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Sample records for hijiori hdr test

  1. One month circulation test at the Hijiori HDR test site in 1996

    SciTech Connect

    Sato, Yoshiteru; Matsunaga, Isao; Nagai, Masahiro

    1996-12-31

    As shown in Table 1, four wells have been used for circulation tests at Hijiori. The diameters of all the open-hole sections of the wells are 8-{1/2} inches. SKG-2 is an injection well. An 1800 m deep reservoir was stimulated hydraulically by water injection into the open-hole section of SKG-2 in 1986. HDR-1 is also an injection well. A 2200 m deep reservoir was stimulated by water injection into the open-hole section of HDR-1 in 1992. HDR-2a and HDR-3 are used to produce steam and hot water from both reservoirs. The subsurface system was created In granodiorite basement rock with temperatures of 250 {degrees}C at a depth of 2,500 m and 270{degrees} C at depth of 2,700 m.

  2. Transient analysis of the 1991 Hijiori Shallow Reservoir Circulation Test

    SciTech Connect

    Hyodo, M.; Shinohara, N.; Takasugi, S.; Wright, C.A.; Conant, R..

    1996-01-24

    Like any dynamic system, HDR reservoirs cannot be fully characterized by their steady-state behavior. Circulation tests analysis should be performed on both the steady-state response and the transient response of HDR systems. Transient analysis allows not only estimation of critical reservoir parameters and how these parameters change with operating conditions / history, but transient analysis also aids in evaluating the feasibility of various modes of HDR system operation (base load, load following, etc.). This paper details the transient analysis of NEDO's FY 1991 Shallow Reservoir Circulation Test at the Hijiori HDR site in Japan. Reservoir fluid storage is carefully bounded through the employment of two distinct methods for calculation of the fluid storage from the observed transient response. A brief discussion is also included of the distribution of reservoir fluid storage; the relationship between pressure, reservoir stress, and apparent reservoir capacitance; and appropriate circulation test design to facilitate transient analysis.

  3. Overview of the Hijiori shallow reservoir circulation tests and reservoir fluid storage analysis

    SciTech Connect

    Takahiro Shiga; Masami Hyodo; Shinji Takasugi; Wright, C.A.; Conant, R.A.

    1996-01-24

    Since 1985, NEDO has advanced a]Hot Dry Rock project in Hijiori, Japan. Circulation tests have been performed in FY1991 (in a shallow reservoir), and in FY1995 (in both shallow and deep reservoirs). In 1991 circulation test, the result was that 78% fluid recovery at an injection rate of 60 tons/hour and production temperatures of 150 °C - 190 °C . However no detailed analysis of flow conditions was given. Therefore, a simplified HDR model has been proposed to understand the Hijion HDR reservoir. We have analyzed the 1991 circulation test using the model. This study is very important for analyzing the circulation test in both of shallow and deep reservoir which was conducted in 1995. This paper summarizes the 1991 circulation test at the Hijiori HDR test site, and estimation of the reservoir fluid storage by using "unrecovered" flow from the new conceptual idea of HDR reservoir model.

  4. Interference of production between two wells during a one month circulation test at the Hijiori Hot Dry Rock test site

    SciTech Connect

    Tenma, Norio; yamaguchi, Tsutomu; Matsunaga, Isao; Kuriyagawa, Michio; Sato, Yoshiteru

    1996-01-24

    In 1995, a one-month circulation test (Exp.9501) was carried out with HDR-1 as an injection well and HDR-2 and HDR-3 as production wells at the Hijiori HDR site in Yamagata prefecture, Japan. There are two reservoirs in a high temperature granite at the site. Exp.9501 was the first circulation test to evaluate characteristics of the deeper reservoir at about 2200 m deep and was a preliminary test for the subsequent two-years circulation test. The interference between the two reservoirs was observed because of water level changes in production wells. This observation was simulated by using a wellbore heat transfer ( WBHT) code and concluded that this could occur when downhole pressure changed by heating up of the wellbore. Geochemistry of the produced fluid support this conclusion.

  5. Interference of production between two wells during a one month circulation test at the Hijiori Hot Dry Rock test site

    SciTech Connect

    Tenma, Norio; Yamaguchi, Tsutomu; Matsunaga, Isao

    1996-12-31

    In 1995, a one-month circulation test (Exp.9501) was carried out with HDR-1 as an injection well and HDR-2 and HDR-3 as production wells at the Hijiori HDR site in Yamagata prefecture, Japan. There are two reservoirs in a high temperature granite at the site. Exp.9501 was the first circulation test to evaluate characteristics of the deeper reservoir at about 2200 m deep and was a preliminary test for the subsequent two-years circulation test. The interference between the two reservoirs was observed because of water level changes in production wells. This observation was simulated by using a wellbore heat transfer (WBHT) code and concluded that this could occur when downhole pressure changed by heating up of the wellbore. Geochemistry of the produced fluid support this conclusion.

  6. Development of hot dry rock technology at Hijiori test site: Program for a long-term circulation test

    SciTech Connect

    Tenma, Norio; Iwakiri, Shunichi; Matsunaga, Isao

    1998-10-01

    Since 1985, the New Energy and Industrial Technology Development Organization (NEDO) has continued the development of hot dry rock power generation in Hijiori Hot Dry Rock test site, Yamagata prefecture, Japan, as part of the Sunshine Project and succeeding New Sunshine Project sponsored by the Agency of Industrial Science and Technology (AIST), a branch of the Ministry of International Trade and Industry (MITI). The objective of this project is to identify the feasibility of a Hot Dry Rock power generation system in Japan. Thus, the research and development being undertaken at Hijiori HDR test site is aiming to establish hot rock drilling technology, logging borehole technology for evaluating the state of the rock around the well, hydraulic fracturing technology for creating artificial fractures in rock, fracture mapping technology for surveying the reservoir area, and reservoir evaluation technology for predicting reservoir longevity.

  7. Analysis of energy extraction in the 1995 Hijiori 25-day circulation test

    SciTech Connect

    Kruger, P.; Sato, Yoshitero; Shinohara, Nobuo

    1996-12-31

    A 25-day circulation test was carried out in the summer of 1995 to characterize the two-production wells in the deeper reservoir of the Hijiori HDR resource. The test protocol included two stimulations of the injection well and two short step-rate injection tests during the circulation period. The test data showed that the flow in the two production wells originated from both the deeper reservoir at 2200 m and the original upper reservoir at 1800 m. For analysis of thermal extraction, the test data for the two production wells were treated as independent zonal sectors, as described by Kruger and Yamaguchi for the Hijiori 90-day circulation test of the upper reservoir and Kruger and Yamamoto for the Ogachi 151-day circulation test. Temperature cross-sections were calculated across each zonal sector. The two methods provide an estimation of the thermal energy extracted from the two reservoir zonal sectors during the circulation period and an estimate of the reservoir lifetime to the selected abandonment temperature.

  8. HDR Opportunities and Challenges Beyond the Long-Term Flow Test

    SciTech Connect

    Duchane, David

    1992-03-24

    The long term flow test (LTFT) of the worlds largest, deepest, and hottest hot dry rock (HDR) reservoir currently underway at Fenton Hill, NM, is expected to demonstrate that thermal energy can be mined from hot rock within the earth on a sustainable basis with minimal water consumption. This test will simulate the operations of a commercial facility in some ways, but it will not show that energy from HDR can be produced at a variety of locations with different geological settings. Since the Fenton Hill system was designed as a research facility rather than strictly for production purposes, it will also not demonstrate economic viability, although it may well give indications of system modifications needed for economic HDR operations. A second production site must be constructed, ideally under the direction of the private geothermal community, to begin the process of proving that the vast HDR resources can be accessed on a worldwide scale. This facility should be designed and engineered to produce and market energy at competitive prices. At the same time, a wide variety of techniques to advance the state-of-the-art of HDR technology must be pursued to develop this infant technology rapidly to its maximum potential. A number of design and operational techniques have been conceived which may lead to improved economics in HDR systems. After careful technical and economic scrutiny, those showing merit should be vigorously pursued. Finally, research and development work in areas such as reservoir interrogation, and system modeling must be accelerated to increase the competitiveness and geographical applications of HDR and the geothermal industry in general. This paper addresses the above issues in detail and outlines possible paths to future prosperity for the commercial geothermal industry.

  9. A summary of the Fire Testing Program at the German HDR Test Facility

    SciTech Connect

    Nowlen, S.P.

    1995-11-01

    This report provides an overview of the fire safety experiments performed under the sponsorship of the German government in the containment building of the decommissioned pilot nuclear power plant known as HDR. This structure is a highly complex, multi-compartment, multi-level building which has been used as the test bed for a wide range of nuclear power plant operation safety experiments. These experiments have included numerous fire tests. Test fire fuel sources have included gas burners, wood cribs, oil pools, nozzle release oil fires, and cable in cable trays. A wide range of ventilation conditions including full natural ventilation, full forced ventilation, and combined natural and forced ventilation have been evaluated. During most of the tests, the fire products mixed freely with the full containment volume. Macro-scale building circulation patterns which were very sensitive to such factors as ventilation configuration were observed and characterized. Testing also included the evaluation of selective area pressurization schemes as a means of smoke control for emergency access and evacuation stairwells.

  10. HDR imaging evaluation of a NT-proBNP test with a mobile phone.

    PubMed

    Preechaburana, P; Macken, S; Suska, A; Filippini, D

    2011-01-15

    The determination of NT-proBNP levels is key for the monitoring of patients with diagnosed heart failure and it is a routine measurement typically performed at health care centers, which would benefit from decentralized alternatives. Here we investigate the quantitative evaluation of a well-established NT-proBNP test using a standard mobile phone (Nokia 6720) as measuring platform rather than a dedicated instrument. A Java ME software developed for this application controls the illumination and imaging of the proBNP test under defined time intervals, which enables the composition of multi-exposure sets that are processed as high dynamic range (HDR) images for contrast enhancement. The results show that HDR processing significantly increases the sensitivity and resolution of the technique achieving a performance within the diagnostics range. These results demonstrate the feasibility to exploit a ubiquitous device to decentralize the evaluation of a routine test and identify key processing alternatives to bring the performance of such systems within the diagnostics range.

  11. Verification of experimental modal modeling using HDR (Heissdampfreaktor) dynamic test data

    SciTech Connect

    Srinivasan, M.G.; Kot, C.A.; Hsieh, B.J.

    1983-01-01

    Experimental modal modeling involves the determination of the modal parameters of the model of a structure from recorded input-output data from dynamic tests. Though commercial modal analysis algorithms are being widely used in many industries their ability to identify a set of reliable modal parameters of an as-built nuclear power plant structure has not been systematically verified. This paper describes the effort to verify MODAL-PLUS, a widely used modal analysis code, using recorded data from the dynamic tests performed on the reactor building of the Heissdampfreaktor, situated near Frankfurt, Federal Republic of Germany. In the series of dynamic tests on HDR in 1979, the reactor building was subjected to forced vibrations from different types and levels of dynamic excitations. Two sets of HDR containment building input-output data were chosen for MODAL-PLUS analyses. To reduce the influence of nonlinear behavior on the results, these sets were chosen so that the levels of excitation are relatively low and about the same in the two sets. The attempted verification was only partially successful in that only one modal model, with a limited range of validity, could be synthesized and in that the goodness of fit could be verified only in this limited range.

  12. High level seismic/vibrational tests at the HDR: An overview

    SciTech Connect

    Kot, C.A.; Srinivasan, M.G.; Hsieh, B.J.; Schrammel, D.; Malcher, L.; Steinhilber, H.; Costello, J.F.

    1991-12-31

    As part of the Phase II testing at the HDR Test Facility in Kahl/Main, FRG, two series of high-level seismic/vibrational experiments were performed. In the first of these (SHAG) a coast-down shaker, mounted on the reactor operating floor and capable of generating 1000 tonnes of force, was used to investigate full-scale structural response, soil-structure interaction (SSI), and piping/equipment response at load levels equivalent to those of a design basis earthquake. The HDR soil/structure system was tested to incipient failure exhibiting highly nonlinear response. In the load transmission from structure to piping/equipment significant response amplifications and shifts to higher frequencies occurred. The performance of various pipe support configurations was evaluated. This latter effort was continued in the second series of tests (SHAM), in which an in-plant piping system was investigated at simulated seismic loads (generated by two servo-hydraulic actuators each capable of generating 40 tonnes of force), that exceeded design levels manifold and resulted in considerable pipe plastification and failure of some supports (snubbers). The evaluation of six different support configurations demonstrated that proper system design (for a given spectrum) rather than number of supports or system stiffness is essential to limiting pipe stresses. Pipe strains at loads exceeding the design level eightfold were still tolerable, indicating that pipe failure even under extreme seismic loads is unlikely inspite of multiple support failures. Conservatively, an excess capacity (margin) of at least four was estimated for the piping system, and the pipe damping was found to be 4%. Comparisons of linear and nonlinear computational results with measurements showed that analytical predictions have wide scatter and do not necessarily yield conservative responses, underpredicting, in particular, peak support forces.

  13. High level seismic/vibrational tests at the HDR: An overview

    SciTech Connect

    Kot, C.A.; Srinivasan, M.G.; Hsieh, B.J. ); Schrammel, D.; Malcher, L. ); Steinhilber, H. ); Costello, J.F. . Office of Nuclear Regulatory Research)

    1991-01-01

    As part of the Phase II testing at the HDR Test Facility in Kahl/Main, FRG, two series of high-level seismic/vibrational experiments were performed. In the first of these (SHAG) a coast-down shaker, mounted on the reactor operating floor and capable of generating 1000 tonnes of force, was used to investigate full-scale structural response, soil-structure interaction (SSI), and piping/equipment response at load levels equivalent to those of a design basis earthquake. The HDR soil/structure system was tested to incipient failure exhibiting highly nonlinear response. In the load transmission from structure to piping/equipment significant response amplifications and shifts to higher frequencies occurred. The performance of various pipe support configurations was evaluated. This latter effort was continued in the second series of tests (SHAM), in which an in-plant piping system was investigated at simulated seismic loads (generated by two servo-hydraulic actuators each capable of generating 40 tonnes of force), that exceeded design levels manifold and resulted in considerable pipe plastification and failure of some supports (snubbers). The evaluation of six different support configurations demonstrated that proper system design (for a given spectrum) rather than number of supports or system stiffness is essential to limiting pipe stresses. Pipe strains at loads exceeding the design level eightfold were still tolerable, indicating that pipe failure even under extreme seismic loads is unlikely inspite of multiple support failures. Conservatively, an excess capacity (margin) of at least four was estimated for the piping system, and the pipe damping was found to be 4%. Comparisons of linear and nonlinear computational results with measurements showed that analytical predictions have wide scatter and do not necessarily yield conservative responses, underpredicting, in particular, peak support forces.

  14. SHAM: High-level seismic tests of piping at the HDR

    SciTech Connect

    Kot, C.A.; Srinivasan, M.G.; Hsieh, B.J.; Malcher, L.; Schrammel, D.; Steinhilber, H.; Costello, J.F.

    1988-01-01

    As part of the second phase of vibrational/earthquake investigations at the HDR (Heissdampfreaktor) Test Facility in Kahl/Main, FRG, high-level simulated seismic tests (SHAM) were performed during April--May 1988 on the VKL (Versuchskreislauf) in-plant piping system with two servohydraulic actuators, each capable of generating 40 tons of force. The purpose of these experiments was to study the behavior of piping subjected to seismic excitation levels that exceed design levels manifold and may result in failure/plastification of pipe supports and pipe elements, and to establish seismic margins for piping and pipe supports. The performance of six different dynamic pipe support systems was compared in these tests and the response, operability, and fragility of dynamic supports and of a typical US gate valve were investigated. Data obtained in the tests are used to validate analysis methods. Very preliminary evaluations lead to the observation that, in general, failures of dynamic supports (in particular snubbers) occur only at load levels that substantially exceed the design capacity. Pipe strains at load levels exceeding the design level threefold are quite small, and even when exceeding the design level eightfold are quite tolerable. Hence, under seismic loading, even at extreme levels and in spite of multiple support failures, pipe failure is unlikely. 5 refs., 16 figs.

  15. Image and video compression for HDR content

    NASA Astrophysics Data System (ADS)

    Zhang, Yang; Reinhard, Erik; Agrafiotis, Dimitris; Bull, David R.

    2012-10-01

    High Dynamic Range (HDR) technology can offer high levels of immersion with a dynamic range meeting and exceeding that of the Human Visual System (HVS). A primary drawback with HDR images and video is that memory and bandwidth requirements are significantly higher than for conventional images and video. Many bits can be wasted coding redundant imperceptible information. The challenge is therefore to develop means for efficiently compressing HDR imagery to a manageable bit rate without compromising perceptual quality. In this paper, we build on previous work of ours and propose a compression method for both HDR images and video, based on an HVS optimised wavelet subband weighting method. The method has been fully integrated into a JPEG 2000 codec for HDR image compression and implemented as a pre-processing step for HDR video coding (an H.264 codec is used as the host codec for video compression). Experimental results indicate that the proposed method outperforms previous approaches and operates in accordance with characteristics of the HVS, tested objectively using a HDR Visible Difference Predictor (VDP). Aiming to further improve the compression performance of our method, we additionally present the results of a psychophysical experiment, carried out with the aid of a high dynamic range display, to determine the difference in the noise visibility threshold between HDR and Standard Dynamic Range (SDR) luminance edge masking. Our findings show that noise has increased visibility on the bright side of a luminance edge. Masking is more consistent on the darker side of the edge.

  16. ICFT: An initial closed-loop flow test of the Fenton Hill Phase II HDR reservoir

    SciTech Connect

    Dash, Z.V.; Aguilar, R.G.; Dennis, B.R.; Dreesen, D.S.; Fehler, M.C.; Hendron, R.H.; House, L.S.; Ito, H.; Kelkar, S.M.; Malzahn, M.V.

    1989-02-01

    A 30-day closed-loop circulation test of the Phase II Hot Dry Rock reservoir at Fenton Hill, New Mexico, was conducted to determine the thermal, hydraulic, chemical, and seismic characteristics of the reservoir in preparation for a long-term energy-extraction test. The Phase II heat-extraction loop was successfully tested with the injection of 37,000 m/sup 3/ of cold water and production of 23,300 m/sup 3/ of hot water. Up to 10 MW/sub t/ was extracted when the production flow rate reached 0.0139 m/sup 3//s at 192/degree/C. By the end of the test, the water-loss rate had decreased to 26% and a significant portion of the injected water was recovered; 66% during the test and an additional 20% during subsequent venting. Analysis of thermal, hydraulic, geochemical, tracer, and seismic data suggests the fractured volume of the reservoir was growing throughout the test. 19 refs., 64 figs., 19 tabs.

  17. Tone compatibility between HDR displays

    NASA Astrophysics Data System (ADS)

    Bist, Cambodge; Cozot, Rémi; Madec, Gérard; Ducloux, Xavier

    2016-09-01

    High Dynamic Range (HDR) is the latest trend in television technology and we expect an in ux of HDR capable consumer TVs in the market. Initial HDR consumer displays will operate on a peak brightness of about 500-1000 nits while in the coming years display peak brightness is expected to go beyond 1000 nits. However, professionally graded HDR content can range from 1000 to 4000 nits. As with Standard Dynamic Range (SDR) content, we can expect HDR content to be available in variety of lighting styles such as low key, medium key and high key video. This raises concerns over tone-compatibility between HDR displays especially when adapting to various lighting styles. It is expected that dynamic range adaptation between HDR displays uses similar techniques as found with tone mapping and tone expansion operators. In this paper, we survey simple tone mapping methods of 4000 nits color-graded HDR content for 1000 nits HDR displays. We also investigate tone expansion strategies when HDR content graded in 1000 nits is displayed on 4000 nits HDR monitors. We conclude that the best tone reproduction technique between HDR displays strongly depends on the lighting style of the content.

  18. Automatic face recognition in HDR imaging

    NASA Astrophysics Data System (ADS)

    Pereira, Manuela; Moreno, Juan-Carlos; Proença, Hugo; Pinheiro, António M. G.

    2014-05-01

    The gaining popularity of the new High Dynamic Range (HDR) imaging systems is raising new privacy issues caused by the methods used for visualization. HDR images require tone mapping methods for an appropriate visualization on conventional and non-expensive LDR displays. These visualization methods might result in completely different visualization raising several issues on privacy intrusion. In fact, some visualization methods result in a perceptual recognition of the individuals, while others do not even show any identity. Although perceptual recognition might be possible, a natural question that can rise is how computer based recognition will perform using tone mapping generated images? In this paper, a study where automatic face recognition using sparse representation is tested with images that result from common tone mapping operators applied to HDR images. Its ability for the face identity recognition is described. Furthermore, typical LDR images are used for the face recognition training.

  19. Next stages in HDR technology development

    SciTech Connect

    Duchane, D.V.

    1993-03-01

    Twenty years of research and development have brought HDR heat mining technology from the purely conceptual stage to the establishment of an engineering-scale heat mine at Fenton Hill, NM. In April 1992, a long-term flow test (LTFT) of the HDR reservoir at Fenton Hill was begun. The test was carried out under steady-state conditions on a continuous basis for four months, but a major equipment failure in late July forced a temporary suspension of operations. Even this short test provided valuable information and extremely encouraging results as summarized below: There was no indication of thermal drawdown of the reservoir. There was evidence of increasing access to hot rock with time. Water consumption was in the rangki of 10--12%. Measured pumping costs were $0.003 per kilowatt of energy produced. Temperature logs conducted in the reservoir production zone during and after the flow test confirmed the fact that there was no decline in the average temperature of the fluid being produced from the reservoir. In fact, tracer testing showed that the fluid was taking more indirect pathways and thus contacting a greater amount of hot rock as the test progressed. Water usage quickly dropped to a level of 10--15 gallons per minute, an amount equivalent to about 10--12% of the injected fluid volume. At a conversion rate of 10--15%, these would translate to effective ``fuel costs`` of 2--3{cents} per kilowatt hour of electricity production potential. The completion of the LTFT will set the stage for commercialization of HDR but will not bring HDR technology to maturity. Relatively samples extensions of the current technology may bring significant improvements in efficiency, and these should be rapidly investigated. In the longer run, advanced operational concepts could further improve the efficiency of HDR energy extraction and may even offer the possibility of cogeneration schemes which solve both energy and water problems throughout the world.

  20. Virtual HDR CyberKnife treatment for localized prostatic carcinoma: dosimetry comparison with HDR brachytherapy and preliminary clinical observations.

    PubMed

    Fuller, Donald B; Naitoh, John; Lee, Charles; Hardy, Steven; Jin, Haoran

    2008-04-01

    We tested our ability to approximate the dose (38 Gy), fractionation (four fractions), and distribution of high-dose-rate (HDR) brachytherapy for prostate cancer with CyberKnife (CK) stereotactic body radiotherapy (SBRT) plans. We also report early clinical observations of CK SBRT treatment. Ten patients were treated with CK. For each CK SBRT plan, an HDR plan was designed using common contour sets and simulated HDR catheters. Planning target volume coverage, intraprostatic dose escalation, and urethra, rectum, and bladder exposure were compared. Planning target volume coverage by the prescription dose was similar for CK SBRT and HDR plans, whereas percent of volume of interest receiving 125% of prescribed radiation dose (V125) and V150 values were higher for HDR, reflecting higher doses near HDR source dwell positions. Urethra dose comparisons were lower for CK SBRT in 9 of 10 cases, suggesting that CK SBRT may more effectively limit urethra dose. Bladder maximum point doses were higher with HDR, but bladder dose falloff beyond the maximum dose region was more rapid with HDR. Maximum rectal wall doses were similar, but CK SBRT created sharper rectal dose falloff beyond the maximum dose region. Second CK SBRT plans, constructed by equating urethra radiation dose received by point of maximum exposure of volume of interest to the HDR plan, significantly increased V125 and V150. Clinically, 4-month post-CK SBRT median prostate-specific antigen levels decreased 86% from baseline. Acute toxicity was primarily urologic and returned to baseline by 2 months. Acute rectal morbidity was minimal and transient. It is possible to construct CK SBRT plans that closely recapitulate HDR dosimetry and deliver the plans noninvasively.

  1. Towards a robust HDR imaging system

    NASA Astrophysics Data System (ADS)

    Long, Xin; Zeng, Xiangrong; Huangpeng, Qizi; Zhou, Jinglun; Feng, Jing

    2016-07-01

    High dynamic range (HDR) images can show more details and luminance information in general display device than low dynamic image (LDR) images. We present a robust HDR imaging system which can deal with blurry LDR images, overcoming the limitations of most existing HDR methods. Experiments on real images show the effectiveness and competitiveness of the proposed method.

  2. Virtual HDR{sup SM} CyberKnife Treatment for Localized Prostatic Carcinoma: Dosimetry Comparison With HDR Brachytherapy and Preliminary Clinical Observations

    SciTech Connect

    Fuller, Donald B. Naitoh, John; Lee, Charles; Hardy, Steven C.; Jin, Haoran

    2008-04-01

    Background: We tested our ability to approximate the dose (38 Gy), fractionation (four fractions), and distribution of high-dose-rate (HDR) brachytherapy for prostate cancer with CyberKnife (CK) stereotactic body radiotherapy (SBRT) plans. We also report early clinical observations of CK SBRT treatment. Methods and Materials: Ten patients were treated with CK. For each CK SBRT plan, an HDR plan was designed using common contour sets and simulated HDR catheters. Planning target volume coverage, intraprostatic dose escalation, and urethra, rectum, and bladder exposure were compared. Results: Planning target volume coverage by the prescription dose was similar for CK SBRT and HDR plans, whereas percent of volume of interest receiving 125% of prescribed radiation dose (V125) and V150 values were higher for HDR, reflecting higher doses near HDR source dwell positions. Urethra dose comparisons were lower for CK SBRT in 9 of 10 cases, suggesting that CK SBRT may more effectively limit urethra dose. Bladder maximum point doses were higher with HDR, but bladder dose falloff beyond the maximum dose region was more rapid with HDR. Maximum rectal wall doses were similar, but CK SBRT created sharper rectal dose falloff beyond the maximum dose region. Second CK SBRT plans, constructed by equating urethra radiation dose received by point of maximum exposure of volume of interest to the HDR plan, significantly increased V125 and V150. Clinically, 4-month post-CK SBRT median prostate-specific antigen levels decreased 86% from baseline. Acute toxicity was primarily urologic and returned to baseline by 2 months. Acute rectal morbidity was minimal and transient. Conclusions: It is possible to construct CK SBRT plans that closely recapitulate HDR dosimetry and deliver the plans noninvasively.

  3. User's manual for HDR3 computer code

    SciTech Connect

    Arundale, C.J.

    1982-10-01

    A description of the HDR3 computer code and instructions for its use are provided. HDR3 calculates space heating costs for a hot dry rock (HDR) geothermal space heating system. The code also compares these costs to those of a specific oil heating system in use at the National Aeronautics and Space Administration Flight Center at Wallops Island, Virginia. HDR3 allows many HDR system parameters to be varied so that the user may examine various reservoir management schemes and may optimize reservoir design to suit a particular set of geophysical and economic parameters.

  4. Live HDR video streaming on commodity hardware

    NASA Astrophysics Data System (ADS)

    McNamee, Joshua; Hatchett, Jonathan; Debattista, Kurt; Chalmers, Alan

    2015-09-01

    High Dynamic Range (HDR) video provides a step change in viewing experience, for example the ability to clearly see the soccer ball when it is kicked from the shadow of the stadium into sunshine. To achieve the full potential of HDR video, so-called true HDR, it is crucial that all the dynamic range that was captured is delivered to the display device and tone mapping is confined only to the display. Furthermore, to ensure widespread uptake of HDR imaging, it should be low cost and available on commodity hardware. This paper describes an end-to-end HDR pipeline for capturing, encoding and streaming high-definition HDR video in real-time using off-the-shelf components. All the lighting that is captured by HDR-enabled consumer cameras is delivered via the pipeline to any display, including HDR displays and even mobile devices with minimum latency. The system thus provides an integrated HDR video pipeline that includes everything from capture to post-production, archival and storage, compression, transmission, and display.

  5. Analysis of visual quality improvements provided by known tools for HDR content

    NASA Astrophysics Data System (ADS)

    Kim, Jaehwan; Alshina, Elena; Lee, JongSeok; Park, Youngo; Choi, Kwang Pyo

    2016-09-01

    In this paper, the visual quality of different solutions for high dynamic range (HDR) compression using MPEG test contents is analyzed. We also simulate the method for an efficient HDR compression which is based on statistical property of the signal. The method is compliant with HEVC specification and also easily compatible with other alternative methods which might require HEVC specification changes. It was subjectively tested on commercial TVs and compared with alternative solutions for HDR coding. Subjective visual quality tests were performed using SUHD TVs model which is SAMSUNG JS9500 with maximum luminance up to 1000nit in test. The solution that is based on statistical property shows not only improvement of objective performance but improvement of visual quality compared to other HDR solutions, while it is compatible with HEVC specification.

  6. Harmony search optimization for HDR prostate brachytherapy

    NASA Astrophysics Data System (ADS)

    Panchal, Aditya

    In high dose-rate (HDR) prostate brachytherapy, multiple catheters are inserted interstitially into the target volume. The process of treating the prostate involves calculating and determining the best dose distribution to the target and organs-at-risk by means of optimizing the time that the radioactive source dwells at specified positions within the catheters. It is the goal of this work to investigate the use of a new optimization algorithm, known as Harmony Search, in order to optimize dwell times for HDR prostate brachytherapy. The new algorithm was tested on 9 different patients and also compared with the genetic algorithm. Simulations were performed to determine the optimal value of the Harmony Search parameters. Finally, multithreading of the simulation was examined to determine potential benefits. First, a simulation environment was created using the Python programming language and the wxPython graphical interface toolkit, which was necessary to run repeated optimizations. DICOM RT data from Varian BrachyVision was parsed and used to obtain patient anatomy and HDR catheter information. Once the structures were indexed, the volume of each structure was determined and compared to the original volume calculated in BrachyVision for validation. Dose was calculated using the AAPM TG-43 point source model of the GammaMed 192Ir HDR source and was validated against Varian BrachyVision. A DVH-based objective function was created and used for the optimization simulation. Harmony Search and the genetic algorithm were implemented as optimization algorithms for the simulation and were compared against each other. The optimal values for Harmony Search parameters (Harmony Memory Size [HMS], Harmony Memory Considering Rate [HMCR], and Pitch Adjusting Rate [PAR]) were also determined. Lastly, the simulation was modified to use multiple threads of execution in order to achieve faster computational times. Experimental results show that the volume calculation that was

  7. A dosimetric selectivity intercomparison of HDR brachytherapy, IMRT and helical tomotherapy in prostate cancer radiotherapy.

    PubMed

    Hermesse, Johanne; Biver, Sylvie; Jansen, Nicolas; Lenaerts, Eric; De Patoul, Nathalie; Vynckier, Stefaan; Coucke, Philippe; Scalliet, Pierre; Nickers, Philippe

    2009-11-01

    Dose escalation in order to improve the biochemical control in prostate cancer requires the application of irradiation techniques with high conformality. The dosimetric selectivity of three radiation modalities is compared: high-dose-rate brachytherapy (HDR-BT), intensity-modulated radiation radiotherapy (IMRT), and helical tomotherapy (HT). Ten patients with prostate adenocarcinoma treated by a 10-Gy HDR-BT boost after external-beam radiotherapy were investigated. For each patient, HDR-BT, IMRT and HT theoretical treatment plans were realized using common contour sets. A 10-Gy dose was prescribed to the planning target volume (PTV). The PTVs and critical organs' dose-volume histograms obtained were compared using Student's t-test. HDR-BT delivers spontaneously higher mean doses to the PTV with smaller cold spots compared to IMRT and HT. 33% of the rectal volume received a mean HDR-BT dose of 3.86 + or - 0.3 Gy in comparison with a mean IMRT dose of 6.57 + or - 0.68 Gy and a mean HT dose of 5.58 + or - 0.71 Gy (p < 0.0001). HDR-BT also enables to better spare the bladder. The hot spots inside the urethra are greater with HDR-BT. The volume of healthy tissue receiving 10% of the prescribed dose is reduced at least by a factor of 8 with HDR-BT (p < 0.0001). HDR-BT offers better conformality in comparison with HT and IMRT and reduces the volume of healthy tissue receiving a low dose.

  8. The general solution to HDR rendering

    NASA Astrophysics Data System (ADS)

    McCann, John

    2012-03-01

    Our High-Dynamic-Range (HDR) world is the result of nonuniform illumination. We like to believe that 21st century technology makes it possible to accurately reproduce any scene. On further study, we find that scene rendition remains a best compromise. Despite all the remarkable accomplishments in digital imaging, we cannot capture and reproduce the light in the world exactly. With still further study, we find that accurate reproduction is not necessary. We need an interdisciplinary study of image making - painting, photography and image processing - to find the general solution. HDR imaging would be very confusing, without two observations that resolve many paradoxes. First, optical veiling glare, that depends on the scene content, severely limits the range of light on cameras' sensors, and on retinas. Second, the neural spatial image processing in human vision counteracts glare with variable scene dependent responses. The counter actions of these optical and neural processes shape the goals of HDR imaging. Successful HDR increases the apparent contrast of details lost in the shadows and highlights of conventional images. They change the spatial relationships by altering the local contrast of edges and gradients. The goal of HDR imaging is displaying calculated appearance, rather than accurate light reproduction. By using this strategy we can develop universal algorithms that process all images, LDR and HDR, achromatic and color, by mimicking human vision. The study of the general solution for HDR imaging incorporates painting photography, vision research, color constancy and digital image processing.

  9. Cosmetic effect in patients with early breast cancer treated with breast conserving therapy (BCT) and with HDR brachytherapy (HDR-BT) "boost".

    PubMed

    Kulik, Anna; Łyczek, Jarosław; Kawczyn Ska, Maria; Gruszczyn Ska, Ewelina

    2009-06-01

    The estimation of cosmetic effect in 93 patients with early breast cancer treated with breast conserving surgery (BCS) followed by combined radiotherapy, including HDR brachytherapy (HDR-BT) boost. After BCS (tumorectomy or quadrantectomy) external beam radiation therapy (EBRT) was used in total dose of 50 Gy for the whole breast. Tumor bed was localized basing on clinical and mammographic preoperative examinations and histopathology evaluation. 10 Gy in one fraction was applied to all patients using HDR-BT. Steel interstitial needles stabilized by plastic templates were used. 192-Ir with 10 Ci nominal activity and HDR-GammaMed 12i unit (Mick Radio-Nuclear Instruments, Inc., Mt. Vernon, NY) and ABACUS software were used. 31 patients received additional chemotherapy. Cosmetic effect was evaluated in 36 month after the end of brachytherapy treatment basing on modified EORTC scale. For statistical analysis the rang of correlation test, contingent test, linear regression test and ProbRough rulet induction test were used. HDR-BT tolerance was good in most of the cases. Excellent and very good cosmetic effect was observed in 79 patients (85%). Statistically important correlations between following examined prognostic factors and cosmetics outcome were observed: clinical and mammographic tumor estimation, method of breast conserving surgery, type of skin incision, number of interstitial applicators, irradiated reference volume (PTV) and type of optimization method. No correlations with cosmetics effect were found in factors such as: age of patients, location of tumor or additional therapy.

  10. The first Korean case of HDR syndrome confirmed by clinical and molecular investigation.

    PubMed

    Cheon, Chong Kun; Kim, Gu Hwan; Yoo, Han Wook

    2015-01-01

    Hypoparathyroidism, deafness, and renal dysplasia (HDR) syndrome is a rare condition inherited as autosomal dominant trait and characterized by hypoparathyroidism, sensorineural deafness, and renal dysplasia. HDR syndrome is caused by haploinsufficiency of the GATA3 gene located on chromosome 10p15. Here, we report the case of a 32-day-old Korean male with HDR syndrome. He was presented due to repeated seizures over previous 3 days. The patient was born after 40 weeks of gestation with birth weight of 2930 g, and was the first-born baby of healthy Korean parents. Hypoparathyroidism was first noticed due to seizure. A multicystic left dysplastic kidney and vesicoureteral reflux were detected by ultrasound after birth. Auditory brainstem response (ABR) testing revealed that the patient had moderate sensorineural deafness, with hearing losses of 80 dB at the mid and higher frequencies for both ears. Echocardiography finding revealed secundum atrial septal deftect. Based on biochemical results and clinical findings, a presumptive diagnosis of HDR syndrome was made. GATA3 mutation analysis identified a heterozygous deletion, c.153del (p.Phe51Leufs*144) in exon 1 causing a frameshift mutation, which is a novel de novo mutation. Therefore, we suggest that HDR syndrome should be considered in the differential diagnosis in symptomatic or asymptomatic patients with hypoparathyroidism, and that renal ultrasound or ABR testing be performed to prevent a missed diagnosis. This is the first report on Korean patient with confirmed HDR syndrome with novel mutation.

  11. Investigation of superstructure damping identification for the HDR containment building

    SciTech Connect

    Hsieh, B.J.; Kot, C.A.; Srinivasan, M.G.

    1985-01-01

    A method for the estimation of first mode structural damping, developed by other investigators, was applied to shaker test data of the HDR containment building. Due to inadequate precision in the experimental phase measurements no valid results could be obtained. Based on modal analysis it was also noted that for systems such as the HDR building, contributions of higher modes are not negligible as was assumed in the original approach. Therefore, the procedure for the determination of superstructure damping using experimental data was extended to include the effects of higher modes. The extended method does not lead to any higher order nonlinear equations than the first mode approximation and was found to be as simple to apply as the original approach.

  12. A New CT Prostate Segmentation for CT-Based HDR Brachytherapy.

    PubMed

    Yang, Xiaofeng; Rossi, Peter; Ogunleye, Tomi; Jani, Ashesh B; Curran, Walter J; Liu, Tian

    High-dose-rate (HDR) brachytherapy has become a popular treatment modality for localized prostate cancer. Prostate HDR treatment involves placing 10 to 20 catheters (needles) into the prostate gland, and then delivering radiation dose to the cancerous regions through these catheters. These catheters are often inserted with transrectal ultrasound (TRUS) guidance and the HDR treatment plan is based on the CT images. The main challenge for CT-based HDR planning is to accurately segment prostate volume in CT images due to the poor soft tissue contrast and additional artifacts introduced by the catheters. To overcome these limitations, we propose a novel approach to segment the prostate in CT images through TRUS-CT deformable registration based on the catheter locations. In this approach, the HDR catheters are reconstructed from the intra-operative TRUS and planning CT images, and then used as landmarks for the TRUS-CT image registration. The prostate contour generated from the TRUS images captured during the ultrasound-guided HDR procedure was used to segment the prostate on the CT images through deformable registration. We conducted two studies. A prostate-phantom study demonstrated a submillimeter accuracy of our method. A pilot study of 5 prostate-cancer patients was conducted to further test its clinical feasibility. All patients had 3 gold markers implanted in the prostate that were used to evaluate the registration accuracy, as well as previous diagnostic MR images that were used as the gold standard to assess the prostate segmentation. For the 5 patients, the mean gold-marker displacement was 1.2 mm; the prostate volume difference between our approach and the MRI was 7.2%, and the Dice volume overlap was over 91%. Our proposed method could improve prostate delineation, enable accurate dose planning and delivery, and potentially enhance prostate HDR treatment outcome.

  13. The geochemical and petrological characteristics of prenatal caldera volcano: a case of the newly formed small dacitic caldera, Hijiori, Northeast Japan

    NASA Astrophysics Data System (ADS)

    Miyagi, Isoji; Kita, Noriko; Morishita, Yuichi

    2017-09-01

    Evaluating the magma depth and its physical properties is critical to conduct a better geophysical assessment of magma chambers of caldera volcanoes that may potentially cause future volcanic hazards. To understand pre-eruptive conditions of a magma chamber before its first appearance at the surface, this paper describes the case of Hijiori caldera volcano in northeastern Japan, which emerged approximately 12,000 years ago at a place where no volcano ever existed. We estimated the depth, density, bulk modulus, vesicularity, crystal content, and bulk H_2O content of the magma chamber using petrographic interpretations, bulk and microchemical compositions, and thermodynamic calculations. The chemical mass balance calculations and thermodynamic modeling of the erupted magmas indicate that the upper portion of the Hijiori magmatic plumbing system was located at depths between 2 and 4 km, and had the following characteristics: (1) pre-eruptive temperature: about 780 °C; (2) bulk magma composition: 66 ± 1.5 wt% SiO2; (3) bulk magmatic H_2O: approximately 2.5 wt%, and variable characteristics that depend on depth; (4) crystal content: ≤57 vol%; (5) bulk modulus of magma: 0.1-0.8 GPa; (6) magma density: 1.8-2.3 g/cm3; and (7) amount of excess magmatic H_2O: 11-32 vol% or 48-81 mol%. The range of melt water contents found in quartz-hosted melt inclusions (2-9 wt%) suggests the range of depth phenocrysts growth to be wide (2˜13 km). Our data suggest the presence of a vertically elongated magma chamber whose top is nearly solidified but highly vesiculated; this chamber has probably grown and re-mobilized by repeated injections of a small amount of hot dacitic magma originated from the depth.

  14. Towards real-time 3D ultrasound planning and personalized 3D printing for breast HDR brachytherapy treatment.

    PubMed

    Poulin, Eric; Gardi, Lori; Fenster, Aaron; Pouliot, Jean; Beaulieu, Luc

    2015-03-01

    Two different end-to-end procedures were tested for real-time planning in breast HDR brachytherapy treatment. Both methods are using a 3D ultrasound (3DUS) system and a freehand catheter optimization algorithm. They were found fast and efficient. We demonstrated a proof-of-concept approach for personalized real-time guidance and planning to breast HDR brachytherapy treatments. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  15. Seismic investigations of the HDR Safety Program. Summary report

    SciTech Connect

    Malcher, L.; Schrammel, D.; Steinhilber, H.; Kot, C.A.

    1994-08-01

    The primary objective of the seismic investigations, performed at the HDR facility in Kahl/Main, FRG was to validate calculational methods for the seismic evaluation of nuclear-reactor systems, using experimental data from an actual nuclear plant. Using eccentric mass shaker excitation the HDR soil/structure system was tested to incipient failure, exhibiting highly nonlinear response and demonstrating that structures not seismically designed can sustain loads equivalent to a design basin earthquake (DBE). Load transmission from the structure to piping/equipment indicated significant response amplifications and shifts to higher frequencies, while the response of tanks/vessels depended mainly on their support conditions. The evaluation of various piping support configurations demonstrated that proper system design (for a given spectrum) rather than number of supports or system stiffness is important to limiting pipe greens. Piping at loads exceeding the DBE eightfold still had significant margins and failure is improbable inspite of multiple support failures. The mean value for pipe damping, even under extreme loads, was found to be about 4%. Comparison of linear and nonlinear computational results with piping response measurements showed that predictions have a wide scatter and do not necessarily yield conservative responses underpredicting, in particular, peak support forces. For the soil/structure system the quality of the predictions did not depend so much on the complexity of the modeling, but rather on whether the model captured the salient features and nonlinearities of the system.

  16. Prostate CT segmentation method based on nonrigid registration in ultrasound-guided CT-based HDR prostate brachytherapy

    SciTech Connect

    Yang, Xiaofeng Rossi, Peter; Ogunleye, Tomi; Marcus, David M.; Jani, Ashesh B.; Curran, Walter J.; Liu, Tian; Mao, Hui

    2014-11-01

    Purpose: The technological advances in real-time ultrasound image guidance for high-dose-rate (HDR) prostate brachytherapy have placed this treatment modality at the forefront of innovation in cancer radiotherapy. Prostate HDR treatment often involves placing the HDR catheters (needles) into the prostate gland under the transrectal ultrasound (TRUS) guidance, then generating a radiation treatment plan based on CT prostate images, and subsequently delivering high dose of radiation through these catheters. The main challenge for this HDR procedure is to accurately segment the prostate volume in the CT images for the radiation treatment planning. In this study, the authors propose a novel approach that integrates the prostate volume from 3D TRUS images into the treatment planning CT images to provide an accurate prostate delineation for prostate HDR treatment. Methods: The authors’ approach requires acquisition of 3D TRUS prostate images in the operating room right after the HDR catheters are inserted, which takes 1–3 min. These TRUS images are used to create prostate contours. The HDR catheters are reconstructed from the intraoperative TRUS and postoperative CT images, and subsequently used as landmarks for the TRUS–CT image fusion. After TRUS–CT fusion, the TRUS-based prostate volume is deformed to the CT images for treatment planning. This method was first validated with a prostate-phantom study. In addition, a pilot study of ten patients undergoing HDR prostate brachytherapy was conducted to test its clinical feasibility. The accuracy of their approach was assessed through the locations of three implanted fiducial (gold) markers, as well as T2-weighted MR prostate images of patients. Results: For the phantom study, the target registration error (TRE) of gold-markers was 0.41 ± 0.11 mm. For the ten patients, the TRE of gold markers was 1.18 ± 0.26 mm; the prostate volume difference between the authors’ approach and the MRI-based volume was 7.28% ± 0

  17. Prostate CT segmentation method based on nonrigid registration in ultrasound-guided CT-based HDR prostate brachytherapy.

    PubMed

    Yang, Xiaofeng; Rossi, Peter; Ogunleye, Tomi; Marcus, David M; Jani, Ashesh B; Mao, Hui; Curran, Walter J; Liu, Tian

    2014-11-01

    The technological advances in real-time ultrasound image guidance for high-dose-rate (HDR) prostate brachytherapy have placed this treatment modality at the forefront of innovation in cancer radiotherapy. Prostate HDR treatment often involves placing the HDR catheters (needles) into the prostate gland under the transrectal ultrasound (TRUS) guidance, then generating a radiation treatment plan based on CT prostate images, and subsequently delivering high dose of radiation through these catheters. The main challenge for this HDR procedure is to accurately segment the prostate volume in the CT images for the radiation treatment planning. In this study, the authors propose a novel approach that integrates the prostate volume from 3D TRUS images into the treatment planning CT images to provide an accurate prostate delineation for prostate HDR treatment. The authors' approach requires acquisition of 3D TRUS prostate images in the operating room right after the HDR catheters are inserted, which takes 1-3 min. These TRUS images are used to create prostate contours. The HDR catheters are reconstructed from the intraoperative TRUS and postoperative CT images, and subsequently used as landmarks for the TRUS-CT image fusion. After TRUS-CT fusion, the TRUS-based prostate volume is deformed to the CT images for treatment planning. This method was first validated with a prostate-phantom study. In addition, a pilot study of ten patients undergoing HDR prostate brachytherapy was conducted to test its clinical feasibility. The accuracy of their approach was assessed through the locations of three implanted fiducial (gold) markers, as well as T2-weighted MR prostate images of patients. For the phantom study, the target registration error (TRE) of gold-markers was 0.41 ± 0.11 mm. For the ten patients, the TRE of gold markers was 1.18 ± 0.26 mm; the prostate volume difference between the authors' approach and the MRI-based volume was 7.28% ± 0.86%, and the prostate volume Dice

  18. Prostate CT segmentation method based on nonrigid registration in ultrasound-guided CT-based HDR prostate brachytherapy

    PubMed Central

    Yang, Xiaofeng; Rossi, Peter; Ogunleye, Tomi; Marcus, David M.; Jani, Ashesh B.; Mao, Hui; Curran, Walter J.; Liu, Tian

    2014-01-01

    Purpose: The technological advances in real-time ultrasound image guidance for high-dose-rate (HDR) prostate brachytherapy have placed this treatment modality at the forefront of innovation in cancer radiotherapy. Prostate HDR treatment often involves placing the HDR catheters (needles) into the prostate gland under the transrectal ultrasound (TRUS) guidance, then generating a radiation treatment plan based on CT prostate images, and subsequently delivering high dose of radiation through these catheters. The main challenge for this HDR procedure is to accurately segment the prostate volume in the CT images for the radiation treatment planning. In this study, the authors propose a novel approach that integrates the prostate volume from 3D TRUS images into the treatment planning CT images to provide an accurate prostate delineation for prostate HDR treatment. Methods: The authors’ approach requires acquisition of 3D TRUS prostate images in the operating room right after the HDR catheters are inserted, which takes 1–3 min. These TRUS images are used to create prostate contours. The HDR catheters are reconstructed from the intraoperative TRUS and postoperative CT images, and subsequently used as landmarks for the TRUS–CT image fusion. After TRUS–CT fusion, the TRUS-based prostate volume is deformed to the CT images for treatment planning. This method was first validated with a prostate-phantom study. In addition, a pilot study of ten patients undergoing HDR prostate brachytherapy was conducted to test its clinical feasibility. The accuracy of their approach was assessed through the locations of three implanted fiducial (gold) markers, as well as T2-weighted MR prostate images of patients. Results: For the phantom study, the target registration error (TRE) of gold-markers was 0.41 ± 0.11 mm. For the ten patients, the TRE of gold markers was 1.18 ± 0.26 mm; the prostate volume difference between the authors’ approach and the MRI-based volume was 7.28% ± 0

  19. The conception and implementation of a local HDR fusion algorithm depending on contrast and luminosity parameters

    NASA Astrophysics Data System (ADS)

    Besrour, Amine; Abdelkefi, Fatma; Siala, Mohamed; Snoussi, Hichem

    2015-09-01

    Nowadays, the high dynamic range (HDR) imaging represents the subject of the most researches. The major problem lies in the implementation of the best algorithm to acquire the best video quality. In fact, the major constraint is to conceive an optimal fusion which must meet the rapid movement of video frames. The implemented merging algorithms were not quick enough to reconstitute the HDR video. In this paper, we detail each of the previous existing works before detailing our algorithm and presenting results from the acquired HDR images, tone mapped with various techniques. Our proposed algorithm guarantees a more enhanced and faster solution compared to the existing ones. In fact, it has the ability to calculate the saturation matrix related to the saturation rate of the neighboring pixels. The computed coefficients are affected respectively to each picture from the tested ones. This analysis provides faster and efficient results in terms of quality and brightness. The originality of our work remains on its processing method including the pixels saturation in the totality of the captured pictures and their combination in order to obtain the best pictures illustrating all the possible details. These parameters are computed for each zone depending on the contrast and the luminosity of the current pixel and its neighboring. The final HDR image's coefficients are calculated dynamically ensuring the best image quality equilibrating the brightness and contrast values and making the perfect final image.

  20. Evaluating the performance of TG-43 protocol in esophageal HDR brachytherapy viewpoint to trachea inhomogeneity.

    PubMed

    Hosseini Daghigh, Seyed Mohsen; Baghani, Hamid Reza; Aghamiri, Seyed Mahmoud Reza; Mahdavi, Seyed Rabi

    2017-01-01

    The aim of this study is to evaluate the effect of air within trachea on dose calculations of esophageal HDR brachytherapy treatment planning. Dose calculations in esophageal HDR brachytherapy treatment planning systems are greatly based on TG-43 protocol which in all materials are considered to be water equivalent. A cylindrical PMMA phantom with a tube in the center (neck equivalent phantom) accompanied by Flexitron HDR brachytherapy system was used in this study. Brachytherapy applicators with various diameters were placed inside the esophageal tube and EDR2 film was used for dosimetry. The absorbed dose by reference point of esophageal HDR brachytherapy and anterior wall of trachea were measured and compared with those calculated by Flexiplan treatment planning system. Based on the performed statistical analysis (t-test) with 95% confidence level (t-value >1.96), there was a meaningful difference between the results of film dosimetry and treatment planning at all of the points understudy. The meaningful difference between the results of film dosimetry and treatment planning indicates that the trachea inhomogeneity has a considerable effect on dose calculations of Flexiplan treatment planning software featuring the TG-43 dose calculation algorithm. This mismatch can affect the accuracy of performed treatment plan and irradiation.

  1. HDR brachytherapy (HDR-BT) combined with stent placement in palliative treatment of esophageal cancer.

    PubMed

    Kanikowski, Marek; Skowronek, Janusz; Kubaszewska, Magda; Chichel, Adam; Piotrowski, Tomasz

    2009-03-01

    In the study we present the initial results of palliative treatment using combined methods of HDR-BT and stent insertion in patients with advanced esophagus cancer. Fifty patients were treated in the Great Poland Cancer Center using HDR-BT between June 2001 and December 2005 and they were enrolled into the study. All patients underwent endoscopic insertion of self-expanding, metal, endoesophageal stents owing to blockages in the lumen of the esophagus which excluded brachytherapy. The group included 41 men and 9 women, aged between 44 and 79 years (average 59.3 years). 36 of patients received 3 fractions of HDR once a week of 7.5 Gy, up to total dose of 22.5 Gy, 14 patients received 2 fractions of 7.5 Gy (15 Gy). The average patient observation period was 5.4 months. Complete remission (CR) was observed after 4 weeks in 2 cases (4%), partial remission (PR) in 31 (62%), no remission (NR) was seen in 6 patients (12%) and progression was noted in 11 cases (22%). Complications of brachytherapy for esophageal cancer were observed in 11 patients (22%), ulceration in 1 patient (2%), haemorrhage in 1 patient (2%) and bronchotracheal fistulas in 9 (18%) patients. The average observation period for patients with bronchotracheal fistulas was notably shorter than in remaining patients and amounted 3.5 months. 1. Endoscopic implantation of stents to the lumen of the esophagus provides access to esophagus and, in many cases, allows application of HDR-BT. 2. HDR-BT for advanced esophageal cancer brought relief from dysphagia in most of patients. 3. The combination of the two methods of treatment represents an effective choice for palliative care of this group of patients, with a complication rate similar to observed one in the instance of brachytherapy alone.

  2. Effects of display rendering on HDR image quality assessment

    NASA Astrophysics Data System (ADS)

    Zerman, Emin; Valenzise, Giuseppe; De Simone, Francesca; Banterle, Francesco; Dufaux, Frederic

    2015-09-01

    High dynamic range (HDR) displays use local backlight modulation to produce both high brightness levels and large contrast ratios. Thus, the display rendering algorithm and its parameters may greatly affect HDR visual experience. In this paper, we analyze the impact of display rendering on perceived quality for a specific display (SIM2 HDR47) and for a popular application scenario, i.e., HDR image compression. To this end, we assess whether significant differences exist between subjective quality of compressed images, when these are displayed using either the built-in rendering of the display, or a rendering algorithm developed by ourselves. As a second contribution of this paper, we investigate whether the possibility to estimate the true pixel-wise luminance emitted by the display, offered by our rendering approach, can improve the performance of HDR objective quality metrics that require true pixel-wise luminance as input.

  3. HDR color conversion with varying distortion metrics

    NASA Astrophysics Data System (ADS)

    Norkin, Andrey

    2016-09-01

    The paper compares three algorithms, which attenuate artifacts that may appear in HDR video in Y'CbCr 4:2:0 format. The algorithms attenuate artifacts in colors at the color gamut boundaries while also improving the objective quality. Two closed form solutions demonstrate the same subjective quality as the iterative approach, while being computationally simpler. One of the closed form solutions also shows similar objective results to the iterative algorithm. The choice of the upsampling filter in the pre-processing stage is important and may negatively affect both the objective and subjective quality if there is a mismatch with the upsampling filter used in the reconstruction.

  4. A novel GATA3 nonsense mutation in a newly diagnosed adult patient of hypoparathyroidism, deafness, and renal dysplasia (HDR) syndrome.

    PubMed

    Nanba, Kazutaka; Usui, Takeshi; Nakamura, Michikazu; Toyota, Yuko; Hirota, Keisho; Tamanaha, Tamiko; Kawashima, Sachiko-Tsukamoto; Nakao, Kanako; Yuno, Akiko; Tagami, Tetsuya; Naruse, Mitsuhide; Shimatsu, Akira

    2013-01-01

    Hypoparathyroidism, deafness, and renal dysplasia (HDR) syndrome is an autosomal dominant disorder caused by a GATA3 gene mutation. Here we report a novel mutation of GATA3 in a patient diagnosed with HDR syndrome at the age of 58 with extensive intracranial calcification. A 58-year-old Japanese man showed severe hypocalcemia and marked calcification in the basal ganglia, cerebellum, deep white matter, and gray-white junction on computed tomography (CT). The serum intact parathyroid hormone level was relatively low against low serum calcium concentration. The patient had been diagnosed with bilateral sensorineural deafness in childhood and had a family history of hearing disorders. Imaging studies revealed no renal anomalies. The patient was diagnosed with HDR syndrome, and genetic testing was performed. Genetic analysis of GATA3 showed a novel nonsense mutation at codon 198 (S198X) in exon 3. The S198X mutation leads to a loss of two zinc finger deoxyribonucleic acid (DNA) binding domains and is considered to be responsible for HDR syndrome. We identified a novel nonsense mutation of GATA3 in an adult patient with HDR syndrome who showed extensive intracranial calcification.

  5. Creating cinematic wide gamut HDR-video for the evaluation of tone mapping operators and HDR-displays

    NASA Astrophysics Data System (ADS)

    Froehlich, Jan; Grandinetti, Stefan; Eberhardt, Bernd; Walter, Simon; Schilling, Andreas; Brendel, Harald

    2014-03-01

    High quality video sequences are required for the evaluation of tone mapping operators and high dynamic range (HDR) displays. We provide scenic and documentary scenes with a dynamic range of up to 18 stops. The scenes are staged using professional film lighting, make-up and set design to enable the evaluation of image and material appearance. To address challenges for HDR-displays and temporal tone mapping operators, the sequences include highlights entering and leaving the image, brightness changing over time, high contrast skin tones, specular highlights and bright, saturated colors. HDR-capture is carried out using two cameras mounted on a mirror-rig. To achieve a cinematic depth of field, digital motion picture cameras with Super-35mm size sensors are used. We provide HDR-video sequences to serve as a common ground for the evaluation of temporal tone mapping operators and HDR-displays. They are available to the scientific community for further research.

  6. Peceptual rendering of HDR in painting and photography

    NASA Astrophysics Data System (ADS)

    McCann, John J.

    2008-02-01

    Pictures can be drawn by hand, or imaged by optical means. Over time, pictures have changed from being rare and unique to ubiquitous and common. They have changed from treasures to transients. This paper summarizes many picture technologies, and discusses their dynamic range, their color and tone-scale rendering and their spatial image processing. High Dynamic Range (HDR) image capture and display has long been an interest for artists and photographers. The discipline of reproducing scenes with a high range of luminances has a 5-century history that includes painting, photography, electronic imaging and image processing. HDR images render high-range scene information into lowrange reproductions. This paper studies the artistic techniques and scientific issues that control HDR image capture and reproduction. Both the artist and the scientist synthesize HDR reproductions with spatial image processing. The artists paints, or dodges and burns, the image he visualizes based on his human visual processing. The scientist, using algorithms that mimic vision, calculates perceptually correct renditions with inaccurate reproductions of scene radiances. The paper will discuss artists' techniques used in both painting and photography for HDR compression. It will also describe how optical veiling glare severely limits the range of luminance that can be captured and seen. The improvement in quality in digital HDR reproductions, as in HDR in art, depends on the spatial rendering of details in the highlights and shadows.

  7. Impact Analysis of Baseband Quantizer on Coding Efficiency for HDR Video

    NASA Astrophysics Data System (ADS)

    Wong, Chau-Wai; Su, Guan-Ming; Wu, Min

    2016-10-01

    Digitally acquired high dynamic range (HDR) video baseband signal can take 10 to 12 bits per color channel. It is economically important to be able to reuse the legacy 8 or 10-bit video codecs to efficiently compress the HDR video. Linear or nonlinear mapping on the intensity can be applied to the baseband signal to reduce the dynamic range before the signal is sent to the codec, and we refer to this range reduction step as a baseband quantization. We show analytically and verify using test sequences that the use of the baseband quantizer lowers the coding efficiency. Experiments show that as the baseband quantizer is strengthened by 1.6 bits, the drop of PSNR at a high bitrate is up to 1.60dB. Our result suggests that in order to achieve high coding efficiency, information reduction of videos in terms of quantization error should be introduced in the video codec instead of on the baseband signal.

  8. High-dynamic-range fluorescence laminar optical tomography (HDR-FLOT)

    PubMed Central

    Tang, Qinggong; Liu, Yi; Tsytsarev, Vassiliy; Lin, Jonathan; Wang, Bohan; Kanniyappan, Udayakumar; Li, Zhifang; Chen, Yu

    2017-01-01

    Three-dimensional fluorescence laminar optical tomography (FLOT) can achieve resolutions of 100-200 µm and penetration depths of 2-3 mm. FLOT has been used in tissue engineering, neuroscience, as well as oncology. The limited dynamic range of the charge-coupled device-based system makes it difficult to image fluorescent samples with a large concentration difference, limits its penetration depth, and diminishes the quantitative accuracy of 3D reconstruction data. Here, incorporating the high-dynamic-range (HDR) method widely used in digital cameras, we present HDR-FLOT, increasing penetration depth and improving the ability to image fluorescent samples with a large concentration difference. The method was tested using an agar phantom and a B6 mouse for brain imaging in vivo. PMID:28736659

  9. Ghost removing for HDR real-time video stream generation

    NASA Astrophysics Data System (ADS)

    Bouderbane, Mustapha; Dubois, Julien; Heyrman, Barthélémy; Lapray, Pierre-Jean; Ginhac, Dominique

    2016-04-01

    High dynamic range (HDR) imaging generation from a set of low dynamic range images taken in different exposure times is a low cost and an easy technique. This technique provides a good result for static scenes. Temporal exposure bracketing cannot be applied directly for dynamic scenes, since camera or object motion in bracketed exposures creates ghosts in the resulting HDR image. In this paper we describe a real-time ghost removing hardware implementation on high dynamic range video ow added for our HDR FPGA based smart camera which is able to provide full resolution (1280 x 1024) HDR video stream at 60 fps. We present experimental results to show the efficiency of our implemented method in ghost removing.

  10. Single-layer HDR video coding with SDR backward compatibility

    NASA Astrophysics Data System (ADS)

    Lasserre, S.; François, E.; Le Léannec, F.; Touzé, D.

    2016-09-01

    The migration from High Definition (HD) TV to Ultra High Definition (UHD) is already underway. In addition to an increase of picture spatial resolution, UHD will bring more color and higher contrast by introducing Wide Color Gamut (WCG) and High Dynamic Range (HDR) video. As both Standard Dynamic Range (SDR) and HDR devices will coexist in the ecosystem, the transition from Standard Dynamic Range (SDR) to HDR will require distribution solutions supporting some level of backward compatibility. This paper presents a new HDR content distribution scheme, named SL-HDR1, using a single layer codec design and providing SDR compatibility. The solution is based on a pre-encoding HDR-to-SDR conversion, generating a backward compatible SDR video, with side dynamic metadata. The resulting SDR video is then compressed, distributed and decoded using standard-compliant decoders (e.g. HEVC Main 10 compliant). The decoded SDR video can be directly rendered on SDR displays without adaptation. Dynamic metadata of limited size are generated by the pre-processing and used to reconstruct the HDR signal from the decoded SDR video, using a post-processing that is the functional inverse of the pre-processing. Both HDR quality and artistic intent are preserved. Pre- and post-processing are applied independently per picture, do not involve any inter-pixel dependency, and are codec agnostic. Compression performance, and SDR quality are shown to be solidly improved compared to the non-backward and backward-compatible approaches, respectively using the Perceptual Quantization (PQ) and Hybrid Log Gamma (HLG) Opto-Electronic Transfer Functions (OETF).

  11. A review of nonstandardized applicators digitization in Nucletron™ HDR procedures.

    PubMed

    Wang, Kelin; Ferenci, Michele S; de la Zerda, Alberto; Padgett, Kyle R; Bossart, Elizabeth L; Chao, Ming; Shao, Hua; Zhang, Mutain

    2017-09-01

    The major errors in HDR procedures were failures to enter the correct treatment distance, which could be caused by either entering wrong transmission lengths or imprecisely digitizing the dwelling positions. Most of those errors were not easily avoidable by enhancing the HDR management level because they were caused by implementations of nonstandardized applicators utilizing transmission tubes of different lengths in standard HDR procedures. We performed this comprehensive study to include all possible situations with different nonstandardized applicators that frequently occurred in HDR procedures, provide corresponding situations with standard applicator as comparisons, list all possible errors and in planning, clarify the confusions in offsets setting, and provide mathematical and quantitative solutions for each given scenarios. Training on HDR procedures with nonstandardized applicators are normally not included in most residential program for medical physics, thus this study could be meaningful in both clinical and educational purpose. At precision of 1 mm, our study could be used as the essential and practical reference for finding the correct treatment length as well as locating the accurate dwelling positions in any HDR procedure with nonstandardized applicators. © 2017 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

  12. The effect of split pixel HDR image sensor technology on MTF measurements

    NASA Astrophysics Data System (ADS)

    Deegan, Brian M.

    2014-03-01

    Split-pixel HDR sensor technology is particularly advantageous in automotive applications, because the images are captured simultaneously rather than sequentially, thereby reducing motion blur. However, split pixel technology introduces artifacts in MTF measurement. To achieve a HDR image, raw images are captured from both large and small sub-pixels, and combined to make the HDR output. In some cases, a large sub-pixel is used for long exposure captures, and a small sub-pixel for short exposures, to extend the dynamic range. The relative size of the photosensitive area of the pixel (fill factor) plays a very significant role in the output MTF measurement. Given an identical scene, the MTF will be significantly different, depending on whether you use the large or small sub-pixels i.e. a smaller fill factor (e.g. in the short exposure sub-pixel) will result in higher MTF scores, but significantly greater aliasing. Simulations of split-pixel sensors revealed that, when raw images from both sub-pixels are combined, there is a significant difference in rising edge (i.e. black-to-white transition) and falling edge (white-to-black) reproduction. Experimental results showed a difference of ~50% in measured MTF50 between the falling and rising edges of a slanted edge test chart.

  13. HDR video synthesis for vision systems in dynamic scenes

    NASA Astrophysics Data System (ADS)

    Shopovska, Ivana; Jovanov, Ljubomir; Goossens, Bart; Philips, Wilfried

    2016-09-01

    High dynamic range (HDR) image generation from a number of differently exposed low dynamic range (LDR) images has been extensively explored in the past few decades, and as a result of these efforts a large number of HDR synthesis methods have been proposed. Since HDR images are synthesized by combining well-exposed regions of the input images, one of the main challenges is dealing with camera or object motion. In this paper we propose a method for the synthesis of HDR video from a single camera using multiple, differently exposed video frames, with circularly alternating exposure times. One of the potential applications of the system is in driver assistance systems and autonomous vehicles, involving significant camera and object movement, non- uniform and temporally varying illumination, and the requirement of real-time performance. To achieve these goals simultaneously, we propose a HDR synthesis approach based on weighted averaging of aligned radiance maps. The computational complexity of high-quality optical flow methods for motion compensation is still pro- hibitively high for real-time applications. Instead, we rely on more efficient global projective transformations to solve camera movement, while moving objects are detected by thresholding the differences between the trans- formed and brightness adapted images in the set. To attain temporal consistency of the camera motion in the consecutive HDR frames, the parameters of the perspective transformation are stabilized over time by means of computationally efficient temporal filtering. We evaluated our results on several reference HDR videos, on synthetic scenes, and using 14-bit raw images taken with a standard camera.

  14. FY 1996 Summary of Hot Dry Rock Geothermal Power Project

    SciTech Connect

    1996-12-31

    The report describes progress and status of the HDR project at Hijiori. The year was notable for a flow enhancement test of a system with two production wells in operation. Other items include a geochemical survey, reinterpretation of acoustic emission data from 1988 through 1995, borehole measurements to find intersections with fractures, a geological survey, preparation for modeling fractures, improvements in crack simulation in a reservoir analysis model, and environmental survey work. (DJE 2005)

  15. HDR-del: A tool based on Hamming distance for prioritizing pathogenic chromosomal deletions in exome sequencing.

    PubMed

    Imai, Atsuko; Kohda, Masakazu; Kobayashi, Kaori; Hirata, Tomoko; Sakata, Yasushi; Murayama, Kei; Ohtake, Akira; Okazaki, Yasushi; Nakaya, Akihiro; Ott, Jurg

    2017-07-19

    High-density oligonucleotide arrays have been widely used to detect pathogenic chromosomal deletions. In addition to high-density oligonucleotide arrays, programs using whole exome sequencing have become available for estimating copy number variations using depth of coverage. Here we propose a new statistical method, HDR-del, to prioritize pathogenic chromosomal deletions based on Hamming distance in exome sequencing. In vcf (Variant Call Format) files generated from exome sequencing, hemizygous chromosomal deletion regions lack heterozygous variants and lead to apparent long runs of homozygosity (ROH). In our HDR-del approach, we calculate the "difference" in heterozygous status between an affected individual and control individuals using the Hamming Distance Ratio (HDR) over all candidate chromosomal deletion regions defined as ROH longer than 1Mbp. Using a suitable test statistic, which is expected to be large for a true pathogenic deletion region, we prioritize candidate chromosomal deletion regions based on this statistic. In our approach, we were able to considerably narrow down true pathogenic chromosomal deletion regions, which were confirmed by high-density oligonucleotide arrays in four mitochondrial disease patients. Our HDR-del approach represents an easy method for detecting chromosomal deletions. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  16. HDR quality assurance methods for personal digital assistants.

    PubMed

    Astrahan, Melvin A

    2004-01-01

    An important component of every clinical high-dose-rate (HDR) brachytherapy program is quality assurance (QA). One of the QA recommendations of the AAPM TG59 report is an independent verification on the results of treatment planning. It is desirable for the verification procedure to be as quick and easy to perform as possible and yet to have a high probability of detecting significant errors. The objective of this work is to describe the dosimetric methods and software developed to implement a departmental HDR QA program using personal digital assistants (PDAs). Verification of MammoSite treatment plans is presented as a practical example. PDAs that run the PalmOS were selected for their low cost and popularity among health care professionals. General-purpose applications were developed for linear sources, planar, and volume implants, that estimate the total dwell time of an HDR implant. This value can then be compared to the total dwell time calculated by the primary treatment planning system. The software incorporates the Paterson-Parker (PP) radium tables and the Greenfield-Tichman-Norman (GTN) version of the Quimby radium tables, which have been modified to a form more convenient for HDR calculations. A special purpose application based on the AAPM TG43 formalism was developed for the MammoSite breast applicator. For QA calculations perpendicular to the center of a single Iridium-192 (192I) HDR source, as exemplified by MammoSite treatments, linearly interpolating the PP or GTN tables is equivalent to applying the TG43 formalism at distances up to 5 cm from the source axis. The MammoSite-specific software also offers the option to calculate dosimetry based on the balloon volume. The PDA clock/calendar permits the software to automatically account for source decay. The touch-sensitive screen allows the familiar tabular format to be maintained while minimizing the effort required for calculations. The PP and GTN radium implant tables are easily modified to a form

  17. Optimizing parametrial aperture design utilizing HDR brachytherapy isodose distribution.

    PubMed

    Chapman, Katherine L; Ohri, Nitin; Showalter, Timothy N; Doyle, Laura A

    2013-03-01

    Treatment of cervical cancer includes combination of external beam radiation therapy (EBRT) and brachytherapy (BRT). Traditionally, coronal images displaying dose distribution from a ring and tandem (R&T) implant aid in construction of parametrial boost fields. This research aimed to evaluate a method of shaping parametrial fields utilizing contours created from the high-dose-rate (HDR) BRT dose distribution. Eleven patients receiving HDR-BRT via R&T were identified. The BRT and EBRT CT scans were sent to FocalSim (v4.62)(®) and fused based on bony anatomy. The contour of the HDR isodose line was transferred to the EBRT scan. The EBRT scan was sent to CMS-XIO (v4.62)(®) for planning. This process provides an automated, potentially more accurate method of matching the medial parametrial border to the HDR dose distribution. This allows for a 3D-view of dose from HDR-BRT for clinical decision-making, utilizes a paperless process and saves time over the traditional technique.

  18. Optimizing parametrial aperture design utilizing HDR brachytherapy isodose distribution

    PubMed Central

    Chapman, Katherine L.; Ohri, Nitin; Showalter, Timothy N.

    2013-01-01

    Treatment of cervical cancer includes combination of external beam radiation therapy (EBRT) and brachytherapy (BRT). Traditionally, coronal images displaying dose distribution from a ring and tandem (R&T) implant aid in construction of parametrial boost fields. This research aimed to evaluate a method of shaping parametrial fields utilizing contours created from the high-dose-rate (HDR) BRT dose distribution. Eleven patients receiving HDR-BRT via R&T were identified. The BRT and EBRT CT scans were sent to FocalSim (v4.62)® and fused based on bony anatomy. The contour of the HDR isodose line was transferred to the EBRT scan. The EBRT scan was sent to CMS-XIO (v4.62)® for planning. This process provides an automated, potentially more accurate method of matching the medial parametrial border to the HDR dose distribution. This allows for a 3D-view of dose from HDR-BRT for clinical decision-making, utilizes a paperless process and saves time over the traditional technique. PMID:23634156

  19. TU-C-201-02: Clinical Implementation of HDR: Afterloader and Applicator Selection

    SciTech Connect

    Esthappan, J.

    2015-06-15

    Recent use of HDR has increased while planning has become more complex often necessitating 3D image-based planning. While many guidelines for the use of HDR exist, they have not kept pace with the increased complexity of 3D image-based planning. Furthermore, no comprehensive document exists to describe the wide variety of current HDR clinical indications. This educational session aims to summarize existing national and international guidelines for the safe implementation of an HDR program. A summary of HDR afterloaders available on the market and their existing applicators will be provided, with guidance on how to select the best fit for each institution’s needs. Finally, the use of checklists will be discussed as a means to implement a safe and efficient HDR program and as a method by which to verify the quality of an existing HDR program. This session will provide the perspective of expert HDR physicists as well as the perspective of a new HDR user. Learning Objectives: Summarize national and international safety and staffing guidelines for HDR implementation Discuss the process of afterloader and applicator selection for gynecologic, prostate, breast, interstitial, surface treatments Learn about the use of an audit checklist tool to measure of quality control of a new or existing HDR program Describe the evolving use of checklists within an HDR program.

  20. TU-C-201-00: Clinical Implementation of HDR Brachytherapy

    SciTech Connect

    2015-06-15

    Recent use of HDR has increased while planning has become more complex often necessitating 3D image-based planning. While many guidelines for the use of HDR exist, they have not kept pace with the increased complexity of 3D image-based planning. Furthermore, no comprehensive document exists to describe the wide variety of current HDR clinical indications. This educational session aims to summarize existing national and international guidelines for the safe implementation of an HDR program. A summary of HDR afterloaders available on the market and their existing applicators will be provided, with guidance on how to select the best fit for each institution’s needs. Finally, the use of checklists will be discussed as a means to implement a safe and efficient HDR program and as a method by which to verify the quality of an existing HDR program. This session will provide the perspective of expert HDR physicists as well as the perspective of a new HDR user. Learning Objectives: Summarize national and international safety and staffing guidelines for HDR implementation Discuss the process of afterloader and applicator selection for gynecologic, prostate, breast, interstitial, surface treatments Learn about the use of an audit checklist tool to measure of quality control of a new or existing HDR program Describe the evolving use of checklists within an HDR program.

  1. FVP10: enhancements of VPX for SDR/HDR applications

    NASA Astrophysics Data System (ADS)

    Topiwala, Pankaj; Dai, Wei; Krishnan, Madhu

    2016-09-01

    This paper describes a study to investigate possible ways to improve the VPX codecs in the context of both 8-bit SDR video and 10-bit HDR video content, for two types of applications: streaming and high quality (near lossless) coding for content contribution editing. For SDR content, the following tools are investigated: (a) lapped biorthogonal transforms for near lossless applications; and (b) optimized resampling filter pairs for adaptive resolution coding in streaming applications. For HDR content, a data adaptive grading technique in conjunction with the VP9/VP10 encoder is studied. Both the objective metrics (measured using BD rate) and informal subjective visual quality assessments are recorded. It is asserted that useful improvements are possible in each of these categories. In particular, substantial value is offered in the coding of HDR content, and especially in creating a coding scheme offering backwards compatibility with SDR.

  2. Fast HDR image upscaling using locally adapted linear filters

    NASA Astrophysics Data System (ADS)

    Talebi, Hossein; Su, Guan-Ming; Yin, Peng

    2015-02-01

    A new method for upscaling high dynamic range (HDR) images is introduced in this paper. Overshooting artifact is the common problem when using linear filters such as bicubic interpolation. This problem is visually more noticeable while working on HDR images where there exist more transitions from dark to bright. Our proposed method is capable of handling these artifacts by computing a simple gradient map which enables the filter to be locally adapted to the image content. This adaptation consists of first, clustering pixels into regions with similar edge structures and second, learning the shape and length of our symmetric linear filter for each of these pixel groups. This new filter can be implemented in a separable fashion which perfectly fits hardware implementations. Our experimental results show that training our filter with HDR images can effectively reduce the overshooting artifacts and improve upon the visual quality of the existing linear upscaling approaches.

  3. Evaluating HDR photos using Web 2.0 technology

    NASA Astrophysics Data System (ADS)

    Qiu, Guoping; Mei, Yujie; Duan, Jiang

    2011-01-01

    High dynamic range (HDR) photography is an emerging technology that has the potential to dramatically enhance the visual quality and realism of digital photos. One of the key technical challenges of HDR photography is displaying HDR photos on conventional devices through tone mapping or dynamic range compression. Although many different tone mapping techniques have been developed in recent years, evaluating tone mapping operators prove to be extremely difficult. Web2.0, social media and crowd-sourcing are emerging Internet technologies which can be harnessed to harvest the brain power of the mass to solve difficult problems in science, engineering and businesses. Paired comparison is used in the scientific study of preferences and attitudes and has been shown to be capable of obtaining an interval-scale ordering of items along a psychometric dimension such as preference or importance. In this paper, we exploit these technologies for evaluating HDR tone mapping algorithms. We have developed a Web2.0 style system that enables Internet users from anywhere to evaluate tone mapped HDR photos at any time. We adopt a simple paired comparison protocol, Internet users are presented a pair of tone mapped images and are simply asked to select the one that they think is better or click a "no difference" button. These user inputs are collected in the web server and analyzed by a rank aggregation algorithm which ranks the tone mapped photos according to the votes they received. We present experimental results which demonstrate that the emerging Internet technologies can be exploited as a new paradigm for evaluating HDR tone mapping algorithms. The advantages of this approach include the potential of collecting large user inputs under a variety of viewing environments rather than limited user participation under controlled laboratory environments thus enabling more robust and reliable quality assessment. We also present data analysis to correlate user generated qualitative

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

    PubMed Central

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

    2010-01-01

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

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

    PubMed

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

    2010-06-01

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

  6. High dynamic range (HDR) virtual bronchoscopy rendering for video tracking

    NASA Astrophysics Data System (ADS)

    Popa, Teo; Choi, Jae

    2007-03-01

    In this paper, we present the design and implementation of a new rendering method based on high dynamic range (HDR) lighting and exposure control. This rendering method is applied to create video images for a 3D virtual bronchoscopy system. One of the main optical parameters of a bronchoscope's camera is the sensor exposure. The exposure adjustment is needed since the dynamic range of most digital video cameras is narrower than the high dynamic range of real scenes. The dynamic range of a camera is defined as the ratio of the brightest point of an image to the darkest point of the same image where details are present. In a video camera exposure is controlled by shutter speed and the lens aperture. To create the virtual bronchoscopic images, we first rendered a raw image in absolute units (luminance); then, we simulated exposure by mapping the computed values to the values appropriate for video-acquired images using a tone mapping operator. We generated several images with HDR and others with low dynamic range (LDR), and then compared their quality by applying them to a 2D/3D video-based tracking system. We conclude that images with HDR are closer to real bronchoscopy images than those with LDR, and thus, that HDR lighting can improve the accuracy of image-based tracking.

  7. 3D-image-guided HDR-brachytherapy versus 2D HDR - brachytherapy after external beam radiotherapy for early T-stage nasopharyngeal carcinoma.

    PubMed

    Ren, YuFeng; Zhao, QuanCheng; Liu, Hui; Huang, YingJuan; Wang, ZhenYu; Cao, XinPing; Teh, Bin S; Wen, BiXiu

    2014-11-29

    Two-dimensional high-dose-rate brachytherapy (2D-HDR-BT) is an effective method of dose escalation for local tumor control in early T-stage nasopharyngeal carcinoma (NPC). Treatment outcomes for 3D-image-guided high-dose-rate brachytherapy (3D-image-guided-HDR-BT) after external beam radiotherapy (ERT) have not been examined in early T-stage NPC patients. The current study was designed to evaluate whether addition of 3D-HDR-BT to ERT showed further improvement in treatment outcomes in patients with early T-stage NPC when compared to 2D-HDR-BT after ERT. The current study retrospectively analyzed and compared treatment outcomes for patients with nonmetastatic stage T1-2b NPC treated with 2D-HDR-BT (n =101) or 3D-HDR-BT (n =118) after ERT. Patients in both groups were treated with ERT at a mean dose of 60 Gy and a brachytherapy dose of 12Gy (8 ~ 20Gy), 2.5 ~ 5Gy per fraction under local anesthesia. Compared to patients treated with 2D-HDR-BT after ERT, patients treated with 3D-HDR-BT after ERT showed improvement in five-year actuarial local control survival rates (p = 0.024), local/regional relapse-free survival rates (p = 0.038), and disease-free survival rates (p = 0.021). Multivariate analysis showed that NPC patients treated with 3D-HDR-BT had improved local control survival (p = 0.042). The incidence rates of acute or chronic complications were similar between two groups. The current study showed that 3D-image-guided HDR-BT after ERT was an effective treatment modality for patients with stage T1-2 NPC with acceptable complications. The improvement in local tumor control and disease free survival is likely due to improved conformal dose distributions.

  8. Renal phenotypic variability in HDR syndrome: glomerular nephropathy as a novel finding.

    PubMed

    Chenouard, Alexis; Isidor, Bertrand; Allain-Launay, Emma; Moreau, Anne; Le Bideau, Marc; Roussey, Gwenaelle

    2013-01-01

    HDR syndrome (hypoparathyroidism, sensorineural deafness, renal abnormalities) (OMIM #146265) is a rare autosomal dominant disorder caused by mutations in the GATA-3 gene (OMIM 13120), a transcription factor coding for a protein involved in vertebrate embryonic development. More than a hundred cases with variable renal features have been described so far. Here, we report on a patient suffering from HDR syndrome with glomerular nephropathy. Hypoparathyroidism appeared early in childhood but the subsequent features of HDR occurred later in the form of bilateral sensorineural deafness and renal insufficiency associated with nephrocalcinosis. HDR was not initially diagnosed due to the appearance of a transitory cardiac involvement and atypical renal symptoms (diffuse proliferative glomerulonephritis characterized by a self-limiting nephrotic syndrome). HDR syndrome with glomerular nephropathy has not yet been reported to our knowledge. Further studies of GATA-3 are needed to explore the involvement of this transcription factor in the development of HDR in humans, particularly in the kidneys.

  9. Vitamin D deficiency in a patient with HDR syndrome.

    PubMed

    Kostoglou-Athanassiou, Ifigenia; Stefanopoulos, Dimitrios; Karfi, Areti; Athanassiou, Panagiotis

    2015-07-08

    The case of a patient with clinical symptoms, laboratory and imaging findings of hypoparathyroidism, sensorineural deafness, renal dysplasia HDR, or Barakat syndrome (hypoparathyroidism, deafness, renal dysplasia), and vitamin D deficiency, is presented. A Caucasian man aged 51 years with a history of chronic hypocalcaemia since childhood, was admitted with hypertonia of the body and extremities, and loss of consciousness. On admission, he was found to have severe hypocalcaemia, hyperphosphataemia, severe hypoparathyroidism, low serum magnesium and mild renal insufficiency. Calcium gluconate was administered intravenously supplemented with magnesium, and the patient recovered consciousness while clinical and laboratory findings improved. Evaluation revealed left renal aplasia and sensorineural deafness affecting both ears. Vitamin D deficiency was also present. He was given calcium and vitamin D supplements orally, and the hypocalcaemia was corrected. This case is described as it is an extremely rare case of HDR syndrome with concurrent vitamin D deficiency.

  10. A survey of quality control practices for high dose rate (HDR) and pulsed dose rate (PDR) brachytherapy in the United Kingdom.

    PubMed

    Palmer, Antony L; Bidmead, Margaret; Nisbet, Andrew

    2012-12-01

    A survey of quality control (QC) currently undertaken in UK radiotherapy centres for high dose rate (HDR) and pulsed dose rate (PDR) brachytherapy has been conducted. The purpose was to benchmark current accepted practice of tests, frequencies and tolerances to assure acceptable HDR/PDR equipment performance. It is 20 years since a similar survey was conducted in the UK and the current review is timed to coincide with a revision of the IPEM Report 81 guidelines for quality control in radiotherapy. ALL RADIOTHERAPY CENTRES IN THE UK WERE INVITED BY EMAIL TO COMPLETE A COMPREHENSIVE QUESTIONNAIRE ON THEIR CURRENT BRACHYTHERAPY QC PRACTICE, INCLUDING: equipment type, patient workload, source calibration method, level of image guidance for planning, prescribing practices, QC tests, method used, staff involved, test frequencies, and acceptable tolerance limits. Survey data was acquired between June and August 2012. Of the 64 centres invited, 47 (73%) responded, with 31 centres having brachytherapy equipment (3 PDR) and fully completing the survey, 13 reporting no HDR/PDR brachytherapy, and 3 intending to commence HDR brachytherapy in the near future. All centres had comprehensive QC schedules in place and there was general agreement on key test frequencies and tolerances. Greatest discord was whether source strength for treatment planning should be derived from measurement, as at 58% of centres, or from the certified value, at 42%. IPEM Report 81 continues to be the most frequently cited source of QC guidance, followed by ESTRO Booklet No. 8. A comprehensive survey of QC practices for HDR/PDR brachytherapy in UK has been conducted. This is a useful reference to which centres may benchmark their own practice. However, individuals should take a risk-assessment based approach, employing full knowledge of local equipment, clinical procedures and available test equipment in order to determine individual QC needs.

  11. Co-occurrence of 22q11 deletion syndrome and HDR syndrome.

    PubMed

    Fukai, Ryoko; Ochi, Nobuhiko; Murakami, Akira; Nakashima, Mitsuko; Tsurusaki, Yoshinori; Saitsu, Hirotomo; Matsumoto, Naomichi; Miyake, Noriko

    2013-10-01

    22q11 deletion syndrome is one of the most common chromosomal deletion syndromes and is usually caused by a 1.5-3.0 Mb deletion at chromosome 22q11.2. It is characterized by hypocalcemia resulting from hypoplasia of the parathyroid glands, hypoplasia of the thymus, and defects of the cardiac outflow tract. We encountered a Japanese boy presenting with an unusually severe phenotype of 22q11 deletion syndrome, including progressive renal failure and severe intellectual disabilities. Diagnostic testing using fluorescent in situ hybridization revealed deletion of the 22q11 region, but this did not explain the additional complications. Copy number analysis was therefore performed using whole genome single nucleotide polymorphism (SNP) assay, which identified an additional de novo deletion at 10p14. This region is the locus for hypoparathyroidism, deafness, and renal dysplasia (HDR) syndrome caused by haploinsufficiency of GATA3. Together, these two syndromes sufficiently explain the patient's phenotype. This is the first known case report of the co-occurrence of 22q11 deletion syndrome and HDR syndrome. As the two syndromes overlap clinically, this study indicates the importance of carrying out careful clinical and genetic assessment of patients with atypical clinical phenotypes or unique complications. Unbiased genetic analysis using whole genome copy number SNP arrays is especially useful for detecting such rare double mutations. Copyright © 2013 Wiley Periodicals, Inc.

  12. Artist's colour rendering of HDR scenes in 3D Mondrian colour-constancy experiments

    NASA Astrophysics Data System (ADS)

    Parraman, Carinna E.; McCann, John J.; Rizzi, Alessandro

    2010-01-01

    The presentation provides an update on ongoing research using three-dimensional Colour Mondrians. Two still life arrangements comprising hand-painted coloured blocks of 11 different colours were subjected to two different lighting conditions of a nearly uniform light and directed spotlights. The three-dimensional nature of these test targets adds shadows and multiple reflections, not found in flat Mondrian targets. Working from exactly the same pair of scenes, an author painted them using watercolour inks and paints to recreate both LDR and HDR Mondrians on paper. This provided us with a second set of appearance measurements of both scenes. Here we measured appearances by measuring reflectances of the artist's rendering. Land's Colour Mondrian extended colour constancy from a pixel to a complex scene. Since it used a planar array in uniform illumination, it did not measure the appearances of real life 3-D scenes in non-uniform illumination. The experiments in this paper, by simultaneously studying LDR and HDR renditions of the same array of reflectances, extend Land's Mondrian towards real scenes in non-uniform illumination. The results show that the appearances of many areas in complex scenes do not correlate with reflectance.

  13. Rendering of HDR content on LDR displays: an objective approach

    NASA Astrophysics Data System (ADS)

    Krasula, Lukáš; Narwaria, Manish; Fliegel, Karel; Le Callet, Patrick

    2015-09-01

    Dynamic range compression (or tone mapping) of HDR content is an essential step towards rendering it on traditional LDR displays in a meaningful way. This is however non-trivial and one of the reasons is that tone mapping operators (TMOs) usually need content-specific parameters to achieve the said goal. While subjective TMO parameter adjustment is the most accurate, it may not be easily deployable in many practical applications. Its subjective nature can also influence the comparison of different operators. Thus, there is a need for objective TMO parameter selection to automate the rendering process. To that end, we investigate into a new objective method for TMO parameters optimization. Our method is based on quantification of contrast reversal and naturalness. As an important advantage, it does not require any prior knowledge about the input HDR image and works independently on the used TMO. Experimental results using a variety of HDR images and several popular TMOs demonstrate the value of our method in comparison to default TMO parameter settings.

  14. WE-F-BRD-01: HDR Brachytherapy II: Integrating Imaging with HDR

    SciTech Connect

    Craciunescu, O; Todor, D; Leeuw, A de

    2014-06-15

    In recent years, with the advent of high/pulsed dose rate afterloading technology, advanced treatment planning systems, CT/MRI compatible applicators, and advanced imaging platforms, image-guided adaptive brachytherapy treatments (IGABT) have started to play an ever increasing role in modern radiation therapy. The most accurate way to approach IGABT treatment is to provide the infrastructure that combines in a single setting an appropriate imaging device, a treatment planning system, and a treatment unit. The Brachytherapy Suite is not a new concept, yet the modern suites are incorporating state-of-the-art imaging (MRI, CBCT equipped simulators, CT, and /or US) that require correct integration with each other and with the treatment planning and delivery systems. Arguably, an MRI-equipped Brachytherapy Suite is the ideal setup for real-time adaptive brachytherapy treatments. The main impediment to MRI-IGABT adoption is access to MRI scanners. Very few radiation oncology departments currently house MRI scanners, and even fewer in a dedicated Brachytherapy Suite. CBCT equipped simulators are increasingly offered by manufacturers as part of a Brachytherapy Suite installation. If optimized, images acquired can be used for treatment planning, or can be registered with other imaging modalities. This infrastructure is relevant for all forms of brachytherapy, especially those utilizing multi-fractionated courses of treatment such as prostate and cervix. Moreover, for prostate brachytherapy, US imaging systems can be part of the suite to allow for real-time HDR/LDR treatments. Learning Objectives: Understand the adaptive workflow of MR-based IGBT for cervical cancer. Familiarize with commissioning aspects of a CBCT equipped simulator with emphasis on brachytherapy applications Learn about the current status and future developments in US-based prostate brachytherapy.

  15. A comprehensive study on HDR brachytherapy treatments of cervical cancers: using the first Co-60 BEBIG Multisource Unit in Bangladesh.

    PubMed

    Malik, Sadiq R; Banu, Parvin A; Rukhsana, Naheed

    2011-06-01

    The report presents an extraordinary synthesis of customer acceptance procedures (CAP), quality assurance tests (QA) in the treatment of cervical cancer patients, using the first Co-60 Multisource Unit(®) in Bangladesh. The QA and commissioning required measurements and emergency tests verifying the functional limits of parameters acceptable for the new HDR afterloader. Acceptable limits were: 1) the deviation between specified and measured source strength: ± 3%; 2) the positional accuracy and uniformity: ± 1 mm; 3) the temporal accuracy (i.e. timer error and linearity and end error): ± 1% or 30 sec.; 4) treatment planning system (digitizer and localization software): ± 3% or 1 mm; 5) the distance from line to first dwell position and all the others: 5 mm and 10 mm (± 1 mm). Till February 2011, 47 patients were treated with HDR with more than 140 insertions applied. Amongst them, 12 patients were in stage IIB and IIIB, 22 were postoperative (IA and IB) while the remaining 13 patients were with unknown stage. All the cases with stage IIB and IIIB received concurrent chemo-radiation and brachytherapy. Postoperative patients received EBRT (50 Gy and HDR) according to the institutional protocol. CT scans were completed before HDR-plus planning with a good reproducibility (± 2%) and were documented in repeating the plan for the same set up of a patient. Absorbed dose (Gy) to a point P, at a distance of "r" in centimeters from a source of the Reference Air Kerma Rate (RAKR) has been utilized for the QA of the source, where source strength measurement was accomplished. All methods and analysis applicable to the QA and commissioning of Co-60 have been investigated and systematically analyzed, measured and documented before the treatment of a patient. Studies and safety requirements of this HDR remote afterloader were carried out. Acceptance and the QA were imperative to justify functionality and dependability in delivering the treatment. Implications of these

  16. SU-E-T-548: Case Study of HDR Vs IMRT in Pediatric Sarcomas.

    PubMed

    Chinsky, B; Vatner, R; Narayana, A; Becker, S J

    2012-06-01

    To compare the dose to critical structures using HDR brachytherapy versus IMRT in pediatric tumors. Two sarcoma cases, for which both HDR and IMRT could be options, were selected for this case study. Case 1 targeted a volume on the posterior neck/upper back with an HDR prescription of 600cGy × 5 fractions, 3000cGy total. The IMRT prescription used was 180cGy × 25 fractions, 4500cGy total with a boost of 180cGy × 6 fractions, 1080cGy. The IMRT PTV used was a 0.5cmexpansion of the HDR PTV; the boost PTV was identical to the HDR treatment plan. Case 2 targeted a volume on the palette of the mouth with an HDR prescription of 300cGy × 12 fractions, 3600cGy total. The IMRT prescription used was 180cGy × 28 fractions, 5040cGy total. A 0.5cm expansion of the HDR PTV was used for the IMRT PTV. In both cases, for both HDR and IMRT, at least 95% of the PTV received 100% prescription dose, following Children's Oncology Group protocols. Case 1 : the mean doses to the body, brachial plexus, esophagus, spinal cord and thyroid were higher using IMRT than HDR. Integral dose was 6.6 times higher using IMRT than HDR. Case 2: the mean doses to the body, mandible, and parotids were higher using IMRT than HDR. Integral dose was 2.9 times higher using IMRT than HDR. This study shows the potential benefit of treating with HDR compared to IMRT in select pediatric cases. These results suggest that HDR can be superior to IMRT in the sparing of critical structures and in delivering less integral dose to the patient while still achieving adequate target coverage. However, lower mean doses to critical structures must also be weighed against the possibility of complications from HDR's very high hotspots. © 2012 American Association of Physicists in Medicine.

  17. SU-E-T-124: Dosimetric Comparison of HDR Brachytherapy and Intensity Modulated Proton Therapy

    SciTech Connect

    Wu, J; Wu, H; Das, I

    2014-06-01

    Purpose: Brachytherapy is known to be able to deliver more radiation dose to tumor while minimizing radiation dose to surrounding normal tissues. Proton therapy also provides superior dose distribution due to Bragg peak. Since both HDR and Intensity Modulated Proton Therapy (IMPT) are beneficial for their quick dose drop off, our goal in this study is to compare the pace of dose gradient drop-off between HDR and IMPT plans based on the same CT image data-set. In addition, normal tissues sparing were also compared among HDR, IMPT and SBRT. Methods: Five cervical cancer cases treated with EBRT + HDR boost combination with Tandem and Ovoid applicator were used for comparison purpose. Original HDR plans with prescribed dose of 5.5 Gy x 5 fractions were generated and optimized. The 100% isodose line of HDR plans was converted to a dose volume, and treated as CTV for IMPT and SBRT planning. The same HDR CT scans were also used for IMPT plan and SBRT plan for direct comparison. The philosophy of the IMPT and SBRT planning was to create the same CTV coverage as HDR plans. All three modalities treatment plans were compared to each other with a set of predetermined criteria. Results: With similar target volume coverage in cervix cancer boost treatment, HDR provides a slightly sharper dose drop-off from 100% to 50% isodose line, averagely in all directions compared to IMPT. However, IMPT demonstrated more dose gradient drop-off at the junction of the target and normal tissues by providing more normal tissue sparing and superior capability to reduce integral dose. Conclusion: IMPT is capable of providing comparable dose drop-off as HDR. IMPT can be explored as replacement for HDR brachytherapy in various applications.

  18. TU-C-201-01: Clinical Implementation of HDR: A New User’s Perspective

    SciTech Connect

    Al-Hallaq, H.

    2015-06-15

    Recent use of HDR has increased while planning has become more complex often necessitating 3D image-based planning. While many guidelines for the use of HDR exist, they have not kept pace with the increased complexity of 3D image-based planning. Furthermore, no comprehensive document exists to describe the wide variety of current HDR clinical indications. This educational session aims to summarize existing national and international guidelines for the safe implementation of an HDR program. A summary of HDR afterloaders available on the market and their existing applicators will be provided, with guidance on how to select the best fit for each institution’s needs. Finally, the use of checklists will be discussed as a means to implement a safe and efficient HDR program and as a method by which to verify the quality of an existing HDR program. This session will provide the perspective of expert HDR physicists as well as the perspective of a new HDR user. Learning Objectives: Summarize national and international safety and staffing guidelines for HDR implementation Discuss the process of afterloader and applicator selection for gynecologic, prostate, breast, interstitial, surface treatments Learn about the use of an audit checklist tool to measure of quality control of a new or existing HDR program Describe the evolving use of checklists within an HDR program.

  19. High dynamic range optical projection tomography (HDR-OPT).

    PubMed

    Fei, Peng; Yu, Zhilong; Wang, Xu; Lu, Peter J; Fu, Yusi; He, Zi; Xiong, Jingwei; Huang, Yanyi

    2012-04-09

    Traditional optical projection tomography (OPT) acquires a single image at each rotation angle, thereby suffering from limitations in CCD dynamic range; this conventional usage cannot resolve features in samples with highly heterogeneous absorption, such as in small animals with organs of varying size. We present a novel technique, applying multiple-exposure high dynamic range (HDR) imaging to OPT, and demonstrate its ability to resolve fine details in zebrafish embryos, without complicated chemical clearing. We implement the tomographic reconstruction algorithm on the GPU, yielding a performance increase of two orders of magnitude. These features give our method potential application in high-throughput, high-resolution in vivo 3D imaging.

  20. Redrilling of well EE-3 at the Los Alamos National Laboratory HDR (Hot Dry Rock) project

    SciTech Connect

    Schillo, J.C.; Nicholson, R.W.; Hendron, R.H.; Thomson, J.C.

    1987-01-01

    The successful sidetracking of well EE-3 and the drilling of well EE-3A proved that with detailed planning and by adjusting techniques based on previous experience at Fenton Hill, drilling can be accomplished with reduced risk. The primary drilling problems associated with drilling of hot, crystalline basement rock, are (a) abrasiveness between the downhole tools and the formations and (b) a crooked wellbore path. These were essentially eliminated by a specially designed drilling fluid and careful pre-planning of the directional drilling operations. These improvements have taken much of the risk out of drilling at the Fenton Hill Hot Dry Rock (HDR) Geothermal Test Site. The sidetracking of EE-3 and drilling of EE-3A were undertaken to complete the hydraulic connection between boreholes. Drilling through fractured regions indicated by the dense zones of microseismic activity increased the probability of success. EE-3 was sidetracked at 9373' and redrilled to a depth of 13,182'.

  1. A comprehensive evaluation of adaptive daily planning for cervical cancer HDR brachytherapy.

    PubMed

    Meerschaert, Rebecca; Nalichowski, Adrian; Burmeister, Jay; Paul, Arun; Miller, Steven; Hu, Zhenghui; Zhuang, Ling

    2016-11-01

    The purpose of this study was to evaluate adaptive daily planning for cervical cancer patients who underwent high-dose-rate intracavitary brachytherapy (HDR-BT) using comprehensive interfractional organ motion measurements. This study included 22 cervical cancer patients who underwent 5 fractions of HDR-BT. Regions of interest (ROIs) including high-risk clinical tumor volume (HR-CTV) and organs at risk (OARs) were manually contoured on daily CT images. All patients were clinically treated with adaptive daily plans (ADP), which involved ROI delineation and dose optimization at each treatment fraction. Single treatment plans (SP) were retrospectively generated by applying the first treatment fraction's dwell times adjusted for decay and dwell positions of the applicator to subsequent treatment fractions. Various existing similarity metrics were calculated for the ROIs to quantify interfractional organ variations. A novel similarity (JRARM) score was established, which combined both volumetric overlap metrics (DSC, JSC, and RVD) and distance metrics (ASD, MSD, and RMSD). Linear regression was performed to determine a relationship between interfractional organ variations of various similarity metrics and D2cc variations from both plans. Wilcoxon signed-rank tests were used to assess ADP and SP by comparing EQD2D2cc(α/β=3) for OARs. For interfractional organ variations, the sigmoid demonstrated the greatest variations based on the JRARM, DSC, and RMSD metrics. Comparisons between paired ROIs showed differences in metrics at each treatment fraction. RVD, MSD, and RMSD were found to be significantly correlated to D2cc variations for bladder and sigmoid. The comparison between plans found ADP provided lower EQD2 D2cc of OARs than SP. Specifically, the sigmoid demonstrated statistically significant dose variations (p=0.015). Substantial interfractional organ motion occurs during HDR-BT based on comprehensive measurements and may significantly affect D2cc of OARs. Adaptive

  2. A comprehensive evaluation of adaptive daily planning for cervical cancer HDR brachytherapy.

    PubMed

    Meerschaert, Rebecca; Nalichowski, Adrian; Burmeister, Jay; Paul, Arun; Miller, Steven; Hu, Zhenghui; Zhuang, Ling

    2016-11-08

    The purpose of this study was to evaluate adaptive daily planning for cervi-cal cancer patients who underwent high-dose-rate intracavitary brachytherapy (HDR-BT) using comprehensive interfractional organ motion measurements. This study included 22 cervical cancer patients who underwent 5 fractions of HDR-BT. Regions of interest (ROIs) including high-risk clinical tumor volume (HR-CTV) and organs at risk (OARs) were manually contoured on daily CT images. All patients were clinically treated with adaptive daily plans (ADP), which involved ROI delineation and dose optimization at each treatment fraction. Single treatment plans (SP) were retrospectively generated by applying the first treatment fraction's dwell times adjusted for decay and dwell positions of the applicator to subsequent treatment fractions. Various existing similarity metrics were calculated for the ROIs to quantify interfractional organ variations. A novel similarity (JRARM) score was established, which combined both volumetric overlap metrics (DSC, JSC, and RVD) and distance metrics (ASD, MSD, and RMSD). Linear regression was performed to determine a relationship between interfractional organ varia-tions of various similarity metrics and D2cc variations from both plans. Wilcoxon signed-rank tests were used to assess ADP and SP by comparing EQD2 D2cc (α/β = 3) for OARs. For interfractional organ variations, the sigmoid demonstrated the greatest variations based on the JRARM, DSC, and RMSD metrics. Comparisons between paired ROIs showed differences in metrics at each treatment fraction. RVD, MSD, and RMSD were found to be significantly correlated to D2cc varia-tions for bladder and sigmoid. The comparison between plans found ADP provided lower EQD2 D2cc of OARs than SP. Specifically, the sigmoid demonstrated sta-tistically significant dose variations (p = 0.015). Substantial interfractional organ motion occurs during HDR-BT based on comprehensive measurements and may significantly affect D2cc of OARs

  3. Expert viewing protocol performance study: the case of subjective evaluation of HDR coding

    NASA Astrophysics Data System (ADS)

    Baroncini, Vittorio; Baroncini, Giacomo; Topiwala, Pankaj

    2016-09-01

    This paper tries to examine the results of a subjective evaluation experiment, made by means of the new Expert Viewing Protocol, recently approved by ITU-R Study Group 6 [1]. The EVP subjective test was designed and performed to compare different HDR coding technologies during an MPEG meeting (San Diego, CA, February 2016) [2]. Thanks to the wide and enthusiastic participation of the MPEG experts to the subjective evaluation experiment, it was possible to collect data from a total of sixteen viewers; this allowed to perform a sort of "validation" of the performance of the EVP. The ITU-R Recommendation states that tests with nine viewers is sufficient to get acceptable results from an EVP experiment. In our case, having data from 16 viewers, it was possible to compute the MOS and the Confidence Interval data as if it were a standard subjective assessment experiment (which typically requires more viewers). This allowed a sort of "validation" of the results obtained using results from 9 experts only vs. the results obtained using the data from the 16 viewers. The analysis of the raw data showed a rather good conversion of the EVP results towards the results obtained using the full viewers' data set. The results of the EVP evaluation of MPEG HDR content was described in details in a previous paper [3], to which we defer for details on the EVP protocol procedure and rules. This paper instead tries to answer to a demand for further clarification on the "context" and "limitations of use" of the EVP when performed in alternative to a formal subjective experiment trial.

  4. An automated optimization tool for high-dose-rate (HDR) prostate brachytherapy with divergent needle pattern

    NASA Astrophysics Data System (ADS)

    Borot de Battisti, M.; Maenhout, M.; de Senneville, B. Denis; Hautvast, G.; Binnekamp, D.; Lagendijk, J. J. W.; van Vulpen, M.; Moerland, M. A.

    2015-10-01

    Focal high-dose-rate (HDR) for prostate cancer has gained increasing interest as an alternative to whole gland therapy as it may contribute to the reduction of treatment related toxicity. For focal treatment, optimal needle guidance and placement is warranted. This can be achieved under MR guidance. However, MR-guided needle placement is currently not possible due to space restrictions in the closed MR bore. To overcome this problem, a MR-compatible, single-divergent needle-implant robotic device is under development at the University Medical Centre, Utrecht: placed between the legs of the patient inside the MR bore, this robot will tap the needle in a divergent pattern from a single rotation point into the tissue. This rotation point is just beneath the perineal skin to have access to the focal prostate tumor lesion. Currently, there is no treatment planning system commercially available which allows optimization of the dose distribution with such needle arrangement. The aim of this work is to develop an automatic inverse dose planning optimization tool for focal HDR prostate brachytherapy with needle insertions in a divergent configuration. A complete optimizer workflow is proposed which includes the determination of (1) the position of the center of rotation, (2) the needle angulations and (3) the dwell times. Unlike most currently used optimizers, no prior selection or adjustment of input parameters such as minimum or maximum dose or weight coefficients for treatment region and organs at risk is required. To test this optimizer, a planning study was performed on ten patients (treatment volumes ranged from 8.5 cm3to 23.3 cm3) by using 2-14 needle insertions. The total computation time of the optimizer workflow was below 20 min and a clinically acceptable plan was reached on average using only four needle insertions.

  5. WE-E-BRD-01: HDR Brachytherapy I: Overview of Clinical Application and QA

    SciTech Connect

    Libby, B; Showalter, T

    2014-06-15

    With the increased usage of high dose rate (HDR) brachytherapy and the introduction of dedicated image guided brachytherapy suites, it is necessary to review the processes and procedures associated with safely delivering these treatments in the expedited time scales that dedicated treatment suites afford. The speakers will present the clinical aspects of switching from LDR to HDR treatments, including guidelines for patient selection, and the clinical outcomes comparing LDR to HDR. The speakers will also discuss the HDR treatment process itself, because the shortened clinical timeline involved with a streamlined scan/plan/treat workflow can introduce other issues. Safety and QA aspects involved with the streamlined process, including increased personnel required for parallel tasks, and possible interfering tasks causing delays in patient treatments will also be discussed. Learning Objectives: To understand the clinical aspects of HDR Brachytherapy, including common clinical indications, patient selection, and the evolving evidence in support of this therapeutic modality To review the current prominent clinical trials for HDR brachytherapy To interpret the established guidelines for HDR brachytherapy quality assurance for implementation into practical clinical settings. To introduce the basic requirements for image guided brachytherapy.

  6. No-Reference Quality Assessment of Tone-Mapped HDR Pictures.

    PubMed

    Kundu, Debarati; Ghadiyaram, Deepti; Bovik, Alan; Evans, Brian

    2017-03-22

    Being able to automatically predict digital picture quality, as perceived by human observers, has become important in many applications where humans are the ultimate consumers of displayed visual information. Standard dynamic range (SDR) images provide 8 bits/color/pixel. High dynamic range (HDR) images which are usually created from multiple exposures of the same scene, can provide 16 or 32 bits/color/pixel, but must be tonemapped to SDR for display on standard monitors. Multi-exposure fusion (MEF) techniques bypass HDR creation, by fusing the exposure stack directly to SDR format while aiming for aesthetically pleasing luminance and color distributions. Here we describe a new no-reference image quality assessment (NR IQA) model for HDR pictures that is based on standard measurements of the bandpass and on newlyconceived differential natural scene statistics (NSS) of HDR pictures. We derive an algorithm from the model which we call the HDR Image GRADient based Evaluator (HIGRADE). NSS models have previously been used to devise NR IQA models that effectively predict the subjective quality of SDR images, but they perform significantly worse on tonemapped HDR content. Towards ameliorating this we make here the following contributions: (1) We design HDR picture NR IQA models and algorithms using both standard space-domain NSS features as well as novel HDR-specific gradient based features that significantly elevate prediction performance, (2) We validate the proposed models on a large-scale crowdsourced HDR image database, and (3) We demonstrate that the proposed models also perform well on legacy natural SDR images. The software is available at: http://live.ece.utexas.edu/research/Quality/higradeRelease.zip.

  7. Dosimetric analysis and comparison of IMRT and HDR brachytherapy in treatment of localized prostate cancer.

    PubMed

    Murali, V; Kurup, P G G; Mahadev, P; Mahalakshmi, S

    2010-04-01

    Radical radiotherapy is one of the options for the management of prostate cancer. In external beam therapy, 3D conformal radiotherapy (3DCRT) and intensity modulated radiotherapy (IMRT) are the options for delivery of increased radiation dose, as vital organs are very close to the prostate and a higher dose to these structures leads to an increased toxicity. In brachytherapy, low dose rate brachytherapy with permanent implant of radioactive seeds and high dose rate brachytherapy (HDR) with remote after loaders are available. A dosimetric analysis has been made on IMRT and HDR brachytherapy plans. Ten cases from each IMRT and HDR brachytherapy have been taken for the study. The analysis includes comparison of conformity and homogeneity indices, D100, D95, D90, D80, D50, D10 and D5 of the target. For the organs at risk (OAR), namely rectum and bladder, V100, V90 and V50 are compared. In HDR brachytherapy, the doses to 1 cc and 0.1 cc of urethra have also been studied. Since a very high dose surrounds the source, the 300% dose volumes in the target and within the catheters are also studied in two plans, to estimate the actual volume of target receiving dose over 300%. This study shows that the prescribed dose covers 93 and 92% of the target volume in IMRT and HDR brachytherapy respectively. HDR brachytherapy delivers a much lesser dose to OAR, compared to the IMRT. For rectum, the V50 in IMRT is 34.0cc whilst it is 7.5cc in HDR brachytherapy. With the graphic optimization tool in HDR brachytherapy planning, the dose to urethra could be kept within 120% of the target dose. Hence it is concluded that HDR brachytherapy may be the choice of treatment for cancer of prostate in the early stage.

  8. Microseismicity and Stimulated Hydrogeologic Structures in HDR/HWR Reservoirs

    NASA Astrophysics Data System (ADS)

    Niitsuma, H.

    2006-12-01

    Fluid injection to enhance productivity in oil and geothermal reservoir has been widely conducted since 1980's. The fluid injection is also one of the key technologies to create artificial circulation system in Hot Dry Rock (HDR)/ Hot Wet Rock (HWR) geothermal development. It is advantageous for understanding fluid induced faulting to analyze the subsurface response during the fluid injections, because the injection processes are controlled and hydraulic data are recorded. Some of this information can be obtained from well logs such as flow, temperature, pressure, BHTV, FMI, etc. However, they only provide restricted information near the well. Microseismic monitoring is currently the best available method for obtaining three-dimensional information about reservoirs and fracture systems at locations remote from boreholes. The primary problem of the method is its location accuracy. When located with conventional location algorithms, the events are frequently seen to be distributed as a cloud with little macro- or microstructure. It is difficult to meaningfully correlate such images with logging data of existing wells. Therefore, information on detailed reservoir structure, fracture orientation, and hydraulic behavior cannot be obtained from the application of conventional microseismic location techniques. There have been considerable improvements in microseismic mapping technology in these fifteen years. Various techniques to reduce location error have been developed which include collapsing, doublet/multiplet analysis, double-difference method, and multiplet-clustering analysis. These high resolution mapping techniques demonstrate that the diffuse clouds obtained using conventional techniques are largely artefacts of location error, and reveal macro- and microstructures within the cloud that can be correlated with geological and hydraulic structures identified from well logs. These high-resolution seismic mapping techniques have been applied to the microseismic data

  9. Commissioning of a well type chamber for HDR and LDR brachytherapy applications: a review of methodology and outcomes.

    PubMed

    Mukwada, Godfrey; Neveri, Gabor; Alkhatib, Zaid; Waterhouse, David K; Ebert, Martin

    2016-03-01

    For safe and accurate dose delivery in brachytherapy, associated equipment is subject to commissioning and ongoing quality assurance (QA). Many centres depend on the use of a well-type chamber ('well chamber') for performing brachytherapy dosimetry. Documentation of well chamber commissioning is scarce despite the important role the chamber plays in the whole brachytherapy QA process. An extensive and structured commissioning of the HDR 1000 plus well chamber (Standard Imaging Inc, Middleton WI) for HDR and LDR dosimetry was undertaken at Sir Charles Gairdner Hospital. The methodology and outcomes of this commissioning is documented and presented as a guideline to others involved in brachytherapy. The commissioning tests described include mechanical integrity, leakage current, directional dependence, response, length of uniform response, the influence of insert holders, ion collection efficiency, polarity effect, accuracy of measured air kerma strength (S(K)) or reference air kerma rate (K(R)) and baseline setting (for ongoing constancy checks). For the HDR 1000 plus well chamber, some of the insert holders modify the response curve. The measured sweet length was 2.5 cm which is within 0.5% of that specified by the manufacturer. Correction for polarity was negligible (0.9999) and ion recombination was small (0.9994). Directional dependence was small (less than 0.2%) and leakage current was negligible. The measured K(R) for (192)Ir agreed within 0.11% compared with a second well chamber of similar model and was within 0.5% of that determined via a free-in-air measurement method. Routine constancy checks over a year agreed with the baseline within 0.4%.

  10. SU-C-202-02: A Comprehensive Evaluation of Adaptive Daily Planning for Cervical Cancer HDR Brachytherapy

    SciTech Connect

    Meerschaert, R; Paul, A; Zhuang, L; Nalichowski, A; Burmeister, J; Miller, A

    2016-06-15

    Purpose: To evaluate adaptive daily planning for cervical cancer patients who underwent high-dose-rate intra-cavitary brachytherapy (HDR-ICBT). Methods: This study included 22 cervical cancer patients who underwent 5 fractions of HDR ICBT. Regions of interest (ROIs) including high-risk clinical tumor volume (HR-CTV) and organs-at-risk (OARs) were manually contoured on daily CT images. All patients were treated with adaptive daily plans, which involved ROI delineation and dose optimization at each treatment fraction. Single treatment plans were retrospectively generated by applying the first treatment fraction’s dwell times adjusted for decay and dwell positions of the applicator to subsequent treatment fractions. Various existing similarity metrics were calculated for the ROIs to quantify interfractional organ variations. A novel similarity score (JRARM) was established, which combined both volumetric overlap metrics (DSC, JSC, and RVD) and distance metrics (ASD, MSD, and RMSD). Linear regression was performed to determine a relationship between inter-fractional organ variations of various similarity metrics and D2cc variations from both plans. Wilcoxon Signed Rank Tests were used to assess adaptive daily plans and single plans by comparing EQD2 D2cc (α/β=3) for OARs. Results: For inter-fractional organ variations, the sigmoid demonstrated the greatest variations based on the JRARM and DSC similarity metrics. Comparisons between paired ROIs showed differences in JRARM scores and DSCs at each treatment fraction. RVD, MSD, and RMSD were found to be significantly correlated to D2cc variations for bladder and sigmoid. The comparison between plans found that adaptive daily planning provided lower EQD2 D2cc of OARs than single planning, specifically for the sigmoid (p=0.015). Conclusion: Substantial inter-fractional organ motion can occur during HDR-BT, which may significantly affect D2cc of OARs. Adaptive daily planning provides improved dose sparing for OARs

  11. Direct measurement of instantaneous source speed for a HDR brachytherapy unit using an optical fiber based detector

    SciTech Connect

    Minamisawa, R. A.; Rubo, R. A.; Seraide, R. M.; Rocha, J. R. O.; Almeida, A.

    2010-10-15

    a radiation source in a HDR brachytherapy unit traveling from the unit safe to the end of the catheter and between interdwell distances. The method is feasible and accurate to implement on quality assurance tests and provides a unique database for efficient computational simulations of the transient dose.

  12. Penile cancer brachytherapy HDR mould technique used at the Holycross Cancer Center

    PubMed Central

    Kubicka-Mendak, Iwona; Łyczek, Jarosław; Pawłowski, Piotr; Stawiarska, Iwona; Miedzinska, Joanna; Banatkiewicz, Paweł; Łaskawska-Wiatr, Aldona; Wittych, Justyna

    2011-01-01

    The aim of this pictorial essay is to present the mould based HDR brachytherapy technique used at the Holycross Cancer Center for penile cancer patients. We use images to describe this method step by step. PMID:23346132

  13. Penile cancer brachytherapy HDR mould technique used at the Holycross Cancer Center.

    PubMed

    Matys, Robert; Kubicka-Mendak, Iwona; Lyczek, Jarosław; Pawłowski, Piotr; Stawiarska, Iwona; Miedzinska, Joanna; Banatkiewicz, Paweł; Laskawska-Wiatr, Aldona; Wittych, Justyna

    2011-12-01

    The aim of this pictorial essay is to present the mould based HDR brachytherapy technique used at the Holycross Cancer Center for penile cancer patients. We use images to describe this method step by step.

  14. SU-E-T-785: Using Systems Engineering to Design HDR Skin Treatment Operation for Small Lesions to Enhance Patient Safety

    SciTech Connect

    Saw, C; Baikadi, M; Peters, C; Brereton, H

    2015-06-15

    Purpose: Using systems engineering to design HDR skin treatment operation for small lesions using shielded applicators to enhance patient safety. Methods: Systems engineering is an interdisciplinary field that offers formal methodologies to study, design, implement, and manage complex engineering systems as a whole over their life-cycles. The methodologies deal with human work-processes, coordination of different team, optimization, and risk management. The V-model of systems engineering emphasize two streams, the specification and the testing streams. The specification stream consists of user requirements, functional requirements, and design specifications while the testing on installation, operational, and performance specifications. In implementing system engineering to this project, the user and functional requirements are (a) HDR unit parameters be downloaded from the treatment planning system, (b) dwell times and positions be generated by treatment planning system, (c) source decay be computer calculated, (d) a double-check system of treatment parameters to comply with the NRC regulation. These requirements are intended to reduce human intervention to improve patient safety. Results: A formal investigation indicated that the user requirements can be satisfied. The treatment operation consists of using the treatment planning system to generate a pseudo plan that is adjusted for different shielded applicators to compute the dwell times. The dwell positions, channel numbers, and the dwell times are verified by the medical physicist and downloaded into the HDR unit. The decayed source strength is transferred to a spreadsheet that computes the dwell times based on the type of applicators and prescribed dose used. Prior to treatment, the source strength, dwell times, dwell positions, and channel numbers are double-checked by the radiation oncologist. No dosimetric parameters are manually calculated. Conclusion: Systems engineering provides methodologies to

  15. SU-E-T-758: To Determine the Source Dwell Positions of HDR Brachytherapy Using 2D 729 Ion Chamber Array

    SciTech Connect

    Kumar, Syam; Sitha

    2015-06-15

    Purpose: Determination of source dwell positions of HDR brachytherapy using 2D 729 ion chamber array Methods: Nucletron microselectron HDR and PTW 2D array were used for the study. Different dwell positions were assigned in the HDR machine. Rigid interstitial needles and vaginal applicator were positioned on the 2D array. The 2D array was exposed for this programmed dwell positions. The positional accuracy of the source was analyzed after the irradiation of the 2D array. This was repeated for different dwell positions. Different test plans were transferred from the Oncentra planning system and irradiated with the same applicator position on the 2D array. The results were analyzed using the in house developed excel program. Results: Assigned dwell positions versus corresponding detector response were analyzed. The results show very good agreement with the film measurements. No significant variation found between the planned and measured dwell positions. Average dose response with 2D array between the planned and nearby dwell positions was found to be 0.0804 Gy for vaginal cylinder applicator and 0.1234 Gy for interstitial rigid needles. Standard deviation between the doses for all the measured dwell positions for interstitial rigid needle for 1 cm spaced positions were found to be 0.33 and 0.37 for 2cm spaced dwell positions. For intracavitory vaginal applicator this was found to be 0.21 for 1 cm spaced dwell positions and 0.06 for 2cm spaced dwell positions. Intracavitory test plans reproduced on the 2D array with the same applicator positions shows the ideal dose distribution with the TPS planned. Conclusion: 2D array is a good tool for determining the dwell position of HDR brachytherapy. With the in-house developed program in excel it is easy and accurate. The traditional way with film analysis can be replaced by this method, as the films will be more costly.

  16. Transition from LDR to HDR brachytherapy for cervical cancer: Evaluation of tumor control, survival, and toxicity.

    PubMed

    Romano, K D; Pugh, K J; Trifiletti, D M; Libby, B; Showalter, T N

    In 2012, our institution transitioned from low-dose-rate (LDR) brachytherapy to high dose-rate (HDR) brachytherapy. We report clinical outcomes after brachytherapy for cervical cancer at our institution over a continuous 10-year period. From 2004 to 2014, 258 women (184 LDR and 74 HDR) were treated with tandem and ovoid brachytherapy in the multidisciplinary management of International Federation of Gynecology and Obstetrics Stages IA-IVB cervical cancer. Clinical and treatment-related prognostic factors including age, stage, smoking status, relevant doses, and toxicity data were recorded. Median followup for the LDR and HDR groups was 46 months and 12 months, respectively. The majority of patients (92%) received external beam radiotherapy as well as concurrent chemotherapy (83%) before the start of brachytherapy. For all stages, the 1-year local control and overall survival (OS) rates were comparable between the LDR and HDR groups (87% vs. 81%, p = 0.12; and 75% vs. 85%, p = 0.16), respectively. Factors associated with OS on multivariate analysis include age, stage, and nodal involvement. On multivariate analysis, severe toxicity (acute or chronic) was higher with HDR than LDR (24% vs. 10%, p = 0.04). Additional prognostic factors associated with increased severe toxicity include former/current smokers and total dose to lymph nodes. This comparative retrospective analysis of a large cohort of women treated with brachytherapy demonstrates no significant difference in OS or local control between the LDR and HDR. Acute and chronic toxicity increased shortly after the implementation of HDR, highlighting the importance of continued refinement of HDR methods, including integrating advanced imaging. Copyright © 2016 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  17. The emerging role of high-dose-rate (HDR) brachytherapy as monotherapy for prostate cancer

    PubMed Central

    Yoshioka, Yasuo; Yoshida, Ken; Yamazaki, Hideya; Nonomura, Norio; Ogawa, Kazuhiko

    2013-01-01

    High-dose-rate (HDR) brachytherapy as monotherapy is a comparatively new brachytherapy procedure for prostate cancer. In addition to the intrinsic advantages of brachytherapy, including radiation dose concentration to the tumor and rapid dose fall-off at the surrounding normal tissue, HDR brachytherapy can yield a more homogeneous and conformal dose distribution through image-based decisions for source dwell positions and by optimization of individual source dwell times. Indication can be extended even to T3a/b or a part of T4 tumors because the applicators can be positioned at the extracapsular lesion, into the seminal vesicles, and/or into the bladder, without any risk of source migration or dropping out. Unlike external beam radiotherapy, with HDR brachytherapy inter-/intra-fraction organ motion is not problematic. However, HDR monotherapy requires patients to stay in bed for 1–4 days during hospitalization, even though the actual overall treatment time is short. Recent findings that the α/β value for prostate cancer is less than that for the surrounding late-responding normal tissue has made hypofractionation attractive, and HDR monotherapy can maximize this advantage of hypofractionation. Research on HDR monotherapy is accelerating, with a growing number of publications reporting excellent preliminary clinical results due to the high ‘biologically effective dose (BED)’ of >200 Gy. Moreover, the findings obtained for HDR monotherapy as an early model of extreme hypofractionation tend to be applied to other radiotherapy techniques such as stereotactic radiotherapy. All these developments point to the emerging role of HDR brachytherapy as monotherapy for prostate cancer. PMID:23543798

  18. The emerging role of high-dose-rate (HDR) brachytherapy as monotherapy for prostate cancer.

    PubMed

    Yoshioka, Yasuo; Yoshida, Ken; Yamazaki, Hideya; Nonomura, Norio; Ogawa, Kazuhiko

    2013-09-01

    High-dose-rate (HDR) brachytherapy as monotherapy is a comparatively new brachytherapy procedure for prostate cancer. In addition to the intrinsic advantages of brachytherapy, including radiation dose concentration to the tumor and rapid dose fall-off at the surrounding normal tissue, HDR brachytherapy can yield a more homogeneous and conformal dose distribution through image-based decisions for source dwell positions and by optimization of individual source dwell times. Indication can be extended even to T3a/b or a part of T4 tumors because the applicators can be positioned at the extracapsular lesion, into the seminal vesicles, and/or into the bladder, without any risk of source migration or dropping out. Unlike external beam radiotherapy, with HDR brachytherapy inter-/intra-fraction organ motion is not problematic. However, HDR monotherapy requires patients to stay in bed for 1-4 days during hospitalization, even though the actual overall treatment time is short. Recent findings that the α/β value for prostate cancer is less than that for the surrounding late-responding normal tissue has made hypofractionation attractive, and HDR monotherapy can maximize this advantage of hypofractionation. Research on HDR monotherapy is accelerating, with a growing number of publications reporting excellent preliminary clinical results due to the high 'biologically effective dose (BED)' of >200 Gy. Moreover, the findings obtained for HDR monotherapy as an early model of extreme hypofractionation tend to be applied to other radiotherapy techniques such as stereotactic radiotherapy. All these developments point to the emerging role of HDR brachytherapy as monotherapy for prostate cancer.

  19. Commissioning and quality assurance procedures for the HDR Valencia skin applicators

    PubMed Central

    Granero, Domingo; Candela-Juan, Cristian; Ballester, Facundo; Ouhib, Zoubir; Vijande, Javier; Richart, Jose

    2016-01-01

    The Valencia applicators (Nucletron, an Elekta company, Elekta AB, Stockholm, Sweden) are cup-shaped tungsten applicators with a flattening filter used to collimate the radiation produced by a high-dose-rate (HDR) 192Ir source, and provide a homogeneous absorbed dose at a given depth. This beam quality provides a good option for the treatment of skin lesions at shallow depth (3-4 mm). The user must perform commissioning and periodic testing of these applicators to guarantee the proper and safe delivery of the intended absorbed dose, as recommended in the standards in radiation oncology. In this study, based on AAPM and GEC-ESTRO guidelines for brachytherapy units and our experience, a set of tests for the commissioning and periodic testing of the Valencia applicators is proposed. These include general considerations, verification of the manufacturer documentation and physical integrity, evaluation of the source-to-indexer distance and reproducibility, setting the library plan in the treatment planning system, evaluation of flatness and symmetry, absolute output and percentage depth dose verification, independent calculation of the treatment time, and visual inspection of the applicator before each treatment. For each test, the proposed methodology, equipment, frequency, expected results, and tolerance levels (when applicable) are provided. PMID:27895687

  20. Commissioning and quality assurance procedures for the HDR Valencia skin applicators.

    PubMed

    Granero, Domingo; Candela-Juan, Cristian; Ballester, Facundo; Ouhib, Zoubir; Vijande, Javier; Richart, Jose; Perez-Calatayud, Jose

    2016-10-01

    The Valencia applicators (Nucletron, an Elekta company, Elekta AB, Stockholm, Sweden) are cup-shaped tungsten applicators with a flattening filter used to collimate the radiation produced by a high-dose-rate (HDR) (192)Ir source, and provide a homogeneous absorbed dose at a given depth. This beam quality provides a good option for the treatment of skin lesions at shallow depth (3-4 mm). The user must perform commissioning and periodic testing of these applicators to guarantee the proper and safe delivery of the intended absorbed dose, as recommended in the standards in radiation oncology. In this study, based on AAPM and GEC-ESTRO guidelines for brachytherapy units and our experience, a set of tests for the commissioning and periodic testing of the Valencia applicators is proposed. These include general considerations, verification of the manufacturer documentation and physical integrity, evaluation of the source-to-indexer distance and reproducibility, setting the library plan in the treatment planning system, evaluation of flatness and symmetry, absolute output and percentage depth dose verification, independent calculation of the treatment time, and visual inspection of the applicator before each treatment. For each test, the proposed methodology, equipment, frequency, expected results, and tolerance levels (when applicable) are provided.

  1. Biological effective dose evaluation in gynaecological brachytherapy: LDR and HDR treatments, dependence on radiobiological parameters, and treatment optimisation.

    PubMed

    Bianchi, C; Botta, F; Conte, L; Vanoli, P; Cerizza, L

    2008-10-01

    This study was undertaken to compare the biological efficacy of different high-dose-rate (HDR) and low-dose-rate (LDR) treatments of gynaecological lesions, to identify the causes of possible nonuniformity and to optimise treatment through customised calculation. The study considered 110 patients treated between 2001 and 2006 with external beam radiation therapy and/or brachytherapy with either LDR (afterloader Selectron, (137)Cs) or HDR (afterloader microSelectron Classic, (192)Ir). The treatments were compared in terms of biologically effective dose (BED) to the tumour and to the rectum (linear-quadratic model) by using statistical tests for comparisons between independent samples. The difference between the two treatments was statistically significant in one case only. However, within each technique, we identified considerable nonuniformity in therapeutic efficacy due to differences in fractionation schemes and overall treatment time. To solve this problem, we created a Microsoft Excel spreadsheet allowing calculation of the optimal treatment for each patient: best efficacy (BED(tumour)) without exceeding toxicity threshold (BED(rectum)). The efficacy of a treatment may vary as a result of several factors. Customised radiobiological evaluation is a useful adjunct to clinical evaluation in planning equivalent treatments that satisfy all dosimetric constraints.

  2. SU-E-T-254: Development of a HDR-BT QA Tool for Verification of Source Position with Oncentra Applicator Modeling

    SciTech Connect

    Kumazaki, Y; Miyaura, K; Hirai, R; Miyazawa, K; Makino, S; Tamaki, T; Shikama, N; Kato, S

    2015-06-15

    Purpose: To develop a High Dose Rate Brachytherapy (HDR-BT) quality assurance (QA) tool for verification of source position with Oncentra applicator modeling, and to report the results of radiation source positions with this tool. Methods: We developed a HDR-BT QA phantom and automated analysis software for verification of source position with Oncentra applicator modeling for the Fletcher applicator used in the MicroSelectron HDR system. This tool is intended for end-to-end tests that mimic the clinical 3D image-guided brachytherapy (3D-IGBT) workflow. The phantom is a 30x30x3 cm cuboid phantom with radiopaque markers, which are inserted into the phantom to evaluate applicator tips and reference source positions; positions are laterally shifted 10 mm from the applicator axis. The markers are lead-based and scatter radiation to expose the films. Gafchromic RTQA2 films are placed on the applicators. The phantom includes spaces to embed the applicators. The source position is determined as the distance between the exposed source position and center position of two pairs of the first radiopaque markers. We generated a 3D-IGBT plan with applicator modeling. The first source position was 6 mm from the applicator tips, and the second source position was 10 mm from the first source position. Results: All source positions were consistent with the exposed positions within 1 mm for all Fletcher applicators using in-house software. Moreover, the distance between source positions was in good agreement with the reference distance. Applicator offset, determined as the distance from the applicator tips at the first source position in the treatment planning system, was accurate. Conclusion: Source position accuracy of applicator modeling used in 3D-IGBT was acceptable. This phantom and software will be useful as a HDR-BT QA tool for verification of source position with Oncentra applicator modeling.

  3. Comparison of radiation shielding requirements for HDR brachytherapy using 169Yb and 192Ir sources.

    PubMed

    Lymperopoulou, G; Papagiannis, P; Sakelliou, L; Georgiou, E; Hourdakis, C J; Baltas, D

    2006-07-01

    169Yb has received a renewed focus lately as an alternative to 192Ir sources for high dose rate (HDR) brachytherapy. Following the results of a recent work by our group which proved 169Yb to be a good candidate for HDR prostate brachytherapy, this work seeks to quantify the radiation shielding requirements for 169Yb HDR brachytherapy applications in comparison to the corresponding requirements for the current 192Ir HDR brachytherapy standard. Monte Carlo simulation (MC) is used to obtain 169Yb and 192Ir broad beam transmission data through lead and concrete. Results are fitted to an analytical equation which can be used to readily calculate the barrier thickness required to achieve a given dose rate reduction. Shielding requirements for a HDR brachytherapy treatment room facility are presented as a function of distance, occupancy, dose limit, and facility workload, using analytical calculations for both 169Yb and 192Ir HDR sources. The barrier thickness required for 169Yb is lower than that for 192Ir by a factor of 4-5 for lead and 1.5-2 for concrete. Regarding 169Yb HDR brachytherapy applications, the lead shielding requirements do not exceed 15 mm, even in highly conservative case scenarios. This allows for the construction of a lead door in most cases, thus avoiding the construction of a space consuming, specially designed maze. The effects of source structure, attenuation by the patient, and scatter conditions within an actual treatment room on the above-noted findings are also discussed using corresponding MC simulation results.

  4. SU-F-BRA-04: Prostate HDR Brachytherapy with Multichannel Robotic System

    SciTech Connect

    Joseph, F Maria; Podder, T; Yu, Y

    2015-06-15

    Purpose: High-dose-rate (HDR) brachytherapy is gradually becoming popular in treating patients with prostate cancers. However, placement of the HDR needles at desired locations into the patient is challenging. Application of robotic system may improve the accuracy of the clinical procedure. This experimental study is to evaluate the feasibility of using a multichannel robotic system for prostate HDR brachytherapy. Methods: In this experimental study, the robotic system employed was a 6-DOF Multichannel Image-guided Robotic Assistant for Brachytherapy (MIRAB), which was designed and fabricated for prostate seed implantation. The MIRAB has the provision of rotating 16 needles while inserting them. Ten prostate HDR brachytherapy needles were simultaneously inserted using MIRAB into a commercially available prostate phantom. After inserting the needles into the prostate phantom at desired locations, 2mm thick CT slices were obtained for dosimetric planning. HDR plan was generated using Oncetra planning system with a total prescription dose of 34Gy in 4 fractions. Plan quality was evaluated considering dose coverage to prostate and planning target volume (PTV), with 3mm margin around prostate, as well as the dose limit to the organs at risk (OARs) following the American Brachytherapy Society (ABS) guidelines. Results: From the CT scan, it is observed that the needles were inserted straight into the desired locations and they were adequately spaced and distributed for a clinically acceptable HDR plan. Coverage to PTV and prostate were about 91% (V100= 91%) and 96% (V100=96%), respectively. Dose to 1cc of urethra, rectum, and bladder were within the ABS specified limits. Conclusion: The MIRAB was able to insert multiple needles simultaneously into the prostate precisely. By controlling the MIRAB to insert all the ten utilized needles into the prostate phantom, we could achieve the robotic HDR brachytherapy successfully. Further study for assessing the system

  5. Tracer measurements during long-term circulation of the Rosemanowes HDR geothermal system

    SciTech Connect

    Kwakwa, K.A.

    1988-01-01

    Circulation experiments have been in operation for over two years in the artificially stimulated hot dry rock (HDR) doublet of the Camborne School of Mines (CSM) research facility in Cornwall, England. During that period tracer tests have been run at intervals using inert and reactive compounds. Initially, the results of the inert tracer investigations showed that the active volume (indicated by modal and median volumes) of the circulating system was dormant. Then, after a period of sustained oscillation, notable increases in active volume were observed which depended on both the subsequent flow rate changes and circulation time. these dynamic changes had almost reached optimum values when a downhole pump was introduced in the production well. The drawdown in the production well caused a reduction of the modal volume, whilst the median volume remained almost the same. Since then, the active volume has remained unchanged and irresponsive to circulation time and flow rate. The results of the reactive tracer tests confirm increasing chemical reaction with increasing circulation time and correlate qualitatively with the opening of newer and hotter pathways within the reservoir. However, repeated production logs throughout the circulation have identified flow paths that have depleted thermally; a discrepancy that can be explained by the geometry of the system and the preferential downward reservoir growth.

  6. MAGIC with formaldehyde applied to dosimetry of HDR brachytherapy source

    NASA Astrophysics Data System (ADS)

    Marques; T; Fernandes; J; Barbi; G; Nicolucci; P; Baffa; O

    2009-05-01

    The use of polymer gel dosimeters in brachytherapy can allow the determination of three-dimensional dose distributions in large volumes and with high spatial resolution if an adequate calibration process is performed. One of the major issues in these experiments is the polymer gel response dependence on dose rate when high dose rate sources are used and the doses in the vicinity of the sources are to be determinated. In this study, the response of a modified MAGIC polymer gel with formaldehyde around an Iridium-192 HDR brachytherapy source is presented. Experimental results obtained with this polymer gel were compared with ionization chamber measurements and with Monte Carlo simulation with PENELOPE. A maximum difference of 3.10% was found between gel dose measurements and Monte Carlo simulation at a radial distance of 18 mm from the source. The results obtained show that the gel's response is strongly influenced by dose rate and that a different calibration should be used for the vicinity of the source and for regions of lower dose rates. The results obtained in this study show that, provided the proper calibration is performed, MAGIC with formaldehyde can be successfully used to accurate determinate dose distributions form high dose rate brachytherapy sources.

  7. NPIP: A skew line needle configuration optimization system for HDR brachytherapy

    SciTech Connect

    Siauw, Timmy; Cunha, Adam; Berenson, Dmitry; Atamtuerk, Alper; Hsu, I-Chow; Goldberg, Ken; Pouliot, Jean

    2012-07-15

    or fewer needles than the current HDR brachytherapy workflow. Combined with robot assisted brachytherapy, this system has the potential to reduce side effects associated with treatment. A physical trial should be done to test the implant feasibility of NPIP needle configurations.

  8. Efficacy and toxicity of MDR versus HDR brachytherapy for primary vaginal cancer.

    PubMed

    Rutkowski, T; Białas, B; Rembielak, A; Fijałkowski, M; Nowakowski, K

    2002-01-01

    The retrospective analysis includes a group of 50 patients with primary, invasive vaginal cancer treated with brachytherapy in the period of 1982-1993. Over 80% cases were squamous cell carcinoma. There were 14 patients in stage I according to FIGO classification and 20%, 36%, and 16% of patients in stage II, III and IV, respectively. Twenty one patients (42%) received MDR brachytherapy using Cs137 source, the remaining 29 (58%) were treated with HDR using Co60 or Ir192 sources. Among 50 patients 31 (62%) received also external beam irradiation. An overall 5-year actuarial disease-free survival was 40%, and it was 78.6% (11/14), 40% (4/10), 27.8% (5/18), 0% (0/8) for stage I, II, III and IV, respectively. For MDR or HDR5-year disease-free survival was 38% and 41%, respectively. No influence of dose rate on survival has been found (p=0.7). Local failure occurred in 20 patients (40%). Recurrences appeared in 10 patients (20%). Late complications rate was 0% and 17% for MDR and HDR, respectively. Effectiveness of brachytherapy MDR and HDR was similar, whereas serious late complications developed more often after HDR brachytherapy.

  9. BrachyView, a novel in-body imaging system for HDR prostate brachytherapy: Experimental evaluation

    SciTech Connect

    Safavi-Naeini, M.; Han, Z.; Alnaghy, S.; Cutajar, D.; Petasecca, M.; Lerch, M. L. F.; Rosenfeld, A. B.; Franklin, D. R.; Bucci, J.; Carrara, M.; Zaider, M.

    2015-12-15

    Purpose: This paper presents initial experimental results from a prototype of high dose rate (HDR) BrachyView, a novel in-body source tracking system for HDR brachytherapy based on a multipinhole tungsten collimator and a high resolution pixellated silicon detector array. The probe and its associated position estimation algorithms are validated and a comprehensive evaluation of the accuracy of its position estimation capabilities is presented. Methods: The HDR brachytherapy source is moved through a sequence of positions in a prostate phantom, for various displacements in x, y, and z. For each position, multiple image acquisitions are performed, and source positions are reconstructed. Error estimates in each dimension are calculated at each source position and combined to calculate overall positioning errors. Gafchromic film is used to validate the accuracy of source placement within the phantom. Results: More than 90% of evaluated source positions were estimated with an error of less than one millimeter, with the worst-case error being 1.3 mm. Experimental results were in close agreement with previously published Monte Carlo simulation results. Conclusions: The prototype of HDR BrachyView demonstrates a satisfactory level of accuracy in its source position estimation, and additional improvements are achievable with further refinement of HDR BrachyView’s image processing algorithms.

  10. Highly efficient CRISPR/HDR-mediated knock-in for mouse embryonic stem cells and zygotes.

    PubMed

    Wang, Bangmei; Li, Kunyu; Wang, Amy; Reiser, Michelle; Saunders, Thom; Lockey, Richard F; Wang, Jia-Wang

    2015-10-01

    The clustered regularly interspaced short palindromic repeat (CRISPR) gene editing technique, based on the non-homologous end-joining (NHEJ) repair pathway, has been used to generate gene knock-outs with variable sizes of small insertion/deletions with high efficiency. More precise genome editing, either the insertion or deletion of a desired fragment, can be done by combining the homology-directed-repair (HDR) pathway with CRISPR cleavage. However, HDR-mediated gene knock-in experiments are typically inefficient, and there have been no reports of successful gene knock-in with DNA fragments larger than 4 kb. Here, we describe the targeted insertion of large DNA fragments (7.4 and 5.8 kb) into the genomes of mouse embryonic stem (ES) cells and zygotes, respectively, using the CRISPR/HDR technique without NHEJ inhibitors. Our data show that CRISPR/HDR without NHEJ inhibitors can result in highly efficient gene knock-in, equivalent to CRISPR/HDR with NHEJ inhibitors. Although NHEJ is the dominant repair pathway associated with CRISPR-mediated double-strand breaks (DSBs), and biallelic gene knock-ins are common, NHEJ and biallelic gene knock-ins were not detected. Our results demonstrate that efficient targeted insertion of large DNA fragments without NHEJ inhibitors is possible, a result that should stimulate interest in understanding the mechanisms of high efficiency CRISPR targeting in general.

  11. BrachyView, a novel in-body imaging system for HDR prostate brachytherapy: Experimental evaluation.

    PubMed

    Safavi-Naeini, M; Han, Z; Alnaghy, S; Cutajar, D; Petasecca, M; Lerch, M L F; Franklin, D R; Bucci, J; Carrara, M; Zaider, M; Rosenfeld, A B

    2015-12-01

    This paper presents initial experimental results from a prototype of high dose rate (HDR) BrachyView, a novel in-body source tracking system for HDR brachytherapy based on a multipinhole tungsten collimator and a high resolution pixellated silicon detector array. The probe and its associated position estimation algorithms are validated and a comprehensive evaluation of the accuracy of its position estimation capabilities is presented. The HDR brachytherapy source is moved through a sequence of positions in a prostate phantom, for various displacements in x, y, and z. For each position, multiple image acquisitions are performed, and source positions are reconstructed. Error estimates in each dimension are calculated at each source position and combined to calculate overall positioning errors. Gafchromic film is used to validate the accuracy of source placement within the phantom. More than 90% of evaluated source positions were estimated with an error of less than one millimeter, with the worst-case error being 1.3 mm. Experimental results were in close agreement with previously published Monte Carlo simulation results. The prototype of HDR BrachyView demonstrates a satisfactory level of accuracy in its source position estimation, and additional improvements are achievable with further refinement of HDR BrachyView's image processing algorithms.

  12. Audiometric characteristics of a dutch family with a new mutation in GATA3 causing HDR syndrome.

    PubMed

    van Beelen, E; Leijendeckers, J M; Admiraal, R J C; Huygen, P L M; Hoefsloot, L H; Pennings, R J E; Snik, A F M; Kunst, H P M

    2014-01-01

    We present the case of a Dutch family with a new mutation (c523_528dup) in GATA3 causing HDR syndrome. HDR syndrome is characterised by hypoparathyroidism, deafness and renal defects. In this study, we describe the audiometric characteristics of 5 patients from this family. Their hearing impairment was congenital, bilateral and symmetric. Audiograms showed mild-to-moderate hearing impairment with a flat audiogram configuration. Higher frequencies tended to be affected more strongly. Cross-sectional analyses showed no progression, and a mean audiogram was established. Psychophysical measurements in 3 HDR patients - including speech reception in noise, loudness scaling, gap detection and difference limen for frequency - were obtained to assess hearing function in greater detail. Overall, the results of the psychophysical measurements indicated characteristics of outer hair cell loss. CT scanning showed no anomalies in 3 of the HDR patients. Although 2 patients displayed vestibular symptoms, no anomalies in the vestibular system were found by vestibulo-ocular examination. Our results are in agreement with the theory that outer hair cell malfunctioning can play a major role in HDR syndrome.

  13. FV10: an efficient single-layer approach to HDR coding, with backward compatibility options

    NASA Astrophysics Data System (ADS)

    Topiwala, Pankaj; Dai, Wei; Krishnan, Madhu

    2016-09-01

    High Dynamic Range and Wide Color Gamut (HDR/WCG) video is now at the forefront of modern broadcast and other video delivery systems. The efficient transmission and display of such video over diverse networks and systems is an important problem. This paper presents a novel, state of the art approach in HDR/WCG video coding (called FV10) which uses a new, fully automatic video data adaptive regrading process, which converts HDR to Standard Dynamic Range (SDR). Our method differs from one developed recently in standards committees (the Joint Collaborative Team on Video Coding, or JCT-VC, of ITU|ISO/IEC), based on the HEVC Main10 Profile as the core codec, which is an HDR10 compliant system ("anchor"). FV10 also works entirely within the framework of HEVC Main10 Profile, but makes greater use of existing SEI messages. Reconstructed video using our methods show a subjective visual quality superior to the output of an example HDR10 anchor. Moreover, a usable backwards compatible SDR video is obtained as a byproduct in the processing chain, allowing service efficiencies. Representative objective results for the system include: results for RGB-PSNR, DE100, MD100, tOSNR-XYZ were -46.0%, -21.6%, -29.6%, 16.2% respectively.

  14. Efficient precise knockin with a double cut HDR donor after CRISPR/Cas9-mediated double-stranded DNA cleavage.

    PubMed

    Zhang, Jian-Ping; Li, Xiao-Lan; Li, Guo-Hua; Chen, Wanqiu; Arakaki, Cameron; Botimer, Gary D; Baylink, David; Zhang, Lu; Wen, Wei; Fu, Ya-Wen; Xu, Jing; Chun, Noah; Yuan, Weiping; Cheng, Tao; Zhang, Xiao-Bing

    2017-02-20

    Precise genome editing via homology-directed repair (HDR) after double-stranded DNA (dsDNA) cleavage facilitates functional genomic research and holds promise for gene therapy. However, HDR efficiency remains low in some cell types, including some of great research and clinical interest, such as human induced pluripotent stem cells (iPSCs). Here, we show that a double cut HDR donor, which is flanked by single guide RNA (sgRNA)-PAM sequences and is released after CRISPR/Cas9 cleavage, increases HDR efficiency by twofold to fivefold relative to circular plasmid donors at one genomic locus in 293 T cells and two distinct genomic loci in iPSCs. We find that a 600 bp homology in both arms leads to high-level genome knockin, with 97-100% of the donor insertion events being mediated by HDR. The combined use of CCND1, a cyclin that functions in G1/S transition, and nocodazole, a G2/M phase synchronizer, doubles HDR efficiency to up to 30% in iPSCs. Taken together, these findings provide guidance for the design of HDR donor vectors and the selection of HDR-enhancing factors for applications in genome research and precision medicine.

  15. Error Analysis of non-TLD HDR Brachytherapy Dosimetric Techniques

    NASA Astrophysics Data System (ADS)

    Amoush, Ahmad

    The American Association of Physicists in Medicine Task Group Report43 (AAPM-TG43) and its updated version TG-43U1 rely on the LiF TLD detector to determine the experimental absolute dose rate for brachytherapy. The recommended uncertainty estimates associated with TLD experimental dosimetry include 5% for statistical errors (Type A) and 7% for systematic errors (Type B). TG-43U1 protocol does not include recommendation for other experimental dosimetric techniques to calculate the absolute dose for brachytherapy. This research used two independent experimental methods and Monte Carlo simulations to investigate and analyze uncertainties and errors associated with absolute dosimetry of HDR brachytherapy for a Tandem applicator. An A16 MicroChamber* and one dose MOSFET detectors† were selected to meet the TG-43U1 recommendations for experimental dosimetry. Statistical and systematic uncertainty analyses associated with each experimental technique were analyzed quantitatively using MCNPX 2.6‡ to evaluate source positional error, Tandem positional error, the source spectrum, phantom size effect, reproducibility, temperature and pressure effects, volume averaging, stem and wall effects, and Tandem effect. Absolute dose calculations for clinical use are based on Treatment Planning System (TPS) with no corrections for the above uncertainties. Absolute dose and uncertainties along the transverse plane were predicted for the A16 microchamber. The generated overall uncertainties are 22%, 17%, 15%, 15%, 16%, 17%, and 19% at 1cm, 2cm, 3cm, 4cm, and 5cm, respectively. Predicting the dose beyond 5cm is complicated due to low signal-to-noise ratio, cable effect, and stem effect for the A16 microchamber. Since dose beyond 5cm adds no clinical information, it has been ignored in this study. The absolute dose was predicted for the MOSFET detector from 1cm to 7cm along the transverse plane. The generated overall uncertainties are 23%, 11%, 8%, 7%, 7%, 9%, and 8% at 1cm, 2cm, 3cm

  16. Color appearance and color rendering of HDR scenes: an experiment

    NASA Astrophysics Data System (ADS)

    Parraman, Carinna; Rizzi, Alessandro; McCann, John J.

    2009-01-01

    In order to gain a deeper understanding of the appearance of coloured objects in a three-dimensional scene, the research introduces a multidisciplinary experimental approach. The experiment employed two identical 3-D Mondrians, which were viewed and compared side by side. Each scene was subjected to different lighting conditions. First, we used an illumination cube to diffuse the light and illuminate all the objects from each direction. This produced a low-dynamicrange (LDR) image of the 3-D Mondrian scene. Second, in order to make a high-dynamic range (HDR) image of the same objects, we used a directional 150W spotlight and an array of WLEDs assembled in a flashlight. The scenes were significant as each contained exactly the same three-dimensional painted colour blocks that were arranged in the same position in the still life. The blocks comprised 6 hue colours and 5 tones from white to black. Participants from the CREATE project were asked to consider the change in the appearance of a selection of colours according to lightness, hue, and chroma, and to rate how the change in illumination affected appearance. We measured the light coming to the eye from still-life surfaces with a colorimeter (Yxy). We captured the scene radiance using multiple exposures with a number of different cameras. We have begun a programme of digital image processing of these scene capture methods. This multi-disciplinary programme continues until 2010, so this paper is an interim report on the initial phases and a description of the ongoing project.

  17. Extreme retrofocus zoom lens for single-shot single-lens HDR photography and video

    NASA Astrophysics Data System (ADS)

    Vella, Anthony; Bentley, Julie

    2015-09-01

    Traditional high dynamic range (HDR) photography is performed by capturing multiple images of the same scene with different exposure times, which are then digitally combined to produce an image with great detail in both its light and dark areas. However, this method is not viable for moving subjects since the multiple exposures are not captured simultaneously. Recently an alternative method has been developed in which beamsplitters are utilized to simultaneously record the same image on three identical sensors at different illumination levels. This process enables single-shot HDR photography as well as continuous HDR video. This paper describes the design of a 2.5x zoom lens for use in this application. The design satisfies the challenging working distance and ray angle constraints imposed by the placement of two beamsplitters between the lens and the image plane. The particular importance of first-order layout when designing a retrofocus zoom lens is also discussed.

  18. Gafchromic film dosimetry of a new HDR 192Ir brachytherapy source.

    PubMed

    Ayoobian, Navid; Asl, Akbar Sarabi; Poorbaygi, Hosein; Javanshir, Mohammad Reza

    2016-03-08

    High-dose-rate (HDR) brachytherapy is a popular modality for treating cancers of the prostate, cervix, endometrium, breast, skin, bronchus, esophagus, and head and neck as well as soft-tissue sarcomas. Because of different source designs and licensing issues, there is a need for specific dosimetry dataset for each HDR source model. The main objective of the present work is to measure 2D relative dose distribution around a new prototype 192Ir source, referred to as IRAsource-HDR, in PMMA phantom in the framework of AAPM TG-43 and TG-55 recommendations for radial distances of 0.5cm to 4 cm. Radiochromic films (RCFs) Gafchromic EBT and HD-810 were used for measurements. The dose rate constant, Λ, of the source was determined to be 1.084± 4.6%, 1.129 ± 4.4%, and 1.112 ± 0.8% cGyh-1U-1 using EBT RCF, HD-810 RCF, and Monte Carlo (MC) simulation, respectively. The results obtained in this study are in good agreement with previously published data for HDR interstitial 192Ir-HDR sources with a maximum discrepancy of ± 4.5%. An acceptable agreement (within ± 2%) between MC calculations and RCFs measurements showed that HD-810 RCF dosimetry is as good as EBT RCF, within HDR brachytherapy, and justifies the use of specific data for this new source. These data could be used as a benchmark for dose calculations in the conventional brachytherapy treatment planning systems.

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

    PubMed

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

    2014-01-06

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

  20. SU-D-19A-07: Dosimetric Comparison of HDR Plesiotherapy and Electron Beam Therapy for Superficial Lesions

    SciTech Connect

    Mitchell, A; Jacob, D; Andreou, K; Raben, A; Chen, H; Koprowski, C; Mourtada, F

    2014-06-01

    Purpose: Large superficial (skin, soft tissue sarcoma) lesions located on curved areas are hard to treat with electrons. The Freiburg Flap (Nucletron, Netherlands) is a flexible mesh style surface which can be easily shaped to fit curved surfaces for reproducible HDR fraction delivery. To understand the fundamental dosimetric differences, a dosimetric comparison was made between HDR plesiotherapy (Freiburg applicator for lesions over 4cm) and external electron beam radiotherapy over cases with varying target curvature (both stylized and clinical cases). Methods: Four stylized cases with variable complexity were created using artificial DICOM axial CT slices and RT structures (a square and three curved structures on a 4.5cm radius cylinder). They were planned using Oncentra v4.3 and exported to Pinnacle v9.6 for electrons planning. The HDR source dwell positions were optimized for the best coverage of the targets using graphical optimization. Electron treatment plans were created in Pinnacle using the same CT and RT structures of three HDR cases with surface lesions previously treated with the Freiburg flap. The En face electron plans used 6-12 MeV electrons and 0.5–1 cm bolus was added to increase surface dose. The electron plans were prescribed to an isodose line to conform to the target. Results: For all lesions, the average target dose coverage was similar (D90ave of 100% for HDR vs 101% for electrons). For lesions with high curvature, the HDR coverage was better (D90 102% vs D90 97% for electron). For all cases, adjacent structures high dose region was lower for HDR than electrons (D1cc 100% for HDR vs D1cc 111% for electrons). Conclusion: HDR plesiotherapy offers excellent target conformity for superficial targets similar to electrons. However, for lesions with complex curved surfaces, HDR has the advantage to achieve better dose distributions using graphical optimization to spare adjacent normal tissue while maximizing target coverage.

  1. Trans-Pacific HDR Satellite Communications Experiment Phase-2 Project Plan and Experimental Network

    NASA Technical Reports Server (NTRS)

    Hsu, Eddie; Kadowaki, Naoto; Yoshimura, Naoko; Takahashi, Takashi; Yoshikawa, Makoto; Bergman, Larry; Bhasin, Kul

    2000-01-01

    The trans-Pacific high data rate (TP-HDR) satellite communications experiment was proposed at the Japan-U.S. Cooperation in Space (JUCS) Program Workshop held in Hawaii in 1993 and remote high definition video post-production was demonstrated as the first phase trial. ATM-based 45 Mbps trans-Pacific link was established in the first phase, and the following experiments with 155 Mbps was planned as the phase 2. This paper describes the experimental network configuration and project plan of TP-HDR experiment phase 2. Additional information is provided in the original.

  2. Trans-Pacific HDR Satellite Communications Experiment Phase-2 Project Plan and Experimental Network

    NASA Technical Reports Server (NTRS)

    Hsu, Eddie; Kadowaki, Naoto; Yoshimura, Naoko; Takahashi, Takashi; Yoshikawa, Makoto; Bergman, Larry; Bhasin, Kul

    2000-01-01

    The trans-Pacific high data rate (TP-HDR) satellite communications experiment was proposed at the Japan-U.S. Cooperation in Space (JUCS) Program Workshop held in Hawaii in 1993 and remote high definition video post-production was demonstrated as the first phase trial. ATM-based 45 Mbps trans-Pacific link was established in the first phase, and the following experiments with 155 Mbps was planned as the phase 2. This paper describes the experimental network configuration and project plan of TP-HDR experiment phase 2. Additional information is provided in the original.

  3. Evaluation of BEBIG HDR 60Co system for non-invasive image-guided breast brachytherapy

    PubMed Central

    Zehtabian, Mehdi; Sina, Sedigheh; Rivard, Mark J.

    2015-01-01

    Purpose HDR 60Co system has recently been developed and utilized for brachytherapy in many countries outside of the U.S. as an alternative to 192Ir. In addition, the AccuBoost® technique has been demonstrated to be a successful non-invasive image-guided breast brachytherapy treatment option. The goal of this project is to evaluate the possibility of utilizing the BEBIG HDR 60Co system for AccuBoost treatment. These evaluations are performed with Monte Carlo (MC) simulation technique. Material and methods In this project, the MC calculated dose distributions from HDR 60Co for various breast sizes have been compared with the simulated data using an HDR 192Ir source. These calculations were performed using the MCNP5 code. The initial calculations were made with the same applicator dimensions as the ones used with the HDR 192Ir system (referred here after as standard applicator). The activity of the 60Co source was selected such that the dose at the center of the breast would be the same as the values from the 192Ir source. Then, the applicator wall-thickness for the HDR 60Co system was increased to diminish skin dose to levels received when using the HDR 192Ir system. With this geometry, dose values to the chest wall and the skin were evaluated. Finally, the impact of a conical attenuator with the modified applicator for the HDR 60Co system was analyzed. Results These investigations demonstrated that loading the 60Co sources inside the thick-walled applicators created similar dose distributions to those of the 192Ir source in the standard applicators. However, dose to the chest wall and breast skin with 60Co source was reduced using the thick-walled applicators relative to the standard applicators. The applicators with conical attenuator reduced the skin dose for both source types. Conclusions The AccuBoost treatment can be performed with the 60Co source and thick-wall applicators instead of 192Ir with standard applicators. PMID:26816504

  4. Evaluation of BEBIG HDR (60)Co system for non-invasive image-guided breast brachytherapy.

    PubMed

    Zehtabian, Mehdi; Sina, Sedigheh; Rivard, Mark J; Meigooni, Ali S

    2015-12-01

    HDR (60)Co system has recently been developed and utilized for brachytherapy in many countries outside of the U.S. as an alternative to (192)Ir. In addition, the AccuBoost(®) technique has been demonstrated to be a successful non-invasive image-guided breast brachytherapy treatment option. The goal of this project is to evaluate the possibility of utilizing the BEBIG HDR (60)Co system for AccuBoost treatment. These evaluations are performed with Monte Carlo (MC) simulation technique. In this project, the MC calculated dose distributions from HDR (60)Co for various breast sizes have been compared with the simulated data using an HDR (192)Ir source. These calculations were performed using the MCNP5 code. The initial calculations were made with the same applicator dimensions as the ones used with the HDR (192)Ir system (referred here after as standard applicator). The activity of the (60)Co source was selected such that the dose at the center of the breast would be the same as the values from the (192)Ir source. Then, the applicator wall-thickness for the HDR (60)Co system was increased to diminish skin dose to levels received when using the HDR (192)Ir system. With this geometry, dose values to the chest wall and the skin were evaluated. Finally, the impact of a conical attenuator with the modified applicator for the HDR (60)Co system was analyzed. These investigations demonstrated that loading the (60)Co sources inside the thick-walled applicators created similar dose distributions to those of the (192)Ir source in the standard applicators. However, dose to the chest wall and breast skin with (60)Co source was reduced using the thick-walled applicators relative to the standard applicators. The applicators with conical attenuator reduced the skin dose for both source types. The AccuBoost treatment can be performed with the (60)Co source and thick-wall applicators instead of (192)Ir with standard applicators.

  5. A prospective cohort study to compare treatment results between 2 fractionation schedules of high-dose-rate intracavitary brachytherapy (HDR-ICBT) in patients with cervical cancer.

    PubMed

    Huang, Eng-Yen; Sun, Li-Min; Lin, Hao; Lan, Jen-Hong; Chanchien, Chan-Chao; Huang, Yu-Jie; Wang, Chang-Yu; Wang, Chong-Jong

    2013-01-01

    To compare the treatment results of 2 fractionation schedules for high-dose-rate intracavitary brachytherapy (HDR-ICBT) in patients with cervical cancer. From June 2001 through January 2008, 267 patients with stage IB-IVA cervical cancer were enrolled in the study. All patients underwent 4-field pelvic irradiation and HDR-ICBT. The median central and parametrial doses were 39.6 Gy and 45 Gy, respectively. Patient underwent either 6 Gy×4 (HDR-4) (n=144) or 4.5 Gy×6 (HDR-6) (n=123) to point A of ICBT using 192Ir isotope twice weekly. The rates of overall survival, locoregional failure, distant metastasis, proctitis, cystitis, and enterocolitis were compared between HDR-4 and HDR-6. There were no significant differences in the demographic data between HDR-4 and HDR-6 except for total treatment time. The 5-year proctitis rates were 23.0% and 21.5% in HDR-4 and HDR-6 (P=.399), respectively. The corresponding rates of grade 2-4 proctitis were 18.7% and 9.6% (P=.060). The corresponding rates of grades 3-4 proctitis were 5.2% and 1.3% (P=.231). Subgroup analysis revealed that HDR-4 significantly increased grade 2-4 proctitis in patients aged≥62 years old (P=.012) but not in patients aged<62 years (P=.976). The rates of overall survival, locoregional failure, distant metastasis, cystitis, and enterocolitis were not significantly different between HDR-4 and HDR-6 schedules. The small fraction size of HDR-ICBT is associated with grade 2 proctitis without compromise of prognosis in elderly patients. This schedule is suggested for patients who tolerate an additional 2 applications of HDR-ICBT. Copyright © 2013 Elsevier Inc. All rights reserved.

  6. A Prospective Cohort Study to Compare Treatment Results Between 2 Fractionation Schedules of High-Dose-Rate Intracavitary Brachytherapy (HDR-ICBT) in Patients With Cervical Cancer

    SciTech Connect

    Huang, Eng-Yen; Sun, Li-Min; Lin, Hao; Lan, Jen-Hong; Chanchien, Chan-Chao; Huang, Yu-Jie; Wang, Chang-Yu; Wang, Chong-Jong

    2013-01-01

    Purpose: To compare the treatment results of 2 fractionation schedules for high-dose-rate intracavitary brachytherapy (HDR-ICBT) in patients with cervical cancer. Methods and Materials: From June 2001 through January 2008, 267 patients with stage IB-IVA cervical cancer were enrolled in the study. All patients underwent 4-field pelvic irradiation and HDR-ICBT. The median central and parametrial doses were 39.6 Gy and 45 Gy, respectively. Patient underwent either 6 Gy Multiplication-Sign 4 (HDR-4) (n=144) or 4.5 Gy Multiplication-Sign 6 (HDR-6) (n=123) to point A of ICBT using {sup 192}Ir isotope twice weekly. The rates of overall survival, locoregional failure, distant metastasis, proctitis, cystitis, and enterocolitis were compared between HDR-4 and HDR-6. Results: There were no significant differences in the demographic data between HDR-4 and HDR-6 except for total treatment time. The 5-year proctitis rates were 23.0% and 21.5% in HDR-4 and HDR-6 (P=.399), respectively. The corresponding rates of grade 2-4 proctitis were 18.7% and 9.6% (P=.060). The corresponding rates of grades 3-4 proctitis were 5.2% and 1.3% (P=.231). Subgroup analysis revealed that HDR-4 significantly increased grade 2-4 proctitis in patients aged {>=}62 years old (P=.012) but not in patients aged <62 years (P=.976). The rates of overall survival, locoregional failure, distant metastasis, cystitis, and enterocolitis were not significantly different between HDR-4 and HDR-6 schedules. Conclusion: The small fraction size of HDR-ICBT is associated with grade 2 proctitis without compromise of prognosis in elderly patients. This schedule is suggested for patients who tolerate an additional 2 applications of HDR-ICBT.

  7. Evaluation of PC-ISO for customized, 3D printed, gynecologic 192Ir HDR brachytherapy applicators.

    PubMed

    Cunha, J Adam M; Mellis, Katherine; Sethi, Rajni; Siauw, Timmy; Sudhyadhom, Atchar; Garg, Animesh; Goldberg, Ken; Hsu, I-Chow; Pouliot, Jean

    2015-01-01

    The purpose of this study was to evaluate the radiation attenuation properties of PC-ISO, a commercially available, biocompatible, sterilizable 3D printing material, and its suitability for customized, single-use gynecologic (GYN) brachytherapy applicators that have the potential for accurate guiding of seeds through linear and curved internal channels. A custom radiochromic film dosimetry apparatus was 3D-printed in PC-ISO with a single catheter channel and a slit to hold a film segment. The apparatus was designed specifically to test geometry pertinent for use of this material in a clinical setting. A brachytherapy dose plan was computed to deliver a cylindrical dose distribution to the film. The dose plan used an 192Ir source and was normalized to 1500 cGy at 1 cm from the channel. The material was evaluated by comparing the film exposure to an identical test done in water. The Hounsfield unit (HU) distributions were computed from a CT scan of the apparatus and compared to the HU distribution of water and the HU distribution of a commercial GYN cylinder applicator. The dose depth curve of PC-ISO as measured by the radiochromic film was within 1% of water between 1 cm and 6 cm from the channel. The mean HU was -10 for PC-ISO and -1 for water. As expected, the honeycombed structure of the PC-ISO 3D printing process created a moderate spread of HU values, but the mean was comparable to water. PC-ISO is sufficiently water-equivalent to be compatible with our HDR brachytherapy planning system and clinical workflow and, therefore, it is suitable for creating custom GYN brachytherapy applicators. Our current clinical practice includes the use of custom GYN applicators made of commercially available PC-ISO when doing so can improve the patient's treatment. PACS number: none.

  8. Evaluation of PC-ISO for customized, 3D Printed, gynecologic 192-Ir HDR brachytherapy applicators.

    PubMed

    Cunha, J Adam M; Mellis, Katherine; Sethi, Rajni; Siauw, Timmy; Sudhyadhom, Atchar; Garg, Animesh; Goldberg, Ken; Hsu, I-Chow; Pouliot, Jean

    2015-01-08

    The purpose of this study was to evaluate the radiation attenuation properties of PC-ISO, a commercially available, biocompatible, sterilizable 3D printing material, and its suitability for customized, single-use gynecologic (GYN) brachytherapy applicators that have the potential for accurate guiding of seeds through linear and curved internal channels. A custom radiochromic film dosimetry apparatus was 3D-printed in PC-ISO with a single catheter channel and a slit to hold a film segment. The apparatus was designed specifically to test geometry pertinent for use of this material in a clinical setting. A brachytherapy dose plan was computed to deliver a cylindrical dose distribution to the film. The dose plan used an 192Ir source and was normalized to 1500 cGy at 1 cm from the channel. The material was evaluated by comparing the film exposure to an identical test done in water. The Hounsfield unit (HU) distributions were computed from a CT scan of the apparatus and compared to the HU distribution of water and the HU distribution of a commercial GYN cylinder applicator. The dose depth curve of PC-ISO as measured by the radiochromic film was within 1% of water between 1 cm and 6 cm from the channel. The mean HU was -10 for PC-ISO and -1 for water. As expected, the honeycombed structure of the PC-ISO 3D printing process created a moderate spread of HU values, but the mean was comparable to water. PC-ISO is sufficiently water-equivalent to be compatible with our HDR brachytherapy planning system and clinical workflow and, therefore, it is suitable for creating custom GYN brachytherapy applicators. Our current clinical practice includes the use of custom GYN applicators made of commercially available PC-ISO when doing so can improve the patient's treatment. 

  9. Dosimetric evaluation of PLATO and Oncentra treatment planning systems for High Dose Rate (HDR) brachytherapy gynecological treatments

    SciTech Connect

    Singh, Hardev; De La Fuente Herman, Tania; Showalter, Barry; Thompson, Spencer J.; Syzek, Elizabeth J.; Herman, Terence; Ahmad, Salahuddin

    2012-10-23

    This study compares the dosimetric differences in HDR brachytherapy treatment plans calculated with Nucletron's PLATO and Oncentra MasterPlan treatment planning systems (TPS). Ten patients (1 T1b, 1 T2a, 6 T2b, 2 T4) having cervical carcinoma, median age of 43.5 years (range, 34-79 years) treated with tandem and ring applicator in our institution were selected retrospectively for this study. For both Plato and Oncentra TPS, the same orthogonal films anterior-posterior (AP) and lateral were used to manually draw the prescription and anatomical points using definitions from the Manchester system and recommendations from the ICRU report 38. Data input for PLATO was done using a digitizer and Epson Expression 10000XL scanner was used for Oncentra where the points were selected on the images in the screen. The prescription doses for these patients were 30 Gy to points right A (RA) and left A (LA) delivered in 5 fractions with Ir-192 HDR source. Two arrangements: one dwell position and two dwell positions on the tandem were used for dose calculation. The doses to the patient points right B (RB) and left B (LB), and to the organs at risk (OAR), bladder and rectum for each patient were calculated. The mean dose and the mean percentage difference in dose calculated by the two treatment planning systems were compared. Paired t-tests were used for statistical analysis. No significant differences in mean RB, LB, bladder and rectum doses were found with p-values > 0.14. The mean percent difference of doses in RB, LB, bladder and rectum are found to be less than 2.2%, 1.8%, 1.3% and 2.2%, respectively. Dose calculations based on the two different treatment planning systems were found to be consistent and the treatment plans can be made with either system in our department without any concern.

  10. Dosimetric evaluation of PLATO and Oncentra treatment planning systems for High Dose Rate (HDR) brachytherapy gynecological treatments

    NASA Astrophysics Data System (ADS)

    Singh, Hardev; Herman, Tania De La Fuente; Showalter, Barry; Thompson, Spencer J.; Syzek, Elizabeth J.; Herman, Terence; Ahmad, Salahuddin

    2012-10-01

    This study compares the dosimetric differences in HDR brachytherapy treatment plans calculated with Nucletron's PLATO and Oncentra MasterPlan treatment planning systems (TPS). Ten patients (1 T1b, 1 T2a, 6 T2b, 2 T4) having cervical carcinoma, median age of 43.5 years (range, 34-79 years) treated with tandem & ring applicator in our institution were selected retrospectively for this study. For both Plato and Oncentra TPS, the same orthogonal films anterior-posterior (AP) and lateral were used to manually draw the prescription and anatomical points using definitions from the Manchester system and recommendations from the ICRU report 38. Data input for PLATO was done using a digitizer and Epson Expression 10000XL scanner was used for Oncentra where the points were selected on the images in the screen. The prescription doses for these patients were 30 Gy to points right A (RA) and left A (LA) delivered in 5 fractions with Ir-192 HDR source. Two arrangements: one dwell position and two dwell positions on the tandem were used for dose calculation. The doses to the patient points right B (RB) and left B (LB), and to the organs at risk (OAR), bladder and rectum for each patient were calculated. The mean dose and the mean percentage difference in dose calculated by the two treatment planning systems were compared. Paired t-tests were used for statistical analysis. No significant differences in mean RB, LB, bladder and rectum doses were found with p-values > 0.14. The mean percent difference of doses in RB, LB, bladder and rectum are found to be less than 2.2%, 1.8%, 1.3% and 2.2%, respectively. Dose calculations based on the two different treatment planning systems were found to be consistent and the treatment plans can be made with either system in our department without any concern.

  11. SU-E-T-205: Improving Quality Assurance of HDR Brachytherapy: Verifying Agreement Between Planned and Delivered Dose Distributions Using DICOM RTDose and Advanced Film Dosimetry

    SciTech Connect

    Palmer, A L; Bradley, D A; Nisbet, A

    2014-06-01

    Purpose: HDR brachytherapy is undergoing significant development, and quality assurance (QA) checks must keep pace. Current recommendations do not adequately verify delivered against planned dose distributions: This is particularly relevant for new treatment planning system (TPS) calculation algorithms (non TG-43 based), and an era of significant patient-specific plan optimisation. Full system checks are desirable in modern QA recommendations, complementary to device-centric individual tests. We present a QA system incorporating TPS calculation, dose distribution export, HDR unit performance, and dose distribution measurement. Such an approach, more common in external beam radiotherapy, has not previously been reported in the literature for brachytherapy. Methods: Our QA method was tested at 24 UK brachytherapy centres. As a novel approach, we used the TPS DICOM RTDose file export to compare planned dose distribution with that measured using Gafchromic EBT3 films placed around clinical brachytherapy treatment applicators. Gamma analysis was used to compare the dose distributions. Dose difference and distance to agreement were determined at prescription Point A. Accurate film dosimetry was achieved using a glass compression plate at scanning to ensure physically-flat films, simultaneous scanning of known dose films with measurement films, and triple-channel dosimetric analysis. Results: The mean gamma pass rate of RTDose compared to film-measured dose distributions was 98.1% at 3%(local), 2 mm criteria. The mean dose difference, measured to planned, at Point A was -0.5% for plastic treatment applicators and -2.4% for metal applicators, due to shielding not accounted for in TPS. The mean distance to agreement was 0.6 mm. Conclusion: It is recommended to develop brachytherapy QA to include full-system verification of agreement between planned and delivered dose distributions. This is a novel approach for HDR brachytherapy QA. A methodology using advanced film

  12. Systematic quantification of HDR and NHEJ reveals effects of locus, nuclease, and cell type on genome-editing

    PubMed Central

    Miyaoka, Yuichiro; Berman, Jennifer R.; Cooper, Samantha B.; Mayerl, Steven J.; Chan, Amanda H.; Zhang, Bin; Karlin-Neumann, George A.; Conklin, Bruce R.

    2016-01-01

    Precise genome-editing relies on the repair of sequence-specific nuclease-induced DNA nicking or double-strand breaks (DSBs) by homology-directed repair (HDR). However, nonhomologous end-joining (NHEJ), an error-prone repair, acts concurrently, reducing the rate of high-fidelity edits. The identification of genome-editing conditions that favor HDR over NHEJ has been hindered by the lack of a simple method to measure HDR and NHEJ directly and simultaneously at endogenous loci. To overcome this challenge, we developed a novel, rapid, digital PCR–based assay that can simultaneously detect one HDR or NHEJ event out of 1,000 copies of the genome. Using this assay, we systematically monitored genome-editing outcomes of CRISPR-associated protein 9 (Cas9), Cas9 nickases, catalytically dead Cas9 fused to FokI, and transcription activator–like effector nuclease at three disease-associated endogenous gene loci in HEK293T cells, HeLa cells, and human induced pluripotent stem cells. Although it is widely thought that NHEJ generally occurs more often than HDR, we found that more HDR than NHEJ was induced under multiple conditions. Surprisingly, the HDR/NHEJ ratios were highly dependent on gene locus, nuclease platform, and cell type. The new assay system, and our findings based on it, will enable mechanistic studies of genome-editing and help improve genome-editing technology. PMID:27030102

  13. Systematic quantification of HDR and NHEJ reveals effects of locus, nuclease, and cell type on genome-editing.

    PubMed

    Miyaoka, Yuichiro; Berman, Jennifer R; Cooper, Samantha B; Mayerl, Steven J; Chan, Amanda H; Zhang, Bin; Karlin-Neumann, George A; Conklin, Bruce R

    2016-03-31

    Precise genome-editing relies on the repair of sequence-specific nuclease-induced DNA nicking or double-strand breaks (DSBs) by homology-directed repair (HDR). However, nonhomologous end-joining (NHEJ), an error-prone repair, acts concurrently, reducing the rate of high-fidelity edits. The identification of genome-editing conditions that favor HDR over NHEJ has been hindered by the lack of a simple method to measure HDR and NHEJ directly and simultaneously at endogenous loci. To overcome this challenge, we developed a novel, rapid, digital PCR-based assay that can simultaneously detect one HDR or NHEJ event out of 1,000 copies of the genome. Using this assay, we systematically monitored genome-editing outcomes of CRISPR-associated protein 9 (Cas9), Cas9 nickases, catalytically dead Cas9 fused to FokI, and transcription activator-like effector nuclease at three disease-associated endogenous gene loci in HEK293T cells, HeLa cells, and human induced pluripotent stem cells. Although it is widely thought that NHEJ generally occurs more often than HDR, we found that more HDR than NHEJ was induced under multiple conditions. Surprisingly, the HDR/NHEJ ratios were highly dependent on gene locus, nuclease platform, and cell type. The new assay system, and our findings based on it, will enable mechanistic studies of genome-editing and help improve genome-editing technology.

  14. A gEUD-based inverse planning technique for HDR prostate brachytherapy: Feasibility study

    SciTech Connect

    Giantsoudi, D.; Baltas, D.; Karabis, A.; Mavroidis, P.; Zamboglou, N.; Tselis, N.; Shi, C.; Papanikolaou, N.

    2013-04-15

    Purpose: The purpose of this work was to study the feasibility of a new inverse planning technique based on the generalized equivalent uniform dose for image-guided high dose rate (HDR) prostate cancer brachytherapy in comparison to conventional dose-volume based optimization. Methods: The quality of 12 clinical HDR brachytherapy implants for prostate utilizing HIPO (Hybrid Inverse Planning Optimization) is compared with alternative plans, which were produced through inverse planning using the generalized equivalent uniform dose (gEUD). All the common dose-volume indices for the prostate and the organs at risk were considered together with radiobiological measures. The clinical effectiveness of the different dose distributions was investigated by comparing dose volume histogram and gEUD evaluators. Results: Our results demonstrate the feasibility of gEUD-based inverse planning in HDR brachytherapy implants for prostate. A statistically significant decrease in D{sub 10} or/and final gEUD values for the organs at risk (urethra, bladder, and rectum) was found while improving dose homogeneity or dose conformity of the target volume. Conclusions: Following the promising results of gEUD-based optimization in intensity modulated radiation therapy treatment optimization, as reported in the literature, the implementation of a similar model in HDR brachytherapy treatment plan optimization is suggested by this study. The potential of improved sparing of organs at risk was shown for various gEUD-based optimization parameter protocols, which indicates the ability of this method to adapt to the user's preferences.

  15. Intensity modulated perioperative HDR brachytherapy for recurrent and/or advanced head and neck metastases.

    PubMed

    Teudt, Ingo U; Kovàcs, György; Ritter, Matthias; Melchert, Corinna; Soror, Tamer; Wollenberg, Barbara; Meyer, Jens E

    2016-09-01

    Recurrent neck metastases following surgery and full dose adjuvant radiotherapy of squamous cell head and neck cancer remain a clinical challenge. After revision neck dissection and chemotherapy re-irradiation dosage is often limited and survival prognosis deteriorates. Here, adjuvant high-dose rate intensity modulated perioperative brachytherapy (HDR IMBT) offers a second full radiation dose with a limited volume of normal tissue radiation in the neck. In this retrospective study patients were identified who underwent revision surgery and perioperative HDR IMBT for recurrent neck metastases. Survival rates were estimated and the scarce literature on interstitial brachytherapy of the neck was reviewed. From 2006 to 2014, nine patients were treated for recurrent or palliative neck metastases using salvage surgery and HDR IMBT. Eight patients received previous surgery and external beam radiotherapy with or without chemotherapy. Two and five year overall survival was calculated to be 78 and 67 %, respectively. HDR IMBT is a salvage treatment option for selected cases in the neck following surgical revision or last-line treatment strategies. In the literature and this small cohort radiation toxicity and the risk of "carotid blow-out" seemed to be low.

  16. [Enhancement of artemisinin biosynthesis in transgenic Artemisia annua L. by overexpressed HDR and ADS genes].

    PubMed

    Wang, Ya-Xiong; Long, Shi-Ping; Zeng, Li-Xia; Xiang, Li-En; Lin, Zhi; Chen, Min; Liao, Zhi-Hua

    2014-09-01

    Artemisnin is a novel sesquiterpene lactone with an internal peroxide bridge structure, which is extracted from traditional Chinese herb Artemisia annua L. (Qinghao). Recommended by World Health Organization, artemisinin is the first-line drug in the treatment of encephalic and chloroquine-resistant malaria. In the present study, transgenic A. annua plants were developed by overexpressing the key enzymes involved in the biosynthetic pathway of artemisinin. Based on Agrobacterium-mediated transformation methods, transgenic plants of A. annua with overexpression of both HDR and ADS were obtained through hygromycin screening. The genomic PCR analysis confirmed six transgenic lines in which both HDR and ADS were integrated into genome. The gene expression analysis given by real-time quantitative PCR showed that all the transgenic lines had higher expression levels of HDR and ADS than the non-transgenic control (except ah3 in which the expression level of ADS showed no significant difference compared with control); and the HPLC analysis of artemisinin demonstrated that transgenic A. annua plants produced artemisinin at significantly higher level than non-transgenic plants. Especially, the highest content of artemisinin was found in transgenic line ah70, in which the artemisinin content was 3.48 times compared with that in non-transgenic lines. In summary, overexpression of HDR and ADS facilitated artemisinin biosynthesis and this method could be applied to develop transgenic plants of A. annua with higher yield of artemisinin.

  17. Perioperative high dose rate (HDR) brachytherapy in unresectable locally advanced pancreatic tumors

    PubMed Central

    Waniczek, Dariusz; Piecuch, Jerzy; Mikusek, Wojciech; Arendt, Jerzy; Białas, Brygida

    2011-01-01

    Purpose The aim of the study was to present an original technique of catheter implantation for perioperative HDR-Ir192 brachytherapy in patients after palliative operations of unresectable locally advanced pancreatic tumors and to estimate the influence of perioperative HDR-Ir192 brachytherapy on pain relief in terminal pancreatic cancer patients. Material and methods Eight patients with pancreatic tumors located in the head of pancreas underwent palliative operations with the use of HDR-Ir192 brachytherapy. All patients qualified for surgery reported pain of high intensity and had received narcotic painkillers prior to operation. During the last phase of the surgery, the Nucletron® catheters were implanted in patients to prepare them for later perioperative brachytherapy. Since the 6th day after surgery HDR brachytherapy was performed. Before each brachytherapy fraction the location of implants were checked using fluoroscopy. A fractional dose was 5 Gy and a total dose was 20 Gy in the area of radiation. A comparative study of two groups of patients (with and without brachytherapy) with stage III pancreatic cancer according to the TNM scale was taken in consideration. Results and Conclusions The authors claim that the modification of catheter implantation using specially designed cannula, facilitates the process of inserting the catheter into the tumor, shortens the time needed for the procedure, and reduces the risk of complications. Mean survival time was 5.7 months. In the group of performed brachytherapy, the mean survival time was 6.7 months, while in the group of no brachytherapy performed – 4.4 months. In the group of brachytherapy, only one patient increased the dose of painkillers in the last month of his life. Remaining patients took constant doses of medicines. Perioperative HDR-Ir192 brachytherapy could be considered as a practical application of adjuvant therapy for pain relief in patients with an advanced pancreatic cancer. PMID:27895674

  18. Effectiveness of two different HDR brachytherapy regimens with the same BED value in cervical cancer.

    PubMed

    Passi, Kamlesh; Kehwar, Than S; Mittal, Meenakshi; Singh, Bikramjit; Vashistha, Rajesh; Gupta, Sureshchandra J; Yakhmi, J V

    2010-06-01

    To analyze the effectiveness of biologically effective dose (BED) in two different regimens of HDR brachytherapy keeping the same total BED to point A and to compare the relationship of overall treatment time in terms of local control and bladder and rectal complications. The study included two groups comprising a total of 90 cervical cancer patients who underwent external beam radiotherapy (EBRT) followed by HDR intracavitary brachytherapy (ICBT). EBRT treatment was delivered by a Co-60 teletherapy unit to a prescribed dose of 45 Gy with 1.8 Gy per fraction in 25 fractions over a period of five weeks. Parallel opposed anterior-posterior (AP/PA) fields with no central shielding were used, followed by the HDR ICBT dose, to point A, of either two fractions of 9.5 Gy with a gap of 10 days, or three fractions of 7.5 Gy with a gap of 7 days between the fractions. Gemcitabine (dose of 150 mg/m(2)) was given weekly to all the patients as a radiosensitizer. The calculate BED3 to point A was almost the same in both groups to keep the same late complication rates. The doses, and BED10 and BED3, were calculated at different bladder and rectal point as well as at the lymphatic trapezoid points. During and after treatment patients were evaluated for local control and complications for 24 months. Doses and BEDs at different bladder, rectal and lymphatic trapezoid points, local control, and complications in both HDR ICBT groups did not have statistically significant differences (p > 0.05). Both HDR ICBT schedules are well tolerable and equally effective.

  19. Second primary malignancies after radiotherapy including HDR (252)Cf brachytherapy for cervical cancer.

    PubMed

    Samerdokiene, Vitalija; Valuckas, Konstantinas Povilas; Janulionis, Ernestas; Atkocius, Vydmantas; Rivard, Mark J

    2015-01-01

    Second primary malignancies (SPMs) are among the most serious late adverse effects after radiotherapy experienced over time by the increasing population of cancer survivors worldwide. The study aim was to determine the rate and distribution of SPMs for neutron- and photon-emitting brachytherapy (BT) sources for patients treated for cervical cancer. The cohort comprised 662 patients with invasive cervical cancer (Stages IIB and IIIB) and contributed 5,224 patient-years (PY) of observation. These patients were treated by radiotherapy during the 1989-1999 year period with cobalt-60 source ((60)Co) teletherapy. The first group of patients (N = 375; 3,154 PY) received high-dose-rate (HDR) californium-252 source ((252)Cf) BT, whereas the second group (N = 287; 2,070 PY) received HDR (60)Co BT. Over a 25-year period, 35 SPMs were observed, amounting to 5.3% of all observed patients: in 16 (2.4%) heavily, 2 (0.3%) moderately, 14 (2.1%) lightly irradiated body sites, and 3 (0.5%) other sites. Of these, 21 cases (5.6%) were observed in the HDR (252)Cf BT group, whereas 14 cases (4.9%) were observed in the HDR (60)Co BT group. Exposures received during (60)Co teletherapy and HDR BT with either (252)Cf or (60)Co had statistically equivalent (p = 0.68) effects on SPM development. Cure rates are improving, and therefore, there are more long-term survivors from cervical cancer. This study shows no significant difference in rates or distribution of SPMs in women treated with neutron BT compared with photon BT (p = 0.68). After reviewing related literature and our research results, it is evident that a detailed investigation of SPM frequency, localization, and dose to adjacent organs is a suitable topic for further research. Copyright © 2015 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  20. SU-E-T-574: Fessiblity of Using the Calypso System for HDR Interstitial Catheter Reconstruction

    SciTech Connect

    Li, J S; Ma, C

    2014-06-01

    Purpose: It is always a challenge to reconstruct the interstitial catheter for high dose rate (HDR) brachytherapy on patient CT or MR images. This work aims to investigate the feasibility of using the Calypso system (Varian Medical, CA) for HDR catheter reconstruction utilizing its accuracy on tracking the electromagnetic transponder location. Methods: Experiment was done with a phantom that has a HDR interstitial catheter embedded inside. CT scan with a slice thickness of 1.25 mm was taken for this phantom with two Calypso beacon transponders in the catheter. The two transponders were connected with a wire. The Calypso system was used to record the beacon transponders’ location in real time when they were gently pulled out with the wire. The initial locations of the beacon transponders were used for registration with the CT image and the detected transponder locations were used for the catheter path reconstruction. The reconstructed catheter path was validated on the CT image. Results: The HDR interstitial catheter was successfully reconstructed based on the transponders’ coordinates recorded by the Calypso system in real time when the transponders were pulled in the catheter. After registration with the CT image, the shape and location of the reconstructed catheter are evaluated against the CT image and the result shows an accuracy of 2 mm anywhere in the Calypso detectable region which is within a 10 cm X 10 cm X 10 cm cubic box for the current system. Conclusion: It is feasible to use the Calypso system for HDR interstitial catheter reconstruction. The obstacle for its clinical usage is the size of the beacon transponder whose diameter is bigger than most of the interstitial catheters used in clinic. Developing smaller transponders and supporting software and hardware for this application is necessary before it can be adopted for clinical use.

  1. Perioperative high dose rate (HDR) brachytherapy in unresectable locally advanced pancreatic tumors.

    PubMed

    Waniczek, Dariusz; Piecuch, Jerzy; Rudzki, Marek; Mikusek, Wojciech; Arendt, Jerzy; Białas, Brygida

    2011-06-01

    The aim of the study was to present an original technique of catheter implantation for perioperative HDR-Ir192 brachytherapy in patients after palliative operations of unresectable locally advanced pancreatic tumors and to estimate the influence of perioperative HDR-Ir192 brachytherapy on pain relief in terminal pancreatic cancer patients. Eight patients with pancreatic tumors located in the head of pancreas underwent palliative operations with the use of HDR-Ir192 brachytherapy. All patients qualified for surgery reported pain of high intensity and had received narcotic painkillers prior to operation. During the last phase of the surgery, the Nucletron(®) catheters were implanted in patients to prepare them for later perioperative brachytherapy. Since the 6(th) day after surgery HDR brachytherapy was performed. Before each brachytherapy fraction the location of implants were checked using fluoroscopy. A fractional dose was 5 Gy and a total dose was 20 Gy in the area of radiation. A comparative study of two groups of patients (with and without brachytherapy) with stage III pancreatic cancer according to the TNM scale was taken in consideration. The authors claim that the modification of catheter implantation using specially designed cannula, facilitates the process of inserting the catheter into the tumor, shortens the time needed for the procedure, and reduces the risk of complications. Mean survival time was 5.7 months. In the group of performed brachytherapy, the mean survival time was 6.7 months, while in the group of no brachytherapy performed - 4.4 months. In the group of brachytherapy, only one patient increased the dose of painkillers in the last month of his life. Remaining patients took constant doses of medicines. Perioperative HDR-Ir192 brachytherapy could be considered as a practical application of adjuvant therapy for pain relief in patients with an advanced pancreatic cancer.

  2. Predictors of distant metastasis after combined HDR brachytherapy and external beam radiation for prostate cancer.

    PubMed

    Kamrava, Mitchell; Rwigema, Jean-Claude; Chung, Melody; Banerjee, Robyn; Wang, Jason; Steinberg, Michael; Demanes, David Jeffrey

    2013-09-01

    To determine predictors of distant metastases (DM) in prostate cancer patients treated with high dose rate brachytherapy boost (HDR-B) and external beam radiation therapy (EBRT). From 1991 to 2002, 768 men with localized prostate cancer were treated with HDR-B and EBRT. The mean EBRT dose was 37.5 Gy (range: 30.6-45 Gy), and the HDR-B was 22 or 24 Gy delivered in 4 fractions. Univariate and multivariate analyses using a Cox proportional hazards model including age at diagnosis, T stage, Gleason score (GS), pretreatment PSA, biologically equivalent dose (BED), and use of androgen deprivation therapy (ADT) was used to determine predictors of developing distant metastases. The median follow-up time for the entire patient population was 4.2 years (range: 1-11.2 years). Distant metastases were identified in 22/768 (3%) of patients at a median of 4.1 years. PSA failure according to the Phoenix definition developed in 3%, 5%, and 14% of men with low, intermediate, and high risk disease with a median time to failure of 3.8 years. Prostate cancer specific mortality was observed in 2% of cases. T stage, GS, and use of ADT were significantly associated with developing DM on univariate analysis. GS, and use of ADT were the only factors significantly associated with developing DM on multivariate analysis (p < 0.01). Patients who received ADT had significantly higher risk features suggesting patient selection bias for higher DM in this group of patients rather than a negative interaction between HDR-B and EBRT. In men treated with HDR-B and EBRT, GS is a significant factor on multivariate analysis for developing distant metastasis.

  3. SU-E-T-186: An Automated Quality Assurance Tool for HDR Treatment Planning.

    PubMed

    Nelson, C; Gifford, K; Kisling, K; Bloom, E; Kirsner, S

    2012-06-01

    Treatment planning for high dose rate (HDR) brachytherapy requires many user inputs, all of which are potential sources of error. The goal of quality assurance (QA) is to ensure that errors are not made. In this study, we developed a software program to analyze the treatment printout from the HDR treatment planning computer and flag any suspected errors. The treatment printout from the HDR planning computer is imported by the software. The software then performs the following checks: (1) verifies that the correct source was chosen (we have multiple in our database), (2) performs an independent decay of the Ir-192 source, (3) verifies source step size, (4) verifies the offsets and indexer lengths in the catheter definitions based upon expected values for the applicator used, (4) performs an independent 2nd check of dose to a cloud of dose points surrounding the treatment region, (5) verifies that the dose per fraction and the number of fractions were entered correctly in the planning computer, and (6) verifies that the dose volume histogram (DVH) metrics were within acceptable tolerances. The software then prints this information to a PDF file, which is appended to the original treatment printout and placed in the patient's medical record. This QA tool has now been implemented for six months in our clinic, and is a critical QA tool in our HDR program. Although each plan is checked by an independent 2nd physicist, this tool provides an additional independent check on the treatment plan. A simple series of automatic 2nd checks helps reduce the risk of errors occurring in the treatment planning portion of HDR brachytherapy and can easily be implemented. © 2012 American Association of Physicists in Medicine.

  4. A Pooled Analysis of Biochemical Failure in Intermediate-risk Prostate Cancer Following Definitive Stereotactic Body Radiotherapy (SBRT) or High-Dose-Rate Brachytherapy (HDR-B) Monotherapy.

    PubMed

    Hegde, John V; Collins, Sean P; Fuller, Donald B; King, Christopher R; Demanes, D Jeffrey; Wang, Pin-Chieh; Kupelian, Patrick A; Steinberg, Michael L; Kamrava, Mitchell

    2016-06-17

    To investigate biochemical relapse-free survival (BRFS) in men with National Comprehensive Cancer Network-defined intermediate-risk prostate cancer (PC) treated with either stereotactic body radiotherapy (SBRT) or high-dose-rate brachytherapy (HDR-B) monotherapy. A retrospective, multi-institutional analysis of 437 patients with intermediate-risk PC treated with SBRT (N=300) or HDR-B (N=137) was performed. Men who underwent SBRT were treated to 35 to 40 Gy in 4 to 5 fractions. A total of 95.6% who underwent HDR-B were treated to 42 Gy in 6 fractions. Baseline patient characteristics were compared using a T test for continuous variables and the Mantel-Haenszel χ metric or Fisher exact test for categorical variables. Kaplan-Meier curves were generated to estimate 5-year actuarial BRFS. Multivariate analysis using a Cox proportional-hazards model was used to evaluate factors associated with biochemical failure. The mean age at diagnosis was 68.4 (SD±7.8) years. T-category was T1 in 63.6% and T2 in 36.4%. Mean initial prostate-specific antigen was 7.4 (SD±3.4) ng/mL. Biopsy Gleason score was ≤3+4 in 82.8% and 4+3 in 17.2%. At a median of 4.1 years of follow-up, the BRFS rate (Phoenix definition) was 96.3%, with no difference when stratifying by treatment modality or biologically equivalent dose (BED1.5). On multivariate analysis, age (hazard ratio 1.08, P=0.04) and biopsy Gleason score (hazard ratio 2.48, P=0.03) were significant predictors of BRFS. With a median follow-up period of 4 years, SBRT and HDR-B monotherapy provide excellent BRFS in intermediate-risk PC. Longer-term follow-up is necessary to determine the ultimate efficacy of these hypofractionated approaches, but they appear promising relative to standard fractionation outcomes.

  5. Design and implementation of a film dosimetry audit tool for comparison of planned and delivered dose distributions in high dose rate (HDR) brachytherapy.

    PubMed

    Palmer, Antony L; Lee, Chris; Ratcliffe, Ailsa J; Bradley, David; Nisbet, Andrew

    2013-10-07

    A novel phantom is presented for 'full system' dosimetric audit comparing planned and delivered dose distributions in HDR gynaecological brachytherapy, using clinical treatment applicators. The brachytherapy applicator dosimetry test object consists of a near full-scatter water tank with applicator and film supports constructed of Solid Water, accommodating any typical cervix applicator. Film dosimeters are precisely held in four orthogonal planes bisecting the intrauterine tube, sampling dose distributions in the high risk clinical target volume, points A and B, bladder, rectum and sigmoid. The applicator position is fixed prior to CT scanning and through treatment planning and irradiation. The CT data is acquired with the applicator in a near clinical orientation to include applicator reconstruction in the system test. Gamma analysis is used to compare treatment planning system exported RTDose grid with measured multi-channel film dose maps. Results from two pilot audits are presented, using Ir-192 and Co-60 HDR sources, with a mean gamma passing rate of 98.6% using criteria of 3% local normalization and 3 mm distance to agreement (DTA). The mean DTA between prescribed dose and measured film dose at point A was 1.2 mm. The phantom was funded by IPEM and will be used for a UK national brachytherapy dosimetry audit.

  6. Design and implementation of a film dosimetry audit tool for comparison of planned and delivered dose distributions in high dose rate (HDR) brachytherapy

    NASA Astrophysics Data System (ADS)

    Palmer, Antony L.; Lee, Chris; Ratcliffe, Ailsa J.; Bradley, David; Nisbet, Andrew

    2013-10-01

    A novel phantom is presented for ‘full system’ dosimetric audit comparing planned and delivered dose distributions in HDR gynaecological brachytherapy, using clinical treatment applicators. The brachytherapy applicator dosimetry test object consists of a near full-scatter water tank with applicator and film supports constructed of Solid Water, accommodating any typical cervix applicator. Film dosimeters are precisely held in four orthogonal planes bisecting the intrauterine tube, sampling dose distributions in the high risk clinical target volume, points A and B, bladder, rectum and sigmoid. The applicator position is fixed prior to CT scanning and through treatment planning and irradiation. The CT data is acquired with the applicator in a near clinical orientation to include applicator reconstruction in the system test. Gamma analysis is used to compare treatment planning system exported RTDose grid with measured multi-channel film dose maps. Results from two pilot audits are presented, using Ir-192 and Co-60 HDR sources, with a mean gamma passing rate of 98.6% using criteria of 3% local normalization and 3 mm distance to agreement (DTA). The mean DTA between prescribed dose and measured film dose at point A was 1.2 mm. The phantom was funded by IPEM and will be used for a UK national brachytherapy dosimetry audit.

  7. Handheld directional reflectometer: an angular imaging device to measure BRDF and HDR in real time

    NASA Astrophysics Data System (ADS)

    Mattison, Phillip R.; Dombrowski, Mark S.; Lorenz, James M.; Davis, Keith J.; Mann, Harley C.; Johnson, Philip; Foos, Bryan

    1998-10-01

    Many applications require quantitative measurements of surface light scattering, including quality control on production lines, inspection of painted surfaces, inspection of field repairs, etc. Instruments for measuring surface scattering typically fall into two main categories, namely bidirectional reflectometers, which measure the angular distribution of scattering, and hemispherical directional reflectometers, which measure the total scattering into the hemisphere above the surface. Measurement of the bi-directional reflectance distribution function (BRDF) gives the greatest insight into how light is scattered from a surface. Measurements of BRDF, however, are typically very lengthy measurements taken by moving a source and detector to map the scattering. Since BRDF has four angular degrees of freedom, such measurements can require hours to days to complete. Instruments for measuring BRDF are also typically laboratory devices, although a field- portable bi-directional reflectometer does exist. Hemispherical directional reflectance (HDR) is a much easier measurement to make, although care must be taken to use the proper methodology when measuring at wavelengths beyond 10 micrometer, since integrating spheres (typically used to make such measurements) are very energy inefficient and lose their integrating properties at very long wavelengths. A few field- portable hemispherical directional reflectometers do exist, but typically measure HDR only at near-normal angles. Boeing Defense and Space Group and Surface Optics Corporation, under a contract from the Air Force Research Laboratory, have developed a new hand-held instrument capable of measuring both BRDF and HDR using a unique, patented angular imaging technique. A combination of an hemi-ellipsoidal mirror and an additional lens translate the angular scatter from a surface into a two-dimensional spatial distribution, which is recorded by an imaging array. This configuration fully maps the scattering from a half

  8. A segmentation and point-matching enhanced efficient deformable image registration method for dose accumulation between HDR CT images.

    PubMed

    Zhen, Xin; Chen, Haibin; Yan, Hao; Zhou, Linghong; Mell, Loren K; Yashar, Catheryn M; Jiang, Steve; Jia, Xun; Gu, Xuejun; Cervino, Laura

    2015-04-07

    Deformable image registration (DIR) of fractional high-dose-rate (HDR) CT images is challenging due to the presence of applicators in the brachytherapy image. Point-to-point correspondence fails because of the undesired deformation vector fields (DVF) propagated from the applicator region (AR) to the surrounding tissues, which can potentially introduce significant DIR errors in dose mapping. This paper proposes a novel segmentation and point-matching enhanced efficient DIR (named SPEED) scheme to facilitate dose accumulation among HDR treatment fractions. In SPEED, a semi-automatic seed point generation approach is developed to obtain the incremented fore/background point sets to feed the random walks algorithm, which is used to segment and remove the AR, leaving empty AR cavities in the HDR CT images. A feature-based 'thin-plate-spline robust point matching' algorithm is then employed for AR cavity surface points matching. With the resulting mapping, a DVF defining on each voxel is estimated by B-spline approximation, which serves as the initial DVF for the subsequent Demons-based DIR between the AR-free HDR CT images. The calculated DVF via Demons combined with the initial one serve as the final DVF to map doses between HDR fractions. The segmentation and registration accuracy are quantitatively assessed by nine clinical HDR cases from three gynecological cancer patients. The quantitative analysis and visual inspection of the DIR results indicate that SPEED can suppress the impact of applicator on DIR, and accurately register HDR CT images as well as deform and add interfractional HDR doses.

  9. The Oryza sativa Regulator HDR1 Associates with the Kinase OsK4 to Control Photoperiodic Flowering

    PubMed Central

    Cui, Xuean; Feng, Dan; Wang, Kai; Xu, Ming; Zhou, Li; Han, Xiao; Gu, Xiaofeng; Lu, Tiegang

    2016-01-01

    Rice is a facultative short-day plant (SDP), and the regulatory pathways for flowering time are conserved, but functionally modified, in Arabidopsis and rice. Heading date 1 (Hd1), an ortholog of Arabidopsis CONSTANS (CO), is a key regulator that suppresses flowering under long-day conditions (LDs), but promotes flowering under short-day conditions (SDs) by influencing the expression of the florigen gene Heading date 3a (Hd3a). Another key regulator, Early heading date 1 (Ehd1), is an evolutionarily unique gene with no orthologs in Arabidopsis, which acts as a flowering activator under both SD and LD by promoting the rice florigen genes Hd3a and RICE FLOWERING LOCUST 1 (RFT1). Here, we report the isolation and characterization of the flowering regulator Heading Date Repressor1 (HDR1) in rice. The hdr1 mutant exhibits an early flowering phenotype under natural LD in a paddy field in Beijing, China (39°54'N, 116°23'E), as well as under LD but not SD in a growth chamber, indicating that HDR1 may functionally regulate flowering time via the photoperiod-dependent pathway. HDR1 encodes a nuclear protein that is most active in leaves and floral organs and exhibits a typical diurnal expression pattern. We determined that HDR1 is a novel suppressor of flowering that upregulates Hd1 and downregulates Ehd1, leading to the downregulation of Hd3a and RFT1 under LDs. We have further identified an HDR1-interacting kinase, OsK4, another suppressor of rice flowering under LDs. OsK4 acts similarly to HDR1, suppressing flowering by upregulating Hd1 and downregulating Ehd1 under LDs, and OsK4 can phosphorylate HD1 with HDR1 presents. These results collectively reveal the transcriptional regulators of Hd1 for the day-length-dependent control of flowering time in rice. PMID:26954091

  10. The impact of prostate volume changes during external-beam irradiation in consequence of HDR brachytherapy in prostate cancer treatment.

    PubMed

    Herrmann, Markus Karl Alfred; Gsänger, Tammo; Strauss, Arne; Kertesz, Tereza; Wolff, Hendrik A; Christiansen, Hans; Vorwerk, Hilke; Hess, Clemens Friedrich; Hille, Andrea

    2009-06-01

    To evaluate prostate volume changes during external-beam irradiation in consequence of high-dose-rate (HDR) brachytherapy in prostate cancer treatment. 20 patients who underwent radiotherapy for prostate cancer were included in this prospective evaluation. All patients had a computed tomography (CT) scan for planning of the external-beam irradiation and additional scans after each HDR brachytherapy. For the planning target volume (PTV), a safety margin of 10 mm was added to the clinical target volume (CTV) in each direction. The prostate volume measured in the planning CT was compared with the prostate volumes measured after HDR brachytherapy and, subsequently, the change of prostate volume was calculated. Volume changes which resulted in differences of the prostate radius of > 5 mm for the CTV were defined as a reason for a new treatment-planning procedure for the patient. Taking all patients together, prostate volumes before HDR, 1 day and 4-6 days after the first HDR treatment, as well as 1 day and 4-6 days after the second HDR treatment were in median 37.7 cm(3), 37.6 cm(3), 38.2 cm(3), 39.3 cm(3), and 40.5 cm(3), respectively. In none of the patient, a volume change resulted in a change of the prostate radius of > 5 mm for the CTV. Prerequisite for this calculation was the simplification of the complex prostate geometry to a sphere. No new treatment-planning procedure was necessary during external-beam radiotherapy. HDR brachytherapy does change the prostate volume. Under the condition of a 10-mm safety margin in each direction added to the CTV for the PTV, no new treatment-planning procedure was necessary after HDR brachytherapy. There is no need for CT scans at regular intervals during external-beam radiotherapy.

  11. A segmentation and point-matching enhanced efficient deformable image registration method for dose accumulation between HDR CT images

    NASA Astrophysics Data System (ADS)

    Zhen, Xin; Chen, Haibin; Yan, Hao; Zhou, Linghong; Mell, Loren K.; Yashar, Catheryn M.; Jiang, Steve; Jia, Xun; Gu, Xuejun; Cervino, Laura

    2015-04-01

    Deformable image registration (DIR) of fractional high-dose-rate (HDR) CT images is challenging due to the presence of applicators in the brachytherapy image. Point-to-point correspondence fails because of the undesired deformation vector fields (DVF) propagated from the applicator region (AR) to the surrounding tissues, which can potentially introduce significant DIR errors in dose mapping. This paper proposes a novel segmentation and point-matching enhanced efficient DIR (named SPEED) scheme to facilitate dose accumulation among HDR treatment fractions. In SPEED, a semi-automatic seed point generation approach is developed to obtain the incremented fore/background point sets to feed the random walks algorithm, which is used to segment and remove the AR, leaving empty AR cavities in the HDR CT images. A feature-based ‘thin-plate-spline robust point matching’ algorithm is then employed for AR cavity surface points matching. With the resulting mapping, a DVF defining on each voxel is estimated by B-spline approximation, which serves as the initial DVF for the subsequent Demons-based DIR between the AR-free HDR CT images. The calculated DVF via Demons combined with the initial one serve as the final DVF to map doses between HDR fractions. The segmentation and registration accuracy are quantitatively assessed by nine clinical HDR cases from three gynecological cancer patients. The quantitative analysis and visual inspection of the DIR results indicate that SPEED can suppress the impact of applicator on DIR, and accurately register HDR CT images as well as deform and add interfractional HDR doses.

  12. HDR Pathological Image Enhancement Based on Improved Bias Field Correction and Guided Image Filter

    PubMed Central

    Zhu, Ganzheng; Li, Siqi; Gong, Shang; Yang, Benqiang; Zhang, Libo

    2016-01-01

    Pathological image enhancement is a significant topic in the field of pathological image processing. This paper proposes a high dynamic range (HDR) pathological image enhancement method based on improved bias field correction and guided image filter (GIF). Firstly, a preprocessing including stain normalization and wavelet denoising is performed for Haematoxylin and Eosin (H and E) stained pathological image. Then, an improved bias field correction model is developed to enhance the influence of light for high-frequency part in image and correct the intensity inhomogeneity and detail discontinuity of image. Next, HDR pathological image is generated based on least square method using low dynamic range (LDR) image, H and E channel images. Finally, the fine enhanced image is acquired after the detail enhancement process. Experiments with 140 pathological images demonstrate the performance advantages of our proposed method as compared with related work. PMID:28116303

  13. HDR Pathological Image Enhancement Based on Improved Bias Field Correction and Guided Image Filter.

    PubMed

    Sun, Qingjiao; Jiang, Huiyan; Zhu, Ganzheng; Li, Siqi; Gong, Shang; Yang, Benqiang; Zhang, Libo

    2016-01-01

    Pathological image enhancement is a significant topic in the field of pathological image processing. This paper proposes a high dynamic range (HDR) pathological image enhancement method based on improved bias field correction and guided image filter (GIF). Firstly, a preprocessing including stain normalization and wavelet denoising is performed for Haematoxylin and Eosin (H and E) stained pathological image. Then, an improved bias field correction model is developed to enhance the influence of light for high-frequency part in image and correct the intensity inhomogeneity and detail discontinuity of image. Next, HDR pathological image is generated based on least square method using low dynamic range (LDR) image, H and E channel images. Finally, the fine enhanced image is acquired after the detail enhancement process. Experiments with 140 pathological images demonstrate the performance advantages of our proposed method as compared with related work.

  14. Dosimetric study of surface applicators of HDR brachytherapy GammaMed Plus equipment

    SciTech Connect

    Reyes-Rivera, E. E-mail: modesto@fisica.ugto.mx Sosa, M. E-mail: modesto@fisica.ugto.mx Reyes, U. E-mail: modesto@fisica.ugto.mx Jesús Bernal-Alvarado, José de E-mail: theo@fisica.ugto.mx Córdova, T. E-mail: theo@fisica.ugto.mx Gil-Villegas, A. E-mail: theo@fisica.ugto.mx; Monzón, E.

    2014-11-07

    The cone type surface applicators used in HDR brachytherapy for treatment of small skin lesions are an alternative to be used with both electron beams and orthovoltage X-ray equipment. For a good treatment planning is necessary to know the dose distribution of these applicators, which can be obtained by experimental measurement and Monte Carlo simulation as well. In this study the dose distribution of surface applicators of 3 and 3.5 cm diameter, respectively of HDR brachytherapy GammaMed Plus equipment has been estimated using the Monte Carlo method, MCNP code. The applicators simulated were placed on the surface of a water phantom of 20 × 20 × 20 cm and the dose was calculated at depths from 0 to 3 cm with increments of 0.25 mm. The dose profiles obtained at depth show the expected gradients for surface therapy.

  15. Identification of a novel de novo GATA3 mutation in a patient with HDR syndrome.

    PubMed

    Chen, Liu; Chen, Bing; Leng, Wuilin; Lui, Xiaotian; Wu, Qinan; Ouyang, Xinshou; Liang, Ziwen

    2015-10-01

    We describe the case of a 21-year-old male with hypocalcaemia, hyperphosphataemia, recurrent limb twitch, deafness, proteinuria, increased serum creatinine and urea nitrogen levels, and shrinkage of both kidneys. Brain computed tomography showed intracranial calcifications. The patient was diagnosed with hypoparathyroidism, sensorineural deafness and renal dysplasia (HDR) syndrome. DNA sequence analysis of the GATA3 gene showed a novel de novo mutation, c. 529dupC (p. Arg177profs*126), in exon 2, resulting in a frameshift mutation with a premature stop codon after a new 126 amino acid sequence. We provide further evidence that HDR syndrome is caused by haploinsufficiency of GATA3. © The Author(s) 2015.

  16. Air kerma standard for calibration of well-type chambers in Brazil using {sup 192}Ir HDR sources and its traceability

    SciTech Connect

    Di Prinzio, Renato; Almeida, Carlos Eduardo de

    2009-03-15

    In Brazil there are over 100 high dose rate (HDR) brachytherapy facilities using well-type chambers for the determination of the air kerma rate of {sup 192}Ir sources. This paper presents the methodology developed and extensively tested by the Laboratorio de Ciencias Radiologicas (LCR) and presently in use to calibrate those types of chambers. The system was initially used to calibrate six well-type chambers of brachytherapy services, and the maximum deviation of only 1.0% was observed between the calibration coefficients obtained and the ones in the calibration certificate provided by the UWADCL. In addition to its traceability to the Brazilian National Standards, the whole system was taken to University of Wisconsin Accredited Dosimetry Calibration Laboratory (UWADCL) for a direct comparison and the same formalism to calculate the air kerma was used. The comparison results between the two laboratories show an agreement of 0.9% for the calibration coefficients. Three Brazilian well-type chambers were calibrated at the UWADCL, and by LCR, in Brazil, using the developed system and a clinical HDR machine. The results of the calibration of three well chambers have shown an agreement better than 1.0%. Uncertainty analyses involving the measurements made both at the UWADCL and LCR laboratories are discussed.

  17. SU-E-J-270: Study of PET Response to HDR Brachytherapy of Rectal Cancer

    SciTech Connect

    Hobbs, R; Le, Y; Armour, E; Efron, J; Azad, N; Wahl, R; Gearhart, S; Herman, J

    2014-06-01

    Purpose: Dose-response studies in radiation therapy are typically using single response values for tumors across ensembles of tumors. Using the high dose rate (HDR) treatment plan dose grid and pre- and post-therapy FDG-PET images, we look for correlations between voxelized dose and FDG uptake response in individual tumors. Methods: Fifteen patients were treated for localized rectal cancer using 192Ir HDR brachytherapy in conjunction with surgery. FDG-PET images were acquired before HDR therapy and 6–8 weeks after treatment (prior to surgery). Treatment planning was done on a commercial workstation and the dose grid was calculated. The two PETs and the treatment dose grid were registered to each other using non-rigid registration. The difference in PET SUV values before and after HDR was plotted versus absorbed radiation dose for each voxel. The voxels were then separated into bins for every 400 cGy of absorbed dose and the bin average values plotted similarly. Results: Individual voxel doses did not correlate with PET response; however, when group into tumor subregions corresponding to dose bins, eighty percent of the patients showed a significant positive correlation (R2 > 0) between PET uptake difference in the targeted region and the absorbed dose. Conclusion: By considering larger ensembles of voxels, such as organ average absorbed dose or the dose bins considered here, valuable information may be obtained. The dose-response correlations as measured by FDG-PET difference potentially underlines the importance of FDG-PET as a measure of response, as well as the value of voxelized information.

  18. Pudendal nerve block in HDR-brachytherapy patients: do we really need general or regional anesthesia?

    PubMed

    Schenck, Marcus; Schenck, Catarina; Rübben, Herbert; Stuschke, Martin; Schneider, Tim; Eisenhardt, Andreas; Rossi, Roberto

    2013-04-01

    In male patients, the pudendal block was applied only in rare cases as a therapy of neuralgia of the pudendal nerve. We compared pudendal nerve block (NPB) and combined spinal-epidural anesthesia (CSE) in order to perform a pain-free high-dose-rate (HDR) brachytherapy in a former pilot study in 2010. Regarding this background, in the present study, we only performed the bilateral perineal infiltration of the pudendal nerve. In 25 patients (71.8 ± 4.18 years) suffering from a high-risk prostate carcinoma, we performed the HDR-brachytherapy with the NPB. The perioperative compatibility, the subjective feeling (German school marks principle 1-6), subjective pain (VAS 1-10) and the early postoperative course (mobility, complications) were examined. All patients preferred the NPB. There was no change of anesthesia form necessary. The expense time of NPB was 10.68 ± 2.34 min. The hollow needles (mean 24, range 13-27) for the HDR-brachytherapy remained on average 79.92 ± 12.41 min. During and postoperative, pain feeling was between 1.4 ± 1.08 and 1.08 ± 1.00. A transurethral 22 French Foley catheter was left in place for 6 h. All patients felt the bladder catheter as annoying, but they considered postoperative mobility as more important as complete lack of pain. The subjective feeling was described as 2.28 ± 0.74. Any side effects or complications did not appear. Bilateral NPB is a safe and effective analgesic option in HDR-brachytherapy and can replace CSE. It offers the advantage of almost no impaired mobility of the patient and can be performed by the urologist himself. Using transrectal ultrasound guidance, the method can be learned quickly.

  19. HDR (Hot Dry Rock) technology transfer activities in the Clear Lake Area, California

    SciTech Connect

    Burns, K.; Potter, R.

    1990-01-01

    A large Hot Dry Rock resource has been recognized in northern California. It underlies the region extending NE of The Geysers to N of the City of Clearlake. The long-range productive potential is thousands of megawatts. The geothermal resource is heterogeneous. There are two mechanisms of heat flow occurring together. One is fluid transport, up natural zones of permeability, to outflows as surface springs. The other is conductive heat flow through impermeable rock. The temperature isotherms are thought to be nearly level surfaces, for example, the 300{degree}C isotherm is at about 8000 ft depth, with spikes'' or ridges'' occurring around narrow zones of fluid flow. While there is accessible heat at shallow depth in the naturally permeable rocks, the really substantial resource is in the impermeable rock. This is the HDR resource. The potential reservoir rocks are Franciscan greywackes and greenstones. Recorded drilling problems appear to be mainly due to intersection with serpentinites or to the effects of stimulation, so are potentially avoidable. Greywacke is favoured as a reservoir rock, and is expected to fail by brittle fracture. The water shortages in Northern California appear to be surmountable. Leakoff rates are expected to be low. Sewerage water may be available for fill and makeup. There is a possibility of combining HDR heat power production with sewerage disposal. To establish the first HDR producer in Northern California offers challenges in technology transfer. Two significant challenges will be creation of dispersed permeability in a greywacke reservoir, and pressure management in the vicinity of naturally permeable zones. A successful demonstration of HDR production technology will improve the long-term prospects for the geothermal power industry in California. 29 refs., 20 figs., 4 tabs.

  20. Radiation dose enhancement at tissue-tungsten interfaces in HDR brachytherapy.

    PubMed

    Han, Z; Safavi-Naeini, M; Alnaghy, S; Cutajar, D L; Guatelli, S; Petasecca, M; Franklin, D R; Malaroda, A; Carrara, M; Bucci, J; Zaider, M; Lerch, M L F; Rosenfeld, A B

    2014-11-07

    HDR BrachyView is a novel in-body dosimetric imaging system for real-time monitoring and verification of the source position in high dose rate (HDR) prostate brachytherapy treatment. It is based on a high-resolution pixelated detector array with a semi-cylindrical multi-pinhole tungsten collimator and is designed to fit inside a compact rectal probe, and is able to resolve the 3D position of the source with a maximum error of 1.5 mm. This paper presents an evaluation of the additional dose that will be delivered to the patient as a result of backscatter radiation from the collimator. Monte Carlo simulations of planar and cylindrical collimators embedded in a tissue-equivalent phantom were performed using Geant4, with an (192)Ir source placed at two different source-collimator distances. The planar configuration was replicated experimentally to validate the simulations, with a MOSkin dosimetry probe used to measure dose at three distances from the collimator. For the cylindrical collimator simulation, backscatter dose enhancement was calculated as a function of axial and azimuthal displacement, and dose distribution maps were generated at three distances from the collimator surface. Although significant backscatter dose enhancement was observed for both geometries immediately adjacent to the collimator, simulations and experiments indicate that backscatter dose is negligible at distances beyond 1 mm from the collimator. Since HDR BrachyView is enclosed within a 1 mm thick tissue-equivalent plastic shell, all backscatter radiation resulting from its use will therefore be absorbed before reaching the rectal wall or other tissues. dosimetry, brachytherapy, HDR.

  1. Large-Scale Crowdsourced Study for Tone-Mapped HDR Pictures.

    PubMed

    Kundu, Debarati; Ghadiyaram, Deepti; Bovik, Alan C; Evans, Brian L

    2017-10-01

    Measuring digital picture quality, as perceived by human observers, is increasingly important in many applications in which humans are the ultimate consumers of visual information. Standard dynamic range (SDR) images provide 8 b/color/pixel. High dynamic range (HDR) images, usually created from multiple exposures of the same scene, can provide 16 or 32 b/color/pixel, but need to be tonemapped to SDR for display on standard monitors. Multiexposure fusion (MEF) techniques bypass HDR creation by fusing an exposure stack directly to SDR images to achieve aesthetically pleasing luminance and color distributions. Many HDR and MEF databases have a relatively small number of images and human opinion scores, obtained under stringently controlled conditions, thereby limiting realistic viewing. Moreover, many of these databases are intended to compare tone-mapping algorithms, rather than being specialized for developing and comparing image quality assessment models. To overcome these challenges, we conducted a massively crowdsourced online subjective study. The primary contributions described in this paper are: 1) the new ESPL-LIVE HDR Image Database that we created containing diverse images obtained by tone-mapping operators and MEF algorithms, with and without post-processing; 2) a large-scale subjective study that we conducted using a crowdsourced platform to gather more than 300 000 opinion scores on 1811 images from over 5000 unique observers; and 3) a detailed study of the correlation performance of the state-of-the-art no-reference image quality assessment algorithms against human opinion scores of these images. The database is available at http://signal.ece.utexas.edu/%7Edebarati/HDRDatabase.zip.

  2. IPIP: A new approach to inverse planning for HDR brachytherapy by directly optimizing dosimetric indices

    SciTech Connect

    Siauw, Timmy; Cunha, Adam; Atamtuerk, Alper; Hsu, I-Chow; Pouliot, Jean; Goldberg, Ken

    2011-07-15

    Purpose: Many planning methods for high dose rate (HDR) brachytherapy require an iterative approach. A set of computational parameters are hypothesized that will give a dose plan that meets dosimetric criteria. A dose plan is computed using these parameters, and if any dosimetric criteria are not met, the process is iterated until a suitable dose plan is found. In this way, the dose distribution is controlled by abstract parameters. The purpose of this study is to develop a new approach for HDR brachytherapy by directly optimizing the dose distribution based on dosimetric criteria. Methods: The authors developed inverse planning by integer program (IPIP), an optimization model for computing HDR brachytherapy dose plans and a fast heuristic for it. They used their heuristic to compute dose plans for 20 anonymized prostate cancer image data sets from patients previously treated at their clinic database. Dosimetry was evaluated and compared to dosimetric criteria. Results: Dose plans computed from IPIP satisfied all given dosimetric criteria for the target and healthy tissue after a single iteration. The average target coverage was 95%. The average computation time for IPIP was 30.1 s on an Intel(R) Core{sup TM}2 Duo CPU 1.67 GHz processor with 3 Gib RAM. Conclusions: IPIP is an HDR brachytherapy planning system that directly incorporates dosimetric criteria. The authors have demonstrated that IPIP has clinically acceptable performance for the prostate cases and dosimetric criteria used in this study, in both dosimetry and runtime. Further study is required to determine if IPIP performs well for a more general group of patients and dosimetric criteria, including other cancer sites such as GYN.

  3. Trans-Pacific HDR Satellite Communications Experiment Phase-2: Experimental Network and Demonstration Plan

    NASA Technical Reports Server (NTRS)

    Kadowaki, Naoto; Yoshimura, Naoko; Takahashi, Takashi; Yoshikawa, Makoto; Hsu, Eddie; Bergman, Larry; Bhasin, Kul; Gary, Pat

    1998-01-01

    The trans-Pacific high data rate (TP-HDR) satellite communications experiment was proposed at the Japan-U.S. Cooperation in Space (JUCS) Program Workshop held in Hawaii in 1993 and remote high definition video post-production was demonstrated as the first phase trial. Following the first phase, the second phase experiment is currently prepared. This paper describes the experimental network configuration, application demonstration, and performance evaluation plan of the second phase experiment.

  4. Near constant-time optimal piecewise LDR to HDR inverse tone mapping

    NASA Astrophysics Data System (ADS)

    Chen, Qian; Su, Guan-Ming; Yin, Peng

    2015-02-01

    In a backward compatible HDR image/video compression, it is a general approach to reconstruct HDR from compressed LDR as a prediction to original HDR, which is referred to as inverse tone mapping. Experimental results show that 2- piecewise 2nd order polynomial has the best mapping accuracy than 1 piece high order or 2-piecewise linear, but it is also the most time-consuming method because to find the optimal pivot point to split LDR range to 2 pieces requires exhaustive search. In this paper, we propose a fast algorithm that completes optimal 2-piecewise 2nd order polynomial inverse tone mapping in near constant time without quality degradation. We observe that in least square solution, each entry in the intermediate matrix can be written as the sum of some basic terms, which can be pre-calculated into look-up tables. Since solving the matrix becomes looking up values in tables, computation time barely differs regardless of the number of points searched. Hence, we can carry out the most thorough pivot point search to find the optimal pivot that minimizes MSE in near constant time. Experiment shows that our proposed method achieves the same PSNR performance while saving 60 times computation time compared to the traditional exhaustive search in 2-piecewise 2nd order polynomial inverse tone mapping with continuous constraint.

  5. NOTE: Monte Carlo evaluation of kerma in an HDR brachytherapy bunker

    NASA Astrophysics Data System (ADS)

    Pérez-Calatayud, J.; Granero, D.; Ballester, F.; Casal, E.; Crispin, V.; Puchades, V.; León, A.; Verdú, G.

    2004-12-01

    In recent years, the use of high dose rate (HDR) after-loader machines has greatly increased due to the shift from traditional Cs-137/Ir-192 low dose rate (LDR) to HDR brachytherapy. The method used to calculate the required concrete and, where appropriate, lead shielding in the door is based on analytical methods provided by documents published by the ICRP, the IAEA and the NCRP. The purpose of this study is to perform a more realistic kerma evaluation at the entrance maze door of an HDR bunker using the Monte Carlo code GEANT4. The Monte Carlo results were validated experimentally. The spectrum at the maze entrance door, obtained with Monte Carlo, has an average energy of about 110 keV, maintaining a similar value along the length of the maze. The comparison of results from the aforementioned values with the Monte Carlo ones shows that results obtained using the albedo coefficient from the ICRP document more closely match those given by the Monte Carlo method, although the maximum value given by MC calculations is 30% greater.

  6. The high dynamic range pixel array detector (HDR-PAD): Concept and design

    SciTech Connect

    Shanks, Katherine S.; Philipp, Hugh T.; Weiss, Joel T.; Becker, Julian; Tate, Mark W.; Gruner, Sol M.

    2016-07-27

    Experiments at storage ring light sources as well as at next-generation light sources increasingly require detectors capable of high dynamic range operation, combining low-noise detection of single photons with large pixel well depth. XFEL sources in particular provide pulse intensities sufficiently high that a purely photon-counting approach is impractical. The High Dynamic Range Pixel Array Detector (HDR-PAD) project aims to provide a dynamic range extending from single-photon sensitivity to 10{sup 6} photons/pixel in a single XFEL pulse while maintaining the ability to tolerate a sustained flux of 10{sup 11} ph/s/pixel at a storage ring source. Achieving these goals involves the development of fast pixel front-end electronics as well as, in the XFEL case, leveraging the delayed charge collection due to plasma effects in the sensor. A first prototype of essential electronic components of the HDR-PAD readout ASIC, exploring different options for the pixel front-end, has been fabricated. Here, the HDR-PAD concept and preliminary design will be described.

  7. The Ansel Adams zone system: HDR capture and range compression by chemical processing

    NASA Astrophysics Data System (ADS)

    McCann, John J.

    2010-02-01

    We tend to think of digital imaging and the tools of PhotoshopTM as a new phenomenon in imaging. We are also familiar with multiple-exposure HDR techniques intended to capture a wider range of scene information, than conventional film photography. We know about tone-scale adjustments to make better pictures. We tend to think of everyday, consumer, silver-halide photography as a fixed window of scene capture with a limited, standard range of response. This description of photography is certainly true, between 1950 and 2000, for instant films and negatives processed at the drugstore. These systems had fixed dynamic range and fixed tone-scale response to light. All pixels in the film have the same response to light, so the same light exposure from different pixels was rendered as the same film density. Ansel Adams, along with Fred Archer, formulated the Zone System, staring in 1940. It was earlier than the trillions of consumer photos in the second half of the 20th century, yet it was much more sophisticated than today's digital techniques. This talk will describe the chemical mechanisms of the zone system in the parlance of digital image processing. It will describe the Zone System's chemical techniques for image synthesis. It also discusses dodging and burning techniques to fit the HDR scene into the LDR print. Although current HDR imaging shares some of the Zone System's achievements, it usually does not achieve all of them.

  8. Impact of using linear optimization models in dose planning for HDR brachytherapy

    SciTech Connect

    Holm, Aasa; Larsson, Torbjoern; Carlsson Tedgren, Aasa

    2012-02-15

    Purpose: Dose plans generated with optimization models hitherto used in high-dose-rate (HDR) brachytherapy have shown a tendency to yield longer dwell times than manually optimized plans. Concern has been raised for the corresponding undesired hot spots, and various methods to mitigate these have been developed. The hypotheses upon this work is based are (a) that one cause for the long dwell times is the use of objective functions comprising simple linear penalties and (b) that alternative penalties, as these are piecewise linear, would lead to reduced length of individual dwell times. Methods: The characteristics of the linear penalties and the piecewise linear penalties are analyzed mathematically. Experimental comparisons between the two types of penalties are carried out retrospectively for a set of prostate cancer patients. Results: When the two types of penalties are compared, significant changes can be seen in the dwell times, while most dose-volume parameters do not differ significantly. On average, total dwell times were reduced by 4.2%, with a reduction of maximum dwell times by 25%, when the alternative penalties were used. Conclusions: The use of linear penalties in optimization models for HDR brachytherapy is one cause for the undesired long dwell times that arise in mathematically optimized plans. By introducing alternative penalties, a significant reduction in dwell times can be achieved for HDR brachytherapy dose plans. Although various measures for mitigating the long dwell times are already available, the observation that linear penalties contribute to their appearance is of fundamental interest.

  9. Clinical implementation of a new HDR brachytherapy device for partial breast irradiation.

    PubMed

    Scanderbeg, Daniel J; Yashar, Catheryn; Rice, Roger; Pawlicki, Todd

    2009-01-01

    To present the clinical implementation of a new HDR device for partial breast irradiation, the Strut-Adjusted Volume Implant (SAVI), at the University of California, San Diego. The SAVI device has multiple peripheral struts that can be differentially loaded with the HDR source. Planning criteria used for evaluation of the treatment plans included the following dose volume histogram (DVH) criteria: V90 >90%, V150 <50cc and V200 <20cc. SAVI has been used on 20 patients to date at UC San Diego. In each case, the dose was modulated according to patient-specific anatomy to cover the tumor bed, while sparing normal tissues. The dosimetric data show that we can achieve greater than 90% coverage with respect to V90 (median of 95.3%) and also keep a low V150 and V200 dose at 24.5 and 11.2cc, respectively. Complete treatment can be done within a 30-min time slot, which includes implant verification, setup, and irradiation time as well as wound dressing. SAVI has been implemented at UC San Diego for accelerated partial breast irradiation with excellent tumor bed conformance and minimal normal tissue exposure. Patient positioning is the key to identifying any inter-fraction device motion. Device asymmetry or tissue conformance has been shown to resolve itself 24h after the device implantation. The device can be implemented into an existing HDR program with minimal effort.

  10. Interactive multiobjective optimization for anatomy-based three-dimensional HDR brachytherapy

    NASA Astrophysics Data System (ADS)

    Ruotsalainen, Henri; Miettinen, Kaisa; Palmgren, Jan-Erik; Lahtinen, Tapani

    2010-08-01

    In this paper, we present an anatomy-based three-dimensional dose optimization approach for HDR brachytherapy using interactive multiobjective optimization (IMOO). In brachytherapy, the goals are to irradiate a tumor without causing damage to healthy tissue. These goals are often conflicting, i.e. when one target is optimized the other will suffer, and the solution is a compromise between them. IMOO is capable of handling multiple and strongly conflicting objectives in a convenient way. With the IMOO approach, a treatment planner's knowledge is used to direct the optimization process. Thus, the weaknesses of widely used optimization techniques (e.g. defining weights, computational burden and trial-and-error planning) can be avoided, planning times can be shortened and the number of solutions to be calculated is small. Further, plan quality can be improved by finding advantageous trade-offs between the solutions. In addition, our approach offers an easy way to navigate among the obtained Pareto optimal solutions (i.e. different treatment plans). When considering a simulation model of clinical 3D HDR brachytherapy, the number of variables is significantly smaller compared to IMRT, for example. Thus, when solving the model, the CPU time is relatively short. This makes it possible to exploit IMOO to solve a 3D HDR brachytherapy optimization problem. To demonstrate the advantages of IMOO, two clinical examples of optimizing a gynecologic cervix cancer treatment plan are presented.

  11. Genitourinary Toxicity After High-Dose-Rate (HDR) Brachytherapy Combined With Hypofractionated External Beam Radiotherapy for Localized Prostate Cancer: An Analysis to Determine the Correlation Between Dose-Volume Histogram Parameters in HDR Brachytherapy and Severity of Toxicity

    SciTech Connect

    Ishiyama, Hiromichi Kitano, Masashi; Satoh, Takefumi; Kotani, Shouko; Uemae, Mineko; Matsumoto, Kazumasa; Okusa, Hiroshi; Tabata, Ken-ichi; Baba, Shiro; Hayakawa, Kazushige

    2009-09-01

    Purpose: To evaluate the severity of genitourinary (GU) toxicity in high-dose-rate (HDR) brachytherapy combined with hypofractionated external beam radiotherapy (EBRT) for prostate cancer and to explore factors that might affect the severity of GU toxicity. Methods and Materials: A total of 100 Japanese men with prostate cancer underwent {sup 192}Ir HDR brachytherapy combined with hypofractionated EBRT. Mean (SD) dose to 90% of the planning target volume was 6.3 (0.7) Gy per fraction of HDR. After 5 fractions of HDR treatment, EBRT with 10 fractions of 3 Gy was administrated. The urethral volume receiving 1-15 Gy per fraction in HDR brachytherapy (V1-V15) and the dose to at least 5-100% of urethral volume in HDR brachytherapy (D5-D100) were compared between patients with Grade 3 toxicity and those with Grade 0-2 toxicity. Prostate volume, patient age, and International Prostate Symptom Score were also compared between the two groups. Results: Of the 100 patients, 6 displayed Grade 3 acute GU toxicity, and 12 displayed Grade 3 late GU toxicity. Regarding acute GU toxicity, values of V1, V2, V3, and V4 were significantly higher in patients with Grade 3 toxicity than in those with Grade 0-2 toxicity. Regarding late GU toxicity, values of D70, D80, V12, and V13 were significantly higher in patients with Grade 3 toxicity than in those with Grade 0-2 toxicity. Conclusions: The severity of GU toxicity in HDR brachytherapy combined with hypofractionated EBRT for prostate cancer was relatively high. The volume of prostatic urethra was associated with grade of acute GU toxicity, and urethral dose was associated with grade of late GU toxicity.

  12. Genitourinary toxicity after high-dose-rate (HDR) brachytherapy combined with Hypofractionated External beam radiotherapy for localized prostate cancer: an analysis to determine the correlation between dose-volume histogram parameters in HDR brachytherapy and severity of toxicity.

    PubMed

    Ishiyama, Hiromichi; Kitano, Masashi; Satoh, Takefumi; Kotani, Shouko; Uemae, Mineko; Matsumoto, Kazumasa; Okusa, Hiroshi; Tabata, Ken-ichi; Baba, Shiro; Hayakawa, Kazushige

    2009-09-01

    To evaluate the severity of genitourinary (GU) toxicity in high-dose-rate (HDR) brachytherapy combined with hypofractionated external beam radiotherapy (EBRT) for prostate cancer and to explore factors that might affect the severity of GU toxicity. A total of 100 Japanese men with prostate cancer underwent (192)Ir HDR brachytherapy combined with hypofractionated EBRT. Mean (SD) dose to 90% of the planning target volume was 6.3 (0.7) Gy per fraction of HDR. After 5 fractions of HDR treatment, EBRT with 10 fractions of 3 Gy was administrated. The urethral volume receiving 1-15 Gy per fraction in HDR brachytherapy (V1-V15) and the dose to at least 5-100% of urethral volume in HDR brachytherapy (D5-D100) were compared between patients with Grade 3 toxicity and those with Grade 0-2 toxicity. Prostate volume, patient age, and International Prostate Symptom Score were also compared between the two groups. Of the 100 patients, 6 displayed Grade 3 acute GU toxicity, and 12 displayed Grade 3 late GU toxicity. Regarding acute GU toxicity, values of V1, V2, V3, and V4 were significantly higher in patients with Grade 3 toxicity than in those with Grade 0-2 toxicity. Regarding late GU toxicity, values of D70, D80, V12, and V13 were significantly higher in patients with Grade 3 toxicity than in those with Grade 0-2 toxicity. The severity of GU toxicity in HDR brachytherapy combined with hypofractionated EBRT for prostate cancer was relatively high. The volume of prostatic urethra was associated with grade of acute GU toxicity, and urethral dose was associated with grade of late GU toxicity.

  13. Developing A Directional High-Dose Rate (d-HDR) Brachytherapy Source

    NASA Astrophysics Data System (ADS)

    Heredia, Athena Yvonne

    Conventional sources used in brachytherapy provide nearly isotropic or radially symmetric dose distributions. Optimizations of dose distributions have been limited to varied dwell times at specified locations within a given treatment volume, or manipulations in source position for seed implantation techniques. In years past, intensity modulated brachytherapy (IMBT) has been used to reduce the amount of radiation to surrounding sensitive structures in select intracavitary cases by adding space or partial shields. Previous work done by Lin et al., at the University of Wisconsin-Madison, has shown potential improvements in conformality for brachytherapy treatments using a directionally shielded low dose rate (LDR) source for treatments in breast and prostate. Directional brachytherapy sources irradiate approximately half of the radial angles around the source, and adequately shield a quarter of the radial angles on the opposite side, with sharp gradient zones between the treated half and shielded quarter. With internally shielded sources, the radiation can be preferentially emitted in such a way as to reduce toxicities in surrounding critical organs. The objective of this work is to present findings obtained in the development of a new directional high dose rate (d-HDR) source. To this goal, 103Pd (Z = 46) is reintroduced as a potential radionuclide for use in HDR brachytherapy. 103Pd has a low average photon energy (21 keV) and relatively short half -life (17 days), which is why it has historically been used in low dose rate applications and implantation techniques. Pd-103 has a carrier-free specific activity of 75000 Ci/g. Using cyclotron produced 103Pd, near carrier-free specific activities can be achieved, providing suitability for high dose rate applications. The evolution of the d-HDR source using Monte Carlo simulations is presented, along with dosimetric parameters used to fully characterize the source. In addition, a discussion on how to obtain elemental

  14. High dynamic range adaptive real-time smart camera: an overview of the HDR-ARTiST project

    NASA Astrophysics Data System (ADS)

    Lapray, Pierre-Jean; Heyrman, Barthélémy; Ginhac, Dominique

    2015-04-01

    Standard cameras capture only a fraction of the information that is visible to the human visual system. This is specifically true for natural scenes including areas of low and high illumination due to transitions between sunlit and shaded areas. When capturing such a scene, many cameras are unable to store the full Dynamic Range (DR) resulting in low quality video where details are concealed in shadows or washed out by sunlight. The imaging technique that can overcome this problem is called HDR (High Dynamic Range) imaging. This paper describes a complete smart camera built around a standard off-the-shelf LDR (Low Dynamic Range) sensor and a Virtex-6 FPGA board. This smart camera called HDR-ARtiSt (High Dynamic Range Adaptive Real-time Smart camera) is able to produce a real-time HDR live video color stream by recording and combining multiple acquisitions of the same scene while varying the exposure time. This technique appears as one of the most appropriate and cheapest solution to enhance the dynamic range of real-life environments. HDR-ARtiSt embeds real-time multiple captures, HDR processing, data display and transfer of a HDR color video for a full sensor resolution (1280 1024 pixels) at 60 frames per second. The main contributions of this work are: (1) Multiple Exposure Control (MEC) dedicated to the smart image capture with alternating three exposure times that are dynamically evaluated from frame to frame, (2) Multi-streaming Memory Management Unit (MMMU) dedicated to the memory read/write operations of the three parallel video streams, corresponding to the different exposure times, (3) HRD creating by combining the video streams using a specific hardware version of the Devebecs technique, and (4) Global Tone Mapping (GTM) of the HDR scene for display on a standard LCD monitor.

  15. Source geometry factors for HDR ¹⁹²Ir brachytherapy secondary standard well-type ionization chamber calibrations.

    PubMed

    Shipley, D R; Sander, T; Nutbrown, R F

    2015-03-21

    Well-type ionization chambers are used for measuring the source strength of radioactive brachytherapy sources before clinical use. Initially, the well chambers are calibrated against a suitable national standard. For high dose rate (HDR) (192)Ir, this calibration is usually a two-step process. Firstly, the calibration source is traceably calibrated against an air kerma primary standard in terms of either reference air kerma rate or air kerma strength. The calibrated (192)Ir source is then used to calibrate the secondary standard well-type ionization chamber. Calibration laboratories are usually only equipped with one type of HDR (192)Ir source. If the clinical source type is different from that used for the calibration of the well chamber at the standards laboratory, a source geometry factor, k(sg), is required to correct the calibration coefficient for any change of the well chamber response due to geometric differences between the sources. In this work we present source geometry factors for six different HDR (192)Ir brachytherapy sources which have been determined using Monte Carlo techniques for a specific ionization chamber, the Standard Imaging HDR 1000 Plus well chamber with a type 70010 HDR iridium source holder. The calculated correction factors were normalized to the old and new type of calibration source used at the National Physical Laboratory. With the old Nucletron microSelectron-v1 (classic) HDR (192)Ir calibration source, ksg was found to be in the range 0.983 to 0.999 and with the new Isodose Control HDR (192)Ir Flexisource k(sg) was found to be in the range 0.987 to 1.004 with a relative uncertainty of 0.4% (k = 2). Source geometry factors for different combinations of calibration sources, clinical sources, well chambers and associated source holders, can be calculated with the formalism discussed in this paper.

  16. SU-E-T-242: Design of a Novel Afterloader Clearance QA Device for Biliary HDR Therapy

    SciTech Connect

    Mullins, JP; Deufel, CL

    2015-06-15

    Purpose: Bile duct cancer affects 2–3 thousand people annually in the United States. Radiation therapy has been shown to double median survival, with combined external beam and intraluminal high dose-rate (HDR) brachytherapy being most effective. Endoscopic retrograde cholangiopancreatography (ERCP) biliary HDR, a less-invasive alternative to trans-hepatic brachytherapy, is delivered through a catheter that travels a tortuous path from nose to bile duct, requiring wire drive force and dexterity beyond typical afterloader performance specifications. Thus, specific afterloader quality assurance(QA) is recommended for this procedure. Our aim was to create a device and process for Varisource afterloader clearance QA with objectives that it be quantitative and can monitor afterloader performance over time, compare performance between two distinct afterloaders and potentially Result in a predictive nomogram for patient-specific clearance. Methods: Based on retrospective reconstruction of 20 ERCP patient anatomies, we designed a phantom to test afterloader ability to drive the source wire along an intended treatment path. The ability of the afterloader to fully extend the intended treatment path is a function of number and diameters of turns. We have determined experimentally that relative position of the turns does not impact performance. Results: Both patient and QA paths involve three common turns/loops: a large turn representing the stomach(10.8cm±2.0cm), an elliptical loop representing the duodenum(7.3cm±1.5cmx4.8cm±0.7cm), and a final turn at the end of the bile duct that may be tight for some patient-specific anatomies and absent in others(3.7cm±0.7cm, where present). Our phantom design uses anatomical average turn diameters for the stomach and duodenum then terminates in a turn of quantitatively selectable diameter. The smallest final turn diameter that an afterloader can pass is recorded as the QA parameter. Conclusion: With this device and QA process, we

  17. Improved prostate delineation in prostate HDR brachytherapy with TRUS-CT deformable registration technology: A pilot study with MRI validation.

    PubMed

    Yang, Xiaofeng; Rossi, Peter J; Jani, Ashesh B; Mao, Hui; Zhou, Zhengyang; Curran, Walter J; Liu, Tian

    2017-01-01

    Accurate prostate delineation is essential to ensure proper target coverage and normal-tissue sparing in prostate HDR brachytherapy. We have developed a prostate HDR brachytherapy technology that integrates intraoperative TRUS-based prostate contour into HDR treatment planning through TRUS-CT deformable registration (TCDR) to improve prostate contour accuracy. In a perspective study of 16 patients, we investigated the clinical feasibility as well as the performance of this TCDR-based HDR approach. We compared the performance of the TCDR-based approach with the conventional CT-based HDR in terms of prostate contour accuracy using MRI as the gold standard. For all patients, the average Dice prostate volume overlap was 91.1 ± 2.3% between the TCDR-based and the MRI-defined prostate volumes. In a subset of eight patients, inter and intro-observer reliability study was conducted among three experienced physicians (two radiation oncologists and one radiologist) for the TCDR-based HDR approach. Overall, a 10 to 40% improvement in prostate volume accuracy can be achieved with the TCDR-based approach as compared with the conventional CT-based prostate volumes. The TCDR-based prostate volumes match closely to the MRI-defined prostate volumes for all 3 observers (mean volume difference: 0.5 ± 7.2%, 1.8 ± 7.2%, and 3.5 ± 5.1%); while CT-based contours overestimated prostate volumes by 10.9 ± 28.7%, 13.7 ± 20.1%, and 44.7 ± 32.1%. This study has shown that the TCDR-based HDR brachytherapy is clinically feasible and can significantly improve prostate contour accuracy over the conventional CT-based prostate contour. We also demonstrated the reliability of the TCDR-based prostate delineation. This TCDR-based HDR approach has the potential to enable accurate dose planning and delivery, and potentially enhance prostate HDR treatment outcome. © 2017 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of

  18. A comparison of HDR brachytherapy and IMRT techniques for dose escalation in prostate cancer: A radiobiological modeling study

    SciTech Connect

    Fatyga, M.; Williamson, J. F.; Dogan, N.; Todor, D.; Siebers, J. V.; George, R.; Barani, I.; Hagan, M.

    2009-09-15

    A course of one to three large fractions of high dose rate (HDR) interstitial brachytherapy is an attractive alternative to intensity modulated radiation therapy (IMRT) for delivering boost doses to the prostate in combination with additional external beam irradiation for intermediate risk disease. The purpose of this work is to quantitatively compare single-fraction HDR boosts to biologically equivalent fractionated IMRT boosts, assuming idealized image guided delivery (igIMRT) and conventional delivery (cIMRT). For nine prostate patients, both seven-field IMRT and HDR boosts were planned. The linear-quadratic model was used to compute biologically equivalent dose prescriptions. The cIMRT plan was evaluated as a static plan and with simulated random and setup errors. The authors conclude that HDR delivery produces a therapeutic ratio which is significantly better than the conventional IMRT and comparable to or better than the igIMRT delivery. For the HDR, the rectal gBEUD analysis is strongly influenced by high dose DVH tails. A saturation BED, beyond which no further injury can occur, must be assumed. Modeling of organ motion uncertainties yields mean outcomes similar to static plan outcomes.

  19. Methanogenic heterodisulfide reductase (HdrABC-MvhAGD) uses two noncubane [4Fe-4S] clusters for reduction.

    PubMed

    Wagner, Tristan; Koch, Jürgen; Ermler, Ulrich; Shima, Seigo

    2017-08-18

    In methanogenic archaea, the carbon dioxide (CO2) fixation and methane-forming steps are linked through the heterodisulfide reductase (HdrABC)-[NiFe]-hydrogenase (MvhAGD) complex that uses flavin-based electron bifurcation to reduce ferredoxin and the heterodisulfide of coenzymes M and B. Here, we present the structure of the native heterododecameric HdrABC-MvhAGD complex at 2.15-angstrom resolution. HdrB contains two noncubane [4Fe-4S] clusters composed of fused [3Fe-4S]-[2Fe-2S] units sharing 1 iron (Fe) and 1 sulfur (S), which were coordinated at the CCG motifs. Soaking experiments showed that the heterodisulfide is clamped between the two noncubane [4Fe-4S] clusters and homolytically cleaved, forming coenzyme M and B bound to each iron. Coenzymes are consecutively released upon one-by-one electron transfer. The HdrABC-MvhAGD atomic model serves as a structural template for numerous HdrABC homologs involved in diverse microbial metabolic pathways. Copyright © 2017 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works.

  20. Overexpression and Suppression of Artemisia annua 4-Hydroxy-3-Methylbut-2-enyl Diphosphate Reductase 1 Gene (AaHDR1) Differentially Regulate Artemisinin and Terpenoid Biosynthesis

    PubMed Central

    Ma, Dongming; Li, Gui; Zhu, Yue; Xie, De-Yu

    2017-01-01

    4-Hydroxy-3-methylbut-2-enyl diphosphate reductase (HDR) catalyzes the last step of the 2-C-methyl-D-erythritol 4- phosphate (MEP) pathway to synthesize isopentenyl pyrophosphate (IPP) and dimethylallyl diphosphate (DMAPP). To date, little is known regarding effects of an increase or a decrease of a HDR expression on terpenoid and other metabolite profiles in plants. In our study, an Artemisia annua HDR cDNA (namely AaHDR1) was cloned from leaves. Expression profiling showed that it was highly expressed in leaves, roots, stems, and flowers with different levels. Green florescence protein fusion and confocal microscope analyses showed that AaHDR1 was localized in chloroplasts. The overexpression of AaHDR1 increased contents of artemisinin, arteannuin B and other sesquiterpenes, and multiple monoterpenes. By contrast, the suppression of AaHDR1 by anti-sense led to opposite results. In addition, an untargeted metabolic profiling showed that the overexpression and suppression altered non-polar metabolite profiles. In conclusion, the overexpression and suppression of AaHDR1 protein level in plastids differentially affect artemisinin and other terpenoid biosynthesis, and alter non-polar metabolite profiles of A. annua. Particularly, its overexpression leading to the increase of artemisinin production is informative to future metabolic engineering of this antimalarial medicine. PMID:28197158

  1. SU-E-T-169: Characterization of Pacemaker/ICD Dose in SAVI HDR Brachytherapy

    SciTech Connect

    Kalavagunta, C; Lasio, G; Yi, B; Zhou, J; Lin, M

    2015-06-15

    Purpose: It is important to estimate dose to pacemaker (PM)/Implantable Cardioverter Defibrillator (ICD) before undertaking Accelerated Partial Breast Treatment using High Dose Rate (HDR) brachytherapy. Kim et al. have reported HDR PM/ICD dose using a single-source balloon applicator. To the authors knowledge, there have so far not been any published PM/ICD dosimetry literature for the Strut Adjusted Volume Implant (SAVI, Cianna Medical, Aliso Viejo, CA). This study aims to fill this gap by generating a dose look up table (LUT) to predict maximum dose to the PM/ICD in SAVI HDR brachytherapy. Methods: CT scans for 3D dosimetric planning were acquired for four SAVI applicators (6−1-mini, 6−1, 8−1 and 10−1) expanded to their maximum diameter in air. The CT datasets were imported into the Elekta Oncentra TPS for planning and each applicator was digitized in a multiplanar reconstruction window. A dose of 340 cGy was prescribed to the surface of a 1 cm expansion of the SAVI applicator cavity. Cartesian coordinates of the digitized applicator were determined in the treatment leading to the generation of a dose distribution and corresponding distance-dose prediction look up table (LUT) for distances from 2 to 15 cm (6-mini) and 2 to 20 cm (10–1).The deviation between the LUT doses and the dose to the cardiac device in a clinical case was evaluated. Results: Distance-dose look up table were compared to clinical SAVI plan and the discrepancy between the max dose predicted by the LUT and the clinical plan was found to be in the range (−0.44%, 0.74%) of the prescription dose. Conclusion: The distance-dose look up tables for SAVI applicators can be used to estimate the maximum dose to the ICD/PM, with a potential usefulness for quick assessment of dose to the cardiac device prior to applicator placement.

  2. SU-E-T-149: Brachytherapy Patient Specific Quality Assurance for a HDR Vaginal Cylinder Case

    SciTech Connect

    Barbiere, J; Napoli, J; Ndlovu, A

    2015-06-15

    Purpose: Commonly Ir-192 HDR treatment planning system commissioning is only based on a single absolute measurement of source activity supplemented by tabulated parameters for multiple factors without independent verification that the planned distribution corresponds to the actual delivered dose. The purpose on this work is to present a methodology using Gafchromic film with a statistically valid calibration curve that can be used to validate clinical HDR vaginal cylinder cases by comparing the calculated plan dose distribution in a plane with the corresponding measured planar dose. Methods: A vaginal cylinder plan was created with Oncentra treatment planning system. The 3D dose matrix was exported to a Varian Eclipse work station for convenient extraction of a 2D coronal dose plane corresponding to the film position. The plan was delivered with a sheet of Gafchromic EBT3 film positioned 1mm from the catheter using an Ir-192 Nucletron HDR source. The film was then digitized with an Epson 10000 XL color scanner. Film analysis is performed with MatLab imaging toolbox. A density to dose calibration curve was created using TG43 formalism for a single dwell position exposure at over 100 points for statistical accuracy. The plan and measured film dose planes were registered using a known dwell position relative to four film marks. The plan delivered 500 cGy to points 2 cm from the sources. Results: The distance to agreement of the 500 cGy isodose between the plan and film measurement laterally was 0.5 mm but can be as much as 1.5 mm superior and inferior. The difference between the computed plan dose and film measurement was calculated per pixel. The greatest errors up to 50 cGy are near the apex. Conclusion: The methodology presented will be useful to implement more comprehensive quality assurance to verify patient-specific dose distributions.

  3. Dosimetric characterization of round HDR {sup 192}Ir AccuBoost applicators for breast brachytherapy

    SciTech Connect

    Rivard, Mark J.; Melhus, Christopher S.; Wazer, David E.; Bricault, Raymond J. Jr.

    2009-11-15

    Purpose: The AccuBoost brachytherapy system applies HDR {sup 192}Ir beams peripherally to the breast using collimating applicators. The purpose of this study was to benchmark Monte Carlo simulations of the HDR {sup 192}Ir source, to dosimetrically characterize the round applicators using established Monte Carlo simulation and radiation measurement techniques and to gather data for clinical use. Methods: Dosimetric measurements were performed in a polystyrene phantom, while simulations estimated dose in air, liquid water, polystyrene and ICRU 44 breast tissue. Dose distribution characterization of the 4-8 cm diameter collimators was performed using radiochromic EBT film and air ionization chambers. Results: The central axis dose falloff was steeper for the 4 cm diameter applicator in comparison to the 8 cm diameter applicator, with surface to 3 cm depth-dose ratios of 3.65 and 2.44, respectively. These ratios did not considerably change when varying the phantom composition from breast tissue to polystyrene, phantom thickness from 4 to 8 cm, or phantom radius from 8 to 15 cm. Dose distributions on the central axis were fitted to sixth-order polynomials for clinical use in a hand calculation spreadsheet (i.e., nomogram). Dose uniformity within the useful applicator apertures decreased as depth-dose increased. Conclusions: Monte Carlo benchmarking simulations of the HDR {sup 192}Ir source using the MCNP5 radiation transport code indicated agreement within 1% of the published results over the radial/angular region of interest. Changes in phantom size and radius did not cause noteworthy changes in the central axis depth-dose. Polynomial fit depth-dose curves provide a simple and accurate basis for a nomogram.

  4. Radiochromic film dosimetry of HDR {sup 192}Ir source radiation fields

    SciTech Connect

    Aldelaijan, Saad; Mohammed, Huriyyah; Tomic, Nada; Liang Liheng; DeBlois, Francois; Sarfehnia, Arman; Abdel-Rahman, Wamied; Seuntjens, Jan; Devic, Slobodan

    2011-11-15

    Purpose: A radiochromic film based dosimetry system for high dose rate (HDR) Iridium-192 brachytherapy source was described. A comparison between calibration curves established in water and Solid Water was provided. Methods: Pieces of EBT-2 model GAFCHROMIC film were irradiated in both water and Solid Water with HDR {sup 192}Ir brachytherapy source in a dose range from 0 to 50 Gy. Responses of EBT-2 GAFCHROMIC film were compared for irradiations in water and Solid Water by scaling the dose between media through Monte Carlo calculated conversion factor for both setups. To decrease uncertainty in dose delivery due to positioning of the film piece with respect to the radiation source, traceable calibration irradiations were performed in a parallel-opposed beam setup. Results: The EBT-2 GAFCHROMIC film based dosimetry system described in this work can provide an overall one-sigma dose uncertainty of 4.12% for doses above 1 Gy. The ratio of dose delivered to the sensitive layer of the film in water to the dose delivered to the sensitive layer of the film in Solid Water was calculated using Monte Carlo simulations to be 0.9941 {+-} 0.0007. Conclusions: A radiochromic film based dosimetry system using only the green color channel of a flatbed document scanner showed superior precision if used alone in a dose range that extends up to 50 Gy, which greatly decreases the complexity of work. In addition, Solid Water material was shown to be a viable alternative to water in performing radiochromic film based dosimetry with HDR {sup 192}Ir brachytherapy sources.

  5. A BrachyPhantom for verification of dose calculation of HDR brachytherapy planning system.

    PubMed

    Austerlitz, C; Campos, C A T

    2013-11-01

    To develop a calibration phantom for (192)Ir high dose rate (HDR) brachytherapy units that renders possible the direct measurement of absorbed dose to water and verification of treatment planning system. A phantom, herein designated BrachyPhantom, consists of a Solid Water™ 8-cm high cylinder with a diameter of 14 cm cavity in its axis that allows the positioning of an A1SL ionization chamber with its reference measuring point at the midheight of the cylinder's axis. Inside the BrachyPhantom, at a 3-cm radial distance from the chamber's reference measuring point, there is a circular channel connected to a cylindrical-guide cavity that allows the insertion of a 6-French flexible plastic catheter from the BrachyPhantom surface. The PENELOPE Monte Carlo code was used to calculate a factor, P(sw)(lw), to correct the reading of the ionization chamber to a full scatter condition in liquid water. The verification of dose calculation of a HDR brachytherapy treatment planning system was performed by inserting a catheter with a dummy source in the phantom channel and scanning it with a CT. The CT scan was then transferred to the HDR computer program in which a multiple treatment plan was programmed to deliver a total dose of 150 cGy to the ionization chamber. The instrument reading was then converted to absorbed dose to water using the N(gas) formalism and the P(sw)(lw) factor. Likewise, the absorbed dose to water was calculated using the source strength, Sk, values provided by 15 institutions visited in this work. A value of 1.020 (0.09%, k = 2) was found for P(sw)(lw). The expanded uncertainty in the absorbed dose assessed with the BrachyPhantom was found to be 2.12% (k = 1). To an associated Sk of 27.8 cGy m(2) h(-1), the total irradiation time to deliver 150 cGy to the ionization chamber point of reference was 161.0 s. The deviation between the absorbed doses to water assessed with the BrachyPhantom and those calculated by the treatment plans and using the Sk values

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

    PubMed

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

    2014-02-01

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

  7. Transit dose comparisons for (60)Co and (192)Ir HDR sources.

    PubMed

    Giménez-Alventosa, Vicent; Vijande, Javier; Ballester, Facundo; Perez-Calatayud, Jose

    2016-12-01

    The goal of this study is to evaluate the ambient dose due to the transit of high dose rate (HDR) (60)Co sources along a transfer tube as compared to (192)Ir ones in a realistic clinical scenario. This goal is accomplished by evaluating air-kerma differences with Monte Carlo calculations using PENELOPE2011. Scatter from both the afterloader and the patient was not taken into account. Two sources, mHDR-v2 and Flexisource Co-60, (Elekta Brachytherapy, Veenendaal, the Netherlands) have been considered. These sources were simulated within a standard transfer tube located in an infinite air phantom. The movement of the source was included by displacing their positions along the connecting tube from z  =  -75 cm to z  =  +75 cm and combining them. Since modern afterloaders like Flexitron (Elekta) or Saginova (BEBIG GmbH) are able to use equally (192)Ir and (60)Co sources, it was assumed that both sources are displaced with equal speed. Typical HDR source activity content values were provided by the manufacturer. 2D distributions were obtained with type-A uncertainties (k  =  2) less than 0.01%. From those, the air-kerma ratio (60)Co/(192)Ir was evaluated weighted by their corresponding typical activities. It was found that it varies slowly with distance (less than 10% variation at 75 cm) but strongly in time due to the shorter half-life of the (192)Ir (73.83 d). The maximum ratio is located close to the tube. It reaches a value of 0.57 when the typical activity of the sources at the time when they were installed by the vendor was used. Such ratio increases up to 1.28 at the end of the recommended working life (90 d) of the (192)Ir source. (60)Co/(192)Ir air-kerma ratios are almost constant (0.51-0.57) in the vicinity of the source-tube with recent installed sources. Nevertheless, air-kerma ratios increase rapidly (1.15-1.29) whenever the (192)Ir is approaching the end of its life. In case of a medical event requiring the medical staff to

  8. High dose rate endobronchial brachytherapy (HDR-EB) in recurrent benign complex tracheobronchial stenosis: experience in two cases.

    PubMed

    Tscheikuna, Jamsak; Disayabutr, Supparerk; Kakanaporn, Chumpot; Tuntipumi-Amorn, Lalida; Chansilpa, Yaowalak

    2013-02-01

    Benign complex tracheobronchial stenosis (BCTS) is a tracheobronchial stenosis that is longer than 1 cm or has more than one site of stenotic area. The most common etiology of the stenosis is endobronchial tuberculosis. BCTS causes challenge in diagnosis and management because of nonspecific presentation and usually precluded surgical treatment. Available interventional bronchoscopic techniques fail to manage BCTS because of high rate of restenosis. Experience in using HDR brachytherapy to prevent restenosis in two cases of BCTS is reported. There were two cases of BCTS who received HDR brachytherapy in order to prevent restenosis. First case was a 39 year-old female who had 5 cms tracheal and 2 cms left main bronchial stenosis from previous endobronchial tuberculosis. After 36 procedures of tracheobronchial dilatation by rigid bronchoscopy and two tracheal stents placement, her trachea became restenosis in an average time of 1 month. She also developed anaphylactic reaction with lidocaine. She received HDR brachytherapy with the dose of 10 Gy and no restenosis was found after 5 months follow-up. The second case was a 18 year-old male who had 4 cms tracheal stenosis result from post intubation. He was done dilatation and stenting of the trachea by regid bronchoscopy because he refused surgery. After 1 year the tracheal stent was removed and rapid restenosis of the trachea resulted in respiratory failure occurred in 7 days. The tracheal stent was reimplanted and 1 year later 7.0 Gy HDR brachytherapy was done after stent removal. He was doing well 4 months after with 50% tracheal stenosis and occasional stridor. Failure of intervention bronchoscopic techniques in management of BCTS was significantly shown by the restenosis even after endobronchial stent placement. HDR brachytherapy had a beneficial role in preventing granulation tissue formation and delay or prevent restenosis after bronchoscopic dilatation in selected case of BCTS patients. The case selection and

  9. Survival analysis of HDR brachytherapy versus reoperation versus temozolomide alone: a retrospective cohort analysis of recurrent glioblastoma multiforme.

    PubMed

    Archavlis, Eleftherios; Tselis, Nikolaos; Birn, Gerhard; Ulrich, Peter; Baltas, Dimos; Zamboglou, Nikolaos

    2013-03-15

    Tumour recurrence of glioblastoma multiforme (GBM) after initial treatment with surgical resection, radiotherapy and chemotherapy is an inevitable phenomenon. This retrospective cohort study compared the efficacy of interstitial high dose rate brachytherapy (HDR-BRT), re-resection and sole dose dense temozolomide chemotherapy (ddTMZ) in the treatment of recurrent glioblastoma after initial surgery and radiochemotherapy. Retropective cohort study. Primary level of care with two participating centres. The geographical location was central Germany. From January 2005 to December 2010, a total of 111 patients developed recurrent GBM after initial surgery and radiotherapy with concomitant temozolomide. The inclusion criteria were as follows: (1) histology-proven diagnosis of primary GBM (WHO grade 4), (2) primary treatment with resection and radiochemotherapy, and (3) tumour recurrence/progression. This study compared retrospectively the efficacy of interstitial HDR-BRT, re-resection and ddTMZ alone in the treatment of recurrent glioblastoma. Median survival, progression free survival and complication rate. Median survival after salvage therapy of the recurrence was 37, 30 and 26 weeks, respectively. The HDR-BRT group did significantly better than both the reoperation (p<0.05) and the ddTMZ groups (p<0.05). Moderate to severe complications in the HDR-BRT, reoperation and sole chemotherapy groups occurred in 5/50 (10%), 4/36 (11%) and 9/25 (36%) cases, respectively. CT-guided interstitial HDR-BRT attained higher survival benefits in the management of recurrent glioblastoma after initial surgery and radiotherapy with concurrent temozolomide in comparison with the other treatment modalities. The low risk of complications of the HDR-BRT and the fact that it can be delivered percutaneously in local anaesthesia render it a promissing treatment option for selected patients which should be further evaluated.

  10. Survival analysis of HDR brachytherapy versus reoperation versus temozolomide alone: a retrospective cohort analysis of recurrent glioblastoma multiforme

    PubMed Central

    Archavlis, Eleftherios; Tselis, Nikolaos; Birn, Gerhard; Ulrich, Peter; Baltas, Dimos; Zamboglou, Nikolaos

    2013-01-01

    Objectives Tumour recurrence of glioblastoma multiforme (GBM) after initial treatment with surgical resection, radiotherapy and chemotherapy is an inevitable phenomenon. This retrospective cohort study compared the efficacy of interstitial high dose rate brachytherapy (HDR-BRT), re-resection and sole dose dense temozolomide chemotherapy (ddTMZ) in the treatment of recurrent glioblastoma after initial surgery and radiochemotherapy. Design Retropective cohort study. Setting Primary level of care with two participating centres. The geographical location was central Germany. Participants From January 2005 to December 2010, a total of 111 patients developed recurrent GBM after initial surgery and radiotherapy with concomitant temozolomide. The inclusion criteria were as follows: (1) histology-proven diagnosis of primary GBM (WHO grade 4), (2) primary treatment with resection and radiochemotherapy, and (3) tumour recurrence/progression. Interventions This study compared retrospectively the efficacy of interstitial HDR-BRT, re-resection and ddTMZ alone in the treatment of recurrent glioblastoma. Primary and secondary outcome measures Median survival, progression free survival and complication rate. Results Median survival after salvage therapy of the recurrence was 37, 30 and 26 weeks, respectively. The HDR-BRT group did significantly better than both the reoperation (p<0.05) and the ddTMZ groups (p<0.05). Moderate to severe complications in the HDR-BRT, reoperation and sole chemotherapy groups occurred in 5/50 (10%), 4/36 (11%) and 9/25 (36%) cases, respectively. Conclusions CT-guided interstitial HDR-BRT attained higher survival benefits in the management of recurrent glioblastoma after initial surgery and radiotherapy with concurrent temozolomide in comparison with the other treatment modalities. The low risk of complications of the HDR-BRT and the fact that it can be delivered percutaneously in local anaesthesia render it a promissing treatment option for selected

  11. MO-C-17A-11: A Segmentation and Point Matching Enhanced Deformable Image Registration Method for Dose Accumulation Between HDR CT Images

    SciTech Connect

    Zhen, X; Chen, H; Zhou, L; Yan, H; Jiang, S; Jia, X; Gu, X; Mell, L; Yashar, C; Cervino, L

    2014-06-15

    Purpose: To propose and validate a novel and accurate deformable image registration (DIR) scheme to facilitate dose accumulation among treatment fractions of high-dose-rate (HDR) gynecological brachytherapy. Method: We have developed a method to adapt DIR algorithms to gynecologic anatomies with HDR applicators by incorporating a segmentation step and a point-matching step into an existing DIR framework. In the segmentation step, random walks algorithm is used to accurately segment and remove the applicator region (AR) in the HDR CT image. A semi-automatic seed point generation approach is developed to obtain the incremented foreground and background point sets to feed the random walks algorithm. In the subsequent point-matching step, a feature-based thin-plate spline-robust point matching (TPS-RPM) algorithm is employed for AR surface point matching. With the resulting mapping, a DVF characteristic of the deformation between the two AR surfaces is generated by B-spline approximation, which serves as the initial DVF for the following Demons DIR between the two AR-free HDR CT images. Finally, the calculated DVF via Demons combined with the initial one serve as the final DVF to map doses between HDR fractions. Results: The segmentation and registration accuracy are quantitatively assessed by nine clinical HDR cases from three gynecological cancer patients. The quantitative results as well as the visual inspection of the DIR indicate that our proposed method can suppress the interference of the applicator with the DIR algorithm, and accurately register HDR CT images as well as deform and add interfractional HDR doses. Conclusions: We have developed a novel and robust DIR scheme that can perform registration between HDR gynecological CT images and yield accurate registration results. This new DIR scheme has potential for accurate interfractional HDR dose accumulation. This work is supported in part by the National Natural ScienceFoundation of China (no 30970866 and no

  12. Economic Predictions for Heat Mining: A Review and Analysis of Hot Dry Rock (HDR) Geothermal Energy Technology

    SciTech Connect

    Tester, Jefferson W.; Herzog, Howard J.

    1990-07-01

    The main objectives of this study were first, to review and analyze several economic assessments of Hot Dry Rock (HDR) geothermal energy systems, and second, to reformulate an economic model for HDR with revised cost components. The economic models reviewed include the following studies sponsored by Electric Power Research Institute (EPRI)-Cummings and Morris (1979), Los Alamos National Laboratory (LANL)-Murphy, et al. (1982), United Kingdom (UK)-Shock (1986), Japan-Hori, et al. (1986), Meridian-Entingh (1987) and Bechtel (1988). A general evaluation of the technical feasibility of HDR technology components was also conducted in view of their importance in establishing drilling and reservoir performance parameters required for any economic assessment. In this review, only economic projections for base load electricity produced from HDR systems were considered. Bases of 1989 collars ($) were selected to normalize costs. Following the evaluation of drilling and reservoir performance, power plant choices and cost estimates are discussed in section 6 of the report. In Section 7, the six economics studies cited above are reviewed and compared in terms of their key resource, reservoir and plant performance, and cost assumptions. Based on these comparisons, the report estimates parameters for three composite cases. Important parameters include: (1) resource quality-average geothermal gradient (C/km) and well depth, (2) reservoir performance-effective productivity, flow impedance, and lifetime (thermal drawdown rate), (3) cost components-drilling, reservoir formation, and power plant costs and (4) economic factors-discount and interest rates, taxes, etc. In Section 8, composite case conditions were used to reassess economic projections for HDR-produced electricity. In Section 9, a generalized economic model for HDR-produced electricity is presented to show the effects of resource grade, reservoir performance parameters, and other important factors on projected costs. A

  13. WE-A-17A-10: Fast, Automatic and Accurate Catheter Reconstruction in HDR Brachytherapy Using An Electromagnetic 3D Tracking System

    SciTech Connect

    Poulin, E; Racine, E; Beaulieu, L; Binnekamp, D

    2014-06-15

    Purpose: In high dose rate brachytherapy (HDR-B), actual catheter reconstruction protocols are slow and errors prompt. The purpose of this study was to evaluate the accuracy and robustness of an electromagnetic (EM) tracking system for improved catheter reconstruction in HDR-B protocols. Methods: For this proof-of-principle, a total of 10 catheters were inserted in gelatin phantoms with different trajectories. Catheters were reconstructed using a Philips-design 18G biopsy needle (used as an EM stylet) and the second generation Aurora Planar Field Generator from Northern Digital Inc. The Aurora EM system exploits alternating current technology and generates 3D points at 40 Hz. Phantoms were also scanned using a μCT (GE Healthcare) and Philips Big Bore clinical CT system with a resolution of 0.089 mm and 2 mm, respectively. Reconstructions using the EM stylet were compared to μCT and CT. To assess the robustness of the EM reconstruction, 5 catheters were reconstructed twice and compared. Results: Reconstruction time for one catheter was 10 seconds or less. This would imply that for a typical clinical implant of 17 catheters, the total reconstruction time would be less than 3 minutes. When compared to the μCT, the mean EM tip identification error was 0.69 ± 0.29 mm while the CT error was 1.08 ± 0.67 mm. The mean 3D distance error was found to be 0.92 ± 0.37 mm and 1.74 ± 1.39 mm for the EM and CT, respectively. EM 3D catheter trajectories were found to be significantly more accurate (unpaired t-test, p < 0.05). A mean difference of less than 0.5 mm was found between successive EM reconstructions. Conclusion: The EM reconstruction was found to be faster, more accurate and more robust than the conventional methods used for catheter reconstruction in HDR-B. This approach can be applied to any type of catheters and applicators. We would like to disclose that the equipments, used in this study, is coming from a collaboration with Philips Medical.

  14. Variability of Marker-Based Rectal Dose Evaluation in HDR Cervical Brachytherapy

    SciTech Connect

    Wang Zhou; Jaggernauth, Wainwright; Malhotra, Harish K.; Podgorsak, Matthew B.

    2010-01-01

    In film-based intracavitary brachytherapy for cervical cancer, position of the rectal markers may not accurately represent the anterior rectal wall. This study was aimed at analyzing the variability of rectal dose estimation as a result of interfractional variation of marker placement. A cohort of five patients treated with multiple-fraction tandem and ovoid high-dose-rate (HDR) brachytherapy was studied. The cervical os point and the orientation of the applicators were matched among all fractional plans for each patient. Rectal points obtained from all fractions were then input into each clinical treated plan. New fractional rectal doses were obtained and a new cumulative rectal dose for each patient was calculated. The maximum interfractional variation of distances between rectal dose points and the closest source positions was 1.1 cm. The corresponding maximum variability of fractional rectal dose was 65.5%. The percentage difference in cumulative rectal dose estimation for each patient was 5.4%, 19.6%, 34.6%, 23.4%, and 13.9%, respectively. In conclusion, care should be taken when using rectal markers as reference points for estimating rectal dose in HDR cervical brachytherapy. The best estimate of true rectal dose for each fraction should be determined by the most anterior point among all fractions.

  15. HDR Brachytherapy Dose Distribution is Influenced by the Metal Material of the Applicator.

    PubMed

    Wu, Chin-Hui; Liao, Yi-Jen; Shiau, An-Cheng; Lin, Hsin-Yu; Hsueh Liu, Yen-Wan; Hsu, Shih-Ming

    2015-12-11

    Applicators containing metal have been widely used in recent years when applying brachytherapy to patients with cervical cancer. However, the high dose rate (HDR) treatment-planning system (TPS) that is currently used in brachytherapy still assumes that the treatment environment constitutes a homogeneous water medium and does not include a dose correction for the metal material of the applicator. The primary purpose of this study was to evaluate the HDR (192)Ir dose distribution in cervical cancer patients when performing brachytherapy using a metal-containing applicator. Thermoluminescent dosimeter (TLD) measurements and Monte Carlo N-Particle eXtended (MCNPX) code were used to explore the doses to the rectum and bladder when using a Henschke applicator containing metal during brachytherapy. When the applicator was assumed to be present, the absolute dose difference between the TLD measurement and MCNPX simulation values was within approximately 5%. A comparison of the MCNPX simulation and TPS calculation values revealed that the TPS overestimated the International Commission of Radiation Units and Measurement (ICRU) rectum and bladder reference doses by 57.78% and 49.59%, respectively. We therefore suggest that the TPS should be modified to account for the shielding effects of the applicator to ensure the accuracy of the delivered doses.

  16. HDR Brachytherapy Dose Distribution is Influenced by the Metal Material of the Applicator

    PubMed Central

    Wu, Chin-Hui; Liao, Yi-Jen; Shiau, An-Cheng; Lin, Hsin-Yu; Hsueh Liu, Yen-Wan; Hsu, Shih-Ming

    2015-01-01

    Applicators containing metal have been widely used in recent years when applying brachytherapy to patients with cervical cancer. However, the high dose rate (HDR) treatment-planning system (TPS) that is currently used in brachytherapy still assumes that the treatment environment constitutes a homogeneous water medium and does not include a dose correction for the metal material of the applicator. The primary purpose of this study was to evaluate the HDR 192Ir dose distribution in cervical cancer patients when performing brachytherapy using a metal-containing applicator. Thermoluminescent dosimeter (TLD) measurements and Monte Carlo N-Particle eXtended (MCNPX) code were used to explore the doses to the rectum and bladder when using a Henschke applicator containing metal during brachytherapy. When the applicator was assumed to be present, the absolute dose difference between the TLD measurement and MCNPX simulation values was within approximately 5%. A comparison of the MCNPX simulation and TPS calculation values revealed that the TPS overestimated the International Commission of Radiation Units and Measurement (ICRU) rectum and bladder reference doses by 57.78% and 49.59%, respectively. We therefore suggest that the TPS should be modified to account for the shielding effects of the applicator to ensure the accuracy of the delivered doses. PMID:26658746

  17. A study on the dose distributions in various materials from an Ir-192 HDR brachytherapy source.

    PubMed

    Hsu, Shih-Ming; Wu, Chin-Hui; Lee, Jeng-Hung; Hsieh, Ya-Ju; Yu, Chun-Yen; Liao, Yi-Jen; Kuo, Li-Cheng; Liang, Ji-An; Huang, David Y C

    2012-01-01

    Dose distributions of (192)Ir HDR brachytherapy in phantoms simulating water, bone, lung tissue, water-lung and bone-lung interfaces using the Monte Carlo codes EGS4, FLUKA and MCNP4C are reported. Experiments were designed to gather point dose measurements to verify the Monte Carlo results using Gafchromic film, radiophotoluminescent glass dosimeter, solid water, bone, and lung phantom. The results for radial dose functions and anisotropy functions in solid water phantom were consistent with previously reported data (Williamson and Li). The radial dose functions in bone were affected more by depth than those in water. Dose differences between homogeneous solid water phantoms and solid water-lung interfaces ranged from 0.6% to 14.4%. The range between homogeneous bone phantoms and bone-lung interfaces was 4.1% to 15.7%. These results support the understanding in dose distribution differences in water, bone, lung, and their interfaces. Our conclusion is that clinical parameters did not provide dose calculation accuracy for different materials, thus suggesting that dose calculation of HDR treatment planning systems should take into account material density to improve overall treatment quality.

  18. Preliminary geological and geophysical evaluation of the Castle Dome HDR geothermal prospect, Southwestern Arizona

    SciTech Connect

    Gutmann, J.T.; Aiken, C.L.V.; Ander, M.E.; Laney, R.T.

    1980-01-01

    The Castle Dome HDR geothermal prospect is located in Yuma County, Arizona, in a region centered about 80 km north of Yuma along US Rte. 95. The area of interest is broadly defined by a negative residual Bouguer gravity anomaly which is about 45 km across, steep-sided in many places, and as much as 30 mgals in magnitude. The geology of this Basin and Range area is poorly known, but the few published reports and current Los Alamos Scientific Laboratory (LASL) field studies indicate that the Castle Dome Mountains and adjacent ranges are chiefly a thick pile of welded ash-flow tuffs of probable mid-Tertiary age. The tuffs rest unconformably on Mesozoic metasedimentary rocks exposed only outside steep edges of the gravity low. This gravity anomaly may reflect the presence of a large caldera. A regional magnetotelluric study now in progress will define the depths to electrical conductors within the crust and upper mantle and contribute to understanding of crustal structure, the gravity anomaly, and the Hot Dry Rock (HDR) geothermal potential of the Castle Dome area.

  19. Comparison of 60Co and 192Ir sources in HDR brachytherapy

    PubMed Central

    Zwierzchowski, Grzegorz

    2011-01-01

    This paper compares the isotopes 60Co and 192Ir as radiation sources for high-dose-rate (HDR) afterloading brachytherapy. The smaller size of 192Ir sources made it the preferred radionuclide for temporary brachytherapy treatments. Recently also 60Co sources have been made available with identical geometrical dimensions. This paper compares the characteristics of both nuclides in different fields of brachytherapy based on scientific literature. In an additional part of this paper reports from medical physicists of several radiation therapy institutes are discussed. The purpose of this work is to investigate the advantages or disadvantages of both radionuclides for HDR brachytherapy due to their physical differences. The motivation is to provide useful information to support decision-making procedures in the selection of equipment for brachytherapy treatment rooms. The results of this work show that no advantages or disadvantages exist for 60Co sources compared to 192Ir sources with regard to clinical aspects. Nevertheless, there are potential logistical advantages of 60Co sources due to its longer half-life (5.3 years vs. 74 days), making it an interesting alternative especially in developing countries. PMID:23346129

  20. Image guided Brachytherapy: The paradigm of Gynecologic and Partial Breast HDR Brachytherapy

    NASA Astrophysics Data System (ADS)

    Diamantopoulos, S.; Kantemiris, I.; Konidari, A.; Zaverdinos, P.

    2015-09-01

    High dose rate (HDR) brachytherapy uses high strength radioactive sources and temporary interstitial implants to conform the dose to target and minimize the treatment time. The advances of imaging technology enable accurate reconstruction of the implant and exact delineation of high-risk CTV and the surrounding critical structures. Furthermore, with sophisticated treatment planning systems, applicator devices and stepping source afterloaders, brachytherapy evolved to a more precise, safe and individualized treatment. At the Radiation Oncology Department of Metropolitan Hospital Athens, MRI guided HDR gynecologic (GYN) brachytherapy and accelerated partial breast irradiation (APBI) with brachytherapy are performed routinely. Contouring and treatment planning are based on the recommendations of the GEC - ESTRO Working group. The task of this presentation is to reveal the advantages of 3D image guided brachytherapy over 2D brachytherapy. Thus, two patients treated at our department (one GYN and one APBI) will be presented. The advantage of having adequate dose coverage of the high risk CTV and simultaneous low doses to the OARs when using 3D image- based brachytherapy will be presented. The treatment techniques, equipment issues, as well as implantation, imaging and treatment planning procedures will be described. Quality assurance checks will be treated separately.

  1. A multicentre 'end to end' dosimetry audit for cervix HDR brachytherapy treatment.

    PubMed

    Palmer, Antony L; Diez, Patricia; Gandon, Laura; Wynn-Jones, Andrea; Bownes, Peter; Lee, Chris; Aird, Edwin; Bidmead, Margaret; Lowe, Gerry; Bradley, David; Nisbet, Andrew

    2015-02-01

    To undertake the first multicentre fully 'end to end' dosimetry audit for HDR cervix brachytherapy, comparing planned and delivered dose distributions around clinical treatment applicators, with review of local procedures. A film-dosimetry audit was performed at 46 centres, including imaging, applicator reconstruction, treatment planning and delivery. Film dose maps were calculated using triple-channel dosimetry and compared to RTDose data from treatment planning systems. Deviations between plan and measurement were quantified at prescription Point A and using gamma analysis. Local procedures were also discussed. The mean difference between planned and measured dose at Point A was -0.6% for plastic applicators and -3.0% for metal applicators, at standard uncertainty 3.0% (k=1). Isodose distributions agreed within 1mm over a dose range 2-16Gy. Mean gamma passing rates exceeded 97% for plastic and metal applicators at 3% (local) 2mm criteria. Two errors were found: one dose normalisation error and one applicator library misaligned with the imaged applicator. Suggestions for quality improvement were also made. The concept of 'end to end' dosimetry audit for HDR brachytherapy has been successfully implemented in a multicentre environment, providing evidence that a high level of accuracy in brachytherapy dosimetry can be achieved. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  2. Oxidative stress markers in prostate cancer patients after HDR brachytherapy combined with external beam radiation.

    PubMed

    Woźniak, Alina; Masiak, Rafał; Szpinda, Michał; Mila-Kierzenkowska, Celestyna; Woźniak, Bartosz; Makarewicz, Roman; Szpinda, Anna

    2012-01-01

    Assessment of oxidative stress markers was perfomed in prostate cancer (PCa) patients subjected to high-dose brachytherapy (HDR) with external beam radiotherapy (EBRT). Sixty men with PCa were subjected to combined two-fraction treatment with HDR (tot. 20 Gy) and EBRT (46 Gy). Blood samples were taken before treatment, immediately afterwards, after 1.5-3 months, and approx. 2 years. Control group consisted of 30 healthy men. Erythrocyte glutathione peroxidase activity in the patients was lower than in healthy subjects by 34% (P < 0.001), 50% (P < 0.001), 30% (P < 0.05), and 61% (P < 0.001), respectively, at all periods. No significant differences were found by comparing superoxide dismutase and catalase activity in PCa patients with that of the controls. After 2 years of the end of treatment, the activity of studied enzymes demonstrated a decreasing tendency versus before therapy. Blood plasma thiobarbituric acid reactive substances (TBARS) concentration was higher than in the controls at all periods, while erythrocyte TBARS decreased after 2 years to control levels. The results confirm that in the course of PCa, imbalance of oxidant-antioxidant processes occurs. The therapy did not alter the levels of oxidative stress markers, which may prove its applicability. Two years is too short a period to restore the oxidant-antioxidant balance.

  3. Ir-192 HDR transit dose and radial dose function determination using alanine/EPR dosimetry

    NASA Astrophysics Data System (ADS)

    Guzmán Calcina, Carmen S.; de Almeida, Adelaide; Oliveira Rocha, José R.; Abrego, Felipe Chen; Baffa, Oswaldo

    2005-03-01

    Source positioning close to the tumour in high dose rate (HDR) brachytherapy is not instantaneous. An increment of dose will be delivered during the movement of the source in the trajectory to its static position. This increment is the transit dose, often not taken into account in brachytherapeutic treatment planning. The transit dose depends on the prescribed dose, number of treatment fractions, velocity and activity of the source. Combining all these factors, the transit dose can be 5% higher than the prescribed absorbed dose value (Sang-Hyun and Muller-Runkel, 1994 Phys. Med. Biol. 39 1181 8, Nath et al 1995 Med. Phys. 22 209 34). However, it cannot exceed this percentage (Nath et al 1995). In this work, we use the alanine-EPR (electron paramagnetic resonance) dosimetric system using analysis of the first derivative of the signal. The transit dose was evaluated for an HDR system and is consistent with that already presented for TLD dosimeters (Bastin et al 1993 Int. J. Radiat. Oncol. Biol. Phys. 26 695 702). Also using the same dosimetric system, the radial dose function, used to evaluate the geometric dose degradation around the source, was determined and its behaviour agrees better with those obtained by Monte Carlo simulations (Nath et al 1995, Williamson and Nath 1991 Med. Phys. 18 434 48, Ballester et al 1997 Med. Phys. 24 1221 8, Ballester et al 2001 Phys. Med. Biol. 46 N79 90) than with TLD measurements (Nath et al 1990 Med. Phys. 17 1032 40).

  4. A study of optimization techniques in HDR brachytherapy for the prostate

    NASA Astrophysics Data System (ADS)

    Pokharel, Ghana Shyam

    Several studies carried out thus far are in favor of dose escalation to the prostate gland to have better local control of the disease. But optimal way of delivery of higher doses of radiation therapy to the prostate without hurting neighboring critical structures is still debatable. In this study, we proposed that real time high dose rate (HDR) brachytherapy with highly efficient and effective optimization could be an alternative means of precise delivery of such higher doses. This approach of delivery eliminates the critical issues such as treatment setup uncertainties and target localization as in external beam radiation therapy. Likewise, dosimetry in HDR brachytherapy is not influenced by organ edema and potential source migration as in permanent interstitial implants. Moreover, the recent report of radiobiological parameters further strengthen the argument of using hypofractionated HDR brachytherapy for the management of prostate cancer. Firstly, we studied the essential features and requirements of real time HDR brachytherapy treatment planning system. Automating catheter reconstruction with fast editing tools, fast yet accurate dose engine, robust and fast optimization and evaluation engine are some of the essential requirements for such procedures. Moreover, in most of the cases we performed, treatment plan optimization took significant amount of time of overall procedure. So, making treatment plan optimization automatic or semi-automatic with sufficient speed and accuracy was the goal of the remaining part of the project. Secondly, we studied the role of optimization function and constraints in overall quality of optimized plan. We have studied the gradient based deterministic algorithm with dose volume histogram (DVH) and more conventional variance based objective functions for optimization. In this optimization strategy, the relative weight of particular objective in aggregate objective function signifies its importance with respect to other objectives

  5. Evaluation of hybrid inverse planning and optimization (HIPO) algorithm for optimization in real-time, high-dose-rate (HDR) brachytherapy for prostate.

    PubMed

    Pokharel, Shyam; Rana, Suresh; Blikenstaff, Joseph; Sadeghi, Amir; Prestidge, Bradley

    2013-07-08

    The purpose of this study is to investigate the effectiveness of the HIPO planning and optimization algorithm for real-time prostate HDR brachytherapy. This study consists of 20 patients who underwent ultrasound-based real-time HDR brachytherapy of the prostate using the treatment planning system called Oncentra Prostate (SWIFT version 3.0). The treatment plans for all patients were optimized using inverse dose-volume histogram-based optimization followed by graphical optimization (GRO) in real time. The GRO is manual manipulation of isodose lines slice by slice. The quality of the plan heavily depends on planner expertise and experience. The data for all patients were retrieved later, and treatment plans were created and optimized using HIPO algorithm with the same set of dose constraints, number of catheters, and set of contours as in the real-time optimization algorithm. The HIPO algorithm is a hybrid because it combines both stochastic and deterministic algorithms. The stochastic algorithm, called simulated annealing, searches the optimal catheter distributions for a given set of dose objectives. The deterministic algorithm, called dose-volume histogram-based optimization (DVHO), optimizes three-dimensional dose distribution quickly by moving straight downhill once it is in the advantageous region of the search space given by the stochastic algorithm. The PTV receiving 100% of the prescription dose (V100) was 97.56% and 95.38% with GRO and HIPO, respectively. The mean dose (D(mean)) and minimum dose to 10% volume (D10) for the urethra, rectum, and bladder were all statistically lower with HIPO compared to GRO using the student pair t-test at 5% significance level. HIPO can provide treatment plans with comparable target coverage to that of GRO with a reduction in dose to the critical structures.

  6. Does prostate volume has an impact on biochemical failure in patients with localized prostate cancer treated with HDR boost?

    PubMed

    Vigneault, Eric; Mbodji, Khaly; Beaudet, Marc-Étienne; Després, Philippe; Lavallée, Marie-Claude; Martin, André-Guy; Foster, William; Aubin, Sylviane; Beaulieu, Luc

    2016-11-01

    To compare biochemical failure free survival (BFFS) of patients with small and large prostate glands treated with external beam radiation therapy (EBRT) and HDR (high dose rate) brachytherapy boost. Between 2002 and 2012, 548 patients were treated with EBRT followed by HDR boost. The effect of covariates and prostate volume on biochemical failure was analyzed by survival analysis and Cox regression model. The median follow-up and age were not different between the two groups. The mean prostate gland volume at the time of CT planning was 48.1 and 76.0cc in small (<60cc) and large (⩾ 60cc) prostate volume, respectively (p<0.001). When PSA bounces were excluded, there was no significant difference between the two groups with a 5-years BFFS of 95.8% vs 92.3%, p=0.094. There were no significant differences between the two groups for urinary symptoms (IPSS) as well as acute and late GI toxicities. This study showed that a HDR brachytherapy boost in large prostate gland cases is feasible at the price of increased PSA bounces. When the benign bounces are excluded, there is no significant difference between the two groups for tumor control and toxicity. Therefore, in our experience, there is no rational precluding the use of HDR boost in patients with a prostate size of 60 cc or more so long as an adequate dosimetry is achievable. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  7. A Report on the Clinical Outcome after High-Dose Rate (HDR) Brachytherapy as Monotherapy in Early Prostate Cancer.

    PubMed

    Potharaju, Mahadev; Subramanaiam, Ravishankar; Venkataraman, Murali; Perumal, Karthikeyan; Ramakrishnan, Balasubramaniam; Vangara, Ramakrishna; Reddy, Sathiya

    2015-08-14

    To report the clinical outcome after a single implant, high dose rate (HDR) brachytherapy in early prostate cancer. All clinically localized prostate cancer patients who underwent high-dose rate (HDR) brachytherapy as monotherapy (no external beam radiotherapy) from February 2006 to September 2011 were analyzed prospectively. Acute and chronic toxicity were assessed as per Common Terminology Criteria for Adverse Events (CTCAE), Version 4.03. Biochemical recurrence was analyzed using the Kaplan Meir method. A log-rank analysis was done to compare the factors affecting the outcome.  Forty-four patients with organ-confined prostate cancer opted for HDR brachytherapy between February 2006 to September 2011 with a median follow-up of 68 months  The five-year biochemical recurrence-free survival (bRFS) rate was 91%. Late Grade 2 genitourinary (GU) toxicity was observed in 9% of patients. The predictors of late Grade 2 GU toxicity were urethra V125 ≥ 0.2 cc (urethral volume receiving ≥ 125% of the prescribed dose) and PTV 150 ≥ 35% ( planning target volume receiving ≥ 150% of the prescribed dose) with p-value = 0.001 and 0.002, respectively. Erectile function was preserved in 72% of the patients who had Grade 0-1 erectile dysfunction before brachytherapy. HDR brachytherapy in early prostate cancer results in high local control rates with minimal side-effects.

  8. BrachyView, a novel inbody imaging system for HDR prostate brachytherapy: design and Monte Carlo feasibility study.

    PubMed

    Safavi-Naeini, M; Han, Z; Cutajar, D; Guatelli, S; Petasecca, M; Lerch, M L F; Franklin, D R; Jakubek, J; Pospisil, S; Bucci, J; Zaider, M; Rosenfeld, A B

    2013-07-01

    High dose rate (HDR) brachytherapy is a form of radiation therapy for treating prostate cancer whereby a high activity radiation source is moved between predefined positions inside applicators inserted within the treatment volume. Accurate positioning of the source is essential in delivering the desired dose to the target area while avoiding radiation injury to the surrounding tissue. In this paper, HDR BrachyView, a novel inbody dosimetric imaging system for real time monitoring and verification of the radioactive seed position in HDR prostate brachytherapy treatment is introduced. The current prototype consists of a 15 × 60 mm(2) silicon pixel detector with a multipinhole tungsten collimator placed 6.5 mm above the detector. Seven identical pinholes allow full imaging coverage of the entire treatment volume. The combined pinhole and pixel sensor arrangement is geometrically designed to be able to resolve the three-dimensional location of the source. The probe may be rotated to keep the whole prostate within the transverse plane. The purpose of this paper is to demonstrate the efficacy of the design through computer simulation, and to estimate the accuracy in resolving the source position (in detector plane and in 3D space) as part of the feasibility study for the BrachyView project. Monte Carlo simulations were performed using the GEANT4 radiation transport model, with a (192)Ir source placed in different locations within a prostate phantom. A geometrically accurate model of the detector and collimator were constructed. Simulations were conducted with a single pinhole to evaluate the pinhole design and the signal to background ratio obtained. Second, a pair of adjacent pinholes were simulated to evaluate the error in calculated source location. Simulation results show that accurate determination of the true source position is easily obtainable within the typical one second source dwell time. The maximum error in the estimated projection position was found to be

  9. BrachyView, A novel inbody imaging system for HDR prostate brachytherapy: Design and Monte Carlo feasibility study

    SciTech Connect

    Safavi-Naeini, M.; Han, Z.; Cutajar, D.; Guatelli, S.; Petasecca, M.; Lerch, M. L. F.; Franklin, D. R.; Jakubek, J.; Pospisil, S.; Bucci, J.; Zaider, M.; Rosenfeld, A. B.

    2013-07-15

    Purpose: High dose rate (HDR) brachytherapy is a form of radiation therapy for treating prostate cancer whereby a high activity radiation source is moved between predefined positions inside applicators inserted within the treatment volume. Accurate positioning of the source is essential in delivering the desired dose to the target area while avoiding radiation injury to the surrounding tissue. In this paper, HDR BrachyView, a novel inbody dosimetric imaging system for real time monitoring and verification of the radioactive seed position in HDR prostate brachytherapy treatment is introduced. The current prototype consists of a 15 Multiplication-Sign 60 mm{sup 2} silicon pixel detector with a multipinhole tungsten collimator placed 6.5 mm above the detector. Seven identical pinholes allow full imaging coverage of the entire treatment volume. The combined pinhole and pixel sensor arrangement is geometrically designed to be able to resolve the three-dimensional location of the source. The probe may be rotated to keep the whole prostate within the transverse plane. The purpose of this paper is to demonstrate the efficacy of the design through computer simulation, and to estimate the accuracy in resolving the source position (in detector plane and in 3D space) as part of the feasibility study for the BrachyView project.Methods: Monte Carlo simulations were performed using the GEANT4 radiation transport model, with a {sup 192}Ir source placed in different locations within a prostate phantom. A geometrically accurate model of the detector and collimator were constructed. Simulations were conducted with a single pinhole to evaluate the pinhole design and the signal to background ratio obtained. Second, a pair of adjacent pinholes were simulated to evaluate the error in calculated source location.Results: Simulation results show that accurate determination of the true source position is easily obtainable within the typical one second source dwell time. The maximum error in

  10. A Structural-Thermal Model of the Karkonosze Pluton (Sudetes Mountains, SW Poland) for Hot Dry Rock (HDR) Geothermal Use

    NASA Astrophysics Data System (ADS)

    Bujakowski, Wiesław; Barbacki, Antoni; Miecznik, Maciej; Pająk, Leszek; Skrzypczak, Robert

    2016-12-01

    The main objective of this study was to develop a spatial temperature distribution of the Karkonosze Pluton to indicate optimum locations for HDR systems at drillable depth. HDR geothermal technology makes it possible to extract heat from the Earth in areas where no hydro-geothermal resources are present. To produce electricity in a binary cycle, system temperatures of > 100°C are usually required. In this paper, the authors have analysed the potential opportunities for applying HDR technology in the area of the Karkonosze Pluton, which is regarded as an optimum location for the application of the HDR concept (due to the potential for stimulation offered by the mechanical properties of the granites, radiogenic heat production, modern tectonic activity, and the thickness of the pluton). The model used in the analysis, which takes into account a hypothetical assessment of the manner and paths of fluid migration within the pluton, provides an insight into the spatial distribution of subsurface temperatures. It thus allows the location of relatively shallow high-temperature zones, which are optimal for the efficient application of HDR technology, to be identified. With respect to this technology, the Szklarska Poręba area and the NE part of the pluton seem to be better targets than the Cieplice central area, where the model indicated much lower temperatures (e.g. at a depth of 5,000 m, estimated temperatures in the vicinity of Szklarska Poręba were about 185°C and in the vicinity of Cieplice they were about 140°C).

  11. Vaginal-cuff control and toxicity results of a daily HDR brachytherapy schedule in endometrial cancer patients.

    PubMed

    Ríos, I; Rovirosa, A; Ascaso, C; Valduvieco, I; Herreros, A; Castilla, L; Sabater, S; Holub, K; Pahisa, J; Biete, A; Arenas, M

    2016-09-01

    To analyze the vaginal-cuff local control (VCC) and toxicity in postoperative endometrial carcinoma patients (EC) underwent high-dose-rate brachytherapy (HDR-BT) administered daily. 154 consecutive patients received postoperative HDR-BT for EC from January 2007 to September 2011. FIGO-staging I-IIIC2 patients were divided into two groups according to risk classification: Group 1 (94/154) included high-risk or advanced disease patients and Group 2 (60/154) included intermediate-risk EC patients. Group 1 underwent external beam irradiation (EBI) plus HDR-BT (2 fractions of 5 Gy) and Group 2 underwent HDR-BT alone (4 fractions of 5 Gy). Toxicity evaluation was done with RTOG scores for bladder and rectum, and the objective criteria of LENT-SOMA for vagina. With a median follow-up of 46.7 months (36.6-61 months) only two patients developed vaginal-cuff recurrence in Group 1 (2.1 %) and none in group 2 (0 %). Early toxicity in Group 1 appeared 5.3 % in rectum, 7.5 % in bladder (G1-G2) and 2.1 % in vagina (G1); late toxicity was present in 7.3 % in rectum (all G1-G2 but 1 G3) and in 27.7 % in vagina (all G1-G2 but one G4). In Group 2, 6.7 % developed acute G1-G2 bladder and 6.6 % acute vaginal (G1-G2) toxicity. No late rectal or bladder toxicity was observed; 21.7 % of G1-G2 presented late problems in vagina. The present HDR-BT schedule of 2 fractions of 5 Gy after EBI and 4 fractions of 5 Gy administered daily showed excellent results in terms of VCC and toxicity.

  12. Balloon-based adjuvant radiotherapy in breast cancer: comparison between 99mTc and HDR 192Ir*

    PubMed Central

    de Campos, Tarcísio Passos Ribeiro; de Lima, Carla Flavia; Cuperschmid, Ethel Mizrahy

    2016-01-01

    Objective To perform a comparative dosimetric analysis, based on computer simulations, of temporary balloon implants with 99mTc and balloon brachytherapy with high-dose-rate (HDR) 192Ir, as boosts to radiotherapy. We hypothesized that the two techniques would produce equivalent doses under pre-established conditions of activity and exposure time. Materials and Methods Simulations of implants with 99mTc-filled and HDR 192Ir-filled balloons were performed with the Siscodes/MCNP5, modeling in voxels a magnetic resonance imaging set related to a young female. Spatial dose rate distributions were determined. In the dosimetric analysis of the protocols, the exposure time and the level of activity required were specified. Results The 99mTc balloon presented a weighted dose rate in the tumor bed of 0.428 cGy.h-1.mCi-1 and 0.190 cGyh-1.mCi-1 at the balloon surface and at 8-10 mm from the surface, respectively, compared with 0.499 and 0.150 cGyh-1.mCi-1, respectively, for the HDR 192Ir balloon. An exposure time of 24 hours was required for the 99mTc balloon to produce a boost of 10.14 Gy with 1.0 Ci, whereas only 24 minutes with 10.0 Ci segments were required for the HDR 192Ir balloon to produce a boost of 5.14 Gy at the same reference point, or 10.28 Gy in two 24-minutes fractions. Conclusion Temporary 99mTc balloon implantation is an attractive option for adjuvant radiotherapy in breast cancer, because of its availability, economic viability, and similar dosimetry in comparison with the use of HDR 192Ir balloon implantation, which is the current standard in clinical practice. PMID:27141131

  13. Balloon-based adjuvant radiotherapy in breast cancer: comparison between (99m)Tc and HDR (192)Ir.

    PubMed

    de Campos, Tarcísio Passos Ribeiro; de Lima, Carla Flavia; Cuperschmid, Ethel Mizrahy

    2016-01-01

    To perform a comparative dosimetric analysis, based on computer simulations, of temporary balloon implants with (99m)Tc and balloon brachytherapy with high-dose-rate (HDR) (192)Ir, as boosts to radiotherapy. We hypothesized that the two techniques would produce equivalent doses under pre-established conditions of activity and exposure time. Simulations of implants with (99m)Tc-filled and HDR (192)Ir-filled balloons were performed with the Siscodes/MCNP5, modeling in voxels a magnetic resonance imaging set related to a young female. Spatial dose rate distributions were determined. In the dosimetric analysis of the protocols, the exposure time and the level of activity required were specified. The (99m)Tc balloon presented a weighted dose rate in the tumor bed of 0.428 cGy.h(-1).mCi(-1) and 0.190 cGyh(-1).mCi(-1) at the balloon surface and at 8-10 mm from the surface, respectively, compared with 0.499 and 0.150 cGyh(-1).mCi(-1), respectively, for the HDR (192)Ir balloon. An exposure time of 24 hours was required for the (99m)Tc balloon to produce a boost of 10.14 Gy with 1.0 Ci, whereas only 24 minutes with 10.0 Ci segments were required for the HDR (192)Ir balloon to produce a boost of 5.14 Gy at the same reference point, or 10.28 Gy in two 24-minutes fractions. Temporary (99m)Tc balloon implantation is an attractive option for adjuvant radiotherapy in breast cancer, because of its availability, economic viability, and similar dosimetry in comparison with the use of HDR (192)Ir balloon implantation, which is the current standard in clinical practice.

  14. Unusual Proliferative Glomerulonephritis in a Patient Diagnosed to Have Hypoparathyroidism, Sensorineural Deafness, and Renal Dysplasia (HDR) Syndrome with a Novel Mutation in the GATA3 Gene.

    PubMed

    Kamezaki, Michitsugu; Kusaba, Tetsuro; Adachi, Takaomi; Yamashita, Noriyuki; Nakata, Mayumi; Ota, Noriyoshi; Shiotsu, Yayoi; Ishida, Mami; Usui, Takeshi; Tamagaki, Keiichi

    2017-01-01

    Hypoparathyroidism, sensorineural deafness, and renal dysplasia (HDR) syndrome is a rare autosomal dominant disease caused by GATA3 mutations. Although several cases with variable renal features have been reported, the presence of histological changes within the glomeruli in adult patients is unclear. We herein report an adult case of HDR syndrome with a novel p.C288W (TGC>TGG) missense mutation in GATA3. His renal histology showed a membranoproliferative glomerulonephritis-like glomerular lesion. Additional renal histological analyses of HDR syndrome patients will be needed to clarify the role of GATA3 in both the developing and adult kidney.

  15. Determination of transit dose profile for a {sup 192}Ir HDR source

    SciTech Connect

    Fonseca, G. P.; Antunes, P. C. G.; Yoriyaz, H.

    2013-05-15

    Purpose: Several studies have reported methodologies to calculate and correct the transit dose component of the moving radiation source for high dose rate (HDR) brachytherapy planning systems. However, most of these works employ the average source speed, which varies significantly with the measurement technique used, and does not represent a realistic speed profile, therefore, providing an inaccurate dose determination. In this work, the authors quantified the transit dose component of a HDR unit based on the measurement of the instantaneous source speed to produce more accurate dose values. Methods: The Nucletron microSelectron-HDR Ir-192 source was characterized considering the Task Group 43 (TG-43U1) specifications. The transit dose component was considered through the calculation of the dose distribution using a Monte Carlo particle transport code, MCNP5, for each source position and correcting it by the source speed. The instantaneous source speed measurements were performed in a previous work using two optical fibers connected to a photomultiplier and an oscilloscope. Calculated doses were validated by comparing relative dose profiles with those obtained experimentally using radiochromic films. Results: TG-43U1 source parameters were calculated to validate the Monte Carlo simulations. These agreed with the literature, with differences below 1% for the majority of the points. Calculated dose profiles without transit dose were also validated by comparison with ONCENTRA{sup Registered-Sign} Brachy v. 3.3 dose values, yielding differences within 1.5%. Dose profiles obtained with MCNP5 corrected using the instantaneous source speed profile showed differences near dwell positions of up to 800% in comparison to values corrected using the average source speed, but they are in good agreement with the experimental data, showing a maximum discrepancy of approximately 3% of the maximum dose. Near a dwell position the transit dose is about 22% of the dwell dose delivered

  16. Correction factors for source strength determination in HDR brachytherapy using the in-phantom method.

    PubMed

    Ubrich, Frank; Wulff, Jörg; Engenhart-Cabillic, Rita; Zink, Klemens

    2014-05-01

    For the purpose of clinical source strength determination for HDR brachytherapy sources, the German society for Medical Physics (DGMP) recommends in their report 13 the usage of a solid state phantom (Krieger-phantom) with a thimble ionization chamber. In this work, the calibration chain for the determination of the reference air-kerma rate Ka,100 and reference dose rate to waterDw,1 by ionization chamber measurement in the Krieger-phantom was modeled via Monte Carlo simulations. These calculations were used to determine global correction factors k(tot), which allows a user to directly convert the reading of an ionization chamber calibrated in terms of absorbed dose to water, into the desired quantity Ka,100 or Dw,1. The factor k(tot) was determined for four available (192)Ir sources and one (60)Co source with three different thimble ionization chambers. Finally, ionization chamber measurements on three μSelectron V2 HDR sources within the Krieger-phantom were performed and Ka,100 was determined according to three different methods: 1) using a calibration factor in terms of absorbed dose to water with the global correction factor [Formula: see text] according DGMP 13 2) using a global correction factor calculated via Monte Carlo 3) using a direct reference air-kerma rate calibration factor determined by the national metrology institute PTB. The comparison of Monte Carlo based [Formula: see text] with those from DGMP 13 showed that the DGMP data were systematically smaller by about 2-2.5%. The experimentally determined [Formula: see text] , based on the direct Ka,100 calibration were also systematically smaller by about 1.5%. Despite of these systematical deviations, the agreement of the different methods was in almost all cases within the 1σ level of confidence of the interval of their respective uncertainties in a Gaussian distribution. The application of Monte Carlo based [Formula: see text] for the determination of Ka,100 for three μSelectron V2 sources

  17. Comparison of air-kerma strength determinations for HDR {sup 192}Ir sources

    SciTech Connect

    Rasmussen, Brian E.; Davis, Stephen D.; Schmidt, Cal R.; Micka, John A.; DeWerd, Larry A.

    2011-12-15

    Purpose: To perform a comparison of the interim air-kerma strength standard for high dose rate (HDR) {sup 192}Ir brachytherapy sources maintained by University of Wisconsin Accredited Dosimetry Calibration Laboratory (UWADCL) with measurements of the various source models using modified techniques from the literature. The current interim standard was established by Goetsch et al. in 1991 and has remained unchanged to date. Methods: The improved, laser-aligned seven-distance apparatus of University of Wisconsin Medical Radiation Research Center (UWMRRC) was used to perform air-kerma strength measurements of five different HDR {sup 192}Ir source models. The results of these measurements were compared with those from well chambers traceable to the original standard. Alternative methodologies for interpolating the {sup 192}Ir air-kerma calibration coefficient from the NIST air-kerma standards at {sup 137}Cs and 250 kVp x rays (M250) were investigated and intercompared. As part of the interpolation method comparison, the Monte Carlo code EGSnrc was used to calculate updated values of A{sub wall} for the Exradin A3 chamber used for air-kerma strength measurements. The effects of air attenuation and scatter, room scatter, as well as the solution method were investigated in detail. Results: The average measurements when using the inverse N{sub K} interpolation method for the Classic Nucletron, Nucletron microSelectron, VariSource VS2000, GammaMed Plus, and Flexisource were found to be 0.47%, -0.10%, -1.13%, -0.20%, and 0.89% different than the existing standard, respectively. A further investigation of the differences observed between the sources was performed using MCNP5 Monte Carlo simulations of each source model inside a full model of an HDR 1000 Plus well chamber. Conclusions: Although the differences between the source models were found to be statistically significant, the equally weighted average difference between the seven-distance measurements and the well

  18. Dosimetric intercomparison of permanent Ho-166 seed's implants and HDR Ir-192 brachytherapy in breast cancer.

    PubMed

    de Campos, Tarcisio Passos Ribeiro; Nogueira, Luciana Batista; Trindade, Bruno; Cuperschmid, Ethel Mizrahy

    2016-01-01

    To provide a comparative dosimetric analysis of permanent implants of Ho(166)-seeds and temporary HDR Ir(192)-brachytherapy through computational simulation. Brachytherapy with Ir(192)-HDR or LDR based on temporary wires or permanent radioactive seed implants can be used as dose reinforcement for breast radiation therapy. Permanent breast implants have not been a practical clinical routine; although, I(125) and Pd(103)-seeds have already been reported. Biodegradable Ho(166)-ceramic-seeds have been addressed recently. Simulations of implants of nine Ho(166)-seeds and equivalent with HDR Ir(192)-brachytherapy were elaborated in MCNP5, shaped in a computational multivoxel simulator which reproduced a female thorax phantom. Spatial dose rate distributions and dose-volume histograms were generated. Protocol's analysis involving exposure time, seed's activities and dose were performed. Permanent Ho(166)-seed implants presented a maximum dose rate per unit of contained activity (MDR) of 1.1601 μGy h(-1) Bq(-1); and, a normalized MDR in standard points (8 mm, equidistant to 03-seeds - SP1, 10 mm - SP2) of 1.0% (SP1) and 0.5% (SP2), respectively. Ir(192)-brachytherapy presented MDR of 4.3945 × 10(-3) μGy h(-1) Bq(-1); and, 30% (SP1), and 20% (SP2). Therefore, seed's implant activities of 333 MBq (Ho(166)) and 259 GBq (Ir(192)) produced prescribed doses of 58 Gy (SP1; 5d) and 56 Gy (SP1, 5 fractions, 6 min), respectively. Breast Ho(166)-implants of 37-111 MBq are attractive due to the high dose rate near 6-10 mm from seeds, equivalent to Ir(192)-brachytherapy of 259 GBq (3 fractions, 6 min) providing similar dose in standard points at a week; however, with spatial dose distribution better confined. The seed positioning can be adjusted for controlling the breast tumor, in stages I and II, in flat and deep tumors, without any breast volumetric limitation.

  19. Source position verification and dosimetry in HDR brachytherapy using an EPID

    SciTech Connect

    Smith, R. L.; Taylor, M. L.; McDermott, L. N.; Franich, R. D.; Haworth, A.; Millar, J. L.

    2013-11-15

    Purpose: Accurate treatment delivery in high dose rate (HDR) brachytherapy requires correct source dwell positions and dwell times to be administered relative to each other and to the surrounding anatomy. Treatment delivery inaccuracies predominantly occur for two reasons: (i) anatomical movement or (ii) as a result of human errors that are usually related to incorrect implementation of the planned treatment. Electronic portal imaging devices (EPIDs) were originally developed for patient position verification in external beam radiotherapy and their application has been extended to provide dosimetric information. The authors have characterized the response of an EPID for use with an {sup 192}Ir brachytherapy source to demonstrate its use as a verification device, providing both source position and dosimetric information.Methods: Characterization of the EPID response using an {sup 192}Ir brachytherapy source included investigations of reproducibility, linearity with dose rate, photon energy dependence, and charge build-up effects associated with exposure time and image acquisition time. Source position resolution in three dimensions was determined. To illustrate treatment verification, a simple treatment plan was delivered to a phantom and the measured EPID dose distribution compared with the planned dose.Results: The mean absolute source position error in the plane parallel to the EPID, for dwells measured at 50, 100, and 150 mm source to detector distances (SDD), was determined to be 0.26 mm. The resolution of the z coordinate (perpendicular distance from detector plane) is SDD dependent with 95% confidence intervals of ±0.1, ±0.5, and ±2.0 mm at SDDs of 50, 100, and 150 mm, respectively. The response of the EPID is highly linear to dose rate. The EPID exhibits an over-response to low energy incident photons and this nonlinearity is incorporated into the dose calibration procedure. A distance (spectral) dependent dose rate calibration procedure has been

  20. Research on HDR image fusion algorithm based on Laplace pyramid weight transform with extreme low-light CMOS

    NASA Astrophysics Data System (ADS)

    Guan, Wen; Li, Li; Jin, Weiqi; Qiu, Su; Zou, Yan

    2015-10-01

    Extreme-Low-Light CMOS has been widely applied in the field of night-vision as a new type of solid image sensor. But if the illumination in the scene has drastic changes or the illumination is too strong, Extreme-Low-Light CMOS can't both clearly present the high-light scene and low-light region. According to the partial saturation problem in the field of night-vision, a HDR image fusion algorithm based on the Laplace Pyramid was researched. The overall gray value and the contrast of the low light image is very low. We choose the fusion strategy based on regional average gradient for the top layer of the long exposure image and short exposure image, which has rich brightness and textural features. The remained layers which represent the edge feature information of the target are based on the fusion strategy based on regional energy. In the process of source image reconstruction with Laplacian pyramid image, we compare the fusion results with four kinds of basal images. The algorithm is tested using Matlab and compared with the different fusion strategies. We use information entropy, average gradient and standard deviation these three objective evaluation parameters for the further analysis of the fusion result. Different low illumination environment experiments show that the algorithm in this paper can rapidly get wide dynamic range while keeping high entropy. Through the verification of this algorithm features, there is a further application prospect of the optimized algorithm. Keywords: high dynamic range imaging, image fusion, multi-exposure image, weight coefficient, information fusion, Laplacian pyramid transform.

  1. Calculated organ doses using Monte Carlo simulations in a reference male phantom undergoing HDR brachytherapy applied to localized prostate carcinoma

    SciTech Connect

    Candela-Juan, Cristian; Perez-Calatayud, Jose; Ballester, Facundo; Rivard, Mark J.

    2013-03-15

    Purpose: The aim of this study was to obtain equivalent doses in radiosensitive organs (aside from the bladder and rectum) when applying high-dose-rate (HDR) brachytherapy to a localized prostate carcinoma using {sup 60}Co or {sup 192}Ir sources. These data are compared with results in a water phantom and with expected values in an infinite water medium. A comparison with reported values from proton therapy and intensity-modulated radiation therapy (IMRT) is also provided. Methods: Monte Carlo simulations in Geant4 were performed using a voxelized phantom described in International Commission on Radiological Protection (ICRP) Publication 110, which reproduces masses and shapes from an adult reference man defined in ICRP Publication 89. Point sources of {sup 60}Co or {sup 192}Ir with photon energy spectra corresponding to those exiting their capsules were placed in the center of the prostate, and equivalent doses per clinical absorbed dose in this target organ were obtained in several radiosensitive organs. Values were corrected to account for clinical circumstances with the source located at various positions with differing dwell times throughout the prostate. This was repeated for a homogeneous water phantom. Results: For the nearest organs considered (bladder, rectum, testes, small intestine, and colon), equivalent doses given by {sup 60}Co source were smaller (8%-19%) than from {sup 192}Ir. However, as the distance increases, the more penetrating gamma rays produced by {sup 60}Co deliver higher organ equivalent doses. The overall result is that effective dose per clinical absorbed dose from a {sup 60}Co source (11.1 mSv/Gy) is lower than from a {sup 192}Ir source (13.2 mSv/Gy). On the other hand, equivalent doses were the same in the tissue and the homogeneous water phantom for those soft tissues closer to the prostate than about 30 cm. As the distance increased, the differences of photoelectric effect in water and soft tissue, and appearance of other materials

  2. NOTE: Monte Carlo dosimetric study of the BEBIG Co-60 HDR source

    NASA Astrophysics Data System (ADS)

    Ballester, F.; Granero, D.; Pérez-Calatayud, J.; Casal, E.; Agramunt, S.; Cases, R.

    2005-11-01

    Although not as widespread as Ir-192, Co-60 is also available on afterloading equipment devoted to high dose rate brachytherapy, mainly addressed to the treatment of gynaecological lesions. The purpose of this study is to obtain the dosimetric parameters of the Co-60 source used by the BEBIG MultiSource remote afterloader (BEBIG GmbH, Germany) for which there are no dosimetric data available in the literature. The Monte Carlo code GEANT4 has been used to obtain the TG43 parameters and the 2D dose rate table in Cartesian coordinates of the BEBIG Co-60 HDR source. The dose rate constant, radial dose function and anisotropy function have been calculated and are presented in a tabular form as well as a detailed 2D dose rate table in Cartesian coordinates. These dosimetric datasets can be used as input data and to validate the treatment planning system calculations.

  3. A BrachyPhantom for verification of dose calculation of HDR brachytherapy planning system

    SciTech Connect

    Austerlitz, C.; Campos, C. A. T.

    2013-11-15

    Purpose: To develop a calibration phantom for {sup 192}Ir high dose rate (HDR) brachytherapy units that renders possible the direct measurement of absorbed dose to water and verification of treatment planning system.Methods: A phantom, herein designated BrachyPhantom, consists of a Solid Water™ 8-cm high cylinder with a diameter of 14 cm cavity in its axis that allows the positioning of an A1SL ionization chamber with its reference measuring point at the midheight of the cylinder's axis. Inside the BrachyPhantom, at a 3-cm radial distance from the chamber's reference measuring point, there is a circular channel connected to a cylindrical-guide cavity that allows the insertion of a 6-French flexible plastic catheter from the BrachyPhantom surface. The PENELOPE Monte Carlo code was used to calculate a factor, P{sub sw}{sup lw}, to correct the reading of the ionization chamber to a full scatter condition in liquid water. The verification of dose calculation of a HDR brachytherapy treatment planning system was performed by inserting a catheter with a dummy source in the phantom channel and scanning it with a CT. The CT scan was then transferred to the HDR computer program in which a multiple treatment plan was programmed to deliver a total dose of 150 cGy to the ionization chamber. The instrument reading was then converted to absorbed dose to water using the N{sub gas} formalism and the P{sub sw}{sup lw} factor. Likewise, the absorbed dose to water was calculated using the source strength, S{sub k}, values provided by 15 institutions visited in this work.Results: A value of 1.020 (0.09%, k= 2) was found for P{sub sw}{sup lw}. The expanded uncertainty in the absorbed dose assessed with the BrachyPhantom was found to be 2.12% (k= 1). To an associated S{sub k} of 27.8 cGy m{sup 2} h{sup −1}, the total irradiation time to deliver 150 cGy to the ionization chamber point of reference was 161.0 s. The deviation between the absorbed doses to water assessed with the Brachy

  4. Dosimetric comparison between the microSelectron HDR 192Ir v2 source and the BEBIG 60Co source for HDR brachytherapy using the EGSnrc Monte Carlo transport code

    PubMed Central

    Islam, M. Anwarul; Akramuzzaman, M. M.; Zakaria, G. A.

    2012-01-01

    Manufacturing of miniaturized high activity 192Ir sources have been made a market preference in modern brachytherapy. The smaller dimensions of the sources are flexible for smaller diameter of the applicators and it is also suitable for interstitial implants. Presently, miniaturized 60Co HDR sources have been made available with identical dimensions to those of 192Ir sources. 60Co sources have an advantage of longer half life while comparing with 192Ir source. High dose rate brachytherapy sources with longer half life are logically pragmatic solution for developing country in economic point of view. This study is aimed to compare the TG-43U1 dosimetric parameters for new BEBIG 60Co HDR and new microSelectron 192Ir HDR sources. Dosimetric parameters are calculated using EGSnrc-based Monte Carlo simulation code accordance with the AAPM TG-43 formalism for microSlectron HDR 192Ir v2 and new BEBIG 60Co HDR sources. Air-kerma strength per unit source activity, calculated in dry air are 9.698×10-8 ± 0.55% U Bq-1 and 3.039×10-7 ± 0.41% U Bq-1 for the above mentioned two sources, respectively. The calculated dose rate constants per unit air-kerma strength in water medium are 1.116±0.12% cGy h-1U-1 and 1.097±0.12% cGy h-1U-1, respectively, for the two sources. The values of radial dose function for distances up to 1 cm and more than 22 cm for BEBIG 60Co HDR source are higher than that of other source. The anisotropic values are sharply increased to the longitudinal sides of the BEBIG 60Co source and the rise is comparatively sharper than that of the other source. Tissue dependence of the absorbed dose has been investigated with vacuum phantom for breast, compact bone, blood, lung, thyroid, soft tissue, testis, and muscle. No significant variation is noted at 5 cm of radial distance in this regard while comparing the two sources except for lung tissues. The true dose rates are calculated with considering photon as well as electron transport using appropriate cut

  5. Dosimetric comparison between the microSelectron HDR (192)Ir v2 source and the BEBIG (60)Co source for HDR brachytherapy using the EGSnrc Monte Carlo transport code.

    PubMed

    Islam, M Anwarul; Akramuzzaman, M M; Zakaria, G A

    2012-10-01

    Manufacturing of miniaturized high activity (192)Ir sources have been made a market preference in modern brachytherapy. The smaller dimensions of the sources are flexible for smaller diameter of the applicators and it is also suitable for interstitial implants. Presently, miniaturized (60)Co HDR sources have been made available with identical dimensions to those of (192)Ir sources. (60)Co sources have an advantage of longer half life while comparing with (192)Ir source. High dose rate brachytherapy sources with longer half life are logically pragmatic solution for developing country in economic point of view. This study is aimed to compare the TG-43U1 dosimetric parameters for new BEBIG (60)Co HDR and new microSelectron (192)Ir HDR sources. Dosimetric parameters are calculated using EGSnrc-based Monte Carlo simulation code accordance with the AAPM TG-43 formalism for microSlectron HDR (192)Ir v2 and new BEBIG (60)Co HDR sources. Air-kerma strength per unit source activity, calculated in dry air are 9.698×10(-8) ± 0.55% U Bq(-1) and 3.039×10(-7) ± 0.41% U Bq(-1) for the above mentioned two sources, respectively. The calculated dose rate constants per unit air-kerma strength in water medium are 1.116±0.12% cGy h(-1)U(-1) and 1.097±0.12% cGy h(-1)U(-1), respectively, for the two sources. The values of radial dose function for distances up to 1 cm and more than 22 cm for BEBIG (60)Co HDR source are higher than that of other source. The anisotropic values are sharply increased to the longitudinal sides of the BEBIG (60)Co source and the rise is comparatively sharper than that of the other source. Tissue dependence of the absorbed dose has been investigated with vacuum phantom for breast, compact bone, blood, lung, thyroid, soft tissue, testis, and muscle. No significant variation is noted at 5 cm of radial distance in this regard while comparing the two sources except for lung tissues. The true dose rates are calculated with considering photon as well as electron

  6. Sci-Sat AM(2): Brachy-01: A novel HDR Ir-192 brachytherapy water calorimeter standard.

    PubMed

    Sarfehnia, A; Seuntjens, J

    2008-07-01

    Parameters influencing the accuracy of absorbed dose measurements for HDR 192Ir brachytherapy using water calorimetry were investigated with the goal to develop a novel primary absorbed dose to water standard. To provide greater stability, flexibility, and accuracy in the source-detector distance dsrc-det positioning and measurement, a new spring-loaded catheter holder composed of two concentric cylindrical sleeves with multiple orthogonal adjusting screws was developed. The absorbed dose from Nucletron microSelectron-HDR 192Ir brachytherapy sources with air kerma strengths ranging between 21000-38000 U was studied. dsrc-det is optimized so as to balance signal-to-noise ratio (decreasing with increasing dsrc-det ) and temperature drift effects resulting from source self-heating. The irradiation times were adjusted to yield a minimum 1 Gy of dose at the measurement point. Successful measurements at dsrc-det ranging between 25-50 mm were performed. COMSOL MULTIPHYSICS™ software was used to determine the heat loss correction due to conduction defined as the ratio between temperature rise at a point under ideal conditions to realistic conditions (i.e., no conduction). An agreement of better than 6.5% was observed between TG-43 calculated and calorimetrically measured absorbed dose rates. The effects of convection where calculated to be negligible as the glass vessel provides a convective barrier significantly decoupling the water velocity in the interior and exterior of the vessel (water velocities were 1-2 orders of magnitude different). Our work paves the way to successful primary absorbed dose determination for radioactive sources using calorimetric techniques. © 2008 American Association of Physicists in Medicine.

  7. The contribution from transit dose for (192)Ir HDR brachytherapy treatments.

    PubMed

    Fonseca, G P; Landry, G; Reniers, B; Hoffmann, A; Rubo, R A; Antunes, P C G; Yoriyaz, H; Verhaegen, F

    2014-04-07

    Brachytherapy treatment planning systems that use model-based dose calculation algorithms employ a more accurate approach that replaces the TG43-U1 water dose formalism and adopt the TG-186 recommendations regarding composition and geometry of patients and other relevant effects. However, no recommendations were provided on the transit dose due to the source traveling inside the patient. This study describes a methodology to calculate the transit dose using information from the treatment planning system (TPS) and considering the source's instantaneous and average speed for two prostate and two gynecological cases. The trajectory of the (192)Ir HDR source was defined by importing applicator contour points and dwell positions from the TPS. The transit dose distribution was calculated using the maximum speed, the average speed and uniform accelerations obtained from the literature to obtain an approximate continuous source distribution simulated with a Monte Carlo code. The transit component can be negligible or significant depending on the speed profile adopted, which is not clearly reported in the literature. The significance of the transit dose can also be due to the treatment modality; in our study interstitial treatments exhibited the largest effects. Considering the worst case scenario the transit dose can reach 3% of the prescribed dose in a gynecological case with four catheters and up to 11.1% when comparing the average prostate dose for a case with 16 catheters. The transit dose component increases by increasing the number of catheters used for HDR brachytherapy, reducing the total dwell time per catheter or increasing the number of dwell positions with low dwell times. This contribution may become significant (>5%) if it is not corrected appropriately. The transit dose cannot be completely compensated using simple dwell time corrections since it may have a non-uniform distribution. An accurate measurement of the source acceleration and maximum speed should

  8. Clinical application of MOSkin dosimeters to rectal wall in vivo dosimetry in gynecological HDR brachytherapy.

    PubMed

    Carrara, M; Romanyukha, A; Tenconi, C; Mazzeo, D; Cerrotta, A; Borroni, M; Cutajar, D; Petasecca, M; Lerch, M; Bucci, J; Richetti, A; Presilla, S; Fallai, C; Gambarini, G; Pignoli, E; Rosenfeld, A

    2017-09-01

    Three MOSkins dosimeters were assembled over a rectal probe and used to perform in vivo dosimetry during HDR brachytherapy treatments of vaginal cancer. The purpose of this study was to verify the applicability of the developed tool to evaluate discrepancies between planned and measured doses to the rectal wall. MOSkin dosimeters from the Centre for Medical Radiation Physics are particularly suitable for brachytherapy procedures for their ability to be easily incorporated into treatment instrumentation. In this study, 26 treatment sessions of HDR vaginal brachytherapy were monitored using three MOSkin mounted on a rectal probe. A total of 78 measurements were collected and compared to doses determined by the treatment planning system. Mean dose discrepancy was determined as 2.2±6.9%, with 44.6% of the measurements within ±5%, 89.2% within ±10% and 10.8% higher than ±10%. When dose discrepancies were grouped according to the time elapsed between imaging and treatment (i.e., group 1: ≤90min; group 2: >90min), mean discrepancies resulted in 4.7±3.6% and 7.1±5.0% for groups 1 and 2, respectively. Furthermore, the position of the dosimeter on the rectal catheter was found to affect uncertainty, where highest uncertainties were observed for the dosimeter furthest inside the rectum. This study has verified MOSkin applicability to in-patient dose monitoring in gynecological brachytherapy procedures, demonstrating the dosimetric rectal probe setup as an accurate and convenient IVD instrument for rectal wall dose verification. Furthermore, the study demonstrates that the delivered dose discrepancy may be affected by the duration of treatment planning. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  9. Cloning, molecular characterization and functional analysis of 1-hydroxy-2-methyl-2-(E)-butenyl-4-diphosphate reductase (HDR) gene for diterpenoid tanshinone biosynthesis in Salvia miltiorrhiza Bge. f. alba.

    PubMed

    Hao, Gangping; Shi, Renjiu; Tao, Ru; Fang, Qian; Jiang, Xingyu; Ji, Haiwei; Feng, Lei; Huang, Luqi

    2013-09-01

    The enzyme 1-hydroxy-2-methyl-2-(E)-butenyl-4-diphosphate reductase (HDR) is a terminal-acting enzyme in the plastid MEP pathway, which produce isoprenoid precursors. The full-length cDNA of HDR, designated SmHDR1 (Genbank Accession No. JX516088), was isolated for the first time from Salvia miltiorrhiza Bge. f. alba. SmHDR1 contains a 1389-bp open reading frame encoding 463 amino acids. The deduced SmHDR1 protein, which shows high identity to HDRs of other plant species, is predicted to possess a chloroplast transit peptide at the N-terminus and four conserved cysteine residues. Transcription pattern analysis revealed that SmHDR1 has high levels of transcription in leaves and low levels of transcription in roots and stems. The expression of SmHDR1 was induced by 0.1 mM methyl-jasmonate (MeJA) and salicylic acid (SA), but not by 0.1 mM abscisic acid (ABA), in the hairy roots of S. miltiorrhiza Bge. f. alba. Complementation of SmHDR1 in the Escherichia coli HDR mutant MG1655 ara < > ispH demonstrated the function of this enzyme. A functional color assay in E. coli showed that SmHDR1 accelerates the biosynthesis of β-carotene, indicating that SmHDR1 encodes a functional protein. Overexpression of SmHDR1 enhanced the production of tanshinones in cultured hairy roots of S. miltiorrhiza Bge. f. alba. These results indicate that SmHDR1 is a novel and important enzyme involved in the biosynthesis of diterpenoid tanshinones in S. miltiorrhiza Bge. f. alba.

  10. Virtual HDR CyberKnife SBRT for Localized Prostatic Carcinoma: 5-Year Disease-Free Survival and Toxicity Observations.

    PubMed

    Fuller, Donald Blake; Naitoh, John; Mardirossian, George

    2014-01-01

    Prostate stereotactic body radiotherapy (SBRT) may substantially recapitulate the dose distribution of high-dose-rate (HDR) brachytherapy, representing an externally delivered "Virtual HDR" treatment method. Herein, we present 5-year outcomes from a cohort of consecutively treated virtual HDR SBRT prostate cancer patients. Seventy-nine patients were treated from 2006 to 2009, 40 low-risk, and 39 intermediate-risk, under IRB-approved clinical trial, to 38 Gy in four fractions. The planning target volume (PTV) included prostate plus a 2-mm volume expansion in all directions, with selective use of a 5-mm prostate-to-PTV expansion and proximal seminal vesicle coverage in intermediate-risk patients, to better cover potential extraprostatic disease; rectal PTV margin reduced to zero in all cases. The prescription dose covered >95% of the PTV (V100 ≥95%), with a minimum 150% PTV dose escalation to create "HDR-like" PTV dose distribution. Median pre-SBRT PSA level of 5.6 ng/mL decreased to 0.05 ng/mL 5 years out and 0.02 ng/mL 6 years out. At least one PSA bounce was seen in 55 patients (70%) but only 3 of them subsequently relapsed, biochemical-relapse-free survival was 100 and 92% for low-risk and intermediate-risk patients, respectively, by ASTRO definition (98 and 92% by Phoenix definition). Local relapse did not occur, distant metastasis-free survival was 100 and 95% by risk-group, and disease-specific survival was 100%. Acute and late grade 2 GU toxicity incidence was 10 and 9%, respectively; with 6% late grade 3 GU toxicity. Acute urinary retention did not occur. Acute and late grade 2 GI toxicity was 0 and 1%, respectively, with no grade 3 or higher toxicity. Of patient's potent pre-SBRT, 65% remained so at 5 years. Virtual HDR prostate SBRT creates a very low PSA nadir, a high rate of 5-year disease-free survival and an acceptable toxicity incidence, with results closely resembling those reported post-HDR brachytherapy.

  11. [HDR 192Ir brachytherapy in treatment of basal cell carcinoma of the lower eyelid and inner angle - our experience].

    PubMed

    Furdová, A; Lukačko, P; Lederleitner, D

    2013-06-01

    First experience and evaluation of relapses in group of patients after surgery with applied adjuvant HDR brachytherapy for recurrent tumor after incomplete excision of basal cell carcinoma of the lower eyelid and inner angle. Patients with recurrent basal cell carcinoma of the lower eyelid in year 2010. In 3 male patients with recurrent finding of basal cell after surgery we applied adjuvant HDR 192Ir brachytherapy. The isodose curve chosen to prescribe the dose was 5 mm away from the skin surface. In the year 2010 we applied adjuvant HDR 192Ir brachytherapy in 3 male patients with recurrent basal cell carcinoma. The average age was 58 years (52 to 75 years). From group of 41 patients with non melanotic malignant tumors of the eyelids in 3 patients (7.3 %) with relapse after incomplete excision of the basal cell carcinoma of the lower eyelid we applied after removal of stitches after surgery adjuvant HDR 192Ir brachytherapy. For each patient was made individual orfit mask that bore plastic applicators. Tungsten eye shield applicator was applied to protect the eye globe. Treatment of 10 fractions of 4.5 Gy single dose (5 times weekly) were scheduled within 2 weeks. Patients received outpatient treatment. Acute toxicity postradiation erythema of eyelid and skin around relieved by standard symptomatic treatment within a few days after completion of radiation therapy. In 2 year interval after HDR 192Ir brachytherapy we did not record the occurrence of late complications such as corneal ulcers. Our preliminary experience shows excellent early skin tolerance. After 2 years of follow-up at 6 month interval we did not recognize relapse in our group of patients. The proposed technique of HDR 192Ir brachytherapy after surgery should be considered a new clinical treatment in patients with recurrent non melanotic eyelid cancer. Its main advantage lies in the usefulness in all types of basal cell and squamous cell carcinoma and sebaceous carcinoma of the eyelids, without

  12. Additional androgen deprivation makes the difference: Biochemical recurrence-free survival in prostate cancer patients after HDR brachytherapy and external beam radiotherapy.

    PubMed

    Schiffmann, Jonas; Lesmana, Hans; Tennstedt, Pierre; Beyer, Burkhard; Boehm, Katharina; Platz, Volker; Tilki, Derya; Salomon, Georg; Petersen, Cordula; Krüll, Andreas; Graefen, Markus; Schwarz, Rudolf

    2015-04-01

    The role of additional androgen deprivation therapy (ADT) in prostate cancer (PCa) patients treated with combined HDR brachytherapy (HDR-BT) and external beam radiotherapy (EBRT) is still unknown. Consecutive PCa patients classified as D'Amico intermediate and high-risk who underwent HDR-BT and EBRT treatment ± ADT at our institution between January 1999 and February 2009 were assessed. Multivariable Cox regression models predicting biochemical recurrence (BCR) were performed. BCR-free survival was assessed with Kaplan-Meier analyses. Overall, 392 patients were assessable. Of these, 221 (56.4 %) underwent trimodality (HDR-BT and EBRT and ADT) and 171 (43.6 %) bimodality (HDR-BT and EBRT) treatment. Additional ADT administration reduced the risk of BCR (HR: 0.4, 95 % CI: 0.3-0.7, p < 0.001). D'Amico high-risk patients had superior BCR-free survival when additional ADT was administered (log-rank p < 0.001). No significant difference for BCR-free survival was recorded when additional ADT was administered to D'Amico intermediate-risk patients (log-rank p = 0.2). Additional ADT administration improves biochemical control in D'Amico high-risk patients when HDR-BT and EBRT are combined. Physicians should consider the oncological benefit of ADT administration for these patients during the decision-making process.

  13. Clinical implementation and failure mode and effects analysis of HDR skin brachytherapy using Valencia and Leipzig surface applicators.

    PubMed

    Sayler, Elaine; Eldredge-Hindy, Harriet; Dinome, Jessie; Lockamy, Virginia; Harrison, Amy S

    2015-01-01

    The planning procedure for Valencia and Leipzig surface applicators (VLSAs) (Nucletron, Veenendaal, The Netherlands) differs substantially from CT-based planning; the unfamiliarity could lead to significant errors. This study applies failure modes and effects analysis (FMEA) to high-dose-rate (HDR) skin brachytherapy using VLSAs to ensure safety and quality. A multidisciplinary team created a protocol for HDR VLSA skin treatments and applied FMEA. Failure modes were identified and scored by severity, occurrence, and detectability. The clinical procedure was then revised to address high-scoring process nodes. Several key components were added to the protocol to minimize risk probability numbers. (1) Diagnosis, prescription, applicator selection, and setup are reviewed at weekly quality assurance rounds. Peer review reduces the likelihood of an inappropriate treatment regime. (2) A template for HDR skin treatments was established in the clinic's electronic medical record system to standardize treatment instructions. This reduces the chances of miscommunication between the physician and planner as well as increases the detectability of an error. (3) A screen check was implemented during the second check to increase detectability of an error. (4) To reduce error probability, the treatment plan worksheet was designed to display plan parameters in a format visually similar to the treatment console display, facilitating data entry and verification. (5) VLSAs are color coded and labeled to match the electronic medical record prescriptions, simplifying in-room selection and verification. Multidisciplinary planning and FMEA increased detectability and reduced error probability during VLSA HDR brachytherapy. This clinical model may be useful to institutions implementing similar procedures. Copyright © 2015 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  14. HDR and LDR Brachytherapy in the Treatment of Lip Cancer: the Experience of the Catalan Institute of Oncology

    PubMed Central

    Mena, Estefanía Palacios; Fabregas, Joan Pera; Miguelez, Cristina Gutiérrez; Guedea, Ferran

    2010-01-01

    Purpose Lip cancer can be treated by surgery, external radiotherapy, and/or brachytherapy (BT). In recent years, BT has become increasingly favored for this type of cancer. The aim of the present study was to analyze local control and survival of patients treated at our institution between July 1989 and June 2008. Material and methods We performed a retrospective study of 121 patients (109 males and 12 females) who underwent lip cancer brachytherapy from July 1989 to June 2008. Median age was 67 years and median follow-up was 31.8 months (range 20-188 months). Out of 121 patients, 100 (82.6%) were treated with low dose rate (LDR) BT while the remaining 21 patients (17.4%) received high dose rate (HDR) BT. Results The most common cell type was squamous cell carcinoma (115 cases; 95%) and most tumors were located on the lower lip (107 patients; 88.4%). Most cases were either stage T1 (62 patients; 51.2%), or T2 (44 cases; 36.4%). After 15 years of follow-up, overall survival was 89.5%, cause-specific survival 97.8%, and disease-free survival 86.6%. Local, regional, and distant control at 15 years were 90%, 92%, and 98.8%, respectively. Grade 3 mucosal toxicity was observed in 23% of patients treated with LDR compared to 33% of HDR patients, and grade 4 mucosal toxicity in 9% versus 0% in the HDR group. Conclusions Our findings confirm that brachytherapy is an effective treatment for lip cancer. The results from our series are in line with those published elsewhere. Based on our limited data, HDR appears to be equally as good as LDR, although this needs to be confirmed by further studies. PMID:28031737

  15. Evaluation of scatter contribution and distance error by iterative methods for strength determination of HDR 192Ir brachytherapy source.

    PubMed

    Kumar, Sudhir; Srinivasan, Panchapakesan; Sharma, Sunil D; Subbaiah, Kamatam V; Mayya, Yelia S

    2010-01-01

    High-dose rate (HDR) 192Ir brachytherapy sources are commonly used for management of malignancies by brachytherapy applications. Measurement of source strength at the hospital is an important dosimetry requirement. The use of 0.6-cm(3) cylindrical ionization chamber is one of the methods of measuring the source strength at the hospitals because this chamber is readily available for beam calibration and dosimetry. While using the cylindrical chamber for this purpose, it is also required to determine the positioning error of the ionization chamber, with respect to the source, commonly called a distance error (c). The contribution of scatter radiation (M(s)) from floor, walls, ceiling, and other materials available in the treatment room also need to be determined accurately so that appropriate correction can be applied while calculating the source strength from the meter reading. Iterative methods of Newton-Raphson and least-squares were used in this work to determine scatter contribution in the experimentally observed meter reading (pC/s) of a cylindrical ionization chamber. Monte Carlo simulation was also used to cross verify the results of the least-squares method. The experimentally observed, least-squares calculated and Monte Carlo estimated values of meter readings from HDR 192Ir brachytherapy source were in good agreement. Considering procedural simplicity, the method of least-squares is recommended for use at the hospitals to estimate values of f (constant of proportionality), c, and M(s) required to determine the strength of HDR 192Ir brachytherapy sources.

  16. A Feasibility Study of Fricke Dosimetry as an Absorbed Dose to Water Standard for 192Ir HDR Sources

    PubMed Central

    deAlmeida, Carlos Eduardo; Ochoa, Ricardo; de Lima, Marilene Coelho; David, Mariano Gazineu; Pires, Evandro Jesus; Peixoto, José Guilherme; Salata, Camila; Bernal, Mario Antônio

    2014-01-01

    High dose rate brachytherapy (HDR) using 192Ir sources is well accepted as an important treatment option and thus requires an accurate dosimetry standard. However, a dosimetry standard for the direct measurement of the absolute dose to water for this particular source type is currently not available. An improved standard for the absorbed dose to water based on Fricke dosimetry of HDR 192Ir brachytherapy sources is presented in this study. The main goal of this paper is to demonstrate the potential usefulness of the Fricke dosimetry technique for the standardization of the quantity absorbed dose to water for 192Ir sources. A molded, double-walled, spherical vessel for water containing the Fricke solution was constructed based on the Fricke system. The authors measured the absorbed dose to water and compared it with the doses calculated using the AAPM TG-43 report. The overall combined uncertainty associated with the measurements using Fricke dosimetry was 1.4% for k = 1, which is better than the uncertainties reported in previous studies. These results are promising; hence, the use of Fricke dosimetry to measure the absorbed dose to water as a standard for HDR 192Ir may be possible in the future. PMID:25521914

  17. SBRT and HDR brachytherapy produce lower PSA nadirs and different PSA decay patterns than conventionally fractionated IMRT in patients with low- or intermediate-risk prostate cancer.

    PubMed

    Kishan, Amar U; Wang, Pin-Chieh; Upadhyaya, Shrinivasa K; Hauswald, Henrik; Demanes, D Jeffrey; Nickols, Nicholas G; Kamrava, Mitchell; Sadeghi, Ahmad; Kupelian, Patrick A; Steinberg, Michael L; Prionas, Nicolas D; Buyyounouski, Mark K; King, Christopher R

    2016-01-01

    To compare patterns of prostate-specific antigen (PSA) response following stereotactic body radiation therapy (SBRT), high-dose-rate (HDR) brachytherapy, and conventionally fractionated intensity modulated radiation therapy (IMRT) in patients with low- or intermediate-risk prostate cancer (CaP). Eligible study patients included 439 patients with low- or intermediate-risk prostate cancer who were treated with radiation therapy (RT) alone between 2003 and 2013, remained free of biochemical recurrence, and had at least 2 PSA values within the first year following RT. Of these, 130 were treated with SBRT, 220 with HDR brachytherapy, and 89 with IMRT. Multivariate regression analysis was used to compare PSA nadirs (nPSA), time to nPSA, and PSA bounce parameters among the 3 modalities. Indicator variable analysis was used to develop empirical models of PSA decay using the treatment modalities as indicator variables. Significantly more patients treated with SBRT or HDR brachytherapy achieved raw nPSAs of <0.5 ng/mL compared with patients treated with IMRT (76.2% and 75.9% vs 44.9%, respectively; P < .0001 for SBRT or HDR brachytherapy vs IMRT). On multivariate analysis, nPSA was significantly lower with SBRT and HDR compared with IMRT (P < .0001). Time to nPSA and bounce parameters was not significantly different among IMRT, SBRT, and HDR. Overall, SBRT and HDR brachytherapy caused significantly larger PSA decay rates (P < .001). When truncating follow-up at 1000 days, the corresponding decay rates were larger for all 3 modalities, with no significant differences between them. Stereotactic body radiation therapy and HDR brachytherapy produce lower nPSAs than IMRT. Within 1000 days of follow-up, the modalities produce similar rates of PSA decay; subsequently, decay continues (albeit at a slower pace) after SBRT and HDR brachytherapy but plateaus with IMRT. Because nPSA is a validated predictor of long-term outcome, these data not only suggest a distinct radiobiological

  18. HDR brachytherapy of prostate cancer – two years experience in Greater Poland Cancer Centre

    PubMed Central

    Skowronek, Janusz; Chicheł, Adam

    2009-01-01

    Purpose The aim of this work was to analyze the results and complications of three treatment schemes of patients with initially localized prostate cancer after two years of observation time. Material and methods Sixty-three patients were enrolled into the study and divided into groups according to radiation schemes (I group – EBRT 50 Gy/BRT 15 Gy, II – EBRT 46 Gy/BRT 2 × 10 Gy, III group – BRT 3 × 15 Gy). Group I, II and III consisted of 46 (73%), 14 (22.2%), 3 (4.8%) patients, respectively. The low-, intermediate- and high risk groups consisted of 23 (36.5%), 18 (28.5%) and 22 (35%) men, respectively. Results and tolerance of the treatment and acute complications in analyzed groups were discussed. Results Median observation time was 24 months. Complete remission was observed in 43 patients (68.3%) out of the whole group. Locoregional and distal metastases progression were noted in 4 patients (6.4%). Partial remission was observed in low-, intermediate- and high risk group: 7.9%, 9.5% and 9.5% of all men. Nadir of PSA results were estimated as mean value of 0.094 ng/ml, average 0.0-0.63. The mean value for the complete group decreased from 0.98 ng/ml (range 0.0-9.7) in the third months to 0.32 ng/ml after one year (0.0-3.34) of the end of treatment time. Urologic and gastrointenstinal side effects were noted in different rates according to 1 month observation (dysuria – 22.2%, urinary incontinence – 7.9%, frequency – 58.7%, weak stream – 68.3%, rectal bleeding – 15.9%). Conclusions 1. HDR brachytherapy of prostate cancer can be used as a boost after or before the external beam radiation therapy in different treatment schemes. 2. In selected groups under investigation trials, sole HDR-BRT is a suitable method of treatment. 3. To confirm superiority of analyzed modality treatment a prospective investigation with larger groups of patients would be required. PMID:27807455

  19. Fast, automatic, and accurate catheter reconstruction in HDR brachytherapy using an electromagnetic 3D tracking system

    SciTech Connect

    Poulin, Eric; Racine, Emmanuel; Beaulieu, Luc; Binnekamp, Dirk

    2015-03-15

    Purpose: In high dose rate brachytherapy (HDR-B), current catheter reconstruction protocols are relatively slow and error prone. The purpose of this technical note is to evaluate the accuracy and the robustness of an electromagnetic (EM) tracking system for automated and real-time catheter reconstruction. Methods: For this preclinical study, a total of ten catheters were inserted in gelatin phantoms with different trajectories. Catheters were reconstructed using a 18G biopsy needle, used as an EM stylet and equipped with a miniaturized sensor, and the second generation Aurora{sup ®} Planar Field Generator from Northern Digital Inc. The Aurora EM system provides position and orientation value with precisions of 0.7 mm and 0.2°, respectively. Phantoms were also scanned using a μCT (GE Healthcare) and Philips Big Bore clinical computed tomography (CT) system with a spatial resolution of 89 μm and 2 mm, respectively. Reconstructions using the EM stylet were compared to μCT and CT. To assess the robustness of the EM reconstruction, five catheters were reconstructed twice and compared. Results: Reconstruction time for one catheter was 10 s, leading to a total reconstruction time inferior to 3 min for a typical 17-catheter implant. When compared to the μCT, the mean EM tip identification error was 0.69 ± 0.29 mm while the CT error was 1.08 ± 0.67 mm. The mean 3D distance error was found to be 0.66 ± 0.33 mm and 1.08 ± 0.72 mm for the EM and CT, respectively. EM 3D catheter trajectories were found to be more accurate. A maximum difference of less than 0.6 mm was found between successive EM reconstructions. Conclusions: The EM reconstruction was found to be more accurate and precise than the conventional methods used for catheter reconstruction in HDR-B. This approach can be applied to any type of catheters and applicators.

  20. Catheter-based ultrasound hyperthermia with HDR brachytherapy for treatment of locally advanced cancer of the prostate and cervix

    NASA Astrophysics Data System (ADS)

    Diederich, Chris J.; Wootton, Jeff; Prakash, Punit; Salgaonkar, Vasant; Juang, Titania; Scott, Serena; Chen, Xin; Cunha, Adam; Pouliot, Jean; Hsu, I. C.

    2011-03-01

    A clinical treatment delivery platform has been developed and is being evaluated in a clinical pilot study for providing 3D controlled hyperthermia with catheter-based ultrasound applicators in conjunction with high dose rate (HDR) brachytherapy. Catheter-based ultrasound applicators are capable of 3D spatial control of heating in both angle and length of the devices, with enhanced radial penetration of heating compared to other hyperthermia technologies. Interstitial and endocavity ultrasound devices have been developed specifically for applying hyperthermia within HDR brachytherapy implants during radiation therapy in the treatment of cervix and prostate. A pilot study of the combination of catheter based ultrasound with HDR brachytherapy for locally advanced prostate and cervical cancer has been initiated, and preliminary results of the performance and heating distributions are reported herein. The treatment delivery platform consists of a 32 channel RF amplifier and a 48 channel thermocouple monitoring system. Controlling software can monitor and regulate frequency and power to each transducer section as required during the procedure. Interstitial applicators consist of multiple transducer sections of 2-4 cm length × 180 deg and 3-4 cm × 360 deg. heating patterns to be inserted in specific placed 13g implant catheters. The endocavity device, designed to be inserted within a 6 mm OD plastic tandem catheter within the cervix, consists of 2-3 transducers × dual 180 or 360 deg sectors. 3D temperature based treatment planning and optimization is dovetailed to the HDR optimization based planning to best configure and position the applicators within the catheters, and to determine optimal base power levels to each transducer section. To date we have treated eight cervix implants and six prostate implants. 100 % of treatments achieved a goal of >60 min duration, with therapeutic temperatures achieved in all cases. Thermal dosimetry within the hyperthermia target

  1. Virtual HDR CyberKnife SBRT for Localized Prostatic Carcinoma: 5-Year Disease-Free Survival and Toxicity Observations

    PubMed Central

    Fuller, Donald Blake; Naitoh, John; Mardirossian, George

    2014-01-01

    Purpose: Prostate stereotactic body radiotherapy (SBRT) may substantially recapitulate the dose distribution of high-dose-rate (HDR) brachytherapy, representing an externally delivered “Virtual HDR” treatment method. Herein, we present 5-year outcomes from a cohort of consecutively treated virtual HDR SBRT prostate cancer patients. Methods: Seventy-nine patients were treated from 2006 to 2009, 40 low-risk, and 39 intermediate-risk, under IRB-approved clinical trial, to 38 Gy in four fractions. The planning target volume (PTV) included prostate plus a 2-mm volume expansion in all directions, with selective use of a 5-mm prostate-to-PTV expansion and proximal seminal vesicle coverage in intermediate-risk patients, to better cover potential extraprostatic disease; rectal PTV margin reduced to zero in all cases. The prescription dose covered >95% of the PTV (V100 ≥95%), with a minimum 150% PTV dose escalation to create “HDR-like” PTV dose distribution. Results: Median pre-SBRT PSA level of 5.6 ng/mL decreased to 0.05 ng/mL 5 years out and 0.02 ng/mL 6 years out. At least one PSA bounce was seen in 55 patients (70%) but only 3 of them subsequently relapsed, biochemical-relapse-free survival was 100 and 92% for low-risk and intermediate-risk patients, respectively, by ASTRO definition (98 and 92% by Phoenix definition). Local relapse did not occur, distant metastasis-free survival was 100 and 95% by risk-group, and disease-specific survival was 100%. Acute and late grade 2 GU toxicity incidence was 10 and 9%, respectively; with 6% late grade 3 GU toxicity. Acute urinary retention did not occur. Acute and late grade 2 GI toxicity was 0 and 1%, respectively, with no grade 3 or higher toxicity. Of patient’s potent pre-SBRT, 65% remained so at 5 years. Conclusion: Virtual HDR prostate SBRT creates a very low PSA nadir, a high rate of 5-year disease-free survival and an acceptable toxicity incidence, with results closely resembling those reported

  2. Catheter-based ultrasound hyperthermia with HDR brachytherapy for treatment of locally advanced cancer of the prostate and cervix

    PubMed Central

    Diederich, Chris J.; Wootton, Jeff; Prakash, Punit; Salgaonkar, Vasant; Juang, Titania; Scott, Serena; Chen, Xin; Cunha, Adam; Pouliot, Jean; Hsu, I.C.

    2014-01-01

    A clinical treatment delivery platform has been developed and is being evaluated in a clinical pilot study for providing 3D controlled hyperthermia with catheter-based ultrasound applicators in conjunction with high dose rate (HDR) brachytherapy. Catheter-based ultrasound applicators are capable of 3D spatial control of heating in both angle and length of the devices, with enhanced radial penetration of heating compared to other hyperthermia technologies. Interstitial and endocavity ultrasound devices have been developed specifically for applying hyperthermia within HDR brachytherapy implants during radiation therapy in the treatment of cervix and prostate. A pilot study of the combination of catheter based ultrasound with HDR brachytherapy for locally advanced prostate and cervical cancer has been initiated, and preliminary results of the performance and heating distributions are reported herein. The treatment delivery platform consists of a 32 channel RF amplifier and a 48 channel thermocouple monitoring system. Controlling software can monitor and regulate frequency and power to each transducer section as required during the procedure. Interstitial applicators consist of multiple transducer sections of 2–4 cm length × 180 deg and 3–4 cm × 360 deg. heating patterns to be inserted in specific placed 13g implant catheters. The endocavity device, designed to be inserted within a 6 mm OD plastic tandem catheter within the cervix, consists of 2–3 transducers × dual 180 or 360 deg sectors. 3D temperature based treatment planning and optimization is dovetailed to the HDR optimization based planning to best configure and position the applicators within the catheters, and to determine optimal base power levels to each transducer section. To date we have treated eight cervix implants and six prostate implants. 100 % of treatments achieved a goal of >60 min duration, with therapeutic temperatures achieved in all cases. Thermal dosimetry within the hyperthermia

  3. A dosimetric analysis of intensity-modulated radiation therapy (IMRT) as an alternative to adjuvant high-dose-rate (HDR) brachytherapy in early endometrial cancer patients

    SciTech Connect

    Aydogan, Bulent . E-mail: baydogan@radonc.uchicago.edu; Mundt, Arno J.; Smith, Brett D.; Mell, Loren K.; Wang, Steve; Sutton, Harold; Roeske, John C.

    2006-05-01

    Purpose: To evaluate the role of intensity-modulated radiation treatment (IMRT) as an alternative to high-dose-rate (HDR) brachytherapy in the treatment of the vagina in postoperative early endometrial cancer patients after surgery. Methods and Materials: Planning computed tomography (CT) scans of 10 patients previously treated with HDR were used in this study. In all cases, a dose of 700 cGy/fraction was prescribed at a distance of 0.5 cm from the cylinder surface. The same CT scans were then used in IMRT planning. In this paradigm, the vaginal cylinder represents a component of a hypothetical immobilization system that would be indexed to the linac treatment table. Results: Our study showed that IMRT provided relatively lower rectal doses than HDR when treatment was prescribed at a distance of 0.5 cm away from the cylinder surface. Maximum rectal doses were lower with IMRT compared with HDR (average: 89.0% vs. 142.6%, respectively, p < 0.05). Moreover, the mean rectal dose was lower in IMRT plans compared with HDR plans with treatment prescribed either to the surface (average: 14.8% vs. 21.4%, respectively, p < 0.05) or to 0.5 cm (average: 19.6% vs. 33.5%, respectively, p < 0.05). IMRT plans had planning target volume (PTV) coverage comparable with HDR (average PTV minimum for treatment prescribed to 0.5 cm: 93.9% vs. 92.1%, p = 0.71, respectively) with less inhomogeneity (average PTV maximum: 110.8% vs. 381.6%, p < 0.05). Conclusion: Our dosimetric analysis suggests that when used in conjunction with a suitable immobilization system, IMRT may provide an alternative to HDR brachytherapy in women with early endometrial cancer after hysterectomy. However, more studies are needed to evaluate the clinical merit of the IMRT in these patients.

  4. TU-AB-201-05: Automatic Adaptive Per-Operative Re-Planning for HDR Prostate Brachytherapy - a Simulation Study On Errors in Needle Positioning

    SciTech Connect

    Borot de Battisti, M; Maenhout, M; Lagendijk, J J W; Van Vulpen, M; Moerland, M A; Senneville, B Denis de

    2015-06-15

    Purpose: To develop adaptive planning with feedback for MRI-guided focal HDR prostate brachytherapy with a single divergent needle robotic implant device. After each needle insertion, the dwell positions for that needle are calculated and the positioning of remaining needles and dosimetry are both updated based on MR imaging. Methods: Errors in needle positioning may occur due to inaccurate needle insertion (caused by e.g. the needle’s bending) and unpredictable changes in patient anatomy. Consequently, the dose plan quality might dramatically decrease compared to the preplan. In this study, a procedure was developed to re-optimize, after each needle insertion, the remaining needle angulations, source positions and dwell times in order to obtain an optimal coverage (D95% PTV>19 Gy) without exceeding the constraints of the organs at risk (OAR) (D10% urethra<21 Gy, D1cc bladder<12 Gy and D1cc rectum<12 Gy). Complete HDR procedures with 6 needle insertions were simulated for a patient MR-image set with PTV, prostate, urethra, bladder and rectum delineated. Random angulation errors, modeled by a Gaussian distribution (standard deviation of 3 mm at the needle’s tip), were generated for each needle insertion. We compared the final dose parameters for the situations (I) without re-optimization and (II) with the automatic feedback. Results: The computation time of replanning was below 100 seconds on a current desk computer. For the patient tested, a clinically acceptable dose plan was achieved while applying the automatic feedback (median(range) in Gy, D95% PTV: 19.9(19.3–20.3), D10% urethra: 13.4(11.9–18.0), D1cc rectum: 11.0(10.7–11.6), D1cc bladder: 4.9(3.6–6.8)). This was not the case without re-optimization (median(range) in Gy, D95% PTV: 19.4(14.9–21.3), D10% urethra: 12.6(11.0–15.7), D1cc rectum: 10.9(8.9–14.1), D1cc bladder: 4.8(4.4–5.2)). Conclusion: An automatic guidance strategy for HDR prostate brachytherapy was developed to compensate

  5. Air-kerma evaluation at the maze entrance of HDR brachytherapy facilities.

    PubMed

    Pujades, M C; Granero, D; Vijande, J; Ballester, F; Perez-Calatayud, J; Papagiannis, P; Siebert, F A

    2014-12-01

    In the absence of procedures for evaluating the design of brachytherapy (BT) facilities for radiation protection purposes, the methodology used for external beam radiotherapy facilities is often adapted. The purpose of this study is to adapt the NCRP 151 methodology for estimating the air-kerma rate at the door in BT facilities. Such methodology was checked against Monte Carlo (MC) techniques using the code Geant4. Five different facility designs were studied for (192)Ir and (60)Co HDR applications to account for several different bunker layouts.For the estimation of the lead thickness needed at the door, the use of transmission data for the real spectra at the door instead of the ones emitted by (192)Ir and (60)Co will reduce the lead thickness by a factor of five for (192)Ir and ten for (60)Co. This will significantly lighten the door and hence simplify construction and operating requirements for all bunkers.The adaptation proposed in this study to estimate the air-kerma rate at the door depends on the complexity of the maze: it provides good results for bunkers with a maze (i.e. similar to those used for linacs for which the NCRP 151 methodology was developed) but fails for less conventional designs. For those facilities, a specific Monte Carlo study is in order for reasons of safety and cost-effectiveness.

  6. The Application of Elliptic Cylindrical Phantom in Brachytherapy Dosimetric Study of HDR 192Ir Source

    NASA Astrophysics Data System (ADS)

    Ahn, Woo Sang; Park, Sung Ho; Jung, Sang Hoon; Choi, Wonsik; Do Ahn, Seung; Shin, Seong Soo

    2014-06-01

    The purpose of this study is to determine the radial dose function of HDR 192Ir source based on Monte Carlo simulation using elliptic cylindrical phantom, similar to realistic shape of pelvis, in brachytherapy dosimetric study. The elliptic phantom size and shape was determined by analysis of dimensions of pelvis on CT images of 20 patients treated with brachytherapy for cervical cancer. The radial dose function obtained using the elliptic cylindrical water phantom was compared with radial dose functions for different spherical phantom sizes, including the Williamsion's data loaded into conventional planning system. The differences in the radial dose function for the different spherical water phantoms increase with radial distance, r, and the largest differences in the radial dose function appear for the smallest phantom size. The radial dose function of the elliptic cylindrical phantom significantly decreased with radial distance in the vertical direction due to different scatter condition in comparison with the Williamson's data. Considering doses to ICRU rectum and bladder points, doses to reference points can be underestimated up to 1-2% at the distance from 3 to 6 cm. The radial dose function in this study could be used as realistic data for calculating the brachytherapy dosimetry for cervical cancer.

  7. Speedup of optimization-based approach to local backlight dimming of HDR displays

    NASA Astrophysics Data System (ADS)

    Burini, Nino; Nadernejad, Ehsan; Korhonen, Jari; Forchhammer, Soren; Wu, Xiaolin

    2012-06-01

    Local backlight dimming in Liquid Crystal Displays (LCD) is a technique for reducing power consumption and simultaneously increasing contrast ratio to provide a High Dynamic Range (HDR) image reproduction. Several backlight dimming algorithms exist with focus on reducing power consumption, while other algorithms aim at enhancing contrast, with power savings as a side effect. In our earlier work, we have modeled backlight dimming as a linear programming problem, where the target is to minimize the cost function measuring the distance between ideal and actual output. In this paper, we propose a version of the abovementioned algorithm, speeding up execution by decreasing the number of input variables. This is done by using a subset of the input pixels, selected among the ones experiencing leakage or clipping distortions. The optimization problem is then solved on this subset. Sample reduction can also be beneficial in conjunction with other approaches, such as an algorithm based on gradient descent, also presented here. All the proposals have been compared against other known approaches on simulated edge- and direct-lit displays, and the results show that the optimal distortion level can be reached using a subset of pixels, with significantly reduced computational load compared to the optimal algorithm with the full image.

  8. Optimization of HDR brachytherapy dose distributions using linear programming with penalty costs

    SciTech Connect

    Alterovitz, Ron; Lessard, Etienne; Pouliot, Jean; Hsu, I-Chow Joe; O'Brien, James F.; Goldberg, Ken

    2006-11-15

    Prostate cancer is increasingly treated with high-dose-rate (HDR) brachytherapy, a type of radiotherapy in which a radioactive source is guided through catheters temporarily implanted in the prostate. Clinicians must set dwell times for the source inside the catheters so the resulting dose distribution minimizes deviation from dose prescriptions that conform to patient-specific anatomy. The primary contribution of this paper is to take the well-established dwell times optimization problem defined by Inverse Planning by Simulated Annealing (IPSA) developed at UCSF and exactly formulate it as a linear programming (LP) problem. Because LP problems can be solved exactly and deterministically, this formulation provides strong performance guarantees: one can rapidly find the dwell times solution that globally minimizes IPSA's objective function for any patient case and clinical criteria parameters. For a sample of 20 prostates with volume ranging from 23 to 103 cc, the new LP method optimized dwell times in less than 15 s per case on a standard PC. The dwell times solutions currently being obtained clinically using simulated annealing (SA), a probabilistic method, were quantitatively compared to the mathematically optimal solutions obtained using the LP method. The LP method resulted in significantly improved objective function values compared to SA (P=1.54x10{sup -7}), but none of the dosimetric indices indicated a statistically significant difference (P<0.01). The results indicate that solutions generated by the current version of IPSA are clinically equivalent to the mathematically optimal solutions.

  9. A novel optical calorimetry dosimetry approach applied to an HDR Brachytherapy source

    NASA Astrophysics Data System (ADS)

    Cavan, A.; Meyer, J.

    2013-06-01

    The technique of Digital Holographic Interferometry (DHI) is applied to the measurement of radiation absorbed dose distribution in water. An optical interferometer has been developed that captures the small variations in the refractive index of water due to the radiation induced temperature increase ΔT. The absorbed dose D is then determined with high temporal and spatial resolution using the calorimetric relation D=cΔT (where c is the specific heat capacity of water). The method is capable of time resolving 3D spatial calorimetry. As a proof-of-principle of the approach, a prototype DHI dosimeter was applied to the measurement of absorbed dose from a High Dose Rate (HDR) Brachytherapy source. Initial results are in agreement with modelled doses from the Brachyvision treatment planning system, demonstrating the viability of the system for high dose rate applications. Future work will focus on applying corrections for heat diffusion and geometric effects. The method has potential to contribute to the dosimetry of diverse high dose rate applications which require high spatial resolution such as microbeam radiotherapy (MRT) or small field proton beam dosimetry but may potentially also be useful for interface dosimetry.

  10. Observing and characterizing avalanche activity in the Khumbu Himal, Nepal, using Pleiades and airborne HDR imagery

    NASA Astrophysics Data System (ADS)

    Thompson, Sarah; Nicholson, Lindsey; Klug, Christoph; Rieg, Lorenzo; Sailer, Rudolf; Bucher, Tilman; Brauchle, Jörg

    2017-04-01

    In the high, steep terrain of the Khumbu Himal, Nepal, snow avalanches play an important role in glacier mass balance, and rockfall supplies much of the rock material that forms the extensive debris covers on glaciers in the region. Information on the frequency and size of gravitational mass movements is helpful for understanding current and future glacier behaviour but currently lacking. In this study we use a combination of high resolution Pleiades optical satellite imagery in conjunction with airborne HDR imagery of slopes in deep shadow or overexposed snow slopes, provided by the German Aerospace Center (DLR) MACS system (see Brauchle et al., MM3.2/GI2.12/GMPV6.4/HS11.13/NH8.9/SSS12.24), to undertake a qualitative observational study of the gravitational processes evident in these sets of imagery. We classify the features found and discuss their likely frequency in the context of previously published research findings. Terrain analysis based upon digital terrain models derived from the same Pleiades imagery is used to investigate the slope angle, degree of confinement, curvature and aspect of observed avalanche and rock fall tracks. This work presents a first overview of the types of gravitational slides affecting glaciers of the Khumbu Himal. Subsequent research efforts will focus on attempting to quantify volumes of mass movement using repeat satellite imagery.

  11. Ahsa1 and Hsp90 activity confers more severe craniofacial phenotypes in a zebrafish model of hypoparathyroidism, sensorineural deafness and renal dysplasia (HDR).

    PubMed

    Sheehan-Rooney, Kelly; Swartz, Mary E; Zhao, Feng; Liu, Dong; Eberhart, Johann K

    2013-09-01

    The severity of most human birth defects is highly variable. Our ability to diagnose, treat and prevent defects relies on our understanding of this variability. Mutation of the transcription factor GATA3 in humans causes the highly variable hypoparathyroidism, sensorineural deafness and renal dysplasia (HDR) syndrome. Although named for a triad of defects, individuals with HDR can also exhibit craniofacial defects. Through a forward genetic screen for craniofacial mutants, we isolated a zebrafish mutant in which the first cysteine of the second zinc finger of Gata3 is mutated. Because mutation of the homologous cysteine causes HDR in humans, these zebrafish mutants could be a quick and effective animal model for understanding the role of gata3 in the HDR disease spectrum. We demonstrate that, unexpectedly, the chaperone proteins Ahsa1 and Hsp90 promote severe craniofacial phenotypes in our zebrafish model of HDR syndrome. The strengths of the zebrafish system, including rapid development, genetic tractability and live imaging, make this an important model for variability.

  12. SU-E-T-560: Commissioning An HDR Freiburg Flap Applicator for Skin Lesion Treatment

    SciTech Connect

    Dou, K; Li, B; Lerma, F; Aroumougame, V; Sarfaraz, M; Laser, B; Jacobs, M

    2014-06-01

    Purpose: Flexible Freiburg flap used with high dose rate afterloaders is easy to cut into any size for any body site and to dwell with a precise source position, conforms to curved skin surface and then to the planned target. However, unlike intracavity or interstitial situations, incomplete scatter environment due to flap applicators exposed to air might lead to dose difference between the delivered and planned. This research is focused on the dose deviation of incomplete scatter versus full scatter. Methods: A 12x12 cm of Freiburg flap applicator was used for the validation. A Nucletron Oncentra Brachy Ver. 4.3 treatment planning system (TPS) was used for treatment planning. However, no heterogeneity correction incorporated into the brachytherap TPS needs to be considered. A Philips Brilliance CT Big Bore was employed for CT scan. Radiation was delivered using a Nucletron HDR remote afterloader system. A 10cm bolus was used to cover the flap for obtaining a full scatter. An OSL, ion chamber, and Gafchromic EBT2 film were used for commissioning the flap applicator. Results: The applicator calibration at 5mm depth was performed using an OSL dosimeter. Applicator source dwelling positions with 1D and 2D array exposed to and recorded by Gafchromic EBT2 film showed an agreement within 1mm. 1D array of Freiburg flap exhibited 4.2% cooler in dose with incomplete scatter than full scatter. 2D array showed 7.1% lower in dose for incomplete scatter than full scatter. The deviation was found more than 10% beyond 8cm in depth. Conclusion: Significant dose deviation caused by the incomplete scatter environment was found to be 7.1% at 1cm depth. This deviation was increased with increasing depth. The inaccuracy resulted from the incomplete scatter can be fixed by either placing a bolus on the top of the flap or making the plan at least 7% hotter.

  13. HDR {sup 192}Ir source speed measurements using a high speed video camera

    SciTech Connect

    Fonseca, Gabriel P.; Rubo, Rodrigo A.; Sales, Camila P. de; Verhaegen, Frank

    2015-01-15

    Purpose: The dose delivered with a HDR {sup 192}Ir afterloader can be separated into a dwell component, and a transit component resulting from the source movement. The transit component is directly dependent on the source speed profile and it is the goal of this study to measure accurate source speed profiles. Methods: A high speed video camera was used to record the movement of a {sup 192}Ir source (Nucletron, an Elekta company, Stockholm, Sweden) for interdwell distances of 0.25–5 cm with dwell times of 0.1, 1, and 2 s. Transit dose distributions were calculated using a Monte Carlo code simulating the source movement. Results: The source stops at each dwell position oscillating around the desired position for a duration up to (0.026 ± 0.005) s. The source speed profile shows variations between 0 and 81 cm/s with average speed of ∼33 cm/s for most of the interdwell distances. The source stops for up to (0.005 ± 0.001) s at nonprogrammed positions in between two programmed dwell positions. The dwell time correction applied by the manufacturer compensates the transit dose between the dwell positions leading to a maximum overdose of 41 mGy for the considered cases and assuming an air-kerma strength of 48 000 U. The transit dose component is not uniformly distributed leading to over and underdoses, which is within 1.4% for commonly prescribed doses (3–10 Gy). Conclusions: The source maintains its speed even for the short interdwell distances. Dose variations due to the transit dose component are much lower than the prescribed treatment doses for brachytherapy, although transit dose component should be evaluated individually for clinical cases.

  14. Non-melanoma skin cancer treated with HDR Valencia applicator: clinical outcomes.

    PubMed

    Tormo, Alejandro; Celada, Francisco; Rodriguez, Silvia; Botella, Rafael; Ballesta, Antonio; Kasper, Michael; Ouhib, Zoubir; Santos, Manuel; Perez-Calatayud, Jose

    2014-06-01

    Radiotherapy (RT) has played a significant role in treating non melanoma skin cancer (NMSC). High-dose-rate brachytherapy (HDR-BT) approaches have a paramount relevance due to their adaptability, patient protection, and variable dose fractionation schedules. Several innovative applicators have been introduced to the brachytherapy community. The Valencia applicator is a new superficial device that improves the dose distribution compared with the Leipzig applicator. The purpose of this work is to assess the tumor control, cosmesis, and toxicity in patients with NMSC treated with the Valencia applicator and a new regimen of hypofractionation. From January 2008 to March 2010, 32 patients with 45 NMSC lesions were treated with the Valencia applicator in the Hospital La Fe. The gross tumor volume was visually assessed, but the tumor depth was evaluated using ultrasound imaging. All lesions for the selected cases were limited to 4 mm depth. The prescription dose was 42 Gy in 6 or 7 fractions (biologically effective dose [BED] ≈ 70 Gy), delivered twice a week. Ninety-eight percent of the lesions were locally controlled at 47 months from treatment. Ninety-three percent of patients were out at least 36 months from treatment. The treatment was well tolerated in all cases. The highest skin toxicity was grade 1 RTOG/EORTC, having resolved with topical treatment at 4 weeks in all but one case which required 2 months. There were no grade 2 or higher late adverse events. In patients with superficial basal cell carcinoma lesions less than 25 mm in maximum diameter, HDRBT treatment with the Valencia applicator using a hypofractionated regimen provides excellent results, for both cosmetic and local control at a minimum of 3 years follow-up. Moreover, the shorter hypofractionated regimen facilitates compliance, which is very relevant for the elderly patients in our series. Valencia applicators offer a simple, safe, quick, and attractive nonsurgical treatment option.

  15. Non-melanoma skin cancer treated with HDR Valencia applicator: clinical outcomes

    PubMed Central

    Tormo, Alejandro; Celada, Francisco; Rodriguez, Silvia; Botella, Rafael; Ballesta, Antonio; Kasper, Michael; Ouhib, Zoubir; Santos, Manuel

    2014-01-01

    Purpose Radiotherapy (RT) has played a significant role in treating non melanoma skin cancer (NMSC). High-dose-rate brachytherapy (HDR-BT) approaches have a paramount relevance due to their adaptability, patient protection, and variable dose fractionation schedules. Several innovative applicators have been introduced to the brachytherapy community. The Valencia applicator is a new superficial device that improves the dose distribution compared with the Leipzig applicator. The purpose of this work is to assess the tumor control, cosmesis, and toxicity in patients with NMSC treated with the Valencia applicator and a new regimen of hypofractionation. Material and methods From January 2008 to March 2010, 32 patients with 45 NMSC lesions were treated with the Valencia applicator in the Hospital La Fe. The gross tumor volume was visually assessed, but the tumor depth was evaluated using ultrasound imaging. All lesions for the selected cases were limited to 4 mm depth. The prescription dose was 42 Gy in 6 or 7 fractions (biologically effective dose [BED] ≈ 70 Gy), delivered twice a week. Results Ninety-eight percent of the lesions were locally controlled at 47 months from treatment. Ninety-three percent of patients were out at least 36 months from treatment. The treatment was well tolerated in all cases. The highest skin toxicity was grade 1 RTOG/EORTC, having resolved with topical treatment at 4 weeks in all but one case which required 2 months. There were no grade 2 or higher late adverse events. Conclusions In patients with superficial basal cell carcinoma lesions less than 25 mm in maximum diameter, HDRBT treatment with the Valencia applicator using a hypofractionated regimen provides excellent results, for both cosmetic and local control at a minimum of 3 years follow-up. Moreover, the shorter hypofractionated regimen facilitates compliance, which is very relevant for the elderly patients in our series. Valencia applicators offer a simple, safe, quick, and

  16. Estimation of distance error by fuzzy set theory required for strength determination of HDR (192)Ir brachytherapy sources.

    PubMed

    Kumar, Sudhir; Datta, D; Sharma, S D; Chourasiya, G; Babu, D A R; Sharma, D N

    2014-04-01

    Verification of the strength of high dose rate (HDR) (192)Ir brachytherapy sources on receipt from the vendor is an important component of institutional quality assurance program. Either reference air-kerma rate (RAKR) or air-kerma strength (AKS) is the recommended quantity to specify the strength of gamma-emitting brachytherapy sources. The use of Farmer-type cylindrical ionization chamber of sensitive volume 0.6 cm(3) is one of the recommended methods for measuring RAKR of HDR (192)Ir brachytherapy sources. While using the cylindrical chamber method, it is required to determine the positioning error of the ionization chamber with respect to the source which is called the distance error. An attempt has been made to apply the fuzzy set theory to estimate the subjective uncertainty associated with the distance error. A simplified approach of applying this fuzzy set theory has been proposed in the quantification of uncertainty associated with the distance error. In order to express the uncertainty in the framework of fuzzy sets, the uncertainty index was estimated and was found to be within 2.5%, which further indicates that the possibility of error in measuring such distance may be of this order. It is observed that the relative distance li estimated by analytical method and fuzzy set theoretic approach are consistent with each other. The crisp values of li estimated using analytical method lie within the bounds computed using fuzzy set theory. This indicates that li values estimated using analytical methods are within 2.5% uncertainty. This value of uncertainty in distance measurement should be incorporated in the uncertainty budget, while estimating the expanded uncertainty in HDR (192)Ir source strength measurement.

  17. MO-FG-210-02: Implementation of Image-Guided Prostate HDR Brachytherapy Using MR-Ultrasound Fusion

    SciTech Connect

    Libby, B.

    2015-06-15

    Ultrasound (US) is one of the most widely used imaging modalities in medical practice. Since US imaging offers real-time imaging capability, it has becomes an excellent option to provide image guidance for brachytherapy (IGBT). (1) The physics and the fundamental principles of US imaging are presented, and the typical steps required to commission an US system for IGBT is provided for illustration. (2) Application of US for prostate HDR brachytherapy, including partial prostate treatments using MR-ultrasound co-registration to enable a focused treatment on the disease within the prostate is also presented. Prostate HDR with US image guidance planning can benefit from real time visualization of the needles, and fusion of the ultrasound images with T2 weighted MR allows the focusing of the treatment to the specific areas of disease within the prostate, so that the entire gland need not be treated. Finally, (3) ultrasound guidance for an eye plaque program is presented. US can be a key component of placement and QA for episcleral plaque brachytherapy for ocular cancer, and the UCLA eye plaque program with US for image guidance is presented to demonstrate the utility of US verification of plaque placement in improving the methods and QA in episcleral plaque brachytherapy. Learning Objectives: To understand the physics of an US system and the necessary aspects of commissioning US for image guided brachytherapy (IGBT). To understand real time planning of prostate HDR using ultrasound, and its application in partial prostate treatments using MR-ultrasound fusion to focus treatment on disease within the prostate. To understand the methods and QA in applying US for localizing the target and the implant during a episcleral plaque brachytherapy procedures.

  18. An Eight-Year Experience of HDR Brachytherapy Boost for Localized Prostate Cancer: Biopsy and PSA Outcome

    SciTech Connect

    Bachand, Francois; Martin, Andre-Guy; Beaulieu, Luc; Harel, Francois M.Sc.; Vigneault, Eric

    2009-03-01

    Purpose: To evaluate the biochemical recurrence-free survival (bRFS), the 2-year biopsy outcome and the prostate-specific antigen (PSA) bounce in patients with localized prostate cancer treated with an inversely planned high-dose-rate (HDR) brachytherapy boost. Materials and methods: Data were collected from 153 patients treated between 1999 and 2006 with external beam pelvic radiation followed by an HDR Ir-192 prostate boost. These patients were given a boost of 18 to 20 Gy using inverse-planning with simulated annealing (IPSA).We reviewed and analyzed all prostate-specific antigen levels and control biopsies. Results: The median follow-up was 44 months (18-95 months). When categorized by risk of progression, 74.5% of patients presented an intermediate risk and 14.4% a high one. Prostate biopsies at 2 years posttreatment were negative in 86 of 94 patients (91.5%), whereas two biopsies were inconclusive. Biochemical control at 60 months was at 96% according to the American Society for Therapeutic Radiology and Oncology and the Phoenix consensus definitions. A PSA bounce (PSA values of 2 ng/mL or more above nadir) was observed in 15 patients of 123 (9.8%). The median time to bounce was 15.2 months (interquartile range, 11.0-17.7) and the median bounce duration 18.7 months (interquartile range, 12.1-29). The estimate of overall survival at 60 months was 97.1% (95% CI, 91.6-103%). Conclusions: Considering that inverse planned HDR brachytherapy prostate boosts led to an excellent biochemical response, with a 2-year negative biopsy rate, we recommend a conservative approach in face of a PSA bounce even though it was observed in 10% of patients.

  19. SU-C-16A-05: OAR Dose Tolerance Recommendations for Prostate and Cervical HDR Brachytherapy: Dose Versus Volume Metrics

    SciTech Connect

    Geneser, S; Cunha, J; Pouliot, J; Hsu, I

    2014-06-15

    Purpose: HDR brachytherapy consensus dose tolerance recommendations for organs at risk (OARs) remain widely debated. Prospective trials reporting metrics must be sufficiently data-dense to assess adverse affects and identify optimally predictive tolerances. We explore the tradeoffs between reporting dose-metrics versus volume-metrics and the potential impact on trial outcome analysis and tolerance recommendations. Methods: We analyzed 26 prostate patients receiving 15 Gy HDR single-fraction brachytherapy boost to 45 Gy external beam radiation therapy and 28 cervical patients receiving 28 Gy HDR brachytherapy monotherapy in 4 fractions using 2 implants. For each OAR structure, a robust linear regression fit was performed for the dose-metrics as a function of the volume-metrics. The plan quality information provided by recommended dose-metric and volume-metric values were compared. Results: For prostate rectal dose, D2cc and V75 lie close to the regression line, indicating they are similarly informative. Two outliers for prostate urethral dose are substantially different from the remaining cohort in terms of D0.1cc and V75, but not D1cc, suggesting the choice of reporting dose metric is essential. For prostate bladder and cervical bladder, rectum, and bowel, dose outliers are more apparent via V75 than recommended dose-metrics. This suggests that for prostate bladder dose and all cervical OAR doses, the recommended volume-metrics may be better predictors of clinical outcome than dose-metrics. Conclusion: For plan acceptance criteria, dose and volume-metrics are reciprocally equivalent. However, reporting dosemetrics or volume-metrics alone provides substantially different information. Our results suggest that volume-metrics may be more sensitive to differences in planned dose, and if one metric must be chosen, volumemetrics are preferable. However, reporting discrete DVH points severely limits the ability to identify planning tolerances most predictive of adverse

  20. SU-E-T-517: Analytic Formalism to Compute in Real Time Dose Distributions Delivered by HDR Units

    SciTech Connect

    Pokhrel, S; Loyalka, S; Palaniswaamy, G; Rangaraj, D; Izaguirre, E

    2014-06-01

    Purpose: Develop an analytical algorithm to compute the dose delivered by Ir-192 dwell positions with high accuracy using the 3-dimensional (3D) dose distribution of an HDR source. Using our analytical function, the dose delivered by an HDR unit as treatment progresses can be determined using the actual delivered temporal and positional data of each individual dwell. Consequently, true delivered dose can be computed when each catheter becomes active. We hypothesize that the knowledge of such analytical formulation will allow developing HDR systems with a real time treatment evaluation tool to avoid mistreatments. Methods: In our analytic formulation, the dose is computed by using the full anisotropic function data of the TG 43 formalism with 3D ellipsoidal function. The discrepancy between the planned dose and the delivered dose is computed using an analytic perturbation method over the initial dose distribution. This methodology speeds up the computation because only changes in dose discrepancies originated by spatial and temporal deviations are computed. A dose difference map at the point of interest is obtained from these functions and this difference can be shown during treatment in real time to examine the treatment accuracy. Results: We determine the analytical solution and a perturbation function for the 3 translational 3 rotational, and 1D temporal errors in source distributions. The analytic formulation is a sequence of simple equations that can be processed in any modern computer in few seconds. Because computations are based in an analytical solution, small deviations of the dose when sub-millimeter positional changes occur can be detected. Conclusions: We formulated an analytical method to compute 4D dose distributions and dose differences based on an analytical solution and perturbations to the original dose. This method is highly accurate and can be.

  1. SU-E-T-783: Using Matrixx to Determine Transit Dose Contribution Over Clinically Useful Limits of HDR Source Activity

    SciTech Connect

    Bhagwat, M; O’Farrell, D; Wagar, M; Buzurovic, I; Friesen, S; Damato, A; Devlin, P; Cormack, R

    2015-06-15

    Purpose: Most HDR brachytherapy treatment planning systems (TPS) use TG-43 formalism to calculate dose without including transit dose corrections. Historically, measurement of this contribution has required sophisticated apparatus unavailable in most hospitals. We use Matrixx to investigate several scenarios where transit dose contribution may effect a clinical treatment. Methods: Treatment plans were generated using Oncentra Brachy TPS (Version 4.3.0.410, Nucletron ) on a CT scan of a 24-catheter Freiburg applicator (Nucletron ) laid flat on the MatriXX (IBA) detector. This detector is an array of 1020 parallel plate ion chambers. All 24 catheters were digitized and dwells within a central square region of 5×5cm of the applicator were activated. Each of the active catheters had 6 dwells in increments of 1.0cm. The plans were normalized to 10mm. This places the 100% isodose line at the correct effective point of measurement, which lies half-way between the parallel plates of the ion chambers. It is also within the clinically relevant treatment depth for superficial applications. A total of 6 plans were delivered for 3 prescription doses, 1Gy, 2Gy and 4Gy using source activities of 2.9Ci and 11.2Ci. The MatriXX array was operated to capture dosimetric snaps every 500ms and yielded an integral dose at the end of treatment. Results: A comparison of integral dose from 2 different source activities shows that the transit dose contribution is larger when the source activity is higher. It is also observed that the relative transit dose contribution decreases as prescription dose increases. This is quantified by the Gamma analysis. Conclusion: We have demonstrated that the Matrixx detector can be used to evaluate the contribution for a HDR source during transit from the HDR afterloader to a dwell location, and between adjacent dwell locations.

  2. Long term results of HDR brachytherapy in men older than 75 with localized carcinoma of the prostate.

    PubMed

    Soumarová, Renata; Homola, Luboš; Perková, Hana

    2012-01-01

    Prostate cancer is an illness with a high incidence, especially among older men. The choice of a treatment option among men above 75 years is, however, not clear. Radical prostatectomy in this age group is connected with a relatively high morbidity. A further possibility of curative treatment is radiotherapy which can be administered in the form of external beam or in combination with high dose rate (HDR) brachytherapy. The aim of our work was to evaluate how HDR brachytherapy is tolerated among men older than 75 and how associated diseases can influence the tolerance to this treatment. Of interest to us were the treatment results and mortality from other diseases. We analyzed a sample of 20 men above 75 years old (median 77 years) who were undergoing treatment by a combination of external radiotherapy and brachytherapy. Sixteen (80%) of them had prostate cancer with an intermediate and high risk of recurrence, four had low risk prostate cancer. Most patients, 14 (70%), had less than two comorbidities. The median observation period was 57 months. No perioperative complications were recorded. Acute genitourinary toxicity (GU) to a maximum grade of 1-2 manifested in 60% of cases. Acute gastrointestinal toxicity (GIT) was observed only at grade 1 and in 25% of cases. Late GU toxicity occurred in 35% of patients, with only one showing grade 3; late GIT toxicity was recorded at grade 1 only in 3 patients (15%). 70% of the men lived longer than 3 years after treatment, at present, 50% lived more than 5 years. Long-term biochemical remission was achieved in 18 patients (90%). HDR BRT is possible and well-tolerated in older men above 75 years in good condition and without serious intercurrence. Well-selected older patients with higher-risk tumours and without serious comorbidities undoubtedly benefit from radical treatment when compared with watchful waiting.

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

    PubMed

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

    2016-10-29

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

  4. Determination of contributions of scatter and distance error to the source strength of 192Ir HDR brachytherapy source

    NASA Astrophysics Data System (ADS)

    Bondel, Shwetha; Ravikumar, Manickam

    2016-09-01

    High dose rate (HDR) brachytherapy commonly employs a 192Ir encapsulated source to deliver high dose to the malignant tissues. Calibrations of brachytherapy sources are performed by the manufacturer using a well-type chamber or by in-air measurement using a cylindrical ionization chamber. Calibration using the latter involves measurements to be carried out at several distances and room scatter can also be determined. The aim of the present study is to estimate the scatter contribution from the walls, floor and various materials in the room in order to determine the reference air kerma rate of an 192Ir HDR brachytherapy source by in-air measurements and also to evaluate the error in the setup distance between the source centre and chamber centre. Air kerma measurements were performed at multiple distances from 10 cm to 40 cm between the source and chamber. The room scatter correction factor was determined using the iterative technique. The distance error of -0.094 cm and -0.112 cm was observed for chamber with and without buildup cap respectively. The scatter component ranges from 0.3% to 5.4% for the chamber with buildup cap and 0.3% to 4.6% without buildup cap for distances between 10 to 40 cm respectively. Since the average of the results at multiple distances is considered to obtain the actual air kerma rate of the HDR source, the seven distance method and iterative technique are very effective in determining the scatter contribution and the error in the distance measurements.

  5. SU-E-T-380: Evaluation of BEBIG HDR 60Co System for AccuBoost Therapy

    SciTech Connect

    Zehtabian, M; Sina, S; Rivard, M; Meigooni, A Soleimani

    2015-06-15

    Purpose: In this project, the possibility of utilizing the BEBIG 60Co HDR system for AccuBoostTM treatment has been evaluated. Methods: Dose distributions in various breast sizes have been calculated for both Co-60 and Ir-192 sources using the MCNP5 code. These calculations were performed in breast tissues with thicknesses of 4cm, 6cm, and 8cm. The initial calculations were performed with the same applicator dimensions as the existing applicators used with the HDR Ir-192 system. The activity of the Co-60 source was selected such that the dose at the breast center was the same as the values from 192Ir. Then, the applicator thicknesses were increased to twice of those used with HDR Ir-192 system, for reducing skin and chest doses by Co-60 system. Dose to breast skin and chest wall were compared for both applicators types, with and without inclusion of a focusing cone at the applicator center. Results: The results showed that loading HDR Co-60 source inside the thin applicators impose higher doses to breast skin and chest wall compared to the 192Ir source. The area of the chest wall covered by 10Gy when treated by Co-60 with the thin and thick applicators, or treated by Ir-192 with thin applicator are 79cm2, 39cm2, and 3.8cm2, respectively. These values are reduced to 34cm2, 0cm2, and 0cm2 by using the focusing cone. It is worth noting that the breast skin areas covered by the 60Gy isodose line are 9.9cm2 and 7.8cm2 for Co-60 with the thin and thick applicators, respectively, while it is 20cm2 for Ir-192 when no focusing cone is present. These values are 0cm2, 0cm2, and 11cm2 in the presence of the focusing cone. Conclusion: The results indicate that using Co-60 with the thicker applicators is beneficial because of the higher half-life of Co-60, and the reduced maximum skin dose when compared with Ir-192.

  6. Results of combined photodynamic therapy (PDT) and high dose rate brachytherapy (HDR) in treatment of obstructive endobronchial non-small cell lung cancer

    NASA Astrophysics Data System (ADS)

    Weinberg, Benjamin D.; Allison, Ron R.; Sibata, Claudio; Parent, Teresa; Downie, Gordon

    2009-06-01

    We reviewed the outcome of combined photodynamic therapy (PDT) and high dose rate brachytherapy (HDR) for patients with symptomatic obstruction from endobronchial non-small cell lung cancer. Methods: Nine patients who received combined PDT and HDR for endobronchial cancers were identified and their charts reviewed. The patients were eight males and one female aged 52-73 at diagnosis, initially presenting with various stages of disease: stage IA (N=1), stage IIA (N=1), stage III (N=6), and stage IV (N=1). Intervention was with HDR (500 cGy to 5 mm once weekly for 3 weeks) and PDT (2 mg/kg Photofrin, followed by 200 J/cm2 illumination 48 hours post infusion). Treatment group 1 (TG-1, N=7) received HDR first; Treatment group 2 (TG-2, N=2) received PDT first. Patients were followed by regular bronchoscopies. Results: Treatments were well tolerated, all patients completed therapy, and none were lost to follow-up. In TG-1, local tumor control was achieved in six of seven patients for: 3 months (until death), 15 months, 2+ years (until death), 2+ years (ongoing), and 5+ years (ongoing, N=2). In TG-2, local control was achieved in only one patient, for 84 days. Morbidities included: stenosis and/or other reversible benign local tissue reactions (N=8); photosensitivity reaction (N=2), and self-limited pleural effusion (N=2). Conclusions: Combined HDR/PDT treatment for endobronchial tumors is well tolerated and can achieve prolonged local control with acceptable morbidity when PDT follows HDR and when the spacing between treatments is one month or less. This treatment regimen should be studied in a larger patient population.

  7. Dosimetric analysis of Co-60 source based high dose rate (HDR) brachytherapy: A case series of ten patients with carcinoma of the uterine cervix.

    PubMed

    Gurjar, Om Prakash; Batra, Manika; Bagdare, Priyusha; Kaushik, Sandeep; Tyagi, Atul; Naik, Ayush; Bhandari, Virendra; Gupta, Krishna Lal

    2016-01-01

    To analyse the dosimetric parameters of Co-60 based high dose rate (HDR) brachytherapy plans for patients of carcinoma uterine cervix. Co-60 high dose rate (HDR) brachytherapy unit has been introduced in past few years and is gaining importance owing to its long half life, economical benefits and comparable clinical outcome compared to Ir-192 HDR brachytherapy. A study was conducted on ten patients with locally advanced carcinoma of the uterine cervix (Ca Cx). Computed tomography (CT) images were taken after three channel applicator insertions. The planning for 7 Gray per fraction (7 Gy/#) was done for Co-60 HDR brachytherapy unit following the American Brachytherapy Society (ABS) guidelines. All the patients were treated with 3# with one week interval between fractions. The mean dose to high risk clinical target volumes (HRCTV) for D90 (dose to 90% volume) was found to be 102.05% (Standard Deviation (SD): 3.07). The mean D2cc (dose to 2 cubic centimeter volume) of the bladder, rectum and sigmoid were found to be 15.9 Gy (SD: 0.58), 11.5 Gy (SD: 0.91) and 4.1 Gy (SD: 1.52), respectively. The target coverage and doses to organs at risk (OARs) were achieved as per the ABS guidelines. Hence, it can be concluded that the Co-60 HDR brachytherapy unit is a good choice especially for the centers with a small number of brachytherapy procedures as no frequent source replacement is required like in an Ir-192 HDR unit.

  8. Comparison of PSA relapse-free survival in patients treated with ultra-high-dose IMRT versus combination HDR brachytherapy and IMRT.

    PubMed

    Deutsch, Israel; Zelefsky, Michael J; Zhang, Zhigang; Mo, Qianxing; Zaider, Marco; Cohen, Gil'ad; Cahlon, Oren; Yamada, Yoshiya

    2010-01-01

    We report on a retrospective comparison of biochemical outcomes using an ultra-high dose of conventionally fractionated intensity-modulated radiation therapy (IMRT) vs. a lower dose of IMRT combined with high-dose-rate (HDR) brachytherapy to increase the biologically effective dose of IMRT. Patients received IMRT of 86.4Gy (n=470) or HDR brachytherapy (21Gy in three fractions) followed by IMRT of 50.4Gy (n=160). Prostate-specific antigen (PSA) relapse was defined as PSA nadir+2. Median followup was 53 months for IMRT alone and 47 months for HDR. The 5-year actuarial PSA relapse-free survival (PRFS) for HDR plus IMRT vs. ultra-high-dose IMRT were 100% vs. 98%, 98% vs. 84%, and 93% vs. 71%, for National Comprehensive Cancer Network low- (p=0.71), intermediate- (p<0.001), and high-risk (p=0.23) groups, respectively. Treatment (p=0.0006), T stage (p<0.0001), Gleason score (p<0.0001), pretreatment PSA (p=0.0037), risk group (p<0.0001), and lack of androgen-deprivation therapy (p=0.0005) were significantly associated with improved PRFS on univariate analysis. HDR plus IMRT vs. ultra-high-dose IMRT (p=0.0012, hazard ratio [HR]=0.184); age (p=0.0222, HR=0.965); and risk group (p<0.0001, HR=2.683) were associated with improved PRFS on multivariate analysis. Dose escalation of IMRT by adding HDR brachytherapy provided improved PRFS in the treatment of prostate cancer compared with ultra-high-dose IMRT, independent of risk group on multivariate analysis, with the most significant benefit for intermediate-risk patients. Copyright © 2010 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

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

    SciTech Connect

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

    2015-12-15

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

  10. HDR brachytherapy decreases proliferation rate and cellular progression of a radioresistant human squamous cell carcinoma in vitro.

    PubMed

    Geraldo, Jony M; Scalzo, Sérgio; Reis, Daniela S; Leão, Thiago L; Guatimosim, Silvia; Ladeira, Luiz O; Andrade, Lídia M

    2017-09-01

    To investigate the effects of high dose rate (HDR) brachytherapy on cellular progression of a radioresistant human squamous cell carcinoma in vitro, based on clinical parameters. An acrylic platform was designed to attach tissue culture flasks and assure source positioning during irradiation. At exponential phase, A431cells, a human squamous cell carcinoma, were irradiated twice up to 1100 cGy. Cellular proliferation was assessed by Trypan blue exclusion assay and survival fraction was calculated by clonogenic assay. DNA content analysis and cell cycle phases were assessed by flow cytometry and gel electrophoresis, respectively. Cellular death patterns were measured by HOPI double-staining method. Significant decreasing cellular proliferation rate (p < 0.05) as well as reduced survival fraction (p < 0.001) in irradiated cells were observed. Moreover, increased percentage of cells arrested in the G2/M phase (32.3 ± 1.5%) in the irradiated group as compared with untreated cells (8.22 ± 1.2%) was detected. Also, a significant (p < 0.0001) nuclei shrinking in irradiated cells without evidence of necrosis or apoptosis was found. HDR brachytherapy led to a decreased proliferation rate and cell survival and also hampered cellular progression to mitosis suggesting that tumor cell death mainly occurred due to mitotic death and G2/M cell cycle arrest.

  11. Dosimetric impact of applicator displacement during high dose rate (HDR) Cobalt-60 brachytherapy for cervical cancer: A planning study

    NASA Astrophysics Data System (ADS)

    Yong, J. S.; Ung, N. M.; Jamalludin, Z.; Malik, R. A.; Wong, J. H. D.; Liew, Y. M.; Ng, K. H.

    2016-02-01

    We investigated the dosimetric impact of applicator displacement on dose specification during high dose rate (HDR) Cobalt-60 (Co-60) brachytherapy for cervical cancer through a planning study. Eighteen randomly selected HDR full insertion plans were restrospectively studied. The tandem and ovoids were virtually shifted translationally and rotationally in the x-, y- and z-axis directions on the treatment planning system. Doses to reference points and volumes of interest in the plans with shifted applicators were compared with the original plans. The impact of dose displacement on 2D (point-based) and 3D (volume-based) treatment planning techniques was also assessed. A ±2 mm translational y-axis applicator shift and ±4° rotational x-axis applicator shift resulted in dosimetric changes of more than 5% to organs at risk (OAR) reference points. Changes to the maximum doses to 2 cc of the organ (D2cc) in 3D planning were statistically significant and higher than the reference points in 2D planning for both the rectum and bladder (p<0.05). Rectal D2cc was observed to be the most sensitive to applicator displacement among all dose metrics. Applicator displacement that is greater than ±2 mm translational y-axis and ±4° rotational x-axis resulted in significant dose changes to the OAR. Thus, steps must be taken to minimize the possibility of applicator displacement during brachytherapy.

  12. A linear programming model for optimizing HDR brachytherapy dose distributions with respect to mean dose in the DVH-tail

    SciTech Connect

    Holm, Åsa; Larsson, Torbjörn; Tedgren, Åsa Carlsson

    2013-08-15

    Purpose: Recent research has shown that the optimization model hitherto used in high-dose-rate (HDR) brachytherapy corresponds weakly to the dosimetric indices used to evaluate the quality of a dose distribution. Although alternative models that explicitly include such dosimetric indices have been presented, the inclusion of the dosimetric indices explicitly yields intractable models. The purpose of this paper is to develop a model for optimizing dosimetric indices that is easier to solve than those proposed earlier.Methods: In this paper, the authors present an alternative approach for optimizing dose distributions for HDR brachytherapy where dosimetric indices are taken into account through surrogates based on the conditional value-at-risk concept. This yields a linear optimization model that is easy to solve, and has the advantage that the constraints are easy to interpret and modify to obtain satisfactory dose distributions.Results: The authors show by experimental comparisons, carried out retrospectively for a set of prostate cancer patients, that their proposed model corresponds well with constraining dosimetric indices. All modifications of the parameters in the authors' model yield the expected result. The dose distributions generated are also comparable to those generated by the standard model with respect to the dosimetric indices that are used for evaluating quality.Conclusions: The authors' new model is a viable surrogate to optimizing dosimetric indices and quickly and easily yields high quality dose distributions.

  13. A linear programming model for optimizing HDR brachytherapy dose distributions with respect to mean dose in the DVH-tail.

    PubMed

    Holm, Åsa; Larsson, Torbjörn; Tedgren, Åsa Carlsson

    2013-08-01

    Recent research has shown that the optimization model hitherto used in high-dose-rate (HDR) brachytherapy corresponds weakly to the dosimetric indices used to evaluate the quality of a dose distribution. Although alternative models that explicitly include such dosimetric indices have been presented, the inclusion of the dosimetric indices explicitly yields intractable models. The purpose of this paper is to develop a model for optimizing dosimetric indices that is easier to solve than those proposed earlier. In this paper, the authors present an alternative approach for optimizing dose distributions for HDR brachytherapy where dosimetric indices are taken into account through surrogates based on the conditional value-at-risk concept. This yields a linear optimization model that is easy to solve, and has the advantage that the constraints are easy to interpret and modify to obtain satisfactory dose distributions. The authors show by experimental comparisons, carried out retrospectively for a set of prostate cancer patients, that their proposed model corresponds well with constraining dosimetric indices. All modifications of the parameters in the authors' model yield the expected result. The dose distributions generated are also comparable to those generated by the standard model with respect to the dosimetric indices that are used for evaluating quality. The authors' new model is a viable surrogate to optimizing dosimetric indices and quickly and easily yields high quality dose distributions.

  14. SU-C-16A-03: Direction Modulated Brachytherapy for HDR Treatment of Cervical Cancer

    SciTech Connect

    Han, D; Webster, M; Scanderbeg, D; Yashar, C; Choi, D; Song, B; Song, W; Devic, S; Ravi, A

    2014-06-15

    Purpose: To investigate a new Directional Modulated Brachytherapy (DMBT) intra-uterine tandem using various 192-Ir after-loaders. Methods: Dose distributions from the 192-Ir sources were modulated using a 6.3mm diameter tungsten shield (18.0g/cm3). The source moved along 6 longitudinal grooves, each 1.3mm in diameter, evenly spaced along periphery of the shield, The tungsten rod was enclosqed by 0.5mm thick Delrin (1.41g/cc). Monte Carlo N particle (MCNPX) was used to calculate dose distributions. 51million particles were calculated on 504 cores of a supercomputer. Fifteen different patients originally treated with a traditional tandem-and-ovoid applicator, with 5 fractions each, (15 patients X 5 fxs = 75 plans) were re-planned with the DMBT applicator combined with traditional ovoids, on an in-house developed HDR brachytherapy planning platform, which used intensity modulated planning capabilities using a constrained gradient optimization algorithm. For all plans the prescription dose was 6 Gy and they were normalized to match the clinical treated V100. Results: Generally, the DMBT plan quality was a remarkable improvement from conventional T and O plans because of the anisotropic dose distribution of DMBT. The largest difference was to the bladder which had a 0.59±0.87 Gy (8.5±28.7%) reduction in dose. This was because of the the horseshoe shape (U-shape) of the bladder. The dose reduction to rectum and sigmoid were 0.48±0.55 Gy (21.1±27.2%) and 0.10±0.38 Gy (40.6±214.9%), respectively. The D90 to the HRCTV was 6.55±0.96 Gy (conventional T and O) and 6.59±1.06 Gy (DMBT). Conclusion: For image guided adaptive brachytherapy, greater flexibility of radiation intensity is essential and DMBT can be the solution.

  15. A CT-based analytical dose calculation method for HDR 192Ir brachytherapy.

    PubMed

    Poon, Emily; Verhaegen, Frank

    2009-09-01

    = 99% for both calculation methods. A correction-based dose calculation method has been validated for HDR 192Ir brachytherapy. Its high calculation efficiency makes it feasible for use in treatment planning. Because tissue inhomogeneity effects are small and primary dose predominates in the near-source region, TG-43 is adequate for target dose estimation provided shielding and contrast solution are not used.

  16. SU-E-T-362: Automatic Catheter Reconstruction of Flap Applicators in HDR Surface Brachytherapy

    SciTech Connect

    Buzurovic, I; Devlin, P; Hansen, J; O'Farrell, D; Bhagwat, M; Friesen, S; Damato, A; Lewis, J; Cormack, R

    2014-06-01

    Purpose: Catheter reconstruction is crucial for the accurate delivery of radiation dose in HDR brachytherapy. The process becomes complicated and time-consuming for large superficial clinical targets with a complex topology. A novel method for the automatic catheter reconstruction of flap applicators is proposed in this study. Methods: We have developed a program package capable of image manipulation, using C++class libraries of The-Visualization-Toolkit(VTK) software system. The workflow for automatic catheter reconstruction is: a)an anchor point is placed in 3D or in the axial view of the first slice at the tip of the first, last and middle points for the curved surface; b)similar points are placed on the last slice of the image set; c)the surface detection algorithm automatically registers the points to the images and applies the surface reconstruction filter; d)then a structured grid surface is generated through the center of the treatment catheters placed at a distance of 5mm from the patient's skin. As a result, a mesh-style plane is generated with the reconstructed catheters placed 10mm apart. To demonstrate automatic catheter reconstruction, we used CT images of patients diagnosed with cutaneous T-cell-lymphoma and imaged with Freiburg-Flap-Applicators (Nucletron™-Elekta, Netherlands). The coordinates for each catheter were generated and compared to the control points selected during the manual reconstruction for 16catheters and 368control point Results: The variation of the catheter tip positions between the automatically and manually reconstructed catheters was 0.17mm(SD=0.23mm). The position difference between the manually selected catheter control points and the corresponding points obtained automatically was 0.17mm in the x-direction (SD=0.23mm), 0.13mm in the y-direction (SD=0.22mm), and 0.14mm in the z-direction (SD=0.24mm). Conclusion: This study shows the feasibility of the automatic catheter reconstruction of flap applicators with a high level

  17. [Focal dose escalation in the treatment of prostate cancer : Long-term results of HDR brachytherapy].

    PubMed

    Cordes, J; Broschk, J; Sommerauer, M; Jocham, D; Merseburger, A S; Melchert, C; Kovács, G

    2017-02-01

    We prospectively examined the effect and the safety of intensity-modulated HDR brachytherapy (IMBT) with focal dose escalation. A total of 139 patients undergoing primary therapy for prostate cancer and 11 patients with recurrence were included. Data analysis focused on the following factors: date of primary diagnosis, Gleason score, initial prostate-specific antigen (PSA) value, PSA nadir, volume of the prostate in the transrectal ultrasound, biopsy of the prostate gland, androgen deprivation, chemotherapy, uroflowmetry, pre- and postoperative post-void residual urine (PVR), number of the needles in the prostate lobes and analysis of follow-up data. In the primary therapy group, 87.6 % of the patients had a PSA of 0-4 ng/ml at the time of follow-up, while in the recurrence group 81.8 % of patients were within this range. Overall, 55.8 % of patients in the primary group had a PSA nadir under 0.1 ng/ml, 37.2 % under 1 ng/ml, 5.8 % under 5 ng/ml and 1.2 % (1 patient) over 5 ng/ml. In the recurrence group, 100 % had a PSA nadir under 0.1 ng/dl. Fifty patients of the primary group reported grade 1 toxicity (Common Toxicity Criteria): 29 localized to the bladder and 21 to the rectum. Seventeen patients had grade 2 toxicity of the bladder and 1 patient had grade 3 toxicity of the bladder. Finally there was one grade 4 toxicity due to perforation of the sigmoid colon. In the recurrence group, 3 patients with grade 1 toxicity were observed (2 bladder and 1 bowl). Also 3 patients had grade 2 toxicity of the bladder, 1 patient had a grade 3 bladder toxicity and 1 patient had grade 4 toxicity due to bowl fistula. There were no grade 5 toxicities. The modifications of the "Kiel method" with focal dose escalation was proven as effective in locally advanced prostate carcinoma and in local recurrences of the disease with low level toxicity.

  18. Physics-aspects of dose accuracy in high dose rate (HDR) brachytherapy: source dosimetry, treatment planning, equipment performance and in vivo verification techniques

    PubMed Central

    Bradley, David; Nisbet, Andrew

    2012-01-01

    This study provides a review of recent publications on the physics-aspects of dosimetric accuracy in high dose rate (HDR) brachytherapy. The discussion of accuracy is primarily concerned with uncertainties, but methods to improve dose conformation to the prescribed intended dose distribution are also noted. The main aim of the paper is to review current practical techniques and methods employed for HDR brachytherapy dosimetry. This includes work on the determination of dose rate fields around brachytherapy sources, the capability of treatment planning systems, the performance of treatment units and methods to verify dose delivery. This work highlights the determinants of accuracy in HDR dosimetry and treatment delivery and presents a selection of papers, focusing on articles from the last five years, to reflect active areas of research and development. Apart from Monte Carlo modelling of source dosimetry, there is no clear consensus on the optimum techniques to be used to assure dosimetric accuracy through all the processes involved in HDR brachytherapy treatment. With the exception of the ESTRO mailed dosimetry service, there is little dosimetric audit activity reported in the literature, when compared with external beam radiotherapy verification. PMID:23349649

  19. Physics-aspects of dose accuracy in high dose rate (HDR) brachytherapy: source dosimetry, treatment planning, equipment performance and in vivo verification techniques.

    PubMed

    Palmer, Antony; Bradley, David; Nisbet, Andrew

    2012-06-01

    This study provides a review of recent publications on the physics-aspects of dosimetric accuracy in high dose rate (HDR) brachytherapy. The discussion of accuracy is primarily concerned with uncertainties, but methods to improve dose conformation to the prescribed intended dose distribution are also noted. The main aim of the paper is to review current practical techniques and methods employed for HDR brachytherapy dosimetry. This includes work on the determination of dose rate fields around brachytherapy sources, the capability of treatment planning systems, the performance of treatment units and methods to verify dose delivery. This work highlights the determinants of accuracy in HDR dosimetry and treatment delivery and presents a selection of papers, focusing on articles from the last five years, to reflect active areas of research and development. Apart from Monte Carlo modelling of source dosimetry, there is no clear consensus on the optimum techniques to be used to assure dosimetric accuracy through all the processes involved in HDR brachytherapy treatment. With the exception of the ESTRO mailed dosimetry service, there is little dosimetric audit activity reported in the literature, when compared with external beam radiotherapy verification.

  20. Comparison of methods for the measurement of radiation dose distributions in high dose rate (HDR) brachytherapy: Ge-doped optical fiber, EBT3 Gafchromic film, and PRESAGE{sup Registered-Sign} radiochromic plastic

    SciTech Connect

    Palmer, A. L.; Di Pietro, P.; Alobaidli, S.; Issa, F.; Doran, S.; Bradley, D.; Nisbet, A.

    2013-06-15

    Purpose: Dose distribution measurement in clinical high dose rate (HDR) brachytherapy is challenging, because of the high dose gradients, large dose variations, and small scale, but it is essential to verify accurate treatment planning and treatment equipment performance. The authors compare and evaluate three dosimetry systems for potential use in brachytherapy dose distribution measurement: Ge-doped optical fibers, EBT3 Gafchromic film with multichannel analysis, and the radiochromic material PRESAGE{sup Registered-Sign} with optical-CT readout. Methods: Ge-doped SiO{sub 2} fibers with 6 {mu}m active core and 5.0 mm length were sensitivity-batched and their thermoluminescent properties used via conventional heating and annealing cycles. EBT3 Gafchromic film of 30 {mu}m active thickness was calibrated in three color channels using a nominal 6 MV linear accelerator. A 48-bit transmission scanner and advanced multichannel analysis method were utilized to derive dose measurements. Samples of the solid radiochromic polymer PRESAGE{sup Registered-Sign }, 60 mm diameter and 100 mm height, were analyzed with a parallel beam optical CT scanner. Each dosimetry system was used to measure the dose as a function of radial distance from a Co-60 HDR source, with results compared to Monte Carlo TG-43 model data. Each system was then used to measure the dose distribution along one or more lines through typical clinical dose distributions for cervix brachytherapy, with results compared to treatment planning system (TPS) calculations. Purpose-designed test objects constructed of Solid Water and held within a full-scatter water tank were utilized. Results: All three dosimetry systems reproduced the general shape of the isolated source radial dose function and the TPS dose distribution. However, the dynamic range of EBT3 exceeded those of doped optical fibers and PRESAGE{sup Registered-Sign }, and the latter two suffered from unacceptable noise and artifact. For the experimental

  1. Gold marker displacement due to needle insertion during HDR-brachytherapy for treatment of prostate cancer: A prospective cone beam computed tomography and kilovoltage on-board imaging (kV-OBI) study

    PubMed Central

    2012-01-01

    Purpose To evaluate gold marker displacement due to needle insertion during HDR-brachytherapy for therapy of prostate cancer. Patients and methods 18 patients entered into this prospective evaluation. Three gold markers were implanted into the prostate during the first HDR-brachytherapy procedure after the irradiation was administered. Three days after marker implantation all patients had a CT-scan for planning purpose of the percutaneous irradiation. Marker localization was defined on the digitally-reconstructed-radiographs (DRR) for daily (VMAT technique) or weekly (IMRT) set-up error correction. Percutaneous therapy started one week after first HDR-brachytherapy. After the second HDR-brachytherapy, two weeks after first HDR-brachtherapy, a cone-beam CT-scan was done to evaluate marker displacement due to needle insertion. In case of marker displacement, the actual positions of the gold markers were adjusted on the DRR. Results The value of the gold marker displacement due to the second HDR-brachytherapy was analyzed in all patients and for each gold marker by comparison of the marker positions in the prostate after soft tissue registration of the prostate of the CT-scans prior the first and second HDR-brachytherapy. The maximum deviation was 5 mm, 7 mm and 12 mm for the anterior-posterior, lateral and superior-inferior direction. At least one marker in each patient showed a significant displacement and therefore new marker positions were adjusted on the DRRs for the ongoing percutaneous therapy. Conclusions Needle insertion in the prostate due to HDR-brachytherapy can lead to gold marker displacements. Therefore, it is necessary to verify the actual position of markers after the second HDR-brachytherapy. In case of significant deviations, a new DRR with the adjusted marker positions should be generated for precise positioning during the ongoing percutaneous irradiation. PMID:22348595

  2. Gold marker displacement due to needle insertion during HDR-brachytherapy for treatment of prostate cancer: a prospective cone beam computed tomography and kilovoltage on-board imaging (kV-OBI) study.

    PubMed

    Herrmann, Markus K A; Kertesz, Tereza; Gsänger, Tammo; Bloch, Eugen; Pollul, Gerhard; Bouabdallaoui, Mohamed; Strauss, Arne; Herrmann, Mareike; Christiansen, Hans; Wolff, Hendrik A; Hess, Clemens F; Hille, Andrea

    2012-02-20

    To evaluate gold marker displacement due to needle insertion during HDR-brachytherapy for therapy of prostate cancer. 18 patients entered into this prospective evaluation. Three gold markers were implanted into the prostate during the first HDR-brachytherapy procedure after the irradiation was administered. Three days after marker implantation all patients had a CT-scan for planning purpose of the percutaneous irradiation. Marker localization was defined on the digitally-reconstructed-radiographs (DRR) for daily (VMAT technique) or weekly (IMRT) set-up error correction. Percutaneous therapy started one week after first HDR-brachytherapy. After the second HDR-brachytherapy, two weeks after first HDR-brachtherapy, a cone-beam CT-scan was done to evaluate marker displacement due to needle insertion. In case of marker displacement, the actual positions of the gold markers were adjusted on the DRR. The value of the gold marker displacement due to the second HDR-brachytherapy was analyzed in all patients and for each gold marker by comparison of the marker positions in the prostate after soft tissue registration of the prostate of the CT-scans prior the first and second HDR-brachytherapy. The maximum deviation was 5 mm, 7 mm and 12 mm for the anterior-posterior, lateral and superior-inferior direction. At least one marker in each patient showed a significant displacement and therefore new marker positions were adjusted on the DRRs for the ongoing percutaneous therapy. Needle insertion in the prostate due to HDR-brachytherapy can lead to gold marker displacements. Therefore, it is necessary to verify the actual position of markers after the second HDR-brachytherapy. In case of significant deviations, a new DRR with the adjusted marker positions should be generated for precise positioning during the ongoing percutaneous irradiation.

  3. A radiation quality correction factor k for well-type ionization chambers for the measurement of the reference air kerma rate of (60)Co HDR brachytherapy sources.

    PubMed

    Schüller, Andreas; Meier, Markus; Selbach, Hans-Joachim; Ankerhold, Ulrike

    2015-07-01

    The aim of this study was to investigate whether a chamber-type-specific radiation quality correction factor kQ can be determined in order to measure the reference air kerma rate of (60)Co high-dose-rate (HDR) brachytherapy sources with acceptable uncertainty by means of a well-type ionization chamber calibrated for (192)Ir HDR sources. The calibration coefficients of 35 well-type ionization chambers of two different chamber types for radiation fields of (60)Co and (192)Ir HDR brachytherapy sources were determined experimentally. A radiation quality correction factor kQ was determined as the ratio of the calibration coefficients for (60)Co and (192)Ir. The dependence on chamber-to-chamber variations, source-to-source variations, and source strength was investigated. For the PTW Tx33004 (Nucletron source dosimetry system (SDS)) well-type chamber, the type-specific radiation quality correction factor kQ is 1.19. Note that this value is valid for chambers with the serial number, SN ≥ 315 (Nucletron SDS SN ≥ 548) onward only. For the Standard Imaging HDR 1000 Plus well-type chambers, the type-specific correction factor kQ is 1.05. Both kQ values are independent of the source strengths in the complete clinically relevant range. The relative expanded uncertainty (k = 2) of kQ is UkQ = 2.1% for both chamber types. The calibration coefficient of a well-type chamber for radiation fields of (60)Co HDR brachytherapy sources can be calculated from a given calibration coefficient for (192)Ir radiation by using a chamber-type-specific radiation quality correction factor kQ. However, the uncertainty of a (60)Co calibration coefficient calculated via kQ is at least twice as large as that for a direct calibration with a (60)Co source.

  4. SU-E-T-459: Impact of Source Position and Traveling Time On HDR Skin Surface Applicator Dosimetry

    SciTech Connect

    Jeong, J; Barker, C; Zaider, M; Cohen, G

    2015-06-15

    Purpose: Observed dosimetric discrepancy between measured and treatment planning system (TPS) predicted values, during applicator commissioning, were traced to source position uncertainty in the applicator. We quantify the dosimetric impact of this geometric uncertainty, and of the source traveling time inside the applicator, and propose corrections for clinical use. Methods: We measured the dose profiles from the Varian Leipzig-style (horizontal) HDR skin applicator, using EBT3 film, photon diode, and optically stimulated luminescence dosimeter (OSLD) and three different GammaMed HDR afterloders. The dose profiles and depth dose of each aperture were measured at several depths (up to about 10 mm, depending on the dosimeter). The measured dose profiles were compared with Acuros calculated profiles in BrachyVision TPS. For the impact of the source position, EBT3 film measurements were performed with applicator, facing-down and facing-up orientations. The dose with and without source traveling was measured with diode detector using HDR timer and electrometer timer, respectively. Results: Depth doses measured using the three dosimeters were in good agreement, but were consistently higher than the Acuros dose calculations. Measurements with the applicator facing-up were significantly lower than those in the facing-down position with maximum difference of about 18% at the surface, due to source sag inside the applicator. Based on the inverse-square law, the effective source sag was evaluated to be about 0.5 mm from the planned position. The additional dose from the source traveling was about 2.8% for 30 seconds with 10 Ci source, decreasing with increased dwelling time and decreased source activity. Conclusion: Due to the short source-to-surface distance of the applicator, the small source sag inside the applicator has significant dosimetric impact, which should be considered before the clinical use of the applicator. Investigation of the effect for other applicators

  5. Increasing Fractional Doses Increases the Probability of Benign PSA Bounce in Patients Undergoing Definitive HDR Brachytherapy for Prostate Cancer.

    PubMed

    Hauck, Carlin R; Ye, Hong; Chen, Peter Y; Gustafson, Gary S; Limbacher, Amy; Krauss, Daniel J

    2017-05-01

    Prostate-specific antigen (PSA) bounce is a temporary elevation of the PSA level above a prior nadir. The purpose of this study was to determine whether the frequency of a PSA bounce following high-dose-rate (HDR) interstitial brachytherapy for the treatment of prostate cancer is associated with individual treatment fraction size. Between 1999 and 2014, 554 patients underwent treatment of low- or intermediate-risk prostate cancer with definitive HDR brachytherapy as monotherapy and had ≥3 subsequent PSA measurements. Four different fraction sizes were used: 950 cGy × 4 fractions, 1200 cGy × 2 fractions, 1350 cGy × 2 fractions, 1900 cGy × 1 fraction. Four definitions of PSA bounce were applied: ≥0.2, ≥0.5, ≥1.0, and ≥2.0 ng/mL above the prior nadir with a subsequent return to the nadir. The median follow-up period was 3.7 years. The actuarial 3-year rate of PSA bounce for the entire cohort was 41.3%, 28.4%, 17.4%, and 6.8% for nadir +0.2, +0.5, +1.0, and +2.0 ng/mL, respectively. The 3-year rate of PSA bounce >0.2 ng/mL was 42.2%, 32.1%, 41.0%, and 59.1% for the 950-, 1200-, 1350-, and 1900-cGy/fraction levels, respectively (P=.002). The hazard ratio for bounce >0.2 ng/mL for patients receiving a single fraction of 1900 cGy compared with those receiving treatment in multiple fractions was 1.786 (P=.024). For patients treated with a single 1900-cGy fraction, the 1-, 2-, and 3-year rates of PSA bounce exceeding the Phoenix biochemical failure definition (nadir +2 ng/mL) were 4.5%, 18.7%, and 18.7%, respectively, higher than the rates for all other administered dose levels (P=.025). The incidence of PSA bounce increases with single-fraction HDR treatment. Knowledge of posttreatment PSA kinetics may aid in decision making regarding management of potential biochemical failures. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Absolute depth-dose-rate measurements for an 192Ir HDR brachytherapy source in water using MOSFET detectors.

    PubMed

    Zilio, Valéry Olivier; Joneja, Om Parkash; Popowski, Youri; Rosenfeld, Anatoly; Chawla, Rakesh

    2006-06-01

    Reported MOSFET measurements concern mostly external radiotherapy and in vivo dosimetry. In this paper, we apply the technique for absolute dosimetry in the context of HDR brachytherapy using an 192Ir source. Measured radial dose rate distributions in water for different planes perpendicular to the source axis are presented and special attention is paid to the calibration of the R and K type detectors, and to the determination of appropriate correction factors for the sensitivity variation with the increase of the threshold voltage and the energy dependence. The experimental results are compared with Monte Carlo simulated dose rate distributions. The experimental results show a good agreement with the Monte Carlo simulations: the discrepancy between experimental and Monte Carlo results being within 5% for 82% of the points and within 10% for 95% of the points. Moreover, all points except two are found to lie within the experimental uncertainties, confirming thereby the quality of the results obtained.

  7. An integrated system for clinical treatment verification of HDR prostate brachytherapy combining source tracking with pretreatment imaging.

    PubMed

    Smith, Ryan L; Hanlon, Max; Panettieri, Vanessa; Millar, Jeremy L; Matheson, Bronwyn; Haworth, Annette; Franich, Rick D

    2017-09-22

    High-dose-rate (HDR) prostate brachytherapy treatment is usually delivered in one or a few large dose fractions. Poor execution of a planned treatment could have significant clinical impact, as high doses are delivered in seconds, and mistakes in an individual fraction cannot be easily rectified. Given that most potential errors in HDR brachytherapy ultimately lead to a geographical miss, a more direct approach to verification of correct treatment delivery is to directly monitor the position of the source throughout the treatment. In this work, we report on the clinical implementation of our treatment verification system that uniquely combines the 2D source-tracking capability with 2D pretreatment imaging, using a single flat panel detector (FPD). The clinical brachytherapy treatment couch was modified to allow integration of the FPD into the couch. This enabled the patient to be set up in the brachytherapy bunker in a position that closely matched that at treatment planning imaging. An anteroposterior image was acquired of the patient immediately before treatment delivery and was assessed by the Radiation Oncologist online, to reestablish the positions of the catheters relative to the prostate. Assessment of catheter positions was performed in the left-right and superior-inferior directions along the entire catheter length and throughout the treatment volume. Source tracking was then performed during treatment delivery, and the measured position of the source dwells were directly compared to the treatment plan for verification. The treatment verification system was integrated into the clinical environment without significant change to workflow. Two patient cases are presented in this work to provide clinical examples of this system, which is now in routine use for all patient treatments in our clinic. The catheter positions were visualized relative to the prostate, immediately before treatment delivery. For one of the patient cases presented in this work, they

  8. TU-AB-201-04: Optimizing the Number of Catheter Implants and Their Tracks for Prostate HDR Brachytherapy

    SciTech Connect

    Riofrio, D; Luan, S; Zhou, J; Ma, L

    2015-06-15

    Purpose: In prostate HDR brachytherapy, interstitial implants are placed manually on the fly. The aim for this research is to develop a computer algorithm to find optimal and reliable implant trajectories using minimal number of implants. Methods: Our new algorithm mainly uses these key ideas: (1) positive charged static particles are uniformly placed on the surface of prostate and critical structures such as urethra, bladder, and rectum. (2) Positive charged kinetic particles are placed at a cross-section of the prostate with an initial velocity parallel to the principal implant direction. (3) The kinetic particles move through the prostate, interacting with each other, spreading out, while staying away from the prostate surface and critical structures. The initial velocity ensures that the trajectories observe the curvature constraints of typical implant procedures. (4) The finial trajectories of kinetic particles are smoothed using a third-degree polynomial regression, which become the implant trajectories. (5) The dwelling times and final dose distribution are calculated using least-distance programming. Results: (1) We experimented with previously treated cases. Our plan achieves all prescription goals while reducing the number of implants by 41%! Our plan also has less uniform target dose, which implies a higher dose is delivered to the prostate. (2) We expect future implant procedures will be performed under the guidance of such pre-calculated trajectories. To assess the applicability, we randomly perturb the tracks to mimic the manual implant errors. Our studies showed the impact of these perturbations are negligible, which is compensated by the least distance programming. Conclusions: We developed a new inverse planning system for prostate HDR therapy that can find optimal implant trajectories while minimizing the number of implants. For future work, we plan to integrate our new inverse planning system with an existing needle tracking system.

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

    SciTech Connect

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

    2014-06-01

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

  10. Endocavity Ultrasound Hyperthermia for Locally Advanced Cervical Cancer: Patient-specific Modeling, Experimental Verification, and Combination with HDR Brachytherapy

    SciTech Connect

    Wootton, Jeffery; Diederich, Chris; Chen Xin; Prakash, Punit; Juang, Titania

    2010-03-09

    The feasibility of targeted hyperthermia delivery by an intrauterine ultrasound applicator to patient-specific treatment volumes in conjunction with HDR brachytherapy was investigated using theory and experiment. 30 HDR brachytherapy treatment plans were inspected to define hyperthermia treatment volumes (HTVs) based on tumor and radiation target volumes. Several typical cases were imported into a patient-specific treatment planning platform that optimized acoustic output power from an endocavity multisectored tubular array to conform temperature and thermal dose to HTVs. Perfusion was within a clinical range of 0.5-3 kg m{sup -3} s{sup -1}. Applicators were constructed with 1-3 elements at 6.5-8 MHz with 90 deg. -360 deg. sectoring and 25-35 mm heating length housed in a water-cooled PET catheter. Acoustic output was compared to heating in ex vivo tissue assessed with implanted thermometry. Radiation attenuation through the device was measured in an ionization chamber. The HTV extends 2-4 cm in diameter and 2-4 cm in length. The bladder and rectum can be within 10-12 mm. HTV targets can be covered with temperature clouds >41 deg. and thermal dose t{sup 43}>5 min with 45 deg. C maximum temperature and rectal temperature <41.5 deg. C. Sectored applicators preferentially direct energy laterally into the parametrium to limit heating of rectum and bladder. Interstitial brachytherapy catheters within the HTV could be used for thermal feedback during HT treatment. Temperature distributions in phantom show preferential heating within sectors and align well with acoustic output. Heating control along the device length and in angle is evident. A 4-6% reduction in radiation transmission through the transducers was observed, which could likely be compensated for in planning. Patient-specific modeling and experimental heating demonstrated 3-D conformal heating capabilities of endocavity ultrasound applicators.

  11. Analysis of prognostic factors in localized high-risk prostate cancer patients treated with HDR brachytherapy, hypofractionated 3D-CRT and neoadjuvant/adjuvant androgen deprivation therapy (trimodality therapy).

    PubMed

    Aoki, Manabu; Miki, Kenta; Kido, Masahito; Sasaki, Hiroshi; Nakamura, Wataru; Kijima, Yoshikazu; Kobayashi, Masao; Egawa, Shin; Kanehira, Chihiro

    2014-05-01

    Trimodality therapy consisting of high dose rate (HDR) brachytherapy combined with external beam radiation therapy (EBRT), neoadjuvant hormonal therapy (NHT) and adjuvant hormonal therapy (AHT) has been used to treat localized high-risk prostate cancer. In this study, an analysis of patients receiving the trimodality therapy was performed to identify prognostic factors of biochemical relapse-free survival (bRFS). Between May 2005 and November 2008, 123 high-risk prostate cancer patients (D'Amico classification) were treated with NHT prior to HDR brachytherapy combined with hypofractionated EBRT. Among these patients, 121 had completed AHT. The patients were assigned by time to be treated with a low-dose or high-dose arm of HDR brachytherapy with subsequent hypofractionated 3D conformal radiation therapy (3D-CRT). Multivariate analysis was used to determine prognostic factors for bRFS. With a median follow-up of 60 months, the 5-year bRFS for all patients was 84.3% (high-dose arm, 92.9%; low-dose arm, 72.4%, P = 0.047). bRFS in the pre-HDR PSA ≤ 0.1 ng/ml subgroup was significantly improved compared with that in the pre-HDR PSA > 0.1 ng/ml subgroup (88.3% vs 68.2%, P = 0.034). On multivariate analysis, dose of HDR (P = 0.045, HR = 0.25, 95% CI = 0.038-0.97) and pre-HDR PSA level (P = 0.02 HR = 3.2, 95% CI = 1.18-10.16) were significant prognostic factors predicting bRFS. In high-risk prostate cancer patients treated with the trimodality therapy, the dose of HDR and pre-HDR PSA were significant prognostic factors. The pre-HDR PSA ≤ 0.1 subgroup had significantly improved bRFS. Further studies are needed to confirm the relevance of pre-HDR PSA in trimodality therapy.

  12. In vivo dosimetry in the urethra using alanine/ESR during (192)Ir HDR brachytherapy of prostate cancer--a phantom study.

    PubMed

    Anton, Mathias; Wagner, Daniela; Selbach, Hans-Joachim; Hackel, Thomas; Hermann, Robert Michael; Hess, Clemens Friedrich; Vorwerk, Hilke

    2009-05-07

    A phantom study for dosimetry in the urethra using alanine/ESR during (192)Ir HDR brachytherapy of prostate cancer is presented. The measurement method of the secondary standard of the Physikalisch-Technische Bundesanstalt had to be slightly modified in order to be able to measure inside a Foley catheter. The absorbed dose to water response of the alanine dosimetry system to (192)Ir was determined with a reproducibility of 1.8% relative to (60)Co. The resulting uncertainty for measurements inside the urethra was estimated to be 3.6%, excluding the uncertainty of the dose rate constant Lambda. The applied dose calculated by a treatment planning system is compared to the measured dose for a small series of (192)Ir HDR irradiations in a gel phantom. The differences between the measured and applied dose are well within the limits of uncertainty. Therefore, the method is considered to be suitable for measurements in vivo.

  13. In vivo dosimetry in the urethra using alanine/ESR during 192Ir HDR brachytherapy of prostate cancer—a phantom study

    NASA Astrophysics Data System (ADS)

    Anton, Mathias; Wagner, Daniela; Selbach, Hans-Joachim; Hackel, Thomas; Hermann, Robert Michael; Hess, Clemens Friedrich; Vorwerk, Hilke

    2009-05-01

    A phantom study for dosimetry in the urethra using alanine/ESR during 192Ir HDR brachytherapy of prostate cancer is presented. The measurement method of the secondary standard of the Physikalisch-Technische Bundesanstalt had to be slightly modified in order to be able to measure inside a Foley catheter. The absorbed dose to water response of the alanine dosimetry system to 192Ir was determined with a reproducibility of 1.8% relative to 60Co. The resulting uncertainty for measurements inside the urethra was estimated to be 3.6%, excluding the uncertainty of the dose rate constant Λ. The applied dose calculated by a treatment planning system is compared to the measured dose for a small series of 192Ir HDR irradiations in a gel phantom. The differences between the measured and applied dose are well within the limits of uncertainty. Therefore, the method is considered to be suitable for measurements in vivo.

  14. SU-E-T-634: Analysis of Volume Based GYN HDR Brachytherapy Plans for Dose Calculation to Organs At Risk(OAR)

    SciTech Connect

    Nair, M; Li, C; White, M; Davis, J

    2014-06-15

    Purpose: We have analyzed the dose volume histogram of 140 CT based HDR brachytherapy plans and evaluated the dose received to OAR ; rectum, bladder and sigmoid colon based on recommendations from ICRU and Image guided brachytherapy working group for cervical cancer . Methods: Our treatment protocol consist of XRT to whole pelvis with 45 Gy at 1.8Gy/fraction followed by 30 Gy at 6 Gy per fraction by HDR brachytherapy in 2 weeks . The CT compatible tandem and ovoid applicators were used and stabilized with radio opaque packing material. The patient was stabilized using special re-locatable implant table and stirrups for reproducibility of the geometry during treatment. The CT scan images were taken at 3mm slice thickness and exported to the treatment planning computer. The OAR structures, bladder, rectum and sigmoid colon were outlined on the images along with the applicators. The prescription dose was targeted to A left and A right as defined in Manchester system and optimized on geometry . The dosimetry was compared on all plans using the parameter Ci.sec.cGy-1 . Using the Dose Volume Histogram (DVH) obtained from the plans the doses to rectum, sigmoid colon and bladder for ICRU defined points and 2cc volume were analyzed and reported. The following criteria were used for limiting the tolerance dose by volume (D2cc) were calculated. The rectum and sigmoid colon doses were limited to <75Gy. The bladder dose was limited to < 90Gy from both XRT and HDR brachytherapy. Results: The average total (XRT+HDRBT) BED values to prescription volume was 120 Gy. Dose 2cc to rectum was 70Gy +/− 17Gy, dose to 2cc bladder was 82+/−32 Gy. The average Ci.sec.cGy-1 calculated for the HDR plans was 6.99 +/− 0.5 Conclusion: The image based treatment planning enabled to evaluati volume based dose to critical structures for clinical interpretation.

  15. Multimodality Image-Guided HDR/IMRT in Prostate Cancer: Combined Molecular Targeting Using Nanoparticle MR, 3D MRSI, and 11C Acetate PET Imaging

    DTIC Science & Technology

    2005-08-01

    of information is estimated to average 1 hour per response, including the time for reviewing instructions, searching existing data sources , gathering...The protocol will include primary source documents and case report forms, informed consent documents, statistical analysis of primary and secondary...scheduled to undergo HDR brachytherapy and IMRT, as currently being performed in a Phase I/II Trial at VCU MCC, however, increased dosage would be

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

    PubMed

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

    2017-05-01

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

  17. A national survey of HDR source knowledge among practicing radiation oncologists and residents: Establishing a willingness-to-pay threshold for cobalt-60 usage.

    PubMed

    Mailhot Vega, Raymond; Talcott, Wesley; Ishaq, Omar; Cohen, Patrice; Small, Christina J; Duckworth, Tamara; Sarria Bardales, Gustavo; Perez, Carmen A; Schiff, Peter B; Small, William; Harkenrider, Matthew M

    Ir-192 is the predominant source for high-dose-rate (HDR) brachytherapy in United States markets. Co-60, with longer half-life and fewer source exchanges, has piloted abroad with comparable clinical dosimetry but increased shielding requirements. We sought to identify practitioner knowledge of Co-60 and establish acceptable willingness-to-pay (WTP) thresholds for additional shielding requirements for use in future cost-benefit analysis. A nationwide survey of U.S. radiation oncologists was conducted from June to July 2015, assessing knowledge of HDR sources, brachytherapy unit shielding, and factors that may influence source-selection decision-making. Self-identified decision makers in radiotherapy equipment purchase and acquisition were asked their WTP on shielding should a more cost-effective source become available. Four hundred forty surveys were completed and included. Forty-four percent were ABS members. Twenty percent of respondents identified Co-60 as an HDR source. Respondents who identified Co-60 were significantly more likely to be ABS members, have attended a national brachytherapy conference, and be involved in brachytherapy selection. Sixty-six percent of self-identified decision makers stated that their facility would switch to a more cost-effective source than Ir-192, if available. Cost and experience were the most common reasons provided for not switching. The most common WTP value selected by respondents was <$25,000. A majority of respondents were unaware of Co-60 as a commercially available HDR source. This investigation was novel in directly assessing decision makers to establish WTP for shielding costs that source change to Co-60 may require. These results will be used to establish WTP threshold for future cost-benefit analysis. Copyright © 2017 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  18. A Pilot Study of Catheter-Based Ultrasound Hyperthermia with HDR Brachytherapy for Treatment of Locally Advanced Cancer of the Prostate and Cervix

    NASA Astrophysics Data System (ADS)

    Diederich, Chris J.; Wootton, Jeff; Prakash, Punit; Salgaonkar, Vasant; Juang, Titania; Scott, Serena; Chen, Xin; Cunha, Adam; Pouliot, Jean; Hsu, I. C.

    2011-09-01

    Interstitial and endocavity ultrasound devices have been developed specifically for applying hyperthermia within temporary HDR brachytherapy implants during radiation therapy. Catheter-based ultrasound applicators are capable of 3D spatial control of heating in both angle and length of the devices, with enhanced radial penetration of heating compared to other hyperthermia technologies. A pilot study of the combination of catheter based ultrasound with HDR brachytherapy for locally advanced prostate and cervical cancer has been initiated, and preliminary results of the performance and heating distributions are reported herein. The treatment delivery platform consists of a 32 channel RF amplifier and a 48 channel thermocouple monitoring system. Controlling software can monitor and regulate frequency and power to each transducer section as required during the procedure. Interstitial applicators consist of multiple transducer sections of 2-4 cm length×180 deg and 3-4 cm×360 deg. heating patterns to be inserted in specific placed 13g implant catheters. The endocavity device, designed to be inserted within a 6 mm OD plastic tandem catheter within the cervix, consists of 2-3 transducers x dual 180 or 360 deg sectors. 3D temperature based treatment planning and optimization is dovetailed to the HDR optimization based planning to best configure and position the applicators within the catheters, and to determine optimal base power levels to each transducer section. To date we have treated eight cervix implants and four prostate implants. 100% of treatments achieved a goal of >60 min duration, with therapeutic temperatures achieved in all cases. Thermal dosimetry within the hyperthermia target volume (HTV) and clinical target volume (CTV) are reported. Catheter-based ultrasound hyperthermia with HDR appears feasible with therapeutic temperature coverage of the target volume within the prostate or cervix while sparing surrounding more sensitive regions.

  19. SU-E-T-580: On the Significance of Model Based Dosimetry for Breast and Head and Neck 192Ir HDR Brachytherapy

    SciTech Connect

    Peppa, V; Pappas, E; Pantelis, E; Papagiannis, P; Major, T; Polgar, C

    2015-06-15

    Purpose: To assess the dosimetric and radiobiological differences between TG43-based and model-based dosimetry in the treatment planning of {sup 192}Ir HDR brachytherapy for breast and head and neck cancer. Methods: Two cohorts of 57 Accelerated Partial Breast Irradiation (APBI) and 22 head and neck (H&N) patients with oral cavity carcinoma were studied. Dosimetry for the treatment plans was performed using the TG43 algorithm of the Oncentra Brachy v4.4 treatment planning system (TPS). Corresponding Monte Carlo (MC) simulations were performed using MCNP6 with input files automatically prepared by the BrachyGuide software tool from DICOM RT plan data. TG43 and MC data were compared in terms of % dose differences, Dose Volume Histograms (DVHs) and related indices of clinical interest for the Planning Target Volume (PTV) and the Organs-At-Risk (OARs). A radiobiological analysis was also performed using the Equivalent Uniform Dose (EUD), mean survival fraction (S) and Tumor Control Probability (TCP) for the PTV, and the Normal Tissue Control Probability (N TCP) and the generalized EUD (gEUD) for the OARs. Significance testing of the observed differences performed using the Wilcoxon paired sample test. Results: Differences between TG43 and MC DVH indices, associated with the increased corresponding local % dose differences observed, were statistically significant. This is mainly attributed to their consistency however, since TG43 agrees closely with MC for the majority of DVH and radiobiological parameters in both patient cohorts. Differences varied considerably among patients only for the ipsilateral lung and ribs in the APBI cohort, with a strong correlation to target location. Conclusion: While the consistency and magnitude of differences in the majority of clinically relevant DVH indices imply that no change is needed in the treatment planning practice, individualized dosimetry improves accuracy and addresses instances of inter-patient variability observed. Research

  20. Evaluation of wall correction factor of INER's air-kerma primary standard chamber and dose variation by source displacement for HDR ¹⁹²Ir brachytherapy.

    PubMed

    Lee, J H; Wang, J N; Huang, T T; Su, S H; Chang, B J; Su, C H; Hsu, S M

    2013-01-01

    The aim of the present study was to estimate the wall effect of the self-made spherical graphite-walled cavity chamber with the Monte Carlo method for establishing the air-kerma primary standard of high-dose-rate (HDR) ¹⁹²Ir brachytherapy sources at the Institute of Nuclear Energy Research (INER, Taiwan). The Monte Carlo method established in this paper was also employed to respectively simulate wall correction factors of the ¹⁹²Ir air-kerma standard chambers used at the National Institute of Standards and Technology (NIST, USA) and the National Physical Laboratory (NPL, UK) for comparisons and verification. The chamber wall correction calculation results will be incorporated into INER's HDR ¹⁹²Ir primary standard in the future. For the brachytherapy treatment in the esophagus or in the bronchi, the position of the isotope may have displacement in the cavity. Thus the delivered dose would differ from the prescribed dose in the treatment plan. We also tried assessing dose distribution due to the position displacement of HDR ¹⁹²Ir brachytherapy source in a phantom with a central cavity by the Monte Carlo method. The calculated results could offer a clinical reference for the brachytherapy within the human organs with cavity.

  1. Technical Note: Removing the stem effect when performing Ir-192 HDR brachytherapy in vivo dosimetry using plastic scintillation detectors: A relevant and necessary step

    SciTech Connect

    Therriault-Proulx, Francois; Beddar, Sam; Briere, Tina M.; Archambault, Louis; Beaulieu, Luc

    2011-04-15

    Purpose: The purpose of this study was to investigate whether or not a stem effect removal technique is necessary when performing Ir-192 HDR brachytherapy in vivo dosimetry using a scintillation detector. Methods: A red-green-blue photodiode connected to a multichannel electrometer was used to detect the light emitted from a plastic scintillation detector (PSD) during irradiation with an Ir-192 HDR brachytherapy source. Accuracy in dose measurement was compared with and without the use of stem effect removal techniques. Monochromatic and polychromatic filtration techniques were studied. An in-house template was built for accurate positioning of catheters in which the source and the PSD were inserted. Dose distribution was measured up to 5 cm from source to detector in the radial and longitudinal directions. Results: The authors found the stem effect to be particularly important when the source was close to the optical fiber guide and far from the scintillation component of the detector. It can account for up to (72{+-}3)% of the signal under clinically relevant conditions. The polychromatic filtration outperformed the monochromatic filtration as well as the absence of filtration in regard to dose measurement accuracy. Conclusions: It is necessary to implement a stem effect removal technique when building a PSD for in vivo dosimetry during Ir-192 HDR brachytherapy. The PSD that the authors have developed for this study would be suitable for such an application.

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

    PubMed

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

    2011-01-01

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

  3. Enrichment of G2/M cell cycle phase in human pluripotent stem cells enhances HDR-mediated gene repair with customizable endonucleases.

    PubMed

    Yang, Diane; Scavuzzo, Marissa A; Chmielowiec, Jolanta; Sharp, Robert; Bajic, Aleksandar; Borowiak, Malgorzata

    2016-02-18

    Efficient gene editing is essential to fully utilize human pluripotent stem cells (hPSCs) in regenerative medicine. Custom endonuclease-based gene targeting involves two mechanisms of DNA repair: homology directed repair (HDR) and non-homologous end joining (NHEJ). HDR is the preferred mechanism for common applications such knock-in, knock-out or precise mutagenesis, but remains inefficient in hPSCs. Here, we demonstrate that synchronizing synchronizing hPSCs in G2/M with ABT phase increases on-target gene editing, defined as correct targeting cassette integration, 3 to 6 fold. We observed improved efficiency using ZFNs, TALENs, two CRISPR/Cas9, and CRISPR/Cas9 nickase to target five genes in three hPSC lines: three human embryonic stem cell lines, neural progenitors and diabetic iPSCs. neural progenitors and diabetic iPSCs. Reversible synchronization has no effect on pluripotency or differentiation. The increase in on-target gene editing is locus-independent and specific to the cell cycle phase as G2/M phase enriched cells show a 6-fold increase in targeting efficiency compared to cells in G1 phase. Concurrently inhibiting NHEJ with SCR7 does not increase HDR or improve gene targeting efficiency further, indicating that HR is the major DNA repair mechanism after G2/M phase arrest. The approach outlined here makes gene editing in hPSCs a more viable tool for disease modeling, regenerative medicine and cell-based therapies.

  4. Evaluation of Wall Correction Factor of INER's Air-Kerma Primary Standard Chamber and Dose Variation by Source Displacement for HDR 192Ir Brachytherapy

    PubMed Central

    Lee, J. H.; Wang, J. N.; Huang, T. T.; Su, S. H.; Chang, B. J.; Su, C. H.; Hsu, S. M.

    2013-01-01

    The aim of the present study was to estimate the wall effect of the self-made spherical graphite-walled cavity chamber with the Monte Carlo method for establishing the air-kerma primary standard of high-dose-rate (HDR) 192Ir brachytherapy sources at the Institute of Nuclear Energy Research (INER, Taiwan). The Monte Carlo method established in this paper was also employed to respectively simulate wall correction factors of the 192Ir air-kerma standard chambers used at the National Institute of Standards and Technology (NIST, USA) and the National Physical Laboratory (NPL, UK) for comparisons and verification. The chamber wall correction calculation results will be incorporated into INER's HDR 192Ir primary standard in the future. For the brachytherapy treatment in the esophagus or in the bronchi, the position of the isotope may have displacement in the cavity. Thus the delivered dose would differ from the prescribed dose in the treatment plan. We also tried assessing dose distribution due to the position displacement of HDR 192Ir brachytherapy source in a phantom with a central cavity by the Monte Carlo method. The calculated results could offer a clinical reference for the brachytherapy within the human organs with cavity. PMID:24222907

  5. Endocervical ultrasound applicator for integrated hyperthermia and HDR brachytherapy in the treatment of locally advanced cervical carcinoma

    PubMed Central

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

    2011-01-01

    Purpose: The clinical success of hyperthermia adjunct to radiotherapy depends on adequate temperature elevation in the tumor with minimal temperature rise in organs at risk. Existing technologies for thermal treatment of the cervix have limited spatial control or rapid energy falloff. The objective of this work is to develop an endocervical applicator using a linear array of multisectored tubular ultrasound transducers to provide 3-D conformal, locally targeted hyperthermia concomitant to radiotherapy in the uterine cervix. The catheter-based device is integrated within a HDR brachytherapy applicator to facilitate sequential and potentially simultaneous heat and radiation delivery. Methods: Treatment planning images from 35 patients who underwent HDR brachytherapy for locally advanced cervical cancer were inspected to assess the dimensions of radiation clinical target volumes (CTVs) and gross tumor volumes (GTVs) surrounding the cervix and the proximity of organs at risk. Biothermal simulation was used to identify applicator and catheter material parameters to adequately heat the cervix with minimal thermal dose accumulation in nontargeted structures. A family of ultrasound applicators was fabricated with two to three tubular transducers operating at 6.6–7.4 MHz that are unsectored (360°), bisectored (2×180°), or trisectored (3×120°) for control of energy deposition in angle and along the device length in order to satisfy anatomical constraints. The device is housed in a 6 mm diameter PET catheter with cooling water flow for endocervical implantation. Devices were characterized by measuring acoustic efficiencies, rotational acoustic intensity distributions, and rotational temperature distributions in phantom. Results: The CTV in HDR brachytherapy plans extends 20.5±5.0 mm from the endocervical tandem with the rectum and bladder typically <8 mm from the target boundary. The GTV extends 19.4±7.3 mm from the tandem. Simulations indicate that for 60 min

  6. Endocervical ultrasound applicator for integrated hyperthermia and HDR brachytherapy in the treatment of locally advanced cervical carcinoma

    SciTech Connect

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

    2011-02-15

    Purpose: The clinical success of hyperthermia adjunct to radiotherapy depends on adequate temperature elevation in the tumor with minimal temperature rise in organs at risk. Existing technologies for thermal treatment of the cervix have limited spatial control or rapid energy falloff. The objective of this work is to develop an endocervical applicator using a linear array of multisectored tubular ultrasound transducers to provide 3-D conformal, locally targeted hyperthermia concomitant to radiotherapy in the uterine cervix. The catheter-based device is integrated within a HDR brachytherapy applicator to facilitate sequential and potentially simultaneous heat and radiation delivery. Methods: Treatment planning images from 35 patients who underwent HDR brachytherapy for locally advanced cervical cancer were inspected to assess the dimensions of radiation clinical target volumes (CTVs) and gross tumor volumes (GTVs) surrounding the cervix and the proximity of organs at risk. Biothermal simulation was used to identify applicator and catheter material parameters to adequately heat the cervix with minimal thermal dose accumulation in nontargeted structures. A family of ultrasound applicators was fabricated with two to three tubular transducers operating at 6.6-7.4 MHz that are unsectored (360 deg.), bisectored (2x180 deg.), or trisectored (3x120 deg.) for control of energy deposition in angle and along the device length in order to satisfy anatomical constraints. The device is housed in a 6 mm diameter PET catheter with cooling water flow for endocervical implantation. Devices were characterized by measuring acoustic efficiencies, rotational acoustic intensity distributions, and rotational temperature distributions in phantom. Results: The CTV in HDR brachytherapy plans extends 20.5{+-}5.0 mm from the endocervical tandem with the rectum and bladder typically <8 mm from the target boundary. The GTV extends 19.4{+-}7.3 mm from the tandem. Simulations indicate that for 60

  7. Adaptive error detection for HDR/PDR brachytherapy: Guidance for decision making during real-time in vivo point dosimetry

    SciTech Connect

    Kertzscher, Gustavo Andersen, Claus E.; Tanderup, Kari

    2014-05-15

    Purpose: This study presents an adaptive error detection algorithm (AEDA) for real-timein vivo point dosimetry during high dose rate (HDR) or pulsed dose rate (PDR) brachytherapy (BT) where the error identification, in contrast to existing approaches, does not depend on an a priori reconstruction of the dosimeter position. Instead, the treatment is judged based on dose rate comparisons between measurements and calculations of the most viable dosimeter position provided by the AEDA in a data driven approach. As a result, the AEDA compensates for false error cases related to systematic effects of the dosimeter position reconstruction. Given its nearly exclusive dependence on stable dosimeter positioning, the AEDA allows for a substantially simplified and time efficient real-time in vivo BT dosimetry implementation. Methods: In the event of a measured potential treatment error, the AEDA proposes the most viable dosimeter position out of alternatives to the original reconstruction by means of a data driven matching procedure between dose rate distributions. If measured dose rates do not differ significantly from the most viable alternative, the initial error indication may be attributed to a mispositioned or misreconstructed dosimeter (false error). However, if the error declaration persists, no viable dosimeter position can be found to explain the error, hence the discrepancy is more likely to originate from a misplaced or misreconstructed source applicator or from erroneously connected source guide tubes (true error). Results: The AEDA applied on twoin vivo dosimetry implementations for pulsed dose rate BT demonstrated that the AEDA correctly described effects responsible for initial error indications. The AEDA was able to correctly identify the major part of all permutations of simulated guide tube swap errors and simulated shifts of individual needles from the original reconstruction. Unidentified errors corresponded to scenarios where the dosimeter position was

  8. Comparison of single and multiple dwell position methods in MammoSite high dose rate (HDR) brachytherapy planning.

    PubMed

    Kim, Yongbok; Trombetta, Mark G; Miften, Moyed

    2010-05-28

    The purpose of this study is to dosimetrically compare two plans generated using single dwell position method (SDPM) and multiple dwell position methods (MDPM) in MammoSite high dose rate (HDR) brachytherapy planning for 19 breast cancer patients. In computed tomography (CT) image-based HDR planning, a surface optimization technique was used in both methods. Following dosimetric parameters were compared for fraction 1 plans: %PTV_EVAL (planning target volume for plan evaluation) coverage, dose homogeneity index (DHI), dose con-formal index (COIN), maximum dose to skin and ipsilateral lung, and breast tissue volume receiving 150% (V150[cc]) and 200% (V200[cc]) of the prescribed dose. In addition, a plan was retrospectively generated for each fraction 2-10 to simulate the clinical situation where the fraction 1 plan was used for fractions 2-10 without modification. In order to create nine derived plans for each method and for each of the 19 patients, the catheter location and contours of target and critical structures were defined on the CT images acquired prior to each fraction 2-10, while using the same dwell-time distribution as used for fraction 1 (original plan). Interfraction dose variations were evaluated for 19 patients by comparing the derived nine plans (each for fractions 2-10) with the original plan (fraction 1) using the same dosimetric parameters used for fraction 1 plan comparison. For the fraction 1 plan comparison, the MDPM resulted in slightly increased %PTV_EVAL coverage, COIN, V150[cc] and V200[cc] values by an average of 1.2%, 0.025, 0.5 cc and 0.7cc, respectively, while slightly decreased DHI, maximum skin and ipsilateral lung dose by an average of 0.003, 3.2 cGy and 5.8 cGy, respectively. For the inter-fraction dose variation comparison, the SDPM resulted in slightly smaller variations in %PTV_EVAL coverage, DHI, maximum skin dose and V150[cc] values by an average of 0.4%, 0.0005, 0.5 cGy and 0.2 cc, respectively, while slightly higher average

  9. SU-F-P-42: “To Navigate, Or Not to Navigate: HDR BT in Recurrent Spine Lesions”

    SciTech Connect

    Voros, L; Cohen, G; Zaider, M; Yamada, Y

    2016-06-15

    Purpose: We compare the accuracy of HDR catheter placement for paraspinal lesions using O-arm CBCT imaging combined with StealthStation navigation and traditional fluoroscopically guided catheter placement. Methods: CT and MRI scans were acquired pre-treatment to outline the lesions and design treatment plans (pre-plans) to meet dosimetric constrains. The pre-planned catheter trajectories were transferred into the StealthStation Navigation system prior to the surgery. The StealthStation is an infra red (IR) optical navigation system used for guidance of surgical instruments. An intraoperative CBCT scan (O-arm) was acquired with reference IR optical fiducials anchored onto the patient and registered with the preplan image study to guide surgical instruments in relation to the patients’ anatomy and to place the brachytherapy catheters along the pre-planned trajectories. The final treatment plan was generated based on a 2nd intraoperative CBCT scan reflecting achieved implant geometry. The 2nd CBCT was later registered with the initial CT scan to compare the preplanned dwell positions with actual dwell positions (catheter placements). Similar workflow was used in placement of 8 catheters (1 patient) without navigation, but under fluoroscopy guidance in an interventional radiology suite. Results: A total of 18 catheters (3 patients) were placed using navigation assisted surgery. Average displacement of 0.66 cm (STD=0.37cm) was observed between the pre-plan source positions and actual source positions in the 3 dimensional space. This translates into an average 0.38 cm positioning error in one direction including registration errors, digitization errors, and the surgeons ability to follow the planned trajectory. In comparison, average displacement of non-navigated catheters was 0.50 cm (STD=0.22cm). Conclusion: Spinal lesion HDR brachytherapy planning is a difficult task. Catheter placement has a direct impact on target coverage and dose to critical structures. While

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

    NASA Astrophysics Data System (ADS)

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

    2011-07-01

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

  11. Dose Reduction Study in Vaginal Balloon Packing Filled With Contrast for HDR Brachytherapy Treatment;HDR; Uterine cervix cancer; Vaginal balloon packing; Contrast; Monte Carlo

    SciTech Connect

    Saini, Amarjit S.; Zhang, Geoffrey G.; Finkelstein, Steven E.; Biagioli, Matthew C.

    2011-07-15

    Purpose: Vaginal balloon packing is a means to displace organs at risk during high dose rate brachytherapy of the uterine cervix. We tested the hypothesis that contrast-filled vaginal balloon packing reduces radiation dose to organs at risk, such as the bladder and rectum, in comparison to water- or air-filled balloons. Methods and Materials: In a phantom study, semispherical vaginal packing balloons were filled with air, saline solution, and contrast agents. A high dose rate iridium-192 source was placed on the anterior surface of the balloon, and the diode detector was placed on the posterior surface. Dose ratios were taken with each material in the balloon. Monte Carlo (MC) simulations, by use of the MC computer program DOSXYZnrc, were performed to study dose reduction vs. balloon size and contrast material, including commercially available iodine- and gadolinium-based contrast agents. Results: Measured dose ratios on the phantom with the balloon radius of 3.4 cm were 0.922 {+-} 0.002 for contrast/saline solution and 0.808 {+-} 0.001 for contrast/air. The corresponding ratios by MC simulations were 0.895 {+-} 0.010 and 0.781 {+-} 0.010. The iodine concentration in the contrast was 23.3% by weight. The dose reduction of contrast-filled balloon ranges from 6% to 15% compared with water-filled balloon and 11% to 26% compared with air-filled balloon, with a balloon size range between 1.4 and 3.8 cm, and iodine concentration in contrast of 24.9%. The dose reduction was proportional to the contrast agent concentration. The gadolinium-based contrast agents showed less dose reduction because of much lower concentrations in their solutions. Conclusions: The dose to the posterior wall of the bladder and the anterior wall of the rectum can be reduced if the vaginal balloon is filled with contrast agent in comparison to vaginal balloons filled with saline solution or air.

  12. Development and implementation of a remote audit tool for high dose rate (HDR) Ir-192 brachytherapy using optically stimulated luminescence dosimetry

    PubMed Central

    Casey, Kevin E.; Alvarez, Paola; Kry, Stephen F.; Howell, Rebecca M.; Lawyer, Ann; Followill, David

    2013-01-01

    Purpose: The aim of this work was to create a mailable phantom with measurement accuracy suitable for Radiological Physics Center (RPC) audits of high dose-rate (HDR) brachytherapy sources at institutions participating in National Cancer Institute-funded cooperative clinical trials. Optically stimulated luminescence dosimeters (OSLDs) were chosen as the dosimeter to be used with the phantom. Methods: The authors designed and built an 8 × 8 × 10 cm3 prototype phantom that had two slots capable of holding Al2O3:C OSLDs (nanoDots; Landauer, Glenwood, IL) and a single channel capable of accepting all 192Ir HDR brachytherapy sources in current clinical use in the United States. The authors irradiated the phantom with Nucletron and Varian 192Ir HDR sources in order to determine correction factors for linearity with dose and the combined effects of irradiation energy and phantom characteristics. The phantom was then sent to eight institutions which volunteered to perform trial remote audits. Results: The linearity correction factor was kL = (−9.43 × 10−5 × dose) + 1.009, where dose is in cGy, which differed from that determined by the RPC for the same batch of dosimeters using 60Co irradiation. Separate block correction factors were determined for current versions of both Nucletron and Varian 192Ir HDR sources and these vendor-specific correction factors differed by almost 2.6%. For the Nucletron source, the correction factor was 1.026 [95% confidence interval (CI) = 1.023–1.028], and for the Varian source, it was 1.000 (95% CI = 0.995–1.005). Variations in lateral source positioning up to 0.8 mm and distal/proximal source positioning up to 10 mm had minimal effect on dose measurement accuracy. The overall dose measurement uncertainty of the system was estimated to be 2.4% and 2.5% for the Nucletron and Varian sources, respectively (95% CI). This uncertainty was sufficient to establish a ±5% acceptance criterion for source strength audits under a formal RPC

  13. TU-F-BRF-02: MR-US Prostate Registration Using Patient-Specific Tissue Elasticity Property Prior for MR-Targeted, TRUS-Guided HDR Brachytherapy

    SciTech Connect

    Yang, X; Rossi, P; Ogunleye, T; Jani, A; Curran, W; Liu, T

    2014-06-15

    Purpose: High-dose-rate (HDR) brachytherapy has become a popular treatment modality for prostate cancer. Conventional transrectal ultrasound (TRUS)-guided prostate HDR brachytherapy could benefit significantly from MR-targeted, TRUS-guided procedure where the tumor locations, acquired from the multiparametric MRI, are incorporated into the treatment planning. In order to enable this integration, we have developed a MR-TRUS registration with a patient-specific biomechanical elasticity prior. Methods: The proposed method used a biomechanical elasticity prior to guide the prostate volumetric B-spline deformation in the MRI and TRUS registration. The patient-specific biomechanical elasticity prior was generated using ultrasound elastography, where two 3D TRUS prostate images were acquired under different probe-induced pressures during the HDR procedure, which takes 2-4 minutes. These two 3D TRUS images were used to calculate the local displacement (elasticity map) of two prostate volumes. The B-spline transformation was calculated by minimizing the Euclidean distance between the normalized attribute vectors of the prostate surface landmarks on the MR and TRUS. This technique was evaluated through two studies: a prostate-phantom study and a pilot study with 5 patients undergoing prostate HDR treatment. The accuracy of our approach was assessed through the locations of several landmarks in the post-registration and TRUS images; our registration results were compared with the surface-based method. Results: For the phantom study, the mean landmark displacement of the proposed method was 1.29±0.11 mm. For the 5 patients, the mean landmark displacement of the surface-based method was 3.25±0.51 mm; our method, 1.71±0.25 mm. Therefore, our proposed method of prostate registration outperformed the surfaced-based registration significantly. Conclusion: We have developed a novel MR-TRUS prostate registration approach based on patient-specific biomechanical elasticity prior

  14. Development and implementation of a remote audit tool for high dose rate (HDR) Ir-192 brachytherapy using optically stimulated luminescence dosimetry

    SciTech Connect

    Casey, Kevin E.; Kry, Stephen F.; Howell, Rebecca M.; Followill, David; Alvarez, Paola; Lawyer, Ann

    2013-11-15

    Purpose: The aim of this work was to create a mailable phantom with measurement accuracy suitable for Radiological Physics Center (RPC) audits of high dose-rate (HDR) brachytherapy sources at institutions participating in National Cancer Institute-funded cooperative clinical trials. Optically stimulated luminescence dosimeters (OSLDs) were chosen as the dosimeter to be used with the phantom.Methods: The authors designed and built an 8 × 8 × 10 cm{sup 3} prototype phantom that had two slots capable of holding Al{sub 2}O{sub 3}:C OSLDs (nanoDots; Landauer, Glenwood, IL) and a single channel capable of accepting all {sup 192}Ir HDR brachytherapy sources in current clinical use in the United States. The authors irradiated the phantom with Nucletron and Varian {sup 192}Ir HDR sources in order to determine correction factors for linearity with dose and the combined effects of irradiation energy and phantom characteristics. The phantom was then sent to eight institutions which volunteered to perform trial remote audits.Results: The linearity correction factor was k{sub L}= (−9.43 × 10{sup −5}× dose) + 1.009, where dose is in cGy, which differed from that determined by the RPC for the same batch of dosimeters using {sup 60}Co irradiation. Separate block correction factors were determined for current versions of both Nucletron and Varian {sup 192}Ir HDR sources and these vendor-specific correction factors differed by almost 2.6%. For the Nucletron source, the correction factor was 1.026 [95% confidence interval (CI) = 1.023–1.028], and for the Varian source, it was 1.000 (95% CI = 0.995–1.005). Variations in lateral source positioning up to 0.8 mm and distal/proximal source positioning up to 10 mm had minimal effect on dose measurement accuracy. The overall dose measurement uncertainty of the system was estimated to be 2.4% and 2.5% for the Nucletron and Varian sources, respectively (95% CI). This uncertainty was sufficient to establish a ±5% acceptance

  15. Development and implementation of a remote audit tool for high dose rate (HDR) Ir-192 brachytherapy using optically stimulated luminescence dosimetry.

    PubMed

    Casey, Kevin E; Alvarez, Paola; Kry, Stephen F; Howell, Rebecca M; Lawyer, Ann; Followill, David

    2013-11-01

    The aim of this work was to create a mailable phantom with measurement accuracy suitable for Radiological Physics Center (RPC) audits of high dose-rate (HDR) brachytherapy sources at institutions participating in National Cancer Institute-funded cooperative clinical trials. Optically stimulated luminescence dosimeters (OSLDs) were chosen as the dosimeter to be used with the phantom. The authors designed and built an 8 × 8 × 10 cm(3) prototype phantom that had two slots capable of holding Al2O3:C OSLDs (nanoDots; Landauer, Glenwood, IL) and a single channel capable of accepting all (192)Ir HDR brachytherapy sources in current clinical use in the United States. The authors irradiated the phantom with Nucletron and Varian (192)Ir HDR sources in order to determine correction factors for linearity with dose and the combined effects of irradiation energy and phantom characteristics. The phantom was then sent to eight institutions which volunteered to perform trial remote audits. The linearity correction factor was kL = (-9.43 × 10(-5) × dose) + 1.009, where dose is in cGy, which differed from that determined by the RPC for the same batch of dosimeters using (60)Co irradiation. Separate block correction factors were determined for current versions of both Nucletron and Varian (192)Ir HDR sources and these vendor-specific correction factors differed by almost 2.6%. For the Nucletron source, the correction factor was 1.026 [95% confidence interval (CI) = 1.023-1.028], and for the Varian source, it was 1.000 (95% CI = 0.995-1.005). Variations in lateral source positioning up to 0.8 mm and distal∕proximal source positioning up to 10 mm had minimal effect on dose measurement accuracy. The overall dose measurement uncertainty of the system was estimated to be 2.4% and 2.5% for the Nucletron and Varian sources, respectively (95% CI). This uncertainty was sufficient to establish a ± 5% acceptance criterion for source strength audits under a formal RPC audit program. Trial

  16. Pre-test estimates of temperature decline for the LANL Fenton Hill Long-Term Flow Test

    SciTech Connect

    Robinson, B.A.; Kruger, P.

    1992-06-01

    Pre-test predications for the Long-Term Flow Test (LTFT) of the experimental Hot Dry Rock (HDR) reservoir at Fenton Hill were made using two models. Both models are dependent on estimates of the ``effective`` reservoir volume accessed by the fluid and the mean fracture spacing (MFS) of major joints for fluid flow. The effective reservoir volume was estimated using a variety of techniques, and the range of values for the MFS was set through experience in modeling the thermal cooldown of other experimental HDR reservoirs. The two pre-test predictions for cooldown to 210{degrees}C (a value taken to compare the models) from initial temperature of 240{degrees}C are 6.1 and 10.7 years. Assuming that a minimum of 10{degrees}C is required to provide an unequivocal indication of thermal cooldown, both models predict that the reservoir will not exhibit observable cooldown for at least two years.

  17. Comparison of organ doses for patients undergoing balloon brachytherapy of the breast with HDR 192Ir or electronic sources using monte carlo simulations in a heterogeneous human phantom.

    PubMed

    Mille, Matthew M; Xu, X George; Rivard, Mark J

    2010-02-01

    Accelerated partial breast irradiation via interstitial balloon brachytherapy is a fast and effective treatment method for certain early stage breast cancers. The radiation can be delivered using a conventional high-dose rate (HDR) 192Ir gamma-emitting source or a novel electronic brachytherapy (eBx) source which uses lower energy x rays that do not penetrate as far within the patient. A previous study [A. Dickler, M. C. Kirk, N. Seif, K. Griem, K. Dowlatshahi, D. Francescatti, and R. A. Abrams, "A dosimetric comparison of MammoSite high-dose-rate brachytherapy and Xoft Axxent electronic brachytherapy," Brachytherapy 6, 164-168 (2007)] showed that the target dose is similar for HDR 192Ir and eBx. This study compares these sources based on the dose received by healthy organs and tissues away from the treatment site. A virtual patient with left breast cancer was represented by a whole-body, tissue-heterogeneous female voxel phantom. Monte Carlo methods were used to calculate the dose to healthy organs in a virtual patient undergoing balloon brachytherapy of the left breast with HDR 192Ir or eBx sources. The dose-volume histograms for a few organs which received large doses were also calculated. Additional simulations were performed with all tissues in the phantom defined as water to study the effect of tissue inhomogeneities. For both HDR 192Ir and eBx, the largest mean organ doses were received by the ribs, thymus gland, left lung, heart, and sternum which were close to the brachytherapy source in the left breast, eBx yielded mean healthy organ doses that were more than a factor of approximately 1.4 smaller than for HDR 192Ir for all organs considered, except for the three closest ribs. Excluding these ribs, the average and median dose-reduction factors were approximately 28 and approximately 11, respectively. The volume distribution of doses in nearby soft tissue organs that were outside the PTV were also improved with eBx. However, the maximum dose to the closest

  18. Acute genitourinary toxicity after high dose rate (HDR) brachytherapy combined with hypofractionated external-beam radiation therapy for localized prostate cancer: Second analysis to determine the correlation between the urethral dose in HDR brachytherapy and the severity of acute genitourinary toxicity

    SciTech Connect

    Akimoto, Tetsuo . E-mail: takimoto@showa.gunma-u.ac.jp; Katoh, Hiroyuki; Noda, Shin-ei; Ito, Kazuto; Yamamoto, Takumi; Kashiwagi, Bunzo; Nakano, Takashi

    2005-10-01

    Purpose: We have been treating localized prostate cancer with high-dose-rate (HDR) brachytherapy combined with hypofractionated external beam radiation therapy (EBRT) at our institution. We recently reported the existence of a correlation between the severity of acute genitourinary (GU) toxicity and the urethral radiation dose in HDR brachytherapy by using different fractionation schema. The purpose of this study was to evaluate the role of the urethral dose in the development of acute GU toxicity more closely than in previous studies. For this purpose, we conducted an analysis of patients who had undergone HDR brachytherapy with a fixed fractionation schema combined with hypofractionated EBRT. Methods and Materials: Among the patients with localized prostate cancer who were treated by 192-iridium HDR brachytherapy combined with hypofractionated EBRT at Gunma University Hospital between August 2000 and November 2004, we analyzed 67 patients who were treated by HDR brachytherapy with the fractionation schema of 9 Gy x two times combined with hypofractionated EBRT. Hypofractionated EBRT was administered at a fraction dose of 3 Gy three times weekly, and a total dose of 51 Gy was delivered to the prostate gland and seminal vesicles using the four-field technique. No elective pelvic irradiation was performed. After the completion of EBRT, all the patients additionally received transrectal ultrasonography-guided HDR brachytherapy. The planning target volume was defined as the prostate gland with a 5-mm margin all around, and the planning was conducted based on computed tomography images. The tumor stage was T1c in 13 patients, T2 in 31 patients, and T3 in 23 patients. The Gleason score was 2-6 in 12 patients, 7 in 34 patients, and 8-10 in 21 patients. Androgen ablation was performed in all the patients. The median follow-up duration was 11 months (range 3-24 months). The toxicities were graded based on the Radiation Therapy Oncology Group and the European Organization

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

    PubMed

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

    2012-06-01

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

  20. SU-E-T-310: Dosimetric Comparison of Tandem and Ovoid (TO) Vs. Tandem and Ring (TR) Applicators in High-Dose Rate (HDR) Brachytherapy (BT) for the Treatment of Locally-Advanced Cervical-Cancer

    SciTech Connect

    Kuo, L; Viswanathan, A; Damato, A

    2015-06-15

    Purpose: To investigate the dosimetric differences associated with the use of TO or TR applicators for cervical-cancer HDR BT. Methods: The records of all cervical-cancer patients treated with image-guided HDR BT in 2013 were reviewed. Image-based planning based on isodose line and DVH metrics inspections was performed following the GEC-ESTRO recommendations. CTV volume, CTV D90, and rectum, bladder and sigmoid D2cc were collected as % of the prescription dose (80Gy EQD2). Patients receiving both TO and TR were identified and plans were compared (paired analysis). A Student T-test was used to evaluate statistical significance (p ≤ 0.05). Results: Twenty-eight patients were identified (20 TR only, 4 TO only, 4 TO and TR), associated with 116 plans (109 TR, 7 TO). Overall metrics: CTV volume, 26.5±10.4 cm3 (TR) and 39.1±14.0 cm3 (TO, p < 0.01); CTV D90, 126±28% (TR) and 110±15% (TO, p = 0.15); rectum D2cc, 56±11% (TR) and 58±19% (TO, p = 0.91); bladder D2cc, 74±20% (TR) and 88±19% (TO, p = 0.09); sigmoid D2cc, 52±17% (TR) and 49±20% (TO, p = 0.63). The paired analysis results were: CTV volume, 37.3±11.9 cm3 (TR) and 51.0±23.1 cm3 (TO, p = 0.23); CTV D90, 111±12% (TR) and 101±17% (TO, p = 0.50); rectum D2cc, 56±12% (TR) and 53±16% (TO, p = 0.71); bladder D2cc, 73±14% (TR) and 90±20% (TO, p = 0.22); sigmoid D2cc, 59±10% (TR) and 59±22% (TO, p = 0.98). Conclusion: TR and TO were both used with good dosimetric results. TO were used for patients with larger CTV volumes than TR, although paired analysis suggest that tissue distortion and contouring bias may partially explain this Result. CTV D90 on average > 80 Gy EQD2 were achieved in both groups despite the different CTV volume. Higher bladder D2cc for TO than TR was observed.

  1. The FlxABCD-HdrABC proteins correspond to a novel NADH dehydrogenase/heterodisulfide reductase widespread in anaerobic bacteria and involved in ethanol metabolism in Desulfovibrio vulgaris Hildenborough.

    PubMed

    Ramos, Ana Raquel; Grein, Fabian; Oliveira, Gonçalo P; Venceslau, Sofia S; Keller, Kimberly L; Wall, Judy D; Pereira, Inês A C

    2015-07-01

    Flavin-based electron bifurcation (FBEB) is an important mechanism for the energy metabolism of anaerobes. A new family of NADH dehydrogenases, the flavin oxidoreductase (FlxABCD, previously called FloxABCD), was proposed to perform FBEB in sulphate-reducing organisms coupled with heterodisulfide reductase (HdrABC). We found that the hdrABC-flxABCD gene cluster is widespread among anaerobic bacteria, pointing to a general and important role in their bioenergetics. In this work, we studied FlxABCD of Desulfovibrio vulgaris Hildenborough. The hdr-flx genes are part of the same transcriptional unit and are increased in transcription during growth in ethanol-sulfate, and to a less extent during pyruvate fermentation. Two mutant strains were generated: one where expression of the hdr-flx genes was interrupted and another lacking the flxA gene. Both strains were unable to grow with ethanol-sulfate, whereas growth was restored in a flxA-complemented strain. The mutant strains also produced very reduced amounts of ethanol compared with the wild type during pyruvate fermentation. Our results show that in D. vulgaris, the FlxABCD-HdrABC proteins are essential for NADH oxidation during growth on ethanol, probably involving a FBEB mechanism that leads to reduction of ferredoxin and the small protein DsrC, while in fermentation they operate in reverse, reducing NAD(+) for ethanol production.

  2. Development of a water calorimetry-based standard for absorbed dose to water in HDR {sup 192}Ir brachytherapy

    SciTech Connect

    Sarfehnia, Arman; Seuntjens, Jan

    2010-04-15

    Purpose: The aim of this article is to develop and evaluate a primary standard for HDR {sup 192}Ir brachytherapy based on 4 deg. C stagnant water calorimetry. Methods: The absolute absorbed dose to water was directly measured for several different Nucletron microSelectron {sup 192}Ir sources of air kerma strength ranging between 21 000 and 38 000 U and for source-to-detector separations ranging between 25 and 70 mm. The COMSOL MULTIPHYSICS software was used to accurately calculate the heat transport in a detailed model geometry. Through a coupling of the ''conduction and convection'' module with the ''Navier-Stokes incompressible fluid'' module in the software, both the conductive and convective effects were modeled. Results: A detailed uncertainty analysis resulted in an overall uncertainty in the absorbed dose of 1.90%(1{sigma}). However, this includes a 1.5% uncertainty associated with a nonlinear predrift correction which can be substantially reduced if sufficient time is provided for the system to come to a new equilibrium in between successive calorimetric runs, an opportunity not available to the authors in their clinical setting due to time constraints on the machine. An average normalized dose rate of 361{+-}7 {mu}Gy/(h U) at a source-to-detector separation of 55 mm was measured for the microSelectron {sup 192}Ir source based on water calorimetry. The measured absorbed dose per air kerma strength agreed to better than 0.8%(1{sigma}) with independent ionization chamber and EBT-1 Gafchromic film reference dosimetry as well as with the currently accepted AAPM TG-43 protocol measurements. Conclusions: This work paves the way toward a primary absorbed dose to water standard in {sup 192}Ir brachytherapy.

  3. Evaluation of linear array MOSFET detectors for in vivo dosimetry to measure rectal dose in HDR brachytherapy.

    PubMed

    Haughey, Aisling; Coalter, George; Mugabe, Koki

    2011-09-01

    The study aimed to assess the suitability of linear array metal oxide semiconductor field effect transistor detectors (MOSFETs) as in vivo dosimeters to measure rectal dose in high dose rate brachytherapy treatments. The MOSFET arrays were calibrated with an Ir192 source and phantom measurements were performed to check agreement with the treatment planning system. The angular dependence, linearity and constancy of the detectors were evaluated. For in vivo measurements two sites were investigated, transperineal needle implants for prostate cancer and Fletcher suites for cervical cancer. The MOSFETs were inserted into the patients' rectum in theatre inside a modified flatus tube. The patients were then CT scanned for treatment planning. Measured rectal doses during treatment were compared with point dose measurements predicted by the TPS. The MOSFETs were found to require individual calibration factors. The calibration was found to drift by approximately 1% ±0.8 per 500 mV accumulated and varies with distance from source due to energy dependence. In vivo results for prostate patients found only 33% of measured doses agreed with the TPS within ±10%. For cervix cases 42% of measured doses agreed with the TPS within ±10%, however of those not agreeing variations of up to 70% were observed. One of the most limiting factors in this study was found to be the inability to prevent the MOSFET moving internally between the time of CT and treatment. Due to the many uncertainties associated with MOSFETs including calibration drift, angular dependence and the inability to know their exact position at the time of treatment, we consider them to be unsuitable for in vivo dosimetry in rectum for HDR brachytherapy.

  4. The effect of patient inhomogeneities in oesophageal 192Ir HDR brachytherapy: a Monte Carlo and analytical dosimetry study.

    PubMed

    Anagnostopoulos, G; Baltas, D; Pantelis, E; Papagiannis, P; Sakelliou, L

    2004-06-21

    The effect of patient inhomogeneities surrounding the oesophagus on the dosimetry planning of an upper thoracic oesophageal 192Ir HDR brachytherapy treatment is studied. The MCNPX Monte Carlo code is used for dosimetry in a patient-equivalent phantom geometry and results are compared in terms of isodose contours as well as dose volume histograms with corresponding calculations by a contemporary treatment planning system software featuring a full TG-43 dose calculation algorithm (PLATO BPS version 14.2.4). It is found that the presence of patient inhomogeneities does not alter the delivery of the planned dose distribution to the planning treatment volume. Regarding the organs at risk, the common practice of current treatment planning systems (TPSs) to consider the patient geometry as a homogeneous water medium leads to a dose overestimation of up to 13% to the spinal cord and an underestimation of up to 15% to the sternum bone. These findings which correspond to the dose region of about 5-10% of the prescribed dose could only be of significance when brachytherapy is used as a boost to external beam therapy. Additionally, an analytical dosimetry model, which is efficient in calculating dose in mathematical phantoms containing inhomogeneity shells of materials of radiobiological interest, is utilized for dosimetry in the patient-equivalent inhomogeneous phantom geometry. Analytical calculations in this work are in good agreement with corresponding Monte Carlo results within the bone inhomogeneities of spinal cord and sternum bone but, like treatment planning system calculations, the model fails to predict the dose distribution in the proximal lung surface as well as within the lungs just as the TPS does, due to its inherent limitation in treating lateral scatter and backscatter radiation.

  5. Comparison between beta radiation dose distribution due to LDR and HDR ocular brachytherapy applicators using GATE Monte Carlo platform.

    PubMed

    Mostafa, Laoues; Rachid, Khelifi; Ahmed, Sidi Moussa

    2016-08-01

    Eye applicators with 90Sr/90Y and 106Ru/106Rh beta-ray sources are generally used in brachytherapy for the treatment of eye diseases as uveal melanoma. Whenever, radiation is used in treatment, dosimetry is essential. However, knowledge of the exact dose distribution is a critical decision-making to the outcome of the treatment. The Monte Carlo technique provides a powerful tool for calculation of the dose and dose distributions which helps to predict and determine the doses from different shapes of various types of eye applicators more accurately. The aim of this work consisted in using the Monte Carlo GATE platform to calculate the 3D dose distribution on a mathematical model of the human eye according to international recommendations. Mathematical models were developed for four ophthalmic applicators, two HDR 90Sr applicators SIA.20 and SIA.6, and two LDR 106Ru applicators, a concave CCB model and a flat CCB model. In present work, considering a heterogeneous eye phantom and the chosen tumor, obtained results with the use of GATE for mean doses distributions in a phantom and according to international recommendations show a discrepancy with respect to those specified by the manufacturers. The QC of dosimetric parameters shows that contrarily to the other applicators, the SIA.20 applicator is consistent with recommendations. The GATE platform show that the SIA.20 applicator present better results, namely the dose delivered to critical structures were lower compared to those obtained for the other applicators, and the SIA.6 applicator, simulated with MCNPX generates higher lens doses than those generated by GATE.

  6. A fast multitarget inverse treatment planning strategy optimizing dosimetric measures for high-dose-rate (HDR) brachytherapy.

    PubMed

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

    2017-09-01

    In this study, we introduce a novel, fast, inverse treatment planning strategy for interstitial high-dose-rate (HDR) brachytherapy with multiple regions of interest solely based on dose-volume-histogram-related dosimetric measures (DMs). We present a new problem formulation of the objective function that approximates the indicator variables of the standard DM optimization problem with a smooth logistic function. This problem is optimized by standard gradient-based methods. The proposed approach is then compared against state-of-the-art optimization strategies. All generated plans fulfilled prescribed DMs for all organs at risk. Compared to clinical practice, a statistically significant improvement (p=0.01) in coverage of target structures was achieved. Simultaneously, DMs representing high-dose regions were significantly reduced (p=0.01). The novel optimization strategies run-time was (0.8 ± 0.3) s and thus outperformed the best competing strategies of the state of the art. In addition, the novel DM-based approach was associated with a statistically significant (p=0.01) increase in the number of active dwell positions and a decrease in the maximum dwell time. The generated plans showed a clinically significant increase in target coverage with fewer hot spots, with an optimization time approximately three orders of magnitude shorter than manual optimization currently used in clinical practice. As optimization is solely based on DMs, intuitive, interactive, real-time treatment planning, which motivated the adoption of manual optimization in our clinic, is possible. © 2017 American Association of Physicists in Medicine.

  7. Direct measurement of absorbed dose to water in HDR {sup 192}Ir brachytherapy: Water calorimetry, ionization chamber, Gafchromic film, and TG-43

    SciTech Connect

    Sarfehnia, Arman; Kawrakow, Iwan; Seuntjens, Jan

    2010-04-15

    Purpose: Gafchromic film and ionometric calibration procedures for HDR {sup 192}Ir brachytherapy sources in terms of dose rate to water are presented and the experimental results are compared to the TG-43 protocol as well as with the absolute dose measurement results from a water calorimetry-based primary standard. Methods: EBT-1 Gafchromic films, an A1SL Exradin miniature Shonka thimble type chamber, and an SI HDR 1000 Plus well-type chamber (Standard Imaging, Inc., Middleton, WI) with an ADCL traceable S{sub k} calibration coefficient (following the AAPM TG-43 protocol) were used. The Farmer chamber and Gafchromic film measurements were performed directly in water. All results were compared to direct and absolute absorbed dose to water measurements from a 4 deg. C stagnant water calorimeter. Results: Based on water calorimetry, the authors measured the dose rate to water to be 361{+-}7 {mu}Gy/(h U) at a 55 mm source-to-detector separation. The dose rate normalized to air-kerma strength for all the techniques agree with the water calorimetry results to within 0.83%. The overall 1-sigma uncertainty on water calorimetry, ionization chamber, Gafchromic film, and TG-43 dose rate measurement amounts to 1.90%, 1.44%, 1.78%, and 2.50%, respectively. Conclusions: This work allows us to build a more realistic uncertainty estimate for absorbed dose to water determination using the TG-43 protocol. Furthermore, it provides the framework necessary for a shift from indirect HDR {sup 192}Ir brachytherapy dosimetry to a more accurate, direct, and absolute measurement of absorbed dose to water.

  8. A dosimetric comparison of 169Yb and 192Ir for HDR brachytherapy of the breast, accounting for the effect of finite patient dimensions and tissue inhomogeneities.

    PubMed

    Lymperopoulou, G; Papagiannis, P; Angelopoulos, A; Karaiskos, P; Georgiou, E; Baltas, D

    2006-12-01

    Monte Carlo simulation dosimetry is used to compare 169Yb to 192Ir for breast high dose rate (HDR) brachytherapy applications using multiple catheter implants. Results for bare point sources show that while 169Yb delivers a greater dose rate per unit air kerma strength at the radial distance range of interest to brachytherapy in homogeneous water phantoms, it suffers a greater dose rate deficit in missing scatter conditions relative to 192Ir. As a result of these two opposing factors, in the scatter conditions defined by the presence of the lung and the finite patient dimensions in breast brachytherapy the dose distributions calculated in a patient equivalent mathematical phantom by Monte Carlo simulations for the same implant of either 169Yb or 1921r commercially available sources are found comparable. Dose volume histogram results support that 169Yb could be at least as effective as 192Ir delivering the same dose to the lung and slightly reduced dose to the breast skin. The current treatment planning systems' approach of employing dosimetry data precalculated in a homogeneous water phantom of given shape and dimensions, however, is shown to notably overestimate the delivered dose distribution for 169Yb. Especially at the skin and the lung, the treatment planning system dose overestimation is on the order of 15%-30%. These findings do not undermine the potential of 169Yb HDR sources for breast brachytherapy relative to the most commonly used 192Ir HDR sources. They imply, however, that there could be a need for the amendment of dose calculation algorithms employed in clinical treatment planning of particular brachytherapy applications, especially for intermediate photon energy sources such as 169Yb.

  9. SU-C-BRD-02: A Team Focused Clinical Implementation and Failure Mode and Effects Analysis of HDR Skin Brachytherapy Using Valencia and Leipzig Surface Applicators

    SciTech Connect

    Sayler, E; Harrison, A; Eldredge-Hindy, H; Dinome, J; Munro, S; Anne, R; Comber, E; Lockamy, V

    2014-06-15

    Purpose: and Leipzig applicators (VLAs) are single-channel brachytherapy surface applicators used to treat skin lesions up to 2cm diameter. Source dwell times can be calculated and entered manually after clinical set-up or ultrasound. This procedure differs dramatically from CT-based planning; the novelty and unfamiliarity could lead to severe errors. To build layers of safety and ensure quality, a multidisciplinary team created a protocol and applied Failure Modes and Effects Analysis (FMEA) to the clinical procedure for HDR VLA skin treatments. Methods: team including physicists, physicians, nurses, therapists, residents, and administration developed a clinical procedure for VLA treatment. The procedure was evaluated using FMEA. Failure modes were identified and scored by severity, occurrence, and detection. The clinical procedure was revised to address high-scoring process nodes. Results: Several key components were added to the clinical procedure to minimize risk probability numbers (RPN): -Treatments are reviewed at weekly QA rounds, where physicians discuss diagnosis, prescription, applicator selection, and set-up. Peer review reduces the likelihood of an inappropriate treatment regime. -A template for HDR skin treatments was established in the clinical EMR system to standardize treatment instructions. This reduces the chances of miscommunication between the physician and planning physicist, and increases the detectability of an error during the physics second check. -A screen check was implemented during the second check to increase detectability of an error. -To reduce error probability, the treatment plan worksheet was designed to display plan parameters in a format visually similar to the treatment console display. This facilitates data entry and verification. -VLAs are color-coded and labeled to match the EMR prescriptions, which simplifies in-room selection and verification. Conclusion: Multidisciplinary planning and FMEA increased delectability and

  10. SU-E-T-413: Examining Acquisition Rate for Using MatriXX Ion Chamber Array to Measure HDR Brachytherapy Treatments

    SciTech Connect

    Wagar, M; Bhagwat, M; O’Farrell, D; Friesen, S; Buzurovic, I; Damato, A; Devlin, P; Cormack, R

    2015-06-15

    Purpose: There are unique obstacles to implementing the MatriXX ionchamber array as a QA tool in Brachytherapy given that the device is designed for use in the MV energy range. One of the challenges we investigate is the affect of acquisition rates on dose measurement accuracy for HDR treatment plans. Methods: A treatment plan was optimized in Oncentra Brachy TPS to deliver a planar dose to a 5×5cm region at 10mm depth. The applicator was affixed to the surface of the MatriXX array. The plan was delivered multiple times using a Nucleatron HDR afterloader with a 2.9Ci Ir192 source. For each measurement the sampling rate of the MatriXX movie mode was varied (30ms and 500ms). This experiment was repeated with identical parameters, following a source exchange, with an 11.2Ci Ir192 source. Finally, a single snap measurement was acquired. Analysis was preformed to evaluate the fidelity of the dose delivery for each iteration of the experiment. Evaluation was based on the comparison between the measured and TPS predicted dose. Results: Higher sample rates induce a greater discrepancy between the predicted and measured dose. Delivering the plan using a lower activity source also produced greater discrepancy in the measurement due to the increased delivery time. Analyzing the single snap measurement showed little difference from the 500ms integral dose measurement. Conclusion: The advantage of using movie mode for HDR treatment delivery QA is the ability for real time source tracking in addition to dose measurement. Our analysis indicates that 500ms is an optimal frame rate.

  11. Nationwide multi-institutional retrospective analysis of high-dose-rate brachytherapy combined with external beam radiotherapy for localized prostate cancer: An Asian Prostate HDR-BT Consortium.

    PubMed

    Ishiyama, Hiromichi; Kamitani, Nobuhiko; Kawamura, Hidemasa; Kato, Shingo; Aoki, Manabu; Kariya, Shinji; Matsumura, Taisei; Kaidu, Motoki; Yoshida, Ken; Hashimoto, Yaichiro; Noda, Yasutaka; Lim, Keith H C; Kawase, Takatsugu; Takahashi, Takeo; Inaba, Koji; Kumano, Motoyasu; Yoshikawa, Nobuhiko; Yoshioka, Yasuo; Nakamura, Katsumasa; Hiratsuka, Junichi; Itami, Jun; Hayakawa, Kazushige

    To report outcomes and risk factors of high-dose-rate (HDR) brachytherapy combined with external beam radiotherapy with or without androgen deprivation therapy (ADT) in prostate cancer patients. This multi-institutional retrospective analysis comprised 3424 patients with localized prostate cancer at 16 Asian hospitals. One-thirds (27.7%) of patients received only neoadjuvant ADT, whereas almost half (49.5%) of patients received both neoadjuvant and adjuvant ADT. Mean duration of neoadjuvant and adjuvant ADT were 8.6 months and 27.9 months, respectively. Biochemical failure was defined by Phoenix ASTRO consensus. Biochemical control rate, clinical disease-free survival (cDFS), cause-specific survival, and overall survival (OS) were calculated. Median followup was 66 months. Ten-year biochemical control, cDFS, cause-specific survival, and OS rate were 81.4%, 81.0%, 97.2%, and 85.6%, respectively. Receiving both neoadjuvant and adjuvant ADT was detected as a favorable factor for biochemical control, cDFS, and OS, but pelvic irradiation was detected as an adverse factor for cause-specific survival, and OS. Ten-year cumulative rates of late Grade ≥2 genitourinary and gastrointestinal toxicities were 26.8% and 4.1%, respectively; receiving both neoadjuvant and adjuvant ADT was detected as a favorable factor for preventing both toxicities. HDR combined with external beam radiotherapy was an effective and safe treatment for localized prostate cancer. Combination of long-term ADT was suggested to be necessary, even for HDR brachytherapy, and was useful in suppressing late toxicities. Meanwhile, pelvic irradiation was suggested to have an adverse effect on OS of our study population. Copyright © 2017 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  12. The IPEM code of practice for determination of the reference air kerma rate for HDR (192)Ir brachytherapy sources based on the NPL air kerma standard.

    PubMed

    Bidmead, A M; Sander, T; Locks, S M; Lee, C D; Aird, E G A; Nutbrown, R F; Flynn, A

    2010-06-07

    This paper contains the recommendations of the high dose rate (HDR) brachytherapy working party of the UK Institute of Physics and Engineering in Medicine (IPEM). The recommendations consist of a Code of Practice (COP) for the UK for measuring the reference air kerma rate (RAKR) of HDR (192)Ir brachytherapy sources. In 2004, the National Physical Laboratory (NPL) commissioned a primary standard for the realization of RAKR of HDR (192)Ir brachytherapy sources. This has meant that it is now possible to calibrate ionization chambers directly traceable to an air kerma standard using an (192)Ir source (Sander and Nutbrown 2006 NPL Report DQL-RD 004 (Teddington: NPL) http://publications.npl.co.uk). In order to use the source specification in terms of either RAKR, Κ(R) (ICRU 1985 ICRU Report No 38 (Washington, DC: ICRU); ICRU 1997 ICRU Report No 58 (Bethesda, MD: ICRU)), or air kerma strength, S(K) (Nath et al 1995 Med. Phys. 22 209-34), it has been necessary to develop algorithms that can calculate the dose at any point around brachytherapy sources within the patient tissues. The AAPM TG-43 protocol (Nath et al 1995 Med. Phys. 22 209-34) and the 2004 update TG-43U1 (Rivard et al 2004 Med. Phys. 31 633-74) have been developed more fully than any other protocol and are widely used in commercial treatment planning systems. Since the TG-43 formalism uses the quantity air kerma strength, whereas this COP uses RAKR, a unit conversion from RAKR to air kerma strength was included in the appendix to this COP. It is recommended that the measured RAKR determined with a calibrated well chamber traceable to the NPL (192)Ir primary standard is used in the treatment planning system. The measurement uncertainty in the source calibration based on the system described in this COP has been reduced considerably compared to other methods based on interpolation techniques.

  13. Inferring mechanical resonances in micro- and nanocantilevers using the harmonic detection of resonance (HDR) method to develop a novel sensing platform

    NASA Astrophysics Data System (ADS)

    Keskar, Gayatri

    During the past two decades, advances in microelectromechanical systems (MEMS) have spurred efforts worldwide to develop sensing platforms based on smart microcantilevers. A microcantilever beam is one of the simplest MEMS structures which forms the basis for portable, fast and highly sensitive schemes that are capable of measuring small deflections in static or dynamic response due to changes in external parameters such as mass, pressure, charge, etc. In this dissertation, I mainly focus on MEMS sensors with transducers in the form of microcantilevers. Variations in the microcantilever's response such as resonant frequency, amplitude, phase and quality factor when exposed to external stimuli are measured. Recently, we have developed a fully electrical sensing platform called the harmonic detection of resonance (HDR) method by which a silicon microcantilever (or a multiwalled carbon nanotube) can be electrically actuated and its resonance parameters electrically detected [4, 5] through capacitance changes. It is well known that a large interfering signal coming from the inherent parasitic capacitance in the circuit at the driving frequency O, is present in the platforms which use the capacitive readout method. However, we found that by driving the cantilever at O and detecting its response at higher harmonics of O, the parasitic capacitance can be avoided, facilitating the measurement of dynamic capacitance with high sensitivity in micro and nano-cantilevers [1, 2]. A significant part of this dissertation is devoted to the study of the nonlinear dynamics of microcantilevers under varying gas environments and pressures using HDR [3]. I also discuss the characteristics of an electrostatically driven microcantilever which exhibits Duffing-like behavior using HDR. The first experimental demonstration of its potential use as a highly sensitive sensing platform is discussed. [4]. We also discuss the behavior of an unfunctionalized microcantilever sensor which can be used

  14. Temporo-spatial cell-cycle kinetics in HeLa cells irradiated by Ir-192 high dose-rate remote afterloading system (HDR-RALS).

    PubMed

    Asahina, Taito; Kaida, Atsushi; Goto, Tatsuaki; Yoshimura, Ryo-Ichi; Sasai, Keisuke; Miura, Masahiko

    2016-07-29

    Intracavitary irradiation plays a pivotal role in definitive radiotherapy for cervical cancer, and the Ir-192 high dose-rate remote afterloading system (HDR-RALS) is often used for this purpose. Under this condition, tumor tissues receive remarkably different absorption doses, with a steep gradient, depending on distance from the radiation source. To obtain temporo-spatial information regarding cell-cycle kinetics in cervical cancer following irradiation by Ir-192 HDR-RALS, we examined HeLa cells expressing the fluorescence ubiquitination-based cell cycle indicator (Fucci), which allowed us to visualize cell-cycle progression. HeLa-Fucci cells, which emit red and green fluorescence in G1 and S/G2/M phases, respectively, were grown on 35-mm dishes and irradiated by Ir-192 HDR-RALS under normoxic and hypoxic conditions. A 6 French (Fr) catheter was used as an applicator. A radiation dose of 6 Gy was prescribed at hypothetical treatment point A, located 20 mm from the radiation source. Changes in Fucci fluorescence after irradiation were visualized for cells from 5 to 20 mm from the Ir-192 source. Several indices, including first green phase duration after irradiation (FGPD), were measured by analysis of time-lapse images. Cells located 5 to 20 mm from the Ir-192 source became green, reflecting arrest in G2, in a similar manner up to 12 h after irradiation; at more distant positions, however, cells were gradually released from the G2 arrest and became red. This could be explained by the observation that the FGPD was longer for cells closer to the radiation source. Detailed observation revealed that FGPD was significantly longer in cells irradiated in the green phase than in the red phase at positions closer to the Ir-192 source. Unexpectedly, the FGPD was significantly longer after irradiation under hypoxia than normoxia, due in large part to the elongation of FGPD in cells irradiated in the red phase. Using HeLa-Fucci cells, we obtained the first temporo

  15. A statistical approach to infer the minimum setup distance of a well chamber to the wall or to the floor for {sup 192}Ir HDR calibration

    SciTech Connect

    Chang Liyun; Ho, S.-Y.; Chui, C.-S.; Lee, J.-H.; Du Yichun; Chen Tainsong

    2008-06-15

    We propose a new method based on statistical analysis technique to determine the minimum setup distance of a well chamber used in the calibration of {sup 192}Ir high dose rate (HDR). The chamber should be placed at least this distance away from any wall or from the floor in order to mitigate the effect of scatter. Three different chambers were included in this study, namely, Sun Nuclear Corporation, Nucletron, and Standard Imaging. The results from this study indicated that the minimum setup distance varies depending on the particular chamber and the room architecture in which the chamber was used. Our result differs from that of a previous study by Podgorsak et al. [Med. Phys. 19, 1311-1314 (1992)], in which 25 cm was suggested, and also differs from that of the International Atomic Energy Agency (IAEA)-TECDOC-1079 report, which suggested 30 cm. The new method proposed in this study may be considered as an alternative approach to determine the minimum setup distance of a well-type chamber used in the calibration of {sup 192}Ir HDR.

  16. 3D workflow for HDR image capture of projection systems and objects for CAVE virtual environments authoring with wireless touch-sensitive devices

    NASA Astrophysics Data System (ADS)

    Prusten, Mark J.; McIntyre, Michelle; Landis, Marvin

    2006-02-01

    A 3D workflow pipeline is presented for High Dynamic Range (HDR) image capture of projected scenes or objects for presentation in CAVE virtual environments. The methods of HDR digital photography of environments vs. objects are reviewed. Samples of both types of virtual authoring being the actual CAVE environment and a sculpture are shown. A series of software tools are incorporated into a pipeline called CAVEPIPE, allowing for high-resolution objects and scenes to be composited together in natural illumination environments [1] and presented in our CAVE virtual reality environment. We also present a way to enhance the user interface for CAVE environments. The traditional methods of controlling the navigation through virtual environments include: glove, HUD's and 3D mouse devices. By integrating a wireless network that includes both WiFi (IEEE 802.11b/g) and Bluetooth (IEEE 802.15.1) protocols the non-graphical input control device can be eliminated. Therefore wireless devices can be added that would include: PDA's, Smart Phones, TabletPC's, Portable Gaming consoles, and PocketPC's.

  17. Monte Carlo study of the impact of a magnetic field on the dose distribution in MRI-guided HDR brachytherapy using Ir-192

    NASA Astrophysics Data System (ADS)

    Beld, E.; Seevinck, P. R.; Lagendijk, J. J. W.; Viergever, M. A.; Moerland, M. A.

    2016-09-01

    In the process of developing a robotic MRI-guided high-dose-rate (HDR) prostate brachytherapy treatment, the influence of the MRI scanner’s magnetic field on the dose distribution needs to be investigated. A magnetic field causes a deflection of electrons in the plane perpendicular to the magnetic field, and it leads to less lateral scattering along the direction parallel with the magnetic field. Monte Carlo simulations were carried out to determine the influence of the magnetic field on the electron behavior and on the total dose distribution around an Ir-192 source. Furthermore, the influence of air pockets being present near the source was studied. The Monte Carlo package Geant4 was utilized for the simulations. The simulated geometries consisted of a simplified point source inside a water phantom. Magnetic field strengths of 0 T, 1.5 T, 3 T, and 7 T were considered. The simulation results demonstrated that the dose distribution was nearly unaffected by the magnetic field for all investigated magnetic field strengths. Evidence was found that, from a dose perspective, the HDR prostate brachytherapy treatment using Ir-192 can be performed safely inside the MRI scanner. No need was found to account for the magnetic field during treatment planning. Nevertheless, the presence of air pockets in close vicinity to the source, particularly along the direction parallel with the magnetic field, appeared to be an important point for consideration.

  18. In vivo rectal wall measurements during HDR prostate brachytherapy with MOSkin dosimeters integrated on a trans-rectal US probe: Comparison with planned and reconstructed doses.

    PubMed

    Carrara, Mauro; Tenconi, Chiara; Rossi, Giulio; Borroni, Marta; Cerrotta, Annamaria; Grisotto, Simone; Cusumano, Davide; Pappalardi, Brigida; Cutajar, Dean; Petasecca, Marco; Lerch, Michael; Gambarini, Grazia; Fallai, Carlo; Rosenfeld, Anatoly; Pignoli, Emanuele

    2016-01-01

    To study if MOSkin detectors coupled to a trans-rectal ultrasound (TRUS) probe may be used for in vivo dosimetry on the rectal wall surface during US-based HDR prostate brachytherapy and to quantify possible discrepancies between planned and delivered doses. MOSkins are a specific type of MOSFET dosimeter optimized to measure dose in steep dose gradients on interfaces. Two MOSkins were assembled on a TRUS probe used for on-line treatment planning. Measurements of the dose to the rectal wall were performed over 18 treatment sessions and compared to the doses calculated on the pre-treatment plan (DPRE) and reconstructed on post-treatment images (DPOST). Averages of the absolute differences between MOSkin readings and DPRE, MOSkin readings and DPOST and DPRE and DPOST were 6.7 ± 5.1%, 3.6 ± 1.9% and 6.3 ± 4.7%, respectively. Agreement between measurements and DPOST was significantly better than between measurements and DPRE (p=0.002) and DPRE and DPOST (p=0.004). Discrepancy between DPOST and DPRE correlated with the time required for treatment planning. MOSkin dosimeters integrated to the TRUS probe proved to be an accurate instrument for measuring the dose delivered to the rectal wall in HDR prostate brachytherapy. The delivered doses may differ significantly from those calculated in the treatment plan. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  19. Comparison of air kerma standards of LNE-LNHB and NPL for 192Ir HDR brachytherapy sources: EUROMET project no 814.

    PubMed

    Douysset, Guilhem; Sander, Thorsten; Gouriou, Jean; Nutbrown, Rebecca

    2008-03-21

    An indirect comparison has been made in the air kerma standards for high dose rate (HDR) 192Ir brachytherapy sources at the Laboratoire National Henri Becquerel (LNHB) and the National Physical Laboratory (NPL). The measurements were carried out at both laboratories between November and December 2004. The comparison was based on measurements using well-type transfer ionization chambers and two different source types, Nucletron microSelectron HDR Classic and version 2. The results show the reported calibration coefficients to agree within 0.47% to 0.63%, which is within the overall standard uncertainty of 0.65% reported by both laboratories at the time of this comparison. Following this comparison, some of the NPL primary standard correction factors were re-evaluated resulting in a change of +0.17% in the overall correction factor. The new factor was implemented in May 2006. Applying the revised chamber factor to the measurements reported in this comparison report will reduce the difference between the two standards by 0.17%.

  20. The economics of heat mining: An analysis of design options and performance requirements of hot dry rock (HDR) geothermal power systems

    SciTech Connect

    Tester, Jefferson W.; Herzog, Howard J.

    1991-01-25

    A generalized economic model was developed to predict the breakeven price of HDR generated electricity. Important parameters include: (1) resource quality--average geothermal gradient ({sup o}C/km) and well depth, (2) reservoir performance--effective productivity, flow impedance, and lifetime (thermal drawdown rate), (3) cost components--drilling, reservoir formation, and power plant costs and (4) economic factors--discount and interest rates, taxes, etc. Detailed cost correlations based on historical data and results of other studies are presented for drilling, stimulation, and power plant costs. Results of the generalized model are compared to the results of several published economic assessments. Critical parameters affecting economic viability are drilling costs and reservoir performance. For example, high gradient areas are attractive because shallower well depths and/or lower reservoir production rates are permissible. Under a reasonable set of assumptions regarding reservoir impedance, accessible rock volumes and surface areas, and mass flow rates (to limit thermal drawdown rates to about 10 C per year), predictions for HDR-produced electricity result in competitive breakeven prices in the range of 5 to 9 cents/kWh for resources having average gradients above 50 C/km. Lower gradient areas require improved reservoir performance and/or lower well drilling costs.

  1. A phantom study of an in vivo dosimetry system using plastic scintillation detectors for real-time verification of 192Ir HDR brachytherapy

    PubMed Central

    Therriault-Proulx, Francois; Briere, Tina M.; Mourtada, Firas; Aubin, Sylviane; Beddar, Sam; Beaulieu, Luc

    2011-01-01

    Purpose: The goal of the present work was to evaluate the accuracy of a plastic scintillation detector (PSD) system to perform in-phantom dosimetry during 192Ir high dose rate (HDR) brachytherapy treatments. Methods: A PSD system capable of stem effect removal was built. A red–green–blue photodiode connected to a dual-channel electrometer was used to detect the scintillation light emitted from a green scintillation component and transmitted along a plastic optical fiber. A clinically relevant prostate treatment plan was built using the HDR brachytherapy treatment planning system. An in-house fabricated template was used for accurate positioning of the catheters, and treatment delivery was performed in a water phantom. Eleven catheters were inserted and used for dose delivery from 192Ir radioactive source, while two others were used to mimic dosimetry at the rectum wall and in the urethra using a PSD. The measured dose and dose rate data were compared to the expected values from the planning system. The importance of removing stem effects from in vivo dosimetry using a PSD during 192Ir HDR brachytherapy treatments was assessed. Applications for dwell position error detection and temporal verification of the treatment delivery were also investigated. Results: In-phantom dosimetry measurements of the treatment plan led to a ratio to the expected dose of 1.003 ± 0.004 with the PSD at different positions in the urethra and 1.043 ± 0.003 with the PSD inserted in the rectum. Verification for the urethra of dose delivered within each catheter and at specific dwell positions led to average measured to expected ratios of 1.015 ± 0.019 and 1.014 ± 0.020, respectively. These values at the rectum wall were 1.059 ± 0.045 within each catheter and 1.025 ± 0.028 for specific dwell positions. The ability to detect positioning errors of the source depended of the tolerance on the difference to the expected value. A 5-mm displacement of the source was

  2. The effect of ambient pressure on well chamber response: Monte Carlo calculated results for the HDR 1000 plus.

    PubMed

    Bohm, Tim D; Griffin, Sheridan L; DeLuca, Paul M; DeWerd, Larry A

    2005-04-01

    The determination of the air kerma strength of a brachytherapy seed is necessary for effective treatment planning. Well ionization chambers are used on site at therapy clinics to determine the air kerma strength of seeds. In this work, the response of the Standard Imaging HDR 1000 Plus well chamber to ambient pressure is examined using Monte Carlo calculations. The experimental work examining the response of this chamber as well as other chambers is presented in a companion paper. The Monte Carlo results show that for low-energy photon sources, the application of the standard temperature pressure PTP correction factor produces an over-response at the reduced air densities/pressures corresponding to high elevations. With photon sources of 20 to 40 keV, the normalized PTP corrected chamber response is as much as 10% to 20% over unity for air densities/pressures corresponding to an elevation of 3048 m (10000 ft) above sea level. At air densities corresponding to an elevation of 1524 m (5000 ft), the normalized PTP-corrected chamber response is 5% to 10% over unity for these photon sources. With higher-energy photon sources (>100 keV), the normalized PTP corrected chamber response is near unity. For low-energy beta sources of 0.25 to 0.50 MeV, the normalized PTP-corrected chamber response is as much as 4% to 12% over unity for air densities/pressures corresponding to an elevation of 3048 m (10000 ft) above sea level. Higher-energy beta sources (>0.75 MeV) have a normalized PTP corrected chamber response near unity. Comparing calculated and measured chamber responses for common 103Pd- and 125I-based brachytherapy seeds show agreement to within 2.7% and 1.9%, respectively. Comparing MCNP calculated chamber responses with EGSnrc calculated chamber responses show agreement to within 3.1% at photon energies of 20 to 40 keV. We conclude that Monte Carlo transport calculations accurately model the response of this well chamber. Further, applying the standard PTP correction

  3. On the experimental validation of model-based dose calculation algorithms for 192Ir HDR brachytherapy treatment planning

    NASA Astrophysics Data System (ADS)

    Pappas, Eleftherios P.; Zoros, Emmanouil; Moutsatsos, Argyris; Peppa, Vasiliki; Zourari, Kyveli; Karaiskos, Pantelis; Papagiannis, Panagiotis

    2017-05-01

    There is an acknowledged need for the design and implementation of physical phantoms appropriate for the experimental validation of model-based dose calculation algorithms (MBDCA) introduced recently in 192Ir brachytherapy treatment planning systems (TPS), and this work investigates whether it can be met. A PMMA phantom was prepared to accommodate material inhomogeneities (air and Teflon), four plastic brachytherapy catheters, as well as 84 LiF TLD dosimeters (MTS-100M 1  ×  1  ×  1 mm3 microcubes), two radiochromic films (Gafchromic EBT3) and a plastic 3D dosimeter (PRESAGE). An irradiation plan consisting of 53 source dwell positions was prepared on phantom CT images using a commercially available TPS and taking into account the calibration dose range of each detector. Irradiation was performed using an 192Ir high dose rate (HDR) source. Dose to medium in medium, Dmm , was calculated using the MBDCA option of the same TPS as well as Monte Carlo (MC) simulation with the MCNP code and a benchmarked methodology. Measured and calculated dose distributions were spatially registered and compared. The total standard (k  =  1) spatial uncertainties for TLD, film and PRESAGE were: 0.71, 1.58 and 2.55 mm. Corresponding percentage total dosimetric uncertainties were: 5.4-6.4, 2.5-6.4 and 4.85, owing mainly to the absorbed dose sensitivity correction and the relative energy dependence correction (position dependent) for TLD, the film sensitivity calibration (dose dependent) and the dependencies of PRESAGE sensitivity. Results imply a LiF over-response due to a relative intrinsic energy dependence between 192Ir and megavoltage calibration energies, and a dose rate dependence of PRESAGE sensitivity at low dose rates (<1 Gy min-1). Calculations were experimentally validated within uncertainties except for MBDCA results for points in the phantom periphery and dose levels  <20%. Experimental MBDCA validation is laborious, yet feasible. Further

  4. The effect of ambient pressure on well chamber response: Monte Carlo calculated results for the HDR 1000 Plus

    SciTech Connect

    Bohm, Tim D.; Griffin, Sheridan L.; DeLuca, Paul M. Jr.; DeWerd, Larry A.

    2005-04-01

    The determination of the air kerma strength of a brachytherapy seed is necessary for effective treatment planning. Well ionization chambers are used on site at therapy clinics to determine the air kerma strength of seeds. In this work, the response of the Standard Imaging HDR 1000 Plus well chamber to ambient pressure is examined using Monte Carlo calculations. The experimental work examining the response of this chamber as well as other chambers is presented in a companion paper. The Monte Carlo results show that for low-energy photon sources, the application of the standard temperature pressure P{sub TP} correction factor produces an over-response at the reduced air densities/pressures corresponding to high elevations. With photon sources of 20 to 40 keV, the normalized P{sub TP} corrected chamber response is as much as 10% to 20% over unity for air densities/pressures corresponding to an elevation of 3048 m (10000 ft) above sea level. At air densities corresponding to an elevation of 1524 m (5000 ft), the normalized P{sub TP}-corrected chamber response is 5% to 10% over unity for these photon sources. With higher-energy photon sources (>100 keV), the normalized P{sub TP} corrected chamber response is near unity. For low-energy {beta} sources of 0.25 to 0.50 MeV, the normalized P{sub TP}-corrected chamber response is as much as 4% to 12% over unity for air densities/pressures corresponding to an elevation of 3048 m (10000 ft) above sea level. Higher-energy {beta} sources (>0.75 MeV) have a normalized P{sub TP} corrected chamber response near unity. Comparing calculated and measured chamber responses for common {sup 103}Pd- and {sup 125}I-based brachytherapy seeds show agreement to within 2.7% and 1.9%, respectively. Comparing MCNP calculated chamber responses with EGSnrc calculated chamber responses show agreement to within 3.1% at photon energies of 20 to 40 keV. We conclude that Monte Carlo transport calculations accurately model the response of this well

  5. HDR prostate monotherapy: dosimetric effects of implant deformation due to posture change between TRUS- and CT-imaging.

    PubMed

    Seppenwoolde, Yvette; Kolkman-Deurloo, Inger-Karine; Sipkema, Dick; de Langen, Mark; Praag, John; Jansen, Peter; Heijmen, Ben

    2008-01-01

    HDR monotherapy for prostate cancer consists of four fractions. The first fraction is delivered with online TRUS-based treatment planning. For the last three fractions the treatment plan is based on a CT-scan acquired in between fractions 1 and 2. The patient position (high lithotomy, rectal US probe) during TRUS-guided catheter implantation and first fraction differs from the patient position in the CT-scan and the remaining three fractions (lowered legs, no TRUS probe). This study describes the effect of posture changes on dose distributions when a plan designed for the TRUS anatomy is applied to the CT-scan anatomy. The aim is to quantify dosimetrical errors that would result from skipping the use of a planning CT-scan, and rely for all fractions on the TRUS plan. Such a procedure would substantially reduce the involved workload, and would increase patient comfort. For three prostate cancer patients, images were acquired during TRUS-guided catheter implantation. Furthermore, a CT-scan (no US probe in rectum, different position of legs) was acquired and matched with the TRUS set. On both TRUS and CT, prostate, urethra and rectum were delineated and all catheters were traced. For each patient, an optimized treatment plan was designed using TRUS images and contours. Catheters with obtained dwell positions of the TRUS plan were transferred individually to the catheter positions in the CT. Changes in dose distribution due to relocation of catheters were evaluated using DVHs. For all patients the dose distributions changed significantly due to rearrangement of the catheters, having most impact on the urethra (maximum observed change: 32% volume receiving > or = 120% of the prescribed dose) and a reduction of PTV coverage (6-28%). Implant deformation when changing from TRUS patient set-up to CT set-up affected negatively the quality of optimized treatment plans. Inclusion of more patients in this study was planned, but because of the observed strong negative effects it

  6. The use of linear programming in optimization of HDR implant dose distributions.

    PubMed

    Jozsef, Gabor; Streeter, Oscar E; Astrahan, Melvin A

    2003-05-01

    The introduction of high dose rate brachytherapy enabled optimization of dose distributions to be used on a routine basis. The objective of optimization is to homogenize the dose distribution within the implant while simultaneously satisfying dose constraints on certain points. This is accomplished by varying the time the source dwells at different locations. As the dose at any point is a linear function of the dwell times, a linear programming approach seems to be a natural choice. The dose constraints are inherently linear inequalities. Homogeneity requirements are linearized by minimizing the maximum deviation of the doses at points inside the implant from a prescribed dose. The revised simplex method was applied for the solution of this linear programming problem. In the homogenization process the possible source locations were chosen as optimization points. To avoid the problem of the singular value of the dose at a source location from the source itself we define the "self-contribution" as the dose at a small distance from the source. The effect of varying this distance is discussed. Test cases were optimized for planar, biplanar and cylindrical implants. A semi-irregular, fan-like implant with diverging needles was also investigated. Mean central dose calculation based on 3D Delaunay-triangulation of the source locations was used to evaluate the dose distributions. The optimization method resulted in homogeneous distributions (for brachytherapy). Additional dose constraints--when applied--were satisfied. The method is flexible enough to include other linear constraints such as the inclusion of the centroids of the Delaunay-triangulation for homogenization, or limiting the maximum allowable dwell time.

  7. SU-C-16A-01: In Vivo Source Position Verification in High Dose Rate (HDR) Prostate Brachytherapy Using a Flat Panel Imager: Initial Clinical Experience

    SciTech Connect

    Franich, R; Smith, R; Millar, J; Haworth, A; Taylor, M; McDermott, L

    2014-06-15

    Purpose: We report our initial clinical experience with a novel position-sensitive source-tracking system based on a flat panel imager. The system has been trialled with 4 prostate HDR brachytherapy patients (8 treatment fractions) in this initial study. Methods: The flat panel imaging system was mounted under a customised carbon fibre couch top assembly (Figure 1). Three gold fiducial markers were implanted into the prostate of each patient at the time of catheter placement. X-ray dwell position markers were inserted into three catheters and a radiograph acquired to locate the implant relative to the imaging device. During treatment, as the HDR source dwells were delivered, images were acquired and processed to determine the position of the source in the patient. Source positions measured by the imaging device were compared to the treatment plan for verification of treatment delivery. Results: Measured dwell positions provided verification of relative dwell spacing within and between catheters, in the coronal plane. Measurements were typically within 2.0mm (0.2mm – 3.3mm, s.d. 0.8mm) of the planned positions over 60 dwells (Figure 2). Discrimination between larger dwell intervals and catheter differentiation were clear. This confirms important delivery attributes such as correct transfer tube connection, source step size, relative catheter positions and therefore overall correct plan selection and delivery. The fiducial markers, visible on the radiograph, provided verification of treatment delivery to the correct anatomical location. The absolute position of the dwells was determined by comparing the measured dwell positions with the x-ray markers from the radiograph, validating the programmed treatment indexer length. The total impact on procedure time was less than 5 minutes. Conclusion: The novel, noninvasive HDR brachytherapy treatment verification system was used clinically with minor impact on workflow. The system allows verification of correct treatment

  8. Objective method to report planner-independent skin/rib maximal dose in balloon-based high dose rate (HDR) brachytherapy for breast cancer

    SciTech Connect

    Kim, Yongbok; Trombetta, Mark G.

    2011-04-15

    Purpose: An objective method was proposed and compared with a manual selection method to determine planner-independent skin and rib maximal dose in balloon-based high dose rate (HDR) brachytherapy planning. Methods: The maximal dose to skin and rib was objectively extracted from a dose volume histogram (DVH) of skin and rib volumes. A virtual skin volume was produced by expanding the skin surface in three dimensions (3D) external to the breast with a certain thickness in the planning computed tomography (CT) images. Therefore, the maximal dose to this volume occurs on the skin surface the same with a conventional manual selection method. The rib was also delineated in the planning CT images and its maximal dose was extracted from its DVH. The absolute (Abdiff=|D{sub max}{sup Man}-D{sub max}{sup DVH}|) and relative (Rediff[%]=100x(|D{sub max}{sup Man}-D{sub max}{sup DVH}|)/D{sub max}{sup DVH}) maximal skin and rib dose differences between the manual selection method (D{sub max}{sup Man}) and the objective method (D{sub max}{sup DVH}) were measured for 50 balloon-based HDR (25 MammoSite and 25 Contura) patients. Results: The average{+-}standard deviation of maximal dose difference was 1.67%{+-}1.69% of the prescribed dose (PD). No statistical difference was observed between MammoSite and Contura patients for both Abdiff and Rediff[%] values. However, a statistically significant difference (p value <0.0001) was observed in maximal rib dose difference compared with maximal skin dose difference for both Abdiff (2.30%{+-}1.71% vs 1.05%{+-}1.43%) and Rediff[%] (2.32%{+-}1.79% vs 1.21%{+-}1.41%). In general, rib has a more irregular contour and it is more proximally located to the balloon for 50 HDR patients. Due to the inverse square law factor, more dose difference was observed in higher dose range (D{sub max}>90%) compared with lower dose range (D{sub max}<90%): 2.16%{+-}1.93% vs 1.19%{+-}1.25% with p value of 0.0049. However, the Rediff[%] analysis eliminated the

  9. Determination of absorbed dose in water at the reference point d(r0, theta0) for an 192Ir HDR brachytherapy source using a Fricke system.

    PubMed

    Austerlitz, C; Mota, H C; Sempau, J; Benhabib, S M; Campos, D; Allison, R; DeAlmeida, C E; Zhu, D; Sibata, C H

    2008-12-01

    A ring-shaped Fricke device was developed to measure the absolute dose on the transverse bisector of a 192Ir high dose rate (HDR) source at 1 cm from its center in water, D(r0, theta0). It consists of a polymethylmethacrylate (PMMA) rod (axial axis) with a cylindrical cavity at its center to insert the 192Ir radioactive source. A ring cavity around the source with 1.5 mm thickness and 5 mm height is centered at 1 cm from the central axis of the source. This ring cavity is etched in a disk shaped base with 2.65 cm diameter and 0.90 cm thickness. The cavity has a wall around it 0.25 cm thick. This ring is filled with Fricke solution, sealed, and the whole assembly is immersed in water during irradiations. The device takes advantage of the cylindrical geometry to measure D(r0, theta0). Irradiations were performed with a Nucletron microselectron HDR unit loaded with an 192Ir Alpha Omega radioactive source. A Spectronic 1001 spectrophotometer was used to measure the optical absorbance using a 1 mL quartz cuvette with 1.00 cm light pathlength. The PENELOPE Monte Carlo code (MC) was utilized to simulate the Fricke device and the 192Ir Alpha Omega source in detail to calculate the perturbation introduced by the PMMA material. A NIST traceable calibrated well type ionization chamber was used to determine the air-kerma strength, and a published dose-rate constant was used to determine the dose rate at the reference point. The time to deliver 30.00 Gy to the reference point was calculated. This absorbed dose was then compared to the absorbed dose measured by the Fricke solution. Based on MC simulation, the PMMA of the Fricke device increases the D(r0, theta0) by 2.0%. Applying the corresponding correction factor, the D(r0, theta0) value assessed with the Fricke device agrees within 2.0% with the expected value with a total combined uncertainty of 3.43% (k=1). The Fricke device provides a promising method towards calibration of brachytherapy radiation sources in terms of D(r0

  10. SU-F-BRA-05: Utility of the Combined Use of Two Types of HDR Sources with the Direction Modulation Brachytherapy (DMBT) Tandem Applicator for Cervical Cancer Treatment

    SciTech Connect

    Safigholi, H; Soliman, A; Song, W; Han, D; Meigooni, A Soleimani; Scanderbeg, D

    2015-06-15

    Purpose: To maximize the dose to HRCTV while minimizing dose to the OARs, the combination of two HDR brachytherapy sources, 192-Ir and 169-Yb, used in combination with the recently-proposed novel direction modulated brachytherapy (DMBT) tandem applicator were examined. Methods: The DMBT tandem, made from nonmagnetic tungsten-alloy rod, with diameter of 5.4mm, has 6 symmetric peripheral holes of 1.3mm diameter. The 0.3mm thick bio-compatible plastic tubing wraps the tandem. MCNPX v.2.6 was used to simulate the mHDR 192-Ir V2 and 4140 HDR 169-Yb sources inside the DMBT applicator. Thought was by combining the higher energy 192-Ir (380keV) and lower energy 169-Yb (92.7keV) sources could create unprecedented level of dose conformality when combined with the high-degree intensity modulation capable DMBT tandem applicator. 3D dose matrices, with 1 mm3 resolution, were imported into an in-house-coded inverse optimization planning system to evaluate plan quality of 19 clinical patient cases. Prescription dose was 15Gy. All plans were normalized to receive the same HRCTV D90. Results: Generally, the use of dual sources produced better plans than using either of the sources alone, with significantly better performance in some patients. The mean D2cc for bladder, rectum, and sigmoid were 11.65±2.30Gy, 7.47±3.05Gy, and 9.84±2.48Gy for 192-Ir-only, respectively. For 169 -Yb-only, they were 11.67±2.26Gy, 7.44±3.02Gy, and 9.83±2.38Gy, respectively. The corresponding data for the dual sources were 11.51±2.24Gy, 7.30±3.00Gy, and 9.68 ±2.39Gy, respectively. The HRCTV D98 and V100 were 16.37±1.86Gy and 97.37±1.92Gy for Ir-192-only, respectively. For 169-Yb-only, they were 16.43±1.86Gy, and 97.51±1.91Gy, respectively. For the dual source, they were 16.42±1.87Gy and 97.47±1.93Gy, respectively. Conclusion: The plan quality improves, in some cases quite significantly, for when dual 192-Ir and 169-Yb sources are used in combination with highly intensity modulation capable

  11. Comorbidity as a predictor of overall survival in prostate cancer patients treated with external beam radiotherapy combined with HDR brachytherapy boosts.

    PubMed

    Hjälm-Eriksson, Marie; Ullén, Anders; Johansson, Hemming; Levitt, Seymoure; Nilsson, Sten; Kälkner, Karl-Mikael

    2017-01-01

    The risk stratification currently applied prior to curative treatment for localized prostate cancer (PC) does not take into account comorbidity or age. Therefore, we investigated the impact of comorbidity on overall survival (OS) in PC patients treated with external beam radiotherapy (EBRT) and high-dose rate (HDR) brachytherapy boost. At a single center, 611 consecutive patients diagnosed with localized PC from 1998 to 2004 underwent definitive EBRT (50 Gy) and HDR brachytherapy boosts (2 × 10 Gy) combined with neoadjuvant total androgen blockade. Comorbidity was assessed with the Charlson comorbidity score. The impact of risk factors on OS and disease-free survival (DFS) was calculated using Cox proportional hazard ratios. Risk groups were defined as follows: low-risk PC: PSA <10, WHO grade 1 and T stage 1; high-risk PC: PSA >20 and/or WHO grade 3 and/or T stage 3a; intermediate-risk PC representing patients who did not fit either the low- or high-risk PC group. Mean age in the study cohort was 66.4 years, and 51% of the patients reported some degree of comorbidity. Divided into risk groups 8.2% were categorized as low-risk, 64% as intermediate-risk and 27.8% as high-risk PC. Overall 10-year survival was 72.2%, and 89% of the patients were relapse-free. In the univariate and multivariate analyses using Cox proportional hazard ratios, age, comorbidity and T stage were statistically significant predictors of OS: hazard ratios 1.56, 1.44 and 1.2 (p-values .002, .04 and .05), respectively. WHO grade, PSA at diagnosis, T stage and comorbidity were also significant predictors of DFS (p-values .0001, .0001, .009 and .003, respectively). Comorbidity assessed with the Charlson score predicts OS in patients with localized PC treated with curative intent using combined EBRT and HDR brachytherapy boost, and should be considered when making decisions before radical treatment.

  12. Image-Guided High-Dose-Rate (HDR) Boost Localization Using MRI/MR Spectroscopy: A Correlation Study with Biopsy

    PubMed Central

    Mbodji, Khaly; Racine, Louis G; Chevrette, Eric; Lavallee, Marie C; Martin, André-Guy; Despres, Philippe; Beaulieu, Luc

    2016-01-01

    93.7% (84.5% - 98.2%) and 82.1% (66.5% - 92.5%), respectively, and a PPV and NPV of 89.4% (79.4% - 95.6%) and 88.9% (73.9% - 96.9%), respectively. Finally, after combining MRI, MRS, and DWI-ADC mapping, compared with biopsy, we obtained a Sn, Sp, PPV, and NPV of 100% (94.8% - 100%), 49% (34.8% - 63.4%), 72.6% (62.5% - 81.3%), and 100% (86.3% - 100%), respectively. Conclusions: The combination of MRI/MRS is a sensitive tool for both the structural and metabolic evaluation of prostate cancer location. MRI/MRS exams are useful to delineate a DIL for high-dose-rate (HDR) intraprostatic boost. PMID:27790388

  13. Imaging of implant needles for real-time HDR-brachytherapy prostate treatment using biplane ultrasound transducers.

    PubMed

    Siebert, Frank-André; Hirt, Markus; Niehoff, Peter; Kovács, György

    2009-08-01

    Ultrasound imaging is becoming increasingly important in prostate brachytherapy. In high-dose-rate (HDR) real-time planning procedures the definition of the implant needles is often performed by transrectal ultrasound. This article describes absolute measurements of the visibility and accuracy of manual detection of implant needle tips and compares measurement results of different biplane ultrasound systems in transversal and longitudinal (i.e., sagittal) ultrasound modes. To obtain a fixed coordinate system and stable conditions the measurements were carried out in a water tank using a dedicated marker system. Needles were manually placed in the phantom until the observer decided by the real-time ultrasound image that the zero position was reached. A comparison of three different ultrasound systems yielded an offset between 0.8 and 3.1 mm for manual detection of the needle tip in ultrasound images by one observer. The direction of the offset was discovered to be in the proximal direction, i.e., the actual needle position was located more distally compared to the ultrasound-based definition. In the second part of the study, the ultrasound anisotropy of trocar implant needles is reported. It was shown that the integrated optical density in a region of interest around the needle tip changes with needle rotation. Three peaks were observed with a phase angle of 120 degrees. Peaks appear not only in transversal but also in longitudinal ultrasound images, with a phase shift of 60 degrees. The third section of this study shows results of observer dependent influences on needle tip detection in sagittal ultrasound images considering needle rotation. These experiments were carried out using the marker system in a water tank. The needle tip was placed exactly at the position z=0 mm. It was found that different users tend to differently interpret the same ultrasound images. The needle tip was manually detected five times in the ultrasound images by three experienced observers

  14. Micron MT29F128G08AJAAA 128GB Asynchronous Flash Memory Total Ionizing Dose Characterization Test Report

    NASA Technical Reports Server (NTRS)

    Campola, Michael; Wyrwas, Edward

    2017-01-01

    The purpose of this test was to characterize the Micron MT29F128G08AJAAAs parameter degradation for total dose response and to evaluate and compare lot date codes for sensitivity. In the test, the device was exposed to both low dose and high dose rate (HDR) irradiations using gamma radiation. Device parameters such as leakage currents, quantity of upset bits and overall chip and die health were investigated to determine which lot is more robust.

  15. Advantages and implications of high dose rate (HDR) total skin electron irradiation (TSEI) for the management of Mycosis Fungoides. Indian experience.

    PubMed

    Parida, Dillip Kumar; Rath, Goura Kishore

    2014-03-01

    Mycosis Fungoides (MF) is an indolent lymphoproliferative disorder affecting dermis caused by abnormal proliferation of CD4+ T-cells. Radiation therapy is the most effective modality of treatment for MF which offers cure in limited stage disease and desirable palliation in advance stage disease. Treating entire skin having many curved surfaces and folds with radiation is the real challenge for the radiation oncologist. Many techniques, dose schedules and modifications in total skin electron irradiation (TSEI) have been tried since 1950s. TSEI treatment is a very time consuming, inconvenient and physically challenging to both patient as well as oncologist. At our center TSEI was performed since 1983 with conventional linear accelerator where the treatment time was prolonged beyond two hours, which was very difficult or the patient, oncologist, technical officer and eating away the machine time hampering the treatment of other patients. From 1998 we shifted to high dose rate (HDR) mode, in order to bring down the treatment time of a single patient every day from two and half hour to 15 min. The reduction of treatment time increases patient compliance and at the same time saved machine time. Between 1998 and 2003, eleven pathological diagnosed MF patients were treated using HDR TSEI. All the patients were male between 40 and 70 years of age, who had the history of having the disease for 7-22 months. Four patients had T2 and seven patients had T3 stage disease with more than 90% skin surface involvement. TSEI was performed with 4 MeV electrons with a daily fraction size of 120 cGy to a total dose of 36 Gy. At the end of 36 Gy, boost dose of 10 Gy was delivered to self shielding regions like sole, scalp and perineum. Considering the treatment related toxicities and consequent treatment interruptions, in the first seven patients, the last four patients were treated using similar HDR TSEI technique with modified treatment schedule, where the treatment was given on

  16. The effect of catheter displacement and anatomical variations on the dose distribution in MRI-guided focal HDR brachytherapy for prostate cancer.

    PubMed

    Maenhout, Metha; van der Voort van Zyp, Jochem R N; Borot de Battisti, Maxence; Peters, Max; van Vulpen, Marco; van den Bosch, Maurice; Moerland, Marinus A

    2017-06-01

    The aim of this study was to analyze the effect of catheter displacement and anatomical variations of prostate and organs at risk on dose distribution in MRI-guided 19 Gy single fraction focal high-dose-rate brachytherapy (HDR-BT) of the prostate. Seventeen patients with localized prostate cancer were enrolled in a prospective trial investigating focal HDR-BT in a 1.5 T MRI-HDR-BT facility. The diagnostic MRI delineations were registered with intraoperative MR scan, and a single fraction of 19 Gy was applied to the visible tumor. Self-anchoring umbrella catheters were used for HDR-BT delivery. A 1.5 T MRI was performed directly after ultrasound (US)-guided catheter placement for treatment planning. After treatment and before removal of catheters, a posttreatment 1.5 T MRI was performed. Regions of interest were also delineated on the posttreatment MR images and the catheters of 17 patients were reconstructed. The dose plan was constructed for the posttreatment MRI scan to assess the influence of catheter migration and anatomical variation on the dose delivered to the target and the organs at risk. Also on the posttreatment MRI, the complete catheter reconstruction was reassessed, to correct for, for example, bending of the catheters. The displacement of catheters between the MRI scans was determined by comparing the catheter tip positions on the treatment planning and posttreatment 1.5 T MRI scans. The displacements of 241 catheters were investigated. Average (range) displacements of the umbrella catheters are 0.6 (0-2.9) mm in the x-direction, 0.5 (0-2.1) mm in the y-direction, and 0.9 (0-5.5) mm in the z-direction. In 3 patients, the displacement was >4 mm and up to 5.5 mm. This occurred in respectively 1/13, 1/16, and 1/18 catheters in these patients. The dosimetric differences between the intraoperative treatment and the posttreatment plans were in most patients less than 1.5 Gy. In 4 patients, a dose difference in clinical target volume D95 of >2

  17. SU-E-P-38: Comparison of Capri Applicator HDR Planning Methods to Meet the NCCN Uterine Neoplasm 2.2015 Guidelines

    SciTech Connect

    Klash, S; Steinman, J; Stanley, T; Kim, D; Yi, S; Yap, J

    2015-06-15

    Purpose: To establish a systematic planning approach for Capri intravaginal multichannel balloon applicators that meet updated Version 2.2015 NCCN guidelines for uterine neoplasms, which dictate delivery of 400 to 600 cGy in 2 to 3 fractions prescribed to the vaginal mucosa for HDR combined with EBRT as well as a regimen of 600 cGy x 5 (to the vaginal mucosa) for HDR brachytherapy alone. Methods: Studies have shown three different channel configurations of the Capri applicator are optimal for dosimetric conformity: central channel combined with the six inner ring channels (R12), all inner and outer ring channels (R23), or all thirteen channels (R123). To minimize the dose to the vaginal mucosa, a traditional 0.5cm expansion contour from the Capri surface was created. Optimization limits were set to push 600 cGy to 100% of the Capri volume, while simultaneously restricting dose to the expansion contour. Results: Plans were created using all three configurations (R12, R23, R123) and evaluated to determine which was best for delivering 600 cGy to the vaginal mucosa. Our criteria was: Capri V100 > 98%, Vaginal Mucosa Dmax < 125%, Bladder Dmax < 100%, Rectum Dmax < 100%. All configurations show Capri V100 values greater than 98.5%, with differences between plans varying by less than 1%. Vaginal mucosal Dmax values showed differences of roughly 5% of prescription. The R12 configuration proved the lowest vaginal mucosa Dmax, on average. The OAR Dmax values showed an average dose difference of roughly 2% of prescription, with the R23 configuration having the best results. Conclusion: The R12 channel configuration optimally fits our planning criteria and NCCN guidelines for 600 cGy prescribed to the vaginal mucosa. On average, it produced the highest Capri V100, the lowest vaginal mucosal Dmax, and a marginally higher OAR Dmax doses compared to the R23 and R123 plans.

  18. A dual-plane co-RASOR technique for accurate and rapid tracking and position verification of an Ir-192 source for single fraction HDR brachytherapy.

    PubMed

    de Leeuw, Hendrik; Moerland, Marinus A; van Vulpen, Marco; Seevinck, Peter R; Bakker, Chris J G

    2013-11-07

    Effective high-dose-rate (HDR) treatment requires accurate and independent treatment verification to ensure that the treatment proceeds as prescribed, in particular if a high dose is given, as in single fraction therapy. Contrary to CT imaging and fluoroscopy, MR imaging provides high soft tissue contrast. Conventional MR techniques, however, do not offer the temporal resolution in combination with the 3D spatial resolution required for accurate brachytherapy source localization. We have developed an MR imaging method (center-out RAdial Sampling with Off-Resonance (co-RASOR)) that generates high positive contrast in the geometrical center of field perturbing objects, such as HDR brachytherapy sources. co-RASOR generates high positive contrast in the geometric center of an Ir-192 source by applying a frequency offset to center-out encoded data. To obtain high spatial accuracy in 3D with adequate temporal resolution, two orthogonal center-out encoded 2D images are applied instead of a full 3D acquisition. Its accuracy in 3D is demonstrated by 3D MRI and CT. The 2D images show high positive contrast in the geometric center of non-radioactive Ir-192 sources, with signal intensities up to 160% of the average signal intensity in the surrounding medium. The accuracy with which the center of the Ir-192 source is located by the dual-plane MRI acquisition corresponds closely to the accuracy obtained by 3D MRI and CT imaging. The positive contrast is shown to be obtained in homogeneous and in heterogeneous tissue. The dual-plane MRI technique allows the brachytherapy source to be tracked in 3D with millimeter accuracy with a temporal resolution of approximately 4 s.

  19. High-resolution genomic assays provide insight into the division of labor between TLS and HDR in mammalian replication of damaged DNA.

    PubMed

    Livneh, Zvi; Cohen, Isadora S; Paz-Elizur, Tamar; Davidovsky, Dana; Carmi, Dalit; Swain, Umakanta; Mirlas-Neisberg, Nataly

    2016-08-01

    The multitude of DNA lesions that continuously form in DNA cannot all be detected and removed prior to replication. Thus, encounters of the replication fork with DNA damage become inevitable. Such encounters inhibit fork progression, leading to replication fork arrest or to replication re-priming downstream of the damage site. Either of these events will result in the formation of gap-lesion structures, in which a damaged base is located in a single stranded stretch of DNA, that is vulnerable to subsequent nicking. The double strand break that would ensue if ssDNA becomes nicked constitutes escalation of the damage from nucleotide(s)-specific to chromosomal scale. Cells employ two universal DNA damage tolerance (DDT) strategies to resolve these situations, by converting the gap-lesion structures into dsDNA without repairing the damage. The first is translesion DNA synthesis (TLS), in which a specialized low-fidelity DNA polymerase inserts a nucleotide opposite the damaged one. TLS is inherently mutagenic, due to the miscoding nature of most damaged nucleotides. The second strategy is homology-dependent repair (HDR), which relies on the presence of an identical intact sister chromatid. The molecular mechanisms that regulate the division of labor between these pathways are poorly understood. This review focuses on the balance between TLS and HDR in mammalian cells, discussing recent findings that were made possible thanks to newly developed high resolution genomic assays, and highlighting the role of the DNA lesion's properties in DDT pathway choice. Copyright © 2016. Published by Elsevier B.V.

  20. A dual-plane co-RASOR technique for accurate and rapid tracking and position verification of an Ir-192 source for single fraction HDR brachytherapy

    NASA Astrophysics Data System (ADS)

    de Leeuw, Hendrik; Moerland, Marinus A.; van Vulpen, Marco; Seevinck, Peter R.; Bakker, Chris J. G.

    2013-11-01

    Effective high-dose-rate (HDR) treatment requires accurate and independent treatment verification to ensure that the treatment proceeds as prescribed, in particular if a high dose is given, as in single fraction therapy. Contrary to CT imaging and fluoroscopy, MR imaging provides high soft tissue contrast. Conventional MR techniques, however, do not offer the temporal resolution in combination with the 3D spatial resolution required for accurate brachytherapy source localization. We have developed an MR imaging method (center-out RAdial Sampling with Off-Resonance (co-RASOR)) that generates high positive contrast in the geometrical center of field perturbing objects, such as HDR brachytherapy sources. co-RASOR generates high positive contrast in the geometric center of an Ir-192 source by applying a frequency offset to center-out encoded data. To obtain high spatial accuracy in 3D with adequate temporal resolution, two orthogonal center-out encoded 2D images are applied instead of a full 3D acquisition. Its accuracy in 3D is demonstrated by 3D MRI and CT. The 2D images show high positive contrast in the geometric center of non-radioactive Ir-192 sources, with signal intensities up to 160% of the average signal intensity in the surrounding medium. The accuracy with which the center of the Ir-192 source is located by the dual-plane MRI acquisition corresponds closely to the accuracy obtained by 3D MRI and CT imaging. The positive contrast is shown to be obtained in homogeneous and in heterogeneous tissue. The dual-plane MRI technique allows the brachytherapy source to be tracked in 3D with millimeter accuracy with a temporal resolution of approximately 4 s.

  1. Sci—Fri AM: Mountain — 03: Current status of the NRC primary standard for {sup 192}Ir HDR brachytherapy sources

    SciTech Connect

    Mainegra-Hing, E; Downton, Brad

    2014-08-15

    The Canadian primary standard for {sup 192}Ir HDR brachytherapy sources has been recently revised in a more accurate manner allowing for more realistic uncertainty estimation. Air-kerma strength S{sub k} is derived from measurements of the source's output using a graphite-walled spherical ionization chamber (2S) at several distances. Traceability to NRC primary standards for the {sup 192}Ir calibration coefficient N{sub k} is insured by estimating it as the inverse arithmetic mean of the inverse of the calibration coefficients for a {sup 137}Cs beam and the medium energy x-ray beam quality N250, both of which are traceable to NRC primary standards. The multiple-distance method is combined with a non-linear least squares fit to determine St, while at the same time removing the effects of room scatter and position offset. The previously used shadow-cone method for directly measuring the room scatter is found to be inadequate due to the increased scatter contribution from the lead cone itself, especially at short source-detector distances. Rather than including the reported 1% difference in source strength for {sup 192}Ir HDR sources of different construction into the total uncertainty, users are cautioned that the calibration coefficient provided by NRC is only valid for a microSelectron V2 model. A comprehensive uncertainty budged shows that the total one sigma uncertainty of the standard is actually 0.6% rather than the previously assumed 1.2%. NRC measured S{sub k} agrees within 0.03% of the manufacturer's value.

  2. Dosimetric feasibility of ablative dose escalated focal monotherapy with MRI-guided high-dose-rate (HDR) brachytherapy for prostate cancer.

    PubMed

    Hosni, Ali; Carlone, Marco; Rink, Alexandra; Ménard, Cynthia; Chung, Peter; Berlin, Alejandro

    2017-01-01

    To determine the dosimetric feasibility of dose-escalated MRI-guided high-dose-rate brachytherapy (HDR-BT) focal monotherapy for prostate cancer (PCa). In all patients, GTV was defined with mpMRI, and deformably registered onto post-catheter insertion planning MRI. PTV included the GTV plus 9mm craniocaudal and 5mm in every other direction. In discovery-cohort, plans were obtained for each PTV independently aiming to deliver ⩾16.5Gy/fraction (two fraction schedule) while respecting predefined organs-at-risk (OAR) constraints or halted when achieved equivalent single-dose plan (24Gy). Dosimetric results of original and focal HDR-BT plans were evaluated to develop a planning protocol for the validation-cohort. In discovery-cohort (20-patients, 32-GTVs): PTV D95% ⩾16.5Gy could not be reached in a single plan (3%) and was accomplished (range 16.5-23.8Gy) in 15 GTVs (47%). Single-dose schedule was feasible in 16 (50%) plans. In the validation-cohort (10-patients, 10-GTVs, two separate implants each): plans met acceptable and ideal criteria in 100% and 43-100% respectively. Migration to single-dose treatment schedule was feasible in 7 implants (35%), without relaxing OAR's constraints or increasing the dose (D100% and D35%) to mpMRI-normal prostate (p>0.05). Focal ablative dose-escalated radiation is feasible with the proposed protocol. Prospective studies are warranted to determine the clinical outcomes. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  3. SU-E-T-615: Investigation of the Dosimetric Impact of Tandem Loading in the Treatment of Cervical Cancer for HDR Brachytherapy Procedures

    SciTech Connect

    Esquivel, C; Patton, L; Nelson, K; Lin, B

    2014-06-01

    Purpose: To quantify the dosimetric impact of the tandem loading in the treatment of cervical cancer for HDR brachytherapy procedures. Methods: Ten patients were evaluated, each of whom received 5 fractions of treatment. Tandem and ovoid sets were inserted into the uterine cavity based on institutional protocols and procedures. Following insertion and stabilization, CT image sets of 1.5mm slice thickness were acquired and sent to the Oncentra V4.3 Treatment Planning System. Critical structures such as the CTV, bladder, rectum, sigmoid, and bowel were contoured and a fractional dose of 5.5Gy was prescribed to Point A for each patient. Six different treatment plans were created for each fraction using varying tandem weightings; from 0.5 to 1.4 times that of the ovoids. Surface dose evaluation of various ovoid diameters, 2.0-3.5cm, at the vaginal fornices was also investigated. Results: Critical structures were evaluated based on varying dose and volume constraints, in particular the 2.0 cc volume recommendation cited by the gynecological GEC-ESTRO working group. Based on dose volume histogram evaluation, a reduction of dose to the critical structures was most often discovered when the tandem weighting was increased. CTV coverage showed little change as the tandem weighting was varied. Ovoid surface dose decreased by 50-65% as the tandem weighting increased. Conclusion: The advantage of 3D planning with HDR brachytherapy is the dose optimization for each individual treatment plan. This investigation shows that by utilizing large tandem weightings, 1.4 times greater than the ovoid, one can still achieve adequate coverage of the CTV and relatively low doses to the critical structures. In some cases, one would still have to optimize further per individual case. In addition, the ovoid surface dose was greatly decreased when large tandem weighting was utilized; especially for small ovoid diameters.

  4. SU-E-T-795: Validations of Dose Calculation Accuracy of Acuros BV in High-Dose-Rate (HDR) Brachytherapy with a Shielded Cylinder Applicator Using Monte Carlo Simulation

    SciTech Connect

    Li, Y; Tian, Z; Hrycushko, B; Jiang, S; Jia, X

    2015-06-15

    Purpose: Acuros BV has become available to perform accurate dose calculations in high-dose-rate (HDR) brachytherapy with phantom heterogeneity considered by solving the Boltzmann transport equation. In this work, we performed validation studies regarding the dose calculation accuracy of Acuros BV in cases with a shielded cylinder applicator using Monte Carlo (MC) simulations. Methods: Fifteen cases were considered in our studies, covering five different diameters of the applicator and three different shielding degrees. For each case, a digital phantom was created in Varian BrachyVision with the cylinder applicator inserted in the middle of a large water phantom. A treatment plan with eight dwell positions was generated for these fifteen cases. Dose calculations were performed with Acuros BV. We then generated a voxelized phantom of the same geometry, and the materials were modeled according to the vendor’s specifications. MC dose calculations were then performed using our in-house developed fast MC dose engine for HDR brachytherapy (gBMC) on a GPU platform, which is able to simulate both photon transport and electron transport in a voxelized geometry. A phase-space file for the Ir-192 HDR source was used as a source model for MC simulations. Results: Satisfactory agreements between the dose distributions calculated by Acuros BV and those calculated by gBMC were observed in all cases. Quantitatively, we computed point-wise dose difference within the region that receives a dose higher than 10% of the reference dose, defined to be the dose at 5mm outward away from the applicator surface. The mean dose difference was ∼0.45%–0.51% and the 95-percentile maximum difference was ∼1.24%–1.47%. Conclusion: Acuros BV is able to accurately perform dose calculations in HDR brachytherapy with a shielded cylinder applicator.

  5. Definitive salvage for vaginal recurrence of endometrial cancer: the impact of modern intensity-modulated-radiotherapy with image-based HDR brachytherapy and the interplay of the PORTEC 1 risk stratification.

    PubMed

    Vargo, John A; Kim, Hayeon; Houser, Christopher J; Berhane, Hebist; Sukumvanich, Paniti; Olawaiye, Alexander B; Kelley, Joseph L; Edwards, Robert P; Comerci, John T; Huang, Marilyn; Courtney-Brooks, Madeleine; Beriwal, Sushil

    2014-10-01

    Data for salvage radiotherapy for recurrent endometrial cancer are limited especially in the era of modern radiotherapy including IMRT and 3-dimensional image-based HDR brachytherapy. Theoretically, modern radiotherapy reduces the dose to critical organs-at-risk and maximizes dose to the target volume, possibly decreasing morbidity and increasing tumor control. Forty-one patients completing definitive salvage radiotherapy for vaginal recurrence of endometrial cancer from June 2004 to December 2013 were retrospectively reviewed. HDR Brachytherapy was completed using image-based planning with contouring/optimization with each fraction to a median dose of 23.75 Gy in 5 fractions. HDR brachytherapy was preceded by external beam radiotherapy predominately using an IMRT technique (90%) to a median dose of 45 Gy in 25 fractions. Toxicity was reported according to CTCAEv4. At a median follow-up of 18 months (range: 3-78), the clinical complete response rate was 95%. The 3-year local control, distant control, recurrence free survival, and overall survival were 95%, 61%, 68%, and 67%. Significant predictors of both distant failure and overall survival were primary prognostic factors of depth of myometrial invasion, FIGO stage, and FIGO grade. There was no grade 3+ acute toxicity; the 3-year rate of grade 3+ late toxicity was 8%. Salvage IMRT plus 3-dimensional image-based HDR brachytherapy shows excellent tumor control and minimal morbidity for vaginal recurrence of endometrial cancer. Anticipated salvage rates must be taken in the context of primary risk factors including depth of myometrial invasion, FIGO stage, and FIGO grade. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  6. Spectral and temperature-dependent infrared emissivity measurements of painted metals for improved temperature estimation during laser damage testing

    NASA Astrophysics Data System (ADS)

    Baumann, Sean M.; Keenan, Cameron; Marciniak, Michael A.; Perram, Glen P.

    2014-10-01

    A database of spectral and temperature-dependent emissivities was created for painted Al-alloy laser-damage-testing targets for the purpose of improving the uncertainty to which temperature on the front and back target surfaces may be estimated during laser-damage testing. Previous temperature estimates had been made by fitting an assumed gray-body radiance curve to the calibrated spectral radiance data collected from the back surface using a Telops Imaging Fourier Transform Spectrometer (IFTS). In this work, temperature-dependent spectral emissivity measurements of the samples were made from room temperature to 500 °C using a Surface Optics Corp. SOC-100 Hemispherical Directional Reflectometer (HDR) with Nicolet FTS. Of particular interest was a high-temperature matte-black enamel paint used to coat the rear surfaces of the Al-alloy samples. The paint had been assumed to have a spectrally flat and temperatureinvariant emissivity. However, the data collected using the HDR showed both spectral variation and temperature dependence. The uncertainty in back-surface temperature estimation during laser-damage testing made using the measured emissivities was improved from greater than +10 °C to less than +5 °C for IFTS pixels away from the laser burn-through hole, where temperatures never exceeded those used in the SOC-100 HDR measurements. At beam center, where temperatures exceeded those used in the SOC-100 HDR, uncertainty in temperature estimates grew beyond those made assuming gray-body emissivity. Accurate temperature estimations during laser-damage testing are useful in informing a predictive model for future high-energy-laser weapon applications.

  7. A multicenter study to quantify systematic variations and associated uncertainties in source positioning with commonly used HDR afterloaders and ring applicators for the treatment of cervical carcinomas

    SciTech Connect

    Awunor, O.; Berger, D.; Kirisits, C.

    2015-08-15

    Purpose: The reconstruction of radiation source position in the treatment planning system is a key part of the applicator reconstruction process in high dose rate (HDR) brachytherapy treatment of cervical carcinomas. The steep dose gradients, of as much as 12%/mm, associated with typical cervix treatments emphasize the importance of accurate and precise determination of source positions. However, a variety of methodologies with a range in associated measurement uncertainties, of up to ±2.5 mm, are currently employed by various centers to do this. In addition, a recent pilot study by Awunor et al. [“Direct reconstruction and associated uncertainties of {sup 192}Ir source dwell positions in ring applicators using gafchromic film in the treatment planning of HDR brachytherapy cervix patients,” Phys. Med. Biol. 58, 3207–3225 (2013)] reported source positional differences of up to 2.6 mm between ring sets of the same type and geometry. This suggests a need for a comprehensive study to assess and quantify systematic source position variations between commonly used ring applicators and HDR afterloaders across multiple centers. Methods: Eighty-six rings from 20 European brachytherapy centers were audited in the form of a postal audit with each center collecting the data independently. The data were collected by setting up the rings using a bespoke jig and irradiating gafchromic films at predetermined dwell positions using four afterloader types, MicroSelectron, Flexitron, GammaMed, and MultiSource, from three manufacturers, Nucletron, Varian, and Eckert & Ziegler BEBIG. Five different ring types in six sizes (Ø25–Ø35 mm) and two angles (45° and 60°) were used. Coordinates of irradiated positions relative to the ring center were determined and collated, and source position differences quantified by ring type, size, and angle. Results: The mean expanded measurement uncertainty (k = 2) along the direction of source travel was ±1.4 mm. The standard deviation

  8. High dynamic range subjective testing

    NASA Astrophysics Data System (ADS)

    Allan, Brahim; Nilsson, Mike

    2016-09-01

    This paper describes of a set of subjective tests that the authors have carried out to assess the end user perception of video encoded with High Dynamic Range technology when viewed in a typical home environment. Viewers scored individual single clips of content, presented in High Definition (HD) and Ultra High Definition (UHD), in Standard Dynamic Range (SDR), and in High Dynamic Range (HDR) using both the Perceptual Quantizer (PQ) and Hybrid Log Gamma (HLG) transfer characteristics, and presented in SDR as the backwards compatible rendering of the HLG representation. The quality of SDR HD was improved by approximately equal amounts by either increasing the dynamic range or increasing the resolution to UHD. A further smaller increase in quality was observed in the Mean Opinion Scores of the viewers by increasing both the dynamic range and the resolution, but this was not quite statistically significant.

  9. Treatment planning study of the 3D dosimetric differences between Co-60 and Ir-192 sources in high dose rate (HDR) brachytherapy for cervix cancer

    PubMed Central

    Hayman, Orla; Muscat, Sarah

    2012-01-01

    Purpose To evaluate whether Co-60 is equivalent to Ir-192 for HDR cervical brachytherapy, through 3D-DVH dose comparisons in standard and optimised plans. Previous studies have only considered 2D dosimetry, point dose comparisons or identical loading. Typical treatment times and economics are considered. Material and methods Plans were produced for eight cervix patients using Co-60 and Ir-192 sources, CT imaging and IU/two-channel-ring applicator (Eckert Ziegler BEBIG). The comparison was made under two conditions: (A) identical dwell positions and loading, prescribed to Point A and (B) optimised source dwells, prescribed to HR-CTV. This provided a direct comparison of inherent differences and residual differences under typical clinical plan optimisation. The DVH (target and OAR), ICRU reference points and isodose distributions were compared. Typical treatment times and source replacement costs were compared. Results Small differences (p < 0.01) in 3D dosimetry exist when using Co-60 compared to Ir-192, prescribed to Point A with identical loading patterns, particularly 3.3% increase in rectum D2cc. No significant difference was observed in this parameter when prescribing to the HR-CTV using dwell-time optimisation. There was no statistically significant difference in D90 between the two isotopes. Co-60 plans delivered consistently higher V150% (mean +4.4%, p = 0.03) and V400% (mean +11.6%, p < 0.01) compared to Ir-192 in optimised plans. Differences in physical source properties were overwhelmed by geometric effects. Conclusions Co-60 may be used as an effective alternative to Ir-192 for HDR cervix brachytherapy, producing similar plans of equivalent D90, but with logistical benefits. There is a small dose increase along the extension of the source axis when using Co-60 compared to Ir-192, leading to small rectal dose increases for identical loading patterns. This can be eliminated by planning optimisation techniques. Such optimisation may also be associated with

  10. SU-E-T-509: Inter-Observer and Inter-Modality Contouring Analysis for Organs at Risk for HDR Gynecological Brachytherapy

    SciTech Connect

    Sadeghi, P; Smith, W; Banerjee, R; Alghamdi, M; Phan, T; Taggar, A

    2015-06-15

    Purpose This study quantifies errors associated with MR-guided High Dose Rate (HDR) gynecological brachytherapy. Uncertainties in this treatment results from contouring, organ motion between imaging and treatment delivery, dose calculation, and dose delivery. We focus on interobserver and inter-modality variability in contouring and the motion of organs at risk (OARs) in the time span between the MR and CT scans (∼1 hour). We report the change in organ volume and position of center of mass (CM) between the two imaging modalities. Methods A total of 8 patients treated with MR-guided HDR brachytherapy were included in this study. Two observers contoured the bladder and rectum on both MR and CT scans. The change in OAR volume and CM position between the MR and CT imaging sessions on both image sets were calculated. Results The absolute mean bladder volume change between the two imaging modalities is 67.1cc. The absolute mean inter-observer difference in bladder volume is much lower at 15.5cc (MR) and 11.0cc (CT). This higher inter-modality volume difference suggests a real change in the bladder filling between the two imaging sessions. Change in Rectum volume inter-observer standard error of means (SEM) is 3.18cc (MR) and 3.09cc (CT), while the inter-modality SEM is 3.65cc (observer 1), and 2.75cc (observer 2). The SEM for rectum CM position in the superior-inferior direction was approximately three times higher than in other directions for both the inter—observer (0.77 cm, 0.92 cm for observers 1 and 2, respectively) and inter-modality (0.91 cm, 0.95 cm for MR and CT, respectively) variability. Conclusion Bladder contours display good consistency between different observers on both CT and MR images. For rectum contouring the highest inconsistency stems from the observers’ choice of the superior-inferior borders. A complete analysis of a larger patient cohort will enable us to separate the true organ motion from the inter-observer variability.

  11. Thermal dosimetry analysis combined with patient-specific thermal modeling of clinical interstitial ultrasound hyperthermia integrated within HDR brachytherapy for treatment of locally advanced prostate cancer

    NASA Astrophysics Data System (ADS)

    Salgaonkar, Vasant A.; Wootton, Jeff; Prakash, Punit; Scott, Serena; Hsu, I. C.; Diederich, Chris J.

    2017-03-01

    This study presents thermal dosimetry analysis from clinical treatments where ultrasound hyperthermia (HT) was administered following high-dose rate (HDR) brachytherapy treatment for locally advanced prostate cancer as part of a clinical pilot study. HT was administered using ultrasound applicators from within multiple 13-g brachytherapy catheters implanted along the posterior periphery of the prostate. The heating applicators were linear arrays of sectored tubular transducers (˜7 MHz), with independently powered array elements enabling energy deposition with 3D spatial control. Typical heat treatments employed time-averaged peak acoustic intensities of 1 - 3 W/cm2 and lasted for 60 - 70 minutes. Throughout the treatments, temperatures at multiple points were monitored using multi-junction thermocouples, placed within available brachytherapy catheters throughout mid-gland prostate and identified as the hyperthermia target volume (HTV). Clinical constraints allowed placement of 8 - 12 thermocouple sensors in the HTV and patient-specific 3D thermal modeling based on finite element methods (FEM) was used to supplement limited thermometry. Patient anatomy, heating device positions, orientations, and thermometry junction locations were obtained from patient CT scans and HDR and hyperthermia planning software. The numerical models utilized the applied power levels recorded during the treatments. Tissue properties such as perfusion and acoustic absorption were varied within physiological ranges such that squared-errors between measured and simulated temperatures were minimized. This data-fitting was utilized for 6 HT treatments to estimate volumetric temperature distributions achieved in the HTV and surrounding anatomy devoid of thermocouples. For these treatments, the measured and simulated T50 values in the hyperthermia target volume (HTV) were between 40.1 - 43.9 °C and 40.3 - 44.9 °C, respectively. Maximum temperatures between 46.8 - 49.8 °C were measured during

  12. SU-F-19A-02: Comparison of Absorbed Dose to Water Standards for HDR Ir-192 Brachytherapy Between the LCR, Brazil and NRC, Canada

    SciTech Connect

    Salata, C; David, M; Almeida, C de; El Gamal, I; Cojocaru, C; Mainegra-Hing, E; McEwen, M

    2014-06-15

    Purpose: To compare absorbed dose to water standards for HDR brachytherapy dosimetry developed by the Radiological Science Laboratory of Rio de Janeiro State University (LCR) and the National Research Council, Canada (NRC). Methods: The two institutions have separately developed absorbed dose standards based on the Fricke dosimetry system. There are important differences between the two standards, including: preparation and read-out of the Fricke solution, irradiation geometry of the Fricke holder in relation to the Ir-192 source, and determination of the G-value to be used at Ir-192 energies. All measurements for both standards were made directly at the NRC laboratory (i.e., no transfer instrument was used) using a single Ir-192 source (microSelectron v2). In addition, the NRC group has established a self-consistent method to determine the G-value for Ir-192, based on an interpolation between G-values obtained at Co-60 and 250kVp X-rays, and this measurement was repeated using the LCR Fricke solution to investigate possible systematic uncertainties. Results: G-values for Co-60 and 250 kVp x-rays, obtained using the LCR Fricke system, agreed with the NRC values within 0.5 % and 1 % respectively, indicating that the general assumption of universal G-values is appropriate in this case. The standard uncertainty in the determination of G for Ir-192 is estimated to be 0.6 %. For the comparison of absorbed dose measurements at the reference point for Ir-192 (1 cm depth in water, perpendicular to the seed long-axis), the ratio Dw(NRC)/Dw(LCR) was found to be 1.011 with a combined standard uncertainty of 1.7 %, k=1. Conclusion: The agreement in the absorbed dose to water values for the LCR and NRC systems is very encouraging. Combined with the lower uncertainty in this approach compared to the present air-kerma approach, these results reaffirm the use of Fricke solution as a potential primary standard for HDR Ir-192 brachytherapy.

  13. SU-F-BRF-09: A Non-Rigid Point Matching Method for Accurate Bladder Dose Summation in Cervical Cancer HDR Brachytherapy

    SciTech Connect

    Chen, H; Zhen, X; Zhou, L; Zhong, Z; Pompos, A; Yan, H; Jiang, S; Gu, X

    2014-06-15

    Purpose: To propose and validate a deformable point matching scheme for surface deformation to facilitate accurate bladder dose summation for fractionated HDR cervical cancer treatment. Method: A deformable point matching scheme based on the thin plate spline robust point matching (TPSRPM) algorithm is proposed for bladder surface registration. The surface of bladders segmented from fractional CT images is extracted and discretized with triangular surface mesh. Deformation between the two bladder surfaces are obtained by matching the two meshes' vertices via the TPS-RPM algorithm, and the deformation vector fields (DVFs) characteristic of this deformation is estimated by B-spline approximation. Numerically, the algorithm is quantitatively compared with the Demons algorithm using five clinical cervical cancer cases by several metrics: vertex-to-vertex distance (VVD), Hausdorff distance (HD), percent error (PE), and conformity index (CI). Experimentally, the algorithm is validated on a balloon phantom with 12 surface fiducial markers. The balloon is inflated with different amount of water, and the displacement of fiducial markers is benchmarked as ground truth to study TPS-RPM calculated DVFs' accuracy. Results: In numerical evaluation, the mean VVD is 3.7(±2.0) mm after Demons, and 1.3(±0.9) mm after TPS-RPM. The mean HD is 14.4 mm after Demons, and 5.3mm after TPS-RPM. The mean PE is 101.7% after Demons and decreases to 18.7% after TPS-RPM. The mean CI is 0.63 after Demons, and increases to 0.90 after TPS-RPM. In the phantom study, the mean Euclidean distance of the fiducials is 7.4±3.0mm and 4.2±1.8mm after Demons and TPS-RPM, respectively. Conclusions: The bladder wall deformation is more accurate using the feature-based TPS-RPM algorithm than the intensity-based Demons algorithm, indicating that TPS-RPM has the potential for accurate bladder dose deformation and dose summation for multi-fractional cervical HDR brachytherapy. This work is supported in part by

  14. A method for verification of treatment delivery in HDR prostate brachytherapy using a flat panel detector for both imaging and source tracking

    SciTech Connect

    Smith, Ryan L. Millar, Jeremy L.; Franich, Rick D.; Haworth, Annette; Panettieri, Vanessa

    2016-05-15

    Purpose: Verification of high dose rate (HDR) brachytherapy treatment delivery is an important step, but is generally difficult to achieve. A technique is required to monitor the treatment as it is delivered, allowing comparison with the treatment plan and error detection. In this work, we demonstrate a method for monitoring the treatment as it is delivered and directly comparing the delivered treatment with the treatment plan in the clinical workspace. This treatment verification system is based on a flat panel detector (FPD) used for both pre-treatment imaging and source tracking. Methods: A phantom study was conducted to establish the resolution and precision of the system. A pretreatment radiograph of a phantom containing brachytherapy catheters is acquired and registration between the measurement and treatment planning system (TPS) is performed using implanted fiducial markers. The measured catheter paths immediately prior to treatment were then compared with the plan. During treatment delivery, the position of the {sup 192}Ir source is determined at each dwell position by measuring the exit radiation with the FPD and directly compared to the planned source dwell positions. Results: The registration between the two corresponding sets of fiducial markers in the TPS and radiograph yielded a registration error (residual) of 1.0 mm. The measured catheter paths agreed with the planned catheter paths on average to within 0.5 mm. The source positions measured with the FPD matched the planned source positions for all dwells on average within 0.6 mm (s.d. 0.3, min. 0.1, max. 1.4 mm). Conclusions: We have demonstrated a method for directly comparing the treatment plan with the delivered treatment that can be easily implemented in the clinical workspace. Pretreatment imaging was performed, enabling visualization of the implant before treatment delivery and identification of possible catheter displacement. Treatment delivery verification was performed by measuring the

  15. Prostate Specific Antigen (PSA) as Predicting Marker for Clinical Outcome and Evaluation of Early Toxicity Rate after High-Dose Rate Brachytherapy (HDR-BT) in Combination with Additional External Beam Radiation Therapy (EBRT) for High Risk Prostate Cancer

    PubMed Central

    Ecke, Thorsten H.; Huang-Tiel, Hui-Juan; Golka, Klaus; Selinski, Silvia; Geis, Berit Christine; Koswig, Stephan; Bathe, Katrin; Hallmann, Steffen; Gerullis, Holger

    2016-01-01

    High-dose-rate brachytherapy (HDR-BT) with external beam radiation therapy (EBRT) is a common treatment option for locally advanced prostate cancer (PCa). Seventy-nine male patients (median age 71 years, range 50 to 79) with high-risk PCa underwent HDR-BT following EBRT between December 2009 and January 2016 with a median follow-up of 21 months. HDR-BT was administered in two treatment sessions (one week interval) with 9 Gy per fraction using a planning system and the Ir192 treatment unit GammaMed Plus iX. EBRT was performed with CT-based 3D-conformal treatment planning with a total dose administration of 50.4 Gy with 1.8 Gy per fraction and five fractions per week. Follow-up for all patients was organized one, three, and five years after radiation therapy to evaluate early and late toxicity side effects, metastases, local recurrence, and prostate-specific antigen (PSA) value measured in ng/mL. The evaluated data included age, PSA at time of diagnosis, PSA density, BMI (body mass index), Gleason score, D’Amico risk classification for PCa, digital rectal examination (DRE), PSA value after one/three/five year(s) follow-up (FU), time of follow-up, TNM classification, prostate volume, and early toxicity rates. Early toxicity rates were 8.86% for gastrointestinal, and 6.33% for genitourinary side effects. Of all treated patients, 84.81% had no side effects. All reported complications in early toxicity were grade 1. PSA density at time of diagnosis (p = 0.009), PSA on date of first HDR-BT (p = 0.033), and PSA on date of first follow-up after one year (p = 0.025) have statistical significance on a higher risk to get a local recurrence during follow-up. HDR-BT in combination with additional EBRT in the presented design for high-risk PCa results in high biochemical control rates with minimal side-effects. PSA is a negative predictive biomarker for local recurrence during follow-up. A longer follow-up is needed to assess long-term outcome and toxicities. PMID:27834929

  16. Prostate Specific Antigen (PSA) as Predicting Marker for Clinical Outcome and Evaluation of Early Toxicity Rate after High-Dose Rate Brachytherapy (HDR-BT) in Combination with Additional External Beam Radiation Therapy (EBRT) for High Risk Prostate Cancer.

    PubMed

    Ecke, Thorsten H; Huang-Tiel, Hui-Juan; Golka, Klaus; Selinski, Silvia; Geis, Berit Christine; Koswig, Stephan; Bathe, Katrin; Hallmann, Steffen; Gerullis, Holger

    2016-11-10

    High-dose-rate brachytherapy (HDR-BT) with external beam radiation therapy (EBRT) is a common treatment option for locally advanced prostate cancer (PCa). Seventy-nine male patients (median age 71 years, range 50 to 79) with high-risk PCa underwent HDR-BT following EBRT between December 2009 and January 2016 with a median follow-up of 21 months. HDR-BT was administered in two treatment sessions (one week interval) with 9 Gy per fraction using a planning system and the Ir192 treatment unit GammaMed Plus iX. EBRT was performed with CT-based 3D-conformal treatment planning with a total dose administration of 50.4 Gy with 1.8 Gy per fraction and five fractions per week. Follow-up for all patients was organized one, three, and five years after radiation therapy to evaluate early and late toxicity side effects, metastases, local recurrence, and prostate-specific antigen (PSA) value measured in ng/mL. The evaluated data included age, PSA at time of diagnosis, PSA density, BMI (body mass index), Gleason score, D'Amico risk classification for PCa, digital rectal examination (DRE), PSA value after one/three/five year(s) follow-up (FU), time of follow-up, TNM classification, prostate volume, and early toxicity rates. Early toxicity rates were 8.86% for gastrointestinal, and 6.33% for genitourinary side effects. Of all treated patients, 84.81% had no side effects. All reported complications in early toxicity were grade 1. PSA density at time of diagnosis (p = 0.009), PSA on date of first HDR-BT (p = 0.033), and PSA on date of first follow-up after one year (p = 0.025) have statistical significance on a higher risk to get a local recurrence during follow-up. HDR-BT in combination with additional EBRT in the presented design for high-risk PCa results in high biochemical control rates with minimal side-effects. PSA is a negative predictive biomarker for local recurrence during follow-up. A longer follow-up is needed to assess long-term outcome and toxicities.

  17. A radiation quality correction factor k{sub Q} for well-type ionization chambers for the measurement of the reference air kerma rate of {sup 60}Co HDR brachytherapy sources

    SciTech Connect

    Schüller, Andreas Meier, Markus; Selbach, Hans-Joachim; Ankerhold, Ulrike

    2015-07-15

    Purpose: The aim of this study was to investigate whether a chamber-type-specific radiation quality correction factor k{sub Q} can be determined in order to measure the reference air kerma rate of {sup 60}Co high-dose-rate (HDR) brachytherapy sources with acceptable uncertainty by means of a well-type ionization chamber calibrated for {sup 192}Ir HDR sources. Methods: The calibration coefficients of 35 well-type ionization chambers of two different chamber types for radiation fields of {sup 60}Co and {sup 192}Ir HDR brachytherapy sources were determined experimentally. A radiation quality correction factor k{sub Q} was determined as the ratio of the calibration coefficients for {sup 60}Co and {sup 192}Ir. The dependence on chamber-to-chamber variations, source-to-source variations, and source strength was investigated. Results: For the PTW Tx33004 (Nucletron source dosimetry system (SDS)) well-type chamber, the type-specific radiation quality correction factor k{sub Q} is 1.19. Note that this value is valid for chambers with the serial number, SN ≥ 315 (Nucletron SDS SN ≥ 548) onward only. For the Standard Imaging HDR 1000 Plus well-type chambers, the type-specific correction factor k{sub Q} is 1.05. Both k{sub Q} values are independent of the source strengths in the complete clinically relevant range. The relative expanded uncertainty (k = 2) of k{sub Q} is U{sub k{sub Q}} = 2.1% for both chamber types. Conclusions: The calibration coefficient of a well-type chamber for radiation fields of {sup 60}Co HDR brachytherapy sources can be calculated from a given calibration coefficient for {sup 192}Ir radiation by using a chamber-type-specific radiation quality correction factor k{sub Q}. However, the uncertainty of a {sup 60}Co calibration coefficient calculated via k{sub Q} is at least twice as large as that for a direct calibration with a {sup 60}Co source.

  18. Comparison of organ doses for patients undergoing balloon brachytherapy of the breast with HDR {sup 192}Ir or electronic sources using Monte Carlo simulations in a heterogeneous human phantom

    SciTech Connect

    Mille, Matthew M.; Xu, X. George; Rivard, Mark J.

    2010-02-15

    Purpose: Accelerated partial breast irradiation via interstitial balloon brachytherapy is a fast and effective treatment method for certain early stage breast cancers. The radiation can be delivered using a conventional high-dose rate (HDR) {sup 192}Ir gamma-emitting source or a novel electronic brachytherapy (eBx) source which uses lower energy x rays that do not penetrate as far within the patient. A previous study [A. Dickler, M. C. Kirk, N. Seif, K. Griem, K. Dowlatshahi, D. Francescatti, and R. A. Abrams, ''A dosimetric comparison of MammoSite high-dose-rate brachytherapy and Xoft Axxent electronic brachytherapy,'' Brachytherapy 6, 164-168 (2007)] showed that the target dose is similar for HDR {sup 192}Ir and eBx. This study compares these sources based on the dose received by healthy organs and tissues away from the treatment site. Methods: A virtual patient with left breast cancer was represented by a whole-body, tissue-heterogeneous female voxel phantom. Monte Carlo methods were used to calculate the dose to healthy organs in a virtual patient undergoing balloon brachytherapy of the left breast with HDR {sup 192}Ir or eBx sources. The dose-volume histograms for a few organs which received large doses were also calculated. Additional simulations were performed with all tissues in the phantom defined as water to study the effect of tissue inhomogeneities. Results: For both HDR {sup 192}Ir and eBx, the largest mean organ doses were received by the ribs, thymus gland, left lung, heart, and sternum which were close to the brachytherapy source in the left breast. eBx yielded mean healthy organ doses that were more than a factor of {approx}1.4 smaller than for HDR {sup 192}Ir for all organs considered, except for the three closest ribs. Excluding these ribs, the average and median dose-reduction factors were {approx}28 and {approx}11, respectively. The volume distribution of doses in nearby soft tissue organs that were outside the PTV were also improved with e

  19. Comparison of organ doses for patients undergoing balloon brachytherapy of the breast with HDR 192Ir or electronic sources using Monte Carlo simulations in a heterogeneous human phantom1

    PubMed Central

    Mille, Matthew M.; Xu, X. George; Rivard, Mark J.

    2010-01-01

    Purpose: Accelerated partial breast irradiation via interstitial balloon brachytherapy is a fast and effective treatment method for certain early stage breast cancers. The radiation can be delivered using a conventional high-dose rate (HDR) 192Ir gamma-emitting source or a novel electronic brachytherapy (eBx) source which uses lower energy x rays that do not penetrate as far within the patient. A previous study [A. Dickler, M. C. Kirk, N. Seif, K. Griem, K. Dowlatshahi, D. Francescatti, and R. A. Abrams, “A dosimetric comparison of MammoSite high-dose-rate brachytherapy and Xoft Axxent electronic brachytherapy,” Brachytherapy 6, 164–168 (2007)] showed that the target dose is similar for HDR 192Ir and eBx. This study compares these sources based on the dose received by healthy organs and tissues away from the treatment site. Methods: A virtual patient with left breast cancer was represented by a whole-body, tissue-heterogeneous female voxel phantom. Monte Carlo methods were used to calculate the dose to healthy organs in a virtual patient undergoing balloon brachytherapy of the left breast with HDR 192Ir or eBx sources. The dose-volume histograms for a few organs which received large doses were also calculated. Additional simulations were performed with all tissues in the phantom defined as water to study the effect of tissue inhomogeneities. Results: For both HDR 192Ir and eBx, the largest mean organ doses were received by the ribs, thymus gland, left lung, heart, and sternum which were close to the brachytherapy source in the left breast. eBx yielded mean healthy organ doses that were more than a factor of ∼1.4 smaller than for HDR 192Ir for all organs considered, except for the three closest ribs. Excluding these ribs, the average and median dose-reduction factors were ∼28 and ∼11, respectively. The volume distribution of doses in nearby soft tissue organs that were outside the PTV were also improved with eBx. However, the maximum dose to the closest

  20. Direction Modulated Brachytherapy (DMBT) for Treatment of Cervical Cancer: A Planning Study with 192Ir, 60Co, and 169Yb HDR Sources.

    PubMed

    Safigholi, Habib; Han, Dae Yup; Mashouf, Shahram; Soliman, Abraam; Meigooni, Ali S; Owrangi, Amir; Song, William Y

    2017-09-22

    To evaluate plan quality of a novel MRI-compatible direction modulated brachytherapy (DMBT) tandem applicator using 192Ir, 60Co, and 169Yb HDR brachytherapy sources, for various cervical cancer high-risk clinical target volumes (CTVHR ). The novel DMBT tandem applicator has six peripheral grooves of 1.3-mm diameter along a 5.4-mm thick nonmagnetic tungsten alloy rod. Monte Carlo (MC) simulations were used to benchmark the dosimetric parameters of the 192Ir, 60Co, and 169Yb HDR sources in a water phantom against the literature data. 45 clinical cases that were treated using conventional tandem-and-ring applicators with 192Ir source (192Ir-T&R) were selected consecutively from intErnational MRI-guided BRAchytherapy in CErvical cancer (EMBRACE) trial. Then, for each clinical case, 3D dose distribution of each source inside the DMBT and conventional applicators were calculated and imported onto an in-house developed inverse planning optimization code to generate optimal plans. All plans generated by the DMBT tandem-and-ring (DMBT T&R) from all three sources were compared to the respective 192Ir-T&R plans. For consistency, all plans were normalized to the same CTVHR D90 achieved in clinical plans. The D2cm3 for organs at risk (OAR) such as bladder, rectum, and sigmoid, and D90, D98, D10, V100, and V200 for CTVHR were calculated. In general, plan quality significantly improved when a conventional tandem (Con.T) is replaced with the DMBT tandem. The target coverage metrics were similar across 192Ir-T&R and DMBT T&R plans with all three sources (p>0.093). 60Co-DMBT T&R generated greater hot spots and less dose homogeneity in the target volumes compared with the 192Ir- and 169Yb-DMBT T&R plans. Mean OAR doses in the DMBT T&R plans were significantly smaller (P<0.0084) than the 192Ir-T&R plans. Mean bladder D2cm3 was reduced by 4.07%, 4.15%, and 5.13%, for the 192Ir-, 60Co-, and 169Yb-DMBT T&R plans, respectively. Mean rectum (sigmoid) D2cm3 was reduced by 3.17% (3.63%), 2

  1. Comparison of 3D dose distributions for HDR 192Ir brachytherapy sources with normoxic polymer gel dosimetry and treatment planning system.

    PubMed

    Senkesen, Oznur; Tezcanli, Evrim; Buyuksarac, Bora; Ozbay, Ismail

    2014-01-01

    Radiation fluence changes caused by the dosimeter itself and poor spatial resolution may lead to lack of 3-dimensional (3D) information depending on the features of the dosimeter and quality assurance of dose distributions for high-dose rate (HDR) iridium-192 ((192)Ir) brachytherapy sources is challenging and experimental dosimetry methods used for brachytherapy sources are limited. In this study, we investigated 3D dose distributions of (192)Ir brachytherapy sources for irradiation with single and multiple dwell positions using a normoxic gel dosimeter and compared them with treatment planning system (TPS) calculations. For dose calibration purposes, 100-mL gel-containing vials were irradiated at predefined doses and then scanned in an magnetic resonance (MR) imaging unit. Gel phantoms prepared in 2 spherical glasses were irradiated with (192)Ir for the calculated dwell positions, and MR scans of the phantoms were obtained. The images were analyzed with MATLAB software. Dose distributions and profiles derived with 1-mm resolution were compared with TPS calculations. Linearity was observed between the delivered dose and the reciprocal of the T2 relaxation time constant of the gel. The x-, y-, and z-axes were defined as the sagittal, coronal, and axial planes, respectively, the sagittal and axial planes were defined parallel to the long axis of the source while the coronal plane was defined horizontally to the long axis of the source. The differences between measured and calculated profile widths of 3-cm source length and point source for 70%, 50%, and 30% isodose lines were evaluated at 3 dose levels using 18 profiles of comparison. The calculations for 3-cm source length revealed a difference of > 3mm in 1 coordinate at 50% profile width on the sagittal plane and 3 coordinates at 70% profile width and 2 coordinates at 50% and 30% profile widths on the axial plane. Calculations on the coronal plane for 3-cm source length showed > 3-mm difference in 1 coordinate at

  2. Comparison of 3D dose distributions for HDR {sup 192}Ir brachytherapy sources with normoxic polymer gel dosimetry and treatment planning system

    SciTech Connect

    Senkesen, Oznur; Tezcanli, Evrim; Buyuksarac, Bora; Ozbay, Ismail

    2014-10-01

    Radiation fluence changes caused by the dosimeter itself and poor spatial resolution may lead to lack of 3-dimensional (3D) information depending on the features of the dosimeter and quality assurance of dose distributions for high–dose rate (HDR) iridium-192 ({sup 192}Ir) brachytherapy sources is challenging and experimental dosimetry methods used for brachytherapy sources are limited. In this study, we investigated 3D dose distributions of {sup 192}Ir brachytherapy sources for irradiation with single and multiple dwell positions using a normoxic gel dosimeter and compared them with treatment planning system (TPS) calculations. For dose calibration purposes, 100-mL gel-containing vials were irradiated at predefined doses and then scanned in an magnetic resonance (MR) imaging unit. Gel phantoms prepared in 2 spherical glasses were irradiated with {sup 192}Ir for the calculated dwell positions, and MR scans of the phantoms were obtained. The images were analyzed with MATLAB software. Dose distributions and profiles derived with 1-mm resolution were compared with TPS calculations. Linearity was observed between the delivered dose and the reciprocal of the T2 relaxation time constant of the gel. The x-, y-, and z-axes were defined as the sagittal, coronal, and axial planes, respectively, the sagittal and axial planes were defined parallel to the long axis of the source while the coronal plane was defined horizontally to the long axis of the source. The differences between measured and calculated profile widths of 3-cm source length and point source for 70%, 50%, and 30% isodose lines were evaluated at 3 dose levels using 18 profiles of comparison. The calculations for 3-cm source length revealed a difference of > 3 mm in 1 coordinate at 50% profile width on the sagittal plane and 3 coordinates at 70% profile width and 2 coordinates at 50% and 30% profile widths on the axial plane. Calculations on the coronal plane for 3-cm source length showed > 3-mm difference in 1

  3. SU-E-T-352: Effects of Skull Attenuation and Missing Backscatter On Brain Dose in HDR Treatment of the Head with Surface Applicators

    SciTech Connect

    Cifter, F; Dhou, S; Lewis, J; Cormack, R; Altundal, Y; Sajo, E

    2015-06-15

    Purpose: To calculate the effect of lack of backscatter from air and attenuation of bone on dose distributions in brachytherapy surface treatment of head. Existing treatment planning systems based on TG43 do not account for heterogeneities, and thus may overestimate the dose to the brain. While brachytherapy generally has rapid dose falloff, the dose to the deeper tissues (in this case, the brain) can become significant when treating large curved surfaces. Methods: Applicator geometries representing a range of clinical cases were simulated in MCNP5. An Ir-192 source was modeled using the energy spectrum presented by TG-43. The head phantom was modeled as a 7.5-cm radius water sphere, with a 7 -mm thick skull embedded 5-mm beneath the surface. Dose values were calculated at 20 points inside the head, in which 10 of them were on the central axis and the other 10 on the axis connecting the central of the phantom with the second to last source from the applicator edge. Results: Central and peripheral dose distributions for a range of applicator and head sizes are presented. The distance along the central axis at which the dose falls to 80% of the prescribed dose (D80) was 7 mm for a representative small applicator and 9 mm for a large applicator. Corresponding D50 and D30 for the same small applicator were 17 mm and 32 mm respectively. D50 and D30 for the larger applicator were 32 mm and 60 mm respectively. These results reflect the slower falloff expected for larger applicators on a curved surface. Conclusion: Our results can provide guidance for clinicians to calculate the dose reduction effect due to bone attenuation and the lack of backscatter from air to estimate the brain dose for the HDR treatments of surface lesions.

  4. SU-E-T-491: Influence of Applicator Dimensions On Doses to Bladder, Rectum and Sigmoid in HDR Brachytherapy for Cervical Cancer

    SciTech Connect

    Dumane, V; Rhome, R; Yuan, Y; Gupta, V

    2015-06-15

    Purpose: To study the influence of dimensions of the tandem and ring applicator on bladder D2cc, rectum D2cc and sigmoid D2cc in HDR treatment planning for cervical cancer. Methods: 53 plans from 13 patients treated at our institution with the tandem and ring applicator were retrospectively reviewed. Prescription doses were one of the following: 8 Gy x 3, 7 Gy x 4 and 5.5 Gy x 5. Doses to the D2ccs of the bladder, rectum and the sigmoid were recorded. These doses were normalized to their relative prescriptions doses. Correlations between the normalized bladder D2cc, rectum D2cc and sigmoid D2cc were investigated and linear regression models were developed to study the dependence of these doses on the ring diameter and the applicator angle. Results: Normalized doses to the D2cc of the bladder, rectum and sigmoid showed statistically significant correlation (P < 0.05) to the applicator angle. Significant correlation was also noted for the normalized D2cc of the rectum and the sigmoid with the ring diameter. The normalized bladder D2cc was found to decrease with applicator angle on an average by 22.65% ± 4.43% while the same for the rectum and sigmoid were found to increase on an average by 14.43% ± 1.65% and 14.01% ± 1.42% respectively. Both the rectum and sigmoid D2cc reduced with increasing ring diameter by 12.93% ± 1.95% and 11.27% ± 1.79%. No correlation was observed between the normalized bladder D2cc and the ring diameter. Conclusion: Preliminary regression models developed in this study can potentially aid in the choice of the appropriate applicator angle and ring diameter for tandem and ring implant so as to optimize doses to the bladder, rectum and sigmoid.

  5. Application of a pelvic phantom in brachytherapy dosimetry for high-dose-rate (HDR) 192Ir source based on Monte Carlo simulations

    NASA Astrophysics Data System (ADS)

    Ahn, Woo Sang; Choi, Wonsik; Shin, Seong Soo; Jung, Jinhong

    2014-08-01

    In this study, we evaluate how the radial dose function is influenced by the source position as well as the phantom size and shape. A pelvic water phantom similar to the pelvic shape of a human body was designed by averaging dimensions obtained from computed tomography (CT) images of patients treated with brachytherapy for cervical cancer. Furthermore, for the study of the effects of source position on the dose distribution, the position of the source in the water phantom was determined by using the center of mass of the gross target volume (GTV) in the CT images. To obtain the dosimetric parameter of a high-dose-rate (HDR) 192Ir source, we performed Monte Carlo simulations by using the Monte Carlo n-particle extended code (MCNPX). The radial dose functions obtained using the pelvic water phantom were compared with those of spherical phantom with different sizes, including the Monte Carlo (MC) results of Williamson and Li. Differences between the radial dose functions from this study and the data in the literature increased with the radial distances. The largest differences appeared for spherical phantom with the smallest size. In contrast to the published MC results, the radial dose function of the pelvic water phantom significantly decreased with radial distance in the vertical direction because full scattering was not possible. When the source was located in posterior position 2 cm from the center in the pelvic water phantom, the differences between the radial dose functions rapidly decreased with the radial distance in the lower vertical direction. If the International Commission on Radiation Units and Measurements bladder and rectum points are considered, doses to these reference points could be underestimated by up to 1%-2% at a distance of 3 to 6 cm. Our simulation results provide a valid clinical reference data and can used to improve the accuracy of the doses delivered during brachytherapy applied to patients with cervical cancer.

  6. SU-F-19A-10: Recalculation and Reporting Clinical HDR 192-Ir Head and Neck Dose Distributions Using Model Based Dose Calculation

    SciTech Connect

    Carlsson Tedgren, A; Persson, M; Nilsson, J

    2014-06-15

    Purpose: To retrospectively re-calculate dose distributions for selected head and neck cancer patients, earlier treated with HDR 192Ir brachytherapy, using Monte Carlo (MC) simulations and compare results to distributions from the planning system derived using TG43 formalism. To study differences between dose to medium (as obtained with the MC code) and dose to water in medium as obtained through (1) ratios of stopping powers and (2) ratios of mass energy absorption coefficients between water and medium. Methods: The MC code Algebra was used to calculate dose distributions according to earlier actual treatment plans using anonymized plan data and CT images in DICOM format. Ratios of stopping power and mass energy absorption coefficients for water with various media obtained from 192-Ir spectra were used in toggling between dose to water and dose to media. Results: Differences between initial planned TG43 dose distributions and the doses to media calculated by MC are insignificant in the target volume. Differences are moderate (within 4–5 % at distances of 3–4 cm) but increase with distance and are most notable in bone and at the patient surface. Differences between dose to water and dose to medium are within 1-2% when using mass energy absorption coefficients to toggle between the two quantities but increase to above 10% for bone using stopping power ratios. Conclusion: MC predicts target doses for head and neck cancer patients in close agreement with TG43. MC yields improved dose estimations outside the target where a larger fraction of dose is from scattered photons. It is important with awareness and a clear reporting of absorbed dose values in using model based algorithms. Differences in bone media can exceed 10% depending on how dose to water in medium is defined.

  7. SU-E-T-297: Dosimetric Assessment of An Air-Filled Balloon Applicator in HDR Vaginal Cuff Brachytherapy Using the Monte Carlo Method

    SciTech Connect

    Jiang, H; Lee, Y; Pokhrel, D; Badkul, R

    2015-06-15

    Purpose: As an alternative to cylindrical applicators, air inflated balloon applicators have been introduced into HDR vaginal cuff brachytherapy treatment to achieve sufficient dose to vagina mucosa as well as to spare rectum and bladder. In general, TG43 formulae based treatment planning systems do not take into account tissue inhomogeneity, and air in the balloon applicator can cause higher delivered dose to mucosa than treatment plan reported. We investigated dosimetric effect of air in balloon applicator using the Monte Carlo method. Methods: The thirteen-catheter Capri applicator with a Nucletron Ir-192 seed was modeled for various balloon diameters (2cm to 3.5cm) using the MCNP Monte Carlo code. Ir-192 seed was placed in both central and peripheral catheters to replicate real patient situations. Existence of charged particle equilibrium (CPE) with air balloon was evaluated by comparing kerma and dose at various distances (1mm to 70mm) from surface of air-filled applicator. Also mucosa dose by an air-filled applicator was compared with by a water-filled applicator to evaluate dosimetry accuracy of planning system without tissue inhomogeneity correction. Results: Beyond 1mm from air/tissue interface, the difference between kerma and dose was within 2%. CPE (or transient CPE) condition was deemed existent, and in this region no electron transport was necessary in Monte Carlo simulations. At 1mm or less, the deviation of dose from kerma became more apparent. Increase of dose to mucosa depended on diameter of air balloon. The increment of dose to mucosa was 2.5% and 4.3% on average for 2cm and 3.5cm applicators, respectively. Conclusion: After introduction of air balloon applicator, CPE fails only at the proximity of air/tissue interface. Although dose to mucosa is increased, there is no significant dosimetric difference (<5%) between air and water filled applicators. Tissue inhomogeneity correction is not necessary for air-filled applicators.

  8. 4D analysis of influence of patient movement and anatomy alteration on the quality of 3D U/S-based prostate HDR brachytherapy treatment delivery

    SciTech Connect

    Milickovic, Natasa; Mavroidis, Panayiotis; Tselis, Nikolaos; Nikolova, Iliyana; Katsilieri, Zaira; Kefala, Vasiliki; Zamboglou, Nikolaos; Baltas, Dimos

    2011-09-15

    Purpose: Modern HDR brachytherapy treatment for prostate cancer based on the 3D ultrasound (U/S) plays increasingly important role. The purpose of this study is to investigate possible patient movement and anatomy alteration between the clinical image set acquisition, made after the needle implantation, and the patient irradiation and their influence on the quality of treatment. Methods: The authors used 3D U/S image sets and the corresponding treatment plans based on a 4D-treatment planning procedure: plans of 25 patients are obtained right after the needle implantation (clinical plan is based on this 3D image set) and just before and after the treatment delivery. The authors notice the slight decrease of treatment quality with increase of time gap between the clinical image set acquisition and the patient irradiation. 4D analysis of dose-volume-histograms (DVHs) for prostate: CTV1 = PTV, and urethra, rectum, and bladder as organs at risk (OARs) and conformity index (COIN) is presented, demonstrating the effect of prostate, OARs, and needles displacement. Results: The authors show that in the case that the patient body movement/anatomy alteration takes place, this results in modification of DVHs and radiobiological parameters, hence the plan quality. The observed average displacement of needles (1 mm) and of prostate (0.57 mm) is quite small as compared with the average displacement noted in several other reports [A. A. Martinez et al., Int. J. Radiat. Oncol., Biol., Phys. 49(1), 61-69 (2001); S. J. Damore et al., Int. J. Radiat. Oncol., Biol., Phys. 46(5), 1205-1211 (2000); P. J. Hoskin et al., Radiotherm. Oncol. 68(3), 285-288 (2003); E. Mullokandov et al., Int. J. Radiat. Oncol., Biol., Phys. 58(4), 1063-1071 (2004)] in the literature. Conclusions: Although the decrease of quality of dosimetric and radiobiological parameters occurs, this does not cause clinically unacceptable changes to the 3D dose distribution, according to our clinical protocol.

  9. Measurement of absorbed dose-to-water for an HDR {sup 192}Ir source with ionization chambers in a sandwich setup

    SciTech Connect

    Araki, Fujio; Kouno, Tomohiro; Ohno, Takeshi; Kakei, Kiyotaka; Yoshiyama, Fumiaki; Kawamura, Shinji

    2013-09-15

    Purpose: In this study, a dedicated device for ion chamber measurements of absorbed dose-to-water for a Nucletron microSelectron-v2 HDR {sup 192}Ir brachytherapy source is presented. The device uses two ionization chambers in a so-called sandwich assembly. Using this setup and by taking the average reading of the two chambers, any dose error due to difficulties in absolute positioning (centering) of the source in between the chambers is cancelled to first order. The method's accuracy was examined by comparing measurements with absorbed dose-to-water determination based on the AAPM TG-43 protocol.Methods: The optimal source-to-chamber distance (SCD) for {sup 192}Ir dosimetry was determined from ion chamber measurements in a water phantom. The {sup 192}Ir source was sandwiched between two Exradin A1SL chambers (0.057 cm{sup 3}) at the optimal SCD separation. The measured ionization was converted to the absorbed dose-to-water using a {sup 60}Co calibration factor and a Monte Carlo-calculated beam quality conversion factor, k{sub Q}, for {sup 60}Co to {sup 192}Ir. An uncertainty estimate of the proposed method was determined based on reproducibility of measurements at different institutions for the same type of source.Results: The optimal distance for the A1SL chamber measurements was determined to be 5 cm from the {sup 192}Ir source center, considering the depth dependency of k{sub Q} for {sup 60}Co to {sup 192}Ir and the chamber positioning. The absorbed dose to water measured at (5 cm, 90°) on the transverse axis was 1.3% lower than TG-43 values and its reproducibility and overall uncertainty were 0.8% and 1.7%, respectively. The measurement doses at anisotropic points agreed within 1.5% with TG-43 values.Conclusions: The ion chamber measurement of absorbed dose-to-water with a sandwich method for the {sup 192}Ir source provides a more accurate, direct, and reference dose compared to the dose-to-water determination based on air-kerma strength in the TG-43 protocol

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

    SciTech Connect

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

    2014-06-15

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

  11. SU-E-T-23: A Novel Two-Step Optimization Scheme for Tandem and Ovoid (T and O) HDR Brachytherapy Treatment for Locally Advanced Cervical Cancer

    SciTech Connect

    Sharma, M; Todor, D; Fields, E

    2014-06-01

    Purpose: To present a novel method allowing fast, true volumetric optimization of T and O HDR treatments and to quantify its benefits. Materials and Methods: 27 CT planning datasets and treatment plans from six consecutive cervical cancer patients treated with 4–5 intracavitary T and O insertions were used. Initial treatment plans were created with a goal of covering high risk (HR)-CTV with D90 > 90% and minimizing D2cc to rectum, bladder and sigmoid with manual optimization, approved and delivered. For the second step, each case was re-planned adding a new structure, created from the 100% prescription isodose line of the manually optimized plan to the existent physician delineated HR-CTV, rectum, bladder and sigmoid. New, more rigorous DVH constraints for the critical OARs were used for the optimization. D90 for the HR-CTV and D2cc for OARs were evaluated in both plans. Results: Two-step optimized plans had consistently smaller D2cc's for all three OARs while preserving good D90s for HR-CTV. On plans with “excellent” CTV coverage, average D90 of 96% (range 91–102), sigmoid D2cc was reduced on average by 37% (range 16–73), bladder by 28% (range 20–47) and rectum by 27% (range 15–45). Similar reductions were obtained on plans with “good” coverage, with an average D90 of 93% (range 90–99). For plans with inferior coverage, average D90 of 81%, an increase in coverage to 87% was achieved concurrently with D2cc reductions of 31%, 18% and 11% for sigmoid, bladder and rectum. Conclusions: A two-step DVH-based optimization can be added with minimal planning time increase, but with the potential of dramatic and systematic reductions of D2cc for OARs and in some cases with concurrent increases in target dose coverage. These single-fraction modifications would be magnified over the course of 4–5 intracavitary insertions and may have real clinical implications in terms of decreasing both acute and late toxicity.

  12. SU-E-T-270: Quality Control of Source Strength and Indexer Length in HDR Brachytherapy Using Sun Nuclear Mapcheck2

    SciTech Connect

    Morales, J

    2014-06-01

    Purpose: The goal of this work was to evaluate Sun Nuclear MapCheck2 capability for quantitative determination of both HDR source strength and position. Predictive power of Mapcheck2 dose matrix, originated by a microSelectron-v2 source from 22mm distance, was investigated. Methods: A Mick MultiDoc phantom with the 1400mm indexer length mark aligned over MapCheck2 central detector plus two additional 5cm plastic slabs were used as a composite phantom. Dose readings were transformed by applying published source anisotropy corrections and experimentally established radial dose and relative sensitivity factors. Angular dependence was not considered. Only readings from diodes located 2cm around the central detector were evaluated. The reproducibility of a fit between transformed dose readings and the ratio of virtual source strength and the square of source-detector distance was investigated. Four parameters were considered in the model: virtual source strength, lateral, longitudinal and vertical source positions. Final source strength calibration factor was calculated from the ratio of reference measurements and results from the fit. Results: Original lateral and longitudinal source position estimations had systematic errors of 0.39mm and 0.75mm. After subtracting these errors, both source positions were predicted with a standard deviation of 0.15mm. Results for vertical positions were reproducible with a standard deviation of 0.05mm. The difference between calculated and reference source strengths from 34 independent measurement setups had a standard deviation of 0.3%. The coefficient of determination for the linear regression between known indexer lengths and results from the fit in the range 1400mm ± 5mm was 0.985. Conclusions: ource strength can be estimated with MapCheck2 at appropriate accuracy levels for quality control. Verification of indexer length with present implementation is more accurate than visual alternatives. Results can be improved by designing a

  13. Development of a fast 3D treatment planning platform for clinical interstitial microwave hyperthermia within free-hand obliquely implanted HDR catheters

    NASA Astrophysics Data System (ADS)

    Scott, Serena J.; Salgaonkar, Vasant A.; Prakash, Punit; Curto, Sergio; Hsu, I.-Chow; Diederich, Chris J.

    2015-03-01

    A treatment planning platform for interstitial microwave hyperthermia was developed for practical, free-hand clinical implants. Such implants, consisting of non-parallel, moderately curved antennas with varying insertion depths, are used in HDR brachytherapy for treating locally advanced cancer. Numerical models for commercially available MA251 antennas (915 MHz, BSD Medical) were developed in COMSOL Multiphysics, a finite element analysis software package. To expedite treatment planning, electric fields, power deposition and temperature rises were computed for a single straight antenna in 2D axisymmetric geometry. A precomputed library of electric field and temperature solutions was created for a range of insertion depths (5-12 cm) and blood perfusion rates (0.5-5 kg/m3/s). 3D models of multiple antennas and benchtop phantoms experiments using temperature-sensitive liquid crystal paper to monitor heating by curved antennas were performed for comparative evaluation of the treatment planning platform. A patient-customizable hyperthermia treatment planning software package was developed in MATLAB with capabilities to interface with a commercial radiation therapy planning platform (Oncentra, Nucleotron), import patient and multicatheter implant geometries, calculate insertion depths, and perform hyperthermia planning with antennas operating in asynchronous or synchronous mode. During asynchronous operation, the net power deposition and temperature rises were approximated as a superposition sum of the respective quantities for one single antenna. During synchronous excitation, a superposition of complex electrical fields was performed with appropriate phasing to compute power deposition. Electric fields and temperatures from the pre-computed single-antenna library were utilized following appropriate non-rigid coordinate transformations. Comparison to 3D models indicated that superposition of electric fields around parallel antennas is valid when they are at least 15 mm

  14. Testing, Testing, Testing

    ERIC Educational Resources Information Center

    Coatney, Sharon

    2005-01-01

    Teacher-librarians and teachers said that testing is driving everything that they do. One elementary teacher said that her entire grade level had not been to the library all year because they did not have time because the testing is all consuming and dictating all they do in the classroom. The teacher-librarian at that school added there was…

  15. Dosimetric Analysis of 3D Image-Guided HDR Brachytherapy Planning for the Treatment of Cervical Cancer: Is Point A-Based Dose Prescription Still Valid in Image-Guided Brachytherapy?

    SciTech Connect

    Kim, Hayeon; Beriwal, Sushil; Houser, Chris; Huq, M. Saiful

    2011-07-01

    The purpose of this study was to analyze the dosimetric outcome of 3D image-guided high-dose-rate (HDR) brachytherapy planning for cervical cancer treatment and compare dose coverage of high-risk clinical target volume (HRCTV) to traditional Point A dose. Thirty-two patients with stage IA2-IIIB cervical cancer were treated using computed tomography/magnetic resonance imaging-based image-guided HDR brachytherapy (IGBT). Brachytherapy dose prescription was 5.0-6.0 Gy per fraction for a total 5 fractions. The HRCTV and organs at risk (OARs) were delineated following the GYN GEC/ESTRO guidelines. Total doses for HRCTV, OARs, Point A, and Point T from external beam radiotherapy and brachytherapy were summated and normalized to a biologically equivalent dose of 2 Gy per fraction (EQD2). The total planned D90 for HRCTV was 80-85 Gy, whereas the dose to 2 mL of bladder, rectum, and sigmoid was limited to 85 Gy, 75 Gy, and 75 Gy, respectively. The mean D90 and its standard deviation for HRCTV was 83.2 {+-} 4.3 Gy. This is significantly higher (p < 0.0001) than the mean value of the dose to Point A (78.6 {+-} 4.4 Gy). The dose levels of the OARs were within acceptable limits for most patients. The mean dose to 2 mL of bladder was 78.0 {+-} 6.2 Gy, whereas the mean dose to rectum and sigmoid were 57.2 {+-} 4.4 Gy and 66.9 {+-} 6.1 Gy, respectively. Image-based 3D brachytherapy provides adequate dose coverage to HRCTV, with acceptable dose to OARs in most patients. Dose to Point A was found to be significantly lower than the D90 for HRCTV calculated using the image-based technique. Paradigm shift from 2D point dose dosimetry to IGBT in HDR cervical cancer treatment needs advanced concept of evaluation in dosimetry with clinical outcome data about whether this approach improves local control and/or decreases toxicities.

  16. Dosimetric analysis of 3D image-guided HDR brachytherapy planning for the treatment of cervical cancer: is point A-based dose prescription still valid in image-guided brachytherapy?

    PubMed

    Kim, Hayeon; Beriwal, Sushil; Houser, Chris; Huq, M Saiful

    2011-01-01

    The purpose of this study was to analyze the dosimetric outcome of 3D image-guided high-dose-rate (HDR) brachytherapy planning for cervical cancer treatment and compare dose coverage of high-risk clinical target volume (HRCTV) to traditional Point A dose. Thirty-two patients with stage IA2-IIIB cervical cancer were treated using computed tomography/magnetic resonance imaging-based image-guided HDR brachytherapy (IGBT). Brachytherapy dose prescription was 5.0-6.0 Gy per fraction for a total 5 fractions. The HRCTV and organs at risk (OARs) were delineated following the GYN GEC/ESTRO guidelines. Total doses for HRCTV, OARs, Point A, and Point T from external beam radiotherapy and brachytherapy were summated and normalized to a biologically equivalent dose of 2 Gy per fraction (EQD2). The total planned D90 for HRCTV was 80-85 Gy, whereas the dose to 2 mL of bladder, rectum, and sigmoid was limited to 85 Gy, 75 Gy, and 75 Gy, respectively. The mean D90 and its standard deviation for HRCTV was 83.2 ± 4.3 Gy. This is significantly higher (p < 0.0001) than the mean value of the dose to Point A (78.6 ± 4.4 Gy). The dose levels of the OARs were within acceptable limits for most patients. The mean dose to 2 mL of bladder was 78.0 ± 6.2 Gy, whereas the mean dose to rectum and sigmoid were 57.2 ± 4.4 Gy and 66.9 ± 6.1 Gy, respectively. Image-based 3D brachytherapy provides adequate dose coverage to HRCTV, with acceptable dose to OARs in most patients. Dose to Point A was found to be significantly lower than the D90 for HRCTV calculated using the image-based technique. Paradigm shift from 2D point dose dosimetry to IGBT in HDR cervical cancer treatment needs advanced concept of evaluation in dosimetry with clinical outcome data about whether this approach improves local control and/or decreases toxicities.

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

    SciTech Connect

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

    2014-06-15

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

  18. HDR brachytherapy for anal cancer

    PubMed Central

    Kovács, Gyoergy

    2014-01-01

    The challenge of treating anal cancer is to preserve the anal sphincter function while giving high doses to the tumor and sparing the organ at risk. For that reason there has been a shift from radical surgical treatment with colostomy to conservative treatment. Radiotherapy combined with chemotherapy has an important role in the treatment of anal cancer patients. New techniques as intensity modulated radiotherapy (IMRT) have shown reduced acute toxicity and high rates of local control in combination with chemotherapy compared to conventional 3-D radiotherapy. Not only external beam radio-chemotherapy treatment (EBRT) is an established method for primary treatment of anal cancer, brachytherapy (BT) is also an approved method. BT is well known for boost irradiation in combination with EBRT (+/– chemotherapy). Because of technical developments like modern image based 3D treatment planning and the possibility of intensity modulation in brachytherapy (IMBT), BT today has even more therapeutic potential than it had in the era of linear sources. The combination of external beam radiotherapy (EBRT) and BT allows the clinician to deliver higher doses to the tumor and to reduce dose to the normal issue. Improvements in local control and reductions in toxicity therefore become possible. Various BT techniques and their results are discussed in this work. PMID:24982770

  19. SU-E-T-525: Dose Volume Histograms (DVH) Analysis and Comparison with ICRU Point Doses in MRI Guided HDR Brachytherapy for Cervical Cancer

    SciTech Connect

    Badkul, R; McClinton, C; Kumar, P; Mitchell, M

    2014-06-01

    .1 overestimated the bladder ICRU point dose up to 43% for conventional-techniques.Bladder-D2 provided a good estimation of ICRU bladder point-doses(within 3.6%) for conventional-techniques. This correlation is not observed for MGO plans perhaps due to steering of isodose line, leading to unpredictable dwell-weighting. Conclusion: MRI based HDR-planning provides accurate delineation of tumor volumes and normal structures, and optimized tumor-coverage can be achieved with acceptable normal-tissue doses. This study showed that for conventional techniques D0.1 rectum dose and D2 bladder dose are good representation of ICRU-reference-point doses.

  20. Determination of absorbed dose to water around a clinical HDR {sup 192}Ir source using LiF:Mg,Ti TLDs demonstrates an LET dependence of detector response

    SciTech Connect

    Carlsson Tedgren, Aasa; Elia, Rouba; Hedtjaern, Haakan; Olsson, Sara; Alm Carlsson, Gudrun

    2012-02-15

    Purpose: Experimental radiation dosimetry with thermoluminescent dosimeters (TLDs), calibrated in a {sup 60}Co or megavoltage (MV) photon beam, is recommended by AAPM TG-43U1for verification of Monte Carlo calculated absorbed doses around brachytherapy sources. However, it has been shown by Carlsson Tedgren et al.[Med. Phys. 38, 5539-5550 (2011)] that for TLDs of LiF:Mg,Ti, detector response was 4% higher in a {sup 137}Cs beam than in a {sup 60}Co one. The aim of this work was to investigate if similar over-response exists when measuring absorbed dose to water around {sup 192}Ir sources, using LiF:Mg,Ti dosimeters calibrated in a 6 MV photon beam. Methods: LiF dosimeters were calibrated to measure absorbed dose to water in a 6 MV photon beam and used to measure absorbed dose to water at distances of 3, 5, and 7 cm from a clinical high dose rate (HDR) {sup 192}Ir source in a polymethylmethacrylate (PMMA) phantom. Measured values were compared to values of absorbed dose to water calculated using a treatment planning system (TPS) including corrections for the difference in energy absorption properties between calibration quality and the quality in the users'{sup 192}Ir beam and for the use of a PMMA phantom instead of the water phantom underlying dose calculations in the TPS. Results: Measured absorbed doses to water around the {sup 192}Ir source were overestimated by 5% compared to those calculated by the TPS. Corresponding absorbed doses to water measured in a previous work with lithium formate electron paramagnetic resonance (EPR) dosimeters by Antonovic et al. [Med. Phys. 36, 2236-2247 (2009)], using the same irradiation setup and calibration procedure as in this work, were 2% lower than those calculated by the TPS. The results obtained in the measurements in this work and those obtained using the EPR lithium formate dosimeters were, within the expanded (k = 2) uncertainty, in agreement with the values derived by the TPS. The discrepancy between the results using

  1. The energy-conserving electron transfer system used by Desulfovibrio alaskensis strain G20 during pyruvate fermentation involves reduction of endogenously formed fumarate and cytoplasmic and membrane-bound complexes, Hdr-Flox and Rnf.

    PubMed

    Meyer, Birte; Kuehl, Jennifer V; Price, Morgan N; Ray, Jayashree; Deutschbauer, Adam M; Arkin, Adam P; Stahl, David A

    2014-11-01

    The adaptation capability of Desulfovibrio to natural fluctuations in electron acceptor availability was evaluated by studying Desulfovibrio alaskensis strain G20 under varying respiratory, fermentative and methanogenic coculture conditions in chemostats. Transition from lactate to pyruvate in coculture resulted in a dramatic shift in the population structure and closer interspecies cell-to-cell interactions. Lower methane production rates in coculture than predicted from pyruvate input was attributed to redirection of electron flow to fumarate reduction. Without a methanogenic partner, accumulation of H₂and formate resulted in greater succinate production. Comparative transcript and gene fitness analysis in concert with physiological data of G20 wildtype and mutants demonstrated that pyruvate fermentation involves respiration of cytoplasmically formed fumarate using cytoplasmic and membrane-bound energy-conserving complexes, Rnf, Hdr-Flox-1 and Hmc. At the low H₂/formate levels maintained in coculture, Rnf likely functions as proton-pumping ferredoxin (Fd): type-I cytochrome c oxidoreductase, which transitions to a proton-pumping Fd(red):  nicotinamide adenine dinucleotide (NAD⁺) oxidoreductase at high H₂/formate levels during fermentation in monoculture. Hdr-Flox-1 is postulated to recycle Fd(red) via a flavin-based electron bifurcation involving NADH, Fdox and the thiol/disulphide-containing DsrC. In a menaquinone (MQ)-based electron confurcation reaction, the high-molecular-weight cytochrome-c₃complex, Hmc, is proposed to then couple DsrC(red) and periplasmic H₂/formate oxidation using the MQ pool to fuel a membrane-bound fumarate reductase.

  2. Anatomy-based definition of point A utilizing three-dimensional volumetric imaging approach for high-dose-rate (HDR) intracavitary brachytherapy dose prescription when treating cervical cancer using limited resources.

    PubMed

    Goyal, Manish K; Rai, D V; Kehwar, Than S; Manjhi, Jayanand; Heintz, Bret H; Shide, Kathleen L; Barker, Jerry L

    2016-07-16

    This study was designed to determine whether volumetric imaging could identify consistent alternative prescription methods to Manchester/point A when prescribing radiation dose in the treatment of cervical cancer using HDR intracavitary brachy-therapy (ICBT). One hundred and twenty-five treatment plans of 25 patients treated for carcinoma of the cervix were reviewed retrospectively. Each patient received 5 fractions of HDR ICBT following initial cisplatin-based pelvic chemoradiation, and radiation dose was originally prescribed to point A (ICRU-38). The gross tumor volume (GTV) and high-risk clinical target volume (HR-CTV) were contoured in three dimensions on the CT datasets, and inferior-superior, anterior-posterior, and left-right dimensions HR-CTV were recorded along with multiple anatomic and skeletal dimensions for each patient. The least square-best fit regression lines were plotted between one half of the HR-CTV width and pelvic cavity dimension at femoral head level and at maximum cavity dimension. The points in both plots lie reasonably close to straight lines and are well defined by straight lines with slopes of 0.15 and 0.17; intercept on y-axes of -0.08 and -0.03, point A, at the same level as defined based on applicator coordinates, is defined using this correlation, which is a function of distance between femoral heads/dimensions of maximum pelvic cavity width. Both relations, defined by straight lines, provide an estimated location of point A, which provides adequate coverage to the HR-CTV compared to the point A defined based on applicator coordinates. The point A defined based on femoral head distance would, therefore, be a reasonable surrogate to use for dose prescription because of subjective variation of cavity width dimension. Simple surrogate anatomic/skeletal landmarks can be useful for prescribing radiation dose when treating cervical cancer using intracavitary brachytherapy in limited-resource settings. Our ongoing work will continue to

  3. Monte Carlo calculations of the ionization chamber wall correction factors for 192Ir and 60Co gamma rays and 250 kV x-rays for use in calibration of 192Ir HDR brachytherapy sources.

    PubMed

    Ferreira, I H; de Almeida, C E; Marre, D; Marechal, M H; Bridier, A; Chavaudra, J

    1999-08-01

    As in the method for the calibration of 192Ir high-dose-rate (HDR) brachytherapy sources, the ionization chamber wall correction factor A(w), is needed for 192Ir and 60Co gamma rays and 250 kV x-rays. This factor takes into account the variation in chamber response due to the attenuation of the photon beam in the chamber wall and build-up cap and the contribution of scattered photons. Monte Carlo calculations were performed using the EGS4 code system with the PRESTA algorithm, to calculate the A(w) factor for 51 commercial ionization chambers and build-up caps exposed to the typical energy spectrum of 192Ir and 60Co gamma rays and 250 kV x-rays. The calculated A(w) correction factors for 192Ir and 60Co sources and 250 kV x-rays agree very well to within 0.1% with published experimental data (the statistical uncertainty is less than 0.1% of the calculated correction factor value). For the 192Ir sources, A(w) varies from 0.973 to 0.993 and for the 250 kV x-rays the minimum value of A(w) for all chambers studied is 0.983. The calculated A(w) correction factors can be used to calculate the air kerma calibration factor of HDR brachytherapy sources, when interpolative methods are considered, contributing to the reduction in the overall uncertainties in the calibration procedure.

  4. SU-E-T-263: Point Dose Variation Using a Single Ir-192 HDR Brachytherapy Plan for Two Treatments with a Single Tandem-Ovoid Insertion for Cervical Cancer

    SciTech Connect

    Liang, X; Morrill, S; Hardee, M; Han, E; Penagaricano, J; Zhang, X; Vaneerat, R

    2014-06-01

    Purpose: To evaluate the point dose variations between Ir-192 HDR treatments on two consecutive days using a single tandem-ovoid insertion without replanning in cervical cancer patients. Methods: This study includes eleven cervical cancer patients undergoing HDR brachytherapy with a prescribed dose of 28 Gy in 4 fractions. Each patient had two tandemovoid insertions one week apart. Each insertion was treated on consecutive days with rescanning and replanning prior to each treatment. To study the effect of no replanning for day 2 treatments, the day 1 plan dwell position and dwell time with decay were applied to the day 2 CT dataset. The point dose variations on the prescription point H (defined according to American Brachytherapy Society), and normal tissue doses at point B, bladder, rectum and vaginal mucosa (based on ICRU Report 38) were obtained. Results: Without replanning, the mean point H dose variation was 4.6 ± 10.7% on the left; 2.3 ± 2.9% on the right. The mean B point variation was 3.8 ± 4.9% on the left; 3.6 ± 4.7% on the right. The variation in the left vaginal mucosal point was 12.2 ± 10.7%; 9.5 ± 12.5% on the right; the bladder point 5.5 ± 7.4%; and the rectal point 7.9 ± 9.1%. Conclusion: Without replanning, there are variations both in the prescription point and the normal tissue point doses. The latter can vary as much as 10% or more. This is likely due to the steep dose gradient from brachytherapy compounded by shifts in the positions of the applicator in relationship to the patients anatomy. Imaging prior to each treatment and replanning ensure effective and safe brachytherapy are recommended.

  5. The CREAM Calorimeter: Performance In Tests And Flights

    SciTech Connect

    Lee, M. H.; Ahn, H. S.; Ganel, O.; Han, J. H.; Kim, K. C.; Lutz, L.; Malinine, A.; Sina, R.; Walpole, P.; Wu, J.; Zinn, S. Y.; Allison, P.; Beatty, J. J.; Brandt, T. J.; Bagliesi, M. G.; Bigongiari, G.; Maestro, P.; Marrocchesi, P. S.; Zei, R.; Barbier, L.

    2006-10-27

    The Cosmic Ray Energetics And Mass (CREAM) balloon-borne experiment, designed to directly measure cosmic-ray particle energies from {approx}1011 to {approx}1015 eV, had two successful flights since December 2004, with a total duration of 70 days. The CREAM calorimeter is comprised of 20 layers of 1 radiation length (X0) tungsten interleaved with 20 active layers each made up of fifty 1 cm wide scintillating fiber ribbons. The scintillation signals are read out with multi pixel Hybrid Photo Diodes (HPDs), VA32-HDR2/TA32C ASICs and LTC1400 ADCs. During detector construction, various tests were carried out using radioactive sources, UV-LEDs, and particle beams. We will present results from these tests and show preliminary results from the two flights.

  6. Anatomy-based definition of point A utilizing three-dimensional volumetric imaging approach for high-dose-rate (HDR) intracavitary brachytherapy dose prescription when treating cervical cancer using limited resources.

    PubMed

    Goyal, Manish K; Rai, D V; Kehwar, Than S; Manjhi, Jayanand; Heintz, Bret H; Shide, Kathleen L; Barker, Jerry L

    2016-11-01

    This study was designed to determine whether volumetric imaging could identify consistent alternative prescription methods to Manchester/point A when prescribing radiation dose in the treatment of cervical cancer using HDR intracavitary brachytherapy (ICBT). One hundred and twenty-five treatment plans of 25 patients treated for carcinoma of the cervix were reviewed retrospectively. Each patient received 5 fractions of HDR ICBT following initial cisplatin-based pelvic chemoradiation, and radiation dose was originally prescribed to point A (ICRU-38). The gross tumor volume (GTV) and high-risk clinical target volume (HR-CTV) were contoured in three dimensions on the CT datasets, and inferior-superior, anterior-posterior, and left-right dimensions HR-CTV were recorded along with multiple anatomic and skeletal dimensions for each patient. The least square-best fit regression lines were plotted between one half of the HR-CTV width and pelvic cavity dimension at femoral head level and at maximum cavity dimension. The points in both plots lie reasonably close to straight lines and are well defined by straight lines with slopes of 0.15 and 0.17; intercept on y-axes of -0.08 and -0.03, point A, at the same level as defined based on applicator coordinates, is defined using this correlation, which is a function of distance between femoral heads/dimensions of maximum pelvic cavity width. Both relations, defined by straight lines, provide an estimated location of point A, which provides adequate coverage to the HR-CTV compared to the point A defined based on applicator coordinates. The point A defined based on femoral head distance would, therefore, be a reasonable surrogate to use for dose prescription because of subjective variation of cavity width dimension. Simple surrogate anatomic/skeletal landmarks can be useful for prescribing radiation dose when treating cervical cancer using intracavitary brachytherapy in limited-resource settings. Our ongoing work will continue to

  7. SU-E-T-787: Utility of the Two Candidate 192-Ir and 169-Yb HDR Sources for Use with a Novel Direction Modulated Brachytherapy Tandem Applicator for Cervical Cancer Treatment

    SciTech Connect

    Safigholi, H; Soliman, A; Song, W; Han, D; Meigooni, A Soleimani

    2015-06-15

    Purpose: A novel tungsten alloy shielded, MRI-compatible, direction modulated brachytherapy (DMBT) concept tandem applicator, which enables unprecedented intensity modulation, was used to evaluate treatment plan quality improvement over a conventional tandem. The utility of the 192-Ir and 169-Yb HDR sources, for use with the DMBT applicator, was evaluated. Methods: The total diameter of the DMBT tandem applicator is 6.0 mm, which consists of 5.4-mm diameter tungsten alloy and 0.3 mm thick plastic sheath. The tandem has 6 symmetric peripheral 1.3-mm diameter grooves for the source to travel. MCNPX v.2.6 was used to simulate the 192-Ir and 169-Yb sources inside the DMBT applicator. First, TG-43 source parameters were evaluated. Second, 3D dose matrix with 1 mm3 resolution were imported into an in-house-coded inverse optimization treatment planning program to obtain optimal plans for 19 clinical cases. All plans were compared with the standard tandem and ring plans. Prescription dose was 15.0 Gy. All plans were normalized to receive the same HRCTV D90. Results: Generally, the DMBT tandem (and ring) plans were better than the conventional tandem and ring plans for 192-Ir and 169-Yb HDR sources. The mean data of D2cc for bladder, rectum, and sigmoid were 11.65±2.30 Gy, 7.47±3.05 Gy, and 9.84±2.48 Gy for Ir-192 DMBT tandem, respectively. These data for Yb-169 were 11.67±2.26 Gy, 7.44±3.02 Gy, and 9.83±2.38 Gy, respectively. The HR-CTV D98 and V100 were 16.37±1.86 Gy and 97.37 ± 1.92 Gy for Ir-192 DMBT, respectively. The corresponding values for Yb-169 were 16.43±1.86 Gy, and 97.51 ± 1.91 Gy. Plans with the 169-Yb source generally produced more favorable results where V100 increased by 13.65% while D2cc across all OARs reduced by 0.54% compared with the 192-Ir plans. Conclusion: For the DMBT tandem applicator, 169-Yb source seems to produce more directional beams resulting in increased intensity modulation capacity, thus resulting in more conformal plans.

  8. Definitive radiotherapy based on HDR brachytherapy with iridium 192 in uterine cervix carcinoma: report on the Vienna University Hospital findings (1993-1997) compared to the preceding period in the context of ICRU 38 recommendations.

    PubMed

    Pötter, R; Knocke, T H; Fellner, C; Baldass, M; Reinthaller, A; Kucera, H

    2000-01-01

    According to the reports described in the literature, fractionated HDR brachytherapy seems to represent one option for the primary treatment of cervical carcinoma. In order to render such treatment transparent and comparable for those interested in the field, we have attempted to report our recent experience obtained in Vienna from 1993-1997 using the terminology proposed by the ICRU report 38, focusing in particular on dose and volume reporting and a linear-quadratic model. Based on these parameters, a comparison with the preceding period in Vienna (LDR/HDR) has been made, with an attempt to correlate different methods and parameters with outcome. One hundred and eighty-nine patients (mean age 67 years) were treated with curative intent (stage Ia: 2, Ib: 11, IIa: 11, IIb: 79, IIIa: 19, IIIb: 59, IVa: 5, IVb: 3 patients) using a combination of intracervical high-dose rate (HDR) brachytherapy (ring-tandem applicator) and a box technique for external-beam therapy (EBT: 48.6-50 Gy, linac 25 MV). Small tumors were treated with 5-6 fractions of 7 Gy at point A and 50 Gy EBT (25 Gy in the brachytherapy reference volume) which is isoeffective to 76-86 Gy at point A. Large tumors received 3-4 fractions of 7 Gy after 50 Gy EBT with open fields, which is isoeffective to 82-92 Gy at point A. TRAK varied from mean 1.4 cGy (3 fractions) to 2.8 cGy (6 fractions) at one meter. 3-D treatment planning for brachytherapy was based on conventional X-rays and in 181/189 patients on computed tomography (CT) with the applicator in place. Computer-calculated volumes of the brachytherapy reference isodose (7 Gy/fraction) ranged from 46-155 ccm (mean 87 ccm); the respective mean hwt-volume (height x width x thickness) was 180 ccm. The 60 Gy HWT volumes (25 Gy from EBT) for the irradiation of small tumors ranged from 240 to 407 ccm (mean 337 ccm) and for larger tumors (50 Gy for EBT) from 452 to 785 ccm (mean 607 ccm). The mean dose for brachytherapy was 16.2 Gy (6.2-37.8 Gy) at the ICRU

  9. A study of pumps for the Hot Dry Rock Geothermal Energy extraction experiment (LTFT (Long Term Flow Test))

    SciTech Connect

    Tatro, C.A.

    1986-10-01

    A set of specifications for the hot dry rock (HDR) Phase II circulation pumping system is developed from a review of basic fluid pumping mechanics, a technical history of the HDR Phase I and Phase II pumping systems, a presentation of the results from experiment 2067 (the Initial Closed-Loop Flow Test or ICFT), and consideration of available on-site electrical power limitations at the experiment site. For the Phase II energy extraction experiment (the Long Term Flow Test or LTFT) it is necessary to provide a continuous, low maintenance, and highly efficient pumping capability for a period of twelve months at variable flowrates up to 420 gpm and at surface injection pressures up to 5000 psi. The pumping system must successfully withstand attacks by corrosive and embrittling gases, erosive chemicals and suspended solids, and fluid pressure and temperature fluctuations. In light of presently available pumping hardware and electric power supply limitations, it is recommended that positive displacement multiplex plunger pumps, driven by variable speed control electric motors, be used to provide the necessary continuous surface injection pressures and flowrates for LTFT. The decision of whether to purchase the required circulation pumping hardware or to obtain contractor provided pumping services has not been made.

  10. Feasibility test of line sensors for optical tissue thickness estimation

    NASA Astrophysics Data System (ADS)

    Stüber, Patrick; Wissel, Tobias; Wagner, Benjamin; Schweikard, Achim; Ernst, Floris

    2015-05-01

    Purpose Line sensors are cheap, fast and have high quantum effciencies. Here, we investigate whether these sensors can replace an area image sensor for the purpose of tissue thickness measurements. Material and Methods As part of a subject study high dynamic range (HDR) images of three subjects were acquired with an area image sensor. To simulate a line sensor as realistic as possible single or multiple lines were extracted from these HDR images. Thereby, horizontally extracted lines correspond to a parallel orientation of the line sensor relative to the incident angle of a laser beam. Vertically extracted lines correspond to an orthogonal orientation. Then, optical features were determined and converted into a tissue thickness using a machine learning algorithm. Results For the tested subjects the worst root mean square error (RMSE) of the learning process was 0:385 mm. The best RMSE was 0:222 mm. For all subjects, the mean RMSE and the standard deviation of RMSE values decreases with a larger number of extracted lines. The orientation of the line sensor turned out to be important for the RMSE. Vertically oriented line sensors achieve lower RMSEs than horizontally oriented sensors because of the influence of the incident angle. Furthermore, the head-pose of the subject seems to be important for the accuracy. Conclusion Line sensors deliver comparable results to previously analysed area image sensors. Nevertheless, the scattering of the values is higher and the size and orientation of the sensor and the head-pose have an influence on the RMSE of the learning process. Therefore, line sensors are feasible for tissue thickness estimation but they are a trade-off between accuracy and speed.

  11. Field Observation of Joint Structures in Various Types of Igneous Rocks

    NASA Astrophysics Data System (ADS)

    Kano, Shingo; Tsuchiya, Noriyoshi

    2006-05-01

    In this study, field observations of natural fracture network systems in some intrusive and extrusive rocks were undertaken, to clarify the fracturing mechanism in the rocks. Shallow intrusives, whose depth of emplacement was less than several hundred metres, include the Momo-iwa Dacite dome on Rebun Island (Hokkaido), and Jodogahama Rhyolite in Iwate prefecture. Extrusive complexes studied include the Tojinbo Andesite and Ojima Rhyodacite in Fukui prefecture. Rocks of `granitic' composition were collected from the Takidani (Japan Alps) and Hijiori (Yamagata prefecture) plutons. The joint structure in Hijiori Granite was evaluated by analysis of core samples extracted from the HDR-3 geothermal production well. Based on detailed field observation, joint structures related to thermal contraction of a rock mass could be classified according to their inferred depth of formation. Joints from a near surface setting, such as shallow intrusive rocks and extrusives, tend to form pentagonal — hexagonal columnar structures (for a variety of rock types), whilst granitic rocks (from a deeper setting) typically exhibit a parallelepiped structure. The apparent differences in joint form are inferred to be dependent on the confining pressure, which acts on joint generation and propagation. In cases of non-confining pressure, such as the near-surface (shallow intrusive/extrusive) setting, joint networks typically form a columnar structure. On the contrary, confining pressure is considerably greater for deeper rock masses, and these form a parallelepiped joint structure.

  12. SU-E-J-103: Propagation of Rectum and Bladder Contours for Tandem and Ring (T&R) HDR Treatment Using Deformable Image Registration

    SciTech Connect

    Yuan, Y; Chao, M; Sheu, R; Dumane, V; Gupta, V; Lo, Y

    2015-06-15

    Purpose: To investigate the feasibility of using DIR to propagate the manually contoured rectum and bladder from the 1st insertion to the new CT images on subsequent insertions and evaluate the segmentation performance. Methods: Ten cervical cancer patients, who were treated by T&R brachytherapy in 3–4 insertions, were retrospectively collected. In each insertion, rectum and bladder were manually delineated on the planning CT by a physicist and verified by a radiation oncologist. Using VelocityAI (Velocity Medical Solutions, Atlanta, GA), a rigid registration was firstly employed to match the bony structures between the first insertion and each of the following insertions, then a multi-pass B-spine DIR was carried out to further map the sub volume that encompasses rectum and bladder. The resultant deformation fields propagated contours, and dice similarity coefficient (DSC) was used to quantitatively evaluate the agreement between the propagated contours and the manually-delineated organs. For the 3rd insertion, we also evaluated if the segmentation performance could be improved by propagating the contours from the most recent insertion, i.e., the 2nd insertion. Results: On average, the contour propagation took about 1 minute. The average and standard deviation of DSC over all insertions and patients was 0.67±0.10 (range: 0.44–0.81) for rectum, and 0.78±0.07 (range: 0.63–0.87) for bladder. For the 3rd insertion, propagating contours from the 2nd insertion could improve the segmentation performance in terms of DSC from 0.63±0.10 to 0.72±0.08 for rectum, and from 0.77±0.07 to 0.79±0.06 for bladder. A Wilcoxon signed rank test indicated that the improvement was statistically significant for rectum (p = 0.004). Conclusion: The preliminary results demonstrate that deformable image registration could efficiently and accurately propagate rectum and bladder contours between CT images in different T&R brachytherapy fractions. We are incorporating the propagated

  13. Anomalous earth stress measurements during a six-year sequence of pumping tests at Fenton Hill, New Mexico

    SciTech Connect

    Brown, D.W.

    1988-01-01

    Since 1982, the Los Alamos National Laboratory has been conducting fracturing and flow-through tests on a deep region of jointed Precambrian rock underlying the western flank of the Valles Caldera, in the Jemez Mountains of north-central New Mexico. These experiments have been conducted as part of the Laboratory's Hot Dry Rock (HDR) Geothermal Energy Project, at our Fenton Hill Test Facility, 30 km west of Los Alamos. During this time, the overall project goal has been to experimentally study (and model) the development and performance of a commercial-sized HDR reservoir -- created hydraulically by multiply-fracturing a very large region of hot crystalline rock. One of the primary objectives of this extensive series of fracturing tests has been to study how hard ''competent'' rock dilates and shears during the continuing injection of water under pressure. In association with these tests, a number of seemingly anomalous results have been observed which, if taken separately, would have been fairly easy to ignore or explain anyway. However, in concert, these disparate results have started to form a picture of rock deformation which is quite different from our previously accepted concepts of hydraulic fracturing, and the interpretation of the resulting stress measurements. Key to this better understanding is the realization that almost all bodies of deep crystalline rock are already flawed by one or more sets of joints or planes of weakness, and that it is the interaction between these joints and the existing stress field determines the nature of the pressure-induced deformation. 16 refs., 8 figs., 2 tabs.

  14. What State Tests Test.

    ERIC Educational Resources Information Center

    McGee, Glenn W.

    What the Illinois Goal Assessment Program (IGAP) test actually tests and the consequences of these tests for funding decisions were studied with a random sample of 100 school districts in the Cook County suburbs of Chicago. Eighth-grade IGAP scores for reading were obtained from the state report card, a document prepared by each school district…

  15. Energy Conservation Designed into HDR's New Building

    ERIC Educational Resources Information Center

    Jenkins, Larry

    1974-01-01

    A new building has been engineered by its engineer-owner tenants with provisions for two gas-oil hot water generators and for an electric boiler, so that operating personnel could switch to whatever fuel is available. (Author/MLF)

  16. Energy Conservation Designed into HDR's New Building

    ERIC Educational Resources Information Center

    Jenkins, Larry

    1974-01-01

    A new building has been engineered by its engineer-owner tenants with provisions for two gas-oil hot water generators and for an electric boiler, so that operating personnel could switch to whatever fuel is available. (Author/MLF)

  17. Test Architecture, Test Retrofit

    ERIC Educational Resources Information Center

    Fulcher, Glenn; Davidson, Fred

    2009-01-01

    Just like buildings, tests are designed and built for specific purposes, people, and uses. However, both buildings and tests grow and change over time as the needs of their users change. Sometimes, they are also both used for purposes other than those intended in the original designs. This paper explores architecture as a metaphor for language…

  18. Test Less - Test Right

    DTIC Science & Technology

    2011-05-17

    Large software product development & testing – Extensive Database & Business Analytics experience  Co-authored 2 books on DB2 and Business ... Intelligence  Frequent speaker at Midrange system conferences  Strategic thinking and execution with completeness of visions http://www.linkedin.com/in

  19. Test plan :

    SciTech Connect

    Dwyer, Stephen F.

    2013-05-01

    This test plan is a document that provides a systematic approach to the planned testing of rooftop structures to determine their actual load carrying capacity. This document identifies typical tests to be performed, the responsible parties for testing, the general feature of the tests, the testing approach, test deliverables, testing schedule, monitoring requirements, and environmental and safety compliance.

  20. HIV Testing

    MedlinePlus

    ... antibody tests, combination or fourth-generation tests, and nucleic acid tests (NAT). HIV tests may be performed on ... retested 3 months after your possible exposure. A nucleic acid test (NAT) looks for HIV in the blood. ...

  1. Pinworm test

    MedlinePlus

    Oxyuriasis test; Enterobiasis test; Tape