control.

  10. Dosimetric Advantages of Four-Dimensional Adaptive Image-Guided Radiotherapy for Lung Tumors Using Online Cone-Beam Computed Tomography

    SciTech Connect

    Harsolia, Asif; Hugo, Geoffrey D.; Kestin, Larry L. Grills, Inga S.; Yan Di

    2008-02-01

    Purpose: This study compares multiple planning techniques designed to improve accuracy while allowing reduced planning target volume (PTV) margins though image-guided radiotherapy (IGRT) with four-dimensional (4D) cone-beam computed tomography (CBCT). Methods and Materials: Free-breathing planning and 4D-CBCT scans were obtained in 8 patients with lung tumors. Four plans were generated for each patient: 3D-conformal, 4D-union, 4D-offline adaptive with a single correction (offline ART), and 4D-online adaptive with daily correction (online ART). For the 4D-union plan, the union of gross tumor volumes from all phases of the 4D-CBCT was created with a 5-mm expansion applied for setup uncertainty. For offline and online ART, the gross tumor volume was delineated at the mean position of tumor motion from the 4D-CBCT. The PTV margins were calculated from the random components of tumor motion and setup uncertainty. Results: Adaptive IGRT techniques provided better PTV coverage with less irradiated normal tissues. Compared with 3D plans, mean relative decreases in PTV volumes were 15%, 39%, and 44% using 4D-union, offline ART, and online ART planning techniques, respectively. This resulted in mean lung volume receiving {>=} 20Gy (V20) relative decreases of 21%, 23%, and 31% and mean lung dose relative decreases of 16%, 26%, and 31% for the 4D-union, 4D-offline ART, and 4D-online ART, respectively. Conclusions: Adaptive IGRT using CBCT is feasible for the treatment of patients with lung tumors and significantly decreases PTV volume and dose to normal tissues, allowing for the possibility of dose escalation. All analyzed 4D planning strategies resulted in improvements over 3D plans, with 4D-online ART appearing optimal.

  11. Adaptive trial of personalized radiotherapy for intrahepatic cancer

    PubMed Central

    Pan, Charlie; Ben-Josef, Edgar; Lawrence, Theodore

    2010-01-01

    Primary liver cancer is a major health problem worldwide, with more than 500,000 new cases diagnosed yearly. Preliminary results suggest excellent local control rates of intrahepatic malignancies treated with stereotactic body radiation therapy (SBRT), but some patients have experienced life-threatening toxicity because the current approaches cannot accurately estimate residual liver function after treatment. An early-phase trial of SBRT in hepatocellular carcinoma patients, including those with compromised liver function, is described. Patients are treated with three fractions of SBRT, then treatment is paused for 4 weeks and liver function is evaluated by means of an indocyanine green assay. The size of the final two fractions of SBRT is determined based on the patient’s indocyanine green assay after the first three fractions, so that the therapy is personalized to each patient’s sensitivity to radiation. The sensitivity to the liver of the final two fractions of SBRT, compared with the first three fractions, is re-estimated using a Bayesian model throughout the trial, so this is an adaptive trial. The operating characteristics of the trial are described by Monte Carlo simulations. PMID:20448804

  12. CTV to PTV in cervical cancer: From static margins to adaptive radiotherapy.

    PubMed

    Sun, R; Mazeron, R; Chargari, C; Barillot, I

    2016-10-01

    Intensity-modulated radiotherapy (IMRT) is increasingly used in order to minimize the gastrointestinal, genitourinary, and hematological toxicity in cervical and uterine cancers. However, the benefit of this high-precision approach is detracted by the margins applied to the clinical target volume (CTV) to generate the planning tumor volume (PTV), taking into account tumor and surrounding organs movements, deformations, and volume changes. Adequate PTV margins should be large enough to prevent geographical misses, but not excessive, which might end the benefit from IMRT. The objectives of this review were: (a) to present the evidence available for the determination of CTV-PTV margin for uterine cancers; (b) to highlight the impact of these margins in the context of adaptive radiotherapy; and (c) to discuss the role of the PTV concept in intracavitary brachytherapy.

  13. SU-E-J-68: Adaptive Radiotherapy of Head and Neck Cancer: Re-Planning Based On Prior Dose

    SciTech Connect

    Dogan, N; Padgett, K; Evans, J; Sleeman, W; Song, S; Fatyga, M

    2015-06-15

    Purpose: Adaptive Radiotherapy (ART) with frequent CT imaging has been used to improve dosimetric accuracy by accounting for anatomical variations, such as primary tumor shrinkage and/or body weight loss, in Head and Neck (H&N) patients. In most ART strategies, the difference between the planned and the delivered dose is estimated by generating new plans on repeated CT scans using dose-volume constraints used with the initial planning CT without considering already delivered dose. The aim of this study was to assess the dosimetric gains achieved by re-planning based on prior dose by comparing them to re-planning not based-on prior dose for H&N patients. Methods: Ten locally-advanced H&N cancer patients were selected for this study. For each patient, six weekly CT imaging were acquired during the course of radiotherapy. PTVs, parotids, cord, brainstem, and esophagus were contoured on both planning and six weekly CT images. ART with weekly re-plans were done by two strategies: 1) Generating a new optimized IMRT plan without including prior dose from previous fractions (NoPriorDose) and 2) Generating a new optimized IMRT plan based on the prior dose given from previous fractions (PriorDose). Deformable image registration was used to accumulate the dose distributions between planning and six weekly CT scans. The differences in accumulated doses for both strategies were evaluated using the DVH constraints for all structures. Results: On average, the differences in accumulated doses for PTV1, PTV2 and PTV3 for NoPriorDose and PriorDose strategies were <2%. The differences in Dmean to the cord and brainstem were within 3%. The esophagus Dmean was reduced by 2% using PriorDose. PriorDose strategy, however, reduced the left parotid D50 and Dmean by 15% and 14% respectively. Conclusion: This study demonstrated significant parotid sparing, potentially reducing xerostomia, by using ART with IMRT optimization based on prior dose for weekly re-planning of H&N cancer patients.

  14. SU-E-J-145: Geometric Uncertainty in CBCT Extrapolation for Head and Neck Adaptive Radiotherapy

    SciTech Connect

    Liu, C; Kumarasiri, A; Chetvertkov, M; Gordon, J; Chetty, I; Siddiqui, F; Kim, J

    2014-06-01

    Purpose: One primary limitation of using CBCT images for H'N adaptive radiotherapy (ART) is the limited field of view (FOV) range. We propose a method to extrapolate the CBCT by using a deformed planning CT for the dose of the day calculations. The aim was to estimate the geometric uncertainty of our extrapolation method. Methods: Ten H'N patients, each with a planning CT (CT1) and a subsequent CT (CT2) taken, were selected. Furthermore, a small FOV CBCT (CT2short) was synthetically created by cropping CT2 to the size of a CBCT image. Then, an extrapolated CBCT (CBCTextrp) was generated by deformably registering CT1 to CT2short and resampling with a wider FOV (42mm more from the CT2short borders), where CT1 is deformed through translation, rigid, affine, and b-spline transformations in order. The geometric error is measured as the distance map ||DVF|| produced by a deformable registration between CBCTextrp and CT2. Mean errors were calculated as a function of the distance away from the CBCT borders. The quality of all the registrations was visually verified. Results: Results were collected based on the average numbers from 10 patients. The extrapolation error increased linearly as a function of the distance (at a rate of 0.7mm per 1 cm) away from the CBCT borders in the S/I direction. The errors (μ±σ) at the superior and inferior boarders were 0.8 ± 0.5mm and 3.0 ± 1.5mm respectively, and increased to 2.7 ± 2.2mm and 5.9 ± 1.9mm at 4.2cm away. The mean error within CBCT borders was 1.16 ± 0.54mm . The overall errors within 4.2cm error expansion were 2.0 ± 1.2mm (sup) and 4.5 ± 1.6mm (inf). Conclusion: The overall error in inf direction is larger due to more large unpredictable deformations in the chest. The error introduced by extrapolation is plan dependent. The mean error in the expanded region can be large, and must be considered during implementation. This work is supported in part by Varian Medical Systems, Palo Alto, CA.

  15. The Radio Language Arts Project: adapting the radio mathematics model.

    PubMed

    Christensen, P R

    1985-01-01

    Kenya's Radio Language Arts Project, directed by the Academy for Educational Development in cooperation with the Kenya Institute of Education in 1980-85, sought to teach English to rural school children in grades 1-3 through use of an intensive, radio-based instructional system. Daily 1/2 hour lessons are broadcast throughout the school year and supported by teachers and print materials. The project further was aimed at testing the feasibility of adaptation of the successful Nicaraguan Radio Math Project to a new subject area. Difficulties were encountered in articulating a language curriculum with the precision required for a media-based instructional system. Also a challenge was defining the acceptable regional standard for pronunciation and grammar; British English was finally selected. An important modification of the Radio Math model concerned the role of the teacher. While Radio Math sought to reduce the teacher's responsibilities during the broadcast, Radio Language Arts teachers played an important instructional role during the English lesson broadcasts by providing translation and checks on work. Evaluations of the Radio language Arts Project suggest significant gains in speaking, listening, and reading skills as well as high levels of satisfaction on the part of parents and teachers.

  16. SU-E-J-267: Weekly Volumetric and Dosimetric Changes in Adaptive Conformal Radiotherapy of Non-Small-Cell-Lung Cancer Using 4D CT and Gating

    SciTech Connect

    Li, Z; Shang, Q; Xiong, F; Zhang, X; Zhang, Q; Fu, S

    2014-06-01

    Purpose: This study was to evaluate the significance of weekly imageguided patient setup and to assess the volumetric and dosimetric changes in no-small-cell-lung cancer (NSCLC) patients treated with adaptive conformal radiotherapy (CRT). Methods: 9 NSCLC patients treated with 3D CRT underwent 4D CT-on-rail every five fractions. ITV was generated from three phases of the 4DCT (the end of exhalation, 25% before and after the end of exhalation). The margin of ITV to PTV is 5mm. 6 weekly CTs were acquired for each patient. The weekly CTs were fused with the planning CT by vertebrae. The couch shift was recorded for each weekly CT to evaluate the setup error. The gross tumor volumes (GTVs) were contoured on weekly CT images by a physician. Beams from the original plans were applied to weekly CTs to calculate the delivered doses. All patients underwent replanning after 20 fractions. Results: Among the total 54 CTs, the average setup error was 2.0± 1.7, 2.6± 2.1, 2.7± 2.2 mm in X, Y, and Z direction, respectively. The average volume of the primary GTV was reduced from 42.45 cc to 22.78 cc (47.04%) after 6 weeks. The maximal volume regression occurred between 15 and 20 fractions. Adaptive radiation therapy (ART) reduced the V20 and V5 of the lung by 33.5% and 16.89%, respectively. ART also reduced Dmean and D1/3 of the heart by 31.7% and 32.32%, respectively. Dmax of the spinal cord did not vary much during the treatment course. Conclusion: 5 mm margin is sufficient for 4D weekly CTguided radiotherapy in lung cancer. Tumor regression was observed in the majority of patients. ART significantly reduced the OARs dose. Our preliminary results indicated that an off-line ART approach is appropriate in clinical practice.

  17. SU-E-J-81: Adaptive Radiotherapy for IMRT Head & Neck Patient in AKUH

    SciTech Connect

    Yousuf, A; Qureshi, B; Qadir, A; Abbasi, N; Hussain, A

    2015-06-15

    Purpose: In this study we proposed Adaptive radiotherapy for IMRT patients which will brought an additional dimension to the management of patients with H&N cancer in Aga Khan University Hospital. Methods: In this study 5 Head and Neck (H&N) patients plan where selected, who’s Re-CT were done during the course of their treatment, they were simulated with IMRT technique to learn the consequence of anatomical changes that may occur during the treatment, as they are more dramatic changes can occur as compare to conventional treatment. All the organ at risk were drawn according RTOG guidelines and doses were checked as per NCCN guidelines. Results: The reduction in size of Planning target volume (PTV) is more than 20% in all the cases which leads to 3 to 5 % overdose to normal tissues and Organ at Risk. Conclusion: Through this study we would like to emphasis the importance of Adaptive Radiotherapy practice in all IMRT (H&N) patients, although prospective studies are required with larger sample sizes to address the safety and the clinical effect of such approaches on patient outcome, also one need to develop protocols before implementation of this technique in practice.

  18. Image-guided adaptive gating of lung cancer radiotherapy: a computer simulation study

    NASA Astrophysics Data System (ADS)

    Aristophanous, Michalis; Rottmann, Joerg; Park, Sang-June; Nishioka, Seiko; Shirato, Hiroki; Berbeco, Ross I.

    2010-08-01

    The purpose of this study is to investigate the effect that image-guided adaptation of the gating window during treatment could have on the residual tumor motion, by simulating different gated radiotherapy techniques. There are three separate components of this simulation: (1) the 'Hokkaido Data', which are previously measured 3D data of lung tumor motion tracks and the corresponding 1D respiratory signals obtained during the entire ungated radiotherapy treatments of eight patients, (2) the respiratory gating protocol at our institution and the imaging performed under that protocol and (3) the actual simulation in which the Hokkaido Data are used to select tumor position information that could have been collected based on the imaging performed under our gating protocol. We simulated treatments with a fixed gating window and a gating window that is updated during treatment. The patient data were divided into different fractions, each with continuous acquisitions longer than 2 min. In accordance to the imaging performed under our gating protocol, we assume that we have tumor position information for the first 15 s of treatment, obtained from kV fluoroscopy, and for the rest of the fractions the tumor position is only available during the beam-on time from MV imaging. The gating window was set according to the information obtained from the first 15 s such that the residual motion was less than 3 mm. For the fixed gating window technique the gate remained the same for the entire treatment, while for the adaptive technique the range of the tumor motion during beam-on time was measured and used to adapt the gating window to keep the residual motion below 3 mm. The algorithm used to adapt the gating window is described. The residual tumor motion inside the gating window was reduced on average by 24% for the patients with regular breathing patterns and the difference was statistically significant (p-value = 0.01). The magnitude of the residual tumor motion depended on the

  19. An automatic dose verification system for adaptive radiotherapy for helical tomotherapy

    NASA Astrophysics Data System (ADS)

    Mo, Xiaohu; Chen, Mingli; Parnell, Donald; Olivera, Gustavo; Galmarini, Daniel; Lu, Weiguo

    2014-03-01

    Purpose: During a typical 5-7 week treatment of external beam radiotherapy, there are potential differences between planned patient's anatomy and positioning, such as patient weight loss, or treatment setup. The discrepancies between planned and delivered doses resulting from these differences could be significant, especially in IMRT where dose distributions tightly conforms to target volumes while avoiding organs-at-risk. We developed an automatic system to monitor delivered dose using daily imaging. Methods: For each treatment, a merged image is generated by registering the daily pre-treatment setup image and planning CT using treatment position information extracted from the Tomotherapy archive. The treatment dose is then computed on this merged image using our in-house convolution-superposition based dose calculator implemented on GPU. The deformation field between merged and planning CT is computed using the Morphon algorithm. The planning structures and treatment doses are subsequently warped for analysis and dose accumulation. All results are saved in DICOM format with private tags and organized in a database. Due to the overwhelming amount of information generated, a customizable tolerance system is used to flag potential treatment errors or significant anatomical changes. A web-based system and a DICOM-RT viewer were developed for reporting and reviewing the results. Results: More than 30 patients were analysed retrospectively. Our in-house dose calculator passed 97% gamma test evaluated with 2% dose difference and 2mm distance-to-agreement compared with Tomotherapy calculated dose, which is considered sufficient for adaptive radiotherapy purposes. Evaluation of the deformable registration through visual inspection showed acceptable and consistent results, except for cases with large or unrealistic deformation. Our automatic flagging system was able to catch significant patient setup errors or anatomical changes. Conclusions: We developed an automatic dose

  20. Dosimetric benefit of adaptive re-planning in pancreatic cancer stereotactic body radiotherapy

    SciTech Connect

    Li, Yongbao; Hoisak, Jeremy D.P.; Li, Nan; Jiang, Carrie; Tian, Zhen; Gautier, Quentin; Zarepisheh, Masoud; Wu, Zhaoxia; Liu, Yaqiang; Jia, Xun; and others

    2015-01-01

    Stereotactic body radiotherapy (SBRT) shows promise in unresectable pancreatic cancer, though this treatment modality has high rates of normal tissue toxicity. This study explores the dosimetric utility of daily adaptive re-planning with pancreas SBRT. We used a previously developed supercomputing online re-planning environment (SCORE) to re-plan 10 patients with pancreas SBRT. Tumor and normal tissue contours were deformed from treatment planning computed tomographies (CTs) and transferred to daily cone-beam CT (CBCT) scans before re-optimizing each daily treatment plan. We compared the intended radiation dose, the actual radiation dose, and the optimized radiation dose for the pancreas tumor planning target volume (PTV) and the duodenum. Treatment re-optimization improved coverage of the PTV and reduced dose to the duodenum. Within the PTV, the actual hot spot (volume receiving 110% of the prescription dose) decreased from 4.5% to 0.5% after daily adaptive re-planning. Within the duodenum, the volume receiving the prescription dose decreased from 0.9% to 0.3% after re-planning. It is noteworthy that variation in the amount of air within a patient's stomach substantially changed dose to the PTV. Adaptive re-planning with pancreas SBRT has the ability to improve dose to the tumor and decrease dose to the nearby duodenum, thereby reducing the risk of toxicity.

  1. SU-E-J-74: Dosimetric Advantages of Adaptive Radiotherapy for Head and Neck Cancer Are Confirmed with Weekly CBCT Images

    SciTech Connect

    Shang, Q; Li, Z; Qu, H; Ward, M; Greskovich, J; Koyfman, S; Xia, P

    2015-06-15

    Purpose: Our previous study showed that weekly dose monitoring using cone-beam CT (CBCT) images can guide the timing and need for adaptive re-planning during the treatment of head and neck (HN) cancer. Here we aim to confirm the dosimetric improvement of adaptive radiotherapy (ART) using weekly CBCTs. Methods: We randomly selected seven HN patients treated with ART due to noticeable anatomic changes. Twenty weekly images acquired during the second treatment course were included. These CBCTs were aligned with both the initial and re-planning simulation CTs according to the clinical shifts. Daily doses were re-calculated for both the initial and adaptive plans. Contours of the tumor and organs-at-risk (OARs) were manually delineated by a physician on the re-planning CT and then were transferred to the CBCTs for plan evaluation. Contour modifications were made based on the daily anatomic changes observed on CBCTs. All patients were treated with 70Gy to the primary tumor and 56Gy to the elective lymph nodes. Results: Volumetric changes of the tumor (range — 43.9%∼+15.9%) were observed. The average D99 to the primary tumor was (70.1±2.0)Gy (range 62.2∼72.5Gy) for the adaptive plan and (66.0±5.5)Gy (range 50.9∼70.7Gy) for the initial plan(p<<0.01). The average D99 to the elective neck was (56.3±1.3)Gy (range 52.8∼59.2Gy) for the adaptive plan and (52.4±7.0)Gy (range 37.7∼58.6Gy) for the initial plan(p=0.01). The parotid decreased in volume during the treatment course (range 7.3%∼42.2%). The average D-mean to the spared parotid decreased by 15.3% (p=0.002) for the adaptive plan when compared to the original. With ART, 4 out of 7 patients experienced better sparing of the spinal cord (D-max reduced by 2.5%∼10.2%) and the oral cavity (D-mean reduced by 3.5%∼20.1%). Conclusion: Weekly CBCT dosimetry confirms that ART is an effective method to accommodate on-treatment anatomic changes. In select patients, tumor coverage and OAR sparing may be improved

  2. Utilising pseudo-CT data for dose calculation and plan optimization in adaptive radiotherapy.

    PubMed

    Whelan, Brendan; Kumar, Shivani; Dowling, Jason; Begg, Jarrad; Lambert, Jonathan; Lim, Karen; Vinod, Shalini K; Greer, Peter B; Holloway, Lois

    2015-12-01

    To quantify the dose calculation error and resulting optimization uncertainty caused by performing inverse treatment planning on inaccurate electron density data (pseudo-CT) as needed for adaptive radiotherapy and Magnetic Resonance Imaging (MRI) based treatment planning. Planning Computer Tomography (CT) data from 10 cervix cancer patients was used to generate 4 pseudo-CT data sets. Each pseudo-CT was created based on an available method of assigning electron density to an anatomic image. An inversely modulated radiotherapy (IMRT) plan was developed on each planning CT. The dose calculation error caused by each pseudo-CT data set was quantified by comparing the dose calculated each pseudo-CT data set with that calculated on the original planning CT for the same IMRT plan. The optimization uncertainty introduced by the dose calculation error was quantified by re-optimizing the same optimization parameters on each pseudo-CT data set and comparing against the original planning CT. Dose differences were quantified by assessing the Equivalent Uniform Dose (EUD) for targets and relevant organs at risk. Across all pseudo-CT data sets and all organs, the absolute mean dose calculation error was 0.2 Gy, and was within 2 % of the prescription dose in 98.5 % of cases. Then absolute mean optimisation error was 0.3 Gy EUD, indicating that that inverse optimisation is impacted by the dose calculation error. However, the additional uncertainty introduced to plan optimisation is small compared the sources of variation which already exist. Use of inaccurate electron density data for inverse treatment planning results in a dose calculation error, which in turn introduces additional uncertainty into the plan optimization process. In this study, we showed that both of these effects are clinically acceptable for cervix cancer patients using four different pseudo-CT data sets. Dose calculation and inverse optimization on pseudo-CT is feasible for this patient cohort.

  3. Online adaptive radiotherapy of the bladder: Small bowel irradiated-volume reduction

    SciTech Connect

    Burridge, Nichola . E-mail: nichola.burridge@physics.cr.man.ac.uk; Amer, Ali; Marchant, Tom; Sykes, Jonathan; Stratford, Julie; Henry, Ann; McBain, Catherine; Price, Pat; Moore, Chris

    2006-11-01

    Purpose: To assess the potential reduction of small bowel volume receiving high-dose radiation by using kilovoltage X-ray cone beam computed tomography (CBCT) and quantized margin selection for adaptive bladder cancer treatment. Methods and Materials: Twenty bladder patients were planned conformally using a four-field, 15-mm uniform margin technique. Two additional planning target volumes (PTVs) were created using margins quantized to 5 and 10 mm in the superior direction only. CBCTs ({approx}8 scans/patient) were acquired during treatment. CBCT volumes were registered with CT planning scans to determine setup errors and to select the appropriate PTV of the day. Margin reduction in other directions was considered. Outlining of small bowel in every fraction is required to properly quantify the volume of small bowel spared from high doses. In the case of CBCT this is not always possible owing to artifacts created by small bowel movement and the presence of gas. A simpler method was adopted by considering the volume difference between PTVs created using uniform and adapted margins, which corresponds to the potential volume of small bowel sparing. Results: The average small bowel volume that can be spared by this form of adaptive radiotherapy is 31 {+-} 23 cm{sup 3} ({+-}1 SD). The bladder for 1 patient was systematically smaller than the planning scan and hence demonstrated the largest average reduction of 76 cm{sup 3}. The clinical target volume to PTV margins in other directions can be safely reduced to 10 mm except in the anterior direction where, like the superior direction, the bladder showed significant variation. Conclusions: Online CBCT-assisted plan selection based on quantized margins can significantly reduce the volume of small bowel receiving high doses for some bladder patients. CBCT allows the 15-mm margins used in some directions to be safely reduced to 10 mm.

  4. Evolution of motion uncertainty in rectal cancer: implications for adaptive radiotherapy

    NASA Astrophysics Data System (ADS)

    Kleijnen, Jean-Paul J. E.; van Asselen, Bram; Burbach, Johannes P. M.; Intven, Martijn; Philippens, Marielle E. P.; Reerink, Onne; Lagendijk, Jan J. W.; Raaymakers, Bas W.

    2016-01-01

    Reduction of motion uncertainty by applying adaptive radiotherapy strategies depends largely on the temporal behavior of this motion. To fully optimize adaptive strategies, insight into target motion is needed. The purpose of this study was to analyze stability and evolution in time of motion uncertainty of both the gross tumor volume (GTV) and clinical target volume (CTV) for patients with rectal cancer. We scanned 16 patients daily during one week, on a 1.5 T MRI scanner in treatment position, prior to each radiotherapy fraction. Single slice sagittal cine MRIs were made at the beginning, middle, and end of each scan session, for one minute at 2 Hz temporal resolution. GTV and CTV motion were determined by registering a delineated reference frame to time-points later in time. The 95th percentile of observed motion (dist95%) was taken as a measure of motion. The stability of motion in time was evaluated within each cine-MRI separately. The evolution of motion was investigated between the reference frame and the cine-MRIs of a single scan session and between the reference frame and the cine-MRIs of several days later in the course of treatment. This observed motion was then converted into a PTV-margin estimate. Within a one minute cine-MRI scan, motion was found to be stable and small. Independent of the time-point within the scan session, the average dist95% remains below 3.6 mm and 2.3 mm for CTV and GTV, respectively 90% of the time. We found similar motion over time intervals from 18 min to 4 days. When reducing the time interval from 18 min to 1 min, a large reduction in motion uncertainty is observed. A reduction in motion uncertainty, and thus the PTV-margin estimate, of 71% and 75% for CTV and tumor was observed, respectively. Time intervals of 15 and 30 s yield no further reduction in motion uncertainty compared to a 1 min time interval.

  5. Dosimetric and geometric evaluation of a hybrid strategy of offline adaptive planning and online image guidance for prostate cancer radiotherapy.

    PubMed

    Liu, Han; Wu, Qiuwen

    2011-08-07

    For prostate cancer patients, online image-guided (IG) radiotherapy has been widely used in clinic to correct the translational inter-fractional motion at each treatment fraction. For uncertainties that cannot be corrected online, such as rotation and deformation of the target volume, margins are still required to be added to the clinical target volume (CTV) for the treatment planning. Offline adaptive radiotherapy has been implemented to optimize the treatment for each individual patient based on the measurements at early stages of treatment process. It has been shown that offline adaptive radiotherapy can effectively reduce the required margin. Recently a hybrid strategy of offline adaptive replanning and online IG was proposed and the geometric evaluation was performed. It was found that the planning margins can further be reduced by 1-2 mm compared to online IG only strategy. The purpose of this study was to investigate the dosimetric benefits of such a hybrid strategy on the target and organs at risk. A total of 420 repeated helical computed tomography scans from 28 patients were included in the study. Both low-risk patients (LRP, CTV = prostate) and intermediate-risk patients (IRP, CTV = prostate + seminal vesicles, SV) were included in the simulation. Two registration methods, based on center-of-mass shift of prostate only and prostate plus SV, were performed for IRP. The intensity-modulated radiotherapy was used in the simulation. Criteria on both cumulative and fractional doses were evaluated. Furthermore, the geometric evaluation was extended to investigate the optimal number of fractions necessary to construct the internal target volume (ITV) for the hybrid strategy. The dosimetric margin improvement was smaller than its geometric counterpart and was in the range of 0-1 mm. The optimal number of fractions necessary for the ITV construction is 2 for LRPs and 3-4 for IRPs in a hypofractionation protocol. A new cumulative index of target volume was proposed

  6. Dosimetric and geometric evaluation of a hybrid strategy of offline adaptive planning and online image guidance for prostate cancer radiotherapy

    NASA Astrophysics Data System (ADS)

    Liu, Han; Wu, Qiuwen

    2011-08-01

    For prostate cancer patients, online image-guided (IG) radiotherapy has been widely used in clinic to correct the translational inter-fractional motion at each treatment fraction. For uncertainties that cannot be corrected online, such as rotation and deformation of the target volume, margins are still required to be added to the clinical target volume (CTV) for the treatment planning. Offline adaptive radiotherapy has been implemented to optimize the treatment for each individual patient based on the measurements at early stages of treatment process. It has been shown that offline adaptive radiotherapy can effectively reduce the required margin. Recently a hybrid strategy of offline adaptive replanning and online IG was proposed and the geometric evaluation was performed. It was found that the planning margins can further be reduced by 1-2 mm compared to online IG only strategy. The purpose of this study was to investigate the dosimetric benefits of such a hybrid strategy on the target and organs at risk. A total of 420 repeated helical computed tomography scans from 28 patients were included in the study. Both low-risk patients (LRP, CTV = prostate) and intermediate-risk patients (IRP, CTV = prostate + seminal vesicles, SV) were included in the simulation. Two registration methods, based on center-of-mass shift of prostate only and prostate plus SV, were performed for IRP. The intensity-modulated radiotherapy was used in the simulation. Criteria on both cumulative and fractional doses were evaluated. Furthermore, the geometric evaluation was extended to investigate the optimal number of fractions necessary to construct the internal target volume (ITV) for the hybrid strategy. The dosimetric margin improvement was smaller than its geometric counterpart and was in the range of 0-1 mm. The optimal number of fractions necessary for the ITV construction is 2 for LRPs and 3-4 for IRPs in a hypofractionation protocol. A new cumulative index of target volume was proposed

  7. What benefit could be derived from on-line adaptive prostate radiotherapy using rectal diameter as a predictor of motion?

    PubMed Central

    Oates, Richard; Gill, Suki; Foroudi, Farshad; Joon, Michael Lim; Schneider, Michal; Bressel, Mathias; Kron, Tomas

    2015-01-01

    This study investigated a relationship between rectum diameter and prostate motion during treatment with a view to reducing planning target volume (PTV) margins for an adaptive protocol. One hundred and ninety-four cone-beam computed tomography (CBCT) images of 10 patients were used to relate rectum diameter on CBCT to prostate intrafraction displacement. A threshold rectum diameter was used to model the impact of an adaptive PTV margin on rectum and bladder dose. Potential dose escalation with a 6 mm uniform margin adaptive protocol was compared to a PTV margin of 10 mm expansion of the clinical target volume (CTV) except 6 mm posterior. Of 194 fractions, 104 had a maximum rectal diameter of ≤3.5 cm. The prostate displaced ≤4 mm in 102 of those fractions. Changing from a standard to an adaptive PTV margin reduced the volume of rectum receiving 25, 50, 60, and 70 Gy by around 12, 9, 10, and 16%, respectively and bladder by approximately 21, 27, 29, and 35%, respectively. An average dose escalation of 4.2 Gy may be possible with an adaptive prostate radiotherapy protocol. In conclusion, a relationship between the prostate motion and the diameter of the rectum on CBCT potentially could enable daily adaptive radiotherapy which can be implemented from the first fraction. PMID:26150683

  8. A dosimetric comparison of real-time adaptive and non-adaptive radiotherapy: A multi-institutional study encompassing robotic, gimbaled, multileaf collimator and couch tracking

    PubMed Central

    Colvill, Emma; Booth, Jeremy; Nill, Simeon; Fast, Martin; Bedford, James; Oelfke, Uwe; Nakamura, Mitsuhiro; Poulsen, Per; Worm, Esben; Hansen, Rune; Ravkilde, Thomas; Scherman Rydhög, Jonas; Pommer, Tobias; Munck af Rosenschold, Per; Lang, Stephanie; Guckenberger, Matthias; Groh, Christian; Herrmann, Christian; Verellen, Dirk; Poels, Kenneth; Wang, Lei; Hadsell, Michael; Sothmann, Thilo; Blanck, Oliver; Keall, Paul

    2016-01-01

    Purpose A study of real-time adaptive radiotherapy systems was performed to test the hypothesis that, across delivery systems and institutions, the dosimetric accuracy is improved with adaptive treatments over non-adaptive radiotherapy in the presence of patient-measured tumor motion. Methods and materials Ten institutions with robotic(2), gimbaled(2), MLC(4) or couch tracking(2) used common materials including CT and structure sets, motion traces and planning protocols to create a lung and a prostate plan. For each motion trace, the plan was delivered twice to a moving dosimeter; with and without real-time adaptation. Each measurement was compared to a static measurement and the percentage of failed points for γ-tests recorded. Results For all lung traces all measurement sets show improved dose accuracy with a mean 2%/2 mm γ-fail rate of 1.6% with adaptation and 15.2% without adaptation (p < 0.001). For all prostate the mean 2%/2 mm γ-fail rate was 1.4% with adaptation and 17.3% without adaptation (p < 0.001). The difference between the four systems was small with an average 2%/2 mm γ-fail rate of <3% for all systems with adaptation for lung and prostate. Conclusions The investigated systems all accounted for realistic tumor motion accurately and performed to a similar high standard, with real-time adaptation significantly outperforming non-adaptive delivery methods. PMID:27016171

  9. Accurate respiration measurement using DC-coupled continuous-wave radar sensor for motion-adaptive cancer radiotherapy.

    PubMed

    Gu, Changzhan; Li, Ruijiang; Zhang, Hualiang; Fung, Albert Y C; Torres, Carlos; Jiang, Steve B; Li, Changzhi

    2012-11-01

    Accurate respiration measurement is crucial in motion-adaptive cancer radiotherapy. Conventional methods for respiration measurement are undesirable because they are either invasive to the patient or do not have sufficient accuracy. In addition, measurement of external respiration signal based on conventional approaches requires close patient contact to the physical device which often causes patient discomfort and undesirable motion during radiation dose delivery. In this paper, a dc-coupled continuous-wave radar sensor was presented to provide a noncontact and noninvasive approach for respiration measurement. The radar sensor was designed with dc-coupled adaptive tuning architectures that include RF coarse-tuning and baseband fine-tuning, which allows the radar sensor to precisely measure movement with stationary moment and always work with the maximum dynamic range. The accuracy of respiration measurement with the proposed radar sensor was experimentally evaluated using a physical phantom, human subject, and moving plate in a radiotherapy environment. It was shown that respiration measurement with radar sensor while the radiation beam is on is feasible and the measurement has a submillimeter accuracy when compared with a commercial respiration monitoring system which requires patient contact. The proposed radar sensor provides accurate, noninvasive, and noncontact respiration measurement and therefore has a great potential in motion-adaptive radiotherapy.

  10. Automatic treatment plan re-optimization for adaptive radiotherapy guided with the initial plan DVHs.

    PubMed

    Li, Nan; Zarepisheh, Masoud; Uribe-Sanchez, Andres; Moore, Kevin; Tian, Zhen; Zhen, Xin; Graves, Yan Jiang; Gautier, Quentin; Mell, Loren; Zhou, Linghong; Jia, Xun; Jiang, Steve

    2013-12-21

    Adaptive radiation therapy (ART) can reduce normal tissue toxicity and/or improve tumor control through treatment adaptations based on the current patient anatomy. Developing an efficient and effective re-planning algorithm is an important step toward the clinical realization of ART. For the re-planning process, manual trial-and-error approach to fine-tune planning parameters is time-consuming and is usually considered unpractical, especially for online ART. It is desirable to automate this step to yield a plan of acceptable quality with minimal interventions. In ART, prior information in the original plan is available, such as dose-volume histogram (DVH), which can be employed to facilitate the automatic re-planning process. The goal of this work is to develop an automatic re-planning algorithm to generate a plan with similar, or possibly better, DVH curves compared with the clinically delivered original plan. Specifically, our algorithm iterates the following two loops. An inner loop is the traditional fluence map optimization, in which we optimize a quadratic objective function penalizing the deviation of the dose received by each voxel from its prescribed or threshold dose with a set of fixed voxel weighting factors. In outer loop, the voxel weighting factors in the objective function are adjusted according to the deviation of the current DVH curves from those in the original plan. The process is repeated until the DVH curves are acceptable or maximum iteration step is reached. The whole algorithm is implemented on GPU for high efficiency. The feasibility of our algorithm has been demonstrated with three head-and-neck cancer IMRT cases, each having an initial planning CT scan and another treatment CT scan acquired in the middle of treatment course. Compared with the DVH curves in the original plan, the DVH curves in the resulting plan using our algorithm with 30 iterations are better for almost all structures. The re-optimization process takes about 30 s using

  11. Automatic treatment plan re-optimization for adaptive radiotherapy guided with the initial plan DVHs

    NASA Astrophysics Data System (ADS)

    Li, Nan; Zarepisheh, Masoud; Uribe-Sanchez, Andres; Moore, Kevin; Tian, Zhen; Zhen, Xin; Jiang Graves, Yan; Gautier, Quentin; Mell, Loren; Zhou, Linghong; Jia, Xun; Jiang, Steve

    2013-12-01

    Adaptive radiation therapy (ART) can reduce normal tissue toxicity and/or improve tumor control through treatment adaptations based on the current patient anatomy. Developing an efficient and effective re-planning algorithm is an important step toward the clinical realization of ART. For the re-planning process, manual trial-and-error approach to fine-tune planning parameters is time-consuming and is usually considered unpractical, especially for online ART. It is desirable to automate this step to yield a plan of acceptable quality with minimal interventions. In ART, prior information in the original plan is available, such as dose-volume histogram (DVH), which can be employed to facilitate the automatic re-planning process. The goal of this work is to develop an automatic re-planning algorithm to generate a plan with similar, or possibly better, DVH curves compared with the clinically delivered original plan. Specifically, our algorithm iterates the following two loops. An inner loop is the traditional fluence map optimization, in which we optimize a quadratic objective function penalizing the deviation of the dose received by each voxel from its prescribed or threshold dose with a set of fixed voxel weighting factors. In outer loop, the voxel weighting factors in the objective function are adjusted according to the deviation of the current DVH curves from those in the original plan. The process is repeated until the DVH curves are acceptable or maximum iteration step is reached. The whole algorithm is implemented on GPU for high efficiency. The feasibility of our algorithm has been demonstrated with three head-and-neck cancer IMRT cases, each having an initial planning CT scan and another treatment CT scan acquired in the middle of treatment course. Compared with the DVH curves in the original plan, the DVH curves in the resulting plan using our algorithm with 30 iterations are better for almost all structures. The re-optimization process takes about 30 s using

  12. Organizational Adaptation of Liberal Arts Colleges during the Great Recession of 2007

    ERIC Educational Resources Information Center

    Hilbun, Ashlie Junot; Mamiseishvili, Ketevan

    2016-01-01

    The study we report here explored how private liberal arts colleges adapted to the Great Recession of 2007. We examined institutional changes at three private liberal arts colleges and their effects on the institutions' operations. For this multiple-case study we analyzed data from three colleges in the southeastern region of the United States;…

  13. The adaptation of megavoltage cone beam CT for use in standard radiotherapy treatment planning.

    PubMed

    Thomas, T Hannah Mary; Devakumar, D; Purnima, S; Ravindran, B Paul

    2009-04-07

    Potential areas where megavoltage computed tomography (MVCT) could be used are second- and third-phase treatment planning in 3D conformal radiotherapy and IMRT, adaptive radiation therapy, single fraction palliative treatment and for the treatment of patients with metal prostheses. A feasibility study was done on using MV cone beam CT (CBCT) images generated by proprietary 3D reconstruction software based on the FDK algorithm for megavoltage treatment planning. The reconstructed images were converted to a DICOM file set. The pixel values of megavoltage cone beam computed tomography (MV CBCT) were rescaled to those of kV CT for use with a treatment planning system. A calibration phantom was designed and developed for verification of geometric accuracy and CT number calibration. The distance measured between two marker points on the CBCT image and the physical dimension on the phantom were in good agreement. Point dose verification for a 10 cm x 10 cm beam at a gantry angle of 0 degrees and SAD of 100 cm were performed for a 6 MV beam for both kV and MV CBCT images. The point doses were found to vary between +/-6.1% of the dose calculated from the kV CT image. The isodose curves for 6 MV for both kV CT and MV CBCT images were within 2% and 3 mm distance-to-agreement. A plan with three beams was performed on MV CBCT, simulating a treatment plan for cancer of the pituitary. The distribution obtained was compared with those corresponding to that obtained using the kV CT. This study has shown that treatment planning with MV cone beam CT images is feasible.

  14. The adaptation of megavoltage cone beam CT for use in standard radiotherapy treatment planning

    NASA Astrophysics Data System (ADS)

    Thomas, T. Hannah Mary; Devakumar, D.; Purnima, S.; Ravindran, B. Paul

    2009-04-01

    Potential areas where megavoltage computed tomography (MVCT) could be used are second- and third-phase treatment planning in 3D conformal radiotherapy and IMRT, adaptive radiation therapy, single fraction palliative treatment and for the treatment of patients with metal prostheses. A feasibility study was done on using MV cone beam CT (CBCT) images generated by proprietary 3D reconstruction software based on the FDK algorithm for megavoltage treatment planning. The reconstructed images were converted to a DICOM file set. The pixel values of megavoltage cone beam computed tomography (MV CBCT) were rescaled to those of kV CT for use with a treatment planning system. A calibration phantom was designed and developed for verification of geometric accuracy and CT number calibration. The distance measured between two marker points on the CBCT image and the physical dimension on the phantom were in good agreement. Point dose verification for a 10 cm × 10 cm beam at a gantry angle of 0° and SAD of 100 cm were performed for a 6 MV beam for both kV and MV CBCT images. The point doses were found to vary between ±6.1% of the dose calculated from the kV CT image. The isodose curves for 6 MV for both kV CT and MV CBCT images were within 2% and 3 mm distance-to-agreement. A plan with three beams was performed on MV CBCT, simulating a treatment plan for cancer of the pituitary. The distribution obtained was compared with those corresponding to that obtained using the kV CT. This study has shown that treatment planning with MV cone beam CT images is feasible.

  15. Real-time auto-adaptive margin generation for MLC-tracked radiotherapy.

    PubMed

    Glitzner, M; Fast, M F; de Senneville, B Denis; Nill, S; Oelfke, U; Lagendijk, J J W; Raaymakers, B W; Crijns, S P M

    2017-01-07

    In radiotherapy, abdominal and thoracic sites are candidates for performing motion tracking. With real-time control it is possible to adjust the multileaf collimator (MLC) position to the target position. However, positions are not perfectly matched and position errors arise from system delays and complicated response of the electromechanic MLC system. Although, it is possible to compensate parts of these errors by using predictors, residual errors remain and need to be compensated to retain target coverage. This work presents a method to statistically describe tracking errors and to automatically derive a patient-specific, per-segment margin to compensate the arising underdosage on-line, i.e. during plan delivery. The statistics of the geometric error between intended and actual machine position are derived using kernel density estimators. Subsequently a margin is calculated on-line according to a selected coverage parameter, which determines the amount of accepted underdosage. The margin is then applied onto the actual segment to accommodate the positioning errors in the enlarged segment. The proof-of-concept was tested in an on-line tracking experiment and showed the ability to recover underdosages for two test cases, increasing [Formula: see text] in the underdosed area about [Formula: see text] and [Formula: see text], respectively. The used dose model was able to predict the loss of dose due to tracking errors and could be used to infer the necessary margins. The implementation had a running time of 23 ms which is compatible with real-time requirements of MLC tracking systems. The auto-adaptivity to machine and patient characteristics makes the technique a generic yet intuitive candidate to avoid underdosages due to MLC tracking errors.

  16. Real-time auto-adaptive margin generation for MLC-tracked radiotherapy

    NASA Astrophysics Data System (ADS)

    Glitzner, M.; Fast, M. F.; de Senneville, B. Denis; Nill, S.; Oelfke, U.; Lagendijk, J. J. W.; Raaymakers, B. W.; Crijns, S. P. M.

    2017-01-01

    In radiotherapy, abdominal and thoracic sites are candidates for performing motion tracking. With real-time control it is possible to adjust the multileaf collimator (MLC) position to the target position. However, positions are not perfectly matched and position errors arise from system delays and complicated response of the electromechanic MLC system. Although, it is possible to compensate parts of these errors by using predictors, residual errors remain and need to be compensated to retain target coverage. This work presents a method to statistically describe tracking errors and to automatically derive a patient-specific, per-segment margin to compensate the arising underdosage on-line, i.e. during plan delivery. The statistics of the geometric error between intended and actual machine position are derived using kernel density estimators. Subsequently a margin is calculated on-line according to a selected coverage parameter, which determines the amount of accepted underdosage. The margin is then applied onto the actual segment to accommodate the positioning errors in the enlarged segment. The proof-of-concept was tested in an on-line tracking experiment and showed the ability to recover underdosages for two test cases, increasing {{V}90 %} in the underdosed area about 47 % and 41 % , respectively. The used dose model was able to predict the loss of dose due to tracking errors and could be used to infer the necessary margins. The implementation had a running time of 23 ms which is compatible with real-time requirements of MLC tracking systems. The auto-adaptivity to machine and patient characteristics makes the technique a generic yet intuitive candidate to avoid underdosages due to MLC tracking errors.

  17. Dose calculation accuracy using cone-beam CT (CBCT) for pelvic adaptive radiotherapy

    NASA Astrophysics Data System (ADS)

    Guan, Huaiqun; Dong, Hang

    2009-10-01

    This study is to evaluate the dose calculation accuracy using Varian's cone-beam CT (CBCT) for pelvic adaptive radiotherapy. We first calibrated the Hounsfield Unit (HU) to electron density (ED) for CBCT using a mini CT QC phantom embedded into an IMRT QA phantom. We then used a Catphan 500 with an annulus around it to check the calibration. The combined CT QC and IMRT phantom provided correct HU calibration, but not Catphan with an annulus. For the latter, not only was the Teflon an incorrect substitute for bone, but the inserts were also too small to provide correct HUs for air and bone. For the former, three different scan ranges (6 cm, 12 cm and 20.8 cm) were used to investigate the HU dependence on the amount of scatter. To evaluate the dose calculation accuracy, CBCT and plan-CT for a pelvic phantom were acquired and registered. The single field plan, 3D conformal and IMRT plans were created on both CT sets. Without inhomogeneity correction, the two CT generated nearly the same plan. With inhomogeneity correction, the dosimetric difference between the two CT was mainly from the HU calibration difference. The dosimetric difference for 6 MV was found to be the largest for the single lateral field plan (maximum 6.7%), less for the 3D conformal plan (maximum 3.3%) and the least for the IMRT plan (maximum 2.5%). Differences for 18 MV were generally 1-2% less. For a single lateral field, calibration with 20.8 cm achieved the minimum dosimetric difference. For 3D and IMRT plans, calibration with a 12 cm range resulted in better accuracy. Because Catphan is the standard QA phantom for the on-board imager (OBI) device, we specifically recommend not using it for the HU calibration of CBCT.

  18. Dose calculation accuracy using cone-beam CT (CBCT) for pelvic adaptive radiotherapy.

    PubMed

    Guan, Huaiqun; Dong, Hang

    2009-10-21

    This study is to evaluate the dose calculation accuracy using Varian's cone-beam CT (CBCT) for pelvic adaptive radiotherapy. We first calibrated the Hounsfield Unit (HU) to electron density (ED) for CBCT using a mini CT QC phantom embedded into an IMRT QA phantom. We then used a Catphan 500 with an annulus around it to check the calibration. The combined CT QC and IMRT phantom provided correct HU calibration, but not Catphan with an annulus. For the latter, not only was the Teflon an incorrect substitute for bone, but the inserts were also too small to provide correct HUs for air and bone. For the former, three different scan ranges (6 cm, 12 cm and 20.8 cm) were used to investigate the HU dependence on the amount of scatter. To evaluate the dose calculation accuracy, CBCT and plan-CT for a pelvic phantom were acquired and registered. The single field plan, 3D conformal and IMRT plans were created on both CT sets. Without inhomogeneity correction, the two CT generated nearly the same plan. With inhomogeneity correction, the dosimetric difference between the two CT was mainly from the HU calibration difference. The dosimetric difference for 6 MV was found to be the largest for the single lateral field plan (maximum 6.7%), less for the 3D conformal plan (maximum 3.3%) and the least for the IMRT plan (maximum 2.5%). Differences for 18 MV were generally 1-2% less. For a single lateral field, calibration with 20.8 cm achieved the minimum dosimetric difference. For 3D and IMRT plans, calibration with a 12 cm range resulted in better accuracy. Because Catphan is the standard QA phantom for the on-board imager (OBI) device, we specifically recommend not using it for the HU calibration of CBCT.

  19. State of the art in adaptive control of robotic systems

    NASA Technical Reports Server (NTRS)

    Tosunoglu, Sabri; Tesar, Delbert

    1988-01-01

    An up-to-date assessment of adaptive control technology as applied to robotics is presented. Although the field is relatively new and does not yet represent a mature discipline, considerable attention for the design of sophisticated robot controllers has occured. In this presentation, adaptive control methods are divided into model reference adaptive systems and self-tuning regulators, with further definition of various approaches given in each class. The similarity and distinct features of the designed controllers are delineated and tabulated to enhance comparative review.

  20. Radiotherapy combined with hormonal therapy in prostate cancer: the state of the art.

    PubMed

    Milecki, Piotr; Martenka, Piotr; Antczak, Andrzej; Kwias, Zbigniew

    2010-10-11

    Androgen-deprivation therapy (ADT) is used routinely in combination with definitive external beam radiation therapy (EBRT) in patients with high-risk clinically localized or locally advanced disease. The combined treatment (ADT-EBRT) also seems to play a significant role in improving treatment results in the intermediate-risk group of prostate cancer patients. On the other hand, there is a growing body of evidence that treatment with ADT can be associated with serious and lifelong adverse events including osteoporosis, cardiovascular disease, diabetes, and many others. Almost all ADT adverse events are time dependant and tend to increase in severity with prolongation of hormonal manipulation. Therefore, it is crucial to clearly state the optimal schedule for ADT in combination with EBRT, that maintaining the positive effect on treatment efficacy would keep the adverse events risk at reasonable level. To achieve this goal, treatment schedule may have to be highly individualized on the basis of the patient-specific potential vulnerability to adverse events. In this study, the concise and evidence-based review of current literature concerning the general rationales for combining radiotherapy and hormonal therapy, its mechanism, treatment results, and toxicity profile is presented.

  1. Adaptation effects to attractiveness of face photographs and art portraits are domain-specific.

    PubMed

    Hayn-Leichsenring, Gregor U; Kloth, Nadine; Schweinberger, Stefan R; Redies, Christoph

    2013-01-01

    We studied the neural coding of facial attractiveness by investigating effects of adaptation to attractive and unattractive human faces on the perceived attractiveness of veridical human face pictures (Experiment 1) and art portraits (Experiment 2). Experiment 1 revealed a clear pattern of contrastive aftereffects. Relative to a pre-adaptation baseline, the perceived attractiveness of faces was increased after adaptation to unattractive faces, and was decreased after adaptation to attractive faces. Experiment 2 revealed similar aftereffects when art portraits rather than face photographs were used as adaptors and test stimuli, suggesting that effects of adaptation to attractiveness are not restricted to facial photographs. Additionally, we found similar aftereffects in art portraits for beauty, another aesthetic feature that, unlike attractiveness, relates to the properties of the image (rather than to the face displayed). Importantly, Experiment 3 showed that aftereffects were abolished when adaptors were art portraits and face photographs were test stimuli. These results suggest that adaptation to facial attractiveness elicits aftereffects in the perception of subsequently presented faces, for both face photographs and art portraits, and that these effects do not cross image domains.

  2. Radiotherapy for non-malignant disorders: state of the art and update of the evidence-based practice guidelines

    PubMed Central

    Micke, O; Muecke, R

    2015-01-01

    Every year in Germany about 50,000 patients are referred and treated by radiotherapy (RT) for “non-malignant disorders”. This highly successful treatment is applied only for specific indications such as preservation or recovery of the quality of life by means of pain reduction or resolution and/or an improvement of formerly impaired physical body function owing to specific disease-related symptoms. Since 1995, German radiation oncologists have treated non-malignant disorders according to national consensus guidelines; these guidelines were updated and further developed over 3 years by implementation of a systematic consensus process to achieve national upgraded and accepted S2e clinical practice guidelines. Throughout this process, international standards of evaluation were implemented. This review summarizes most of the generally accepted indications for the application of RT for non-malignant diseases and presents the special treatment concepts. The following disease groups are addressed: painful degenerative skeletal disorders, hyperproliferative disorders and symptomatic functional disorders. These state of the art guidelines may serve as a platform for daily clinical work; they provide a new starting point for quality assessment, future clinical research, including the design of prospective clinical trials, and outcome research in the underrepresented and less appreciated field of RT for non-malignant disorders. PMID:25955230

  3. Radiotherapy for non-malignant disorders: state of the art and update of the evidence-based practice guidelines.

    PubMed

    Seegenschmiedt, M H; Micke, O; Muecke, R

    2015-07-01

    Every year in Germany about 50,000 patients are referred and treated by radiotherapy (RT) for "non-malignant disorders". This highly successful treatment is applied only for specific indications such as preservation or recovery of the quality of life by means of pain reduction or resolution and/or an improvement of formerly impaired physical body function owing to specific disease-related symptoms. Since 1995, German radiation oncologists have treated non-malignant disorders according to national consensus guidelines; these guidelines were updated and further developed over 3 years by implementation of a systematic consensus process to achieve national upgraded and accepted S2e clinical practice guidelines. Throughout this process, international standards of evaluation were implemented. This review summarizes most of the generally accepted indications for the application of RT for non-malignant diseases and presents the special treatment concepts. The following disease groups are addressed: painful degenerative skeletal disorders, hyperproliferative disorders and symptomatic functional disorders. These state of the art guidelines may serve as a platform for daily clinical work; they provide a new starting point for quality assessment, future clinical research, including the design of prospective clinical trials, and outcome research in the underrepresented and less appreciated field of RT for non-malignant disorders.

  4. Development of a deformable dosimetric phantom to verify dose accumulation algorithms for adaptive radiotherapy

    PubMed Central

    Zhong, Hualiang; Adams, Jeffrey; Glide-Hurst, Carri; Zhang, Hualin; Li, Haisen; Chetty, Indrin J.

    2016-01-01

    Adaptive radiotherapy may improve treatment outcomes for lung cancer patients. Because of the lack of an effective tool for quality assurance, this therapeutic modality is not yet accepted in clinic. The purpose of this study is to develop a deformable physical phantom for validation of dose accumulation algorithms in regions with heterogeneous mass. A three-dimensional (3D) deformable phantom was developed containing a tissue-equivalent tumor and heterogeneous sponge inserts. Thermoluminescent dosimeters (TLDs) were placed at multiple locations in the phantom each time before dose measurement. Doses were measured with the phantom in both the static and deformed cases. The deformation of the phantom was actuated by a motor driven piston. 4D computed tomography images were acquired to calculate 3D doses at each phase using Pinnacle and EGSnrc/DOSXYZnrc. These images were registered using two registration software packages: VelocityAI and Elastix. With the resultant displacement vector fields (DVFs), the calculated 3D doses were accumulated using a mass-and energy congruent mapping method and compared to those measured by the TLDs at four typical locations. In the static case, TLD measurements agreed with all the algorithms by 1.8% at the center of the tumor volume and by 4.0% in the penumbra. In the deformable case, the phantom's deformation was reproduced within 1.1 mm. For the 3D dose calculated by Pinnacle, the total dose accumulated with the Elastix DVF agreed well to the TLD measurements with their differences <2.5% at four measured locations. When the VelocityAI DVF was used, their difference increased up to 11.8%. For the 3D dose calculated by EGSnrc/DOSXYZnrc, the total doses accumulated with the two DVFs were within 5.7% of the TLD measurements which are slightly over the rate of 5% for clinical acceptance. The detector-embedded deformable phantom allows radiation dose to be measured in a dynamic environment, similar to deforming lung tissues, supporting

  5. Adaptation, Learning, and the Art of War: A Cybernetic Perspective

    DTIC Science & Technology

    2014-05-14

    M Asaro, “From Mechanisms of Adaptation to Intelligence Amplifiers: The Philosophy of W. Ross Ashby,” Mechanical Mind in History (2008): 156... Greek word kybernetes, or “steersman,” cybernetics describes goal directedness or how systems move towards and maintain their goals, while countering...without resorting to the rigid tactics and formations of the ancient phalanx or the Prussian “corpse” obedience.179 Additionally, the organization of

  6. Art as an Evolutionary Adaptation: Inspiration from the Visible Supernovae of AD 1054 and AD 3054

    NASA Astrophysics Data System (ADS)

    Corbally, C. J.; Rappaport, M. B.

    2016-01-01

    The authors, an astronomer/priest and an anthropologist/biologist, describe their use of the dramatic arts at the INSAP VIII meeting in their performance of two short skits on the sighting of a supernova in AD 1054 (creating the beautiful Crab Nebula) and a future “Rho Cas” stellar explosion in the constellation Cassiopeia, in AD 3054. They speculate on the emergence of science, religion, and art as bona fide adaptations, responding to natural selection, which served early hominins well in their struggle for existence. They draw parallels to the continued functions of science, religion, and art in modern society.

  7. WE-G-BRD-08: Motion Analysis for Rectal Cancer: Implications for Adaptive Radiotherapy On the MR-Linac

    SciTech Connect

    Kleijnen, J; Asselen, B van; Burbach, M; Intven, M; Philippens, M; Reerink, O; Lagendijk, J; Raaymakers, B

    2015-06-15

    Purpose: Purpose of this study is to find the optimal trade-off between adaptation interval and margin reduction and to define the implications of motion for rectal cancer boost radiotherapy on a MR-linac. Methods: Daily MRI scans were acquired of 16 patients, diagnosed with rectal cancer, prior to each radiotherapy fraction in one week (N=76). Each scan session consisted of T2-weighted and three 2D sagittal cine-MRI, at begin (t=0 min), middle (t=9:30 min) and end (t=18:00 min) of scan session, for 1 minute at 2 Hz temporal resolution. Tumor and clinical target volume (CTV) were delineated on each T2-weighted scan and transferred to each cine-MRI. The start frame of the begin scan was used as reference and registered to frames at time-points 15, 30 and 60 seconds, 9:30 and 18:00 minutes and 1, 2, 3 and 4 days later. Per time-point, motion of delineated voxels was evaluated using the deformation vector fields of the registrations and the 95th percentile distance (dist95%) was calculated as measure of motion. Per time-point, the distance that includes 90% of all cases was taken as estimate of required planning target volume (PTV)-margin. Results: Highest motion reduction is observed going from 9:30 minutes to 60 seconds. We observe a reduction in margin estimates from 10.6 to 2.7 mm and 16.1 to 4.6 mm for tumor and CTV, respectively, when adapting every 60 seconds compared to not adapting treatment. A 75% and 71% reduction, respectively. Further reduction in adaptation time-interval yields only marginal motion reduction. For adaptation intervals longer than 18:00 minutes only small motion reductions are observed. Conclusion: The optimal adaptation interval for adaptive rectal cancer (boost) treatments on a MR-linac is 60 seconds. This results in substantial smaller PTV-margin estimates. Adaptation intervals of 18:00 minutes and higher, show little improvement in motion reduction.

  8. SU-F-BRB-07: A Plan Comparison Tool to Ensure Robustness and Deliverability in Online-Adaptive Radiotherapy

    SciTech Connect

    Hill, P; Labby, Z; Bayliss, R A; Geurts, M; Bayouth, J

    2015-06-15

    Purpose: To develop a plan comparison tool that will ensure robustness and deliverability through analysis of baseline and online-adaptive radiotherapy plans using similarity metrics. Methods: The ViewRay MRIdian treatment planning system allows export of a plan file that contains plan and delivery information. A software tool was developed to read and compare two plans, providing information and metrics to assess their similarity. In addition to performing direct comparisons (e.g. demographics, ROI volumes, number of segments, total beam-on time), the tool computes and presents histograms of derived metrics (e.g. step-and-shoot segment field sizes, segment average leaf gaps). Such metrics were investigated for their ability to predict that an online-adapted plan reasonably similar to a baseline plan where deliverability has already been established. Results: In the realm of online-adaptive planning, comparing ROI volumes offers a sanity check to verify observations found during contouring. Beyond ROI analysis, it has been found that simply editing contours and re-optimizing to adapt treatment can produce a delivery that is substantially different than the baseline plan (e.g. number of segments increased by 31%), with no changes in optimization parameters and only minor changes in anatomy. Currently the tool can quickly identify large omissions or deviations from baseline expectations. As our online-adaptive patient population increases, we will continue to develop and refine quantitative acceptance criteria for adapted plans and relate them historical delivery QA measurements. Conclusion: The plan comparison tool is in clinical use and reports a wide range of comparison metrics, illustrating key differences between two plans. This independent check is accomplished in seconds and can be performed in parallel to other tasks in the online-adaptive workflow. Current use prevents large planning or delivery errors from occurring, and ongoing refinements will lead to

  9. Artisticc: An Art and Science Integration Project to Enquire into Community Level Adaptation to Climate Change

    NASA Astrophysics Data System (ADS)

    Vanderlinden, J. P.; Baztan, J.

    2014-12-01

    The prupose of this paper is to present the "Adaptation Research a Transdisciplinary community and policy centered appoach" (ARTisticc) project. ARTisticc's goal is to apply innovative standardized transdisciplinary art and science integrative approaches to foster robust, socially, culturally and scientifically, community centred adaptation to climate change. The approach used in the project is based on the strong understanding that adaptation is: (a) still "a concept of uncertain form"; (b) a concept dealing with uncertainty; (c) a concept that calls for an analysis that goes beyond the traditional disciplinary organization of science, and; (d) an unconventional process in the realm of science and policy integration. The project is centered on case studies in France, Greenland, Russia, India, Canada, Alaska, and Senegal. In every site we jointly develop artwork while we analyzing how natural science, essentially geosciences can be used in order to better adapt in the future, how society adapt to current changes and how memories of past adaptations frames current and future processes. Artforms are mobilized in order to share scientific results with local communities and policy makers, this in a way that respects cultural specificities while empowering stakeholders, ARTISTICC translates these "real life experiments" into stories and artwork that are meaningful to those affected by climate change. The scientific results and the culturally mediated productions will thereafter be used in order to co-construct, with NGOs and policy makers, policy briefs, i.e. robust and scientifically legitimate policy recommendations regarding coastal adaptation. This co-construction process will be in itself analysed with the goal of increasing arts and science's performative functions in the universe of evidence-based policy making. The project involves scientists from natural sciences, the social sciences and the humanities, as well as artitis from the performing arts (playwriters

  10. Can Approaches to Research in Art and Design Be Beneficially Adapted for Research into Higher Education?

    ERIC Educational Resources Information Center

    Trowler, Paul

    2013-01-01

    This paper examines the research practices in Art and Design that are distinctively different from those common in research into higher education outside those fields. It considers whether and what benefit could be derived from their adaptation by the latter. The paper also examines the factors that are conducive and obstructive to adaptive…

  11. Impact of dose escalation and adaptive radiotherapy for cervical cancers on tumour shrinkage—a modelling study

    NASA Astrophysics Data System (ADS)

    Røthe Arnesen, Marius; Paulsen Hellebust, Taran; Malinen, Eirik

    2017-03-01

    Tumour shrinkage occurs during fractionated radiotherapy and is regulated by radiation induced cellular damage, repopulation of viable cells and clearance of dead cells. In some cases additional tumour shrinkage during external beam therapy may be beneficial, particularly for locally advanced cervical cancer where a small tumour volume may simplify and improve brachytherapy. In the current work, a mathematical tumour model is utilized to investigate how local dose escalation affects tumour shrinkage, focusing on implications for brachytherapy. The iterative two-compartment model is based upon linear-quadratic radiation response, a doubling time for viable cells and a half-time for clearance of dead cells. The model was individually fitted to clinical tumour volume data from fractionated radiotherapy of 25 cervical cancer patients. Three different fractionation patterns for dose escalation, all with an additional dose of 12.2 Gy, were simulated and compared to standard fractionation in terms of tumour shrinkage. An adaptive strategy where dose escalation was initiated after one week of treatment was also considered. For 22 out of 25 patients, a good model fit was achieved to the observed tumour shrinkage. A large degree of inter-patient variation was seen in predicted volume reduction following dose escalation. For the 10 best responding patients, a mean tumour volume reduction of 34  ±  3% (relative to standard treatment) was estimated at the time of brachytherapy. Timing of initiating dose escalation had a larger impact than the number of fractions applied. In conclusion, the model was found useful in evaluating the impact from dose escalation on tumour shrinkage. The results indicate that dose escalation could be conducted from the start of external beam radiotherapy in order to obtain additional tumour shrinkage before brachytherapy.

  12. Expected treatment dose construction and adaptive inverse planning optimization: Implementation for offline head and neck cancer adaptive radiotherapy

    SciTech Connect

    Yan Di; Liang Jian

    2013-02-15

    Purpose: To construct expected treatment dose for adaptive inverse planning optimization, and evaluate it on head and neck (h and n) cancer adaptive treatment modification. Methods: Adaptive inverse planning engine was developed and integrated in our in-house adaptive treatment control system. The adaptive inverse planning engine includes an expected treatment dose constructed using the daily cone beam (CB) CT images in its objective and constrains. Feasibility of the adaptive inverse planning optimization was evaluated retrospectively using daily CBCT images obtained from the image guided IMRT treatment of 19 h and n cancer patients. Adaptive treatment modification strategies with respect to the time and the number of adaptive inverse planning optimization during the treatment course were evaluated using the cumulative treatment dose in organs of interest constructed using all daily CBCT images. Results: Expected treatment dose was constructed to include both the delivered dose, to date, and the estimated dose for the remaining treatment during the adaptive treatment course. It was used in treatment evaluation, as well as in constructing the objective and constraints for adaptive inverse planning optimization. The optimization engine is feasible to perform planning optimization based on preassigned treatment modification schedule. Compared to the conventional IMRT, the adaptive treatment for h and n cancer illustrated clear dose-volume improvement for all critical normal organs. The dose-volume reductions of right and left parotid glands, spine cord, brain stem and mandible were (17 {+-} 6)%, (14 {+-} 6)%, (11 {+-} 6)%, (12 {+-} 8)%, and (5 {+-} 3)% respectively with the single adaptive modification performed after the second treatment week; (24 {+-} 6)%, (22 {+-} 8)%, (21 {+-} 5)%, (19 {+-} 8)%, and (10 {+-} 6)% with three weekly modifications; and (28 {+-} 5)%, (25 {+-} 9)%, (26 {+-} 5)%, (24 {+-} 8)%, and (15 {+-} 9)% with five weekly modifications. Conclusions

  13. SU-E-J-220: Evaluation of Atlas-Based Auto-Segmentation (ABAS) in Head-And-Neck Adaptive Radiotherapy

    SciTech Connect

    Liu, Q; Yan, D

    2014-06-01

    Purpose: Evaluate the accuracy of atlas-based auto segmentation of organs at risk (OARs) on both helical CT (HCT) and cone beam CT (CBCT) images in head and neck (HN) cancer adaptive radiotherapy (ART). Methods: Six HN patients treated in the ART process were included in this study. For each patient, three images were selected: pretreatment planning CT (PreTx-HCT), in treatment CT for replanning (InTx-HCT) and a CBCT acquired in the same day of the InTx-HCT. Three clinical procedures of auto segmentation and deformable registration performed in the ART process were evaluated: a) auto segmentation on PreTx-HCT using multi-subject atlases, b) intra-patient propagation of OARs from PreTx-HCT to InTx-HCT using deformable HCT-to-HCT image registration, and c) intra-patient propagation of OARs from PreTx-HCT to CBCT using deformable CBCT-to-HCT image registration. Seven OARs (brainstem, cord, L/R parotid, L/R submandibular gland and mandible) were manually contoured on PreTx-HCT and InTx-HCT for comparison. In addition, manual contours on InTx-CT were copied on the same day CBCT, and a local region rigid body registration was performed accordingly for each individual OAR. For procedures a) and b), auto contours were compared to manual contours, and for c) auto contours were compared to those rigidly transferred contours on CBCT. Dice similarity coefficients (DSC) and mean surface distances of agreement (MSDA) were calculated for evaluation. Results: For procedure a), the mean DSC/MSDA of most OARs are >80%/±2mm. For intra-patient HCT-to-HCT propagation, the Resultimproved to >85%/±1.5mm. Compared to HCT-to-HCT, the mean DSC for HCT-to-CBCT propagation drops ∼2–3% and MSDA increases ∼0.2mm. This Resultindicates that the inferior imaging quality of CBCT seems only degrade auto propagation performance slightly. Conclusion: Auto segmentation and deformable propagation can generate OAR structures on HCT and CBCT images with clinically acceptable accuracy. Therefore

  14. An augmented parametric response map with consideration of image registration error: towards guidance of locally adaptive radiotherapy

    NASA Astrophysics Data System (ADS)

    Lausch, Anthony; Chen, Jeff; Ward, Aaron D.; Gaede, Stewart; Lee, Ting-Yim; Wong, Eugene

    2014-11-01

    Parametric response map (PRM) analysis is a voxel-wise technique for predicting overall treatment outcome, which shows promise as a tool for guiding personalized locally adaptive radiotherapy (RT). However, image registration error (IRE) introduces uncertainty into this analysis which may limit its use for guiding RT. Here we extend the PRM method to include an IRE-related PRM analysis confidence interval and also incorporate multiple graded classification thresholds to facilitate visualization. A Gaussian IRE model was used to compute an expected value and confidence interval for PRM analysis. The augmented PRM (A-PRM) was evaluated using CT-perfusion functional image data from patients treated with RT for glioma and hepatocellular carcinoma. Known rigid IREs were simulated by applying one thousand different rigid transformations to each image set. PRM and A-PRM analyses of the transformed images were then compared to analyses of the original images (ground truth) in order to investigate the two methods in the presence of controlled IRE. The A-PRM was shown to help visualize and quantify IRE-related analysis uncertainty. The use of multiple graded classification thresholds also provided additional contextual information which could be useful for visually identifying adaptive RT targets (e.g. sub-volume boosts). The A-PRM should facilitate reliable PRM guided adaptive RT by allowing the user to identify if a patient’s unique IRE-related PRM analysis uncertainty has the potential to influence target delineation.

  15. An on-line replanning method for head and neck adaptive radiotherapy

    SciTech Connect

    Ahunbay, Ergun E.; Peng, Cheng; Godley, Andrew; Schultz, Christopher; Li, X. Allen

    2009-10-15

    Daily setup for head and neck (HN) radiotherapy (RT) can vary randomly due to neck rotation and anatomy change. These differences cannot be totally corrected by the current practice of image guided RT with translational repositioning. The authors present a novel rapid correction scheme that can be used on-line to correct both interfractional setup variation and anatomy change for HN RT. The scheme consists of two major steps: (1) Segment aperture morphing (SAM) and (2) segment weight optimization (SWO). SAM is accomplished by applying the spatial relationship between the apertures and the contours of the planning target and organs at risk (OARs) to the new target and OAR contours. The new target contours are transferred from planning target contours to the CT of the day by means of deformable registration (MIMVISTA). The dose distribution for each new aperture was generated using a planning system with a fast dose engine and hardware and was input into a newly developed SWO package using fast sequential quadratic programming. The entire scheme was tested based on the daily CT images acquired for representative HN IMRT cases treated with a linac and CT-on-Rails combo. It was found that the target coverage and/or OAR sparing was degraded based on the CT of the day with the current standard repositioning from rigid registration. This degradation can be corrected by the SAM/SWO scheme. The target coverage and OAR sparing for the SAM/SWO plans were found to be equivalent to the original plan. The SAM/SWO process took 5-8 min for the head and neck cases studied. The proposed aperture morphing with weight optimization is an effective on-line approach for correcting interfractional patient setup and anatomic changes for head and neck cancer radiotherapy.

  16. A self-adaptive case-based reasoning system for dose planning in prostate cancer radiotherapy

    SciTech Connect

    Mishra, Nishikant; Petrovic, Sanja; Sundar, Santhanam

    2011-12-15

    Purpose: Prostate cancer is the most common cancer in the male population. Radiotherapy is often used in the treatment for prostate cancer. In radiotherapy treatment, the oncologist makes a trade-off between the risk and benefit of the radiation, i.e., the task is to deliver a high dose to the prostate cancer cells and minimize side effects of the treatment. The aim of our research is to develop a software system that will assist the oncologist in planning new treatments. Methods: A nonlinear case-based reasoning system is developed to capture the expertise and experience of oncologists in treating previous patients. Importance (weights) of different clinical parameters in the dose planning is determined by the oncologist based on their past experience, and is highly subjective. The weights are usually fixed in the system. In this research, the weights are updated automatically each time after generating a treatment plan for a new patient using a group based simulated annealing approach. Results: The developed approach is analyzed on the real data set collected from the Nottingham University Hospitals NHS Trust, City Hospital Campus, UK. Extensive experiments show that the dose plan suggested by the proposed method is coherent with the dose plan prescribed by an experienced oncologist or even better. Conclusions: The developed case-based reasoning system enables the use of knowledge and experience gained by the oncologist in treating new patients. This system may play a vital role to assist the oncologist in making a better decision in less computational time; it utilizes the success rate of the previously treated patients and it can also be used in teaching and training processes.

  17. SmART: Adaptive grayscale search tools for alignment and registration

    NASA Astrophysics Data System (ADS)

    Hospod, Thomas F.

    1999-03-01

    For OEMs, system integrators and end-users of machine vision requiring highly accurate and robust pattern finding tools capable of precisely locating patterns despite normal process variations, Imaging Technology Incorporated offers its SmARTTM (Smart Alignment and Registration Tool) Search. SmART Search is an extremely accurate and robust pattern locating tool featuring the industry's first and only Training WizardTM--a time-saving utility that takes the guesswork and uncertainty out of the pattern training process. With state-of-the-art GeoSearchTM-assist, SmART Search enables manufacturers of vision-automated equipment to build more robust machines that will automatically adapt to changes in object appearance due to normal process variations.

  18. SU-E-J-52: Dosimetric Benefit of Adaptive Re-Planning in Lung Cancer Stereotactic Body Radiotherapy (SBRT)

    SciTech Connect

    Jia, J; Tian, Z; Gu, X; Yan, H; Jiang, S; Jia, X

    2014-06-01

    Purpose: To investigate the dosimetric benefit of adaptive re-planning for lung stereotactic body radiotherapy(SBRT). Methods: Five lung cancer patients with SBRT treatment were retrospectively investigated. Our in-house supercomputing online re-planning environment (SCORE) was used to realize the re-planning process. First a deformable image registration was carried out to transfer contours from treatment planning CT to each treatment CBCT. Then an automatic re-planning using original plan DVH guided fluence-map optimization is performed to get a new plan for the up-to-date patient geometry. We compared the re-optimized plan to the original plan projected on the up-to-date patient geometry in critical dosimetric parameters, such as PTV coverage, spinal cord maximum and volumetric constraint dose, esophagus maximum and volumetric constraint dose. Results: The average volume of PTV covered by prescription dose for all patients was improved by 7.56% after the adaptive re-planning. The volume of the spinal cord receiving 14.5Gy and 23Gy (V14.5, V23) decreased by 1.48% and 0.68%, respectively. For the esophagus, the volume receiving 19.5Gy (V19.5) reduced by 1.37%. Meanwhile, the maximum dose dropped off by 2.87% for spinal cord and 4.80% for esophagus. Conclusion: Our experimental results demonstrate that adaptive re-planning for lung SBRT has the potential to minimize the dosimetric effect of inter-fraction deformation and thus improve target coverage while reducing the risk of toxicity to nearby normal tissues.

  19. The role of regularization in deformable image registration for head and neck adaptive radiotherapy.

    PubMed

    Ciardo, D; Peroni, M; Riboldi, M; Alterio, D; Baroni, G; Orecchia, R

    2013-08-01

    Deformable image registration provides a robust mathematical framework to quantify morphological changes that occur along the course of external beam radiotherapy treatments. As clinical reliability of deformable image registration is not always guaranteed, algorithm regularization is commonly introduced to prevent sharp discontinuities in the quantified deformation and achieve anatomically consistent results. In this work we analyzed the influence of regularization on two different registration methods, i.e. B-Splines and Log Domain Diffeomorphic Demons, implemented in an open-source platform. We retrospectively analyzed the simulation computed tomography (CTsim) and the corresponding re-planning computed tomography (CTrepl) scans in 30 head and neck cancer patients. First, we investigated the influence of regularization levels on hounsfield units (HU) information in 10 test patients for each considered method. Then, we compared the registration results of the open-source implementation at selected best performing regularization levels with a clinical commercial software on the remaining 20 patients in terms of mean volume overlap, surface and center of mass distances between manual outlines and propagated structures. The regularized B-Splines method was not statistically different from the commercial software. The tuning of the regularization parameters allowed open-source algorithms to achieve better results in deformable image registration for head and neck patients, with the additional benefit of a framework where regularization can be tuned on a patient specific basis.

  20. SU-E-J-208: Fast and Accurate Auto-Segmentation of Abdominal Organs at Risk for Online Adaptive Radiotherapy

    SciTech Connect

    Gupta, V; Wang, Y; Romero, A; Heijmen, B; Hoogeman, M; Myronenko, A; Jordan, P

    2014-06-01

    Purpose: Various studies have demonstrated that online adaptive radiotherapy by real-time re-optimization of the treatment plan can improve organs-at-risk (OARs) sparing in the abdominal region. Its clinical implementation, however, requires fast and accurate auto-segmentation of OARs in CT scans acquired just before each treatment fraction. Autosegmentation is particularly challenging in the abdominal region due to the frequently observed large deformations. We present a clinical validation of a new auto-segmentation method that uses fully automated non-rigid registration for propagating abdominal OAR contours from planning to daily treatment CT scans. Methods: OARs were manually contoured by an expert panel to obtain ground truth contours for repeat CT scans (3 per patient) of 10 patients. For the non-rigid alignment, we used a new non-rigid registration method that estimates the deformation field by optimizing local normalized correlation coefficient with smoothness regularization. This field was used to propagate planning contours to repeat CTs. To quantify the performance of the auto-segmentation, we compared the propagated and ground truth contours using two widely used metrics- Dice coefficient (Dc) and Hausdorff distance (Hd). The proposed method was benchmarked against translation and rigid alignment based auto-segmentation. Results: For all organs, the auto-segmentation performed better than the baseline (translation) with an average processing time of 15 s per fraction CT. The overall improvements ranged from 2% (heart) to 32% (pancreas) in Dc, and 27% (heart) to 62% (spinal cord) in Hd. For liver, kidneys, gall bladder, stomach, spinal cord and heart, Dc above 0.85 was achieved. Duodenum and pancreas were the most challenging organs with both showing relatively larger spreads and medians of 0.79 and 2.1 mm for Dc and Hd, respectively. Conclusion: Based on the achieved accuracy and computational time we conclude that the investigated auto

  1. SU-E-J-20: Adaptive Aperture Morphing for Online Correction for Prostate Cancer Radiotherapy

    SciTech Connect

    Sandhu, R; Qin, A; Yan, D

    2014-06-01

    Purpose: Online adaptive aperture morphing is desirable over translational couch shifts to accommodate not only the target position variation but also anatomic changes (rotation, deformation, and relation of target to organ-atrisks). We proposed quick and reliable method for adapting segment aperture leaves for IMRT treatment of prostate. Methods: The proposed method consists of following steps: (1) delineate the contours of prostate, SV, bladder and rectum on kV-CBCT; (2) determine prostate displacement from the rigid body registration of the contoured prostate manifested on the reference CT and the CBCT; (3) adapt the MLC segment apertures obtained from the pre-treatment IMRT planning to accommodate the shifts as well as anatomic changes. The MLC aperture adaptive algorithm involves two steps; first move the whole aperture according to prostate translational/rotational shifts, and secondly fine-tune the aperture shape to maintain the spatial relationship between the planning target contour and the MLC aperture to the daily target contour. Feasibility of this method was evaluated retrospectively on a seven-field IMRT treatment of prostate cancer patient by comparing dose volume histograms of the original plan and the aperture-adjusted plan, with/without additional segments weight optimization (SWO), on two daily treatment CBCTs selected with relative large motion and rotation. Results: For first daily treatment, the prostate rotation was significant (12degree around lateral-axis). With apertureadjusted plan, the D95 to the target was improved 25% and rectum dose (D30, D40) was reduced 20% relative to original plan on daily volumes. For second treatment-fraction, (lateral shift = 6.7mm), after adjustment target D95 improved by 3% and bladder dose (D30, maximum dose) was reduced by 1%. For both cases, extra SWO did not provide significant improvement. Conclusion: The proposed method of adapting segment apertures is promising in treatment position correction

  2. Lung volume assessment for a cross-comparison of two breathing-adapted techniques in radiotherapy

    SciTech Connect

    Simon, Luc . E-mail: luc.simon@curie.net; Giraud, Philippe; Servois, Vincent; Rosenwald, Jean-Claude

    2005-10-01

    Purpose: To assess the validity of gated radiotherapy of lung by using a cross-check methodology based on four-dimensional (4D)-computed tomography (CT) exams. Variations of volume of a breathing phantom was used as an indicator. Methods and Materials: A balloon was periodically inflated and deflated by a medical ventilator. The volume variation ({delta}V) of the balloon was measured simultaneously by a spirometer, taken as reference, and by contouring 4D-CT series (10 phases) acquired by the real-time position management system (RPM). Similar cross-comparison was performed for 2 lung patients, 1 with free breathing (FB), the other with deep-inspiration breath-hold (DIBH) technique. Results: During FB, {delta}V measured by the spirometer and from 4D-CT were in good agreement: the mean differences for all phases were 8.1 mL for the balloon and 10.5 mL for a patient-test. End-inspiration lung volume has been shown to be slightly underestimated by the 4D-CT. The discrepancy for {delta}V between DIBH and end-expiration, measured from CT and from spirometer, respectively, was less than 3%. Conclusions: Provided that each slice series is correctly associated with the proper breathing phase, 4D-CT allows an accurate assessment of lung volume during the whole breathing cycle ({delta}V error <3% compared with the spirometer signal). Taking the lung volume variation into account is a central issue in the evaluation and control of the toxicity for lung radiation treatments.

  3. Reduction of cardiac and pulmonary complication probabilities after breathing adapted radiotherapy for breast cancer

    SciTech Connect

    Korreman, Stine S. . E-mail: stine.k@rh.dk; Pedersen, Anders N.; Aarup, Lasse Rye; Nottrup, Trine J.; Specht, Lena; Nystroem, Hakan

    2006-08-01

    Purpose: Substantial reductions of cardio-pulmonary radiation doses can be achieved using voluntary deep inspiration breath-hold (DIBH) or free breathing inspiration gating (IG) in radiotherapy after conserving surgery for breast cancer. The purpose of this study is to evaluate the radiobiological implications of such dosimetric benefits. Methods and Materials: Patients from previously reported studies were pooled for a total of 33 patients. All patients underwent DIBH and free breathing (FB) scans, and 17 patients underwent an additional IG scan. Tangential conformal treatment plans covering the remaining breast, internal mammary, and periclavicular nodes were optimized for each scan, prescription dose 48 Gy. Normal tissue complication probabilities were calculated using the relative seriality model for the heart, and the model proposed by Burman et al. for the lung. Results: Previous computed tomography studies showed that both voluntary DIBH and IG provided reduction of the lung V{sub 5} (relative volume receiving more than 50% of prescription dose) on the order of 30-40%, and a 80-90% reduction of the heart V{sub 5} for left-sided cancers. Corresponding pneumonitis probability of 28.1% (range, 0.7-95.6%) for FB could be reduced to 2.6% (range, 0.1-40.1%) for IG, and 4.3% (range, 0.1-59%) for DIBH. The cardiac mortality probability could be reduced from 4.8% (range, 0.1-23.4%) in FB to 0.5% (range, 0.1-2.6%) for IG and 0.1% (range, 0-3.0%) for DIBH. Conclusions: Remarkable potential is shown for simple voluntary DIBH and free breathing IG to reduce the risk of both cardiac mortality and pneumonitis for the common technique of adjuvant tangential breast irradiation.

  4. The efficacy of radiotherapy relies upon induction of type i interferon-dependent innate and adaptive immunity.

    PubMed

    Burnette, Byron C; Liang, Hua; Lee, Youjin; Chlewicki, Lukasz; Khodarev, Nikolai N; Weichselbaum, Ralph R; Fu, Yang-Xin; Auh, Sogyong L

    2011-04-01

    The most widely held explanation for the efficacy of local radiotherapy (RT) is based on direct cytotoxicity to cancer cells through the induction of lethal DNA damage. Recent studies have shown that local ablative radiation of established tumors can lead to increased T-cell priming and T-cell-dependent tumor regression, but the underlying mechanism remains unclear. Here, we describe an essential role for type I IFN in local RT-mediated tumor control. We show that ablative RT increases intratumoral production of IFN-β and, more surprisingly, the antitumor effect of RT is abolished in type I IFN nonresponsive hosts. Furthermore, the major target of RT-induced type I IFN is the hematopoietic compartment. RT drastically enhances the cross-priming capacity of tumor-infiltrating dendritic cells (TIDC) from wild-type mice but not type I IFN receptor-deficient mice. The enhanced cross-priming ability of TIDCs after RT was dependent on autocrine production of type I IFNs. By using adenoviral-mediated expression of IFN-β, we show that delivery of exogenous IFN-β into the tumor tissue in the absence of RT is also sufficient to selectively expand antigen-specific T cells leading to complete tumor regression. Our study reveals that local high-dose RT can trigger production of type I IFN that initiates a cascading innate and adaptive immune attack on the tumor.

  5. SU-E-J-254: Utility of Pinnacle Dynamic Planning Module Utilizing Deformable Image Registration in Adaptive Radiotherapy

    SciTech Connect

    Jani, S

    2014-06-01

    Purpose For certain highly conformal treatment techniques, changes in patient anatomy due to weight loss and/or tumor shrinkage can result in significant changes in dose distribution. Recently, the Pinnacle treatment planning system added a Dynamic Planning module utilizing Deformable Image Registration (DIR). The objective of this study was to evaluate the effectiveness of this software in adapting to altered anatomy and adjusting treatment plans to account for it. Methods We simulated significant tumor response by changing patient thickness and altered chin positions using a commercially-available head and neck (H and N) phantom. In addition, we studied 23 CT image sets of fifteen (15) patients with H and N tumors and eight (8) patients with prostate cancer. In each case, we applied deformable image registration through Dynamic Planning module of our Pinnacle Treatment Planning System. The dose distribution of the original CT image set was compared to the newly computed dose without altering any treatment parameter. Result was a dose if we did not adjust the plan to reflect anatomical changes. Results For the H and N phantom, a tumor response of up to 3.5 cm was correctly deformed by the Pinnacle Dynamic module. Recomputed isodose contours on new anatomies were within 1 mm of the expected distribution. The Pinnacle system configuration allowed dose computations resulting from original plans on new anatomies without leaving the planning system. Original and new doses were available side-by-side with both CT image sets. Based on DIR, about 75% of H and N patients (11/15) required a re-plan using new anatomy. Among prostate patients, the DIR predicted near-correct bladder volume in 62% of the patients (5/8). Conclusions The Dynamic Planning module of the Pinnacle system proved to be an accurate and useful tool in our ability to adapt to changes in patient anatomy during a course of radiotherapy.

  6. Accelerated gradient-based free form deformable registration for online adaptive radiotherapy

    NASA Astrophysics Data System (ADS)

    Yu, Gang; Liang, Yueqiang; Yang, Guanyu; Shu, Huazhong; Li, Baosheng; Yin, Yong; Li, Dengwang

    2015-04-01

    The registration of planning fan-beam computed tomography (FBCT) and daily cone-beam CT (CBCT) is a crucial step in adaptive radiation therapy. The current intensity-based registration algorithms, such as Demons, may fail when they are used to register FBCT and CBCT, because the CT numbers in CBCT cannot exactly correspond to the electron densities. In this paper, we investigated the effects of CBCT intensity inaccuracy on the registration accuracy and developed an accurate gradient-based free form deformation algorithm (GFFD). GFFD distinguishes itself from other free form deformable registration algorithms by (a) measuring the similarity using the 3D gradient vector fields to avoid the effect of inconsistent intensities between the two modalities; (b) accommodating image sampling anisotropy using the local polynomial approximation-intersection of confidence intervals (LPA-ICI) algorithm to ensure a smooth and continuous displacement field; and (c) introducing a ‘bi-directional’ force along with an adaptive force strength adjustment to accelerate the convergence process. It is expected that such a strategy can decrease the effect of the inconsistent intensities between the two modalities, thus improving the registration accuracy and robustness. Moreover, for clinical application, the algorithm was implemented by graphics processing units (GPU) through OpenCL framework. The registration time of the GFFD algorithm for each set of CT data ranges from 8 to 13 s. The applications of on-line adaptive image-guided radiation therapy, including auto-propagation of contours, aperture-optimization and dose volume histogram (DVH) in the course of radiation therapy were also studied by in-house-developed software.

  7. Image-guided adaptive radiotherapy for prostate and head-and-neck cancers

    NASA Astrophysics Data System (ADS)

    O'Daniel, Jennifer C.

    In the current practice of radiation therapy, daily patient alignments have been based on external skin marks or on bone. However, internal organ variation (both motion and volumetric changes) between treatment fractions can displace the treatment target, causing target underdosage and normal tissue overdosage. In order to deliver the radiation treatment as planned, more accurate knowledge of the daily internal anatomy was needed. Additionally, treatments needed to adapt to these variations by either shifting the patient to account for the daily target position or by altering the treatment plan. In this dissertation, the question of whether inter-fractional variations in internal patient anatomy combined with external set-up uncertainties produced measurable differences between planned and delivered doses for prostate and head-and-neck cancer patients was investigated. Image-guided adaptive treatment strategies to improve tumor coverage and/or reduce normal tissue dose were examined. Treatment deliveries utilizing various alignment procedures for ten prostate cancer patients and eleven head-and-neck cancer patients, each of whom received multiple CT scans over the course of treatment, were simulated. The largest prostate dose losses between planning and delivery were correlated with anterior/posterior and superior/inferior prostate displacement. Daily bone alignment sufficiently maintained target coverage for 70% of patients, ultrasound for 90%, and CT for 100%. A no-action-level correction protocol, which corrected the daily bone alignment for the systematic internal displacement of the prostate based on a pre-determined number of CT image sets, successfully improved the prostate and seminal vesicle dosimetric coverage. Three CT image sets were sufficient to accurately correct the bone alignment scheme for the prostate internal systematic shifts. For head-and-neck cancer patient treatment, setup uncertainties and internal organ variations did not greatly affect

  8. WE-G-BRF-01: Adaptation to Intrafraction Tumor Deformation During Intensity-Modulated Radiotherapy: First Proof-Of-Principle Demonstration

    SciTech Connect

    Ge, Y; OBrien, R; Shieh, C; Booth, J; Keall, P

    2014-06-15

    Purpose: Intrafraction tumor deformation limits targeting accuracy in radiotherapy and cannot be adapted to by current motion management techniques. This study simulated intrafractional treatment adaptation to tumor deformations using a dynamic Multi-Leaf Collimator (DMLC) tracking system during Intensity-modulated radiation therapy (IMRT) treatment for the first time. Methods: The DMLC tracking system was developed to adapt to the intrafraction tumor deformation by warping the planned beam aperture guided by the calculated deformation vector field (DVF) obtained from deformable image registration (DIR) at the time of treatment delivery. Seven single phantom deformation images up to 10.4 mm deformation and eight tumor system phantom deformation images up to 21.5 mm deformation were acquired and used in tracking simulation. The intrafraction adaptation was simulated at the DMLC tracking software platform, which was able to communicate with the image registration software, reshape the instantaneous IMRT field aperture and log the delivered MLC fields.The deformation adaptation accuracy was evaluated by a geometric target coverage metric defined as the sum of the area incorrectly outside and inside the reference aperture. The incremental deformations were arbitrarily determined to take place equally over the delivery interval. The geometric target coverage of delivery with deformation adaptation was compared against the delivery without adaptation. Results: Intrafraction deformation adaptation during dynamic IMRT plan delivery was simulated for single and system deformable phantoms. For the two particular delivery situations, over the treatment course, deformation adaptation improved the target coverage by 89% for single target deformation and 79% for tumor system deformation compared with no-tracking delivery. Conclusion: This work demonstrated the principle of real-time tumor deformation tracking using a DMLC. This is the first step towards the development of an

  9. SU-E-J-59: Effective Adaptive DMLC Gated Radiotherapy with OAR Sparing

    SciTech Connect

    Chen, Y; Wu, H; Zhou, Z; Sandison, MinGeorge

    2014-06-01

    Purpose: Patient respiratory motion degrades the effectiveness of cancer radiation treatment. Advanced respiratory gating delivers radiation dose accurately yet with elongated treatment time. The goal of this research is to propose a novel adaptive dMLC dynamic gating with high delivery efficiency and precision. Methods: The dose delivery of dMLC is aided by simultaneous tracking of tumor and organ at risk (OAR). The leaf opening/closing will follow the motion trajectory of the tumor while sparing the OAR. The treatment beam turns on only when there is no overlapping between OAR and tumor in BEV. A variety of evaluation metrics were considered and calculated, including duty cycle, beam toggling rate, and direct irradiation avoidance to OAR, under various combinations of different tumor margins and the distance between the centers of the tumor and OAR in BEV (expressed as dx). Results: Retrospective simulation was performed to investigate the feasibility and superiority of this technique using four groups of synchronized tumor and OAR motion data. The simulation results indicate that the tumor and OAR motion patterns and their relative positions are the dominant influential factors. The duty cycle can be greater than 96.71% yet can be as low as 6.69% depending different motion groups. This proposed technique provides good OAR protection, especially for such cases with low duty cycle for which as high as 77.71% maximal direct irradiation to OAR can be spared. Increasing dx improves the duty cycle (treatment efficiency) and provides better OAR volume sparing, whereas, that of the tumor margins has the opposite influence. Conclusion: This real-time adaptive dMLC gated radiation treatment with synchronous tumor and OAR tracking has inherent accurate dose delivery to tumor with reduced treatment time. In addition, the OAR protection capability make it an outstanding potential treatment strategy for mobile tumors.

  10. An adaptive MR-CT registration method for MRI-guided prostate cancer radiotherapy

    NASA Astrophysics Data System (ADS)

    Zhong, Hualiang; Wen, Ning; Gordon, James J.; Elshaikh, Mohamed A.; Movsas, Benjamin; Chetty, Indrin J.

    2015-04-01

    Magnetic Resonance images (MRI) have superior soft tissue contrast compared with CT images. Therefore, MRI might be a better imaging modality to differentiate the prostate from surrounding normal organs. Methods to accurately register MRI to simulation CT images are essential, as we transition the use of MRI into the routine clinic setting. In this study, we present a finite element method (FEM) to improve the performance of a commercially available, B-spline-based registration algorithm in the prostate region. Specifically, prostate contours were delineated independently on ten MRI and CT images using the Eclipse treatment planning system. Each pair of MRI and CT images was registered with the B-spline-based algorithm implemented in the VelocityAI system. A bounding box that contains the prostate volume in the CT image was selected and partitioned into a tetrahedral mesh. An adaptive finite element method was then developed to adjust the displacement vector fields (DVFs) of the B-spline-based registrations within the box. The B-spline and FEM-based registrations were evaluated based on the variations of prostate volume and tumor centroid, the unbalanced energy of the generated DVFs, and the clarity of the reconstructed anatomical structures. The results showed that the volumes of the prostate contours warped with the B-spline-based DVFs changed 10.2% on average, relative to the volumes of the prostate contours on the original MR images. This discrepancy was reduced to 1.5% for the FEM-based DVFs. The average unbalanced energy was 2.65 and 0.38 mJ cm-3, and the prostate centroid deviation was 0.37 and 0.28 cm, for the B-spline and FEM-based registrations, respectively. Different from the B-spline-warped MR images, the FEM-warped MR images have clear boundaries between prostates and bladders, and their internal prostatic structures are consistent with those of the original MR images. In summary, the developed adaptive FEM method preserves the prostate volume

  11. MagicPlate-512: A 2D silicon detector array for quality assurance of stereotactic motion adaptive radiotherapy

    SciTech Connect

    Petasecca, M. Newall, M. K.; Aldosari, A. H.; Fuduli, I.; Espinoza, A. A.; Porumb, C. S.; Guatelli, S.; Metcalfe, P.; Lerch, M. L. F.; Rosenfeld, A. B.; Booth, J. T.; Colvill, E.; Duncan, M.; Cammarano, D.; Carolan, M.; Oborn, B.; Perevertaylo, V.; Keall, P. J.

    2015-06-15

    Purpose: Spatial and temporal resolutions are two of the most important features for quality assurance instrumentation of motion adaptive radiotherapy modalities. The goal of this work is to characterize the performance of the 2D high spatial resolution monolithic silicon diode array named “MagicPlate-512” for quality assurance of stereotactic body radiation therapy (SBRT) and stereotactic radiosurgery (SRS) combined with a dynamic multileaf collimator (MLC) tracking technique for motion compensation. Methods: MagicPlate-512 is used in combination with the movable platform HexaMotion and a research version of radiofrequency tracking system Calypso driving MLC tracking software. The authors reconstruct 2D dose distributions of small field square beams in three modalities: in static conditions, mimicking the temporal movement pattern of a lung tumor and tracking the moving target while the MLC compensates almost instantaneously for the tumor displacement. Use of Calypso in combination with MagicPlate-512 requires a proper radiofrequency interference shielding. Impact of the shielding on dosimetry has been simulated by GEANT4 and verified experimentally. Temporal and spatial resolutions of the dosimetry system allow also for accurate verification of segments of complex stereotactic radiotherapy plans with identification of the instant and location where a certain dose is delivered. This feature allows for retrospective temporal reconstruction of the delivery process and easy identification of error in the tracking or the multileaf collimator driving systems. A sliding MLC wedge combined with the lung motion pattern has been measured. The ability of the MagicPlate-512 (MP512) in 2D dose mapping in all three modes of operation was benchmarked by EBT3 film. Results: Full width at half maximum and penumbra of the moving and stationary dose profiles measured by EBT3 film and MagicPlate-512 confirm that motion has a significant impact on the dose distribution. Motion

  12. Phase II dose escalation study of image-guided adaptive radiotherapy for prostate cancer: Use of dose-volume constraints to achieve rectal isotoxicity

    SciTech Connect

    Vargas, Carlos; Yan Di; Kestin, Larry L.; Krauss, Daniel; Lockman, David M.; Brabbins, Donald S.; Martinez, Alvaro A. . E-mail: amartinez@beaumont.edu

    2005-09-01

    Purpose: In our Phase II prostate cancer Adaptive Radiation Therapy (ART) study, the highest possible dose was selected on the basis of normal tissue tolerance constraints. We analyzed rectal toxicity rates in different dose levels and treatment groups to determine whether equivalent toxicity rates were achieved as hypothesized when the protocol was started. Methods and Materials: From 1999 to 2002, 331 patients with clinical stage T1 to T3, node-negative prostate cancer were prospectively treated with three-dimensional conformal adaptive RT. A patient-specific confidence-limited planning target volume was constructed on the basis of 5 CT scans and 4 sets of electronic portal images after the first 4 days of treatment. For each case, the rectum (rectal solid) was contoured in its entirety. The rectal wall was defined by use of a 3-mm wall thickness (median volume: 29.8 cc). The prescribed dose level was chosen using the following rectal wall dose constraints: (1) Less than 30% of the rectal wall volume can receive more than 75.6 Gy. (2) Less than 5% of the rectal wall can receive more than 82 Gy. Low-risk patients (PSA < 10, Stage {<=} T2a, Gleason score < 7) were treated to the prostate alone (Group 1). All other patients, intermediate and high risk, where treated to the prostate and seminal vesicles (Group 2). The risk of chronic toxicity (NCI Common Toxicity Criteria 2.0) was assessed for the different dose levels prescribed. HIC approval was acquired for all patients. Median follow-up was 1.6 years. Results: Grade 2 chronic rectal toxicity was experienced by 34 patients (10%) (9% experienced rectal bleeding, 6% experienced proctitis, 3% experienced diarrhea, and 1% experienced rectal pain) at a median interval of 1.1 year. Nine patients (3%) experienced grade 3 or higher chronic rectal toxicity (1 Grade 4) at a median interval of 1.2 years. The 2-year rates of Grade 2 or higher and Grade 3 or higher chronic rectal toxicity were 17% and 3%, respectively. No

  13. Intra-patient semi-automated segmentation of the cervix-uterus in CT-images for adaptive radiotherapy of cervical cancer

    NASA Astrophysics Data System (ADS)

    Luiza Bondar, M.; Hoogeman, Mischa; Schillemans, Wilco; Heijmen, Ben

    2013-08-01

    For online adaptive radiotherapy of cervical cancer, fast and accurate image segmentation is required to facilitate daily treatment adaptation. Our aim was twofold: (1) to test and compare three intra-patient automated segmentation methods for the cervix-uterus structure in CT-images and (2) to improve the segmentation accuracy by including prior knowledge on the daily bladder volume or on the daily coordinates of implanted fiducial markers. The tested methods were: shape deformation (SD) and atlas-based segmentation (ABAS) using two non-rigid registration methods: demons and a hierarchical algorithm. Tests on 102 CT-scans of 13 patients demonstrated that the segmentation accuracy significantly increased by including the bladder volume predicted with a simple 1D model based on a manually defined bladder top. Moreover, manually identified implanted fiducial markers significantly improved the accuracy of the SD method. For patients with large cervix-uterus volume regression, the use of CT-data acquired toward the end of the treatment was required to improve segmentation accuracy. Including prior knowledge, the segmentation results of SD (Dice similarity coefficient 85 ± 6%, error margin 2.2 ± 2.3 mm, average time around 1 min) and of ABAS using hierarchical non-rigid registration (Dice 82 ± 10%, error margin 3.1 ± 2.3 mm, average time around 30 s) support their use for image guided online adaptive radiotherapy of cervical cancer.

  14. Using dual-energy x-ray imaging to enhance automated lung tumor tracking during real-time adaptive radiotherapy

    SciTech Connect

    Menten, Martin J. Fast, Martin F.; Nill, Simeon; Oelfke, Uwe

    2015-12-15

    Purpose: Real-time, markerless localization of lung tumors with kV imaging is often inhibited by ribs obscuring the tumor and poor soft-tissue contrast. This study investigates the use of dual-energy imaging, which can generate radiographs with reduced bone visibility, to enhance automated lung tumor tracking for real-time adaptive radiotherapy. Methods: kV images of an anthropomorphic breathing chest phantom were experimentally acquired and radiographs of actual lung cancer patients were Monte-Carlo-simulated at three imaging settings: low-energy (70 kVp, 1.5 mAs), high-energy (140 kVp, 2.5 mAs, 1 mm additional tin filtration), and clinical (120 kVp, 0.25 mAs). Regular dual-energy images were calculated by weighted logarithmic subtraction of high- and low-energy images and filter-free dual-energy images were generated from clinical and low-energy radiographs. The weighting factor to calculate the dual-energy images was determined by means of a novel objective score. The usefulness of dual-energy imaging for real-time tracking with an automated template matching algorithm was investigated. Results: Regular dual-energy imaging was able to increase tracking accuracy in left–right images of the anthropomorphic phantom as well as in 7 out of 24 investigated patient cases. Tracking accuracy remained comparable in three cases and decreased in five cases. Filter-free dual-energy imaging was only able to increase accuracy in 2 out of 24 cases. In four cases no change in accuracy was observed and tracking accuracy worsened in nine cases. In 9 out of 24 cases, it was not possible to define a tracking template due to poor soft-tissue contrast regardless of input images. The mean localization errors using clinical, regular dual-energy, and filter-free dual-energy radiographs were 3.85, 3.32, and 5.24 mm, respectively. Tracking success was dependent on tumor position, tumor size, imaging beam angle, and patient size. Conclusions: This study has highlighted the influence of

  15. Toward adaptive radiotherapy for head and neck patients: Uncertainties in dose warping due to the choice of deformable registration algorithm

    SciTech Connect

    Veiga, Catarina Royle, Gary; Lourenço, Ana Mónica; Mouinuddin, Syed; Herk, Marcel van; Modat, Marc; Ourselin, Sébastien; McClelland, Jamie R.

    2015-02-15

    Purpose: The aims of this work were to evaluate the performance of several deformable image registration (DIR) algorithms implemented in our in-house software (NiftyReg) and the uncertainties inherent to using different algorithms for dose warping. Methods: The authors describe a DIR based adaptive radiotherapy workflow, using CT and cone-beam CT (CBCT) imaging. The transformations that mapped the anatomy between the two time points were obtained using four different DIR approaches available in NiftyReg. These included a standard unidirectional algorithm and more sophisticated bidirectional ones that encourage or ensure inverse consistency. The forward (CT-to-CBCT) deformation vector fields (DVFs) were used to propagate the CT Hounsfield units and structures to the daily geometry for “dose of the day” calculations, while the backward (CBCT-to-CT) DVFs were used to remap the dose of the day onto the planning CT (pCT). Data from five head and neck patients were used to evaluate the performance of each implementation based on geometrical matching, physical properties of the DVFs, and similarity between warped dose distributions. Geometrical matching was verified in terms of dice similarity coefficient (DSC), distance transform, false positives, and false negatives. The physical properties of the DVFs were assessed calculating the harmonic energy, determinant of the Jacobian, and inverse consistency error of the transformations. Dose distributions were displayed on the pCT dose space and compared using dose difference (DD), distance to dose difference, and dose volume histograms. Results: All the DIR algorithms gave similar results in terms of geometrical matching, with an average DSC of 0.85 ± 0.08, but the underlying properties of the DVFs varied in terms of smoothness and inverse consistency. When comparing the doses warped by different algorithms, we found a root mean square DD of 1.9% ± 0.8% of the prescribed dose (pD) and that an average of 9% ± 4% of

  16. Reconstructing cone-beam CT with spatially varying qualities for adaptive radiotherapy: a proof-of-principle study.

    PubMed

    Lu, Wenting; Yan, Hao; Gu, Xuejun; Tian, Zhen; Luo, Ouyang; Yang, Liu; Zhou, Linghong; Cervino, Laura; Wang, Jing; Jiang, Steve; Jia, Xun

    2014-10-21

    With the aim of maximally reducing imaging dose while meeting requirements for adaptive radiation therapy (ART), we propose in this paper a new cone beam CT (CBCT) acquisition and reconstruction method that delivers images with a low noise level inside a region of interest (ROI) and a relatively high noise level outside the ROI. The acquired projection images include two groups: densely sampled projections at a low exposure with a large field of view (FOV) and sparsely sampled projections at a high exposure with a small FOV corresponding to the ROI. A new algorithm combining the conventional filtered back-projection algorithm and the tight-frame iterative reconstruction algorithm is also designed to reconstruct the CBCT based on these projection data. We have validated our method on a simulated head-and-neck (HN) patient case, a semi-real experiment conducted on a HN cancer patient under a full-fan scan mode, as well as a Catphan phantom under a half-fan scan mode. Relative root-mean-square errors (RRMSEs) of less than 3% for the entire image and ~1% within the ROI compared to the ground truth have been observed. These numbers demonstrate the ability of our proposed method to reconstruct high-quality images inside the ROI. As for the part outside ROI, although the images are relatively noisy, it can still provide sufficient information for radiation dose calculations in ART. Dose distributions calculated on our CBCT image and on a standard CBCT image are in agreement, with a mean relative difference of 0.082% inside the ROI and 0.038% outside the ROI. Compared with the standard clinical CBCT scheme, an imaging dose reduction of approximately 3-6 times inside the ROI was achieved, as well as an 8 times outside the ROI. Regarding computational efficiency, it takes 1-3 min to reconstruct a CBCT image depending on the number of projections used. These results indicate that the proposed method has the potential for application in ART.

  17. Reconstructing cone-beam CT with spatially varying qualities for adaptive radiotherapy: a proof-of-principle study

    NASA Astrophysics Data System (ADS)

    Lu, Wenting; Yan, Hao; Gu, Xuejun; Tian, Zhen; Ouyang, Luo; Yang, Liu; Zhou, Linghong; Cervino, Laura; Wang, Jing; Jiang, Steve; Jia, Xun

    2014-10-01

    With the aim of maximally reducing imaging dose while meeting requirements for adaptive radiation therapy (ART), we propose in this paper a new cone beam CT (CBCT) acquisition and reconstruction method that delivers images with a low noise level inside a region of interest (ROI) and a relatively high noise level outside the ROI. The acquired projection images include two groups: densely sampled projections at a low exposure with a large field of view (FOV) and sparsely sampled projections at a high exposure with a small FOV corresponding to the ROI. A new algorithm combining the conventional filtered back-projection algorithm and the tight-frame iterative reconstruction algorithm is also designed to reconstruct the CBCT based on these projection data. We have validated our method on a simulated head-and-neck (HN) patient case, a semi-real experiment conducted on a HN cancer patient under a full-fan scan mode, as well as a Catphan phantom under a half-fan scan mode. Relative root-mean-square errors (RRMSEs) of less than 3% for the entire image and ~1% within the ROI compared to the ground truth have been observed. These numbers demonstrate the ability of our proposed method to reconstruct high-quality images inside the ROI. As for the part outside ROI, although the images are relatively noisy, it can still provide sufficient information for radiation dose calculations in ART. Dose distributions calculated on our CBCT image and on a standard CBCT image are in agreement, with a mean relative difference of 0.082% inside the ROI and 0.038% outside the ROI. Compared with the standard clinical CBCT scheme, an imaging dose reduction of approximately 3-6 times inside the ROI was achieved, as well as an 8 times outside the ROI. Regarding computational efficiency, it takes 1-3 min to reconstruct a CBCT image depending on the number of projections used. These results indicate that the proposed method has the potential for application in ART.

  18. Reconstructing Cone-beam CT with Spatially Varying Qualities for Adaptive Radiotherapy, a Proof-of-Principle Study1

    PubMed Central

    Lu, Wenting; Yan, Hao; Gu, Xuejun; Tian, Zhen; Luo, Ouyang; Yang, Liu; Zhou, Linghong; Cervino, Laura; Wang, Jing; Jiang, Steve; Jia, Xun

    2014-01-01

    With the aim of maximally reducing imaging dose while meeting requirements for adaptive radiation therapy (ART), we propose in this paper a new cone beam CT (CBCT) acquisition and reconstruction method that delivers images with a low noise level inside a region of interest (ROI) and a relatively high noise level outside the ROI. The acquired projection images include two groups: densely sampled projections at a low exposure with a large field of view (FOV) and sparsely sampled projections at a high exposure with a small FOV corresponding to the ROI. A new algorithm combining the conventional filtered back-projection algorithm and the tight-frame iterative reconstruction algorithm is also designed to reconstruct the CBCT based on these projection data. We have validated our method on a simulated head-and-neck (HN) patient case, a semi-real experiment conducted on a HN cancer patient under a full-fan scan mode, as well as a Catphan phantom under a half-fan scan mode. Relative root-mean-square errors (RRMSE) of less than 3% for the entire image and ~1% within the ROI compared to the ground truth have been observed. These numbers demonstrate the ability of our proposed method to reconstruct high-quality images inside the ROI. As for the part outside ROI, although the images are relatively noisy, it can still provide sufficient information for radiation dose calculations in ART. Dose distributions calculated on our CBCT image and on a standard CBCT image are in agreement, with a mean relative difference of 0.082% inside the ROI and 0.038% outside the ROI. Compared with the standard clinical CBCT scheme, an imaging dose reduction of approximately 3–6 times inside the ROI was achieved, as well as an 8 times outside the ROI. Regarding computational efficiency, it takes 1–3 min to reconstruct a CBCT image depending on the number of projections used. These results indicate that the proposed method has the potential for application in ART. PMID:25255957

  19. Toward adaptive radiotherapy for head and neck patients: Feasibility study on using CT-to-CBCT deformable registration for “dose of the day” calculations

    SciTech Connect

    Veiga, Catarina Lourenço, Ana; Ricketts, Kate; Annkah, James; Royle, Gary; McClelland, Jamie; Modat, Marc; Ourselin, Sébastien; Moinuddin, Syed; D’Souza, Derek

    2014-03-15

    a replan CT. The DD is smaller than 2% of the prescribed dose on 90% of the body's voxels and it passes a 2% and 2 mm gamma-test on over 95% of the voxels. Target coverage similarity was assessed in terms of the 95%-isodose volumes. A mean value of 0.962 was obtained for the DSC, while the distance between surfaces is less than 2 mm in 95.4% of the pixels. The method proposed provided adequate dose estimation, closer to the gold standard than the other two approaches. Differences in DVH curves were mainly due to differences in the OARs definition (manual vs warped) and not due to differences in dose estimation (dose calculated in replan CT vs dose calculated in deformed CT). Conclusions: Deforming a planning CT to match a daily CBCT provides the tools needed for the calculation of the “dose of the day” without the need to acquire a new CT. The initial clinical application of our method will be weekly offline calculations of the “dose of the day,” and use this information to inform adaptive radiotherapy (ART). The work here presented is a first step into a full implementation of a “dose-driven” online ART.

  20. Evaluations of an adaptive planning technique incorporating dose feedback in image-guided radiotherapy of prostate cancer

    SciTech Connect

    Liu Han; Wu Qiuwen

    2011-12-15

    Purpose: Online image guidance (IG) has been used to effectively correct the setup error and inter-fraction rigid organ motion for prostate cancer. However, planning margins are still necessary to account for uncertainties such as deformation and intra-fraction motion. The purpose of this study is to investigate the effectiveness of an adaptive planning technique incorporating offline dose feedback to manage inter-fraction motion and residuals from online correction. Methods: Repeated helical CT scans from 28 patients were included in the study. The contours of prostate and organs-at-risk (OARs) were delineated on each CT, and online IG was simulated by matching center-of-mass of prostate between treatment CTs and planning CT. A seven beam intensity modulated radiation therapy (IMRT) plan was designed for each patient on planning CT for a total of 15 fractions. Dose distribution at each fraction was evaluated based on actual contours of the target and OARs from that fraction. Cumulative dose up to each fraction was calculated by tracking each voxel based on a deformable registration algorithm. The cumulative dose was compared with the dose from initial plan. If the deviation exceeded the pre-defined threshold, such as 2% of the D{sub 99} to the prostate, an adaptive planning technique called dose compensation was invoked, in which the cumulative dose distribution was fed back to the treatment planning system and the dose deficit was made up through boost radiation in future treatment fractions. The dose compensation was achieved by IMRT inverse planning. Two weekly compensation delivery strategies were simulated: one intended to deliver the boost dose in all future fractions (schedule A) and the other in the following week only (schedule B). The D{sub 99} to prostate and generalized equivalent uniform dose (gEUD) to rectal wall and bladder were computed and compared with those without the dose compensation. Results: If only 2% underdose is allowed at the end of the

  1. Proceedings I: State of the Arts Conference on Adapted Physical Education in Mississippi (January 19 and 20, 1979).

    ERIC Educational Resources Information Center

    Churton, Michael W., Ed.

    The proceedings of a conference on the state of the art in adapted physical education in Mississippi are presented. After the conference agenda and a list of the speakers and session leaders, an overview of the conference is provided. The conference was designed to produce data and information that could be used to facilitate programing, research,…

  2. The role of postoperative radiotherapy for stage I/II/III thymic tumor—results of the ChART retrospective database

    PubMed Central

    Liu, Qianwen; Gu, Zhitao; Yang, Fu; Shen, Yi; Wei, Yucheng; Tan, Lijie; Zhang, Peng; Han, Yongtao; Chen, Chun; Zhang, Renquan; Li, Yin; Chen, Keneng; Chen, Hezhong; Liu, Yongyu; Cui, Youbing; Wang, Yun; Pang, Liewen; Yu, Zhentao; Zhou, Xinming; Liu, Yangchun; Xiang, Jin; Liu, Yuan

    2016-01-01

    Background Postoperative radiotherapy (PORT) for thymic tumor is still controversial. The object of the study is to evaluate the role of PORT for stage I to III thymic tumors. Methods The Chinese Alliance for Research in Thymomas (ChART) was searched for patients with stage I to III thymic tumors who underwent surgical resection without neoajuvant therapy between 1994 and 2012. Univariate and multivariate survival analyses were performed. Cox proportional hazard model was used to determine the hazard ratio for death. Result From the ChART database, 1,546 stage I to III patients were identified. Among these patients, 649 (41.98%) received PORT. PORT was associated with gender, histological type (World Health Organization, WHO), thymectomy extent, resection status, Masaoka-Koga stage and adjuvant chemotherapy. The 5-year and 10-year overall survival (OS) rates and disease-free survival (DFS) rates for patients underwent surgery followed by PORT were 90% and 80%, 81% and 63%, comparing with 96% and 95%, 92% and 90% for patients underwent surgery alone (P=0.001, P<0.001) respectively. In univariate analysis, age, histological type (WHO), Masaoka-Koga stage, completeness of resection, and PORT were associated with OS. Multivariable analysis showed that histological type (WHO) (P=0.001), Masaoka-Koga stage (P=0.029) and completeness of resection (P=0.003) were independently prognostic factors of OS. In univariate analysis, gender, myasthenia gravis, histological subtype, Masaoka-Koga stage, surgical approach, PORT and completeness of resection were associated with DFS. Multivariate analysis showed that histological subtype (P<0.001), Masaoka-Koga stage (P=0.005) and completeness of resection (P=0.006) were independent prognostic factors for DFS. Subgroup analysis showed that patients with incomplete resection underwent PORT achieved better OS and DFS (P=0.010, 0.017, respectively). However, patients with complete resection underwent PORT had the worse OS and DFS (P<0

  3. MO-C-17A-13: Uncertainty Evaluation of CT Image Deformable Registration for H and N Cancer Adaptive Radiotherapy

    SciTech Connect

    Qin, A; Yan, D

    2014-06-15

    Purpose: To evaluate uncertainties of organ specific Deformable Image Registration (DIR) for H and N cancer Adaptive Radiation Therapy (ART). Methods: A commercial DIR evaluation tool, which includes a digital phantom library of 8 patients, and the corresponding “Ground truth Deformable Vector Field” (GT-DVF), was used in the study. Each patient in the phantom library includes the GT-DVF created from a pair of CT images acquired prior to and at the end of the treatment course. Five DIR tools, including 2 commercial tools (CMT1, CMT2), 2 in-house (IH-FFD1, IH-FFD2), and a classic DEMON algorithms, were applied on the patient images. The resulting DVF was compared to the GT-DVF voxel by voxel. Organ specific DVF uncertainty was calculated for 10 ROIs: Whole Body, Brain, Brain Stem, Cord, Lips, Mandible, Parotid, Esophagus and Submandibular Gland. Registration error-volume histogram was constructed for comparison. Results: The uncertainty is relatively small for brain stem, cord and lips, while large in parotid and submandibular gland. CMT1 achieved best overall accuracy (on whole body, mean vector error of 8 patients: 0.98±0.29 mm). For brain, mandible, parotid right, parotid left and submandibular glad, the classic Demon algorithm got the lowest uncertainty (0.49±0.09, 0.51±0.16, 0.46±0.11, 0.50±0.11 and 0.69±0.47 mm respectively). For brain stem, cord and lips, the DVF from CMT1 has the best accuracy (0.28±0.07, 0.22±0.08 and 0.27±0.12 mm respectively). All algorithms have largest right parotid uncertainty on patient #7, which has image artifact caused by tooth implantation. Conclusion: Uncertainty of deformable CT image registration highly depends on the registration algorithm, and organ specific. Large uncertainty most likely appears at the location of soft-tissue organs far from the bony structures. Among all 5 DIR methods, the classic DEMON and CMT1 seem to be the best to limit the uncertainty within 2mm for all OARs. Partially supported by

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

    PubMed Central

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

    2016-01-01

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

  5. A comparison between radiation therapists and medical specialists in the use of kilovoltage cone-beam computed tomography scans for potential lung cancer radiotherapy target verification and adaptation

    SciTech Connect

    Watt, Sandie Carolyn; Vinod, Shalini K.; Dimigen, Marion; Descallar, Joseph; Zogovic, Branimere; Atyeo, John; Wallis, Sian; Holloway, Lois C.

    2016-04-01

    Target volume matching using cone-beam computed tomography (CBCT) is the preferred treatment verification method for lung cancer in many centers. However, radiation therapists (RTs) are trained in bony matching and not soft tissue matching. The purpose of this study was to determine whether RTs were equivalent to radiation oncologists (ROs) and radiologists (RDs) in alignment of the treatment CBCT with the gross tumor volume (GTV) defined at planning and in delineating the GTV on the treatment CBCT, as may be necessary for adaptive radiotherapy. In this study, 10 RTs, 1 RO, and 1 RD performed a manual tumor alignment and correction of the planning GTV to a treatment CBCT to generate an isocenter correction distance for 15 patient data sets. Participants also contoured the GTV on the same data sets. The isocenter correction distance and the contoured GTVs from the RTs were compared with the RD and RO. The mean difference in isocenter correction distances was 0.40 cm between the RO and RD, 0.51 cm between the RTs, and RO and 0.42 cm between the RTs and RD. The 95% CIs were smaller than the equivalence limit of 0.5 cm, indicating that the RTs were equivalent to the RO and RD. For GTV delineation comparisons, the RTs were not found to be equivalent to the RD or RO. The alignment of the planning defined GTV and treatment CBCT using soft tissue matching by the RTs has been shown to be equivalent to those by the RO and RD. However, tumor delineation by the RTs on the treatment CBCT was not equivalent to that of the RO and RD. Thus, it may be appropriate for RTs to undertake soft tissue alignment based on CBCT; however, further investigation may be necessary before RTs undertake delineation for adaptive radiotherapy purposes.

  6. Late-Course Adaptive Adjustment Based on Metabolic Tumor Volume Changes during Radiotherapy May Reduce Radiation Toxicity in Patients with Non-Small Cell Lung Cancer

    PubMed Central

    Zhang, Guifang; Zhang, Hui; Gao, Song; Fu, Zheng; Wang, Suzhen; Yu, Qingxi; Yu, Jinming; Yuan, Shuanghu

    2017-01-01

    To reduce the high risk of radiation toxicity and enhance the quality of life of patients with non-small cell lung cancer (NSCLC), we quantified the metabolic tumor volumes (MTVs) from baseline to the late-course of radiotherapy (RT) by fluorodeoxyglucose positron emission tomography computerized tomography (FDG PET-CT) and discussed the potential benefit of late-course adaptive plans rather than original plans by dose volume histogram (DVH) comparisons. Seventeen patients with stage II-III NSCLC who were treated with definitive conventionally fractionated RT were eligible for this prospective study. FDG PET-CT scans were acquired within 1 week before RT (pre-RT) and at approximately two-thirds of the total dose during-RT (approximately 40 Gy). MTVs were taken as gross tumor volumes (GTVs) that included the primary tumor and any involved hilar or mediastinal lymph nodes. An original plan based on the baseline MTVs and adaptive plans based on observations during-RT MTVs were generated for each patient. The DVHs for lung, heart, esophagus and spinal cord were compared between the original plans and composite plans at 66 Gy. At the time of approximately 40 Gy during-RT, MTVs were significantly reduced in patients with NSCLC (pre-RT 136.2±82.3 ml vs. during-RT 64.7±68.0 ml, p = 0.001). The composite plan of the original plan at 40 Gy plus the adaptive plan at 26 Gy resulted in better DVHs for all the organs at risk that were evaluated compared to the original plan at 66 Gy (p<0.05), including V5, V10, V15, V20, V25, V30 and the mean dose of total lung, V10, V20, V30, V40, V50, V60 and the mean dose of heart, V35, V40, V50, V55, V60, the maximum dose and mean dose of the esophagus, and the maximum dose of the spinal-cord. PET-MTVs were reduced significantly at the time of approximately 40 Gy during-RT. Late course adaptive radiotherapy may be an effective way to reduce the dose volume to the organs at risk, thus reducing radiation toxicity in patients with NSCLC. PMID

  7. Late-Course Adaptive Adjustment Based on Metabolic Tumor Volume Changes during Radiotherapy May Reduce Radiation Toxicity in Patients with Non-Small Cell Lung Cancer.

    PubMed

    Xiao, Linlin; Liu, Ning; Zhang, Guifang; Zhang, Hui; Gao, Song; Fu, Zheng; Wang, Suzhen; Yu, Qingxi; Yu, Jinming; Yuan, Shuanghu

    2017-01-01

    To reduce the high risk of radiation toxicity and enhance the quality of life of patients with non-small cell lung cancer (NSCLC), we quantified the metabolic tumor volumes (MTVs) from baseline to the late-course of radiotherapy (RT) by fluorodeoxyglucose positron emission tomography computerized tomography (FDG PET-CT) and discussed the potential benefit of late-course adaptive plans rather than original plans by dose volume histogram (DVH) comparisons. Seventeen patients with stage II-III NSCLC who were treated with definitive conventionally fractionated RT were eligible for this prospective study. FDG PET-CT scans were acquired within 1 week before RT (pre-RT) and at approximately two-thirds of the total dose during-RT (approximately 40 Gy). MTVs were taken as gross tumor volumes (GTVs) that included the primary tumor and any involved hilar or mediastinal lymph nodes. An original plan based on the baseline MTVs and adaptive plans based on observations during-RT MTVs were generated for each patient. The DVHs for lung, heart, esophagus and spinal cord were compared between the original plans and composite plans at 66 Gy. At the time of approximately 40 Gy during-RT, MTVs were significantly reduced in patients with NSCLC (pre-RT 136.2±82.3 ml vs. during-RT 64.7±68.0 ml, p = 0.001). The composite plan of the original plan at 40 Gy plus the adaptive plan at 26 Gy resulted in better DVHs for all the organs at risk that were evaluated compared to the original plan at 66 Gy (p<0.05), including V5, V10, V15, V20, V25, V30 and the mean dose of total lung, V10, V20, V30, V40, V50, V60 and the mean dose of heart, V35, V40, V50, V55, V60, the maximum dose and mean dose of the esophagus, and the maximum dose of the spinal-cord. PET-MTVs were reduced significantly at the time of approximately 40 Gy during-RT. Late course adaptive radiotherapy may be an effective way to reduce the dose volume to the organs at risk, thus reducing radiation toxicity in patients with NSCLC.

  8. First Clinical Release of an Online, Adaptive, Aperture-Based Image-Guided Radiotherapy Strategy in Intensity-Modulated Radiotherapy to Correct for Inter- and Intrafractional Rotations of the Prostate

    SciTech Connect

    Deutschmann, Heinz; Kametriser, Gerhard; Steininger, Philipp; Scherer, Philipp; Schoeller, Helmut; Gaisberger, Christoph; Mooslechner, Michaela; Mitterlechner, Bernhard; Weichenberger, Harald; Fastner, Gert; Wurstbauer, Karl; Jeschke, Stephan; Forstner, Rosemarie; Sedlmayer, Felix

    2012-08-01

    Purpose: We developed and evaluated a correction strategy for prostate rotations using direct adaptation of segments in intensity-modulated radiotherapy (IMRT). Method and Materials: Implanted fiducials (four gold markers) were used to determine interfractional translations, rotations, and dilations of the prostate. We used hybrid imaging: The markers were automatically detected in two pretreatment planar X-ray projections; their actual position in three-dimensional space was reconstructed from these images at first. The structure set comprising prostate, seminal vesicles, and adjacent rectum wall was transformed accordingly in 6 degrees of freedom. Shapes of IMRT segments were geometrically adapted in a class solution forward-planning approach, derived within seconds on-site and treated immediately. Intrafractional movements were followed in MV electronic portal images captured on the fly. Results: In 31 of 39 patients, for 833 of 1013 fractions (supine, flat couch, knee support, comfortably full bladder, empty rectum, no intraprostatic marker migrations >2 mm of more than one marker), the online aperture adaptation allowed safe reduction of margins clinical target volume-planning target volume (prostate) down to 5 mm when only interfractional corrections were applied: Dominant L-R rotations were found to be 5.3 Degree-Sign (mean of means), standard deviation of means {+-}4.9 Degree-Sign , maximum at 30.7 Degree-Sign . Three-dimensional vector translations relative to skin markings were 9.3 {+-} 4.4 mm (maximum, 23.6 mm). Intrafractional movements in 7.7 {+-} 1.5 min (maximum, 15.1 min) between kV imaging and last beam's electronic portal images showed further L-R rotations of 2.5 Degree-Sign {+-} 2.3 Degree-Sign (maximum, 26.9 Degree-Sign ), and three-dimensional vector translations of 3.0 {+-}3.7 mm (maximum, 10.2 mm). Addressing intrafractional errors could further reduce margins to 3 mm. Conclusion: We demonstrated the clinical feasibility of an online

  9. Four and five dimensional radiotherapy with reference to prostate cancer--definitions, state of the art and further directions--an overview.

    PubMed

    Lennernäs, Bo; Castellanos, Enrique; Nilsson, Sten; Levitt, Seymour

    2011-06-01

    Radiotherapy (RT) always requires a compromise between tumor control and normal tissue side-effects. Technical innovation in radiation therapy (RT), such as three dimensional RT, is now established. Concerning prostate cancer (PC), it is reasonable to assume that RT of PC will increase in the future. The combination of small margins, a movable target (prostate), few fractions and high doses will probably demand dynamically positioning systems and in real time. This is called four dimensional radiotherapy (4DRT). Moreover, biological factors must be included in new treatments such as hypofractionation schedules. This new era is called five dimensional radiotherapy, 5DRT. In this paper we discuss new concepts in RT in respect to PC.

  10. Adapting Language Arts, Social Studies, and Science Materials for the Inclusive Classroom. ERIC/OSEP Digest.

    ERIC Educational Resources Information Center

    Lenz, Keith; Schumaker, Jean

    This digest, based on a larger publication of the same title, offers a nine-step process for planning and implementing adaptations to instructional materials for students with disabilities in the inclusive classroom. Introductory material notes that adaptations should be approached as a short-term solution to increase access to the curriculum and…

  11. Adaptive Teaching for English Language Arts: Following the Pathway of Classroom Data in Preservice Teacher Inquiry

    ERIC Educational Resources Information Center

    Athanases, Steven Z.; Bennett, Lisa H.; Wahleithner, Juliet Michelsen

    2015-01-01

    Consensus exists that effective teaching includes capacity to adapt instruction to respond to student learning challenges as they arise. Adaptive teachers may keep pace with rapidly evolving youth literacies and students' increasing cultural and linguistic diversity. Teachers are challenged to critically examine pedagogy when some contexts expect…

  12. Clinical outcome of protocol based image (MRI) guided adaptive brachytherapy combined with 3D conformal radiotherapy with or without chemotherapy in patients with locally advanced cervical cancer

    PubMed Central

    Pötter, Richard; Georg, Petra; Dimopoulos, Johannes C.A.; Grimm, Magdalena; Berger, Daniel; Nesvacil, Nicole; Georg, Dietmar; Schmid, Maximilian P.; Reinthaller, Alexander; Sturdza, Alina; Kirisits, Christian

    2011-01-01

    Background To analyse the overall clinical outcome and benefits by applying protocol based image guided adaptive brachytherapy combined with 3D conformal external beam radiotherapy (EBRT) ± chemotherapy (ChT). Methods Treatment schedule was EBRT with 45–50.4 Gy ± concomitant cisplatin chemotherapy plus 4 × 7 Gy High Dose Rate (HDR) brachytherapy. Patients were treated in the “protocol period” (2001–2008) with the prospective application of the High Risk CTV concept (D90) and dose volume constraints for organs at risk including biological modelling. Dose volume adaptation was performed with the aim of dose escalation in large tumours (prescribed D90 > 85 Gy), often with inserting additional interstitial needles. Dose volume constraints (D2cc) were 70–75 Gy for rectum and sigmoid and 90 Gy for bladder. Late morbidity was prospectively scored, using LENT/SOMA Score. Disease outcome and treatment related late morbidity were evaluated and compared using actuarial analysis. Findings One hundred and fifty-six consecutive patients (median age 58 years) with cervix cancer FIGO stages IB–IVA were treated with definitive radiotherapy in curative intent. Histology was squamous cell cancer in 134 patients (86%), tumour size was >5 cm in 103 patients (66%), lymph node involvement in 75 patients (48%). Median follow-up was 42 months for all patients. Interstitial techniques were used in addition to intracavitary brachytherapy in 69/156 (44%) patients. Total prescribed mean dose (D90) was 93 ± 13 Gy, D2cc 86 ± 17 Gy for bladder, 65 ± 9 Gy for rectum and 64 ± 9 Gy for sigmoid. Complete remission was achieved in 151/156 patients (97%). Overall local control at 3 years was 95%; 98% for tumours 2–5 cm, and 92% for tumours >5 cm (p = 0.04), 100% for IB, 96% for IIB, 86% for IIIB. Cancer specific survival at 3 years was overall 74%, 83% for tumours 2–5 cm, 70% for tumours >5 cm, 83% for IB, 84% for IIB, 52% for IIIB. Overall

  13. Is Consciousness Necessary for Conflict Adaptation? A State of the Art

    PubMed Central

    Desender, Kobe; Van den Bussche, Eva

    2012-01-01

    Facing response conflict, subjects try to improve their responses by reducing the influence of the detrimental information which caused the conflict. It was speculated that this adaptation to conflict can only occur when the conflicting information is consciously perceived. In this review we give an overview of the research looking at the possibility of unconscious stimuli to provoke this conflict adaptation. In a first part we discuss adaptation to conflict on a trial-by-trial basis. When the previous trial contained conflicting information, subjects will adapt to this by reducing the influence of the conflicting information on the current trial. However, the interesting question is whether this is also possible when the conflicting information remains unconscious. In a second part we will discuss blockwise adaptation to conflict. If conflict is very frequent, subjects will adapt to this by reducing the conflicting information sustainably. Again the question is whether this is possible when the conflict was never experienced consciously. In a third part we will discuss the neural basis of conscious and unconscious conflict adaptation. We will critically discuss the research on these topics and highlight strengths and weaknesses of the used paradigms. Finally, we will give some suggestions how future research can be more conclusive in this respect. PMID:22347176

  14. Adapting Language Arts, Social Studies, and Science Materials for the Inclusive Classroom. Volume 3: Grades Six through Eight. ERIC/OSEP Mini-Library.

    ERIC Educational Resources Information Center

    Schumaker, Jean; Lenz, Keith

    This book offers teachers guidelines and suggestions for adapting and/or selecting materials for use with students with disabilities in general language arts, social studies, and science classrooms (grades 6 through 8). Following an introduction, chapter 1 offers a nine-step procedure for adapting materials from first, creating a plan for adapting…

  15. MO-C-17A-06: Online Adaptive Re-Planning to Account for Independent Motions Between Multiple Targets During Radiotherapy of Lung Cancer

    SciTech Connect

    Liu, F; Tai, A; Ahunbay, E; Gore, E; Johnstone, C; Li, X

    2014-06-15

    Purpose: To quantify interfractional independent motions between multiple targets in radiotherapy (RT) of lung cancer, and to study the dosimetric benefits of an online adaptive replanning method to account for these variations. Methods: Ninety five diagnostic-quality daily CTs acquired for 9 lung cancer patients treated with IGRT using an in-room CT (CTVision, Siemens) were analyzed. On each daily CT set, contours of the targets (GTV, CTV, or involved nodes) and organs at risk were generated by populating the planning contours using an auto-segmentation tool (ABAS, Elekta) with manual editing. For each patient, an IMRT plan was generated based on the planning CT with a prescription dose of 60 Gy in 2Gy fractions. Three plans were generated and compared for each daily CT set: an IGRT (repositioning) plan by copying the original plan with the required shifts, an online adaptive plan by rapidly modifying the aperture shapes and segment weights of the original plan to conform to the daily anatomy, and a new fully re-optimized plan based on the daily CT using a planning system (Panther, Prowess). Results: The daily deviations of the distance between centers of masses of the targets from the plans varied daily from -10 to 8 mm with an average −0.9±4.1 mm (one standard deviation). The average CTV V100 are 99.0±0.7%, 97.9±2.8%, 99.0±0.6%, and 99.1±0.6%, and the lung V20 Gy 928±332 cc, 944±315 cc, 917±300 cc, and 891±295 cc for the original, repositioning, adaptive, and re-optimized plans, respectively. Wilcoxon signed-rank tests show that the adaptive plans are statistically significantly better than the repositioning plans and comparable with the reoptimized plans. Conclusion: There exist unpredictable, interfractional, relative volume changes and independent motions between multiple targets during lung cancer RT which cannot be accounted for by the current IGRT repositioning but can be corrected by the online adaptive replanning method.

  16. Individualized Nonadaptive and Online-Adaptive Intensity-Modulated Radiotherapy Treatment Strategies for Cervical Cancer Patients Based on Pretreatment Acquired Variable Bladder Filling Computed Tomography Scans

    SciTech Connect

    Bondar, M.L.; Hoogeman, M.S.; Mens, J.W.; Quint, S.; Ahmad, R.; Dhawtal, G.; Heijmen, B.J.

    2012-08-01

    bladder and rectum inside the PTV (0% to 10% and -1% to 9%; p < 0.004) and the CTV-to-PTV volume (4-96 ml). Conclusions: Compared with population-based margins, an individualized PTV results in better organ-at-risk sparing. Online-adaptive radiotherapy further improves organ-at-risk sparing.

  17. SU-E-J-67: Evaluation of Adaptive MLC Morphing for Online Correction of Prostate Cancer Radiotherapy

    SciTech Connect

    Sandhu, R; Qin, A; Yan, D

    2015-06-15

    Purpose: Online adaptive MLC morphing is desirable over translational couch shifts to accommodate target position as well as anatomic changes. A reliable method of adaptive MLC segment to target during prostate cancer IMRT treatment is proposed and evaluated by comparison with daily online-image guidance (IGRT) correction and online-IMRT planning. Methods: The MLC adaptive algorithm involves following steps; move the MLC segments according to target translational shifts, and then morph the segment shape to maintain the spatial relationship between the planning-target contour and MLC segment. Efficacy of this method was evaluated retrospectively using daily-CBCT images on seven prostate patients treated with seven-beam IMRT treatment to deliver 64Gy in 20 fractions. Daily modification was simulated with three approaches; daily-IGRT correction based on implanted radio-markers, adaptive MLC morphing, and online-IMRT planning, with no-residual variation. The selected dosimetric endpoints and nEUD (normalized equivalent uniform dose to online-IMRT planning) of each organ of interest were determined for evaluation and comparison. Results: For target(prostate), bladder and rectal-wall, the mean±sd of nEUD were 97.6%+3.2%, 103.9%±4.9% and 97.4%±1.1% for daily-IGRT correction; and 100.2%+0.2%, 108.9%±5.1% and 99.8%±1.2% for adaptive MLC morphing, respectively. For daily-IGRT correction, adaptive MLC morphing and online-IMRT planning, target D99 was <95% of the prescription dose in 30%, 0% and 0% of 140 fractions, respectively. For the rectal-wall, D5 exceeded 105% of the planned-D5 in 2.8%, 11.4% and 0% of 140 fractions, respectively. For the bladder, Dmax exceeded 105% of the planned-D5 in 2.8%, 5.6% and 0% of 140 fractions, respectively. D30 of bladder and rectal-wall were well within the planned-D30 for all three approaches. Conclusion: The proposed method of adaptive MLC morphing can be beneficial for the prostate patient population with large deformation and

  18. Moving Adapted Physical Activity: The Possibilities of Arts-Based Research

    ERIC Educational Resources Information Center

    Eales, Lindsay; Peers, Danielle

    2016-01-01

    Where is the moving body in our written bodies of work? How might we articulate truly unspeakable and deeply moving moments of understanding? In what ways can we reflect and honor the knowledge of those who do not use academic words, English words, or any words at all? How might art move us to answer these questions differently--and more…

  19. Adaptive Transcutaneous Power Transfer to Implantable Devices: A State of the Art Review

    PubMed Central

    Bocan, Kara N.; Sejdić, Ervin

    2016-01-01

    Wireless energy transfer is a broad research area that has recently become applicable to implantable medical devices. Wireless powering of and communication with implanted devices is possible through wireless transcutaneous energy transfer. However, designing wireless transcutaneous systems is complicated due to the variability of the environment. The focus of this review is on strategies to sense and adapt to environmental variations in wireless transcutaneous systems. Adaptive systems provide the ability to maintain performance in the face of both unpredictability (variation from expected parameters) and variability (changes over time). Current strategies in adaptive (or tunable) systems include sensing relevant metrics to evaluate the function of the system in its environment and adjusting control parameters according to sensed values through the use of tunable components. Some challenges of applying adaptive designs to implantable devices are challenges common to all implantable devices, including size and power reduction on the implant, efficiency of power transfer and safety related to energy absorption in tissue. Challenges specifically associated with adaptation include choosing relevant and accessible parameters to sense and adjust, minimizing the tuning time and complexity of control, utilizing feedback from the implanted device and coordinating adaptation at the transmitter and receiver. PMID:26999154

  20. Direct Adaptive Control of Systems with Actuator Failures: State of the Art and Continuing Challenges

    NASA Technical Reports Server (NTRS)

    Tao, Gang; Joshi, Suresh M.

    2008-01-01

    In this paper, the problem of controlling systems with failures and faults is introduced, and an overview of recent work on direct adaptive control for compensation of uncertain actuator failures is presented. Actuator failures may be characterized by some unknown system inputs being stuck at some unknown (fixed or varying) values at unknown time instants, that cannot be influenced by the control signals. The key task of adaptive compensation is to design the control signals in such a manner that the remaining actuators can automatically and seamlessly take over for the failed ones, and achieve desired stability and asymptotic tracking. A certain degree of redundancy is necessary to accomplish failure compensation. The objective of adaptive control design is to effectively use the available actuation redundancy to handle failures without the knowledge of the failure patterns, parameters, and time of occurrence. This is a challenging problem because failures introduce large uncertainties in the dynamic structure of the system, in addition to parametric uncertainties and unknown disturbances. The paper addresses some theoretical issues in adaptive actuator failure compensation: actuator failure modeling, redundant actuation requirements, plant-model matching, error system dynamics, adaptation laws, and stability, tracking, and performance analysis. Adaptive control designs can be shown to effectively handle uncertain actuator failures without explicit failure detection. Some open technical challenges and research problems in this important research area are discussed.

  1. SU-E-J-151: Dosimetric Evaluation of DIR Mapped Contours for Image Guided Adaptive Radiotherapy with 4D Cone-Beam CT

    SciTech Connect

    Balik, S; Weiss, E; Williamson, J; Hugo, G; Jan, N; Zhang, L; Roman, N; Christensen, G

    2014-06-01

    Purpose: To estimate dosimetric errors resulting from using contours deformably mapped from planning CT to 4D cone beam CT (CBCT) images for image-guided adaptive radiotherapy of locally advanced non-small cell lung cancer (NSCLC). Methods: Ten locally advanced non-small cell lung cancer (NSCLC) patients underwent one planning 4D fan-beam CT (4DFBCT) and weekly 4DCBCT scans. Multiple physicians delineated the gross tumor volume (GTV) and normal structures in planning CT images and only GTV in CBCT images. Manual contours were mapped from planning CT to CBCTs using small deformation, inverse consistent linear elastic (SICLE) algorithm for two scans in each patient. Two physicians reviewed and rated the DIR-mapped (auto) and manual GTV contours as clinically acceptable (CA), clinically acceptable after minor modification (CAMM) and unacceptable (CU). Mapped normal structures were visually inspected and corrected if necessary, and used to override tissue density for dose calculation. CTV (6mm expansion of GTV) and PTV (5mm expansion of CTV) were created. VMAT plans were generated using the DIR-mapped contours to deliver 66 Gy in 33 fractions with 95% and 100% coverage (V66) to PTV and CTV, respectively. Plan evaluation for V66 was based on manual PTV and CTV contours. Results: Mean PTV V66 was 84% (range 75% – 95%) and mean CTV V66 was 97% (range 93% – 100%) for CAMM scored plans (12 plans); and was 90% (range 80% – 95%) and 99% (range 95% – 100%) for CA scored plans (7 plans). The difference in V66 between CAMM and CA was significant for PTV (p = 0.03) and approached significance for CTV (p = 0.07). Conclusion: The quality of DIR-mapped contours directly impacted the plan quality for 4DCBCT-based adaptation. Larger safety margins may be needed when planning with auto contours for IGART with 4DCBCT images. Reseach was supported by NIH P01CA116602.

  2. Influence of reconstruction settings on the performance of adaptive thresholding algorithms for FDG-PET image segmentation in radiotherapy planning.

    PubMed

    Matheoud, Roberta; Della Monica, Patrizia; Loi, Gianfranco; Vigna, Luca; Krengli, Marco; Inglese, Eugenio; Brambilla, Marco

    2011-01-30

    The purpose of this study was to analyze the behavior of a contouring algorithm for PET images based on adaptive thresholding depending on lesions size and target-to-background (TB) ratio under different conditions of image reconstruction parameters. Based on this analysis, the image reconstruction scheme able to maximize the goodness of fit of the thresholding algorithm has been selected. A phantom study employing spherical targets was designed to determine slice-specific threshold (TS) levels which produce accurate cross-sectional areas. A wide range of TB ratio was investigated. Multiple regression methods were used to fit the data and to construct algorithms depending both on target cross-sectional area and TB ratio, using various reconstruction schemes employing a wide range of iteration number and amount of postfiltering Gaussian smoothing. Analysis of covariance was used to test the influence of iteration number and smoothing on threshold determination. The degree of convergence of ordered-subset expectation maximization (OSEM) algorithms does not influence TS determination. Among these approaches, the OSEM at two iterations and eight subsets with a 6-8 mm post-reconstruction Gaussian three-dimensional filter provided the best fit with a coefficient of determination R² = 0.90 for cross-sectional areas ≤ 133 mm² and R² = 0.95 for cross-sectional areas > 133 mm². The amount of post-reconstruction smoothing has been directly incorporated in the adaptive thresholding algorithms. The feasibility of the method was tested in two patients with lymph node FDG accumulation and in five patients using the bladder to mimic an anatomical structure of large size and uniform uptake, with satisfactory results. Slice-specific adaptive thresholding algorithms look promising as a reproducible method for delineating PET target volumes with good accuracy.

  3. Sen and the Art of Motorcycle Maintenance: Adaptive Preferences and Higher Education

    ERIC Educational Resources Information Center

    Watts, Michael

    2009-01-01

    Adaptive preferences are both a central justification and continuing problem for the use of the capability approach. They are illustrated here with reference to a project examining the choices of young people who had rejected higher education. Jon Elster, Amartya Sen and Martha Nussbaum have all criticised utilitarianism on the grounds that a…

  4. What Price PSAs? The Art of Adapting Your Information to the Needs of Broadcasters.

    ERIC Educational Resources Information Center

    Gardner, Gene

    1981-01-01

    Suggestions are offered for colleges interested in making their publicity pieces adapt to the needs of broadcasters. Eight tips are offered: do not try to cover everything in one spot; tell a story; try to go on location; select the right talent; use time wisely; use humor if appropriate; be seasonal; and learn from professionals. (LC)

  5. Dosimetric and geometric evaluation of the use of deformable image registration in adaptive intensity-modulated radiotherapy for head-and-neck cancer

    PubMed Central

    Eiland, R.B.; Maare, C.; Sjöström, D.; Samsøe, E.; Behrens, C.F.

    2014-01-01

    The aim of this study was to carry out geometric and dosimetric evaluation of the usefulness of a deformable image registration algorithm utilized for adaptive head-and-neck intensity-modulated radiotherapy. Data consisted of seven patients, each with a planning CT (pCT), a rescanning CT (ReCT) and a cone beam CT (CBCT). The CBCT was acquired on the same day (±1 d) as the ReCT (i.e. at Fraction 17, 18, 23, 24 or 29). The ReCT served as ground truth. A deformed CT (dCT) with structures was created by deforming the pCT to the CBCT. The geometrical comparison was based on the volumes of the deformed, and the manually delineated structures on the ReCT. Likewise, the center of mass shift (CMS) and the Dice similarity coefficient were determined. The dosimetric comparison was performed by recalculating the initial treatment plan on the dCT and the ReCT. Dose–volume histogram (DVH) points and a range of conformity measures were used for the evaluation. We found a significant difference in the median volume of the dCT relative to that of the ReCT. Median CMS values were ∼2–5 mm, except for the spinal cord, where the median CMS was 8 mm. Dosimetric evaluation of target structures revealed small differences, while larger differences were observed for organs at risk. The deformed structures cannot fully replace manually delineated structures. Based on both geometrical and dosimetrical measures, there is a tendency for the dCT to overestimate the need for replanning, compared with the ReCT. PMID:24907340

  6. Deformable image registration based automatic CT-to-CT contour propagation for head and neck adaptive radiotherapy in the routine clinical setting

    SciTech Connect

    Kumarasiri, Akila Siddiqui, Farzan; Liu, Chang; Yechieli, Raphael; Shah, Mira; Pradhan, Deepak; Zhong, Hualiang; Chetty, Indrin J.; Kim, Jinkoo

    2014-12-15

    Purpose: To evaluate the clinical potential of deformable image registration (DIR)-based automatic propagation of physician-drawn contours from a planning CT to midtreatment CT images for head and neck (H and N) adaptive radiotherapy. Methods: Ten H and N patients, each with a planning CT (CT1) and a subsequent CT (CT2) taken approximately 3–4 week into treatment, were considered retrospectively. Clinically relevant organs and targets were manually delineated by a radiation oncologist on both sets of images. Four commercial DIR algorithms, two B-spline-based and two Demons-based, were used to deform CT1 and the relevant contour sets onto corresponding CT2 images. Agreement of the propagated contours with manually drawn contours on CT2 was visually rated by four radiation oncologists in a scale from 1 to 5, the volume overlap was quantified using Dice coefficients, and a distance analysis was done using center of mass (CoM) displacements and Hausdorff distances (HDs). Performance of these four commercial algorithms was validated using a parameter-optimized Elastix DIR algorithm. Results: All algorithms attained Dice coefficients of >0.85 for organs with clear boundaries and those with volumes >9 cm{sup 3}. Organs with volumes <3 cm{sup 3} and/or those with poorly defined boundaries showed Dice coefficients of ∼0.5–0.6. For the propagation of small organs (<3 cm{sup 3}), the B-spline-based algorithms showed higher mean Dice values (Dice = 0.60) than the Demons-based algorithms (Dice = 0.54). For the gross and planning target volumes, the respective mean Dice coefficients were 0.8 and 0.9. There was no statistically significant difference in the Dice coefficients, CoM, or HD among investigated DIR algorithms. The mean radiation oncologist visual scores of the four algorithms ranged from 3.2 to 3.8, which indicated that the quality of transferred contours was “clinically acceptable with minor modification or major modification in a small number of contours

  7. SU-E-J-109: Evaluation of Deformable Accumulated Parotid Doses Using Different Registration Algorithms in Adaptive Head and Neck Radiotherapy

    SciTech Connect

    Xu, S; Liu, B

    2015-06-15

    Purpose: Three deformable image registration (DIR) algorithms are utilized to perform deformable dose accumulation for head and neck tomotherapy treatment, and the differences of the accumulated doses are evaluated. Methods: Daily MVCT data for 10 patients with pathologically proven nasopharyngeal cancers were analyzed. The data were acquired using tomotherapy (TomoTherapy, Accuray) at the PLA General Hospital. The prescription dose to the primary target was 70Gy in 33 fractions.Three DIR methods (B-spline, Diffeomorphic Demons and MIMvista) were used to propagate parotid structures from planning CTs to the daily CTs and accumulate fractionated dose on the planning CTs. The mean accumulated doses of parotids were quantitatively compared and the uncertainties of the propagated parotid contours were evaluated using Dice similarity index (DSI). Results: The planned mean dose of the ipsilateral parotids (32.42±3.13Gy) was slightly higher than those of the contralateral parotids (31.38±3.19Gy)in 10 patients. The difference between the accumulated mean doses of the ipsilateral parotids in the B-spline, Demons and MIMvista deformation algorithms (36.40±5.78Gy, 34.08±6.72Gy and 33.72±2.63Gy ) were statistically significant (B-spline vs Demons, P<0.0001, B-spline vs MIMvista, p =0.002). And The difference between those of the contralateral parotids in the B-spline, Demons and MIMvista deformation algorithms (34.08±4.82Gy, 32.42±4.80Gy and 33.92±4.65Gy ) were also significant (B-spline vs Demons, p =0.009, B-spline vs MIMvista, p =0.074). For the DSI analysis, the scores of B-spline, Demons and MIMvista DIRs were 0.90, 0.89 and 0.76. Conclusion: Shrinkage of parotid volumes results in the dose increase to the parotid glands in adaptive head and neck radiotherapy. The accumulated doses of parotids show significant difference using the different DIR algorithms between kVCT and MVCT. Therefore, the volume-based criterion (i.e. DSI) as a quantitative evaluation of

  8. SU-E-J-08: A Hybrid Three Dimensional Registration Framework for Image-Guided Accurate Radiotherapy System ARTS-IGRT

    SciTech Connect

    Wu, Q; Pei, X; Cao, R; Hu, L; Wu, Y

    2014-06-01

    Purpose: The purpose of this work was to develop a registration framework and method based on the software platform of ARTS-IGRT and implement in C++ based on ITK libraries to register CT images and CBCT images. ARTS-IGRT was a part of our self-developed accurate radiation planning system ARTS. Methods: Mutual information (MI) registration treated each voxel equally. Actually, different voxels even having same intensity should be treated differently in the registration procedure. According to their importance values calculated from self-information, a similarity measure was proposed which combined the spatial importance of a voxel with MI (S-MI). For lung registration, Firstly, a global alignment method was adopted to minimize the margin error and achieve the alignment of these two images on the whole. The result obtained at the low resolution level was then interpolated to become the initial conditions for the higher resolution computation. Secondly, a new similarity measurement S-MI was established to quantify how close the two input image volumes were to each other. Finally, Demons model was applied to compute the deformable map. Results: Registration tools were tested for head-neck and lung images and the average region was 128*128*49. The rigid registration took approximately 2 min and converged 10% faster than traditional MI algorithm, the accuracy reached 1mm for head-neck images. For lung images, the improved symmetric Demons registration process was completed in an average of 5 min using a 2.4GHz dual core CPU. Conclusion: A registration framework was developed to correct patient's setup according to register the planning CT volume data and the daily reconstructed 3D CBCT data. The experiments showed that the spatial MI algorithm can be adopted for head-neck images. The improved Demons deformable registration was more suitable to lung images, and rigid alignment should be applied before deformable registration to get more accurate result. Supported by

  9. Adaptation.

    PubMed

    Broom, Donald M

    2006-01-01

    The term adaptation is used in biology in three different ways. It may refer to changes which occur at the cell and organ level, or at the individual level, or at the level of gene action and evolutionary processes. Adaptation by cells, especially nerve cells helps in: communication within the body, the distinguishing of stimuli, the avoidance of overload and the conservation of energy. The time course and complexity of these mechanisms varies. Adaptive characters of organisms, including adaptive behaviours, increase fitness so this adaptation is evolutionary. The major part of this paper concerns adaptation by individuals and its relationships to welfare. In complex animals, feed forward control is widely used. Individuals predict problems and adapt by acting before the environmental effect is substantial. Much of adaptation involves brain control and animals have a set of needs, located in the brain and acting largely via motivational mechanisms, to regulate life. Needs may be for resources but are also for actions and stimuli which are part of the mechanism which has evolved to obtain the resources. Hence pigs do not just need food but need to be able to carry out actions like rooting in earth or manipulating materials which are part of foraging behaviour. The welfare of an individual is its state as regards its attempts to cope with its environment. This state includes various adaptive mechanisms including feelings and those which cope with disease. The part of welfare which is concerned with coping with pathology is health. Disease, which implies some significant effect of pathology, always results in poor welfare. Welfare varies over a range from very good, when adaptation is effective and there are feelings of pleasure or contentment, to very poor. A key point concerning the concept of individual adaptation in relation to welfare is that welfare may be good or poor while adaptation is occurring. Some adaptation is very easy and energetically cheap and

  10. Long-Term Follow-Up of Dose-Adapted and Reduced-Field Radiotherapy With or Without Chemotherapy for Central Nervous System Germinoma

    SciTech Connect

    Jensen, Ashley W.; Issa Laack, Nadia N.; Buckner, Jan C.; Schomberg, Paula J.; Wetmore, Cynthia J.; Brown, Paul D.

    2010-08-01

    Purpose: To update our institutional experience with neoadjuvant chemotherapy and minimized radiotherapy vs. radiation monotherapy for intracranial germinoma. Methods and Materials: We retrospectively reviewed records of 59 patients with diagnosis of primary intracranial germinoma between 1977 and 2007. Treatment was irradiation alone or neoadjuvant platinum-based chemotherapy and local irradiation (initial tumor plus margin) for patients with localized complete response and reduced-dose craniospinal irradiation for others. Results: For the chemoradiotherapy group (n = 28), median follow-up was 7 years. No patient died. The freedom from progression (FFP) rate was 88% at 5 years and 80% at 10 years. In 4 patients, disease recurred 1.1 to 6.8 years after diagnosis. All were young male patients who received 30.6 Gy to local fields after complete response to chemotherapy. The FFP rate was 88% for local irradiation vs. 100% for more extensive fields (p = .06). For the radiotherapy-alone group (n = 31), median follow-up was 15 years. Overall and disease-free survival rates were 93% and 93% at 5 years and 90% and 87% at 15 years. In 5 patients, disease recurred 1.1 to 4.9 years after diagnosis. Most patients in this group were young men 18 to 23 years of age with suprasellar primary disease treated with about 50 Gy to local fields. The FFP rate was 44% for local irradiation vs. 100% for more extensive fields (p < .01). Conclusions: The addition of neoadjuvant chemotherapy to local-field radiotherapy reduced central nervous system cancer recurrence when high-risk patients were excluded by thorough pretreatment staging. There was trend toward improved central nervous system tumor control when larger fields (whole brain, whole ventricle, or craniospinal axis) were used.

  11. TOPICAL REVIEW: Anatomical imaging for radiotherapy

    NASA Astrophysics Data System (ADS)

    Evans, Philip M.

    2008-06-01

    The goal of radiation therapy is to achieve maximal therapeutic benefit expressed in terms of a high probability of local control of disease with minimal side effects. Physically this often equates to the delivery of a high dose of radiation to the tumour or target region whilst maintaining an acceptably low dose to other tissues, particularly those adjacent to the target. Techniques such as intensity modulated radiotherapy (IMRT), stereotactic radiosurgery and computer planned brachytherapy provide the means to calculate the radiation dose delivery to achieve the desired dose distribution. Imaging is an essential tool in all state of the art planning and delivery techniques: (i) to enable planning of the desired treatment, (ii) to verify the treatment is delivered as planned and (iii) to follow-up treatment outcome to monitor that the treatment has had the desired effect. Clinical imaging techniques can be loosely classified into anatomic methods which measure the basic physical characteristics of tissue such as their density and biological imaging techniques which measure functional characteristics such as metabolism. In this review we consider anatomical imaging techniques. Biological imaging is considered in another article. Anatomical imaging is generally used for goals (i) and (ii) above. Computed tomography (CT) has been the mainstay of anatomical treatment planning for many years, enabling some delineation of soft tissue as well as radiation attenuation estimation for dose prediction. Magnetic resonance imaging is fast becoming widespread alongside CT, enabling superior soft-tissue visualization. Traditionally scanning for treatment planning has relied on the use of a single snapshot scan. Recent years have seen the development of techniques such as 4D CT and adaptive radiotherapy (ART). In 4D CT raw data are encoded with phase information and reconstructed to yield a set of scans detailing motion through the breathing, or cardiac, cycle. In ART a set of

  12. Bystander effects and radiotherapy.

    PubMed

    Marín, Alicia; Martín, Margarita; Liñán, Olga; Alvarenga, Felipe; López, Mario; Fernández, Laura; Büchser, David; Cerezo, Laura

    2015-01-01

    Radiation-induced bystander effects are defined as biological effects expressed after irradiation by cells whose nuclei have not been directly irradiated. These effects include DNA damage, chromosomal instability, mutation, and apoptosis. There is considerable evidence that ionizing radiation affects cells located near the site of irradiation, which respond individually and collectively as part of a large interconnected web. These bystander signals can alter the dynamic equilibrium between proliferation, apoptosis, quiescence or differentiation. The aim of this review is to examine the most important biological effects of this phenomenon with regard to areas of major interest in radiotherapy. Such aspects include radiation-induced bystander effects during the cell cycle under hypoxic conditions when administering fractionated modalities or combined radio-chemotherapy. Other relevant aspects include individual variation and genetics in toxicity of bystander factors and normal tissue collateral damage. In advanced radiotherapy techniques, such as intensity-modulated radiation therapy (IMRT), the high degree of dose conformity to the target volume reduces the dose and, therefore, the risk of complications, to normal tissues. However, significant doses can accumulate out-of-field due to photon scattering and this may impact cellular response in these regions. Protons may offer a solution to reduce out-of-field doses. The bystander effect has numerous associated phenomena, including adaptive response, genomic instability, and abscopal effects. Also, the bystander effect can influence radiation protection and oxidative stress. It is essential that we understand the mechanisms underlying the bystander effect in order to more accurately assess radiation risk and to evaluate protocols for cancer radiotherapy.

  13. Imaging Instrumentation and Techniques for Precision Radiotherapy

    NASA Astrophysics Data System (ADS)

    Parodi, Katia; Parodi, Katia; Thieke, Christian; Thieke, Christian

    Over the last decade, several technological advances have considerably improved the achievable precision of dose delivery in radiation therapy. Clinical exploitation of the superior tumor-dose conformality offered by modern radiotherapy techniques like intensity-modulated radiotherapy and ion beam therapy requires morphological and functional assessment of the tumor during the entire therapy chain from treatment planning to beam application and treatment response evaluation. This chapter will address the main rationale and role of imaging in state-of-the-art external beam radiotherapy. Moreover, it will present the status of novel imaging instrumentation and techniques being nowadays introduced in clinical use or still under development for image guidance and, ultimately, dose guidance of precision radiotherapy.

  14. Adapt

    NASA Astrophysics Data System (ADS)

    Bargatze, L. F.

    2015-12-01

    Active Data Archive Product Tracking (ADAPT) is a collection of software routines that permits one to generate XML metadata files to describe and register data products in support of the NASA Heliophysics Virtual Observatory VxO effort. ADAPT is also a philosophy. The ADAPT concept is to use any and all available metadata associated with scientific data to produce XML metadata descriptions in a consistent, uniform, and organized fashion to provide blanket access to the full complement of data stored on a targeted data server. In this poster, we present an application of ADAPT to describe all of the data products that are stored by using the Common Data File (CDF) format served out by the CDAWEB and SPDF data servers hosted at the NASA Goddard Space Flight Center. These data servers are the primary repositories for NASA Heliophysics data. For this purpose, the ADAPT routines have been used to generate data resource descriptions by using an XML schema named Space Physics Archive, Search, and Extract (SPASE). SPASE is the designated standard for documenting Heliophysics data products, as adopted by the Heliophysics Data and Model Consortium. The set of SPASE XML resource descriptions produced by ADAPT includes high-level descriptions of numerical data products, display data products, or catalogs and also includes low-level "Granule" descriptions. A SPASE Granule is effectively a universal access metadata resource; a Granule associates an individual data file (e.g. a CDF file) with a "parent" high-level data resource description, assigns a resource identifier to the file, and lists the corresponding assess URL(s). The CDAWEB and SPDF file systems were queried to provide the input required by the ADAPT software to create an initial set of SPASE metadata resource descriptions. Then, the CDAWEB and SPDF data repositories were queried subsequently on a nightly basis and the CDF file lists were checked for any changes such as the occurrence of new, modified, or deleted

  15. [Hodgkin's lymphoma and radiotherapy].

    PubMed

    Datsenko, P V; Panshin, G A

    2015-01-01

    After a median observation time of 4,5 years, 440 patients with Hodgkin's lymphoma stage I-IV to the Ann Arbor classification were treated with radiotherapy (2200 lymph areas) and ABVD (n=204) or BEACOPP (n=117) or CEA/ABVD (lomustine, etoposide, adriamycine, bleomycine, vinblastine and dacarbacine; n=119) regimens in 1995-2012. Correct allocation of groups with "CR or PR ≥80%" and "PR: 0-79%", after first-line chemotherapy, is extremely important for following RT planning. Adaptation of patients with Hodgkin's lymphoma can take place only after successful treatment, the probability of relapse and fear of repeated courses strongly interfere with this process, especially in the first years after its closure. Duration of remission period, especially in young people, is no less important than the criteria for overall survival. It is impossible to build recommendations for treatment for Hodgkin's lymphoma, based only on long-term survival rates. Importance of radiotherapy in reducing the number of relapses is undeniable, so the idea that the development of the role of chemotherapy in the treatment of the ray method Hodgkin's lymphoma gradually becomes secondary is in serious doubt. Our findings suggest the importance of both maintaining a high disease-free survival and reducing long-term complications in designing treatments of Hodgkin's lymphoma.

  16. Art Education and Children with Visual Impairments.

    ERIC Educational Resources Information Center

    Wellman, Carla

    1994-01-01

    This article discusses how art activities can be adapted for students with visual impairments, focusing on textural art, sculpture, sound art, smell, taste, kinetic art, dioramas and maps, and computer art. Suggestions for adapting visual arts are also offered, by using good contrast in projects or by enlarging or simplifying pictures. (JDD)

  17. Adaptive Radiation Therapy for Head and Neck Cancer—Can an Old Goal Evolve into a New Standard?

    PubMed Central

    Schwartz, David L.; Dong, Lei

    2011-01-01

    Current head and neck intensity-modulated radiotherapy (IMRT) techniques cause significant toxicity. This may be explained in part by the fact that IMRT cannot compensate for changes in the location of disease and normal anatomy during treatment, leading to exposure of at-risk bystander tissues to higher-than-anticipated doses. Adaptive radiotherapy (ART) is a novel approach to correct for daily tumor and normal tissue variations through online or offline modification of original IMRT target volumes and plans. ART has been discussed on a conceptual level for many years, but technical limitations have hampered its integration into routine care. In this paper, we review the key anatomic, dosimetric, and treatment delivery issues at play in current investigational development of head and neck ART. We also describe pilot findings from initial clinical deployment of head and neck ART, as well as emerging pathways of future research. PMID:20847944

  18. [Radiotherapy for nasopharyngeal carcinoma].

    PubMed

    Maingon, P; Blanchard, P; Bidault, F; Calmels, L

    2016-09-01

    Nasapharyngeal carcinoma is a rare disease. Oftenly, the diagnostic is made for advanced disease. Localized tumors, T1 or T2 NO observed a good prognosis and are locally controlled in more than 90 % of the cases by radiotherapy alone. The standard treatment of locally advanced disease is combined chemoradiation. A special vigilance of fast decrease of the volume of the pathological lymph nodes, sometimes associated to loss of weight might indicate an adaptive dosimetric revision. The treatment of recurrent disease is of great importance. Surgical indications are limited but should be discussed in multidisciplinary tumor board when possible. Surgical nodal sampling has to be proposed for nodal recurrence as well as reirradiation, which could be indicated according to the technical issues.

  19. Improved Correlation of the Neuropathologic Classification According to Adapted World Health Organization Classification and Outcome After Radiotherapy in Patients With Atypical and Anaplastic Meningiomas

    SciTech Connect

    Combs, Stephanie E.; Schulz-Ertner, Daniela; Debus, Juergen; Deimling, Andreas von; Hartmann, Christian

    2011-12-01

    Purpose: To evaluate the correlation between the 1993 and 2000/2007 World Health Organization (WHO) classification with the outcome in patients with high-grade meningiomas. Patients and Methods: Between 1985 and 2004, 73 patients diagnosed with atypical or anaplastic meningiomas were treated with radiotherapy. Sections from the paraffin-embedded tumor material from 66 patients (90%) from 13 different pathology departments were re-evaluated according to the first revised WHO classification from 1993 and the revised classifications from 2000/2007. In 4 cases, the initial diagnosis meningioma was not reproducible (5%). Therefore, 62 patients with meningiomas were analyzed. Results: All 62 tumors were reclassified according to the 1993 and 2000/2007 WHO classification systems. Using the 1993 system, 7 patients were diagnosed with WHO grade I meningioma (11%), 23 with WHO grade II (37%), and 32 with WHO grade III meningioma (52%). After scoring using the 2000/2007 system, we found 17 WHO grade I meningiomas (27%), 32 WHO grade II meningiomas (52%), and 13 WHO grade III meningiomas (21%). According to the 1993 classification, the difference in overall survival was not statistically significant among the histologic subgroups (p = .96). Using the 2000/2007 WHO classifications, the difference in overall survival became significant (p = .02). Of the 62 reclassified patients 29 developed tumor progression (47%). No difference in progression-free survival was observed among the histologic subgroups (p = .44). After grading according to the 2000/2007 WHO classifications, significant differences in progression-free survival were observed among the three histologic groups (p = .005). Conclusion: The new 2000/2007 WHO classification for meningiomas showed an improved correlation between the histologic grade and outcome. This classification therefore provides a useful basis to determine the postoperative indication for radiotherapy. According to our results, a comparison of the

  20. [Radiotherapy of bone metastases].

    PubMed

    Thureau, S; Vieillard, M-H; Supiot, S; Lagrange, J-L

    2016-09-01

    Radiotherapy plays a major role in palliative treatment of bone metastases. Recent developments of stereotactic radiotherapy and intensity modulated radiation therapy give the possibility to treat oligometastatic diseases. The objective of this paper is to report indications and treatment modalities of radiotherapy in these situations.

  1. Modeling the Dust Properties of z ~ 6 Quasars with ART2—All-Wavelength Radiative Transfer with Adaptive Refinement Tree

    NASA Astrophysics Data System (ADS)

    Li, Yuexing; Hopkins, Philip F.; Hernquist, Lars; Finkbeiner, Douglas P.; Cox, Thomas J.; Springel, Volker; Jiang, Linhua; Fan, Xiaohui; Yoshida, Naoki

    2008-05-01

    The detection of large quantities of dust in z ~ 6 quasars by infrared and radio surveys presents puzzles for the formation and evolution of dust in these early systems. Previously, Li et al. showed that luminous quasars at zgtrsim 6 can form through hierarchical mergers of gas-rich galaxies, and that these systems are expected to evolve from starburst through quasar phases. Here, we calculate the dust properties of simulated quasars and their progenitors using a three-dimensional Monte Carlo radiative transfer code, ART2 (All-wavelength Radiative Transfer with Adaptive Refinement Tree). ART2 incorporates a radiative equilibrium algorithm which treats dust emission self-consistently, an adaptive grid method which can efficiently cover a large dynamic range in both spatial and density scales, a multiphase model of the interstellar medium which accounts for the observed scaling relations of molecular clouds, and a supernova-origin model for dust which can explain the existence of dust in cosmologically young objects. By applying ART2 to the hydrodynamic simulations of Li et al., we reproduce the observed spectral energy distribution (SED) and inferred dust properties of SDSS J1148+5251, the most distant Sloan quasar. We find that the dust and infrared emission are closely associated with the formation and evolution of the quasar host. The system evolves from a cold to a warm ultraluminous infrared galaxy (ULIRG) owing to heating and feedback from stars and the active galactic nucleus (AGN). Furthermore, the AGN activity has significant implications for the interpretation of observation of the hosts. Our results suggest that vigorous star formation in merging progenitors is necessary to reproduce the observed dust properties of z ~ 6 quasars, supporting a merger-driven origin for luminous quasars at high redshifts and the starburst-to-quasar evolutionary hypothesis.

  2. Art and Technology.

    ERIC Educational Resources Information Center

    Lamal, Pauline Dove

    Art has always adapted technological advances to its own uses. In the last 15 years, art has turned to color photocopiers, computers, mimeograph machines, and thermofax copiers. With this in mind, Central Piedmont Community College began offering a course in 1982 called "Art and Technology" which focused on the application of office…

  3. Characterization and Management of Interfractional Anatomic Changes for Pancreatic Cancer Radiotherapy

    SciTech Connect

    Liu Feng; Erickson, Beth; Peng Cheng; Li, X. Allen

    2012-07-01

    Purpose: To quantitatively characterize interfractional anatomic variations in pancreatic cancer radiotherapy (RT) and to study dosimetric advantages for using an online adaptive replanning scheme to account for these variations. Methods and Materials: Targets and organs at risk (OAR) were delineated by autosegmentation based on daily computed tomography (CT) images acquired using a respiration-gated in-room CT during daily image-guided RT (IGRT) for 10 pancreatic cancer patients. Various parameters, including the maximum overlap ratio (MOR) between the volumes based on planning and daily CTs for a structure, while the overlapping volumes were maximized, were used to quantify the interfractional organ deformation with the intrafractional variations largely excluded. An online adaptive RT (ART) was applied to these daily CTs. To evaluate the dosimetric benefits of ART, the dose distributions from the online ART were compared to those from the repositioning in the current standard IGRT practice. Results: The interfractional anatomic variations, particularly the organ deformation, are significant during pancreas irradiation. For the patients studied, the average MORs of all daily CTs were 80.2%, 61.7%, and 72.2% for pancreatic head, duodenum, and stomach, respectively. The online ART leads to improved dosimetric plan with better target coverage and/or OAR sparing than IGRT repositioning. For the patients studied, the mean V{sub 50.4Gy} (volume covered by 50.4 Gy) for the duodenum was reduced from 43.4% for IGRT to 15.6% for the online ART scheme. Conclusions: The online adaptive RT scheme can effectively account for the significant interfractional anatomic variations observed in pancreas irradiation. The dosimetric advantages with the online ART may enable safe dose escalation in radiation therapy for pancreatic cancer.

  4. Assessment Study of the State of the Art in Adaptive Control and its Applications to Aircraft Control

    NASA Technical Reports Server (NTRS)

    Kaufman, Howard

    1998-01-01

    Many papers relevant to reconfigurable flight control have appeared over the past fifteen years. In general these have consisted of theoretical issues, simulation experiments, and in some cases, actual flight tests. Results indicate that reconfiguration of flight controls is certainly feasible for a wide class of failures. However many of the proposed procedures although quite attractive, need further analytical and experimental studies for meaningful validation. Many procedures assume the availability of failure detection and identification logic that will supply adequately fast, the dynamics corresponding to the failed aircraft. This in general implies that the failure detection and fault identification logic must have access to all possible anticipated faults and the corresponding dynamical equations of motion. Unless some sort of explicit on line parameter identification is included, the computational demands could possibly be too excessive. This suggests the need for some form of adaptive control, either by itself as the prime procedure for control reconfiguration or in conjunction with the failure detection logic. If explicit or indirect adaptive control is used, then it is important that the identified models be such that the corresponding computed controls deliver adequate performance to the actual aircraft. Unknown changes in trim should be modelled, and parameter identification needs to be adequately insensitive to noise and at the same time capable of tracking abrupt changes. If however, both failure detection and system parameter identification turn out to be too time consuming in an emergency situation, then the concepts of direct adaptive control should be considered. If direct model reference adaptive control is to be used (on a linear model) with stability assurances, then a positive real or passivity condition needs to be satisfied for all possible configurations. This condition is often satisfied with a feedforward compensator around the plant

  5. [Radiotherapy of hypopharynx cancers].

    PubMed

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

    2016-09-01

    The intensity-modulated radiotherapy is the gold standard in the treatment of hypopharynx cancers. Early T1 and T2 tumours could be treated by exclusive radiotherapy or surgery. For tumours requiring total pharyngolaryngectomy (T2 or T3), induction chemotherapy followed by exclusive radiotherapy or concurrent chemoradiotherapy are possible. For T4 tumours, 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, curative dose is 70Gy and 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 for locally advanced cancers with dose levels based on pathologic criteria (66Gy for R1 resection, 50 to 54Gy for complete resection). Volume delineation is based on guidelines.

  6. Heavy-ion radiotherapy

    NASA Astrophysics Data System (ADS)

    Kanai, Tatsuaki

    2000-11-01

    Heavy-ion radiotherapy using high-energy carbon beams has been performed at the National Institute of Radiological Sciences, Japan. The physical frame works for heavy-ion radiotherapy are established using physical understandings of radiation physics. In order to increase the accuracy of heavy-ion radiotherapy, many physical problems should be solved. Unsolved problems, such as the depth dose distributions, range of heavy-ion in patients and heavy-ion dosimetry in the radiation therapy, are discussed. .

  7. [Radiotherapy of oropharynx carcinoma].

    PubMed

    Servagi Vernat, S; Tochet, F; Vieillevigne, L; Pointreau, Y; Maingon, P; Giraud, P

    2016-09-01

    Indication, doses, technique of radiotherapy and concomitant chemotherapy for oropharynx carcinoma are presented. The recommendations for delineation of the target volumes and organs at risk are detailed.

  8. 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

  9. SU-E-J-102: Performance Variations Among Clinically Available Deformable Image Registration Tools in Adaptive Radiotherapy: How Should We Evaluate and Interpret the Result?

    SciTech Connect

    Nie, K; Pouliot, J; Smith, E; Chuang, C

    2015-06-15

    Purpose: To evaluate the performance variations in commercial deformable image registration (DIR) tools for adaptive radiation therapy. Methods: Representative plans from three different anatomical sites, prostate, head-and-neck (HN) and cranial spinal irradiation (CSI) with L-spine boost, were included. Computerized deformed CT images were first generated using virtual DIR QA software (ImSimQA) for each case. The corresponding transformations served as the “reference”. Three commercial software packages MIMVista v5.5 and MIMMaestro v6.0, VelocityAI v2.6.2, and OnQ rts v2.1.15 were tested. The warped contours and doses were compared with the “reference” and among each other. Results: The performance in transferring contours was comparable among all three tools with an average DICE coefficient of 0.81 for all the organs. However, the performance of dose warping accuracy appeared to rely on the evaluation end points. Volume based DVH comparisons were not sensitive enough to illustrate all the detailed variations while isodose assessment on a slice-by-slice basis could be tedious. Point-based evaluation was over-sensitive by having up to 30% hot/cold-spot differences. If adapting the 3mm/3% gamma analysis into the evaluation of dose warping, all three algorithms presented a reasonable level of equivalency. One algorithm had over 10% of the voxels not meeting this criterion for the HN case while another showed disagreement for the CSI case. Conclusion: Overall, our results demonstrated that evaluation based only on the performance of contour transformation could not guarantee the accuracy in dose warping. However, the performance of dose warping accuracy relied on the evaluation methodologies. Nevertheless, as more DIR tools are available for clinical use, the performance could vary at certain degrees. A standard quality assurance criterion with clinical meaning should be established for DIR QA, similar to the gamma index concept, in the near future.

  10. [Good practice of image-guided radiotherapy].

    PubMed

    de Crevoisier, R; Créhange, G; Castelli, J; Lafond, C; Delpon, G

    2015-10-01

    Image-guided radiotherapy (IGRT) aims to take into account the anatomical variations occurring during the course of radiotherapy, by direct or indirect visualization of the target volume followed by a corrective action. The movements of the target, or at least the set-up errors are corrected by moving the treatment table, corresponding to the simplest and most validated IGRT modality in a standard practice. The deformations of the target volume and organs at risk are however much more common, and unfortunately much more complicated to consider, requiring multiple planning before or during the treatment, corresponding to the adaptive radiotherapy strategies. The planning target volume must be carefully chosen according to these anatomic variations. This article reviews the modalities of IGRT, standard or under evaluation, according to the different tumour sites.

  11. [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.

  12. Art in the Mainstream: Ideology and Hope.

    ERIC Educational Resources Information Center

    Feldman, Edmund Burke

    1983-01-01

    Adapted from the presidential address to the National Art Education Association in the Spring of 1983, this article discusses the professional identity of art teachers and why art belongs "in the mainstream" of education. (RM)

  13. Exact ART: A Complete Implementation of an ART Network.

    PubMed

    Molenaar, Peter C.M.; Raijmakers, Maartje E.J.

    1997-06-01

    In this article we introduce a continuous time implementation of adaptive resonance theory (ART). ART designed by Grossberg concerns neural networks that self-organize stable pattern recognition categories of arbitrary sequences of input patterns. In contrast to the current implementations of ART we introduce a complete implementation of an ART network, including all regulatory and logical functions, as a system of ordinary differential equations capable of stand-alone running in real time. This means that transient behavior is kept in tact. This implementation of ART is based on ART 2 and is called Exact ART. Exact ART includes an implementation of a gated dipole field and an implementation of the orienting sub-system. The most important features of Exact ART, which are the design principles of ART 2, are proven mathematically. Also simulation studies show that Exact ART self-organizes stable recognition codes that agree with the classification behavior of ART 2. Copyright 1997 Elsevier Science Ltd.

  14. The Nano-X Linear Accelerator: A Compact and Economical Cancer Radiotherapy System Incorporating Patient Rotation.

    PubMed

    Eslick, Enid M; Keall, Paul J

    2015-10-01

    Rapid technological improvements in radiotherapy delivery results in improved outcomes to patients, yet current commercial systems with these technologies on board are costly. The aim of this study was to develop a state-of-the-art cancer radiotherapy system that is economical and space efficient fitting with current world demands. The Nano-X system is a compact design that is light weight combining a patient rotation system with a vertical 6 MV fixed beam. In this paper, we present the Nano-X system design configuration, an estimate of the system dimensions and its potential impact on shielding cost reductions. We provide an assessment of implementing such a radiotherapy system clinically, its advantages and disadvantages compared to a compact conventional gantry rotating linac. The Nano-X system has several differentiating features from current radiotherapy systems, it is [1] compact and therefore can fit into small vaults, [2] light weight, and [3] engineering efficient, i.e., it rotates a relatively light component and the main treatment delivery components are not under rotation (e.g., DMLCs). All these features can have an impact on reducing the costs of the system. In terms of shielding requirements, leakage radiation was found to be the dominant contributor to the Nano-X vault and as such no primary shielding was necessary. For a low leakage design, the Nano-X vault footprint and concrete volume required is 17 m2 and 35 m3 respectively, compared to 54 m2 and 102 m3 for a conventional compact linac vault, resulting in decreased costs in shielding. Key issues to be investigated in future work are the possible patient comfort concerns associated with the patient rotation system, as well as the magnitude of deformation and subsequent adaptation requirements.

  15. [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.

  16. Analysis of Prostate Bed Motion Using Daily Cone-Beam Computed Tomography During Postprostatectomy Radiotherapy

    SciTech Connect

    Ost, Piet; De Meerleer, Gert; De Gersem, Werner; Impens, Aline; De Neve, Wilfried

    2011-01-01

    Purpose: To report on the interfraction total positioning error of the postoperative prostate bed and to quantify its components (bony misalignment [BM]and prostate bed motion [PBM]) using daily kilovoltage cone-beam computed tomography (CBCT). The role of an adaptive radiotherapy schedule (ART) was investigated. Methods and Materials: A total of 547 daily CBCT images from 15 consecutive patients who had been treated with prostate bed radiotherapy were retrospectively analyzed. The positioning error was measured by rigid co-registration of the daily CBCT with pretreatment CT planning scan. The total positioning error was quantified by co-registration of the CBCT with the CT planning scan to match the anterior rectal wall. Automatic bony pelvis co-registration was performed to separate BM and PBM. The ART was determined by the average total positioning error from the first 5 CBCT images. Results: The systematic error for the total positioning error in the left-right, superoinferior, and anteroposterior direction was 2.69, 2.00, and 2.65 mm with a random error of 1.99, 1.49, and 2.25 mm, resulting in a planning target volume margin of 8, 6, and 8 mm, respectively. ART reduced the margin by 54%, 44%, and 40%, respectively. Systematic errors in the left-right, superoinferior, and anteroposterior direction for BM was 2.66, 1.83, and 2.60 mm and for PBM was 0.44, 0.92, and 2.50 mm with a random error of 1.88, 1.24, and 1.77 mm for BM and 0.99, 1.38, and 2.32 mm for PBM, respectively. Conclusion: Without treatment verifications, 6-8-mm planning target volume margins are required because of PBM and BM. The anteroposterior PBM was significant. An ART protocol can reduce these planning target volume margins.

  17. Concomitant use of radiotherapy and two topoisomerase inhibitors to treat adult T-cell leukemia with a radiotherapy-resistant bulky disease: a case series.

    PubMed

    Obama, Kosuke

    2014-01-01

    Concomitant chemoradiotherapy is established as the standard treatment to improve the prognosis of several types of solid tumor, but has not been the general practice for hematological malignancies. Here, I report two cases of adult T-cell leukemia (ATL) with a radiotherapy-resistant bulky disease treated with concomitant radiotherapy and two topoisomerase inhibitors: etoposide (VP-16) and irinotecan (CPT-11). Patient 1 was a 78-year-old man with chemotherapy-resistant inguinal bulky mass. Radiotherapy (total 40 Gy) for this inguinal lesion was started; however, the bulky disease was found to be resistant to radiotherapy and progressed. VP-16 and CPT-11 were administered in addition to radiotherapy (after a total of 20 Gy of radiotherapy). Patient 2 was a 71-year-old man with a solitary bulky mass in left cervical lesion. Various previous chemotherapy and radiotherapy approaches had not been able to control the disease. Six months after first radiotherapy, the bulky disease rapidly progressed with the occurrence of pain. Second radiotherapy (30 Gy) was started with simultaneous administration of CPT-11 and VP-16. In both cases, the bulky disease gradually regressed and completely disappeared by the end of radiotherapy. Thus, flexible adaptation of concomitant chemoradiotherapy including two topoisomerase inhibitors may offer a potential therapeutic option for radiotherapy-resistant bulky diseases, even in hematological malignancies.

  18. Computational and Physical Quality Assurance Tools for Radiotherapy

    NASA Astrophysics Data System (ADS)

    Graves, Yan Jiang

    Radiation therapy aims at delivering a prescribed amount of radiation dose to cancerous targets while sparing dose to normal organs. Treatment planning and delivery in modern radiotherapy are highly complex. To ensure the accuracy of the delivered dose to a patient, a quality assurance (QA) procedure is needed before the actual treatment delivery. This dissertation aims at developing computational and physical tools to facilitate the QA process. In Chapter 2, we have developed a fast and accurate computational QA tool using a graphics processing unit based Monte Carlo (MC) dose engine. This QA tool aims at identifying any errors in the treatment planning stage and machine delivery process by comparing three dose distributions: planned dose computed by a treatment planning system, planned dose and delivered dose reconstructed using the MC method. Within this tool, several modules have been built. (1) A denoising algorithm to smooth the MC calculated dose. We have also investigated the effects of statistical uncertainty in MC simulations on a commonly used dose comparison metric. (2) A linear accelerator source model with a semi-automatic commissioning process. (3) A fluence generation module. With all these modules, a web application for this QA tool with a user friendly interface has been developed to provide users with easy access to our tool, facilitating its clinical utilizations. Even after an initial treatment plan fulfills the QA requirements, a patient may experience inter-fractional anatomy variations, which compromise the initial plan optimality. To resolve this issue, adaptive radiotherapy (ART) has been proposed, where treatment plan is redesigned based on most recent patient anatomy. In Chapter 3, we have constructed a physical deformable head and neck (HN) phantom with in-vivo dosimetry capability. This phantom resembles HN patient geometry and simulates tumor shrinkage with a high level of realism. The ground truth deformation field can be measured

  19. 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)

  20. Into the Curriculum. Art/Social Studies: What Costume Can You Make?; Mathematics: Roman Numerals; Reading/Language Arts: The "Rumplestiltskin Problem" and Other Adapted Tales; Social Studies: What's the Truth about Gladiators?

    ERIC Educational Resources Information Center

    Barwick, Martha

    2002-01-01

    Provides four fully developed library media activities that are designed for use with specific curriculum units in art, social studies, reading, and language arts. Library media skills, curriculum objectives, grade levels, resources, instructional roles, procedures, evaluation, and follow-up are described for each activity. (LRW)

  1. Deformable image registration for geometrical evaluation of DIBH radiotherapy treatment of lung cancer patients

    NASA Astrophysics Data System (ADS)

    Ottosson, W.; Lykkegaard Andersen, J. A.; Borrisova, S.; Mellemgaard, A.; Behrens, C. F.

    2014-03-01

    Respiration and anatomical variation during radiotherapy (RT) of lung cancer yield dosimetric uncertainties of the delivered dose, possibly affecting the clinical outcome if not corrected for. Adaptive radiotherapy (ART), based on deformable image registration (DIR) and Deep-Inspiration-Breath-Hold (DIBH) gating can potentially improve the accuracy of RT. Purpose: The objective was to investigate the performance of contour propagation on repeated CT and Cone Beam CT (CBCT) images in DIBH compared to images acquired in free breathing (FB), using a recently released DIR software. Method: Three locally advanced non-small cell lung cancer patients were included, each with a planning-, midterm- and final CT (pCT, mCT, fCT) and 7 CBCTs acquired weekly and on the same day as the mCT and fCT. All imaging were performed in both FB and DIBH, using Varian RPM system for respiratory tracking. Delineations of anatomical structures were performed on each image set. The CT images were retrospective rigidly and deformable registered to all obtained images using the Varian Smart Adapt v. 11.0. The registered images were analysed for volume change and Dice Similarity Coefficient (DSC). Result: Geometrical similarities were found between propagated and manually delineated structures, with a slightly favour of FB imaging. Special notice should be taken to registrations where image artefacts or low tissue contrast are present. Conclusion: This study does not support the hypothesis that DIBH images perform better image registration than FB images. However DIR is a feasible tool for ART of lung cancer.

  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.

  3. [Radiotherapy for retroperitoneal sarcomas].

    PubMed

    Sargos, P; Stoeckle, E; Henriques de Figueiredo, B; Antoine, M; Delannes, M; Mervoyer, A; Kantor, G

    2016-10-01

    The management of retroperitoneal sarcoma can be very challenging, and the quality of initial treatment strategy appears to be a crucial prognostic factor. En bloc surgery is currently the standard of care for these rare tumours and perioperative treatments such as chemotherapy or radiotherapy have not been validated yet. However, local-regional relapse constitutes the most common disease course. While adjuvant radiotherapy is less and less common due to gastrointestinal toxicities, preoperative radiation therapy offers numerous advantages and is being evaluated as part of a national multicentre phase II study (TOMOREP trial) and is the subject of a European randomized phase III study (STRASS trial). The objective of this article is to present data on preoperative irradiation in terms of dose, volumes and optimal radiotherapy techniques for the treatment of this rare disease.

  4. 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.

  5. Precision radiotherapy for brain tumors

    PubMed Central

    Yan, Ying; Guo, Zhanwen; Zhang, Haibo; Wang, Ning; Xu, Ying

    2012-01-01

    OBJECTIVE: Precision radiotherapy plays an important role in the management of brain tumors. This study aimed to identify global research trends in precision radiotherapy for brain tumors using a bibliometric analysis of the Web of Science. DATA RETRIEVAL: We performed a bibliometric analysis of data retrievals for precision radiotherapy for brain tumors containing the key words cerebral tumor, brain tumor, intensity-modulated radiotherapy, stereotactic body radiation therapy, stereotactic ablative radiotherapy, imaging-guided radiotherapy, dose-guided radiotherapy, stereotactic brachytherapy, and stereotactic radiotherapy using the Web of Science. SELECTION CRITERIA: Inclusion criteria: (a) peer-reviewed articles on precision radiotherapy for brain tumors which were published and indexed in the Web of Science; (b) type of articles: original research articles and reviews; (c) year of publication: 2002-2011. Exclusion criteria: (a) articles that required manual searching or telephone access; (b) Corrected papers or book chapters. MAIN OUTCOME MEASURES: (1) Annual publication output; (2) distribution according to country; (3) distribution according to institution; (4) top cited publications; (5) distribution according to journals; and (6) comparison of study results on precision radiotherapy for brain tumors. RESULTS: The stereotactic radiotherapy, intensity-modulated radiotherapy, and imaging-guided radiotherapy are three major methods of precision radiotherapy for brain tumors. There were 260 research articles addressing precision radiotherapy for brain tumors found within the Web of Science. The USA published the most papers on precision radiotherapy for brain tumors, followed by Germany and France. European Synchrotron Radiation Facility, German Cancer Research Center and Heidelberg University were the most prolific research institutes for publications on precision radiotherapy for brain tumors. Among the top 13 research institutes publishing in this field, seven

  6. Arts Education Grants, Fiscal Year 2009

    ERIC Educational Resources Information Center

    National Assembly of State Arts Agencies, 2011

    2011-01-01

    National Assembly of State Arts Agencies (NASAA) is the authority on state arts agency funding and grant making. NASAA publications provide extensive information on strategic planning, needs assessment and program evaluation methods specifically adapted to public arts agencies. This document presents the total number of arts education grant awards…

  7. [Radiotherapy of breast cancer].

    PubMed

    Hennequin, C; Barillot, I; Azria, D; Belkacémi, Y; Bollet, M; Chauvet, B; Cowen, D; Cutuli, B; Fourquet, A; Hannoun-Lévi, J M; Leblanc, M; Mahé, M A

    2016-09-01

    In breast cancer, radiotherapy is an essential component of the treatment. After conservative surgery for an infiltrating carcinoma, radiotherapy must be systematically performed, regardless of the characteristics of the disease, because it decreases the rate of local recurrence and by this way, specific mortality. Partial breast irradiation could not be proposed routinely but only in very selected and informed patients. For ductal carcinoma in situ, adjuvant radiotherapy must be also systematically performed after lumpectomy. After mastectomy, chest wall irradiation is required for pT3-T4 tumours and if there is an axillary nodal involvement, whatever the number of involved lymph nodes. After neo-adjuvant chemotherapy and mastectomy, in case of pN0 disease, chest wall irradiation is recommended if there is a clinically or radiologically T3-T4 or node positive disease before chemotherapy. Axillary irradiation is recommended only if there is no axillary surgical dissection and a positive sentinel lymph node. Supra and infra-clavicular irradiation is advised in case of positive axillary nodes. Internal mammary irradiation must be discussed case by case, according to the benefit/risk ratio (cardiac toxicity). Dose to the chest wall or the breast must be between 45-50Gy with a conventional fractionation. A boost dose over the tumour bed is required if the patient is younger than 60 years old. Hypofractionation (42.5 Gy in 16 fractions, or 41.6 Gy en 13 or 40 Gy en 15) is possible after tumorectomy and if a nodal irradiation is not mandatory. Delineation of the breast, the chest wall and the nodal areas are based on clinical and radiological evaluations. 3D-conformal irradiation is the recommended technique, intensity-modulated radiotherapy must be proposed only in case of specific clinical situations. Respiratory gating could be useful to decrease the cardiac dose. Concomitant administration of chemotherapy in unadvised, but hormonal treatment could be start with

  8. Gourdeous Art

    ERIC Educational Resources Information Center

    Coy, Mary

    2007-01-01

    In this article, the author describes a gourd art project for her art club. Prior to students actually working on the gourds, the author and her art volunteer did a joint demonstration on the process students would go through to create their project. The volunteer brought in and explained her gourd art and shared information about the drying and…

  9. Radiotherapy equipment--purchase or lease?

    PubMed

    Nisbet, A; Ward, A

    2001-08-01

    Against a background of increasing demand for radiotherapy equipment, this study was undertaken to investigate options for equipment procurement, in particular to compare purchase with lease. The perceived advantages of lease are that equipment can be acquired within budget and cashflow constraints, with relatively low amounts of cash leaving the NHS in the first year, avoiding the necessity of capitalizing the equipment and providing protection against the risk of obsolescence associated with high technology equipment. The perceived disadvantages of leasing are that the Trust does not own the equipment, leasing can be more expensive in revenue terms, the tender process is extended and there may be lease conditions to be met, which may be costly and/or restrictive. There are also a number of technical considerations involved in the leasing of radiotherapy equipment that influence the financial analysis and practical operation of the radiotherapy service. The technical considerations include servicing and planned preventative maintenance, upgrades, spare parts, subsequent purchase of "add ons", modification of equipment, research and development work, commencement of the lease period, return of equipment at the end of the lease period and negotiations at the end of the lease period. A study from Raigmore Hospital, Inverness is described, which involves the procurement of new, state-of-the-art radiotherapy equipment. This provides an overview of the procurement process, including a summary of the advantages and disadvantages of leasing, with the figures from the financial analysis presented and explained. In addition, a detailed description is given of the technical considerations to be taken into account in the financial analysis and negotiation of any lease contract.

  10. [Radiotherapy for Graves' ophthalmopathy].

    PubMed

    Kuhnt, T; Müller, A C; Janich, M; Gerlach, R; Hädecke, J; Duncker, G I W; Dunst, J

    2004-11-01

    Graves' ophthalmopathy (GO) is the most frequent extrathyroidal manifestation of Graves' disease, an autoimmune disorder of the thyroid, whereas the precise pathogenesis still remains unclear. In Hashimoto's thyroiditis the occurrence of proptosis is an extremely rare event. The therapy for middle and severe courses of GO shows in partly disappointing results, although several therapy modalities are possible (glucocorticoid therapy, radiotherapy, antithyroid drug treatment, surgery). All these therapies lead in only 40 - 70 % to an improvement of the pathogenic symptoms. An intensive interdisciplinary cooperation is necessary to satisfy the requirements for the treatment of Graves' ophthalmopathy. As a consequence of the very different results of the few of clinical studies that were accomplished with reference to this topic, treatment by radiotherapy in the management of the disease is presently controversially discussed. In the German-speaking countries the radiotherapy is, however, firmly established as a therapy option in the treatment of the moderate disease classes (class 2-5 according to NO SPECS), especially if diplopia is present. This article describes the sequences, dosages and fractionation schemes as well as the risks and side effects of the radiotherapy. Altogether, radiotherapy is assessed as an effective and sure method. The administration of glucocorticoids can take place before the beginning of or during the radiotherapy. For the success of treatment the correct selection of patients who may possibly profit from a radiotherapy is absolutely essential. By realising that GO proceeds normally over a period of 2-5 years, which is followed by a period of fibrotic alteration, the application of the radiotherapy in the early, active phase is indispensable. A precise explanation for the effects of radiotherapy in treatment of the GO does not exist at present. The determination of the most effective irradiation doses was made from retrospectively evaluated

  11. Art Education/Art Therapy.

    ERIC Educational Resources Information Center

    Rogers, John R., Ed.

    1978-01-01

    The special issue presents 13 articles dealing with art education and art therapy for special groups. Included are the following titles and authors: "Art Education for Special Groups: The Emotionally Disturbed" (E. Ulman); "You Are The Early Warning System" (C. Stember); "School Art Therapist Rationale for DPI Certification" (V. Minar); "Art…

  12. Radiotherapy for bone pain.

    PubMed Central

    Needham, P R; Mithal, N P; Hoskin, P J

    1994-01-01

    Painful bone metastases are a common problem for cancer patients. Although current evidence supports the use of a single fraction of radiotherapy as the treatment of choice, many radiotherapists, for a variety of reasons, continue to use fractionated regimens. Over one six month period 105 patients received external beam irradiation for painful bone metastases at the Royal London Hospital (RLH). Thirty-one per cent of the patients were aged 70 or over. The treatment of 97 of these patients was assessed. They had a total of 280 sites treated over the course of their disease. Fifty-nine per cent of sites treated received a fractionated course of radiotherapy. Site significantly influenced fractionation. Overall response rates of 82% were achieved. Fractionation did not appear to influence this. Ten patients received large field irradiation. Fifteen patients had five or more sites irradiated, of whom only one received hemibody irradiation. PMID:7523672

  13. Melanoma: Last call for radiotherapy.

    PubMed

    Espenel, Sophie; Vallard, Alexis; Rancoule, Chloé; Garcia, Max-Adrien; Guy, Jean-Baptiste; Chargari, Cyrus; Deutsch, Eric; Magné, Nicolas

    2017-02-01

    Melanoma is traditionally considered to be a radioresistant tumor. However, radiotherapy and immunotherapy latest developments might upset this radiobiological dogma. Stereotactic radiotherapy allows high dose per fraction delivery, with high dose rate. More DNA lethal damages, less sublethal damages reparation, endothelial cell apoptosis, and finally clonogenic cell dysfunction are produced, resulting in improved local control. Radiotherapy can also enhance immune responses, inducing neoantigens formation, tumor antigen presentation, and cytokines release. A synergic effect of radiotherapy with immunotherapy is expected, and might lead to abscopal effects. If hadrontherapy biological properties seem able to suppress hypoxia-induced radioresistance and increase biological efficacy, ballistic advantages over photon radiations might also improve radiotherapy outcomes on usually poor prognosis locations. The present review addresses biological and clinical effects of high fraction dose, bystander effect, abscopal effect, and hadrontherapy features in melanoma. Clinical trials results are warranted to establish indications of innovative radiotherapy in melanoma.

  14. Accident prevention in radiotherapy

    PubMed Central

    Holmberg, O

    2007-01-01

    In order to prevent accidents in radiotherapy, it is important to learn from accidents that have occurred previously. Lessons learned from a number of accidents are summarised and underlying patterns are looked for in this paper. Accidents can be prevented by applying several safety layers of preventive actions. Categories of these preventive actions are discussed together with specific actions belonging to each category of safety layer. PMID:21614274

  15. [Radiotherapy of bladder cancer].

    PubMed

    Riou, O; Chauvet, B; Lagrange, J-L; Martin, P; Llacer Moscardo, C; Charissoux, M; Lauche, O; Aillères, N; Fenoglietto, P; Azria, D

    2016-09-01

    Surgery (radical cystectomy) is the standard treatment of muscle-invasive bladder cancer. Radiochemotherapy has risen as an alternative treatment option to surgery as part as organ-sparing combined modality treatment or for patients unfit for surgery. Radiochemotherapy achieves 5-year bladder intact survival of 40 to 65% and 5-year overall survival of 40 to 50% with excellent quality of life. This article introduces the French recommendations for radiotherapy of bladder cancer: indications, exams, technique, dosimetry, delivery and image guidance.

  16. Radiotherapy DICOM packet sniffing.

    PubMed

    Ackerly, T; Gesoand, M; Smith, R

    2008-09-01

    The Digital Imaging and Communications in Medicine (DICOM) standard is meant to allow communication of medical images between equipment provided by different vendors, but when two applications do not interact correctly in a multi-vendor environment it is often first necessary to demonstrate non-compliance of either the sender or the receiver before a resolution to the problem can be progressed. Sometimes the only way to do this is to monitor the network communication between the two applications to find out which one is not complying with the DICOM standard. Packet sniffing is a technique of network traffic analysis by passive observation of all information transiting a point on the network, regardless of the specified sender or receiver. DICOM packet sniffing traps and interprets the network communication between two DICOM applications to determine which is non compliant. This is illustrated with reference to three examples, a radiotherapy planning system unable to receive CT data from a particular CT scanner, a radiotherapy simulator unable to print correctly on a DICOM printer, and a PACS unable to respond when queried about what images it has in its archive by a radiotherapy treatment planning system. Additionally in this work it has been proven that it is feasible to extract DICOM images from the intercepted network data. This process can be applied to determine the cause of a DICOM image being rendered differently by the sender and the receiver.

  17. Imaging in radiotherapy.

    PubMed

    Van den Berge, D L; De Ridder, M; Storme, G A

    2000-10-01

    Radiotherapy, more then any other treatment modality, relies heavily and often exclusively on medical imaging to determine the extent of disease and the spatial relation between target region and neighbouring healthy tissues. Radically new approaches to radiation delivery are inspired on CT scanning and treat patients in a slice-by-slice fashion using intensity modulated megavoltage fan beams. For quality assurance of complex 3-D dose distributions, MR based 3-D verificative dosimetry on irradiated phantoms has been described. As treatment delivery becomes increasingly refined, the need for accurate target definition increases as well and sophisticated imaging tools like image fusion and 3-D reconstruction are routinely used for treatment planning. While in the past patients were positioned on the treatment machines based exclusively on surface topography and the well-known skin marks, such approach is no longer sufficient for high-accuracy radiotherapy and special imaging tools like on-line portal imaging are used to verify and correct target positioning. Much of these applications rely on digital image processing, transmission and storage, and the development of standards, like DICOM and PACS have greatly contributed to these applications. Digital imaging plays an increasing role in many areas in radiotherapy and has been fundamental in new developments that have demonstrated impact on patient care.

  18. Language Arts - Spanish Grammar.

    ERIC Educational Resources Information Center

    Andrade, Magdalena; Sones, Mary

    This publication presents three suggested language arts curriculum units. They represent a cross-section of materials that have been developed to deal with the learning problems of students with special language difficulties. Originally developed for grades 7-12, these units may be adapted for use in adult education or at other grade levels. They…

  19. [Radiotherapy for primary lung carcinoma].

    PubMed

    Giraud, P; Lacornerie, T; Mornex, F

    2016-09-01

    Indication, doses, technique of radiotherapy and concomitant chemotherapy, for primary lung carcinoma are presented. The recommendations for delineation of the target volumes and organs at risk are detailed.

  20. Car Art.

    ERIC Educational Resources Information Center

    Meilach, Dona Z.

    2002-01-01

    Discusses car art and its appeal to boys and girls. Describes the popularity of customizing cars, focusing on this as a future career for students. Includes a list of project ideas that focuses on car art. (CMK)

  1. Art English.

    ERIC Educational Resources Information Center

    Preece, Robert

    1994-01-01

    Art English is a combination of English-as-a-Second-Language (ESL)/English-as-a-Foreign-Language (EFL) and art content. As a new instructional area, it faces several challenges: as with all English for Special Purposes (ESP), exchange of information among programs; development of a suitable combination of art content and ESL, due to lack of…

  2. Rock Art

    ERIC Educational Resources Information Center

    Henn, Cynthia A.

    2004-01-01

    There are many interpretations for the symbols that are seen in rock art, but no decoding key has ever been discovered. This article describes one classroom's experiences with a lesson on rock art--making their rock art and developing their own personal symbols. This lesson allowed for creativity, while giving an opportunity for integration…

  3. Art Safety.

    ERIC Educational Resources Information Center

    BCATA Journal for Art Teachers, 1991

    1991-01-01

    Advocating that Canadian art programs should use and model environmentally safe practices, the articles in this journal focus on issues of safe practices in art education. Articles are: (1) "What is WHMIS?"; (2) "Safety Precautions for Specific Art Processes"; (3) "Toxic Substances"; (4) "Using Clay, Glazes, and…

  4. Wall Art

    ERIC Educational Resources Information Center

    McGinley, Connie Q.

    2004-01-01

    The author of this article, an art teacher at Monarch High School in Louisville, Colorado, describes how her experience teaching in a new school presented an exciting visual challenge for an art teacher--monotonous brick walls just waiting for decoration. This school experienced only minimal instances of graffiti, but as an art teacher, she did…

  5. Integrating Art.

    ERIC Educational Resources Information Center

    BCATA Journal for Art Teachers, 1991

    1991-01-01

    These articles focus on art as a component of interdisciplinary integration. (1) "Integrated Curriculum and the Visual Arts" (Anna Kindler) considers various aspects of integration and implications for art education. (2) "Integration: The New Literacy" (Tim Varro) illustrates how the use of technology can facilitate…

  6. [Definition of accurate planning target volume margins for esophageal cancer radiotherapy].

    PubMed

    Lesueur, P; Servagi-Vernat, S

    2016-10-01

    More than 4000 cases of esophagus neoplasms are diagnosed every year in France. Radiotherapy, which can be delivered in preoperative or exclusive with a concomitant chemotherapy, plays a central role in treatment of esophagus cancer. Even if efficacy of radiotherapy no longer has to be proved, the prognosis of esophagus cancer remains unfortunately poor with a high recurrence rate. Toxicity of esophageal radiotherapy is correlated with the irradiation volume, and limits dose escalation and local control. Esophagus is a deep thoracic organ, which undergoes cardiac and respiratory motion, making the radiotherapy delivery more difficult and increasing the planning target volume margins. Definition of accurate planning target volume margins, taking into account the esophagus' intrafraction motion and set up margins is very important to be sure to cover the clinical target volume and restrains acute and late radiotoxicity. In this article, based on a review of the literature, we propose planning target volume margins adapted to esophageal radiotherapy.

  7. Particle radiotherapy for prostate cancer.

    PubMed

    Shioyama, Yoshiyuki; Tsuji, Hiroshi; Suefuji, Hiroaki; Sinoto, Makoto; Matsunobu, Akira; Toyama, Shingo; Nakamura, Katsumasa; Kudo, Sho

    2015-01-01

    Recent advances in external beam radiotherapy have allowed us to deliver higher doses to the tumors while decreasing doses to the surrounding tissues. Dose escalation using high-precision radiotherapy has improved the treatment outcomes of prostate cancer. Intensity-modulated radiation therapy has been widely used throughout the world as the most advanced form of photon radiotherapy. In contrast, particle radiotherapy has also been under development, and has been used as an effective and non-invasive radiation modality for prostate and other cancers. Among the particles used in such treatments, protons and carbon ions have the physical advantage that the dose can be focused on the tumor with only minimal exposure of the surrounding normal tissues. Furthermore, carbon ions also have radiobiological advantages that include higher killing effects on intrinsic radio-resistant tumors, hypoxic tumor cells and tumor cells in the G0 or S phase. However, the degree of clinical benefit derived from these theoretical advantages in the treatment of prostate cancer has not been adequately determined. The present article reviews the available literature on the use of particle radiotherapy for prostate cancer as well as the literature on the physical and radiobiological properties of this treatment, and discusses the role and the relative merits of particle radiotherapy compared with current photon-based radiotherapy, with a focus on proton beam therapy and carbon ion radiotherapy.

  8. Radiotherapy in the UK

    SciTech Connect

    Ramsay, S.

    1993-10-09

    What is wrong with radiation treatment in the UK Is it bad practice or merely bad publicity Between 1982 and 1991, 1,000 patients receiving isocentric radiation therapy at the North Staffordshire Royal Infirmary received a substantial underdose of radiation; the clinical report on this incident was published last week. The operator had been using a correction factor for tumor-to-skin distance, unaware that this factor had already been applied by the computer system. Although the report pointed out that it is not surprising that the clinicians were not alerted to the undertreatment, is also noted that there were no resources at the hospital to audit the outcome of radiotherapy.

  9. [Radiotherapy during pregnancy].

    PubMed

    Mazeron, R; Barillot, I; Mornex, F; Giraud, P

    2016-09-01

    The diagnostic of cancer during pregnancy is a rare and delicate situation. As the developments of the embryo and the human fetus are extremely sensitive to ionizing radiations, the treatment of these tumors should be discussed. The studies - preclinical and clinical - based mostly on exposure accidents show that subdiaphragmatic treatments are possible during pregnancy. When radiotherapy is used, phantom estimations of the dose to the fetus, confirmed by in vivo measurements are required. Irradiation and imaging techniques should be arranged to decrease as much as possible the dose delivered to the fetus and hold below the threshold of 0.1Gy.

  10. Art Rocks with Rock Art!

    ERIC Educational Resources Information Center

    Bickett, Marianne

    2011-01-01

    This article discusses rock art which was the very first "art." Rock art, such as the images created on the stone surfaces of the caves of Lascaux and Altimira, is the true origin of the canvas, paintbrush, and painting media. For there, within caverns deep in the earth, the first artists mixed animal fat, urine, and saliva with powdered minerals…

  11. [Art therapy and "art brut"].

    PubMed

    Kovács, Emese; Simon, Lajos

    2010-01-01

    The authors in this article explor the most important steps of the development of the research on the psychopathology of expression. They introduce the development of Art Brut and it's place in art history. They deal with the characteristics of art therapy.

  12. [The need for a paradigm shift in radiotherapy].

    PubMed

    Mayer, Árpád; Katona, Csilla; Farkas, Róbert; Póti, Zsuzsa

    2015-11-01

    The status and indications of radiotherapy have significantly changed in the past decade because novel techniques, radiobiological research and major advances in informatics have made better local control possible. Using supplemented marking of the target volume with computer tomography based other image-making methods adapted made it possible to define the tumor and intact surrounding tissues more precisely. With novel radiotherapy techniques the dosage of the homogenity and the covering in the target volume can be raised optimally, especially with intensity modulated arc radiotherapy (volumetric modulated arc therapy) without causing radiation injury or damage to intact surrounding tissues. Furthermore, with novel techniques and target volume marking, new indications have appeared in clinical practice and besides stereotactic radiotherapy for intracranial metastases, the extracranial so-called oligometastic conditions can be maintained close to a curative state (or in remission) for many years. Among these, perhaps the most striking is the stereotactic radiotherapy treatment of liver, lung and spinal cord metastases in one or more fractions, for which the indispensable condition is the image or respiratory guided technique.

  13. 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.

  14. Fertility impairment in radiotherapy

    PubMed Central

    Kuźba-Kryszak, Tamara; Nowikiewicz, Tomasz; Żyromska, Agnieszka

    2016-01-01

    Infertility as a result of antineoplastic therapy is becoming a very important issue due to the growing incidence of neoplastic diseases. Routinely applied antineoplastic treatments and the illness itself lead to fertility disorders. Therapeutic methods used in antineoplastic treatment may cause fertility impairment or sterilization due to permanent damage to reproductive cells. The risk of sterilization depends on the patient's sex, age during therapy, type of neoplasm, radiation dose and treatment area. It is known that chemotherapy and radiotherapy can lead to fertility impairment and the combination of these two gives an additive effect. The aim of this article is to raise the issue of infertility in these patients. It is of growing importance due to the increase in the number of children and young adults who underwent radiotherapy in the past. The progress in antineoplastic therapy improves treatment results, but at the same time requires a deeper look at existential needs of the patient. Reproductive function is an integral element of self-esteem and should be taken into account during therapy planning. PMID:27647982

  15. [Stereotactic radiosurgery and radiotherapy for brain metastases].

    PubMed

    Tanguy, Ronan; Métellus, Philippe; Mornex, Françoise; Mazeron, Jean-Jacques

    2013-01-01

    Brain metastases management is still controversial even though many trials are trying to define the respective roles of neurosurgery, whole-brain radiotherapy, single-dose stereotactic radiotherapy and fractionated stereotactic radiotherapy. In this article, we review data from trials that examine the role of radiosurgery and fractionated stereotactic radiotherapy in the management of brain metastases.

  16. Mindful art.

    PubMed

    Malafouris, Lambros

    2013-04-01

    Bullot & Reber (B&R) begin asking if the study of the mind's inner life can provide a foundation for a science of art. Clearly there are many epistemological problems involved in the study of the cognitive and affective basis of art appreciation. I argue that context is key. I also propose that as long as the "mind's life" continues to be perceived as an "inner" intracranial phenomenon, little progress can be made. Mind and art are one.

  17. [Role of functional imaging in the definition of target volumes for lung cancer radiotherapy].

    PubMed

    Thureau, S; Hapdey, S; Vera, P

    2016-10-01

    Functional imaging with positron emission tomography (PET) is interesting to optimize lung radiotherapy planning, and probably to deliver a heterogeneous dose or adapt the radiation dose during treatment. Only fluorodeoxyglucose (FDG) PET-computed tomography (CT) is validated for staging lung cancer and planning radiotherapy. The optimal segmentation methods remain to be defined as well as the interest of "dose painting" from pre-treatment PET (metabolism: FDG) or hypoxia (fluoromisonidazole: FMISO) and the interest of replanning based on pertherapeutic PET.

  18. Radiotherapy in Phyllodes Tumour

    PubMed Central

    Sasidharan, Balukrishna; Manipadam, Marie Therese; Paul, M J; Backianathan, Selvamani

    2017-01-01

    Introduction Phyllodes Tumour (PT) of the breast is a relatively rare breast neoplasm (<1%) with diverse range of pathology and biological behaviour. Aim To describe the clinical course of PT and to define the role of Radiotherapy (RT) in PT of the breast. Materials and Methods Retrospective analysis of hospital data of patients with PT presented from 2005 to 2014 was done. Descriptive statistics was used to analyze the results. Simple description of data was done in this study. Age and duration of symptoms were expressed in median and range. Percentages, tables and general discussions were used to understand the meaning of the data analyzed. Results Out of the 98 patients, 92 were eligible for analysis. The median age of presentation was 43 years. A total of 64/92 patients were premenopausal. There was no side predilection for this tumour but 57/92 patients presented as an upper outer quadrant lump. Fifty percent of the patients presented as giant (10 cm) PT. The median duration of symptoms was 12 months (range: 1-168 months). A 60% of patients had Benign (B), 23% had Borderline (BL) and 17% had malignant (M) tumours. The surgical treatment for benign histology included Lumpectomy (L) for 15%, Wide Local Excision (WLE) for 48%, and Simple Mastectomy (SM) for 37%. All BL and M tumours were treated with WLE or SM. There was no recurrence in B and BL group when the margin was ≥1 cm. All non-metastatic M tumours received adjuvant RT irrespective of their margin status. Total 3/16 patients with M developed local recurrence. Total 6/16 M patients had distant metastases (lung or bone). Our median duration of follow up was 20 months (range: 1-120 months). Conclusion Surgical resection with adequate margins (>1 cm) gave excellent local control in B and BL tumours. For patients with BL PT, local radiotherapy is useful, if margins are close or positive even after the best surgical resection. There is a trend towards improved local control with adjuvant radiotherapy for

  19. [Respiratory synchronization and breast radiotherapy].

    PubMed

    Mège, A; Ziouèche-Mottet, A; Bodez, V; Garcia, R; Arnaud, A; de Rauglaudre, G; Pourel, N; Chauvet, B

    2016-10-01

    Adjuvant radiation therapy following breast cancer surgery continues to improve locoregional control and overall survival. But the success of highly targeted-conformal radiotherapy such as intensity-modulated techniques, can be compromised by respiratory motion. The intrafraction motion can potentially result in significant under- or overdose, and also expose organs at risk. This article summarizes the respiratory motion and its effects on imaging, dose calculation and dose delivery by radiotherapy for breast cancer. We will review the methods of respiratory synchronization available for breast radiotherapy to minimize the respiratory impact and to spare organs such as heart and lung.

  20. [Task sharing with radiotherapy technicians in image-guided radiotherapy].

    PubMed

    Diaz, O; Lorchel, F; Revault, C; Mornex, F

    2013-10-01

    The development of accelerators with on-board imaging systems now allows better target volumes reset at the time of irradiation (image-guided radiotherapy [IGRT]). However, these technological advances in the control of repositioning led to a multiplication of tasks for each actor in radiotherapy and increase the time available for the treatment, whether for radiotherapy technicians or radiation oncologists. As there is currently no explicit regulatory framework governing the use of IGRT, some institutional experiments show that a transfer is possible between radiation oncologists and radiotherapy technicians for on-line verification of image positioning. Initial training for every technical and drafting procedures within institutions will improve audit quality by reducing interindividual variability.

  1. Radiotherapy Planning using MRI

    PubMed Central

    Schmidt, Maria A; Payne, Geoffrey S

    2016-01-01

    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 minimised, 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. PMID:26509844

  2. Radiotherapy on hidradenocarcinoma

    PubMed Central

    Lalya, Issam; Hadadi, Khalid; Tazi, El Mehdi; Lalya, Ilham; Bazine, Amine; Andaloussy, Khalid; Elmarjany, Mohamed; Sifat, Hassan; Hassouni, Khalid; Kebdani, Tayeb; Mansouri, Hamid; Benjaafar, Noureddine; Elgueddari, Brahim Khalil

    2011-01-01

    Context: Clear cell Hidradenocarcinoma is a rare carcinoma arising from sweat glands. It is an aggressive tumor that most metastasizes to regional lymph nodes and distant viscera; surgery with safe margins is the mainstay of treatment. Case Report: We report a case of 68-year-old woman who presented with an invasive clear cell hidradenocarcinoma situated in the left parotid area which recurred 5 months after surgery, this recurrence was managed successfully by high-dose irradiation of the tumor bed (66 Gy) and regional lymphatic chains (50 Gy), after a follow-up of more than 15 months, the patient is in good local control without significant toxicity. Conclusion: Post operative radiotherapy allows better local control and should be mandatory when histological features predictive of recurrence are present: positive margins, histology poorly differentiated, perineural invasion, vascular and lymphatic invasion, lymph node involvement, and extracapsular spread. PMID:22540063

  3. [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.

  4. Pion radiotherapy at LAMPF

    SciTech Connect

    Bush, S.E.; Smith, A.R.; Zink, S.

    1982-12-01

    Clinical investigations of pi meson radiotherapy were conducted by the Cancer Research and Treatment Center of the University of New Mexico and the Los Alamos National Laboratory from 1974 until 1982. Two hundred and thirty patients have been treated for a variety of locally advanced primary and metastatic neoplasms. One hundred and ninety-six patients have been followed for a minimum of 18 months. Crude survival data range from 11% for unresectable pancreatic carcinoma to 82% for Stages C and D1 adenocarcinoma of the prostate. Acute tolerance of normal tissues is approximately 4500 pion rad in 36 fractions over 7 weeks. Severe chronic reactions have appeared with increasing frequency after doses in excess of 4000 pion rad.

  5. Art Playgroup

    ERIC Educational Resources Information Center

    Heiniger, Christina

    2004-01-01

    In this article, the author discusses how parents can be involved in a developmentally appropriate art program for very young children. "Art Playgroup," a program for children ages two to five and their parents is one suggestion. Operating under the auspices of DTA Center for Learning & Growing, a nonprofit in Ellsworth, Maine, DTA…

  6. Creative Arts.

    ERIC Educational Resources Information Center

    Castellano, Richard J.; Fleming, Mary Ann

    Educational goals and objectives, student activities, and visual aids are included in this guide to a three-dimensional design unit that combines creative art and industrial arts skills. Course goals include challenging students' creative skills, encouraging student interaction and successful group work, and providing an atmosphere of fun and…

  7. Indigenous Art

    ERIC Educational Resources Information Center

    Hu, Helen

    2012-01-01

    Linda Lomahaftewa, a noted painter, has taught at much bigger places than the Institute of American Indian Arts (IAIA). But Lomahaftewa, who is Hopi-Choctaw, and others on the faculty of IAIA are intensely devoted to the mission of this small but unique school. IAIA--the nation's only four-year fine arts institution devoted to American Indian and…

  8. Art Rocks!

    ERIC Educational Resources Information Center

    Chapin, Erika

    2008-01-01

    Though people may like different types of music, everyone likes music. In middle school, music and art are of key importance for students to express and define what kind of person they are. In this article, the author presents an art project where students are asked to create their own guitars. (Contains 1 resource and 3 online resources.)

  9. Graphic Arts.

    ERIC Educational Resources Information Center

    Towler, Alan L.

    This guide to teaching graphic arts, one in a series of instructional materials for junior high industrial arts education, is designed to assist teachers as they plan and implement new courses of study and as they make revisions and improvements in existing courses in order to integrate classroom learning with real-life experiences. This graphic…

  10. Intensity Modulated Radiotherapy with High Energy Photon and Hadron Beams

    NASA Astrophysics Data System (ADS)

    Oelfke, U.

    2004-07-01

    This short contribution will briefly describe the basic concepts of intensity modulated radiation therapy with high energy photons (IMRT) and charged particle beams (IMPT). Dose delivery and optimization strategies like the `Inverse Planning' approach will be explained for both radiation modalities and their potential advantages are demonstrated for characteristic clinical examples. Finally, future development like image guided radiotherapy (IGRT) and adaptive radiation therapy, based on functional imaging methods, will be introduced.

  11. Bone Health and Pelvic Radiotherapy.

    PubMed

    Higham, C E; Faithfull, S

    2015-11-01

    Survivors who have received pelvic radiotherapy make up many of the long-term cancer population, with therapies for gynaecological, bowel, bladder and prostate malignancies. Individuals who receive radiotherapy to the pelvis as part of their cancer treatment are at risk of insufficiency fractures. Symptoms of insufficiency fractures include pelvic and back pain and immobility, which can affect substantially quality of life. This constellation of symptoms can occur within 2 months of radiotherapy up to 63 months post-treatment, with a median incidence of 6-20 months. As a condition it is under reported and evidence is poor as to the contributing risk factors, causation and best management to improve the patient's bone health and mobility. As radiotherapy advances, chronic symptoms, such as insufficiency fractures, as a consequence of treatment need to be better understood and reviewed. This overview explores the current evidence for the effect of radiotherapy on bone health and insufficiency fractures and identifies what we know and where gaps in our knowledge lie. The overview concludes with the need to take seriously complaints of pelvic pain from patients after pelvic radiotherapy and to investigate and manage these symptoms more effectively. There is a clear need for definitive research in this field to provide the evidence-based guidance much needed in practice.

  12. Adaptive Radiation Therapy for Prostate Cancer

    PubMed Central

    Ghilezan, Michel; Yan, Di; Martinez, Alvaro

    2013-01-01

    Adaptive radiotherapy has been introduced to manage an individual's treatment by, including patient-specific treatment variation identified and quantified during the course of radiotherapy in the treatment planning and delivering optimization. Early studies have demonstrated that this technique could significantly improve the therapeutic ratio by safely reducing the large target margin that has to be used in conventional radiotherapy for prostate cancer treatment. Clinical application of off-line image-guided adaptive radiotherapy for prostate cancer has demonstrated encouraging clinical outcome. Long-term clinical follow-up has shown significant improvement in terms of tumor control and low toxicity profile, emphasizing the beneficial effect of image-guidance and adaptive treatment. Continuous development in adaptive radiotherapy has made possible additional increases in target dose by further reducing target margin when using online image-guided adaptive intensity-modulated radiation therapy. However, clinical implementation of new techniques should be explored cautiously and should include a comprehensive management strategy to address uncertainties in target definition and delineation in the preclinical implementation studies. PMID:20219551

  13. [New techniques and potential benefits for radiotherapy of lung cancer].

    PubMed

    Lefebvre, L; Doré, M; Giraud, P

    2014-10-01

    Radiotherapy is used for inoperable lung cancers, sometimes in association with chemotherapy. Outcomes of conventional radiotherapy are disappointing. New techniques improve adaptation to tumour volume, decrease normal tissue irradiation and lead to increasing tumour dose with the opportunity for improved survival. With intensity-modulated radiation therapy, isodoses can conform to complex volumes. It is widely used and seems to be indicated in locally advanced stages. Its dosimetric improvements have been demonstrated but outcomes are still heterogeneous. Stereotactic radiotherapy allows treatment of small volumes with many narrow beams. Dedicated devices or appropriate equipment on classical devices are needed. In early stages, its efficacy is comparable to surgery with an acceptable toxicity. Endobronchial brachytherapy could be used for early stages with specific criteria. Hadrontherapy is still experimental regarding lung cancer. Hadrons have physical properties leading to very accurate dose distribution. In the rare published studies, toxicities are roughly lower than others techniques but for early stages its effectiveness is not better than stereotactic radiotherapy. These techniques are optimized by metabolic imaging which precisely defines the target volume and assesses the therapeutic response; image-guided radiation therapy which allows a more accurate patient set up and by respiratory tracking or gating which takes account of tumour respiratory motions.

  14. Adaptive Image Denoising by Mixture Adaptation

    NASA Astrophysics Data System (ADS)

    Luo, Enming; Chan, Stanley H.; Nguyen, Truong Q.

    2016-10-01

    We propose an adaptive learning procedure to learn patch-based image priors for image denoising. The new algorithm, called the Expectation-Maximization (EM) adaptation, takes a generic prior learned from a generic external database and adapts it to the noisy image to generate a specific prior. Different from existing methods that combine internal and external statistics in ad-hoc ways, the proposed algorithm is rigorously derived from a Bayesian hyper-prior perspective. There are two contributions of this paper: First, we provide full derivation of the EM adaptation algorithm and demonstrate methods to improve the computational complexity. Second, in the absence of the latent clean image, we show how EM adaptation can be modified based on pre-filtering. Experimental results show that the proposed adaptation algorithm yields consistently better denoising results than the one without adaptation and is superior to several state-of-the-art algorithms.

  15. Adaptive Image Denoising by Mixture Adaptation.

    PubMed

    Luo, Enming; Chan, Stanley H; Nguyen, Truong Q

    2016-10-01

    We propose an adaptive learning procedure to learn patch-based image priors for image denoising. The new algorithm, called the expectation-maximization (EM) adaptation, takes a generic prior learned from a generic external database and adapts it to the noisy image to generate a specific prior. Different from existing methods that combine internal and external statistics in ad hoc ways, the proposed algorithm is rigorously derived from a Bayesian hyper-prior perspective. There are two contributions of this paper. First, we provide full derivation of the EM adaptation algorithm and demonstrate methods to improve the computational complexity. Second, in the absence of the latent clean image, we show how EM adaptation can be modified based on pre-filtering. The experimental results show that the proposed adaptation algorithm yields consistently better denoising results than the one without adaptation and is superior to several state-of-the-art algorithms.

  16. Uses of megavoltage digital tomosynthesis in radiotherapy

    NASA Astrophysics Data System (ADS)

    Sarkar, Vikren

    , the software was extended to investigate if the digital tomosynthesis dataset could be used in an adaptive radiotherapy regimen through the use of the Pinnacle treatment planning software to recalculate dose delivered. The feasibility study showed that the megavoltage CBDT visually agreed with corresponding megavoltage computed tomography images. The comparative study showed that the best compromise between imaging quality and imaging dose is obtained when 11 projection images, acquired over an imaging angle of 40°, are used with the filtered back-projection algorithm. DART was successfully used to register reference and daily image sets to within 1 mm in-plane and 2.5 mm out of plane. The DART platform was also effectively used to generate updated files that the Pinnacle treatment planning system used to calculate updated dose in a rigidly shifted patient. These doses were then used to calculate a cumulative dose distribution that could be used by a physician as reference to decide when the treatment plan should be updated. In conclusion, this study showed that a software solution is possible to extend existing electronic portal imaging devices to function as cone-beam digital tomosynthesis devices and achieve daily requirement for image guided intensity modulated radiotherapy treatments. The DART platform also has the potential to be used as a part of adaptive radiotherapy solution.

  17. [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.

  18. 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

  19. Inflammatory Skin Conditions Associated With Radiotherapy.

    PubMed

    Hernández Aragüés, I; Pulido Pérez, A; Suárez Fernández, R

    2017-04-01

    Radiotherapy for cancer is used increasingly. Because skin cells undergo rapid turnover, the ionizing radiation of radiotherapy has collateral effects that are often expressed in inflammatory reactions. Some of these reactions-radiodermatitis and recall phenomenon, for example-are very familiar to dermatologists. Other, less common radiotherapy-associated skin conditions are often underdiagnosed but must also be recognized.

  20. Radiotherapy supports protective tumor-specific immunity

    PubMed Central

    Gupta, Anurag; Sharma, Anu; von Boehmer, Lotta; Surace, Laura; Knuth, Alexander; van den Broek, Maries

    2012-01-01

    Radiotherapy is an important therapeutic option for the treatment of cancer. Growing evidence indicates that, besides inducing an irreversible DNA damage, radiotherapy promotes tumor-specific immune response, which significantly contribute to therapeutic efficacy. We postulate that radiotherapy activates tumor-associated dendritic cells, thus changing the tolerogenic tumor environment into an immunogenic one. PMID:23264910

  1. 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

  2. Second Malignant Neoplasms Following Radiotherapy

    PubMed Central

    Kumar, Sanath

    2012-01-01

    More than half of all cancer patients receive radiotherapy as a part of their treatment. With the increasing number of long-term cancer survivors, there is a growing concern about the risk of radiation induced second malignant neoplasm [SMN]. This risk appears to be highest for survivors of childhood cancers. The exact mechanism and dose-response relationship for radiation induced malignancy is not well understood, however, there have been growing efforts to develop strategies for the prevention and mitigation of radiation induced cancers. This review article focuses on the incidence, etiology, and risk factors for SMN in various organs after radiotherapy. PMID:23249860

  3. Art & Literacy

    ERIC Educational Resources Information Center

    Shmulsky, Lucinda

    2009-01-01

    In July 2004, The National Endowment for the Arts released the results of a survey entitled "Reading at Risk." The survey covered a 20-year period from 1982 to 2002 and documented a dramatic decline in the reading of literary works by all age groups during that period. The steepest decline of 28 percent was found among the youngest age group of…

  4. Producing Art.

    ERIC Educational Resources Information Center

    Hiller, Peter

    1999-01-01

    Describes an art activity for use in a unit on agriculture in which third grade students create packing crate labels. Students compare examples of packing crate labels, identifying the name, image, product description, and visual elements such as color and balance. Discusses the process of creating the labels. (CMK)

  5. Art History

    ERIC Educational Resources Information Center

    Lukehart, Wendy

    2004-01-01

    Whether one views art as a cultural record, a political or religious instrument, a celebration of form and color, or an instinctual force, it is a given that sharing diverse expressions of creativity with children plants fresh understandings and pathways for their own questions and drives. It is impossible to do justice to the many outstanding…

  6. Spanish Art.

    ERIC Educational Resources Information Center

    Henderson, Anne; Wilson, Mary Ellen

    1995-01-01

    Provides instructional strategies and materials designed to introduce students to Spanish art. Includes four lesson plans with student objectives, background information, and step-by-step instructional procedures. Also includes four full-page color reproductions of paintings by Murillo, Picasso, El Greco, and de Goya. (CFR)

  7. Language Arts.

    ERIC Educational Resources Information Center

    Arkansas State Dept. of Education, Little Rock.

    The language arts course content guides presented in this manual cover English, oral communications, and journalism in grades 9-12 and provide a framework from which a curriculum can be built. Within each subject area and at each grade level, skills are identified at three instructional levels: basic, developmental, and extension. The basic skills…

  8. Scanner Art

    ERIC Educational Resources Information Center

    Jaworski, Joy; Murphy, Kris

    2009-01-01

    In this article, the authors describe how they incorporated environmental awareness into their art curriculum. Here, they describe a digital photography project in which their students used flatbed scanners as cameras. Their students composed their objects directly on the scanner. The lesson enabled students to realize that artists have voices…

  9. Nature's Art.

    ERIC Educational Resources Information Center

    Sterling, Vicki; And Others

    Over 60 art activities, designed to enhance environmental awareness and incorporate environmental concepts, are outlined in this document. A sample of the activities presented are: decorated notepaper and cards with feathers or weeds; wall plaques of prairie plants; methods of flower preservation; water plant prints; construction of dolls,…

  10. Fine Arts.

    ERIC Educational Resources Information Center

    Danzer, Gerald A.; Newman, Mark

    1992-01-01

    Discusses the use of fine arts as sources to enrich the study of history. Suggests that such works will serve as barometers of change, examples of cross-cultural influences, and political messages. Includes suggestions of works and artists from different historic periods. (DK)

  11. Chicken Art

    ERIC Educational Resources Information Center

    Bickett, Marianne

    2009-01-01

    In this article, the author describes how a visit from a flock of chickens provided inspiration for the children's chicken art. The gentle clucking of the hens, the rooster crowing, and the softness of the feathers all provided rich aural, tactile, visual, and emotional experiences. The experience affirms the importance and value of direct…

  12. Language Arts.

    ERIC Educational Resources Information Center

    Keener, Paul L.

    Capitalizing on the resources available in an urban city block, this resource guide for the emotionally handicapped (K-6) presents a resource list and objectives and activities relative to teaching language arts (reading, English, listening, speaking, and writing). The resource list is comprised of approximately 150 physical facilities (e.g.,…

  13. [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.

  14. 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.

  15. [Image-guided radiotherapy].

    PubMed

    de Crevoisier, R; Chauvet, B; Barillot, I; Lafond, C; Mahé, M; Delpon, G

    2016-09-01

    The IGRT is described in its various equipment and implementation. IGRT can be based either on ionizing radiation generating 2D imaging (MV or kV) or 3D imaging (CBCT or MV-CT) or on non-ionizing radiation (ultrasound, optical imaging, MRI or radiofrequency). Adaptive radiation therapy is then presented in its principles of implementation. The function of the technicians for IGRT is then presented and the possible dose delivered by the on-board imaging is discussed. The quality control of IGRT devices is finally described.

  16. Technology in Art Therapy: Ethical Challenges

    ERIC Educational Resources Information Center

    Alders, Amanda; Beck, Liz; Allen, Pat B.; Mosinski, Barbara

    2011-01-01

    As technology advances, art therapy practices are adapting to the demands of a new cultural climate. Art therapists face a number of ethical challenges as they interact with increasingly diverse populations and employ new media. This article addresses some of the ethical and professional issues related to the use of technology in clinical…

  17. The Art and Science of Aerial Perspective

    ERIC Educational Resources Information Center

    Kegel, Susan

    2006-01-01

    The author is always looking for ways to see connections and to adapt experiences across different subjects. Combining art with other disciplines helps keep students engaged, even the really analytical and verbal learners. Aerial perspective is an art technique, a scientific principle, and a vehicle for introducing Chinese painting and…

  18. Using the Outdoors To Teach Language Arts.

    ERIC Educational Resources Information Center

    Staley, Rebecca R.; Staley, Frederick A.

    A framework for using the outdoors as a vehicle for providing meaningful language arts experiences is presented in this guide geared toward intermediate students but adaptable for other ages. The introduction outlines goals of language arts instruction and notes that activities conducted outdoors contribute to these goals because they are…

  19. Snow Art

    ERIC Educational Resources Information Center

    Kraus, Nicole

    2012-01-01

    It was nearing the end of a very long, rough winter with a lot of snow and too little time to play outside. The snow had formed small hills and valleys over the bushes and this was at the perfect height for the students to paint. In this article, the author describes how her transitional first-grade students created snow art paintings. (Contains 1…

  20. Art Preservation

    NASA Technical Reports Server (NTRS)

    1989-01-01

    A new class of polyimides, synthesized by Langley Research Center, has been evaluated by the Getty Conservation Institute's Materials Science Group for possible art conservation applications. Polyimides are noted for resistance to high temperature, wear and radiation. They are thermally stable and soluble in some common solvents. After testing under simulated exposures for changes in color, permeability and flexibility, one coating, ODPA-3, 3-ODA may be used to protect bronze statues from corrosion. A test on stained glass windows was unsuccessful.

  1. All About Art.

    ERIC Educational Resources Information Center

    Silverman, Ronald H.

    This is an experimental textbook for teaching about the visual arts at the elementary level. The content answers five questions about art: what is art; who makes art; what are the sources for art; why is art important to you; and why is art important to society. At the end of each section of the text is a set of questions and suggestions for…

  2. "Artforum," Andy Warhol, and the Art of Living: What Art Educators Can Learn from the Recent History of American Art Writing

    ERIC Educational Resources Information Center

    Carrier, David

    2005-01-01

    What is the best way to understand the recent development of American art? An older tradition of commentary focuses on the role of tradition, noting how each new form of painting is rooted in a long history. But Jack Bankoswky and some other art writers discussing Andy Warhol have adapted a different approach, arguing that his art breaks radically…

  3. Art Therapy: What Is Art Therapy?

    MedlinePlus

    ... from art therapy? Art therapy is practiced in mental health, rehabilitation, medical, educational, forensic, wellness, private practice and community settings with diverse client populations in ...

  4. [Stereotactic radiotherapy for pelvic tumors].

    PubMed

    Mazeron, R; Fumagalli, I

    2014-01-01

    Extracranial stereotactic radiotherapy is booming. The development and spread of dedicated accelerators coupled with efficient methods of repositioning can now allow treatments of mobile lesions with moderate size, with high doses per fraction. Intuitively, except for the prostate, pelvic tumours, often requiring irradiation of regional lymph node drainage, lend little to this type of treatment. However, in some difficult circumstances, such as boost or re-radiation, stereotactic irradiation condition is promising and clinical experiences have already been reported.

  5. 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.

  6. Fine Arts: Secondary Visual Arts Curriculum.

    ERIC Educational Resources Information Center

    Utah State Office of Education, Salt Lake City.

    This guide to Utah's requirements for students in secondary visual arts is organized and based upon a student achievement portfolio for each course. Foundation I, the required junior high/middle school visual arts course, is designed to provide an overview of visual arts while studying various art tools and materials. With an emphasis on studio…

  7. History and Art: The Heart of Art.

    ERIC Educational Resources Information Center

    Seiferth, Berniece B; And Others

    Learning to appreciate religious art and to understand the interdependence of history and art are basic to the foundations of culture. Students need to be exposed to the art of the diverse adherents of all major religions in order to understand the beliefs and practices of others. Students can examine religious art from ancient times, including…

  8. Art Supply Inventors. Children's Art Diary.

    ERIC Educational Resources Information Center

    Szekely, George

    2001-01-01

    Discusses types of art materials that children enjoy using in their artworks. Explores the art materials such as tasty art supplies, such as candy; peeled supplies, such as pencil shavings; sticky art supplies, such as Band-Aids; and fast-food supplies, such as forks and spoons. (CMK)

  9. Small Art Images--Big Art Learning

    ERIC Educational Resources Information Center

    Stephens, Pam

    2005-01-01

    When small art images are incorporated into the curriculum, students are afforded opportunities to slow down, observe minute details, and communicate ideas about art and artists. This sort of purposeful art contemplation takes students beyond the day-to-day educational practice. It is through these sorts of art activities that students develop…

  10. Art Therapy Teaching as Performance Art

    ERIC Educational Resources Information Center

    Moon, Bruce L.

    2012-01-01

    This viewpoint asserts that art therapy education is a form of performance art. By designing class sessions as performance artworks, art therapy educators can help their students become more fully immersed in their studies. This view also can be extended to conceptualizing each semester--and the entire art therapy curriculum--as a complex and…

  11. How the United States Funds the Arts. Third Edition

    ERIC Educational Resources Information Center

    National Endowment for the Arts, 2012

    2012-01-01

    The infrastructure for arts and cultural support in the United States is complex and adaptive. Citizens who enjoy the arts can choose from a wide array of drama, visual and media arts, dance, music, and literature available in formal and informal settings--theaters, museums, and concert halls, but also libraries, schools, places of worship,…

  12. Art Education in a World of Cross-Purposes

    ERIC Educational Resources Information Center

    Hope, Samuel

    2005-01-01

    This article is adapted from the Handbook of Research and Policy in Art Education. Elliot Eisner and Michael Day (eds.) [c] 2004 by Lawrence Erlbaum and Associates, Mahwah, NJ, and the National Art Education Association. To study art education is to discover and engage a field rich with achievement and promise. On one hand, this comes as no…

  13. Present Status of Radiotherapy in Clinical Practice

    NASA Astrophysics Data System (ADS)

    Duehmke, Eckhart

    Aims of radiation oncology are cure from malignant diseases and - at the same time preservation of anatomy (e.g. female breast, uterus, prostate) and organ functions (e.g. brain, eye, voice, sphincter ani). At present, methods and results of clinical radiotherapy (RT) are based on experiences with natural history and radiobiology of malignant tumors in properly defined situations as well as on technical developments since World War II in geometrical and biological treatment planning in teletherapy and brachytherapy. Radiobiological research revealed tolerance limits of healthy tissues to be respected, effective total treatment doses of high cure probability depending on histology and tumor volume, and - more recently - altered fractionation schemes to be adapted to specific growth fractions and intrinsic radiosensitivities of clonogenic tumor cells. In addition, Biological Response Modifiers (BRM), such as cis-platinum, oxygen and hyperthermia may steepen cell survival curves of hypoxic tumor cells, others - such as tetrachiordekaoxid (TCDO) - may enhance repair of normal tissues. Computer assisted techniques in geometrical RT-planning based on individual healthy and pathologic anatomy (CT, MRT) provide high precision RT for well defined brain lesions by using dedicated linear accelerators (Stereotaxy). CT-based individual tissue compensators help with homogenization of distorted dose distributions in magna field irradiation for malignant lymphomas and with total body irradiation (TBI) before allogeneic bone marrow transplantation, e.g. for leukemia. RT with fast neutrons, Boron Neutron Capture Therapy (BNCT), RT with protons and heavy ions need to be tested in randomized trials before implementation into clinical routine.

  14. Improving target definition for head and neck radiotherapy: a place for magnetic resonance imaging and 18-fluoride fluorodeoxyglucose positron emission tomography?

    PubMed

    Prestwich, R J D; Sykes, J; Carey, B; Sen, M; Dyker, K E; Scarsbrook, A F

    2012-10-01

    Defining the target for head and neck radiotherapy is a critical issue with the introduction of steep dose gradients associated with intensity-modulated radiotherapy. Tumour delineation inaccuracies are a major source of error in radiotherapy planning. The integration of 18-fluoride fluorodeoxyglucose positron emission tomography ((18)FDG-PET) and magnetic resonance imaging directly into the radiotherapy planning process has the potential to greatly improve target identification/selection and delineation. This raises a range of new issues surrounding image co-registration, delineation methodology and the use of functional data and treatment adaptation. This overview will discuss the practical aspects of integrating (18)FDG-PET and magnetic resonance imaging into head and neck radiotherapy planning.

  15. Supine proton beam craniospinal radiotherapy using a novel tabletop adapter

    SciTech Connect

    Buchsbaum, Jeffrey C.; Besemer, Abby; Simmons, Joseph; Hoene, Ted; Simoneaux, Victor; Sandefur, Amy; Wolanski, Mark; Li, Zhao; Cheng, Chee-Wei

    2013-04-01

    To develop a device that allows supine craniospinal proton and photon therapy to the vast majority of proton and photon facilities currently experiencing limitations as a result of couch design issues. Plywood and carbon fiber were used for the development of a prototype unit. Once this was found to be satisfactory after all design issues were addressed, computer-assisted design (CAD) was used and carbon fiber tables were built to our specifications at a local manufacturer of military and racing car carbon fiber parts. Clinic-driven design was done using real-time team discussion for a prototype design. A local machinist was able to construct a prototype unit for us in <2 weeks after the start of our project. Once the prototype had been used successfully for several months and all development issues were addressed, a custom carbon fiber design was developed in coordination with a carbon fiber manufacturer in partnership. CAD methods were used to design the units to allow oblique fields from head to thigh on patients up to 200 cm in height. Two custom-designed carbon fiber craniospinal tabletop designs now exist: one long and one short. Four are in successful use in our facility. Their weight tolerance is greater than that of our robot table joint (164 kg). The long unit allows for working with taller patients and can be converted into a short unit as needed. An affordable, practical means of doing supine craniospinal therapy with protons or photons can be used in most locations via the use of these devices. This is important because proton therapy provides a much lower integral dose than all other therapy methods for these patients and the supine position is easier for patients to tolerate and for anesthesia delivery. These units have been successfully used for adult and pediatric supine craniospinal therapy, proton therapy using oblique beams to the low pelvis, treatment of various spine tumors, and breast-sparing Hodgkin's therapy.

  16. Radiotherapy in patients with connective tissue diseases.

    PubMed

    Giaj-Levra, Niccolò; Sciascia, Savino; Fiorentino, Alba; Fersino, Sergio; Mazzola, Rosario; Ricchetti, Francesco; Roccatello, Dario; Alongi, Filippo

    2016-03-01

    The decision to offer radiotherapy in patients with connective tissue diseases continues to be challenging. Radiotherapy might trigger the onset of connective tissue diseases by increasing the expression of self-antigens, diminishing regulatory T-cell activity, and activating effectors of innate immunity (dendritic cells) through Toll-like receptor-dependent mechanisms, all of which could potentially lead to breaks of immune tolerance. This potential risk has raised some debate among radiation oncologists about whether patients with connective tissue diseases can tolerate radiation as well as people without connective tissue diseases. Because the number of patients with cancer and connective tissue diseases needing radiotherapy will probably increase due to improvements in medical treatment and longer life expectancy, the issue of interactions between radiotherapy and connective tissue diseases needs to be clearer. In this Review, we discuss available data and evidence for patients with connective tissue diseases treated with radiotherapy.

  17. 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.

  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. National ART Success Rates

    MedlinePlus

    ... 2: ART Cycles using fresh nondonor eggs or embryos What are the steps for an ART cycle ... 37MB] Section 3: ART Cycles using frozen nondonor embryos Did implantation rates differ by a woman’s age? [ ...

  20. Funding the Arts.

    ERIC Educational Resources Information Center

    Starr, Douglas P.

    1983-01-01

    The nature of the National Endowment of the Arts (NEA), its birth, growth, and uncertain future, are examined. What the arts community is doing to insure a national arts environment is discussed. (RM)

  1. American Art Therapy Association

    MedlinePlus

    ... more My AATA Collaborate Types & Benefits Local Chapters Education Art Therapy Education ...Read more Educational Standards Approved Art Therapy Master’s ... Art Therapy Credentials Board (ATCB) Institute for Continuing Education (ICE) Ethics Multicultural Conference Conference Information ...Read more ...

  2. Teaching Art with Art: Grotesque Visions.

    ERIC Educational Resources Information Center

    Hubbard, Guy

    2001-01-01

    Discusses a type of visual art called grotesque art and includes four different examples of grotesque art: (1) the painting "Head of Medusa" by Peter Paul Rubens; (2) Rangda, the widow witch from Bali (Indonesia); (3) totem poles; and (4) grotesque sculptures from the Cathedral of Notre Dame (Paris, France). (CMK)

  3. Arts Impact: Lessons from ArtsBridge

    ERIC Educational Resources Information Center

    Shimshon-Santo, Amy R.

    2010-01-01

    Arts Impact summarizes lessons learned at the ArtsBridge Program. It is informed by in-depth participant observation, logic modeling, and quantitative evaluation of program impact on K-12 students in inner city schools and arts students at the University of California Los Angeles over a two year period. The case study frames its analysis through a…

  4. Keeping the Arts Alive: Fine Arts Databases

    ERIC Educational Resources Information Center

    Young, Terrence E., Jr.

    2005-01-01

    When budgets are tightened, the school library media specialists and/or the arts programs are often considered expendable. No Child Left Behind legislation means increasing academic time for core subjects, which translates into cutting time for arts education. As money becomes tight, frills are cut (i.e., the arts). Schools don't seem able to fill…

  5. The Liberal Arts and the Martial Arts.

    ERIC Educational Resources Information Center

    Levine, Donald N.

    1984-01-01

    Liberal arts and the martial arts are compared from the perspective that courses of training in the martial arts often constitute exemplary educational programs and are worth examining closely. Program characteristics, individual characteristics fostered by them, the relationship between liberal and utilitarian learning, and the moral…

  6. The Art of Teaching Art Teachers.

    ERIC Educational Resources Information Center

    Grauer, Kit

    1999-01-01

    Examines the conceptions of educating beginning art teachers with specific reference to Canadian art education. Addresses the use of the visual journal, which demonstrates visual and verbal thinking, by preservice teachers at the University of British Columbia as a means to develop an artistic understanding of their growth as art teachers. (CMK)

  7. [Radiotherapy of benign intracranial tumors].

    PubMed

    Delannes, M; Latorzeff, I; Chand, M E; Huchet, A; Dupin, C; Colin, P

    2016-09-01

    Most of the benign intracranial tumors are meningiomas, vestibular schwannomas, pituitary adenomas, craniopharyngiomas, and glomus tumors. Some of them grow very slowly, and can be observed without specific treatment, especially if they are asymptomatic. Symptomatic or growing tumors are treated by surgery, which is the reference treatment. When surgery is not possible, due to the location of the lesion, or general conditions, radiotherapy can be applied, as it is if there is a postoperative growing residual tumor, or a local relapse. Indications have to be discussed in polydisciplinary meetings, with precise evaluation of the benefit and risks of the treatments. The techniques to be used are the most modern ones, as multimodal imaging and image-guided radiation therapy. Stereotactic treatments, using fractionated or single doses depending on the size or the location of the tumors, are commonly realized, to avoid as much a possible the occurrence of late side effects.

  8. Radiotherapy for Pancreatic Neuroendocrine Tumors

    SciTech Connect

    Contessa, Joseph N.; Griffith, Kent A.; Wolff, Elizabeth; Ensminger, William; Zalupski, Mark; Ben-Josef, Edgar

    2009-11-15

    Purpose: Pancreatic neuroendocrine tumors (PNTs) are rare malignant neoplasms considered to be resistant to radiotherapy (RT), although data on efficacy are scarce. We reviewed our institutional experience to further delineate the role of RT for patients with PNTs. Methods and Materials: Between 1986 and 2006, 36 patients with PNTs were treated with RT to 49 sites. Of these 36 patients, 23 had radiographic follow-up data, which were used to determine the tumor response rate and freedom from local progression. Long-term toxicity was graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events. Results: The overall response rate to RT was 39% (13% complete response, 26% partial response, 56% stable disease, and 4% progressive disease). A significant difference in the freedom from local progression between the groups receiving either greater than or less than the median 2 Gy/fraction biologically equivalent dose of 49.6 Gy was found, with all radiographic progression occurring in patients who had received <=32 Gy. The actuarial 3-year local freedom from progression rate was 49%. Palliation was achieved in 90% of patients, with either improvement or resolution of symptoms after RT. Of 35 patients, 33 had metastatic disease at their referral for RT, and the median overall survival for this patient population was 2 years. Three long-term Grade 3 or greater toxicities were recorded. Conclusion: RT is an effective modality for achieving local control in patients with PNTs. RT produces high rates of symptomatic palliation and freedom from local progression. Prospective trials of radiotherapy for PNTs are warranted.

  9. Navigated marker placement for motion compensation in radiotherapy

    NASA Astrophysics Data System (ADS)

    Winterstein, A.; März, K.; Franz, A. M.; Hafezi, M.; Fard, N.; Sterzing, F.; Mehrabi, A.; Maier-Hein, L.

    2015-03-01

    Radiotherapy is frequently used to treat unoperated or partially resected tumors. Tumor movement, e.g. caused by respiration, is a major challenge in this context. Markers can be implanted around the tumor prior to radiation therapy for accurate tracking of tumor movement. However, accurate placement of these markers while keeping a secure margin around the target and while taking into account critical structures is a difficult task. Computer-assisted needle insertion has been an active field of research in the past decades. However, the challenge of navigated marker placement for motion compensated radiotherapy has not yet been addressed. This work presents a system to support marker implantation for radiotherapy under consideration of safety margins and optimal marker configuration. It is designed to allow placement of markers both percutaneously and during an open liver surgery. To this end, we adapted the previously proposed EchoTrack system which integrates ultrasound (US) imaging and electromagnetic (EM) tracking in a single mobile modality. The potential of our new marker insertion concept was evaluated in a phantom study by inserting sets of three markers around dedicated targets (n=22) simultaneously spacing the markers evenly around the target as well as placing the markers in a defined distance to the target. In all cases the markers were successfully placed in a configuration fulfilling the predefined criteria. This includes a minimum distance of 18.9 ± 2.4 mm between marker and tumor as well as a divergence of 2.1 ± 1.5 mm from the planned marker positions. We conclude that our system has high potential to facilitate the placement of markers in suitable configurations for surgeons without extensive experience in needle punctions as high quality configurations were obtained even by medical non-experts.

  10. Intraoperative Radiotherapy in Childhood Malignant Astrocytoma

    PubMed Central

    Rana, Sohail R.; Haddy, Theresa B.; Ashayeri, Ebrahim; Goldson, Alfred L.

    1984-01-01

    A 12-year-old black male patient with glioblastoma multiforme was treated with intraoperative radiotherapy followed by conventional external beam radiation and chemotherapy. The authors' clinical experience with these therapeutic measures is discussed. PMID:6330375

  11. Historical aspects of heavy ion radiotherapy

    SciTech Connect

    Raju, M.R.

    1995-03-01

    This paper presents historical developments of heavy-ion radiotherapy including discussion of HILAC and HIMAC and discussion of cooperation between Japan and the United States, along with personal reflections.

  12. [Conformal radiotherapy for vertebral bone metastasis].

    PubMed

    Faivre, J C; Py, J F; Vogin, G; Martinage, G; Salleron, J; Royer, P; Grandgirard, N; Pasquier, D; Thureau, S

    2016-10-01

    Analgesic external beam radiation therapy is a standard of care for patients with uncomplicated painful bone metastases and/or prevention of bone complications. In case of fracture risk, radiation therapy is performed after surgery in a consolidation of an analgesic purpose and stabilizing osteosynthesis. Radiotherapy is mandatory after vertebroplasty or kyphoplasty. Spinal cord compression - the only emergency in radiation therapy - is indicated postoperatively either exclusively for non surgical indication. Analgesic re-irradiation is possible in the case of insufficient response or recurrent pain after radiotherapy. Metabolic radiation, bisphosphonates or denosumab do not dissuade external radiation therapy for pain relief. Systemic oncological treatments can be suspended with a period of wash out given the risk of radiosensitization or recall phenomenon. Better yet, the intensity modulated radiotherapy and stereotactic radiotherapy can be part of a curative strategy for oligometastatic patients and suggest new treatment prospects.

  13. [Hopes of high dose-rate radiotherapy].

    PubMed

    Fouillade, Charles; Favaudon, Vincent; Vozenin, Marie-Catherine; Romeo, Paul-Henri; Bourhis, Jean; Verrelle, Pierre; Devauchelle, Patrick; Patriarca, Annalisa; Heinrich, Sophie; Mazal, Alejandro; Dutreix, Marie

    2017-03-07

    In this review, we present the synthesis of the newly acquired knowledge concerning high dose-rate irradiations and the hopes that these new radiotherapy modalities give rise to. The results were presented at a recent symposium on the subject.

  14. [Radiotherapy of carcinoma of the salivary glands].

    PubMed

    Servagi-Vernat, S; Tochet, F

    2016-09-01

    Indication, doses, and technique of radiotherapy for salivary glands carcinoma are presented, and the contribution of neutrons and carbon ions. The recommendations for delineation of the target volumes and organs at risk are detailed.

  15. Heavy particle radiotherapy: prospects and pitfalls

    SciTech Connect

    Faju, M.R.

    1980-01-01

    The use of heavy particles in radiotherapy of tumor volumes is examined. Particles considered are protons, helium ions, heavy ions, negative pions, and fast neutrons. Advantages and disadvantages are discussed. (ACR)

  16. Intracranial aneurysm formation after radiotherapy for medulloblastoma

    PubMed Central

    Kamide, Tomoya; Mohri, Masanao; Misaki, Kouichi; Uchiyama, Naoyuki; Nakada, Mitsutoshi

    2016-01-01

    Background: The development of an intracranial aneurysm after radiotherapy is rare but secondary effect of cranial irradiation in a primary disease treatment. Case Description: The patient was a 17-year-old male adolescent who was diagnosed as having a posterior fossa medulloblastoma when he was 8 years old. He had undergone tumor resection with radiotherapy and chemotherapy. A distal posterior inferior cerebellar artery aneurysm was identified by magnetic resonance imaging 8 years after radiotherapy and grew rapidly throughout the next 1 year. The patient underwent microsurgical clipping and was discharged without deficit. Conclusion: This experience demonstrates that physicians caring for patients who have undergone intracranial radiotherapy should carefully consider the possibility of an aneurysmal formation when conducting follow-up imaging. PMID:27999713

  17. Women, Art, and Education.

    ERIC Educational Resources Information Center

    Collins, Georgia; Sandell, Renee

    Sex equity issues and efforts in art and art education are examined in five major focus areas: (1) "Matters of Conscious and Consciousness" deals with problematic relationships between women, art and education. (2) "Matters of Protest and Progress" explores the sex equity progress made in art and education. (3) "Matters of Herstory and Heritage"…

  18. Soviet Arts Curriculum Guide.

    ERIC Educational Resources Information Center

    San Diego County Office of Education, CA.

    This extensive curriculum guide was written in conjunction with the San Diego Arts Festival of Soviet Arts in 1989. It aimed to provide teachers with insights and ideas about arts in the Soviet Union before, during, and after the Arts Festival. A curriculum model is presented at the beginning of the guide to illustrate how the lessons were…

  19. Cultivating Demand for the Arts: Arts Learning, Arts Engagement, and State Arts Policy. Summary

    ERIC Educational Resources Information Center

    Zakaras, Laura; Lowell, Julia F.

    2008-01-01

    The findings summarized in this report are intended to shed light on what it means to cultivate demand for the arts, why it is necessary and important to cultivate this demand, and what state arts agencies (SAAs) and other arts and education policymakers can do to help. The research considered only the benchmark arts central to public policy:…

  20. Spotlight on Arts Education.

    ERIC Educational Resources Information Center

    North Carolina State Dept. of Public Education, Raleigh.

    In this annual edition selected cultural arts organizations from across the state are featured, with a specific focus on how these organizations have aided local school systems as they implemented the arts education component of North Carolina's Basic Education Program. The following arts organizations are featured: Winston-Salem Arts Council;…

  1. Art and Religion

    ERIC Educational Resources Information Center

    Shusterman, Richard

    2008-01-01

    Since the nineteenth century's interest in "art for art's sake," many thinkers have argued that art would supplant traditional religion as the spiritual locus of the increasingly secular society of Western modernity. If art can capture the sort of spirituality, idealism, and expressive community of traditional religions but without being ensnared…

  2. Winter Art Education Project

    ERIC Educational Resources Information Center

    Jokela, Timo

    2007-01-01

    The purpose of this article is to describe how the Department of Art Education at the University of Lapland in Finland has developed winter art as a method of environmental and community-based art education. I will focus on the Snow Show Winter Art Education Project, a training project funded by the European Union and the State Provincial Office…

  3. Art Therapy Verses Psychotherapy

    ERIC Educational Resources Information Center

    Del Giacco, Maureen

    2009-01-01

    The purpose of my paper is to identify the difference between psychotherapy and art therapy. Then to introduce a technique within the field of art therapy that is relevant to neuro-plasticity Del Giacco Neuro Art Therapy. The paper identifies the importance of the amygdala and the hippocampus within the role of art therapy. Supporting…

  4. Arts Inspire Community Support.

    ERIC Educational Resources Information Center

    Moore, Dan W.

    1983-01-01

    Describes Southeastern Community College's efforts to focus on the arts, which included a campus visit by the artist Kenneth Larson and events centered on his Heroic Individual prints; a performing arts series supported by local corporations; an Associate in Fine Arts degree; regular art exhibits; and an artist-in-residence program. (DMM)

  5. Art, Reading . . . and Evaluation.

    ERIC Educational Resources Information Center

    Seidenberg, Irving

    1979-01-01

    Interdisciplinary programs which use art to improve or enhance another subject are being developed, perhaps in an attempt to save art education in an era of budget constraints. It is suggested that this trend must not be allowed to destroy the magic of art for art's sake. (KC)

  6. Art Mini-Course

    ERIC Educational Resources Information Center

    Braun, Charlotte

    1976-01-01

    The idea of an open art studio or art mini-course to serve a need above and beyond the regularly scheduled art classes is important and necessary to a school program that is designed to meet the needs of the general intellectual and cultural growth of the child. Describes the art mini-course introduced at the Willow Ridge School in Tonawanda, New…

  7. Cultural Arts Handbook.

    ERIC Educational Resources Information Center

    Pistone, Kathleen A.

    The handbook presents activities to aid elementary school classroom teachers as they develop and implement cultural arts lessons. A cultural arts program is interpreted as a way to help students develop perceptual awareness, build a basic vocabulary in some art cultural form, evaluate their own works of art, appreciate creative expressions, and…

  8. The Language of Art.

    ERIC Educational Resources Information Center

    Winarski, Diana L.

    1995-01-01

    Describes activities of kindergarten through grade-four students in an art classroom that emphasizes expression of creative process along with the product. Explores interconnections between art, thinking, and writing as expressed by a former language arts teacher who transfers her knowledge of language, words, and creative expression to art. (BAC)

  9. K-12 Art Guide.

    ERIC Educational Resources Information Center

    Furney, Trudy; And Others

    The development of students in various art fields is the focus of this K-12 art curriculum guide. The philosophy of the art program and the roles of administrator, teacher, and parent are outlined. The underlying school community relationships, and the objective, goals, and purposes of art education are described. Phases of child development in…

  10. [Radiotherapy for small cell lung carcinoma].

    PubMed

    Pourel, N

    2016-10-01

    Radiotherapy for small cell lung carcinoma has known significant improvements over the past 10 years especially through routine use of PET-CT in the initial work-up and contouring before treatment. Prophylactic cranial irradiation remains a standard of care for locally advanced disease and is a subject of controversy for metastatic disease. A new indication for thoracic radiotherapy may soon arise for metastatic disease, still confirmation studies are ongoing.

  11. Blisters - an unusual effect during radiotherapy.

    PubMed

    Höller, U; Schubert, T; Budach, V; Trefzer, U; Beyer, M

    2013-11-01

    The skin reaction to radiation is regularly monitored in order to detect enhanced radiosensitivity of the patient, unexpected interactions (e.g. with drugs) or any inadvertent overdosage. It is important to distinguish secondary disease from radiation reaction to provide adequate treatment and to avoid unnecessary discontinuation of radiotherapy. A case of bullous eruption or blisters during radiotherapy of the breast is presented. Differential diagnoses bullous pemphigoid, pemphigus vulgaris, and bullous impetigo are discussed and treatment described.

  12. Radiotherapy in the treatment of vertebral hemangiomas

    SciTech Connect

    Faria, S.L.; Schlupp, W.R.; Chiminazzo, H. Jr.

    1985-02-01

    Symptomatic vertebral hemangiomas are not common. Although radiotherapy has been used as treatment, the data are sparse concerning total dose, fractionation and results. The authors report nine patients with vertebral hemangioma treated with 3000-4000 rad, 200 rad/day, 5 fractions per week, followed from 6 to 62 months. Seventy-seven percent had complete or almost complete disappearance of the symptoms. Radiotherapy schedules are discussed.

  13. Radiotherapy for Vestibular Schwannomas: A Critical Review

    SciTech Connect

    Murphy, Erin S.; Suh, John H.

    2011-03-15

    Vestibular schwannomas are slow-growing tumors of the myelin-forming cells that cover cranial nerve VIII. The treatment options for patients with vestibular schwannoma include active observation, surgical management, and radiotherapy. However, the optimal treatment choice remains controversial. We have reviewed the available data and summarized the radiotherapeutic options, including single-session stereotactic radiosurgery, fractionated conventional radiotherapy, fractionated stereotactic radiotherapy, and proton beam therapy. The comparisons of the various radiotherapy modalities have been based on single-institution experiences, which have shown excellent tumor control rates of 91-100%. Both stereotactic radiosurgery and fractionated stereotactic radiotherapy have successfully improved cranial nerve V and VII preservation to >95%. The mixed data regarding the ideal hearing preservation therapy, inherent biases in patient selection, and differences in outcome analysis have made the comparison across radiotherapeutic modalities difficult. Early experience using proton therapy for vestibular schwannoma treatment demonstrated local control rates of 84-100% but disappointing hearing preservation rates of 33-42%. Efforts to improve radiotherapy delivery will focus on refined dosimetry with the goal of reducing the dose to the critical structures. As future randomized trials are unlikely, we suggest regimented pre- and post-treatment assessments, including validated evaluations of cranial nerves V, VII, and VIII, and quality of life assessments with long-term prospective follow-up. The results from such trials will enhance the understanding of therapy outcomes and improve our ability to inform patients.

  14. Holography: science and art

    NASA Astrophysics Data System (ADS)

    Boone, Pierre M.

    1998-09-01

    Art and science are separated by a very large distance nowadays. Long ago, e.g. in Renaissance, or even earlier, in classic Greece and Rome, or still earlier in Egypt or Mesopotamia, arts and sciences were united. Today they seem to go separate paths: science for the industry, arts for the gallery. Holography is an exception: no art without science, but also no science without art.

  15. Prevention of accidental exposure in radiotherapy: the risk matrix approach.

    PubMed

    Vilaragut, J J; Duménigo, C; Delgado, J M; Morales, J; McDonnell, J D; Ferro, R; Ortiz López, P; Ramírez, M L; Pérez Mulas, A; Papadopulos, S; Gonçalves, M; López Morones, R; Sánchez Cayuela, C; Cascajo Castresana, A; Somoano, F; Álvarez, C; Guillén, A; Rodríguez, M; Pereira, P P; Nader, A

    2013-02-01

    Knowledge and lessons from past accidental exposures in radiotherapy are very helpful in finding safety provisions to prevent recurrence. Disseminating lessons is necessary but not sufficient. There may be additional latent risks for other accidental exposures, which have not been reported or have not occurred, but are possible and may occur in the future if not identified, analyzed, and prevented by safety provisions. Proactive methods are available for anticipating and quantifying risk from potential event sequences. In this work, proactive methods, successfully used in industry, have been adapted and used in radiotherapy. Risk matrix is a tool that can be used in individual hospitals to classify event sequences in levels of risk. As with any anticipative method, the risk matrix involves a systematic search for potential risks; that is, any situation that can cause an accidental exposure. The method contributes new insights: The application of the risk matrix approach has identified that another group of less catastrophic but still severe single-patient events may have a higher probability, resulting in higher risk. The use of the risk matrix approach for safety assessment in individual hospitals would provide an opportunity for self-evaluation and managing the safety measures that are most suitable to the hospital's own conditions.

  16. SORS: A New Software for the Simulation of Radiotherapy Schedule

    SciTech Connect

    Tamborra, Pasquale; Simeone, Giovanni; Carioggia, Enza

    2010-10-01

    We present a software for choosing the best radiotherapy treatment schedule for head and neck cancers as a beginning radiotherapy plan or a temporarily interrupted plan. Its application occurs according to two modalities: the first adopts the best estimates for model parameters; the second takes into account the parameters' uncertainty too. In both cases, the choice becomes the schedule with the highest uncomplicated tumor control probability (UTCP). In the UTCP valuation, the normal tissue complication probability (NTCP) of each organ is related to the gravity of its possible late injury. For NTCP calculation, it has been adopted the empirical LKB (Lyman-Kutcher-Burman) model corrected for dose/fraction via linear-quadratic model and the incomplete repair effect. The tumor control probability (TCP) model is Poisson based and contains corrections for dose/fraction and regrowth effect; optionally, it can be accounted for the incomplete repair effect as well. At the end of processing, a detailed file with all informations about UTCP, TCP and single organ NTCP is furnished for every examined schedule. Moreover, a useful 3-D graphic representation of the schedule's UTCP is available, allowing the physician to easily understand the schedules with the highest radiotherapeutic efficacy. The open source characteristic allows the program to adapt to the individual clinical case as well as to be a valid support in radiobiological research.

  17. Whole Pelvic Intensity-modulated Radiotherapy for Gynecological Malignancies: A Review of the Literature

    PubMed Central

    Hymel, Rockne; Jones, Guy C.; Simone, Charles B.

    2015-01-01

    Radiation therapy has long played a major role in the treatment of gynecological malignancies. There is increasing interest in the utility of intensity-modulated radiotherapy (IMRT) and its application to treat gynecological malignancies. Herein, we review the state-of-the-art use of IMRT for gynecological malignancies and report how it is being used alone as well as in combination with chemotherapy in both the adjuvant and definitive settings. Based on dosimetric and clinical evidence, IMRT can reduce gastrointestinal, genitourinary, and hematological toxicities compared with 3D conformal radiotherapy for gynecologic malignancies. We discuss how these attributes of IMRT may lead to improvements in disease outcomes by allowing for dose escalation of radiation therapy, intensification of chemotherapy, and limiting toxicity-related treatment breaks. Currently accruing trials investigating pelvic IMRT for cervical and endometrial cancers are discussed. PMID:25600840

  18. Salvage external beam radiotherapy for prostate cancer after radical prostatectomy: current status and controversy.

    PubMed

    Raldow, Ann; Hamstra, Daniel A; Kim, Sung; Yu, James B

    2010-07-01

    Prostate cancer is the second most common cause of cancer death in American men. What to do when prostate cancer recurs months or years after a patient undergoes radical prostatectomy is an area of active research. Patients who underwent radical prostatectomy without immediate adjuvant radiation therapy (ART) but subsequently have evidence of recurrent disease are candidates for Salvage Radiation Therapy (SRT). Though there are three prospective randomized trials illustrating the efficacy of post-operative ART for selected patients, similarly strong evidence is lacking for SRT. In this article, we define the biochemical recurrence of prostate cancer, distinguish SRT from ART, outline the evidence for SRT, and make recommendations with regard to radiotherapy volume and dose. We discuss the known side effects from SRT, weigh the cost and benefit of SRT, and discuss possible tools that may improve the cost/benefit ratio for SRT by helping to select patients whom SRT may be more likely to benefit.

  19. Development of heavy-ion radiotherapy technology with HIMAC

    NASA Astrophysics Data System (ADS)

    Noda, Koji

    2016-09-01

    Since 1994, HIMAC has carried out clinical studies and treatments for more than 9000 cancer patients with carbon-ion beams. During the first decade of the HIMAC study, a single beam-wobbling method, adopted as the HIMAC beam-delivery technique, was improved for treatments of moving tumors and for obtaining more conformal dose distribution. During the second decade, a pencil-beam 3D scanning method has been developed toward an “adaptive cancer treatment” for treatments of both static and moving tumors. A new treatment research facility was constructed with HIMAC in order to verify the developed 3D scanning technology through a clinical study that has been successfully conducted since 2011. As the next stage, a compact heavy-ion rotating gantry with a superconducting technology has been developed for the more accurate and shorter-course treatments. The twenty-year development of the heavy-ion radiotherapy technologies including accelerator technologies with HIMAC is reviewed.

  20. Creative by Nature: Integrating the Arts into Environmental Science Education.

    ERIC Educational Resources Information Center

    Holmes, Susan A.

    2002-01-01

    Incorporates environmental education into the arts to enhance student learning, imagination, and ability to invent solutions. Provides lesson ideas such as a river walk, bird adaptation sculptures, and a tree scavenger hunt. (YDS)

  1. [Blood in art, art in blood].

    PubMed

    Danic, B; Lefrère, J-J

    2010-12-01

    In the different forms of art developed by Humanity over the centuries, artists have at times chosen themes from the world of medicine or health, such as blood donation or transfusion. In order to illustrate this, we have looked at three artistic domains: painting, movies and body art.

  2. Inspired Spirals. Teaching Art with Art.

    ERIC Educational Resources Information Center

    Hubbard, Guy

    2001-01-01

    Discusses spirals in nature, man-made objects, and art. Focuses on art that incorporates the spiral, including works by M. C. Escher and Frank Lloyd Wright, an African headdress, and a burial urn. Describes activities to help students make spirals of their own, such as constructing a coil clay pot. (CMK)

  3. Focus on Fine Arts: Visual Arts.

    ERIC Educational Resources Information Center

    Brigham, Don L.

    Basic arts education must give students the essence of their civilization, the civilizations that contributed to it, and the more distant civilizations that enriched world civilizations as a whole. All students are potentially capable of experiencing and analyzing the fundamental qualitativeness of art; therefore, it is realistic to propose…

  4. CyberArts: Exploring Art and Technology.

    ERIC Educational Resources Information Center

    Jacobson, Linda, Ed.

    This book takes the position that CyberArts(TM) is the new frontier in creativity, where the worlds of science and art meet. Computer technologies, visual design, music and sound, education and entertainment merge to form the new artistic territory of interactive multimedia. This diverse collection of essays, articles, and commentaries…

  5. Land Art in Preschools. An Art Practice

    ERIC Educational Resources Information Center

    Solberg, Ingunn

    2016-01-01

    The basis for my article is how, and if, a collaborative land art project can provide opportunities for such co-creating as suggested in the national framework plan for preschools, which explicitly states the child as a co-creator of a shared expressive culture. I further wish to propose land art as a meaningful cultural practice, closely…

  6. Radiotherapy Treatment Planning for Testicular Seminoma

    SciTech Connect

    Wilder, Richard B.; Buyyounouski, Mark K.; Efstathiou, Jason A.; Beard, Clair J.

    2012-07-15

    Virtually all patients with Stage I testicular seminoma are cured regardless of postorchiectomy management. For patients treated with adjuvant radiotherapy, late toxicity is a major concern. However, toxicity may be limited by radiotherapy techniques that minimize radiation exposure of healthy normal tissues. This article is an evidence-based review that provides radiotherapy treatment planning recommendations for testicular seminoma. The minority of Stage I patients who choose adjuvant treatment over surveillance may be considered for (1) para-aortic irradiation to 20 Gy in 10 fractions, or (2) carboplatin chemotherapy consisting of area under the curve, AUC = 7 Multiplication-Sign 1-2 cycles. Two-dimensional radiotherapy based on bony anatomy is a simple and effective treatment for Stage IIA or IIB testicular seminoma. Centers with expertise in vascular and nodal anatomy may consider use of anteroposterior-posteroanterior fields based on three-dimensional conformal radiotherapy instead. For modified dog-leg fields delivering 20 Gy in 10 fractions, clinical studies support placement of the inferior border at the top of the acetabulum. Clinical and nodal mapping studies support placement of the superior border of all radiotherapy fields at the top of the T12 vertebral body. For Stage IIA and IIB patients, an anteroposterior-posteroanterior boost is then delivered to the adenopathy with a 2-cm margin to the block edge. The boost dose consists of 10 Gy in 5 fractions for Stage IIA and 16 Gy in 8 fractions for Stage IIB. Alternatively, bleomycin, etoposide, and cisplatin chemotherapy for 3 cycles or etoposide and cisplatin chemotherapy for 4 cycles may be delivered to Stage IIA or IIB patients (e.g., if they have a horseshoe kidney, inflammatory bowel disease, or a history of radiotherapy).

  7. The Art & Science of Mask Making

    ERIC Educational Resources Information Center

    Kirk, Brian; Jefferies, Margaret

    2006-01-01

    Art, particularly observational drawing, plays an important role in science. Scientific illustrators combine science content knowledge, observation skills, and artistic ability. For students, creating representational artwork helps develop observation skills and an appreciation of the diverse ways organisms have adapted to life on Earth. In this…

  8. 4-H Textile Science Textile Arts Projects.

    ERIC Educational Resources Information Center

    Scholl, Jan

    This packet contains three 4-H textile arts projects for students in the textile sciences area. The projects cover weaving, knitting, and crocheting. Each project provides an overview of what the student will learn, what materials are needed, and suggested projects for the area. Projects can be adapted for beginning, intermediate, or advanced…

  9. Nurturing the Language of Art in Children.

    ERIC Educational Resources Information Center

    Dighe, Judith; Calomiris, Zoy; Van Zutphen, Carmen

    1998-01-01

    Describes art as a symbolic language as implemented in Reggio Emilia, Italy, preschools and adapted in U.S. schools. Considers the beauty of the classroom environment, use of materials and tools, use of observation of the child as the source of the curriculum, child-centered planning, teacher-child interaction to guide development of graphic…

  10. MO-G-BRF-06: Radiotherapy and Prompt Oxygen Dynamics

    SciTech Connect

    Kissick, M; Campos, D; Adamson, E; Niles, D; Torres, A; L, Che Fru; Kimple, R; Fain, S; Kogel, A van der; Jacques, S

    2014-06-15

    Purpose: Adaptive radiotherapy requires a knowledge of the changing local tumor oxygen concentrations for times on the order of the treatment time, a time scale far shorter than cell death and proliferation. This knowledge will be needed to guide hypofractionated radiotherapy. Methods: A diffuse optical probe system was developed to spatially average over the whole interior of athymic Sprague Dawley nude mouse xenografts of human head and neck cancers. The blood volume and hemoglobin saturation was measured in real time. The quantities were measured with spectral fitting before and after 10 Gy of radiation is applied. An MRI BOLD scan is acquired before and after 10 Gy that measures regional changes in R2* which is inversely proportional to oxygen availability. Simulations were performed to fit the blood oxygen dynamics and infer changes in hypoxia within the tumor. Results: The optical probe measured nearly constant blood volume and a significant drop in hemoglobin saturation of about 30% after 10 Gy over the time scale of less than 30 minutes. The averaged R2* within the tumor volume increased by 15% after the 10 Gy dose, which is consistent with the optical results. The simulations and experiments support likely dynamic metabolic changes and/or fast vasoconstrictive signals are occurring that change the oxygen concentrations significantly, but not cell death or proliferation. Conclusion: Significant oxygen changes were observed to occur within 30 minutes, coinciding with the treatment time scale. This dynamic is very important for patient specific adaptive therapy. For hypofractionated therapy, the local instantaneous oxygen content is likely the most important variable to control. The invention of a bedside device for the purpose of measuring the instantaneous response to large radiation doses would be an important step to future improvements in outcome.

  11. A framework for automated contour quality assurance in radiation therapy including adaptive techniques

    NASA Astrophysics Data System (ADS)

    Altman, M. B.; Kavanaugh, J. A.; Wooten, H. O.; Green, O. L.; DeWees, T. A.; Gay, H.; Thorstad, W. L.; Li, H.; Mutic, S.

    2015-07-01

    Contouring of targets and normal tissues is one of the largest sources of variability in radiation therapy treatment plans. Contours thus require a time intensive and error-prone quality assurance (QA) evaluation, limitations which also impair the facilitation of adaptive radiotherapy (ART). Here, an automated system for contour QA is developed using historical data (the ‘knowledge base’). A pilot study was performed with a knowledge base derived from 9 contours each from 29 head-and-neck treatment plans. Size, shape, relative position, and other clinically-relevant metrics and heuristically derived rules are determined. Metrics are extracted from input patient data and compared against rules determined from the knowledge base; a computer-learning component allows metrics to evolve with more input data, including patient specific data for ART. Nine additional plans containing 42 unique contouring errors were analyzed. 40/42 errors were detected as were 9 false positives. The results of this study imply knowledge-based contour QA could potentially enhance the safety and effectiveness of RT treatment plans as well as increase the efficiency of the treatment planning process, reducing labor and the cost of therapy for patients.

  12. Multiscale registration of planning CT and daily cone beam CT images for adaptive radiation therapy

    SciTech Connect

    Paquin, Dana; Levy, Doron; Xing Lei

    2009-01-15

    Adaptive radiation therapy (ART) is the incorporation of daily images in the radiotherapy treatment process so that the treatment plan can be evaluated and modified to maximize the amount of radiation dose to the tumor while minimizing the amount of radiation delivered to healthy tissue. Registration of planning images with daily images is thus an important component of ART. In this article, the authors report their research on multiscale registration of planning computed tomography (CT) images with daily cone beam CT (CBCT) images. The multiscale algorithm is based on the hierarchical multiscale image decomposition of E. Tadmor, S. Nezzar, and L. Vese [Multiscale Model. Simul. 2(4), pp. 554-579 (2004)]. Registration is achieved by decomposing the images to be registered into a series of scales using the (BV, L{sup 2}) decomposition and initially registering the coarsest scales of the image using a landmark-based registration algorithm. The resulting transformation is then used as a starting point to deformably register the next coarse scales with one another. This procedure is iterated at each stage using the transformation computed by the previous scale registration as the starting point for the current registration. The authors present the results of studies of rectum, head-neck, and prostate CT-CBCT registration, and validate their registration method quantitatively using synthetic results in which the exact transformations our known, and qualitatively using clinical deformations in which the exact results are not known.

  13. Developmental Transformations Art Therapy: An Embodied, Interactional Approach

    ERIC Educational Resources Information Center

    Rosen, Marni; Pitre, Renée; Johnson, David Read

    2016-01-01

    A new method of art therapy is described, based on Developmental Transformations, in which the therapist participates in joint art making with a client. The therapist's task is to present a graduated set of interpersonal demands on the client through the artwork, helping the client find adaptive responses to accommodations required by others, as…

  14. A systematic review of antiproton radiotherapy

    NASA Astrophysics Data System (ADS)

    Bittner, Martin-Immanuel; Grosu, Anca-Ligia; Wiedenmann, Nicole; Wilkens, Jan

    2013-01-01

    Antiprotons have been proposed as possible particles for radiotherapy; over the past years, the renewed interest in the potential biomedical relevance led to an increased research activity. It is the aim of this review to deliver a comprehensive overview regarding the evidence accumulated so far, analysing the background and depicting the current status of antiprotons in radiotherapy. A literature search has been conducted, including major scientific and commercial databases. All articles and a number of relevant conference abstracts published in the respective field have been included in this systematic review. The physical basis of antiproton radiotherapy is complex; however, the characterisation of the energy deposition profile supports its potential use in radiotherapy. Also the dosimetry improved considerably over the past few years. Regarding the biological properties, data on the effects on cells are presented; however, definite conclusions regarding the relative biological effectiveness cannot be made at the moment and radiobiological evidence of enhanced effectiveness remains scarce. In addition, there is new evidence supporting the potential imaging properties, for example for online dose verification. Clinical settings which might profit from the use of antiprotons have been further tracked. Judging from the evidence available so far, clinical constellations requiring optimal sparing in the entrance region of the beam and re-irradiations might profit most from antiproton radiotherapy. While several open questions remain to be answered, first steps towards a thorough characterisation of this interesting modality have been made.

  15. A systematic review of antiproton radiotherapy

    NASA Astrophysics Data System (ADS)

    Bittner, Martin-Immanuel; Grosu, Anca-Ligia; Wiedenmann, Nicole; Wilkens, Jan

    2014-01-01

    Antiprotons have been proposed as possible particles for radiotherapy; over the past years, the renewed interest in the potential biomedical relevance led to an increased research activity. It is the aim of this review to deliver a comprehensive overview regarding the evidence accumulated so far, analysing the background and depicting the current status of antiprotons in radiotherapy. A literature search has been conducted, including major scientific and commercial databases. All articles and a number of relevant conference abstracts published in the respective field have been included in this systematic review. The physical basis of antiproton radiotherapy is complex; however, the characterisation of the energy deposition profile supports its potential use in radiotherapy. Also the dosimetry improved considerably over the past few years. Regarding the biological properties, data on the effects on cells are presented; however, definite conclusions regarding the relative biological effectiveness cannot be made at the moment and radiobiological evidence of enhanced effectiveness remains scarce. In addition, there is new evidence supporting the potential imaging properties, for example for online dose verification. Clinical settings which might profit from the use of antiprotons have been further tracked. Judging from the evidence available so far, clinical constellations requiring optimal sparing in the entrance region of the beam and re-irradiations might profit most from antiproton radiotherapy. While several open questions remain to be answered, first steps towards a thorough characterisation of this interesting modality have been made.

  16. Fiducial marker guided prostate radiotherapy: a review.

    PubMed

    O'Neill, Angela G M; Jain, Suneil; Hounsell, Alan R; O'Sullivan, Joe M

    2016-12-01

    Image-guided radiotherapy (IGRT) is an essential tool in the accurate delivery of modern radiotherapy techniques. Prostate radiotherapy positioned using skin marks or bony anatomy may be adequate for delivering a relatively homogeneous whole-pelvic radiotherapy dose, but these surrogates are not reliable when using reduced margins, dose escalation or hypofractionated stereotactic radiotherapy. Fiducial markers (FMs) for prostate IGRT have been in use since the 1990s. They require surgical implantation and provide a surrogate for the position of the prostate gland. A variety of FMs are available and they can be used in a number of ways. This review aimed to establish the evidence for using prostate FMs in terms of feasibility, implantation procedures, types of FMs used, FM migration, imaging modalities used and the clinical impact of FMs. A search strategy was defined and a literature search was carried out in Medline. Inclusion and exclusion criteria were applied, which resulted in 50 articles being included in this review. The evidence demonstrates that FMs provide a more accurate surrogate for the position of the prostate than either external skin marks or bony anatomy. A combination of FM alignment and soft-tissue analysis is currently the most effective and widely available approach to ensuring accuracy in prostate IGRT. FM implantation is safe and well tolerated. FM migration is possible but minimal. Standardization of all techniques and procedures in relation to the use of prostate FMs is required. Finally, a clinical trial investigating a non-surgical alternative to prostate FMs is introduced.

  17. Visual Arts and Handicrafts.

    ERIC Educational Resources Information Center

    Winkel, Lois

    1998-01-01

    Lists recommended book titles for children on art, crafts, artists, optical illusions, and drawing. Provides the address for a Web site featuring art activities and information about artists for children. (PEN)

  18. Chemistry, Color, and Art.

    ERIC Educational Resources Information Center

    Orna, Mary Virginia

    2001-01-01

    Describes pigments and artists' colors from a chronological perspective. Explains how chemical analysis can be used to distinguish the differences between artists' palettes, identify the evolution of art, and lead to restoration of an art work. (Contains 13 references.) (YDS)

  19. A dose comparison of proton radiotherapy and photon radiotherapy for pediatric brain tumor

    NASA Astrophysics Data System (ADS)

    Kim, S. Y.; Cho, J. H.

    2014-12-01

    The purpose of this study was to investigate the effectiveness of photon radiotherapy and to compare the dose of treatment planning between proton radiotherapy and 3D conformal radiation therapy (3D-CRT) for pediatric brain tumor patients. This study was conducted in five pediatric brain tumor patients who underwent craniospinal irradiation treatment from October 2013 to April 2014 in the hospital. The study compared organs at risk (OARs) by assessing the dose distribution of normal tissue from the proton plan and 3D-CRT. Furthermore, this study assessed the treatment plans by looking at the homogeneity index (HI) and conformity index (CI). As a result, the study revealed OARs due to the small volume proton radiotherapy dose distribution in the normal tissue. Also, by comparing HI and CI between the 3D-CRT and proton radiotherapy plan, the study found that the dose of proton radiotherapy plan was homogenized. When conducting 3D-CRT and proton radiotherapy in a dose-volume histogram comparison, the dose of distribution turned out to be low. Consequently, proton radiotherapy is used for protecting the normal tissue, and is used in tumor tissue as a homogenized dose for effective treatment.

  20. Transpersonal Art Therapy Education.

    ERIC Educational Resources Information Center

    Franklin, Michael; Farrelly-Hansen, Mimi; Marek, Bernie; Swan-Foster, Nora; Wallingford, Sue

    2000-01-01

    Addresses the task of training future art therapists through a unique branch of transpersonal psychology referred to as "contemplative education." Discusses contemplative practices, such as meditation, and their relationship to creating art. Offers a definition of transpersonal art therapy as well as a literature review. (Contains 80…

  1. Alaska Arts Resource Directory.

    ERIC Educational Resources Information Center

    Dugan, Gene, Ed.

    This directory lists over 250 non-profit and for-profit arts organizations in 90 Alaskan communities. Compiled as a resource guide for artists, arts administrators, and teachers, this document offers information that assist them in sharing resources, communicating, and coordinating arts activities. It contains information from and about arts…

  2. Art Is for Everyone.

    ERIC Educational Resources Information Center

    Ensign, Arselia, Ed.

    1994-01-01

    This pamphlet examines what art can mean to a child with a disability and offers "how-to's" for involving students in the creation of art. It emphasizes that the outcome of an art activity can be more than just the finished piece of work and that emphasis should be placed on involvement with the materials rather than on design or abstract concepts…

  3. Women Art Educators.

    ERIC Educational Resources Information Center

    Zimmerman, Enid, Ed.; Stankiewicz, Mary Ann, Ed.

    This collection of papers on women art educators reveals the variety of roles played by those women, from anonymous art teachers to leaders in their profession. "Mary Rouse: A Remembrance" (G. Hubbard) is a personal perspective on Rouse, the development of her career, and her considerable impact in the field of art education. "The…

  4. Windows to Art Excitement.

    ERIC Educational Resources Information Center

    Laird, Shirley; Crumpecker, Cheryl

    2003-01-01

    Describes an art project that aimed to bring more attention to an art program. Explains that the students created themed murals on the windows of the art classroom, such as a "Jungle,""Ocean,""Masterpiece Paintings," and "Rainforest Tree Frogs." Discusses how the murals were created. (CMK)

  5. Cultural Policy and Art.

    ERIC Educational Resources Information Center

    Degge, Rogena M., Ed.

    1987-01-01

    This document presents three papers by scholars who participated in a lecture series on current controversies regarding politics and the arts. Judith H. Balfe argues in her paper, "Affinities of Art and Politics: Gilt by Association," that despite a history of institutional separateness, art and politics are linked with one another because they…

  6. Art and Montessori.

    ERIC Educational Resources Information Center

    Turner, Joy

    1982-01-01

    Designed for Montessori teachers with little background in the plastic arts, this discussion points out that, while the Montessori program has many features that support creative development, presently, no art curriculum exists. The article indicates the limitations of Maria Montessori's ideas and attitudes about the role of art in the education…

  7. Art and the Handicapped.

    ERIC Educational Resources Information Center

    Virginia State Dept. of Education, Richmond. Div. of Humanities and Secondary Administration.

    The contributions of art experiences to special education are discussed and guidelines for integrating art into the curriculum are provided. Art is seen to have potential for developing handicapped children's self expression, independence, sensory stimulation and motivation, perception discrimination, skill development, and career and personal…

  8. The Arts & Compensatory Education.

    ERIC Educational Resources Information Center

    Michigan State Dept. of Education, Lansing.

    Intended to help compensatory education personnel better understand the role of the arts in cognitive growth, this booklet provides practical suggestions for using arts strategies in basic education. Following a discussion of the role of the arts in the learning process, the booklet presents a number of activities that involve the interaction of…

  9. Art and Physics

    ERIC Educational Resources Information Center

    Metcalf, Suesi

    2004-01-01

    In this paper, the author offers lesson plan ideas that are designed to guide teachers of art and science to encourage their students to see connections between art images and physics principles. The four works of art discussed are examples that can be linked visually and conceptually to physics properties in mathematics, space, energy, and light.…

  10. "I like Art Because..."

    ERIC Educational Resources Information Center

    Leishear, Christina Chiddo

    2012-01-01

    There is a lot of creative energy between students and their art materials. In this lesson, the author discusses materials an artist may use to create a work of art--paint, a paintbrush, a palette, crayons, markers, pastels, and so on. Each student sketched a picture of themselves holding some tools that can be used in art. The objectives of this…

  11. Arts throughout the Curriculum.

    ERIC Educational Resources Information Center

    Manner, Jane Carol

    2002-01-01

    Describes how curriculum integration can help art enhance learning during times when the arts may be considered dispensable and removed from education, presenting examples of how classroom teachers have examined art as a link to expanded understanding of history, science, math, reading, current events, geography, cultural studies, emotions,…

  12. Catalyst--The Arts.

    ERIC Educational Resources Information Center

    Feldman, Edmund Burke

    1978-01-01

    Throughout European history, artists have celebrated the values of their patrons. Today, the schools are the largest employer of artists. To justify art education according to current Back-to-Basics values, art teachers should explain visual art as a language, which they can teach students to read and use. (SJL)

  13. Art Meets Science

    ERIC Educational Resources Information Center

    Rohs, C. Renee

    2007-01-01

    Numerous connections between the visual arts and sciences are evident if we choose to look for them. In February 2006, students and faculty from the Art and Geol/Geog departments at NW Missouri State University put together an exhibit at a local art gallery featuring works that were born out of science, inspired by science, or exploring the…

  14. Computer Aided Art Major.

    ERIC Educational Resources Information Center

    Gibson, Jim

    The Computer Aided Art program offered at Northern State State University (Aberdeen, South Dakota), is coordinated with the traditional art major. The program is designed to familiarize students with a wide range of art-related computer hardware and software and their applications and to prepare students for problem-solving with unfamiliar…

  15. The Art of Running

    ERIC Educational Resources Information Center

    Brown, Jill Harris

    2007-01-01

    Every year, the Parent-Teacher Association of Ferndale Elementary School in Atlanta, Georgia sponsors a fun road race for the students, teachers, families, and community. This annual event has inspired the author to develop the Running and Art project to show off her students' art and squeeze in a little art history, too. In this article, the…

  16. A Work of Art

    ERIC Educational Resources Information Center

    Sloan, Katherine

    2009-01-01

    During the 2002-03 fiscal crisis in Massachusetts, Gov. Mitt Romney proposed sweeping changes for public colleges in the state. Among them was a proposal to privatize three highly specialized colleges, including the Massachusetts College of Art and Design (MassArt), the nation's only independent public college of art and design. The rationale was…

  17. Arts in the Curriculum.

    ERIC Educational Resources Information Center

    Weinstock, Ruth

    This monograph, part of an ongoing series, discusses the need for school arts programs and provides some examples of how the arts can be infused into the regular curriculum at the elementary level. Support systems for such programs are also discussed. Properly conceived, the arts constitute a great integrating force in the curriculum. To achieve…

  18. Windows into Art Classrooms.

    ERIC Educational Resources Information Center

    Grauer, Kit, Ed.

    1995-01-01

    An editorial by Kit Grauer introduces this collection of articles which establish that there is no such thing as a simple definition of art education even within one culture, and that people's views can be reflected by art educators across the world. The first article, "A Window on Three Singapore Art Classrooms" (Jane Chia; John…

  19. The Art of Research

    ERIC Educational Resources Information Center

    Sullivan, Graeme

    2014-01-01

    The purpose of this article is to make the argument that when viewed as mutually supportive processes of inquiry, art and research have the potential to put the agency of educational change well within reach of artists and art teachers. As researchers well schooled in studio practices of many kinds, artists and art teachers understand that, as we…

  20. From soil in art towards Soil Art

    NASA Astrophysics Data System (ADS)

    Feller, C.; Landa, E. R.; Toland, A.; Wessolek, G.

    2015-02-01

    The range of art forms and genres dealing with soil is wide and diverse, spanning many centuries and artistic traditions, from prehistoric painting and ceramics to early Renaissance works in Western literature, poetry, paintings, and sculpture, to recent developments in cinema, architecture and contemporary art. Case studies focused on painting, installation, and cinema are presented with the view of encouraging further exploration of art about, in, with, or featuring soil or soil conservation issues, created by artists, and occasionally scientists, educators or collaborative efforts thereof.

  1. Differences in breast tissue oxygenation following radiotherapy.

    PubMed

    Dornfeld, Ken; Gessert, Charles E; Renier, Colleen M; McNaney, David D; Urias, Rodolfo E; Knowles, Denise M; Beauduy, Jean L; Widell, Sherry L; McDonald, Bonita L

    2011-08-01

    Tissue perfusion and oxygenation changes following radiotherapy may result from and/or contribute to the toxicity of treatment. Breast tissue oxygenation levels were determined in the treated and non-treated breast 1 year after radiotherapy for breast conserving treatment. Transcutaneous oxygenation varied between subjects in both treated and non-treated breast. Subjects without diabetes mellitus (n=16) had an average oxygenation level of 64.8 ± 19.9mmHg in the irradiated breast and an average of 72.3 ± 18.1mmHg (p=0.018) at the corresponding location in the control breast. Patients with diabetes (n=4) showed a different oxygenation pattern, with lower oxygenation levels in control tissue and no decrease in the irradiated breast. This study suggests oxygenation levels in normal tissues vary between patients and may respond differently after radiotherapy.

  2. Oral verrucous carcinoma. Treatment with radiotherapy

    SciTech Connect

    Nair, M.K.; Sankaranarayanan, R.; Padmanabhan, T.K.; Madhu, C.S.

    1988-02-01

    Fifty-two cases of oral verrucous carcinoma treated with radiotherapy at the Regional Cancer Centre, Trivandrum, Kerala, India in 1982 were evaluated to determine the distribution within the oral cavity, clinical extent, and effectiveness of radiotherapy in controlling the disease. The most common site was the buccal mucosa. Fifty percent of the patients had clinically negative regional lymph nodes and 33% were in earlier stages (T1, T2, N0, and M0). The overall 3-year no evidence of disease (NED) survival rate was 44%. The 3-year NED survival rate with radium implant was 86%. We cannot comment on anaplastic transformation after radiotherapy because our treatment failures have not been subjected for biopsy concerning this matter. Because the results are comparable with those of well-differentiated squamous cell carcinoma, we think that the treatment policies advocated for oral squamous cell carcinoma are also applicable to oral verrucous carcinoma.

  3. Radiotherapy-induced hypopituitarism: a review.

    PubMed

    Sathyapalan, Thozhukat; Dixit, Sanjay

    2012-05-01

    Hypopituitarism is a disorder caused by impaired hormonal secretions from the hypothalamic-pituitary axis. Radiotherapy is the most common cause of iatrogenic hypopituitarism. The hypothalamic-pituitary axis inadvertently gets irradiated in patients receiving prophylactic cranial radiotherapy for leukemia, total body irradiation and radiotherapy for intracranial, base skull, sinonasal and nasopharyngeal tumors. Radiation-induced hypopituitarism (RIH) is insidious, progressive and largely nonreversible. Mostly, RIH involves one hypothalamic-pituitary axis; however, multiple hormonal axes deficiency starts developing at higher doses. Although the clinical effects of the hypopituitarism are more profound in children and young adults, its implications in older adults are being increasingly recognized. The risk continues to persist or increase up to 10 years following radiation exposure. The clinical management of hypopituitarism is challenging both for the patients and healthcare providers. Here we have reviewed the scale of the problem, the risk factors and the management of RIH.

  4. One hundred years of radiotherapy in Turkey.

    PubMed

    Dincer, M; Kuter, S

    2001-10-01

    The study and practice of radiology in Turkey began in 1897, only 2 years after the discovery of X-rays. A simple X-ray machine was constructed in Istanbul, consisting of a Crookes tube, a Ruhmkorff coil, and a home-made battery. This machine was first used on wounded soldiers, for diagnostic purposes. The first report of X-rays being used therapeutically in Turkey was published in a national journal in 1904. By 1933, the most up-to-date radiotherapy equipment of the time had been installed in every major city in the country. Innovative radiotherapy techniques, such as rotational treatment, were also being tried in 1930s. Today, there are 45 radiotherapy centres in Turkey, and 400 radiation oncologists and 80 medical physicists practise there.

  5. Visual Adaptation

    PubMed Central

    Webster, Michael A.

    2015-01-01

    Sensory systems continuously mold themselves to the widely varying contexts in which they must operate. Studies of these adaptations have played a long and central role in vision science. In part this is because the specific adaptations remain a powerful tool for dissecting vision, by exposing the mechanisms that are adapting. That is, “if it adapts, it's there.” Many insights about vision have come from using adaptation in this way, as a method. A second important trend has been the realization that the processes of adaptation are themselves essential to how vision works, and thus are likely to operate at all levels. That is, “if it's there, it adapts.” This has focused interest on the mechanisms of adaptation as the target rather than the probe. Together both approaches have led to an emerging insight of adaptation as a fundamental and ubiquitous coding strategy impacting all aspects of how we see. PMID:26858985

  6. Art Therapy: What Is Art Therapy?

    MedlinePlus

    ... skills, improve reality orientation, reduce anxiety, and increase self-esteem. A goal in art therapy is to improve ... supports federal and state policies, legislation, regulations, judicial actions, and initiatives that encourage, promote, and support efforts ...

  7. The Art Classroom as Art Teacher.

    ERIC Educational Resources Information Center

    Barr-Johnson, Virginia; Brockmyer, James J.

    1981-01-01

    Suggests ways of turning the art room into a microenvironment of sensory intensification--a place where a student steps into a new world of color, sound, and smell that delights the eye and inspires the imagination. (Author/SJL)

  8. Beauty and art.

    PubMed

    Chang, C W David

    2006-08-01

    Definitions of beauty and art have been turned upside down when trying to describe 20th century and postmodern art. The classical sense of beauty looks toward the replication of nature as its inspiration. The development of Impressionist art and modern art forced the rules of aesthetics to be rethought and revised. Old standards of aesthetics were brought into question with each successive artistic challenge. This article endeavors to explore the meaning of beauty and the aesthetic experience as it relates to defining art.

  9. Pelvic radiotherapy and sexual function in women

    PubMed Central

    Froeding, Ligita Paskeviciute

    2015-01-01

    Background During the past decade there has been considerable progress in developing new radiation methods for cancer treatment. Pelvic radiotherapy constitutes the primary or (neo) adjuvant treatment of many pelvic cancers e.g., locally advanced cervical and rectal cancer. There is an increasing focus on late effects and an increasing awareness that patient reported outcomes (PROs) i.e., patient assessment of physical, social, psychological, and sexual functioning provides the most valid information on the effects of cancer treatment. Following cure of cancer allow survivors focus on quality of life (QOL) issues; sexual functioning has proved to be one of the most important aspects of concern in long-term survivors. Methods An updated literature search in PubMed was performed on pelvic radiotherapy and female sexual functioning/dysfunction. Studies on gynaecological, urological and gastrointestinal cancers were included. The focus was on the period from 2010 to 2014, on studies using PROs, on potential randomized controlled trials (RCTs) where female sexual dysfunction (FSD) at least constituted a secondary outcome, and on studies reporting from modern radiotherapy modalities. Results The literature search revealed a few RCTs with FSD evaluated as a PRO and being a secondary outcome measure in endometrial and in rectal cancer patients. Very limited information could be extracted regarding FSD in bladder, vulva, and anal cancer patients. The literature before and after 2010 confirms that pelvic radiotherapy, independent on modality, increases the risk significantly for FSD both compared to data from age-matched healthy control women and compared to data on patients treated by surgery only. There was only very limited data available on modern radiotherapy modalities. These are awaited during the next five years. Several newer studies confirm that health care professionals are still reluctant to discuss treatment induced sexual dysfunction with patients. Conclusions

  10. Meningioma after radiotherapy for Hodgkin's disease.

    PubMed

    Deutsch, M; Rosenstein, M; Figura, J H

    1999-08-01

    The most common second primary tumors after treatment of childhood Hodgkin's disease are leukemia, lymphoma, breast cancer, soft tissue sarcoma, and thyroid cancer. Although intracranial meningioma has been reported after radiotherapy to the scalp for benign conditions and for intracranial primary brain tumors, this appears to be an extremely rare sequelae of treatment for Hodgkin's disease. The authors describe a 15-year-old boy who underwent radiotherapy for Hodgkin's disease and in whom a meningioma developed in the posterior fossa 27 years later.

  11. On-line Adaptive Radiation Treatment of Prostate Cancer

    DTIC Science & Technology

    2009-01-01

    Angels, CA, 2007 5. D. Schulze, T. Zhang, et al, “ Dosimetric Comparison of Various Online Adaptive Prostate Cancer Treatment Techniques ”, Los...is to develop an online adaptive treatment technique for prostate cancer treatments . During the first year, we have developed parallel deformable...1 The new system design for online imaging: Tetrahedron Beam Computed Tomography (TBCT): (a) mounted on radiotherapy treatment machine, (b) diagram

  12. The Return of the Body: Performance Art and Art Education.

    ERIC Educational Resources Information Center

    Green, Gaye Leigh

    1999-01-01

    Explains that performance art incorporates different artistic forms, emphasizes the process of art over the product, and blurs the line between life and art. Discusses the history of performance art, highlights the Performance Art, Culture, and Pedagogy Symposium, and provides examples of how to use performance art in the classroom. (CMK)

  13. Art-Based Learning Strategies in Art Therapy Graduate Education

    ERIC Educational Resources Information Center

    Deaver, Sarah P.

    2012-01-01

    This mixed methods research study examined the use of art-based teaching methods in master's level art therapy graduate education in North America. A survey of program directors yielded information regarding in which courses and how frequently art-based methods (individual in-class art making, dyad or group art making, student art projects as…

  14. New School Art Styles: The Project of Art Education

    ERIC Educational Resources Information Center

    Gude, Olivia

    2013-01-01

    Art projects are appropriate building blocks for visual art curriculum because good art projects encode complex aesthetic strategies, giving students tools to investigate and make meaning. Art made in schools will inevitably be some form of "school art," defined by Arthur Efland in "The School Art Style: a Functional Analysis,"…

  15. Radiotherapy in the management of early breast cancer

    SciTech Connect

    Wang, Wei

    2013-03-15

    Radiotherapy is an indispensible part of the management of all stages of breast cancer. In this article, the common indications for radiotherapy in the management of early breast cancer (stages 0, I, and II) are reviewed, including whole-breast radiotherapy as part of breast-conserving treatment for early invasive breast cancer and pre-invasive disease of ductal carcinoma in situ, post-mastectomy radiotherapy, locoregional radiotherapy, and partial breast irradiation. Key clinical studies that underpin our current practice are discussed briefly.

  16. Art in Elementary Education Today

    ERIC Educational Resources Information Center

    Brittain, Lambert

    1976-01-01

    Article discussed the practicalities in art education from the current economic squeeze on art programs to the overworked elementary art teacher attempting to implement art programs of dubious merit. (RK)

  17. Adaptive Management

    EPA Science Inventory

    Adaptive management is an approach to natural resource management that emphasizes learning through management where knowledge is incomplete, and when, despite inherent uncertainty, managers and policymakers must act. Unlike a traditional trial and error approach, adaptive managem...

  18. The Leicester radiotherapy bite block: an aid to head and neck radiotherapy.

    PubMed

    Hollows, P; Hayter, J P; Vasanthan, S

    2001-02-01

    We describe the construction of a custom-made bite block to be used during external beam radiotherapy to the oral cavity. The bite block is made with standard maxillofacial prosthetic techniques and materials. The design allows accurate and reproducible positioning of the perioral tissues to aid planning of radiotherapy and treatment. The compressibility of this device improves comfort for the patient, while it is in use.

  19. Art 10, Art 20, Art 30 Curriculum Guide 1986.

    ERIC Educational Resources Information Center

    Alberta Dept. of Education, Edmonton.

    The curriculum guide details a unified sequential art program for grades 7-12 and clearly outlines specific objectives and descriptions of concepts and experiences. The objectives are designed to accommodate sequential learning and are derived from the goals and philosophy of the program. The format describes appropriate objectives and concepts…

  20. DNA sequence analysis using hierarchical ART-based classification networks

    SciTech Connect

    LeBlanc, C.; Hruska, S.I.; Katholi, C.R.; Unnasch, T.R.

    1994-12-31

    Adaptive resonance theory (ART) describes a class of artificial neural network architectures that act as classification tools which self-organize, work in real-time, and require no retraining to classify novel sequences. We have adapted ART networks to provide support to scientists attempting to categorize tandem repeat DNA fragments from Onchocerca volvulus. In this approach, sequences of DNA fragments are presented to multiple ART-based networks which are linked together into two (or more) tiers; the first provides coarse sequence classification while the sub- sequent tiers refine the classifications as needed. The overall rating of the resulting classification of fragments is measured using statistical techniques based on those introduced to validate results from traditional phylogenetic analysis. Tests of the Hierarchical ART-based Classification Network, or HABclass network, indicate its value as a fast, easy-to-use classification tool which adapts to new data without retraining on previously classified data.

  1. Post-radiotherapy hypothyroidism in dogs treated for thyroid carcinomas.

    PubMed

    Amores-Fuster, I; Cripps, P; Blackwood, L

    2017-03-01

    Hypothyroidism is a common adverse event after head and neck radiotherapy in human medicine, but uncommonly reported in canine patients. Records of 21 dogs with histologically or cytologically confirmed thyroid carcinoma receiving definitive or hypofractionated radiotherapy were reviewed. Nine cases received 48 Gy in 12 fractions, 10 received 36 Gy in 4 fractions and 2 received 32 Gy in 4 fractions. Seventeen cases had radiotherapy in a post-operative setting. Ten cases developed hypothyroidism (47.6%) after radiotherapy. The development of hypothyroidism was not associated with the radiotherapy protocol used. Median time to diagnosis of hypothyroidism was 6 months (range, 1-13 months). Hypothyroidism is a common side effect following radiotherapy for thyroid carcinomas. Monitoring of thyroid function following radiotherapy is recommended. No specific risk factors have been identified.

  2. Breast Cancer Patients’ Experience of External-Beam Radiotherapy

    PubMed Central

    Schnur, Julie B.; Ouellette, Suzanne C.; Bovbjerg, Dana H.; Montgomery, Guy H.

    2013-01-01

    Radiotherapy is a critical component of treatment for the majority of women with breast cancer, particularly those who receive breast conserving surgery. Although medically beneficial, radiotherapy can take a physical and psychological toll on patients. However, little is known about the specific thoughts and feelings experienced by women undergoing breast cancer radiotherapy. Therefore, the study aim was to use qualitative research methods to develop an understanding of these thoughts and feelings based on 180 diary entries, completed during radiotherapy by 15 women with Stage 0-III breast cancer. Thematic analysis identified four primary participant concerns: (a) a preoccupation with time; (b) fantasies (both optimistic and pessimistic) about life following radiotherapy; (c) the toll their side-effect experience takes on their self-esteem; and (d) feeling mystified by radiotherapy. These themes are consistent with previous literature on illness and identity. These findings have implications for the treatment and care of women undergoing breast cancer radiotherapy. PMID:19380502

  3. 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

  4. Radiotherapy for inverted papilloma: a case report.

    PubMed

    Levendag, P C; Annyas, A A; Escajadillo, J R; Elema, J D

    1984-06-01

    Inverted papilloma is an infrequent tumour of the nasal cavity and paranasal sinuses associated with controversy. The incidence of carcinoma in situ associated with inverted papilloma, has not been very well documented until now. Therefore, we present a case report characterized by an aggressive clinical behaviour, treated by extensive surgery and ultimately controlled by radiotherapy.

  5. Results of radiotherapy for Peyronie's disease

    SciTech Connect

    Niewald, Marcus . E-mail: ramnie@uniklinikum-saarland.de; Wenzlawowicz, Knut v.; Fleckenstein, Jochen; Wisser, Lothar; Derouet, Harry; Ruebe, Christian

    2006-01-01

    Purpose: To retrospectively review the results of radiotherapy for Peyronie's disease. Patients and Methods: In the time interval 1983-2000, 154 patients in our clinic were irradiated for Peyronie's disease. Of those, 101 had at least one complete follow-up data set and are the subject of this study. In the majority of patients, penis deviation was between 30 and 50{sup o}, there were one or two indurated foci with a diameter between 5 and 15 mm. Pain was recorded in 48/92 patients. Seventy-two of the 101 patients received radiotherapy with a total dose of 30 Gy, and 25 received 36 Gy in daily fractions of 2.0 Gy. The remaining patients received the following dosage: 34 Gy (1 patient), 38-40 Gy (3 patients). Mean duration of follow-up was 5 years. Results: The best results ever at any time during follow-up were an improvement of deviation in 47%, reduction of number of foci in 32%, reduction of size of foci in 49%, and less induration in 52%. Approximately 50% reported pain relief after radiotherapy. There were 28 patients with mild acute dermatitis and only 4 patients with mild urethritis. There were no long-term side effects. Conclusion: Our results compare well with those of other studies in the literature. In our patient cohort, radiotherapy was an effective therapy option with only very rare and mild side effects.

  6. Mathematical Model for Evaluating Incidence of Acute Rectal Toxicity During Conventional or Hypofractionated Radiotherapy Courses for Prostate Cancer

    SciTech Connect

    Strigari, Lidia Arcangeli, Giorgio; Arcangeli, Stefano; Benassi, Marcello

    2009-04-01

    Purpose: To describe the radiation-induced acute rectal toxicity (ART) using a modified Lyman-Kutcher-Burman normal tissue complication probability model and parameters set, taking into account the overall treatment time. Methods and Materials: A total of 160 patients underwent three-dimensional conformal radiotherapy to the prostate and seminal vesicles and were randomized to receive 80 Gy in 40 fractions within 8 weeks (Group A) or 62 Gy in 20 fractions within 5 weeks, 4 d/wk (Group B). An additional 52 patients (Group C) underwent intensity-modulated radiotherapy with a hypofractionation schedule consisting of 56 Gy, delivered in 16 fractions (4/wk) of 3.5 Gy. Patients were followed for ART weekly during treatment. The overall treatment time, rectal dose-volume histograms, and ART status, defined as Radiation Therapy Oncology Group Grade 2 or greater gastrointestinal toxicity, were used to determine the modified Lyman-Kutcher-Burman model parameters. The m and n values were obtained from the cohort, and the tolerance doses for 50% complication probability for uniform irradiation [TD{sub 50}(1){sub k}] were obtained for each fractionation schedule indicated with k. Results: Of 212 patients treated with localized prostate radiotherapy, 65 developed Grade for {>=}1 week during treatment. The m and n value was 0.17 and 0.08, respectively. The TD{sub 50}(1){sub k} parameter was 79, 62.5, and 53 Gy, respectively for Group A, B, and C. Conclusion: The optimized modified Lyman-Kutcher-Burman normal tissue complication probability model allowed us to describe the ART data from conventional and hypofractionated regimens, using the dose-volume histograms and overall treatment time. This model could prove useful in designing hypofractionation schedules to reduce the incidence of ART.

  7. A Web application for the management of clinical workflow in image-guided and adaptive proton therapy for prostate cancer treatments.

    PubMed

    Yeung, Daniel; Boes, Peter; Ho, Meng Wei; Li, Zuofeng

    2015-05-08

    Image-guided radiotherapy (IGRT), based on radiopaque markers placed in the prostate gland, was used for proton therapy of prostate patients. Orthogonal X-rays and the IBA Digital Image Positioning System (DIPS) were used for setup correction prior to treatment and were repeated after treatment delivery. Following a rationale for margin estimates similar to that of van Herk,(1) the daily post-treatment DIPS data were analyzed to determine if an adaptive radiotherapy plan was necessary. A Web application using ASP.NET MVC5, Entity Framework, and an SQL database was designed to automate this process. The designed features included state-of-the-art Web technologies, a domain model closely matching the workflow, a database-supporting concurrency and data mining, access to the DIPS database, secured user access and roles management, and graphing and analysis tools. The Model-View-Controller (MVC) paradigm allowed clean domain logic, unit testing, and extensibility. Client-side technologies, such as jQuery, jQuery Plug-ins, and Ajax, were adopted to achieve a rich user environment and fast response. Data models included patients, staff, treatment fields and records, correction vectors, DIPS images, and association logics. Data entry, analysis, workflow logics, and notifications were implemented. The system effectively modeled the clinical workflow and IGRT process.

  8. Neo-adjuvant radiotherapy in rectal cancer

    PubMed Central

    Glimelius, Bengt

    2013-01-01

    In rectal cancer treatment, attention has focused on the local primary tumour and the regional tumour cell deposits to diminish the risk of a loco-regional recurrence. Several large randomized trials have also shown that combinations of surgery, radiotherapy and chemotherapy have markedly reduced the risk of a loco-regional recurrence, but this has not yet had any major influence on overall survival. The best results have been achieved when the radiotherapy has been given preoperatively. Preoperative radiotherapy improves loco-regional control even when surgery has been optimized to improve lateral clearance, i.e., when a total mesorectal excision has been performed. The relative reduction is then 50%-70%. The value of radiotherapy has not been tested in combination with more extensive surgery including lateral lymph node clearance, as practised in some Asian countries. Many details about how the radiotherapy is performed are still open for discussion, and practice varies between countries. A highly fractionated radiation schedule (5 Gy × 5), proven efficacious in many trials, has gained much popularity in some countries, whereas a conventionally fractionated regimen (1.8-2.0 Gy × 25-28), often combined with chemotherapy, is used in other countries. The additional therapy adds morbidity to the morbidity that surgery causes, and should therefore be administered only when the risk of loco-regional recurrence is sufficiently high. The best integration of the weakest modality, to date the drugs (conventional cytotoxics and biologicals) is not known. A new generation of trials exploring the best sequence of treatments is required. Furthermore, there is a great need to develop predictors of response, so that treatment can be further individualized and not solely based upon clinical factors and anatomic imaging. PMID:24379566

  9. The martial arts.

    PubMed

    Terry, Charles M

    2006-08-01

    Given the increasing popularity of the martial arts, it is likely that physicians in all specialties encounter patients who participate. From pediatric patients, to geriatric patients, to those living with various disabilities, the martial arts may offer physical, psychologic, and therapeutic benefits. An appreciation of the physical demands of the martial arts is crucial to understanding the pathogenesis of injury as well as to planning treatment and prevention strategies and to determining safe return to participation after injury.

  10. [Adaptive radiation therapy for non-small cell lung cancer].

    PubMed

    Bibault, J-E; Arsène-Henry, A; Durdux, C; Mornex, F; Hamza, S; Trouette, R; Thureau, S; Faivre, J-C; Boisselier, P; Lerouge, D; Paragios, N; Giraud, P

    2015-10-01

    Anatomical changes and tumor regression during thoracic radiotherapy may alter the treatment volumes. These modifications are not taken into account into set-up or motion margins used for treatment planning. Their dosimetric impact could be significant and a better understanding of the changes occurring during the 6 to 7 weeks of treatment could be useful in order to define quantitative thresholds before a new treatment planning is needed. Margins could also be reduced in order to better spare organs at risk and perform targeted dose escalation. This review assesses the potential of morphologic and metabolic imaging during treatment for adaptive radiotherapy in non-small cell lung cancer.

  11. State-of-the-art HDU's critical importance.

    PubMed

    Green, Philip

    2012-09-01

    Phil Green, senior project engineer at independent building services company, Shepherd Engineering Services (SES), describes SES's creation a new 'state-of-the-art', 4.5 million sterling pounds, high dependency unit (HDU) at The James Cook University Hospital, Middlesbrough. Completion of the 16-bed HDU, part of a wider South Tees Hospitals NHS Foundation Trust investment programme to remodel and enhance the hospital's facilities, follows last September's completion, also by SES, of the Endeavour Unit (HEJ - November 2011), a new oncology satellite building built as a key element of the Trust's 30 million sterling pounds expansion and redevelopment of its Radiotherapy Unit at the Middlesbrough hospital.

  12. Learning image context for segmentation of prostate in CT-guided radiotherapy.

    PubMed

    Li, Wei; Liao, Shu; Feng, Qianjin; Chen, Wufan; Shen, Dinggang

    2011-01-01

    Segmentation of prostate is highly important in the external beam radiotherapy of prostate cancer. However, it is challenging to localize prostate in the CT images due to low image contrast, prostate motion, and both intensity and shape changes of bladder and rectum around the prostate. In this paper, an online learning and patient-specific classification method based on location-adaptive image context is proposed to precisely segment prostate in the CT image. Specifically, two sets of position-adaptive classifiers are respectively placed along the two coordinate directions, and further trained with the previous segmented treatment images to jointly perform the prostate segmentation. In particular, each location-adaptive classifier is recursively trained with different image context collected at different scales and orientations for better identification of each prostate region. The proposed learning-based prostate segmentation method has been extensively evaluated on a large set of patients, achieving very promising results.

  13. 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

  14. Wearable Arts of Japan: Seattle Art Museum.

    ERIC Educational Resources Information Center

    Loudon, Sarah

    1996-01-01

    Presents four lesson plans centered around artworks involving Japanese clothing. Instructional materials include color plates of a 19th century print showing women's clothing, two beautifully handcrafted coats, and a coverlet in kimono form. The lesson plans discuss Japanese clothing, art, society, and culture. (MJP)

  15. Art in Chemistry; Chemistry in Art.

    ERIC Educational Resources Information Center

    Greenberg, Barbara R.; Patterson, Dianne

    High school teachers are often challenged to motivate students who have little or no interest in a subject and are bored with traditional instruction. This unique book is designed to help educators make chemistry classes more interesting and links art curriculum to practical applications, integrating the two subjects through scores of hands-on…

  16. Sequencing Events: Exploring Art and Art Jobs.

    ERIC Educational Resources Information Center

    Stephens, Pamela Geiger; Shaddix, Robin K.

    2000-01-01

    Presents an activity for upper-elementary students that correlates the actions of archaeologists, patrons, and artists with the sequencing of events in a logical order. Features ancient Egyptian art images. Discusses the preparation of materials, motivation, a pre-writing activity, and writing a story in sequence. (CMK)

  17. Math in Art or Art in Math.

    ERIC Educational Resources Information Center

    Biller, Jerry

    The concept of integrating mathematics and art course work broadens an appreciation of the connection between the two. Although calculations and getting the right answer have traditionally been the focus of mathematics at the secondary level, other topics have recently begun to be addressed, such as mathographics, or the relationship between art…

  18. Games for "Seeing" Art.

    ERIC Educational Resources Information Center

    Osmundson, Linda

    2000-01-01

    Provides various activities that museum docents use to help students "see" rather than "look" at art objects. Ideas include playing a looking game, using the five senses to describe the painting, creating stories about the art object, and having a treasure hunt while visiting a museum. (CMK)

  19. Art for Libraries' Sake.

    ERIC Educational Resources Information Center

    Lugo, Mark-Elliot

    1999-01-01

    Illustrates the benefits of an aggressive library program of regularly scheduled and professionally curated art exhibitions and related events. Describes the Visual Arts Program at the Pacific Beach branch library (San Diego). A sidebar by Debra Wilcox Johnson discusses libraries' development of cultural programming for adults. (AEF)

  20. Art Education Is Violent

    ERIC Educational Resources Information Center

    Tavin, Kevin

    2014-01-01

    In an era that is rife with aggression and hostility, most art educators hold close to their hearts the belief that they, and their students, can contribute to making the world a better place. Through their acts as teachers and the daily work of art education, they often strive toward creating a space of "non-violence." For K-12…

  1. Language Arts Topics Papers.

    ERIC Educational Resources Information Center

    Bailey, Jane M.; And Others

    This document brings together six papers on language skills and language arts teaching of gifted students. "The State of the Art Issues in Language Study for High Ability Learners: Thinking about Language with Gifted Children" (Michael Clay Thompson) considers two areas traditionally included in discussions of language study--grammar and…

  2. Parallels in the Arts

    ERIC Educational Resources Information Center

    Laffey, Grace

    1972-01-01

    A mini-course of nine weeks was organized as a laboratory course to survey relationships in literature, music, and art. Three periods in the arts (Romanticism, Impressionism, and Contemporary) were matched with three major activities; the basic areas of study and activity were poetry, short story, and novel. (Author)

  3. Art Teacher Education.

    ERIC Educational Resources Information Center

    Grauer, Kit, Ed.

    1994-01-01

    This journal issue provides a cogent look at general issues in art teacher education, specific teacher education programs and particular agendas as they are played out in a number of different countries. The topic is introduced in the Editorial, "The Education of Educators: Art Teacher Education around the World" (Kit Grauer). Articles…

  4. Art in the Garden.

    ERIC Educational Resources Information Center

    Greenman, Geri

    2003-01-01

    Describes an art project in which beginning art students created ceramic vegetables that are supposed to be functional, such as a container. Explains how the teacher can demonstrate the process of creating the ceramic vegetables. Includes a list of materials. (CMK)

  5. Art as Peace Building

    ERIC Educational Resources Information Center

    Marshall, Laurie

    2014-01-01

    Art educators can "critique" senseless violence--mistreatment, exclusion, intimidation, bullying, violation, abuse, corruption, murder, and war--by unleashing the power of students' creativity. In this article, the author, sharing her philosophical context, discusses how art is preventative medicine with the power to transform the cycle…

  6. The Art of Inclusion

    ERIC Educational Resources Information Center

    MacLean, Jan

    2008-01-01

    In this article, the author focuses on secondary students with cognitive or intellectual disabilities. She discusses that these students can be successfully included into the classroom community if schools can provide the appropriate tools such literacy in the arts. Here, she cites the number of reasons why arts can meet the varied needs and…

  7. Art in a Democracy.

    ERIC Educational Resources Information Center

    Blandy, Doug, Ed.; Congdon, Kristin G., Ed.

    Society truly cannot be democratic unless the educational systems function democratically. Art education has a role to play in this process. The perceptions of many different groups in a pluralistic society must be considered in a new multicultural approach to the teaching of art. A "Foreword" (June King McFee) and "Introduction" (Doug Blandy;…

  8. Looking into Oceanic Art.

    ERIC Educational Resources Information Center

    Parks, Nancy Schien; Maxedon, G. Edward

    1997-01-01

    Presents background material, suggested teaching activities, and four color plates illustrating the folk art of the Oceania islands (Melanesia, Micronesia, and Polynesia). The background material is incorporated into an interview with two Oceanic art specialists from Indiana University who discuss the culture of the islands. (MJP)

  9. Cybernetics, Art and Ideas.

    ERIC Educational Resources Information Center

    Reichardt, Jasia, Ed.

    The essays in this volume deal with the relationship of the computer and the arts, especially the exploration and demonstration of connections between creativity and technology, the links between scientific or mathematical approaches, intuitions, and the more irrational and oblique urges associated with the making of music, art, and poetry. The…

  10. The Art of Mexico.

    ERIC Educational Resources Information Center

    Saccardi, Marianne

    1997-01-01

    Provides an annotated bibliography of books for grades K and up which explores the folklore, poetry, fiction, and art of Mexico, and focuses on the Mayans and Aztecs and Diego Rivera and Frida Kahlo. Also suggests various research, reading, drama, music, social studies, physical education, and art activities and lists related videos and Internet…

  11. Comics as Art Therapy

    ERIC Educational Resources Information Center

    Mulholland, Matthew J.

    2004-01-01

    Spider Man and the Green Lantern are not the first images that most people conjure up when someone mentions "important art." In the world of fine art, comic books are often viewed as the bottom rung of the artistic ladder. In the early half of the 1900s, such an assessment would not have been unreasonable. With their rudimentary visuals and…

  12. Gerontology and the Arts.

    ERIC Educational Resources Information Center

    Jones, Jean Ellen, Ed.

    1982-01-01

    Reviews research on the place of the arts in programs for the elderly. In nine articles deals with characteristics and attitudes of adult students in art and music, dance therapy, and creativity. Discusses the aging advocacy movement and suggests it can be useful to program planners and gerontologists. (JAC)

  13. Performance Art: Kinetic Reproductions.

    ERIC Educational Resources Information Center

    Kassin, Cherie

    2001-01-01

    Provides an art project for use with eighth-grade students, who choose a work of art and recreate it in an interpretive and informative manner. Explains that students re-create the background of the artwork and then the students become a part of the painting via characters or objects. (CMK)

  14. Mola Art: Elementary

    ERIC Educational Resources Information Center

    Barsamian, Araxey

    2004-01-01

    In this brief article, the author describes a lesson plan on Mola art she used in her elementary classroom. Using four examples of Kuna Indian molas, the teacher introduced students to the beautiful, colorful, creative art form of molas. The Kuna women have been making these layered pieces of cloth for more than one hundred years. They use a…

  15. The Boutique Liberal Arts?

    ERIC Educational Resources Information Center

    Cohen, Scott

    2014-01-01

    The structure of higher education today, in conjunction with those actively trying to devalue a liberal arts degree in the public sphere, has set the table for what seems like a completely rational solution: finding a "niche." Broadly speaking, colleges offering a liberal arts education identify their "niche market" in terms of…

  16. Art, Society and Education

    ERIC Educational Resources Information Center

    Smith, Ralph A.

    1976-01-01

    In considering the relation of art with society the author comments on the ideas of the American philosopher, John Dewey, the art historian, Lord Kenneth Clark, a popular humanistic educator, Clifton Fadiman, and a major cultural critic, Jacques Barzun. (Author/RK)

  17. Arte Brasileno Erudito y Arte Brasileno Popular. (Brazilian Fine Art and Brazilian Popular Art)

    ERIC Educational Resources Information Center

    Valladares, Clarival Do Prado

    1969-01-01

    Class differences in Brazil explain the inequality between the art produced in the high strata of society and that originating in the economically inferior communities. Genuine expression of art degenerates for two reasons: the influence of modern industrial civilization and the tendency to satisfy the taste of the acquisitive group. (Author/MF)

  18. Visual Arts Research, 1994.

    ERIC Educational Resources Information Center

    Gardner, Nancy C., Ed.; Thompson, Christine, Ed.

    1994-01-01

    This document consists of the two issues of the journal "Visual Arts in Research" published in 1994. This journal focuses on the theory and practice of visual arts education from educational, historical, philosophical, and psychological perspectives. Number 1 of this volume includes the following contributions: (1) "Zooming in on the Qualitative…

  19. Culinary Arts Profile.

    ERIC Educational Resources Information Center

    Missouri Univ., Columbia. Instructional Materials Lab.

    This chart is intended for use in documenting the fact that a student participating in a culinary arts program has achieved the performance standards specified in the Missouri Competency Profile for culinary arts. The chart includes space for recording basic student and instructor information and the student's on-the-job training and work…

  20. Art Education with Attitude

    ERIC Educational Resources Information Center

    Williams, Jere

    2016-01-01

    Purpose: This paper explores the way in which art education advances the goals of citizenship education. In the first section of this paper the similarities between ethical and aesthetic concepts will be outlined and the visual art symbol system will be carefully examined. Findings: It will be argued that the transference of a value-adaptive…

  1. Mathematics and Art

    ERIC Educational Resources Information Center

    Sharp, John

    2012-01-01

    This relationship is omnipresent to those who appreciate the shared attributes of these two areas of creativity. The dynamic nature of media, and further study, enable mathematicians and artists to present new and exciting manifestations of the "mathematics in art", and the "art in mathematics". The illustrative images of the relationship--that…

  2. Sustaining the Military Arts

    DTIC Science & Technology

    1989-09-01

    pidgin isn’t the antidote for strategic illiteracy. The military arts of strategy, operations, and tactics are merely the creative bridges that allow...Strategic pidgin isn’t the antidote for strategic illiteracy. about military arts and sciences is not merely a ’question of rhetorical clarity. Indeed

  3. Art Therapy: A Bibliography.

    ERIC Educational Resources Information Center

    Gantt, Linda, Comp.; Schmal, Marilyn Strauss, Comp.

    The bibliography on art therapy presents 1175 citations (1940-1973) drawn from searches of the medical indexes, computer systems of the National Library of Medicine and the National Institute of Mental Health, other bibliographies, Centre International de Documentation Concernant les Expressions Plastiques, and the American Journal of Art Therapy.…

  4. Art Supports Reading Comprehension

    ERIC Educational Resources Information Center

    Wurst, Douglas; Jones, Dana; Moore, Jim

    2005-01-01

    State-mandated, high-stakes testing is the primary means by which schools are judged. Whether this is a fair and accurate way of judging the performance of schools may remain in debate for a long time. Some school districts have gone so far as reducing or eliminating "special" classes--in particular art and music. Art teachers can help prepare…

  5. Socialization in the Arts.

    ERIC Educational Resources Information Center

    Orend, Richard J.

    Socialization is a process by which children learn the attitudes and orientations that will guide their behavior as adults. The analyses described in this report use this socialization model as a basis for describing the relationship between childhood and early adult arts-related experiences and current arts-related leisure participation. Three…

  6. Bringing Art to Schools.

    ERIC Educational Resources Information Center

    Butterfield, Eric

    2000-01-01

    Discusses the Art and Architecture program that involves K-12 students in the creation of public art. The program provides students with a sense of ownership through design and construction assignments created as part of an integrated curriculum, including mock bids and interpreting a floor plan into an elevation. Tips on how architects can start…

  7. Art in Public.

    ERIC Educational Resources Information Center

    Henry, David J.

    1991-01-01

    Examines four works of art, created for public spaces, to help students understand the value of public art in the community. Illustrates work by Claes Oldenburg and Coosje van Bruggen, Siah Armajani, Jackie Ferrara, and Deborah Butterfield. Outlines lesson activities for elementary and secondary students. (KM)

  8. Visual Arts Research, 1995.

    ERIC Educational Resources Information Center

    Gardner, Nancy C., Ed.; Thompson, Christine, Ed.

    1995-01-01

    This document consists of the two issues of the journal "Visual Arts Research" published in 1995. This journal focuses on the theory and practice of visual arts education from educational, historical, philosophical, and psychological perspectives. Number 1 of this volume includes the following contributions: (1) "Children's Sensitivity to…

  9. Tangrams: Puzzles of Art

    ERIC Educational Resources Information Center

    Fee, Brenda

    2009-01-01

    Challenging one's brain is the beginning of making great art. Tangrams are a great way to keep students thinking about their latest art project long after leaving the classroom. A tangram is a Chinese puzzle. The earliest known reference to tangrams appears in a Chinese book dated 1813, but the puzzles existed long before that date. The puzzle…

  10. I: Making Art

    ERIC Educational Resources Information Center

    Rosenfeld, Malke; Johnson, Marquetta; Plemons, Anna; Makol, Suzanne; Zanskas, Meghan; Dzula, Mark; Mahoney, Meg Robson

    2014-01-01

    Writing about the teaching artist practice should mean writing about art making. As both teacher and artist, the authors are required to be cognizant of their own art-making processes, both how it works and why it is important to them, in order to make this process visible to their students. They also need the same skills to write about how and…

  11. The Talking Art Museum

    ERIC Educational Resources Information Center

    Bundy, Jacqui

    2009-01-01

    Every year, fourth graders at Sterling Morton Elementary School in Ohio present a talking art museum for the school and community. In this article, the author describes a lesson on art history which culminates in an activity showcasing all the students' finished paintings in gold frames. A student stands behind the painting and pokes his or her…

  12. Walking, Talking Art Gallery.

    ERIC Educational Resources Information Center

    Piazza, Sheila

    2002-01-01

    Discusses a project that aimed at educating the public about art by bringing art to the people. Explains that students selected their favorite artwork and made a t-shirt displaying their artwork. States that the students went into their community and also created a mural. (CMK)

  13. The Art of Science.

    ERIC Educational Resources Information Center

    Jory, Tina

    1997-01-01

    Advocates introducing young students to realistic nature drawing as a way of integrating art and science. Describes an earthworm art project using a salt dough model and a realistic drawing. This activity should begin with a view of the real subject whenever possible before proceeding to the actual artwork. (AIM)

  14. Elegant Art Nouveau

    ERIC Educational Resources Information Center

    Fontes, Kris

    2005-01-01

    Gustav Klimt (1862-1918), a Viennese painter, was the founder of the Vienna Secession, the Austrian Art Nouveau movement. Art Nouveau is characterised by flowing lines and flat designs based on organic structures. This style is found in the symbolic aspect of Klimt's later work, and in the works of other artists of the late 1890s and early 1900s…

  15. Elementary Art Education. Focus.

    ERIC Educational Resources Information Center

    Caucutt, Allen, Ed.

    This collection of writings addresses the issue of developing a generation of aesthetically aware and involved individuals. Each of the 19 articles emphasizes art education as an indispensable force in the total school program. Together these writings form sources of inspiration and ideas for the elementary art teacher. Divided into four…

  16. Primary Art Resource Guide.

    ERIC Educational Resources Information Center

    Newton Unified School District 373, KS.

    GRADES OR AGES: Primary Grades. SUBJECT MATTER: Art. ORGANIZATION AND PHYSICAL APPEARANCE: The guide begins with a list of topics for art expression. The main body of the guide contains 15 color-coded sections on the following subjects: 1) mobiles and folded paper; 2) collage and photo montage; 3) square paper and mosaics; 4) wax paper and…

  17. Art & Science Grow Together

    ERIC Educational Resources Information Center

    Stellflue, Pat; Allen, Marie; Gerber, D. Timothy

    2005-01-01

    This article describes a collaborative effort that included a botany professor, an art teacher, and a science teacher, called,"Plants, Pots, and Paints." This interdisciplinary project was successful in connecting content across disciplines (science to art) and for motivating fourth-and fifth-grade students to create something beautiful both they…

  18. PLANNING THE ART ROOM.

    ERIC Educational Resources Information Center

    POPOLIZIO, VINCENT J.; AND OTHERS

    FACILITIES FOR CARRYING OUT AN ART PROGRAM MUST BE DESIGNED TO MEET THE NEEDS OF STUDENTS IN SCHOOL AND THOSE ENROLLED IN ADULT PROGRAMS. PROVISIONS MUST BE INCLUDED FOR PAINTING AND DRAWING, THE GRAPHIC ARTS, GENERAL CRAFTS, MODELING, SCHULPTURING, PHOTOGRAPHY, SERIGRAPHY, AND MECHANICAL DRAWING. WORK CENTERS AND TRAFFIC FLOW NEED CAREFUL…

  19. When Curriculum Meets Art

    ERIC Educational Resources Information Center

    Giardina, Nicola

    2016-01-01

    A three-year grant program at the Metropolitan Museum of Art in New York City encourages teachers to draw connections between curricular topics and works of art. In this article, museum educator Nicola Giardina describes how the program uses inquiry-based lessons to create meaningful learning experiences for underserved students. She highlights…

  20. Art and Thinking Skills.

    ERIC Educational Resources Information Center

    McCoubrey, Sharon

    1994-01-01

    This theme issue reviews and confirms the connection between thinking skills and art education. Articles offer possible teaching approaches and specific lesson plans dealing with thinking skills. The issue includes: (1) "Editor's View" (Sharon McCoubrey); (2) "Critical and Creative Thinking and Making Art" (Carol Fineberg); (3)…

  1. The Art of Education

    ERIC Educational Resources Information Center

    Abdul-Alim, Jamaal

    2012-01-01

    Dr. Robert F. Sabol, professor of visual and performing arts at Purdue University says that art education has suffered some serious setbacks since No Child Left Behind--the landmark federal education law that put a greater emphasis on high-stakes testing. Since No Child Left Behind became law in 2002, school systems--under increased pressure to…

  2. External beam radiotherapy as curative treatment of prostate cancer.

    PubMed

    Pisansky, Thomas M

    2005-07-01

    External beam radiotherapy (RT) has been used as a curative treatment of prostate cancer for more than 5 decades, with the "modern" era emerging more than 3 decades ago. Its history is marked by gradual improvements punctuated by several quantum leaps that are increasingly driven by advancements in the computer and imaging sciences and by its integration with complementary forms of treatment. Consequently, the contemporary use of external beam RT barely resembles its earliest form, and this must be appreciated in the context of current patient care. The influence of predictive factors on the use and outcomes of external beam RT is presented, as is a selected review of the methods and outcomes of external beam RT as a single therapeutic intervention, in association with androgen suppression, or as a postoperative adjunct. Thus, the "state of the (radiotherapeutic) art" is presented to enhance the understanding of this treatment approach with the hope that this information will serve as a useful resource to physicians as they care for patients with prostate cancer.

  3. TU-F-BRB-01: Resolving and Characterizing Breathing Motion for Radiotherapy with MRI

    SciTech Connect

    Tryggestad, E.

    2015-06-15

    The current clinical standard of organ respiratory imaging, 4D-CT, is fundamentally limited by poor soft-tissue contrast and imaging dose. These limitations are potential barriers to beneficial “4D” radiotherapy methods which optimize the target and OAR dose-volume considering breathing motion but rely on a robust motion characterization. Conversely, MRI imparts no known radiation risk and has excellent soft-tissue contrast. MRI-based motion management is therefore highly desirable and holds great promise to improve radiotherapy of moving cancers, particularly in the abdomen. Over the past decade, MRI techniques have improved significantly, making MR-based motion management clinically feasible. For example, cine MRI has high temporal resolution up to 10 f/s and has been used to track and/or characterize tumor motion, study correlation between external and internal motions. New MR technologies, such as 4D-MRI and MRI hybrid treatment machines (i.e. MR-linac or MR-Co60), have been recently developed. These technologies can lead to more accurate target volume determination and more precise radiation dose delivery via direct tumor gating or tracking. Despite all these promises, great challenges exist and the achievable clinical benefit of MRI-based tumor motion management has yet to be fully explored, much less realized. In this proposal, we will review novel MR-based motion management methods and technologies, the state-of-the-art concerning MRI development and clinical application and the barriers to more widespread adoption. Learning Objectives: Discuss the need of MR-based motion management for improving patient care in radiotherapy. Understand MR techniques for motion imaging and tumor motion characterization. Understand the current state of the art and future steps for clinical integration. Henry Ford Health System holds research agreements with Philips Healthcare. Research sponsored in part by a Henry Ford Health System Internal Mentored Grant.

  4. Adaptive SPECT

    PubMed Central

    Barrett, Harrison H.; Furenlid, Lars R.; Freed, Melanie; Hesterman, Jacob Y.; Kupinski, Matthew A.; Clarkson, Eric; Whitaker, Meredith K.

    2008-01-01

    Adaptive imaging systems alter their data-acquisition configuration or protocol in response to the image information received. An adaptive pinhole single-photon emission computed tomography (SPECT) system might acquire an initial scout image to obtain preliminary information about the radiotracer distribution and then adjust the configuration or sizes of the pinholes, the magnifications, or the projection angles in order to improve performance. This paper briefly describes two small-animal SPECT systems that allow this flexibility and then presents a framework for evaluating adaptive systems in general, and adaptive SPECT systems in particular. The evaluation is in terms of the performance of linear observers on detection or estimation tasks. Expressions are derived for the ideal linear (Hotelling) observer and the ideal linear (Wiener) estimator with adaptive imaging. Detailed expressions for the performance figures of merit are given, and possible adaptation rules are discussed. PMID:18541485

  5. Old Friends, Bookends: Art Educators and Art Therapists

    ERIC Educational Resources Information Center

    Allison, Amanda

    2013-01-01

    This viewpoint presents a reflection on a meaningful relationship that developed between a university art education department and a local art therapy studio. Such partnerships are desirable and mutually beneficial because of the significant interest many art educators have in the field of art therapy. The author, an art educator, describes the…

  6. Support for Arts Education. State Arts Agency Fact Sheet

    ERIC Educational Resources Information Center

    National Assembly of State Arts Agencies, 2011

    2011-01-01

    Supporting lifelong learning in the arts is a top priority for state arts agencies. By supporting arts education in the schools, state arts agencies foster young imaginations, address core academic standards, and promote the critical thinking and creativity skills essential to a 21st century work force. State arts agencies also support…

  7. Introduction of audio gating to further reduce organ motion in breathing synchronized radiotherapy.

    PubMed

    Kubo, H Dale; Wang, Lili

    2002-03-01

    With breathing synchronized radiotherapy (BSRT), a voltage signal derived from an organ displacement detector is usually displayed on the vertical axis whereas the elapsed time is shown on the horizontal axis. The voltage gate window is set on the breathing voltage signal. Whenever the breathing signal falls between the two gate levels, a gate pulse is produced to enable the treatment machine. In this paper a new gating mechanism, audio (or time-sequence) gating, is introduced and is integrated into the existing voltage gating system. The audio gating takes advantage of the repetitive nature of the breathing signal when repetitive audio instruction is given to the patient. The audio gating is aimed at removing the regions of sharp rises and falls in the breathing signal that cannot be removed by the voltage gating. When the breathing signal falls between voltage gate levels as well as between audio-gate levels, the voltage- and audio-gated radiotherapy (ART) system will generate an AND gate pulse. When this gate pulse is received by a linear accelerator, the linear accelerator becomes "enabled" for beam delivery and will deliver the beam when all other interlocks are removed. This paper describes a new gating mechanism and a method of recording beam-on signal, both of which are, configured into a laptop computer. The paper also presents evidence of some clinical advantages achieved with the ART system.

  8. Possible revisions in reservoir operation rules as an adaptation to climate change assessed by a global hydrological model with anthropogenic activities and a state-of-the-art river routing model

    NASA Astrophysics Data System (ADS)

    Oki, T.; Mateo, C. M. R.; Hanasaki, N.; Yamazaki, D.; Watanabe, S.; Kiguchi, M.; Komori, D.; Champathong, A.

    2015-12-01

    In the past decade, several advances have been made in incorporating anthropogenic impacts such as reservoir operation in global hydrological models. However, detailed examination of their performance in regional or large river basins is still lacking. The Chao Phraya River Basin in Thailand is a good site for a case study because of the availability of detailed and long-term hydrological records which include the operation of two huge reservoirs, the Bhumibol and Sirikit Reservoirs, in the basin. The ensemble means of the simulation results using eight bias-corrected CMIP5 general circulation models (GCMs), selected based on the availability of the atmospheric forcing inputs needed in a water balance model with human activities, the H08 model, under two representative concentration path scenarios (RCP), RCP4.5 and RCP8.5, for the near future from 2041 to 2059 were compared with the base period simulation from 1981 to 1999. The estimates projected an increase in runoff of 10-15% in RCP4.5 and 40-50% in RCP8.5. While the change in dry season ranges from -10mm to 10mm, the wet season runoff could increase by as much as 160mm in RCP8.5. Hence, the frequency of reservoir emptying will decrease while spilling will increase by as much as 5 times of that of the base period in RCP8.5. In RCP4.5, the frequency of reservoir emptying will not significantly change while spilling will most likely double. Consequently, flooding in the basin will be more frequent and more severe. It was found that the mean inundated area downstream of the two reservoirs, simulated by CaMa-Flood, will increase by approximately 30% in RCP4.5 and about 130% in RCP8.5. At flood inundation depth greater than 1.00m, flooded area will increase by about 95% and 460% in RCP4.5 and RCP8.5, respectively. Possible reservoir operation rules adapting to these changes are examined to minimize flooded area and inundation depth in the downstream area, and to avoid full water levels of the reservoirs. It is

  9. Authenticity in Anatomy Art.

    PubMed

    Adkins, Jessica

    2017-01-12

    The aim of this paper is to observe the evolution and evaluate the 'realness' and authenticity in Anatomy Art, an art form I define as one which incorporates accurate anatomical representations of the human body with artistic expression. I examine the art of 17th century wax anatomical models, the preservations of Frederik Ruysch, and Gunther von Hagens' Body Worlds plastinates, giving consideration to authenticity of both body and art. I give extra consideration to the works of Body Worlds since the exhibit creator believes he has created anatomical specimens with more educational value and bodily authenticity than ever before. Ultimately, I argue that von Hagens fails to offer Anatomy Art 'real human bodies,' and that the lack of bodily authenticity of his plastinates results in his creations being less pedagogic than he claims.

  10. Can Visual Arts Training Improve Physician Performance?

    PubMed Central

    Katz, Joel T.; Khoshbin, Shahram

    2014-01-01

    Clinical educators use medical humanities as a means to improve patient care by training more self-aware, thoughtful, and collaborative physicians. We present three examples of integrating fine arts — a subset of medical humanities — into the preclinical and clinical training as models that can be adapted to other medical environments to address a wide variety of perceived deficiencies. This novel teaching method has promise to improve physician skills, but requires further validation. PMID:25125749

  11. Art, antiquarianism and early anatomy.

    PubMed

    Guest, Clare E L

    2014-12-01

    Discussions of the early relationship between art and anatomy are shaped by Vasari's account of Florentine artists who dissected bodies in order to understand the causes of movement, and the end of movement in action. This account eclipses the role of the study of antiquities in Renaissance anatomical illustration. Beyond techniques of presentation, such as sectioning and analytic illustration, or a preoccupation with the mutilated fragment, antiquarianism offered a reflection on the variant and the role of temperament which could be adapted for anatomical purposes. With its play on ambiguities of life and death, idealisation and damage, antiquarianism also provided a way of negotiating the difficulties of content inherent in anatomical illustration. As such, it goes beyond exclusively historical interest to provoke reflection on the modes, possibilities and humane responsibilities of medical illustration.

  12. Art as behaviour--an ethological approach to visual and verbal art, music and architecture.

    PubMed

    Sütterlin, Christa; Schiefenhövel, Wulf; Lehmann, Christian; Forster, Johanna; Apfelauer, Gerhard

    2014-01-01

    In recent years, the fine arts, architecture, music and literature have increasingly been examined from the vantage point of human ethology and evolutionary psychology. In 2011 the authors formed the research group 'Ethology of the Arts' concentrating on the evolution and biology of perception and behaviour. These novel approaches aim at a better understanding of the various facets represented by the arts by taking into focus possible phylogenetic adaptations, which have shaped the artistic capacities of our ancestors. Rather than culture specificity, which is stressed e.g. by cultural anthropology and numerous other disciplines, universal human tendencies to perceive, feel, think and behave are postulated. Artistic expressive behaviour is understood as an integral part of the human condition, whether expressed in ritual, visual, verbal or musical art. The Ethology of the Arts-group's research focuses on visual and verbal art, music and built environment/architecture and is designed to contribute to the incipient interdisciplinarity in the field of evolutionary art research.

  13. Toll-like receptor 4-dependent contribution of the immune system to anticancer chemotherapy and radiotherapy.

    PubMed

    Apetoh, Lionel; Ghiringhelli, François; Tesniere, Antoine; Obeid, Michel; Ortiz, Carla; Criollo, Alfredo; Mignot, Grégoire; Maiuri, M Chiara; Ullrich, Evelyn; Saulnier, Patrick; Yang, Huan; Amigorena, Sebastian; Ryffel, Bernard; Barrat, Franck J; Saftig, Paul; Levi, Francis; Lidereau, Rosette; Nogues, Catherine; Mira, Jean-Paul; Chompret, Agnès; Joulin, Virginie; Clavel-Chapelon, Françoise; Bourhis, Jean; André, Fabrice; Delaloge, Suzette; Tursz, Thomas; Kroemer, Guido; Zitvogel, Laurence

    2007-09-01

    Conventional cancer treatments rely on radiotherapy and chemotherapy. Such treatments supposedly mediate their effects via the direct elimination of tumor cells. Here we show that the success of some protocols for anticancer therapy depends on innate and adaptive antitumor immune responses. We describe in both mice and humans a previously unrecognized pathway for the activation of tumor antigen-specific T-cell immunity that involves secretion of the high-mobility-group box 1 (HMGB1) alarmin protein by dying tumor cells and the action of HMGB1 on Toll-like receptor 4 (TLR4) expressed by dendritic cells (DCs). During chemotherapy or radiotherapy, DCs require signaling through TLR4 and its adaptor MyD88 for efficient processing and cross-presentation of antigen from dying tumor cells. Patients with breast cancer who carry a TLR4 loss-of-function allele relapse more quickly after radiotherapy and chemotherapy than those carrying the normal TLR4 allele. These results delineate a clinically relevant immunoadjuvant pathway triggered by tumor cell death.

  14. Second cancers following radiotherapy for cancer

    SciTech Connect

    Curtis, R.E.

    1997-03-01

    The study of second cancer risk after radiotherapy provides a unique opportunity to study carcinogenesis since large groups of humans are deliberately exposed to substantial doses of radiation in order to cure disease. Detailed radiotherapy records for cancer patients allow precise quantification of organ dose, and population-based cancer registries are frequently available to provide access to large groups of patients who are closely followed for long periods. Moreover, cancer patients treated with surgery alone (no radiation) are frequently available to serve as a non-irradiated comparison group. New information can be provided on relatively insensitive organs, and low dose exposures in the range of scientific interest are received by organs outside the radiation treatment fields. This paper will review several recently completed studies that characterize the risk of radiation-induced second cancers. Emphasis will be given to studies providing new information on the dose-response relationship of radiation-induced leukemia, breast cancer and lung cancer.

  15. [Radiotherapy as primary treatment for chemodectoma?].

    PubMed

    Verniers, D; Van Limbergen, E; Leysen, J; Ostyn, F; Segers, A

    1990-01-01

    Chemodectomas are slowly growing tumours originating in the chemoreceptor bodies. The diagnosis is based on typical clinical symptoms and radiological investigation. CT scanning with contrast enhancement permits to establish diagnosis in most cases and gives a correct idea of tumour size, tumour extension, displacement of arteries and bone destruction. Small tympanic chemodectomas are successfully managed by surgery, without causing additional cranial nerve palsies. Surgery of larger lesions is frequently followed by a high percentage of local recurrence (greater than 50%) and important morbidity (neurologic sequelae). Our present series confirms that these tumours can successfully be treated by radiotherapy. Persisting local control rates can be obtained in more than 90% of cases with moderate doses (45-50 Gy in 5 weeks) of carefully planned radiotherapy.

  16. [Radiotherapy and targeted therapy/immunotherapy].

    PubMed

    Antoni, D; Bockel, S; Deutsch, E; Mornex, F

    2016-10-01

    Thanks to recent advances achieved in oncologic systemic and local ablative treatment, the treatments become more and more efficient in term of local control and overall survival. Thus, the targeted therapies, immunotherapy or stereotactic radiotherapy have modified the management of patients, especially in case of oligometastatic disease. Many questions are raised by these innovations, particularly the diagnosis and management of new side effects or that of the combination of these different treatments, depending on the type of primary tumor. Fundamental data are available, while clinical data are still limited. Ongoing trials should help to clarify the clinical management protocols. This manuscript is a review of the combination of radiotherapy and targeted therapy/immunotherapy.

  17. Perianal Paget disease treated definitively with radiotherapy.

    PubMed

    Mann, J; Lavaf, A; Tejwani, A; Ross, P; Ashamalla, H

    2012-12-01

    Extramammary Paget disease (empd) is a relatively rare cutaneous disorder described as an apocrine gland tumour occurring in both a benign and a malignant form with metastatic potential. The areas of the body affected are the vulva, perianal region, penis, scrotum, perineum, and axilla, all of which contain apocrine glands. When empd affects the perianal region, it is called perianal Paget disease (ppd). All forms of empd, including ppd, are typically treated by wide surgical excision. Perianal Paget disease usually occurs later in life in patients who are often poor surgical candidates, but the available literature is scarce regarding other treatment modalities, including definitive radiotherapy. We contend that ppd can be safely and effectively treated with radiotherapy, and here, we present the case of a 75-year-old woman with ppd who was successfully so treated. A brief review of the literature concerning the diagnosis, natural history, and treatment of ppd is also included.

  18. Proton Radiotherapy for Solid Tumors of Childhood

    PubMed Central

    Cotter, Shane E.; McBride, Sean M.; Yock, Torunn I.

    2012-01-01

    The increasing efficacy of pediatric cancer therapy over the past four decades has produced many long-term survivors that now struggle with serious treatment related morbidities affecting their quality of life. Radiation therapy is responsible for a significant proportion of these late effects, but a relatively new and emerging modality, proton radiotherapy hold great promise to drastically reduce these treatment related late effects in long term survivors by sparing dose to normal tissues. Dosimetric studies of proton radiotherapy compared with best available photon based treatment show significant dose sparing to developing normal tissues. Furthermore, clinical data are now emerging that begin to quantify the benefit in decreased late treatment effects while maintaining excellent cancer control rates. PMID:22417062

  19. Status of radiotherapy in a multidisciplinary cancer board.

    PubMed

    Ichikawa, Mayumi; Nemoto, Kenji; Miwa, Misako; Ohta, Ibuki; Nomiya, Takuma; Yamakawa, Mayumi; Itho, Yuriko; Fukui, Tadahisa; Yoshioka, Takashi

    2014-03-01

    Multidisciplinary cancer boards (CBs) for making cancer treatment decisions have become popular in many countries; however, the status of radiotherapy in CBs and the influence of CBs on radiotherapy decisions have not been studied. To clarify these issues, we reviewed the minutes of our CBs from February 2010 to March 2012, and we classified planned treatments discussed at the CBs into five categories and analyzed decisions concerning radiotherapy in each category. The fraction of cases for which radiotherapy was recommended was 536/757 (71%). These cases included 478 cases (63%) for which radiation therapy was planned and four cases (0.5%) for which radiation therapy was unexpectedly recommended. On the other hand, radiation therapy was canceled in 21 cases (4%) for which radiation therapy had been planned. This study showed that radiotherapy was discussed in many cases at CBs and that CBs have a great influence on decisions concerning radiotherapy.

  20. Essays on Art and Education.

    ERIC Educational Resources Information Center

    Geering, Adrian D.

    This document contains 10 essays which focus on various aspects of art education in the elementary, secondary, and postsecondary educational institutions of Australia. Titles are "Art Education in Australia," The Visual Arts and Society,""The Parallels Between Primitive Art and Child Art,""The Mildura Sculpture…

  1. Dumbing down Art in America.

    ERIC Educational Resources Information Center

    Swanger, David

    1993-01-01

    Argues that art education does not meet its objective of creativity and instead is replicative rather than original. Contends educational journals such as "Instructor" and "Good Apple" reduce fine art to its antithesis, popular art. Concludes that art educators must work diligently to protect fine art from becoming "dumb…

  2. Whither Programs and Arts Policy?

    ERIC Educational Resources Information Center

    Colwell, Richard

    2005-01-01

    Are these halcyon days for arts education, or are we at least in an auspicious or opportune period for the field? One encounters good news on a daily basis; arts advocates and policymakers are actively promoting the arts and arts education. Yet many in the arts education community do not feel that they are experiencing a renaissance period. What…

  3. Postoperative radiotherapy in the management of keloids

    PubMed Central

    Carvajal, Claudia C; Ibarra, Carla M; Arbulo, Douglas L; Russo, Moisés N; Solé, Claudio P

    2016-01-01

    Background The high recurrence rate following keloid resection has generated interest in adjuvant treatments for this disease. Objective This study assesses keloid recurrence when treated with surgery and adjuvant radiotherapy. Methods Retrospective analysis of resected keloids in patients referred to a Chilean radiation oncology centre between 2006 and 2013. Local recurrence was defined as new tissue growth on the surgical scar margin. Results Around103 keloids were analysed in 63 patients treated with 15 Gy in three fraction radiotherapy which was initiated on the same day as the surgery (75% of cases). The median keloid diameter was 6 cm; the most common site was thoracic (22%); the most common cause was prior surgery (35%); 37% caused symptoms, and several (47%) had received prior treatment with corticosteroids (32%), or surgery (30%). The median follow-up was three years, and 94% of recurrences occurred during the first year following treatment. Uni and multivariate analyses showed that an absence of symptoms was a protective factor for recurrence (OR: 0.24), while the time interval from onset to treatment with surgery plus radiotherapy >4.2 years was a risk factor (OR: 2.23). The first year recurrence rate was 32% and stabilised at 32% by the second year with no recurrences after 15 months. Conclusions The combination of surgery and radiotherapy proved to be a good therapeutic alternative in the management of keloids. Our results are similar to those described in the literature for a dose of 15 Gy. Given these results, our centre will implement a new dose escalation protocol to improve future outcomes. PMID:27994646

  4. Low-Dose Radiotherapy in Indolent Lymphoma

    SciTech Connect

    Rossier, Christine; Schick, Ulrike; Miralbell, Raymond; Mirimanoff, Rene O.; Weber, Damien C.; Ozsahin, Mahmut

    2011-11-01

    Purpose: To assess the response rate, duration of response, and overall survival after low-dose involved-field radiotherapy in patients with recurrent low-grade lymphoma or chronic lymphocytic leukemia (CLL). Methods and Materials: Forty-three (24 women, 19 men) consecutive patients with indolent lymphoma or CLL were treated with a total dose of 4 Gy (2 x 2 Gy) using 6- 18-MV photons. The median age was 73 years (range, 39-88). Radiotherapy was given either after (n = 32; 75%) or before (n = 11; 25%) chemotherapy. The median time from diagnosis was 48 months (range, 1-249). The median follow-up period was 20 months (range, 1-56). Results: The overall response rate was 90%. Twelve patients (28%) had a complete response, 15 (35%) had a partial response, 11 (26%) had stable disease, and 5 (11%) had progressive disease. The median overall survival for patients with a positive response (complete response/partial response/stable disease) was 41 months; for patients with progressive disease it was 6 months (p = 0.001). The median time to in-field progression was 21 months (range, 0-24), and the median time to out-field progression was 8 months (range, 0-40). The 3-year in-field control was 92% in patients with complete response (median was not reached). The median time to in-field progression was 9 months (range, 0.5-24) in patients with partial response and 6 months (range, 0.6-6) in those with stable disease (p < 0.05). Younger age, positive response to radiotherapy, and no previous chemotherapy were the best factors influencing the outcome. Conclusions: Low-dose involved-field radiotherapy is an effective treatment in the management of patients with recurrent low-grade lymphoma or CLL.

  5. Radiation transport in a radiotherapy room

    SciTech Connect

    Agosteo, S.; Para, A.F.; Maggioni, B.

    1995-01-01

    The photoneutron dose equivalent in a linac radio-therapy room and its entrance maze was investigated by means of Monte Carlo simulations under different conditions. Particularly, the effect of neutron absorbers and moderator layers placed on the maze walls was considered. The contribution of prompt gamma rays emitted in absorption reactions of thermal neutrons was also taken into account. The simulation results are compared with some experimental measurements in the therapy room and in the maze. 13 refs., 5 figs., 5 tabs.

  6. Partial breast radiotherapy with simple teletherapy techniques.

    PubMed

    Fekete, Gábor; Újhidy, Dóra; Együd, Zsófia; Kiscsatári, Laura; Marosi, Gusztáv; Kahán, Zsuzsanna; Varga, Zoltán

    2015-01-01

    A prospective pilot study of partial breast irradiation (PBI) with conventional vs hypofractionated schedules was set out. The study aimed to determine efficacy, acute and late side effects, and the preference of photon vs electron irradiation based on individual features. Patients were enrolled according to internationally accepted guidelines on PBI. Conformal radiotherapy plans were generated with both photon and electron beams, and the preferred technique based on dose homogeneity and the radiation exposure of healthy tissues was applied. For electron dose verification, a special phantom was constructed. Patients were randomized for fractionation schedules of 25 × 2 vs 13 × 3Gy. Skin and breast changes were registered at the time of and ≥1 year after the completion of radiotherapy. Dose homogeneity was better with photons. If the tumor bed was located in the inner quadrants, electron beam gave superior results regarding conformity and sparing of organ at risk (OAR). If the tumor was situated in the lateral quadrants, conformity was better with photons. A depth of the tumor bed ≥3.0cm predicted the superiority of photon irradiation (odds ratio [OR] = 23.6, 95% CI: 5.2 to 107.5, p < 0.001) with >90% sensitivity and specificity. After a median follow-up of 39 months, among 72 irradiated cases, 1 local relapse out of the tumor bed was detected. Acute radiodermatitis of grade I to II, hyperpigmentation, and telangiectasia developed ≥1 year after radiotherapy, exclusively after electron beam radiotherapy. The choice of electrons or photons for PBI should be based on tumor bed location; the used methods are efficient and feasible.

  7. Hypothyroidism After Radiotherapy for Nasopharyngeal Cancer Patients

    SciTech Connect

    Wu, Y.-H.; Wang, H-M.; Chen, Hellen Hi-Wen; Lin, C.-Y.; Chen, Eric Yen-Chao; Fan, K.-H.; Huang, S.-F.; Chen, I-How; Liao, C.-T.; Cheng, Ann-Joy; Chang, Joseph Tung-Chieh

    2010-03-15

    Purpose: The aim of this study was to determine the long-term incidence and possible predictive factors for posttreatment hypothyroidism in nasopharyngeal carcinoma (NPC) patients after radiotherapy. Methods and Materials: Four hundred and eight sequential NPC patients who had received regular annual thyroid hormone surveys prospectively after radiotherapy were included in this study. Median patient age was 47.3 years, and 286 patients were male. Thyroid function was prospectively evaluated by measuring thyroid-stimulating hormone (TSH) and serum free thyroxine (FT4) levels. Low FT4 levels indicated clinical hypothyroidism in this study. Results: With a median follow-up of 4.3 years (range, 0.54-19.7 years), the incidence of low FT4 level was 5.3%, 9.0%, and 19.1% at 3, 5, and 10 years after radiotherapy, respectively. Hypothyroidism was more common with early T stage (p = 0.044), female sex (p = 0.037), and three-dimensional conformal therapy with the altered fractionation technique (p = 0.005) after univariate analysis. N stage, chemotherapy, reirradiation, and neck electron boost did not affect the incidence of hypothyroidism. Younger age and conformal therapy were significant factors that determined clinical hypothyroidism after multivariate analysis. Overall, patients presented with a low FT4 level about 1 year after presenting with an elevated TSH level. Conclusion: Among our study group of NPC patients, 19.1% experienced clinical hypothyroidism by 10 years after treatment. Younger age and conformal therapy increased the risk of hypothyroidism. We suggest routine evaluation of thyroid function in NPC patients after radiotherapy. The impact of pituitary injury should be also considered.

  8. Targeting Radiotherapy to Cancer by Gene Transfer

    PubMed Central

    2003-01-01

    Targeted radionuclide therapy is an alternative method of radiation treatment which uses a tumor-seeking agent carrying a radioactive atom to deposits of tumor, wherever in the body they may be located. Recent experimental data signifies promise for the amalgamation of gene transfer with radionuclide targeting. This review encompasses aspects of the integration of gene manipulation and targeted radiotherapy, highlighting the possibilities of gene transfer to assist the targeting of cancer with low molecular weight radiopharmaceuticals. PMID:12721515

  9. Partial breast radiotherapy with simple teletherapy techniques

    SciTech Connect

    Fekete, Gábor; Újhidy, Dóra; Együd, Zsófia; Kiscsatári, Laura; Marosi, Gusztáv; Kahán, Zsuzsanna; Varga, Zoltán

    2015-01-01

    A prospective pilot study of partial breast irradiation (PBI) with conventional vs hypofractionated schedules was set out. The study aimed to determine efficacy, acute and late side effects, and the preference of photon vs electron irradiation based on individual features. Patients were enrolled according to internationally accepted guidelines on PBI. Conformal radiotherapy plans were generated with both photon and electron beams, and the preferred technique based on dose homogeneity and the radiation exposure of healthy tissues was applied. For electron dose verification, a special phantom was constructed. Patients were randomized for fractionation schedules of 25 × 2 vs 13 × 3 Gy. Skin and breast changes were registered at the time of and ≥1 year after the completion of radiotherapy. Dose homogeneity was better with photons. If the tumor bed was located in the inner quadrants, electron beam gave superior results regarding conformity and sparing of organ at risk (OAR). If the tumor was situated in the lateral quadrants, conformity was better with photons. A depth of the tumor bed ≥3.0 cm predicted the superiority of photon irradiation (odds ratio [OR] = 23.6, 95% CI: 5.2 to 107.5, p < 0.001) with >90% sensitivity and specificity. After a median follow-up of 39 months, among 72 irradiated cases, 1 local relapse out of the tumor bed was detected. Acute radiodermatitis of grade I to II, hyperpigmentation, and telangiectasia developed ≥1 year after radiotherapy, exclusively after electron beam radiotherapy. The choice of electrons or photons for PBI should be based on tumor bed location; the used methods are efficient and feasible.

  10. Current concepts on imaging in radiotherapy.

    PubMed

    Lecchi, Michela; Fossati, Piero; Elisei, Federica; Orecchia, Roberto; Lucignani, Giovanni

    2008-04-01

    New high-precision radiotherapy (RT) techniques, such as intensity-modulated radiation therapy (IMRT) or hadrontherapy, allow better dose distribution within the target and spare a larger portion of normal tissue than conventional RT. These techniques require accurate tumour volume delineation and intrinsic characterization, as well as verification of target localisation and monitoring of organ motion and response assessment during treatment. These tasks are strongly dependent on imaging technologies. Among these, computed tomography (CT), magnetic resonance imaging (MRI), ultrasonography (US) and positron emission tomography (PET) have been applied in high-precision RT. For tumour volume delineation and characterization, PET has brought an additional dimension to the management of cancer patients by allowing the incorporation of crucial functional and molecular images in RT treatment planning, i.e. direct evaluation of tumour metabolism, cell proliferation, apoptosis, hypoxia and angiogenesis. The combination of PET and CT in a single imaging system (PET/CT) to obtain a fused anatomical and functional dataset is now emerging as a promising tool in radiotherapy departments for delineation of tumour volumes and optimization of treatment plans. Another exciting new area is image-guided radiotherapy (IGRT), which focuses on the potential benefit of advanced imaging and image registration to improve precision, daily target localization and monitoring during treatment, thus reducing morbidity and potentially allowing the safe delivery of higher doses. The variety of IGRT systems is rapidly expanding, including cone beam CT and US. This article examines the increasing role of imaging techniques in the entire process of high-precision radiotherapy.

  11. The role of radiotherapy in veterinary practice.

    PubMed

    Owen, L N

    1975-11-01

    It is common knowledge today that cancer is by no means an incurable disease and therefore it is no longer necessary to propose euthanasia for all inoperable cases of malignant neoplasia. The veterinary surgeon has a duty to inform his client of current methods of treatment, particularly radiotherapy, which may possibly provide a cure or prolong life without pain for several months. This article outlines the availability and usefulness of this important line of treatment.

  12. Glioblastoma multiforme after radiotherapy for acromegaly

    SciTech Connect

    Piatt, J.H. Jr.; Blue, J.M.; Schold, S.C. Jr.; Burger, P.C.

    1983-07-01

    A case of glioblastoma multiforme that occurred 14 years after radiotherapy for acromegaly is presented. The striking correspondence between the anatomy of the tumor and the geometry of the radiation ports is suggestive of a causal relationship. Previously reported cases of radiation-associated glioma are reviewed, and a brief appraisal of the evidence for induction of these lesions by radiation is presented. The differentiation of radiation-associated neoplasms from radionecrosis is also discussed.

  13. Improving Adaptive Learning Technology through the Use of Response Times

    ERIC Educational Resources Information Center

    Mettler, Everett; Massey, Christine M.; Kellman, Philip J.

    2011-01-01

    Adaptive learning techniques have typically scheduled practice using learners' accuracy and item presentation history. We describe an adaptive learning system (Adaptive Response Time Based Sequencing--ARTS) that uses both accuracy and response time (RT) as direct inputs into sequencing. Response times are used to assess learning strength and…

  14. Adaptable Learning Pathway Generation with Ant Colony Optimization

    ERIC Educational Resources Information Center

    Wong, Lung-Hsiang; Looi, Chee-Kit

    2009-01-01

    One of the new major directions in research on web-based educational systems is the notion of adaptability: the educational system adapts itself to the learning profile, preferences and ability of the student. In this paper, we look into the issues of providing adaptability with respect to learning pathways. We explore the state of the art with…

  15. Medical treatment for biochemical relapse after radiotherapy.

    PubMed

    Quero, L; Hennequin, C

    2014-10-01

    This article's purpose was to review the medical data justifying the use of a medical treatment for biochemical relapse after external beam radiotherapy. The MEDLINE database was searched to identify relevant information with the following medical subject headings: "prostate cancer", "radiotherapy" and "biochemical relapse". Prognostic factors affecting the overall survival of patients with a biochemical relapse after external beam radiotherapy have been identified: short prostate specific antigen (PSA)-doubling time (< 12 months), high PSA value (> 10 ng/mL) and short interval between treatment and biochemical relapse (< 18 months). If a second local treatment is not feasible, timing to initiate a salvage medical treatment is not defined. Particularly, randomized trials did not demonstrate a significant benefit of an early initiation of androgen deprivation treatment. Some retrospective studies suggest that an early androgen deprivation is justified if poor prognostic factors are found. However, if an androgen deprivation treatment is prescribed, intermittent schedule is non-inferior to a continuous administration and seems to offer a better quality of life. Many non-hormonal treatments have also been evaluated in this setting: only 5-alpha-reductase inhibitors could be proposed in some specific situations. In conclusion, the judicious use of a medical treatment for biochemical relapse is still debated. Given the natural history of this clinical situation, a simple surveillance is justified in many cases.

  16. [Influence of radiotherapy on lymphocyte stimulation].

    PubMed

    Renner, H; Renner, K H; Hassenstein, E

    1976-08-01

    More than 300 lymphocyte cultures of 12 patients with seminomas were examined during the prophylactic radiotherapy and, in several cases, during an extended period until 20.5 months after the end of the treatment. The object of this study was to find out by measuring the capacity of the lymphocytes to be stimulated in vitro wheather they could be damaged by the radiotherapy. Among other reasons, the above mentioned patients were chosen because they had been submitted to irradiations of vast volumes of lymphatic tissues at a uniform focal dose of 4000 rad. The different opinions expressed in the literature (stimulation decreassed resp. increased resp. unchanged) are reflected by our results in such a way that we did not find a qualitative loss of the capacity to be stimulated cultures. The problem of the different opinions about the capacity of lymphocytes to be stimulated after a radiotherapy appears; among other things, to be based on different examination methods. According to these methods- morphological determination of the relative number of lymphoblasts, synthesis of DNA by fluid scintillation counting, or determination of the number of surviving cells in vitro -different results are obtained. It seems not possible to use the lymphocyte stimulation in vitro as a method of testing clinical sideefects occuring during the characteristics of immunity and radiation biology are not differentiated in a more precise manner.

  17. Proton beam radiotherapy of iris melanoma

    SciTech Connect

    Damato, Bertil . E-mail: Bertil@damato.co.uk; Kacperek, Andrzej; Chopra, Mona; Sheen, Martin A.; Campbell, Ian R.; Errington, R. Douglas

    2005-09-01

    Purpose: To report on outcomes after proton beam radiotherapy of iris melanoma. Methods and Materials: Between 1993 and 2004, 88 patients with iris melanoma received proton beam radiotherapy, with 53.1 Gy in 4 fractions. Results: The patients had a mean age of 52 years and a median follow-up of 2.7 years. The tumors had a median diameter of 4.3 mm, involving more than 2 clock hours of iris in 32% of patients and more than 2 hours of angle in 27%. The ciliary body was involved in 20%. Cataract was present in 13 patients before treatment and subsequently developed in another 18. Cataract had a 4-year rate of 63% and by Cox analysis was related to age (p = 0.05), initial visual loss (p < 0.0001), iris involvement (p < 0.0001), and tumor thickness (p < 0.0001). Glaucoma was present before treatment in 13 patients and developed after treatment in another 3. Three eyes were enucleated, all because of recurrence, which had an actuarial 4-year rate of 3.3% (95% CI 0-8.0%). Conclusions: Proton beam radiotherapy of iris melanoma is well tolerated, the main problems being radiation-cataract, which was treatable, and preexisting glaucoma, which in several patients was difficult to control.

  18. Anal Cancer: An Examination of Radiotherapy Strategies

    SciTech Connect

    Glynne-Jones, Rob; Lim, Faye

    2011-04-01

    The Radiation Therapy Oncology Group 9811, ACCORD-03, and ACT II Phase III trials in anal cancer showed no benefit for cisplatin-based induction and maintenance chemotherapy, or radiation dose-escalation >59 Gy. This review examines the efficacy and toxicity of chemoradiation (CRT) in anal cancer, and discusses potential alternative radiotherapy strategies. The evidence for the review was compiled from randomized and nonrandomized trials of radiation therapy and CRT. A total of 103 retrospective/observational studies, 4 Phase I/II studies, 16 Phase II prospective studies, 2 randomized Phase II studies, and 6 Phase III trials of radiotherapy or chemoradiation were identified. There are no meta-analyses based on individual patient data. A 'one-size-fits-all' approach for all stages of anal cancer is inappropriate. Early T1 tumors are probably currently overtreated, whereas T3/T4 lesions might merit escalation of treatment. Intensity-modulated radiotherapy or the integration of biological therapy may play a role in future.

  19. Personalized radiotherapy: concepts, biomarkers and trial design

    PubMed Central

    Redalen, K R

    2015-01-01

    In the past decade, and pointing onwards to the immediate future, clinical radiotherapy has undergone considerable developments, essentially including technological advances to sculpt radiation delivery, the demonstration of the benefit of adding concomitant cytotoxic agents to radiotherapy for a range of tumour types and, intriguingly, the increasing integration of targeted therapeutics for biological optimization of radiation effects. Recent molecular and imaging insights into radiobiology will provide a unique opportunity for rational patient treatment, enabling the parallel design of next-generation trials that formally examine the therapeutic outcome of adding targeted drugs to radiation, together with the critically important assessment of radiation volume and dose-limiting treatment toxicities. In considering the use of systemic agents with presumed radiosensitizing activity, this may also include the identification of molecular, metabolic and imaging markers of treatment response and tolerability, and will need particular attention on patient eligibility. In addition to providing an overview of clinical biomarker studies relevant for personalized radiotherapy, this communication will highlight principles in addressing clinical evaluation of combined-modality-targeted therapeutics and radiation. The increasing number of translational studies that bridge large-scale omics sciences with quality-assured phenomics end points—given the imperative development of open-source data repositories to allow investigators the access to the complex data sets—will enable radiation oncology to continue to position itself with the highest level of evidence within existing clinical practice. PMID:25989697

  20. Personalized radiotherapy: concepts, biomarkers and trial design.

    PubMed

    Ree, A H; Redalen, K R

    2015-07-01

    In the past decade, and pointing onwards to the immediate future, clinical radiotherapy has undergone considerable developments, essentially including technological advances to sculpt radiation delivery, the demonstration of the benefit of adding concomitant cytotoxic agents to radiotherapy for a range of tumour types and, intriguingly, the increasing integration of targeted therapeutics for biological optimization of radiation effects. Recent molecular and imaging insights into radiobiology will provide a unique opportunity for rational patient treatment, enabling the parallel design of next-generation trials that formally examine the therapeutic outcome of adding targeted drugs to radiation, together with the critically important assessment of radiation volume and dose-limiting treatment toxicities. In considering the use of systemic agents with presumed radiosensitizing activity, this may also include the identification of molecular, metabolic and imaging markers of treatment response and tolerability, and will need particular attention on patient eligibility. In addition to providing an overview of clinical biomarker studies relevant for personalized radiotherapy, this communication will highlight principles in addressing clinical evaluation of combined-modality-targeted therapeutics and radiation. The increasing number of translational studies that bridge large-scale omics sciences with quality-assured phenomics end points-given the imperative development of open-source data repositories to allow investigators the access to the complex data sets-will enable radiation oncology to continue to position itself with the highest level of evidence within existing clinical practice.

  1. Single crystal diamond detector for radiotherapy

    NASA Astrophysics Data System (ADS)

    Schirru, F.; Kisielewicz, K.; Nowak, T.; Marczewska, B.

    2010-07-01

    The new generation of synthetic diamonds grown as a CVD single crystal on a high pressure high temperature substrate offers a wide range of applications. In particular, because of the near tissue equivalence and its small size (good spatial resolution), CVD single crystal diamond finds applicability in radiotherapy as a dosemeter of ionizing radiation. In this paper we report the electrical and dosimetric properties of a new diamond detector which was fabricated at IFJ based on a single crystal detector-grade CVD diamond provided with a novel contact metallization. Diamond properties were assessed at IFJ using a Theratron 680E therapeutic 60Co gamma rays unit and at COOK with 6 and 18 MV x-rays Varian Clinac CL2300 C/D accelerator. The new dosemeter showed high electric and dosimetric performances: low value of dark current, high current at the level of some nanoamperes during irradiation, very fast dynamic response with a rise time amounting to parts of a second, good stability and repeatability of the current and linearity of the detector signal at different dose and dose rate levels typically applied in radiotherapy. The results confirm the potential applicability of diamond material as a dosemeter for applications in radiotherapy.

  2. Big Data Analytics for Prostate Radiotherapy.

    PubMed

    Coates, James; Souhami, Luis; El Naqa, Issam

    2016-01-01

    Radiation therapy is a first-line treatment option for localized prostate cancer and radiation-induced normal tissue damage are often the main limiting factor for modern radiotherapy regimens. Conversely, under-dosing of target volumes in an attempt to spare adjacent healthy tissues limits the likelihood of achieving local, long-term control. Thus, the ability to generate personalized data-driven risk profiles for radiotherapy outcomes would provide valuable prognostic information to help guide both clinicians and patients alike. Big data applied to radiation oncology promises to deliver better understanding of outcomes by harvesting and integrating heterogeneous data types, including patient-specific clinical parameters, treatment-related dose-volume metrics, and biological risk factors. When taken together, such variables make up the basis for a multi-dimensional space (the "RadoncSpace") in which the presented modeling techniques search in order to identify significant predictors. Herein, we review outcome modeling and big data-mining techniques for both tumor control and radiotherapy-induced normal tissue effects. We apply many of the presented modeling approaches onto a cohort of hypofractionated prostate cancer patients taking into account different data types and a large heterogeneous mix of physical and biological parameters. Cross-validation techniques are also reviewed for the refinement of the proposed framework architecture and checking individual model performance. We conclude by considering advanced modeling techniques that borrow concepts from big data analytics, such as machine learning and artificial intelligence, before discussing the potential future impact of systems radiobiology approaches.

  3. Sacral plexus injury after radiotherapy for carcinoma of cervix

    SciTech Connect

    Stryker, J.A.; Sommerville, K.; Perez, R.; Velkley, D.E. )

    1990-10-01

    A 42-year-old woman developed lower extremity weakness and sensory loss 1 year after external and intracavitary radiotherapy for Stage IB carcinoma of cervix. She has been followed for 5 years posttreatment, and the neurologic abnormalities have persisted, but no evidence of recurrent carcinoma has been found. We believe this to be a rare case of sacral plexus radiculopathy developing as a late complication after radiotherapy. Suggestions are made for improving the radiotherapy technique to prevent this complication in future cases.

  4. MR Imaging Based Treatment Planning for Radiotherapy of Prostate Cancer

    DTIC Science & Technology

    2005-02-01

    treatment planning for radiotherapy : Dosimetric verification for prostate IiMRT" and " Dosimetric evaluation of MRI-based treatment planning for...Shawn M, Ma C-M, Freedman GM and Pollack A. MRI-Based Treatment Planning for Radiotherapy : Dosimetric Verification for Prostate IMRT. International...Freedman GM and Pollack A. MRI- Based Treatment Planning for Radiotherapy : Dosimetric Verification for Prostate ]IMRT. International Journal of Radiation

  5. Climate adaptation

    NASA Astrophysics Data System (ADS)

    Kinzig, Ann P.

    2015-03-01

    This paper is intended as a brief introduction to climate adaptation in a conference devoted otherwise to the physics of sustainable energy. Whereas mitigation involves measures to reduce the probability of a potential event, such as climate change, adaptation refers to actions that lessen the impact of climate change. Mitigation and adaptation differ in other ways as well. Adaptation does not necessarily have to be implemented immediately to be effective; it only needs to be in place before the threat arrives. Also, adaptation does not necessarily require global, coordinated action; many effective adaptation actions can be local. Some urban communities, because of land-use change and the urban heat-island effect, currently face changes similar to some expected under climate change, such as changes in water availability, heat-related morbidity, or changes in disease patterns. Concern over those impacts might motivate the implementation of measures that would also help in climate adaptation, despite skepticism among some policy makers about anthropogenic global warming. Studies of ancient civilizations in the southwestern US lends some insight into factors that may or may not be important to successful adaptation.

  6. Art therapy improves experienced quality of life among women undergoing treatment for breast cancer: a randomized controlled study.

    PubMed

    Svensk, A-C; Oster, I; Thyme, K E; Magnusson, E; Sjödin, M; Eisemann, M; Aström, S; Lindh, J

    2009-01-01

    Women with breast cancer are naturally exposed to strain related to diagnosis and treatment, and this influences their experienced quality of life (QoL). The present paper reports the effect, with regard to QoL aspects, of an art therapy intervention among 41 women undergoing radiotherapy treatment for breast cancer. The women were randomized to an intervention group with individual art therapy sessions for 1 h/week (n = 20), or to a control group (n = 21). The WHOQOL-BREF and EORTC Quality of Life Questionnaire-BR23, were used for QoL assessment, and administrated on three measurement occasions, before the start of radiotherapy and 2 and 6 months later. The results indicate an overall improvement in QoL aspects among women in the intervention group. A significant increase in total health, total QoL, physical health and psychological health was observed in the art therapy group. A significant positive difference within the art therapy group was also seen, concerning future perspectives, body image and systemic therapy side effects. The present study provides strong support for the use of art therapy to improve QoL for women undergoing radiotherapy treatment for breast cancer.

  7. The Lesbian Art Project.

    PubMed

    Klein, Jennie

    2010-01-01

    Critics and artists influenced by the tenets of queer theory have dismissed much of the artwork made in the 1970s from a lesbian feminist perspective. The result has been very little being known or written about this pioneering work. This article is concerned with exploring an often overlooked aspect of lesbian art history: the activities and events associated with the Lesbian Art Project (LAP) founded by Terry Wolverton and Arlene Raven at the Woman's Building in Los Angeles. I argue that what is most significant about the LAP is the way in which the participants articulated lesbian identity and lesbian community through performance, art making, and writing.

  8. Genome-wide transcription responses to synchrotron microbeam radiotherapy.

    PubMed

    Sprung, Carl N; Yang, Yuqing; Forrester, Helen B; Li, Jason; Zaitseva, Marina; Cann, Leonie; Restall, Tina; Anderson, Robin L; Crosbie, Jeffrey C; Rogers, Peter A W

    2012-10-01

    The majority of cancer patients achieve benefit from radiotherapy. A significant limitation of radiotherapy is its relatively low therapeutic index, defined as the maximum radiation dose that causes acceptable normal tissue damage to the minimum dose required to achieve tumor control. Recently, a new radiotherapy modality using synchrotron-generated X-ray microbeam radiotherapy has been demonstrated in animal models to ablate tumors with concurrent sparing of normal tissue. Very little work has been undertaken into the cellular and molecular mechanisms that differentiate microbeam radiotherapy from broad beam. The purpose of this study was to investigate and compare the whole genome transcriptional response of in vivo microbeam radiotherapy versus broad beam irradiated tumors. We hypothesized that gene expression changes after microbeam radiotherapy are different from those seen after broad beam. We found that in EMT6.5 tumors at 4-48 h postirradiation, microbeam radiotherapy differentially regulates a number of genes, including major histocompatibility complex (MHC) class II antigen gene family members, and other immunity-related genes including Ciita, Ifng, Cxcl1, Cxcl9, Indo and Ubd when compared to broad beam. Our findings demonstrate molecular differences in the tumor response to microbeam versus broad beam irradiation and these differences provide insight into the underlying mechanisms of microbeam radiotherapy and broad beam.

  9. Biomarkers for DNA DSB inhibitors and radiotherapy clinical trials.

    PubMed

    Liu, Stanley K; Olive, Peggy L; Bristow, Robert G

    2008-09-01

    Major technical advances in radiotherapy, including IMRT and image-guided radiotherapy, have allowed for improved physical precision and increased dose delivery to the tumor, with better sparing of surrounding normal tissue. The development of inhibitors of the sensing and repair of DNA double-strand breaks (DSBs) is exciting and could be combined with precise radiotherapy targeting to improve local control following radiotherapy. However, caution must be exercised in order that DSB inhibitors are combined with radiotherapy in such a manner as to preserve the therapeutic ratio by exploiting repair deficiencies in malignant cells over that of normal cells. In this review, we discuss the rationale and current approaches to targeting DSB sensing and repair pathways in combined modality with radiotherapy. We also describe potential biomarkers that could be useful in detecting functional inhibition of DSB repair in a patient's tissues during clinical radiotherapy trials. Finally, we examine a number of issues relating to the use of DSB-inhibiting molecular agents and radiotherapy in the context of the tumor microenvironment, effects on normal tissues and the optimal timing and duration of the agent in relation to fractionated radiotherapy.

  10. Proton Radiotherapy for Liver Tumors: Dosimetric Advantages Over Photon Plans

    SciTech Connect

    Wang Xiaochun Krishnan, Sunil; Zhang Xiaodong; Dong Lei; Briere, Tina; Crane, Christopher H.; Martel, Mary; Gillin, Michael; Mohan, Radhe; Beddar, Sam

    2008-01-01

    The purpose of the study is to dosimetrically investigate the advantages of proton radiotherapy over photon radiotherapy for liver tumors. The proton plan and the photon plan were designed using commercial treatment planning systems. The treatment target dose conformity and heterogeneity and dose-volume analyses of normal structures were compared between proton and photon radiotherapy for 9 patients with liver tumors. Proton radiotherapy delivered a more conformal target dose with slightly less homogeneity when compared with photon radiotherapy. Protons significantly reduced the fractional volume of liver receiving dose greater or equal to 30 Gy (V{sub 30}) and the mean liver dose. The stomach and duodenal V{sub 45} were significantly lower with the use of proton radiotherapy. The V{sub 40} and V{sub 50} of the heart and the maximum spinal cord dose were also significantly lower with the use of proton radiotherapy. Protons were better able to spare one kidney completely and deliver less dose to one (generally the left) kidney than photons. The mean dose to the total body and most critical structures was significantly decreased using protons when compared to corresponding photon plans. In conclusion, our study suggests the dosimetric benefits of proton radiotherapy over photon radiotherapy. These dosimetric advantages of proton plans may permit further dose escalation with lower risk of complications.

  11. Radical hysterectomy with adjuvant radiotherapy versus radical radiotherapy for FIGO stage IIB cervical cancer

    PubMed Central

    2014-01-01

    Background The goal of this study was to compare treatment outcomes for Federation of Gynecology and Obstetrics (FIGO) stage IIB cervical carcinoma patients receiving radical surgery followed by adjuvant postoperative radiotherapy versus radical radiotherapy. Methods Medical records of FIGO stage IIB cervical cancer patients treated between July 2008 and December 2011 were retrospectively reviewed. A total of 148 patients underwent radical hysterectomy with pelvic lymph node dissection followed by adjuvant radiotherapy (surgery-based group). These patients were compared with 290 patients that received radical radiotherapy alone (RT-based group). Recurrence rates, progression-free survival (PFS), overall survival (OS), local control rates, and treatment-related complications were compared for these two groups. Results Similar rates of recurrence (16.89% vs. 12.41%, p = 0.200), PFS (log-rank, p = 0.211), OS (log-rank, p = 0.347), and local control rates (log-rank, p = 0.668) were observed for the surgery-based group and the RT-based group, respectively. Moreover, the incidence of acute grade 3–4 gastrointestinal reactions and late grade 3–4 lower limb lymphedema were significantly higher for the surgery-based group versus the RT-based group. Cox multivariate analyses found no significant difference in survival outcome between the two groups, and tumor diameter and histopathology were identified as significant prognostic factors for OS. Conclusions Radical radiotherapy was associated with fewer treatment-related complications and achieved comparable survival outcomes for patients with FIGO stage IIB cervical cancer compared to radical hysterectomy followed by postoperative radiotherapy. PMID:24495453

  12. Arts Teachers' Perceptions and Attitudes on Arts Integration While Participating in a Statewide Arts Integration Initiative

    ERIC Educational Resources Information Center

    May, Brittany Nixon; Robinson, Nicole R.

    2016-01-01

    The purpose of this study was to examine the perceptions and attitudes of the Beverley Taylor Sorenson Arts Learning Program (BTSALP) arts specialists on arts integration. BTSALP arts specialists (N = 50) throughout the state of Utah responded to a 20-item survey. Results indicated that a majority of BTSALP arts specialists believe that arts…

  13. Dynamic targeting image-guided radiotherapy

    SciTech Connect

    Huntzinger, Calvin; Munro, Peter; Johnson, Scott; Miettinen, Mika; Zankowski, Corey; Ahlstrom, Greg; Glettig, Reto; Filliberti, Reto; Kaissl, Wolfgang; Kamber, Martin; Amstutz, Martin; Bouchet, Lionel; Klebanov, Dan; Mostafavi, Hassan; Stark, Richard

    2006-07-01

    Volumetric imaging and planning for 3-dimensional (3D) conformal radiotherapy and intensity-modulated radiotherapy (IMRT) have highlighted the need to the oncology community to better understand the geometric uncertainties inherent in the radiotherapy delivery process, including setup error (interfraction) as well as organ motion during treatment (intrafraction). This has ushered in the development of emerging technologies and clinical processes, collectively referred to as image-guided radiotherapy (IGRT). The goal of IGRT is to provide the tools needed to manage both inter- and intrafraction motion to improve the accuracy of treatment delivery. Like IMRT, IGRT is a process involving all steps in the radiotherapy treatment process, including patient immobilization, computed tomogaphy (CT) simulation, treatment planning, plan verification, patient setup verification and correction, delivery, and quality assurance. The technology and capability of the Dynamic Targeting{sup TM} IGRT system developed by Varian Medical Systems is presented. The core of this system is a Clinac (registered) or Trilogy{sup TM} accelerator equipped with a gantry-mounted imaging system known as the On-Board Imager{sup TM} (OBI). This includes a kilovoltage (kV) x-ray source, an amorphous silicon kV digital image detector, and 2 robotic arms that independently position the kV source and imager orthogonal to the treatment beam. A similar robotic arm positions the PortalVision{sup TM} megavoltage (MV) portal digital image detector, allowing both to be used in concert. The system is designed to support a variety of imaging modalities. The following applications and how they fit in the overall clinical process are described: kV and MV planar radiographic imaging for patient repositioning, kV volumetric cone beam CT imaging for patient repositioning, and kV planar fluoroscopic imaging for gating verification. Achieving image-guided motion management throughout the radiation oncology process

  14. California: Art on the Road.

    ERIC Educational Resources Information Center

    Mark, David

    1982-01-01

    Describes a touring exhibit of posters which has been used to promote cultural events in California since 1976. Many art forms and disciplines were represented, including all the visual arts, photography, film, folk arts, music, theater, and dance. (AM)

  15. Retrospective evaluation of dosimetric quality for prostate carcinomas treated with 3D conformal, intensity modulated and volumetric modulated arc radiotherapy

    SciTech Connect

    Crowe, Scott B; Kairn, Tanya; Middlebrook, Nigel; Hill, Brendan; Christie, David R H; Knight, Richard T; Kenny, John; Langton, Christian M; Trapp, Jamie V

    2013-12-15

    This study examines and compares the dosimetric quality of radiotherapy treatment plans for prostate carcinoma across a cohort of 163 patients treated across five centres: 83 treated with three-dimensional conformal radiotherapy (3DCRT), 33 treated with intensity modulated radiotherapy (IMRT) and 47 treated with volumetric modulated arc therapy (VMAT). Treatment plan quality was evaluated in terms of target dose homogeneity and organs at risk (OAR), through the use of a set of dose metrics. These included the mean, maximum and minimum doses; the homogeneity and conformity indices for the target volumes; and a selection of dose coverage values that were relevant to each OAR. Statistical significance was evaluated using two-tailed Welch's T-tests. The Monte Carlo DICOM ToolKit software was adapted to permit the evaluation of dose metrics from DICOM data exported from a commercial radiotherapy treatment planning system. The 3DCRT treatment plans offered greater planning target volume dose homogeneity than the other two treatment modalities. The IMRT and VMAT plans offered greater dose reduction in the OAR: with increased compliance with recommended OAR dose constraints, compared to conventional 3DCRT treatments. When compared to each other, IMRT and VMAT did not provide significantly different treatment plan quality for like-sized tumour volumes. This study indicates that IMRT and VMAT have provided similar dosimetric quality, which is superior to the dosimetric quality achieved with 3DCRT.

  16. Retrospective evaluation of dosimetric quality for prostate carcinomas treated with 3D conformal, intensity modulated and volumetric modulated arc radiotherapy

    PubMed Central

    Crowe, Scott B; Kairn, Tanya; Middlebrook, Nigel; Hill, Brendan; Christie, David R H; Knight, Richard T; Kenny, John; Langton, Christian M; Trapp, Jamie V

    2013-01-01

    Introduction This study examines and compares the dosimetric quality of radiotherapy treatment plans for prostate carcinoma across a cohort of 163 patients treated across five centres: 83 treated with three-dimensional conformal radiotherapy (3DCRT), 33 treated with intensity modulated radiotherapy (IMRT) and 47 treated with volumetric modulated arc therapy (VMAT). Methods Treatment plan quality was evaluated in terms of target dose homogeneity and organs at risk (OAR), through the use of a set of dose metrics. These included the mean, maximum and minimum doses; the homogeneity and conformity indices for the target volumes; and a selection of dose coverage values that were relevant to each OAR. Statistical significance was evaluated using two-tailed Welch's T-tests. The Monte Carlo DICOM ToolKit software was adapted to permit the evaluation of dose metrics from DICOM data exported from a commercial radiotherapy treatment planning system. Results The 3DCRT treatment plans offered greater planning target volume dose homogeneity than the other two treatment modalities. The IMRT and VMAT plans offered greater dose reduction in the OAR: with increased compliance with recommended OAR dose constraints, compared to conventional 3DCRT treatments. When compared to each other, IMRT and VMAT did not provide significantly different treatment plan quality for like-sized tumour volumes. Conclusions This study indicates that IMRT and VMAT have provided similar dosimetric quality, which is superior to the dosimetric quality achieved with 3DCRT. PMID:26229621

  17. WE-EF-BRD-01: Past, Present and Future: MRI-Guided Radiotherapy From 2005 to 2025

    SciTech Connect

    Lagendijk, J.

    2015-06-15

    MRI-guided treatment is a growing area of medicine, particularly in radiotherapy and surgery. The exquisite soft tissue anatomic contrast offered by MRI, along with functional imaging, makes the use of MRI during therapeutic procedures very attractive. Challenging the utility of MRI in the therapy room are many issues including the physics of MRI and the impact on the environment and therapeutic instruments, the impact of the room and instruments on the MRI; safety, space, design and cost. In this session, the applications and challenges of MRI-guided treatment will be described. The session format is: Past, present and future: MRI-guided radiotherapy from 2005 to 2025: Jan Lagendijk Battling Maxwell’s equations: Physics challenges and solutions for hybrid MRI systems: Paul Keall I want it now!: Advances in MRI acquisition, reconstruction and the use of priors to enable fast anatomic and physiologic imaging to inform guidance and adaptation decisions: Yanle Hu MR in the OR: The growth and applications of MRI for interventional radiology and surgery: Rebecca Fahrig Learning Objectives: To understand the history and trajectory of MRI-guided radiotherapy To understand the challenges of integrating MR imaging systems with linear accelerators To understand the latest in fast MRI methods to enable the visualisation of anatomy and physiology on radiotherapy treatment timescales To understand the growing role and challenges of MRI for image-guided surgical procedures My disclosures are publicly available and updated at: http://sydney.edu.au/medicine/radiation-physics/about-us/disclosures.php.

  18. Workshop: Teaching Primitive Arts.

    ERIC Educational Resources Information Center

    Jordison, Jerry

    1999-01-01

    Discusses the concrete and spiritual aspects of teaching workshops on survival skills or primitive arts. Gives details on lostproofing, or ways to teach a child not to get lost in the outdoors; building a survival shelter; and wilderness cooking. (CDS)

  19. Interviewing Art Linkletter

    ERIC Educational Resources Information Center

    American Vocational Journal, 1974

    1974-01-01

    The article reports on the assignments and activities of Dean Griffin, one of four American Vocational Association associates directors; highlighted is a conversation of Griffin's with Art Linkletter, who addressed the Minnesota Vocational Association in October. (AJ)

  20. Expressing Culture through Art.

    ERIC Educational Resources Information Center

    Nicholson, Jeffrey A.

    2002-01-01

    Describes an elementary art project in which students create a "mud cloth." States that the project was inspired by the clothing worn by teachers at the City School District (Rochester, New York). Includes a list of additional resources. (CMK)

  1. Building Arts Partnerships.

    ERIC Educational Resources Information Center

    Soper, Stephanie

    1993-01-01

    Discusses the activities of the Education Department at the John F. Kennedy Center for the Performing Arts, including the local education outreach program and the Partners in Education program promoting school-community partnerships. (SR)

  2. Assisted Reproductive Technology (ART)

    MedlinePlus

    ... Control and Prevention compiles annual reports on the success rates of ART. These reports can be accessed ... the chance of pregnancy in some cases. The success of IUI depends on the cause of the ...

  3. Sandpainting: A Healing Art

    ERIC Educational Resources Information Center

    Walter, Bethany

    2005-01-01

    As part of a unit on Native American art studies, students researched Navajo sand painting. They used Navajo image resources to develop designs for their sand paintings. The process and precautions for this lesson are described in this article.

  4. Anatomy and art.

    PubMed

    Laios, Konstantinos; Tsoukalas, Gregory; Karamanou, Marianna; Androutsos, George

    2013-01-01

    Leonardo da Vinci, Jean Falcon, Andreas Vesalius, Henry Gray, Henry Vandyke Carter and Frank Netter created some of the best atlases of anatomy. Their works constitute not only scientific medical projects but also masterpieces of art.

  5. Art, surgery and transplantation.

    PubMed

    Toledo-Pereyra, Luis H

    2009-01-01

    Roy Calne (1930-) has elegantly cultivated the science and art of transplantation. Throughout his medical and artistic career his eyes have remained fully open not only to science and scientific advances but to any new developments that would enhance his art of painting as applied to his patients, colleagues, events and surgical operations related to transplantation. Calne contributed to and developed a new field through art in the understanding of the lives of his patients, the working of his colleagues and the application of surgical principles to the specialty in which he labours, surgical transplantation. The application of "Art, Surgery and Transplantation" should in many ways be the fountain of information and support for those seeking this way of therapy.

  6. Directed Art Counseling.

    ERIC Educational Resources Information Center

    Allan, John; Clark, Mary

    1984-01-01

    Describes the use of art counseling in elementary schools, illustrated with a case study. The sessions involved serial drawing, in which the counselor asks the child to draw a house, tree, and person, as well as free drawings. (JAC)

  7. Exploring Art and Science

    ERIC Educational Resources Information Center

    Reece, Carolyn

    1974-01-01

    At two of the Smithsonian Institution's museums in Washington, D. C. special places have been designed for children to enjoy the rich experiences that works of art can provide and to investigate a room filled with touchable exhibits. (CS)

  8. Varieties of Art Curriculum.

    ERIC Educational Resources Information Center

    Feldman, Edmund Burke

    1982-01-01

    Describes the four main types of British art curricula. The content, objectives, and underlying principles are examined. Available from Carfax Publishing Company, P.O. Box 25, Abingdon, Oxfordshire OX14 1RW England. (AM)

  9. Art Criticism and Reading.

    ERIC Educational Resources Information Center

    Feldman, Edmund Burke; Woods, Don

    1981-01-01

    The authors review a body of theory and accumulating evidence which suggests that critical study of the arts facilitates the development of cognitive skills, including those essential to reading. (Author/SJL)

  10. Arts/Crafts.

    ERIC Educational Resources Information Center

    Instructor, 1980

    1980-01-01

    Described are various arts and crafts ideas, mostly with a February theme. Included are: ceramic boxes, valentine ideas, and patriotic projects--symbols of our country, silhouettes of George Washington and Abraham Lincoln, and stars and stripes. (KC)

  11. Fine Arts through Nature.

    ERIC Educational Resources Information Center

    Gentry, Carol

    1986-01-01

    Describes how high school students are involved in using natural materials found in the local environment for art projects. The materials used include wood, clay, and natural fibers. Provides photographs of ten students' projects. (JDH)

  12. Pop-Art Panels

    ERIC Educational Resources Information Center

    Alford, Joanna

    2012-01-01

    James Rosenquist's giant Pop-art panels included realistic renderings of well-known contemporary foods and objects, juxtaposed with famous people in the news--largely from the 1960s, '70s and '80s--and really serve as visual time capsules. In this article, eighth-graders focus on the style of James Rosenquist to create their own Pop-art panel that…

  13. Dwarfism in art.

    PubMed

    Limon, Janusz

    2015-01-01

    Throughout the history of mankind the birth of a child with congenital malformation raised anxiety and torment, along with attempts to explain its origins. It is possible to find relics of such events in prehistoric rock drawings and primitive sculptures, in numerous art pieces produced through the centuries up to modern sculptures, paintings and drawings. The aim of the present article is to show how dwarfs were portrayed in a variety of art forms at different moments in the history of our world.

  14. The art of consultation

    PubMed Central

    Bhangoo, Kulwant S.

    2014-01-01

    Sophisticated marketing and practice-enhancing strategies can help bring patients to a surgeon's practice. However, the ability to retain these patients and also convert the consultations into surgical procedures depends on the art of consultation. This very important aspect of clinical practice is seldom taught in the medical school. In this paper, the author discusses many aspects of the art of consultation, which he has learned in his practice over the years. PMID:25190910

  15. Effectiveness of Radiotherapy for Elderly Patients With Glioblastoma

    SciTech Connect

    Scott, Jacob; Tsai, Ya-Yu; Chinnaiyan, Prakash; Yu, Hsiang-Hsuan Michael

    2011-09-01

    Purpose: Radiotherapy plays a central role in the definitive treatment of glioblastoma. However, the optimal management of elderly patients with glioblastoma remains controversial, as the relative benefit in this patient population is unclear. To better understand the role that radiation plays in the treatment of glioblastoma in the elderly, we analyzed factors influencing patient survival using a large population-based registry. Methods and Materials: A total of 2,836 patients more than 70 years of age diagnosed with glioblastoma between 1993 and 2005 were identified from the Surveillance, Epidemiology, and End Results (SEER) registry. Demographic and clinical variables used in the analysis included gender, ethnicity, tumor size, age at diagnosis, surgery, and radiotherapy. Cancer-specific survival and overall survival were evaluated using the Kaplan-Meier method. Univariate and multivariate analysis were performed using Cox regression. Results: Radiotherapy was administered in 64% of these patients, and surgery was performed in 68%. Among 2,836 patients, 46% received surgery and radiotherapy, 22% underwent surgery only, 18% underwent radiotherapy only, and 14% did not undergo either treatment. The median survival for patients who underwent surgery and radiotherapy was 8 months. The median survival for patients who underwent radiotherapy only was 4 months, and for patients who underwent surgery only was 3 months. Those who received neither surgery nor radiotherapy had a median survival of 2 months (p < 0.001). Multivariate analysis showed that radiotherapy significantly improved cancer-specific survival (hazard ratio [HR], 0.43, 95% confidence interval [CI] 0.38-0.49) after adjusting for surgery, tumor size, gender, ethnicity, and age at diagnosis. Other factors associated with Cancer-specific survival included surgery, tumor size, age at diagnosis, and ethnicity. Analysis using overall survival as the endpoint yielded very similar results. Conclusions: Elderly

  16. Toothbrush Adaptations.

    ERIC Educational Resources Information Center

    Exceptional Parent, 1987

    1987-01-01

    Suggestions are presented for helping disabled individuals learn to use or adapt toothbrushes for proper dental care. A directory lists dental health instructional materials available from various organizations. (CB)

  17. Arts Smarts: First-Rate Arts Education Programs.

    ERIC Educational Resources Information Center

    Chen, Vivien; Granger, Lenny

    1988-01-01

    The Alliance for Arts Education, formed by an agreement between the U.S. Department of Education and the John F. Kennedy Center for the Performing Arts (Washington, D.C.), aims to advance arts education for all U.S. students through networking activities. This article highlights center activities, suggests fine arts leadership strategies, and…

  18. Arts Education Beyond the Classroom. ACA Arts Research Seminar Series.

    ERIC Educational Resources Information Center

    Balfe, Judith H., Ed.; Heine, Joni Cherbo, Ed.

    The 13 seminar papers presented in this collection discuss various avenues used for educating adults in the arts in order to enrich existing arts audiences and to educate the widest possible adult population in the practice and history of art and aesthetics. These efforts will ensure that the quality and quantity of arts participation and support…

  19. State Arts Agency Fact Sheet: Support for Arts Education

    ERIC Educational Resources Information Center

    Online Submission, 2015

    2015-01-01

    This national overview of state arts agency grants and services for arts education includes summary statistics and geographic distribution. The fact sheet uses data from Final Descriptive Reports of state arts agency grant-making activities submitted annually to the National Assembly of State Arts Agencies (NASAA) and the National Endowment for…

  20. [Art-chance and art-experience in classical Greece].

    PubMed

    Ban, Deokjin

    2011-06-30

    In Classical Greece, works defining the nature of art appeared in the various disciplines like medicine, rhetoric, dietetics, architecture and painting. Hippocratic authors tried to show that an art of medicine existed indeed. They contrasted the concept of art with that of chance, not experience that Plato and Aristotle distinguished from art. In fact there are similarities and discrepancies between Hippocratic epistemology and Platoic epistemology. Hippocratic authors maintained that the products of chance were not captured by art. They distinguished the domain of art charactered by explanatory knowledge and prediction from the domain of chance ruled by the unexplained and the unforeseeable. They minimized the role of luck and believed the role of art. Hippocratic authors thought that professional ability contained both knowledge and experience. In Hippocratic corpus, experience is a synonym of competence and usually has a positive meaning. But Plato gave empirical knowledge the disdainful sense and decided a ranking between two types of knowledge. Both Hippocratic authors and Plato held that a genuine art had connection with explanatory knowledge of the nature of its subject matter. A common theme that goes through arguments about art-chance and art-chance is the connection between art and nature. Hippocratic authors and Plato regarded art as a highly systematic process. Art provides us with general and explanatory knowledge of human nature. Art and nature is a mutual relationship. The systematic understanding of nature helps us gain the exactness of art and an exact art helps us understand nature well.