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Sample records for applicator guided stereotactic

  1. Stereotactic (Mammographically Guided) Breast Biopsy

    Science.gov (United States)

    ... Resources Professions Site Index A-Z Stereotactic Breast Biopsy Stereotactic breast biopsy uses mammography – a specific type ... Breast Biopsy? What is Stereotactic (Mammographically Guided) Breast Biopsy? Lumps or abnormalities in the breast are often ...

  2. Fractionated stereotactically guided radiotherapy for pharmacoresistant epilepsy

    International Nuclear Information System (INIS)

    Aim: This prospective study evaluated the efficiency of fractionated stereotactically guided radiotherapy as a treatment of pharmacoresistant temporal lobe epilepsy. Patients and Methods: Inclusion criteria were patients aged between 17 and 65 years with one-sided temporally located focus, without sufficient epilepsy control by, antiepileptic drugs or neurosurgery. Between 1997 and 1999, two groups of six patients each were treated with 21 Gy (7 times 3 Gy) and 30 Gy (15 times 2 Gy). Study end points were seizure frequency, intensity, seizure length and neuropsychological parameters. Results: All patients experienced a marked reduction in seizure frequency. The mean reduction of seizures was 37% (range 9-77%, i.e. seizures reduced from a monthly mean number of 11.75 to 7.52) at 18 months following radiation treatment and 46% (23-94%, i.e. 0.2-23 seizures per month) during the whole follow-up time. Seizure length was reduced in five out of eleven patients and intensity of seizures in seven out of eleven patients. Conclusion: Radiotherapy was identified as safe and effective for pharmacoresistant epilepsy since a very good reduction of seizure frequency was observed. It is no substitute for regular use of antiepileptic drugs, but means an appropriate alternative for patients with contraindication against neurosurgery or insufficient seizure reduction after neurosurgery. (orig.)

  3. CT-guided stereotactic brain surgery

    International Nuclear Information System (INIS)

    An apparatus for stereotactic brain surgery combined with a whole-body CT scanner, by which surgery can be performed by CT scanning, was developed. This apparatus and an Archimedes screw were clinically applied to surgery for removal of deep-seated intracranial hematomas, and satisfactory results were obtained. An outline of this apparatus is given, and combined use of the apparatus and the Secta type of ultrasound apparatus for monitoring surgery is described. (Namekawa, K.)

  4. MRI-guided vacuum-assisted breast biopsy: comparison with stereotactically guided and ultrasound-guided techniques

    OpenAIRE

    Imschweiler, Thomas; Haueisen, Harald; Kampmann, Gert; Rageth, Luzi; Seifert, Burkhardt; Rageth, Christoph; Freiwald, Bianka; Kubik-Huch, Rahel A.

    2013-01-01

    Objectives To analyse the development of MRI-guided vacuum-assisted biopsy (VAB) in Switzerland and to compare the procedure with stereotactically guided and ultrasound-guided VAB. Methods We performed a retrospective analysis of VABs between 2009 and 2011. A total of 9,113 VABs were performed. Of these, 557 were MRI guided. Results MRI-guided VAB showed the highest growth rate (97 %) of all three procedures. The technical success rates for MRI-guided, stereotactically guided and ultrasound-g...

  5. MRI-guided vacuum-assisted breast biopsy: comparison with stereotactically guided and ultrasound-guided techniques

    Energy Technology Data Exchange (ETDEWEB)

    Imschweiler, Thomas; Freiwald, Bianka; Kubik-Huch, Rahel A. [Kantonspital Baden AG, Institute for Radiology, Baden (Switzerland); Haueisen, Harald [Kantonspital Aarau AG, Institute for Radiology, Aarau (Switzerland); Kampmann, Gert [Clinica Sant' Anna, Lugano, Sorengo (Switzerland); Rageth, Luzi [Adjumed Services AG, Zurich (Switzerland); Seifert, Burkhardt [Institute for Social and Preventive Medicine, University of Zurich, Division of Biostatistics, Zuerich (Switzerland); Rageth, Christoph [Breast Centre, Zurich (Switzerland)

    2014-01-15

    To analyse the development of MRI-guided vacuum-assisted biopsy (VAB) in Switzerland and to compare the procedure with stereotactically guided and ultrasound-guided VAB. We performed a retrospective analysis of VABs between 2009 and 2011. A total of 9,113 VABs were performed. Of these, 557 were MRI guided. MRI-guided VAB showed the highest growth rate (97 %) of all three procedures. The technical success rates for MRI-guided, stereotactically guided and ultrasound-guided VAB were 98.4 % (548/557), 99.1 % (5,904/5,960) and 99.6 % (2,585/2,596), respectively. There were no significant differences (P = 0.12) between the MRI-guided and the stereotactically guided procedures. The technical success rate for ultrasound-guided VAB was significantly higher than that for MRI-guided VAB (P < 0.001). There were no complications using MRI-guided VAB requiring open surgery. The malignancy diagnosis rate for MRI-guided VAB was similar to that for stereotactically guided VAB (P = 0.35). MRI-guided VAB is a safe and accurate procedure that provides insight into clinical breast findings. (orig.)

  6. CT guided stereotactic evacuation for hypertensive intracerebral hematoma

    International Nuclear Information System (INIS)

    Sixty-one cases of hypertensive intracerebral hematoma were evacuated by CT guided stereotactic method. The operation was performed in the CT room under general anesthesia using the KOMAI-NAKAJIMA STEREOTACTIC DEVICE. This instrument has a micromanipulater that can be used for various kinds of stereotactic procedures. Three dimensional position of the target point (aspiration point of the hematoma) was determined on the film obtained from CT scanning of the patient in the stereotactic system. If the hematoma was small, the target point was enough to be one point at the center of the hematoma, but in case of the large hematoma, several target points were given according to the shape of hematoma. The probe, ordinarily a steel tube 4 mm in outer diameter, was inserted through brain to the target point and the hematoma was aspirated through a silicon tube connected to a vacuum system. Among 61 cases examined, 30 cases of thalamic hemorrhage were operated upon and 36 cases were not operated. They were classified according to the volume of hematoma into 3 groups as follows: A=less than 10 ml, B=11-25 ml, C=more than 25 ml. The operated cases were compared with the non operated cases on the improvement of consciousness in each group. In the A group, the operated patients in the level I recovered more slowly than the non operated patients, but in the level II patients, this was reversed. In the B group, the operated patients improved more quickly except the level I patients. In the C group, almost all of non operated patients died. Thus, this operation was very useful in improving consciousness of level II or III patients independent of hematoma volume. It accelerated the recovery of motor function in the level I. This non inversive technique is considered effective for the removal of deep intracerebral hematoma. (author)

  7. A study on CT-guided stereotactic technique for functional neurosurgery

    International Nuclear Information System (INIS)

    Recently, CT-guided stereotactic surgery has become of major interest, and some authors have discussed its potential in functional neurosurgery. The following is a comparative study of the CT-guided stereotactic technique and the conventional roentogenographic stereotactic technique. The Brown-Roberts-Wells apparatus was used for both types of procedures. 37 stereotactic procedures were performed on 35 patients under local anesthesia; 16 for stereotactic biopsy and 21 for stereotactic functional neurosurgery. Target points for stereotactic biopsy were determined by the CT-guided technique and target points for functional neurosurgery were determined by the conventional roentogenographic technique. The correlation with the position of target point determined by both techniques was investigated in the 21 functional neurosurgical procedures. On these occasions the authors used the reformatted horizontal and sagittal CT through the anterior and posterior commissure to determine the position of target point by the CT-guided technique. Results: It was found that the AC-PC line crossed with Reid's base line at angle of 11 ± 1 deg, and therefore it is important to obtain a CT images including AC-PC line at this angle. When applying the CT guided stereotactic procedure for functional surgery, it should be known that there could be a discrepancy within 2 mm from the conventional target determination. (author)

  8. CT guided stereotactic evacuation of hypertensive and traumatic intracerebral hematomas

    International Nuclear Information System (INIS)

    Recent advancement of CT system provides not only definite diagnosis and location of intracerebral hematoma but also coordinates of the center of the hematoma. Trials of stereotactic evacuation of the hematoma have been reported by some authors in the cases of subacute or chronic stages of hypertensive intracerebral hemorrhage. In this series, similar surgery has been performed in 33 cases of hypertensive intracerebral hematoma including 22 cases in acute stage, and 2 cases of traumatic hematoma. Clinical outcomes were investigated and the results were considered to be equivalent or rather better in the conventional microsurgery with evacuation of hematoma under direct vision. However, there still remained controversial problems in the cases of threatened herniation signs, because in these cases regular surgery with total evacuation of the hematoma at one time might have been preferable. The benefits of this CT guided stereotactic approach for the evacuation of the hematoma were thought to be as follow: 1) the procedure is simple and safe, 2) operation is readily performed under local anesthesia, and 3) the hematoma was drained out totally by means of urokinase activity. It is our impression that this surgery not only is indicated as emergency treatment for the patients of high-age or in high risk, but also can institute as a routine surgery for the intracerebral hematomas in patients showing no herniation sign. (J.P.N.)

  9. CT-guided stereotactic evacuation of hypertensive intracerebral hematomas

    International Nuclear Information System (INIS)

    Computerized tomography (CT) is now effective not only for definite diagnosis and location of intracerebral hematomas but also for coordination of the center of a hematoma. CT-guided stereotactic evacuation of hypertensive intracerebral hematoma was performed in 51 cases: 34 of basal ganglionic hematoma with or without ventricular perforation, 11 of subcortical hematoma, 3 of thalamic hematoma and 3 of cerebellar hematoma. Three dimensional CT images or biplane CT images were taken to determine the coordinates of the target point, which was the center of the hematoma. Then, a silicon tube (O.D. 3.5 phi, I.D. 2.1 phi) was inserted into the center of the hematoma through a burr-hole under local anesthesia, and the liquid or solid hematoma was aspirated as completely as possible with a syringe. Urokinase (6,000 I.U./5 ml saline) was administered through this silicon tube every 6 or 12 hours for several days until the hematoma had drained out competely. The silicon tube was taken out when repeated CT scanning revealed no hematoma. The results of clinical follow-ups indicated that this procedure is as good as, or rather better than conventional microsurgery with evacuation of hematoma under direct vision. Moreover this CT-guided stereotactic approach for evacuation of the hematoma has the following advantages: 1) the procedure is simple and safe, 2) operation can be performed under local anesthesia, and 3) the hematoma is drained out completely with the aid of urokinase. This surgery seems indicated as an emergency treatment for high-age or high risk patients and also as a routine surgery for intracerebral hematomas in patients showing no herination signs. (author)

  10. An image guided small animal stereotactic radiotherapy system

    Science.gov (United States)

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

    2016-01-01

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

  11. An image guided small animal stereotactic radiotherapy system.

    Science.gov (United States)

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

    2016-04-01

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

  12. MRI guided stereotactic ventrointermediate thalamotomy for writer's cramp: two cases report and literature review

    Directory of Open Access Journals (Sweden)

    Chao-shi NIU

    2015-10-01

    Full Text Available Objective To explore the methods and curative effect of stereotactic surgery for treating writer's cramp (WC. Methods and Results Two patients with writer's cramp (tremor type underwent MRI guided stereotactic ventrointermediate (Vim thalamotomy on the left side. The symptoms of one patient disappeared immediately after operation, and the patient could write legibly. The tremor of right upper extremity in another patient was improved significantly. Two patients did not present obvious complications, and the previous symptoms were not found to recur during follow-up period respectively. Conclusions Stereotactic surgery for treatment of writer's cramp has definite therapeutic effect. MRI guided stereotactic technique can effectively avoid the complications of Vim thalamotomy. However, the indications of two methods in surgical treatment [thalamotomy and deep brain stimulation (DBS] and the respective merits still need further study. DOI: 10.3969/j.issn.1672-6731.2015.10.009

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

    International Nuclear Information System (INIS)

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

  14. Accuracy of MRI-guided stereotactic thalamic functional neurosurgery

    Energy Technology Data Exchange (ETDEWEB)

    Bourgeois, G.; Magnin, M.; Morel, A.; Jeanmonod, D. [Laboratory for Functional Neurosurgery, Neurosurgical Clinic, University Hospital, Zurich (Switzerland); Sartoretti, S.; Huisman, T.; Tuncdogan, E. [Department of Neuroradiology, University Hospital, Zurich (Switzerland); Meier, D. [Institute of Biomedical Engineering and Medical Informatics, University and ETH, Zurich (Switzerland)

    1999-09-01

    Our goal was to evaluate the accuracy of stereotactic technique using MRI in thalamic functional neurosurgery. A phantom study was designed to estimate errors due to MRI distortion. Stereotactic mechanical accuracy was assessed with the Suetens-Gybels-Vandermeulen (SGV) angiographic localiser. Three-dimensional MRI reconstructions of 86 therapeutic lesions were performed. Their co-ordinates were corrected from adjustments based on peroperative electrophysiological data and compared to those planned. MR image distortion (maximum: 1 mm) and chemical shift of petroleum oil-filled localiser rods (2.2 mm) induced an anterior target displacement of 2.6 mm (at a field strength of 1.5 T, frequency encoding bandwidth of 187.7 kHz, on T1-weighted images). The average absolute error of the stereotactic material was 0.7 mm for anteroposterior (AP), 0.5 mm for mediolateral (ML) and 0.8 mm for dorsoventral (DV) co-ordinates (maximal absolute errors: 1.6 mm, 2.2 mm and 1.7 mm, respectively; mean euclidean error: 1 mm). Three-dimensional MRI reconstructions showed an average absolute error of 0.8 mm, 0.9 mm and 1.9 mm in AP, ML and DV co-ordinates, respectively (maximal absolute errors: 2.4 mm, 2.7 mm and 5.7 mm, respectively; mean euclidean error: 2.3 mm). MRI distortion and chemical-shift errors must be determined by a phantom study and then compensated for. The most likely explanation for an average absolute error of 1.9 mm in the DV plane is displacement of the brain under the pressure of the penetrating electrode. When this displacement is corrected for by microelectrode recordings and stimulation data, MRI offers a high degree of accuracy and reliability for thalamic stereotaxy. (orig.)

  15. 数字乳腺X线三维定位系统引导Mammotome微创活检的临床应用价值%Clinical application of digital mammography X-ray stereotactic system-guided mammotome minimally invasive biopsy

    Institute of Scientific and Technical Information of China (English)

    谭欢; 曾勇明

    2013-01-01

    目的 探讨数字乳腺X线三维定位系统引导Mammotome微创活检的临床应用价值.方法 回顾性分析77例应用数字乳腺X线三维定位系统引导Mammotome微创旋切技术对乳腺触诊阴性病变进行微创切除活检病例.结果 77例病例成功手术72例.发现良性病变61例(84.7%);乳腺癌11例(15.3%),其中4例为乳腺导管内癌,7例为乳腺浸润性导管癌.结论 应用数字乳腺X线三维定位系统引导Mammotome微创活检乳腺触诊阴性病例可发现有临床意义的病灶,是一种确诊早期乳腺癌的微创方法.%Objective To investigate the clinical application of digital mammography X-ray stereotactic system-guided mammotome minimally invasive biopsy. Methods 77 patients with non-palpable lesions, examined by digital mammography X-ray stereotactic system-guided mammotome minimally invasive biopsy, were selected and analyzed. Results 72 cases of the patients were successfully operated on. 61 cases of them were benign lesions and 11 cases of them were breast cancer (4 cases were ductal carcinoma, and 7 cases were invasive ductal carcinoma). Conclusion Digital mammography X-ray stereotactic system-guided mammotome minimally invasive biopsy is a useful method for diagnosis of early breast cancer.

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

    Directory of Open Access Journals (Sweden)

    Vojtěch Z

    2015-02-01

    Full Text Available Zdenek Vojtěch,1 Hana Malíková,2 Lenka Krámská,3 Roman Liščák,4 Vilibald Vladyka41Department of Neurology, 2Department of Radiodiagnostics, 3Department of Psychology, 4Department of Stereotactic and Radiation Neurosurgery, Na Homolce Hospital, Prague, Czech RepublicBackground: This paper presents our experience of stereotactic radiofrequency amygdalohippocampectomy performed for intractable mesial temporal lobe epilepsy.Methods: The article describes the cases of 61 patients who were treated during the period from 2004 to 2010. Mean postoperative follow-up was 5.3 years. Neuropsychological results were obtained for a subset of 31 patients.Results: At their last postsurgical visit, 43 (70.5% patients were Engel class I, six (9.8% class II, nine (14.8% class III, and three (4.9% class IV. The surgery was complicated by four intracranial hematomas. One of them caused acute hydrocephalus and was treated by shunting and resolved without sequelae, while another caused transitory aphasia. The remaining hematomas were asymptomatic. There were two cases of meningitis which required antibiotic treatment. One patient committed suicide due to postoperative depression. After the procedure, we performed open epilepsy surgery and rethermolesions in three and two patients, respectively (8.2%. Patients showed increases in their mean full scale, verbal, and performance intelligence quotient (IQ scores of 4, 3, and 4 IQ points, respectively (P<0.05. Five (17.2%, four (13.8%, and four (13.3% patients improved their full scale, verbal, and performance IQ scores, respectively. No significant changes were found in memory performance, with a mean increase of 1, 3, and 0 memory quotient points in global, verbal, and visual memory, respectively (P<0.05. Global memory improved in three (10.3% patients, verbal memory in one (3.4%, and one patient (3.3% showed deterioration in visual memory.Conclusion: Stereotactic radiofrequency amygdalohippocampectomy offers a

  17. Image-guided non-invasive stereotactic radiosurgery/radiotherapy

    International Nuclear Information System (INIS)

    The objective of this study is to develop a non-invasive intracranial stereotactic radiosurgery technique with the same high degree of accuracy as that of the current invasive head ring SRS technique. The proposed methodology is to use the image registration to correlate the daily CT images with the planning images and use the head frame with bite block assembly, such that the target isocenter is coincided with the LINAC isocenter through stereotactic setup. In addition, the treatment delivery system (Varian LINAC/CT-on-rails unit) is equipped with a 6D robotic couch top, which the head frame interface device could always be maintained perpendicular to the couch-top surface. Through the head phantom study and the limited patient treatments to demonstrate, a new era of treating intracranial SRS without the pins screwed into the patient's skull but achieve the same precision of treatment delivery, is available now. A stereotactic QA head phantom was used to evaluate the proposed technique. The QA head phantom was attached to a head ring and the phantom was leveled by adjusting the robotic arms of the 6D couch-top. A set of planning CT scans was acquired. Then, a sphere ball inside the QA phantom was chosen as the target. A plan was generated for this test as seen: to remove the phantom, then reattach the head phantom to the head frame interface device. The phantom was not leveled at this time to simulate a different setup (the phantom had a 0.3 degree roll and the weight of the phantom was tilted down by 0.4 degree). A set of CT images was acquired to represent as the daily CT prior to the treatment. The daily CT images were registered with the planning CT images. Then, the 9-rod on the daily CT images was identified and the dose distributions were optimized based on the daily CT images; a daily isocenter was used. The localized target laser frame (LTLF) was set to the coordinates of the new isocenter, then the AP and RT LAT EPID portal images were acquired. For the

  18. Diagnostic yield and morbidity by neuronavigation-guided frameless stereotactic biopsy using magnetic resonance imaging and by frame-based computed tomography-guided stereotactic biopsy

    Directory of Open Access Journals (Sweden)

    Masamitsu Nishihara

    2014-01-01

    Full Text Available Background: We compared the diagnostic yield and morbidity by frame-based computed tomography-guided stereotactic biopsy (CTSTB with Brown-Roberts-Wells (BRW unit and by neuronavigation-guided frameless stereotactic biopsy (NSTB using magnetic resonance imaging (MRI. Methods: The subjects′ age range was 15-83 years. CTSTB with BRW unit was performed for 59 tumors (58 cases, 1988-2007. NSTB was performed for 38 tumors (35 cases, 2007-2013 with the needle sheath attached to the head holder. By NSTB, target locations of sampling points and trajectories were confirmed by using MRI. Diffusion tensor imaging-based fiber tractography was used to achieve safe trajectories. STB by using BRW did not visualize the trajectory virtually; however, the planning images for NSTB were able to show the trajectory virtually before the procedure. Results: Histological diagnoses were established for 93 tumors at the first biopsy. The diagnostic yield was 94.9% by CTSTB and 97.4% by NSTB (P = 0.944. The morbidity rate was 5.1% by CTSTB and 0% by NSTB (P = 0.417. The absolute risk reduction was 23.1% by NSTB when the targets were basal ganglia (putamen, globus pallidus or thalamus. In the cases of glioma for which the targets were basal ganglia (putamen, globus pallidus or thalamus, the absolute risk reduction by NSTB was 30%. Conclusions: There was no significant difference between CTSTB and NSTB concerning the diagnostic yield and morbidity. However, when the target is the basal ganglia (putamen, globus pallidus or thalamus and glioma is suspected, NSTB by using MRI with virtual trajectory is preferable to CTSTB concerning morbidity.

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

    Science.gov (United States)

    Wang, Shu-Wen; Ren, Juan; Yan, Yan-Li; Xue, Chao-Fan; Tan, Li; Ma, Xiao-Wei

    2016-01-01

    The objective of this study was to compare the effects of image-guided hypofractionated radiotherapy and conventional fractionated radiotherapy on non-small-cell lung cancer (NSCLC). Fifty stage- and age-matched cases with NSCLC were randomly divided into two groups (A and B). There were 23 cases in group A and 27 cases in group B. Image-guided radiotherapy (IGRT) and stereotactic radiotherapy were conjugately applied to the patients in group A. Group A patients underwent hypofractionated radiotherapy (6-8 Gy/time) three times per week, with a total dose of 64-66 Gy; group B received conventional fractionated radiotherapy, with a total dose of 68-70 Gy five times per week. In group A, 1-year and 2-year local failure survival rate and 1-year local failure-free survival rate were significantly higher than in group B (P0.05) were lower in group A than in group B. The overall survival rate of group A was significantly higher than that of group B (P=0.03), and the survival rate at 1 year was 87% vs 63%, (P0.05). Compared with conventional fractionated radiation therapy, image-guided hypofractionated stereotactic radiotherapy in NSCLC received better treatment efficacy and showed good tolerability. PMID:27574441

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

    Science.gov (United States)

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

    2013-11-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  2. Cirurgia estereotáxica guiada para angiomas cavernosos Stereotactic-guided surgery for cavernous angioma

    Directory of Open Access Journals (Sweden)

    MURILO S. MENESES

    2000-03-01

    Full Text Available Os angiomas cavernosos intracerebrais são lesões que podem causar hemorragias, crises convulsivas e déficits neurológicos. Essa patologia passou a ter diagnóstico mais precoce com o advento da ressonância magnética. A remoção radical por cirurgia é o melhor método de tratamento. Devido a frequente localização subcortical ou profunda, a utilização de métodos de localização por imagem como a estereotaxia apresentam várias vantagens como: menor incisão de pele, craniotomia e manipulação do tecido cerebral, consequentemente com menor morbidade. Apresentamos uma série de nove angiomas cavernosos tratados por ressecção cirúrgica radical guiada por estereotaxia. Em todos os casos o diagnóstico foi realizado por ressonância magnética e houve confirmação anátomo-patológica. A média de idade dos pacientes foi 30 anos, variando entre 20 e 54 anos. Como morbidade transitória, um paciente teve uma crise convulsiva no 3° dia pós-operatório e uma paciente apresentou disfasia e hemiparesia no 2° dia pós-operatório, com recuperação total na evolução. No total, a remoção foi radical em todos os casos e os pacientes permanecem sem nenhum déficit neurológico relacionado à cirurgia.Intracerebral cavernous angiomas may cause hemorrhage, epileptic seizures and neurological deficits. The diagnosis of these lesions became easier with the advent of the magnetic resonance image (MRI. Radical resection is the treatment of choice. Due to frequent subcortical or deep location, image-guided techniques, such as stereotactic-guided surgery, offer many advantages as smaller skin incision and craniotomy, less brain manipulation with consequently lower morbidity. We present a series of nine cavernous angiomas treated by stereotactic-guided radical surgical resection. The diagnosis was done by MRI and confirmed by pathologic studies in all cases. Mean age of patients was 30 years old (range 20-54 years. Postoperative morbidity

  3. Image-guided stereotactic radiotherapy for patients with vestibular schwannoma. A clinical study

    Energy Technology Data Exchange (ETDEWEB)

    Badakhshi, H.; Muellner, S.; Budach, V. [Charite School of Medicine and University Hospital of Berlin, Departments for Radiation Oncology, Berlin (Germany); Wiener, E. [School of Medicine and University Hospital of Berlin, Institute for Neuroradiology, Berlin (Germany)

    2014-06-15

    Local tumor control and functional outcome after linac-based stereotactic radiosurgery (SRS) and fractionated stereotactic radiotherapy (FSRT) for vestibular schwannoma (VS) were assessed. In all, 250 patients with VS were treated: 190 patients with tumors < 2 cm diameter underwent SRS and 60 patients with tumors >2 to 3.5 cm underwent FSRT. Dose prescription for all cases with SRS (n = 190, 76 %) was 13.5 Gy. For FSRT, mainly two hypofractionated schedules (n = 60, 24 %) with either 7 fractions of 5 Gy (total dose: 35 Gy; n = 35) or 11 fractions of 3.8 Gy (total dose: 41.8 Gy; n = 16) were used. The primary endpoint was local tumor control. Secondary endpoints were symptomatic control and morbidity. The median follow-up was 33.8 months. The 3-year local tumor control was 88.9 %. Local control for SRS and FSRT was 88 and 92 %, respectively. For FSRT with 35 and 41.8 Gy, local control was 90 and 100 %, respectively. There were no acute reactions exceeding grade I. In 61 cases (24.4 % of the entire cohort), trigeminal neuralgia was reported prior to treatment. At last follow-up, 16.3 % (10/61) of those patients reported relief of pain. Regarding facial nerve dysfunction, 45 patients (18 %) presented with symptoms prior to RT. At the last follow-up, 13.3% (6/45) of those patients reported a relief of dysesthesia. Using SRS to treat small VS results in good local control rates. FSRT for larger lesions also seems effective. Severe treatment-related complications are not frequent. Therefore, image-guided stereotactic radiotherapy is an appropriate alternative to microsurgery for patients with VS. (orig.) [German] Wir analysierten die lokale Kontrolle und die funktionellen Verlaeufe bei Patienten mit einem Vestibularisschwannom (VS), die sich einer linacbasierten stereotaktischen Radiochirurgie (SRS) oder einer fraktionierten stereotaktischen Radiotherapie (FSRT) unterzogen. Zwischen 1998 und 2008 wurden 250 Patienten mit einem VS behandelt. In dieser Kohorte wurden 190

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

    Energy Technology Data Exchange (ETDEWEB)

    Toporek, Grzegorz, E-mail: grzegorz.toporek@artorg.unibe.ch; Wallach, Daphne, E-mail: daphne.wallach@artorg.unibe.ch; Weber, Stefan [ARTORG Center for Biomedical Engineering Research, University of Bern (Switzerland); Bale, Reto; Widmann, Gerlig [Innsbruck Medical University, Section of Microinvasive Therapy, Department of Radiology (Austria)

    2013-12-15

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

  5. Adjuvant therapy after resection of brain metastases. Frameless image-guided LINAC-based radiosurgery and stereotactic hypofractionated radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Broemme, J.; Aebersold, D.M.; Pica, A. [Bern Univ., Bern Univ. Hospital (Switzerland). Dept. of Radiation Oncology; Abu-Isa, J.; Beck, J.; Raabe, A. [Bern Univ., Bern Univ. Hospital (Switzerland). Neurosurgery; Kottke, R.; Wiest, R. [Bern Univ., Bern Univ. Hospital (Switzerland). Neuroradiology; Malthaner, M.; Schmidhalter, D. [Bern Univ., Bern Univ. Hospital (Switzerland). Div. of Medical Radiation Physics

    2013-09-15

    Background: Tumor bed stereotactic radiosurgery (SRS) after resection of brain metastases is a new strategy to delay or avoid whole-brain irradiation (WBRT) and its associated toxicities. This retrospective study analyzes results of frameless image-guided linear accelerator (LINAC)-based SRS and stereotactic hypofractionated radiotherapy (SHRT) as adjuvant treatment without WBRT. Materials and methods: Between March 2009 and February 2012, 44 resection cavities in 42 patients were treated with SRS (23 cavities) or SHRT (21 cavities). All treatments were delivered using a stereotactic LINAC. All cavities were expanded by {>=} 2 mm in all directions to create the clinical target volume (CTV). Results: The median planning target volume (PTV) for SRS was 11.1 cm{sup 3}. The median dose prescribed to the PTV margin for SRS was 17 Gy. Median PTV for SHRT was 22.3 cm{sup 3}. The fractionation schemes applied were: 4 fractions of 6 Gy (5 patients), 6 fractions of 4 Gy (6 patients) and 10 fractions of 4 Gy (10 patients). Median follow-up was 9.6 months. Local control (LC) rates after 6 and 12 months were 91 and 77 %, respectively. No statistically significant differences in LC rates between SRS and SHRT treatments were observed. Distant brain control (DBC) rates at 6 and 12 months were 61 and 33 %, respectively. Overall survival (OS) at 6 and 12 months was 87 and 63.5 %, respectively, with a median OS of 15.9 months. One patient treated by SRS showed symptoms of radionecrosis, which was confirmed histologically. Conclusion: Frameless image-guided LINAC-based adjuvant SRS and SHRT are effective and well tolerated local treatment strategies after resection of brain metastases in patients with oligometastatic disease. (orig.)

  6. Fractionated stereotactically guided radiotherapy for pharmacoresistant epilepsy; Fraktionierte, stereotaktisch gefuehrte Radiotherapie der pharmakoresistenten Epilepsie

    Energy Technology Data Exchange (ETDEWEB)

    Grabenbauer, G.G.; Reinhold, C.; Lambrecht, U.; Sauer, R. [Klinik und Poliklinik fuer Strahlentherapie, Friedrich-Alexander-Univ. Erlangen-Nuernberg, Erlangen (Germany); Kerling, F.; Pauli, E.; Stefan, H. [Neurologische Klinik, Abt. Epileptologie, Friedrich-Alexander-Univ. Erlangen-Nuernberg, Erlangen (Germany); Mueller, R.G. [Inst. fuer Medizinische Physik, Friedrich-Alexander-Univ. Erlangen-Nuernberg, Erlangen (Germany); Ganslandt, O. [Neurochirurgische Klinik, Friedrich-Alexander-Univ. Erlangen-Nuernberg, Erlangen (Germany)

    2003-01-01

    Aim: This prospective study evaluated the efficiency of fractionated stereotactically guided radiotherapy as a treatment of pharmacoresistant temporal lobe epilepsy. Patients and Methods: Inclusion criteria were patients aged between 17 and 65 years with one-sided temporally located focus, without sufficient epilepsy control by, antiepileptic drugs or neurosurgery. Between 1997 and 1999, two groups of six patients each were treated with 21 Gy (7 times 3 Gy) and 30 Gy (15 times 2 Gy). Study end points were seizure frequency, intensity, seizure length and neuropsychological parameters. Results: All patients experienced a marked reduction in seizure frequency. The mean reduction of seizures was 37% (range 9-77%, i.e. seizures reduced from a monthly mean number of 11.75 to 7.52) at 18 months following radiation treatment and 46% (23-94%, i.e. 0.2-23 seizures per month) during the whole follow-up time. Seizure length was reduced in five out of eleven patients and intensity of seizures in seven out of eleven patients. Conclusion: Radiotherapy was identified as safe and effective for pharmacoresistant epilepsy since a very good reduction of seizure frequency was observed. It is no substitute for regular use of antiepileptic drugs, but means an appropriate alternative for patients with contraindication against neurosurgery or insufficient seizure reduction after neurosurgery. (orig.) [German] Ziel: Diese prospektive Studie untersuchte die Effizienz einer fraktionierten stereotaktischen Radiotherapie (RT) bei therapieresistenter Temporallappenepilepsie. Patienten und Methoden: Einschlusskriterien waren Patienten im Alter von 17 bis 65 Jahren, die weder medikamentoes noch epilepsiechirurgisch anfallsfrei wurden und einen einseitigen Fokus aufwiesen. Zwei Patientenkohorten zu je sechs Patienten wurden zwischen 1997 und 1999 einer fraktionierten, stereotaktisch gefuehrten Radiotherapie mit 21 Gy (7 x 3 Gy) bzw. 30 Gy (15 x 2 Gy) unterzogen. Endpunkte der Untersuchung waren

  7. Unix Application Migration Guide

    CERN Document Server

    Microsoft. Redmond

    2003-01-01

    Drawing on the experience of Microsoft consultants working in the field, as well as external organizations that have migrated from UNIX to Microsoft® Windows®, this guide offers practical, prescriptive guidance on the issues you are likely to face when porting existing UNIX applications to the Windows operating system environment. Senior IT decision makers, network managers, and operations managers will get real-world guidance and best practices on planning and implementation issues to understand the different methods through which migration or co-existence can be accomplished. Also detailing

  8. CBCT-Guided Rapid Arc for stereotactic ablative radiotherapy (SABR) in lung tumors

    Energy Technology Data Exchange (ETDEWEB)

    Fandino, J. M.; Silva, M. C.; Izquierdo, P.; Candal, A.; Diaz, I.; Fernandez, C.; Gesto, C.; Poncet, M.; Soto, M.; Triana, G.; Losada, C.; Marino, A.

    2013-07-01

    Stereotactic ablative radiotherapy has emerged as a standard treatment option for stage I non-small cell lung cancer in patients unfit for surgery, or who refuse surgery. An increasing number of prospective phase I/II trials, as well as large single and multicenter studies have reported local control rates to be in excess of 85% for early stage non-small cell lung cancer. Volumetric arc therapy RapidArc with tumor-based image guidance technique will be presented as well as our preliminary observations. (Author)

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

    Energy Technology Data Exchange (ETDEWEB)

    Jereczek-Fossa, Barbara Alicja, E-mail: barbara.jereczek@ieo.it [Department of Radiotherapy, European Institute of Oncology, Milan (Italy); University of Milan, Milan (Italy); Beltramo, Giancarlo [CyberKnife Center CDI, Milan (Italy); Fariselli, Laura [Radiotherapy Unit, Carlo Besta Neurological Institute Foundation, Milan (Italy); Fodor, Cristiana [Department of Radiotherapy, European Institute of Oncology, Milan (Italy); Santoro, Luigi [Department of Epidemiology and Statistics, European Institute of Oncology, Milan (Italy); Vavassori, Andrea; Zerini, Dario [Department of Radiotherapy, European Institute of Oncology, Milan (Italy); Gherardi, Federica [Department of Radiotherapy, European Institute of Oncology, Milan (Italy); University of Milan, Milan (Italy); Ascione, Carmen [Department of Radiotherapy, European Institute of Oncology, Milan (Italy); Seconda Universita degli Studi di Napoli, Naples (Italy); Bossi-Zanetti, Isa; Mauro, Roberta [Department of Radiotherapy, European Institute of Oncology, Milan (Italy); University of Milan, Milan (Italy); Bregantin, Achille; Bianchi, Livia Corinna [CyberKnife Center CDI, Milan (Italy); De Cobelli, Ottavio [Department of Urology, European Institute of Oncology, Milan (Italy); Orecchia, Roberto [Department of Radiotherapy, European Institute of Oncology, Milan (Italy); University of Milan, Milan (Italy)

    2012-02-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  11. Image guided respiratory gated hypofractionated Stereotactic Body Radiation Therapy (H-SBRT) for liver and lung tumors: Initial experience

    Energy Technology Data Exchange (ETDEWEB)

    Wurm, R.E.; Gum, F.; Erbel, S. [Charite Campus Mitte, Berlin (Germany). Dept. of Radiation Oncology

    2006-09-15

    To evaluate our initial experience with image guided respiratory gated H-SBRT for liver and lung tumors. The system combines a stereoscopic x-ray imaging system (ExacTrac{sup R} X-Ray 6D) with a dedicated conformal stereotactic radiosurgery and radiotherapy linear accelerator (Novalis) and ExacTrac{sup R} Adaptive Gating for dynamic adaptive treatment. Moving targets are located and tracked by x-ray imaging of implanted fiducial markers defined in the treatment planning computed tomography (CT). The marker position is compared with the position in verification stereoscopic x-ray images, using fully automated marker detection software. The required shift for a correct, gated set-up is calculated and automatically applied. We present our acceptance testing and initial experience in patients with liver and lung tumors. For treatment planning CT and Fluorodeoxyglucose-Positron Emission Tomography (FDG-PET) as well as magnetic resonance imaging (MRI) taken at free breathing and expiration breath hold with internal and external fiducials present were used. Patients were treated with 8-11 consecutive fractions to a dose of 74.8-79.2 Gy. Phantom tests demonstrated targeting accuracy with a moving target to within {+-}1 mm. Inter- and intrafractional patient set-up displacements, as corrected by the gated set-up and not detectable by a conventional set-up, were up to 30 mm. Verification imaging to determine target location during treatment showed an average marker position deviation from the expected position of up to 4 mm on real patients. This initial evaluation shows the accuracy of the system and feasibility of image guided real-time respiratory gated H-SBRT for liver and lung tumors.

  12. Lipiodol versus diaphragm in 4D-CBCT-guided stereotactic radiotherapy of hepatocellular carcinomas

    Energy Technology Data Exchange (ETDEWEB)

    Chan, Mark K.H.; Lee, Venus; Chiang, C.L.; Lee, Francis A.S.; Law, Gilbert; Wong, Frank C.S.; Tung, Stewart Y.; Luk, Hollis [TuenMun Hospital, Department of Clinical Oncology, TuenMun, Hong Kong (China); Sin, N.Y.; Siu, K.L. [TuenMun Hospital, Department of Diagnostic Radiology, TuenMun, Hong Kong (China); Blanck, Oliver [University Clinic Schleswig-Holstein, Department of Radiation Oncology, Saphir Radiosurgery Center, Kiel (Germany)

    2016-02-15

    The purpose of this work was to investigate the potential of lipiodol as a direct tumor surrogate alternative to the diaphragm surrogate on four-dimensional cone-beam computed tomography (4D-CBCT) image guidance for stereotactic radiotherapy of hepatocellular carcinomas. A total of 29 hepatocellular carcinomas (HCC) patients treated by stereotactic radiotherapy following transarterial chemoembolization (TACE) with homogeneous or partial defective lipiodol retention were included. In all, 4-7 pretreatment 4D-CBCT scans were selected for each patient. For each scan, either lipiodol or the diaphragm was used for 4D registration. Resulting lipiodol/diaphragm motion ranges and position errors relative to the reconstructed midventilation images were analyzed to obtain the motion variations, and group mean (ΔM), systematic (Σ), and random (σ) errors of the treatment setup. Of the lipiodolized tumors, 55 % qualified for direct localization on the 4D-CBCT. Significant correlations of lipiodol and diaphragm positions were found in the left-right (LR), craniocaudal (CC), and anteroposterior (AP) directions. ΔM and σ obtained with lipiodol and diaphragm were similar, agreed to within 0.5 mm in the LR and AP, and 0.3 mm in the CC directions, and Σ differed by 1.4 (LR), 1.1 (CC), and 0.6 (AP) mm. Variations of diaphragm motion range > 5 mm were not observed with lipiodol and in one patient with diaphragm. The margin required for the tumor prediction error using the diaphragm surrogate was 6.7 (LR), 11.7 (CC), and 4.1 (AP) mm. Image-guidance combining lipiodol with 4D-CBCT enabled accurate localization of HCC and thus margin reduction. A major limitation was the degraded lipiodol contrast on 4D-CBCT. (orig.) [German] Ziel dieser Studie war es, das Potential von Lipiodol als direktes Tumorsurrogat alternativ zum Zwerchfellsurrogat fuer die vierdimensionale Cone-beam-Computertomographie (4D-CBCT) in der stereotaktischen Strahlentherapie von hepatozellulaeren Karzinomen (HCC

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

    Energy Technology Data Exchange (ETDEWEB)

    Sahgal, Arjun, E-mail: arjun.sahgal@rmp.uhn.on.ca [Department of Radiation Oncology, Princess Margaret Hospital, University of Toronto, Toronto, ON (Canada); Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON (Canada); Weinberg, Vivian [University of California San Francisco Helen Diller Family Comprehensive Cancer Center Biostatistics Core, San Francisco, California (United States); Ma, Lijun [Department of Radiation Oncology, University of California at San Francisco, San Francisco, California (United States); Chang, Eric [Department of Radiation Oncology, University of Southern California and University of Texas MD Anderson Cancer Center, University of Texas, Houston, Texas (United States); Chao, Sam [Department of Radiation Oncology and Neurosurgery, Cleveland Clinic, Cleveland, Ohio (United States); Muacevic, Alexander [European Cyberknife Center Munich in affiliation with University Hospitals of Munich, Munich (Germany); Gorgulho, Alessandra [Department of Neurosurgery, University of California at Los Angeles, Los Angeles, California (United States); Soltys, Scott [Department of Radiation Oncology, Stanford University, Stanford, California (United States); Gerszten, Peter C. [Departments of Neurological Surgery and Radiation Oncology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (United States); Ryu, Sam [Department of Radiation Oncology, Henry Ford Hospital, Detroit, Michigan (United States); Angelov, Lilyana [Department of Radiation Oncology and Neurosurgery, Cleveland Clinic, Cleveland, Ohio (United States); Gibbs, Iris [Department of Radiation Oncology, Stanford University, Stanford, California (United States); Wong, C. Shun [Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON (Canada); Larson, David A. [Department of Radiation Oncology, University of California at San Francisco, San Francisco, California (United States)

    2013-02-01

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

  14. Image-Guided Robotic Stereotactic Radiation Therapy with Fiducial-Free Tumor Tracking for Lung Cancer

    International Nuclear Information System (INIS)

    Stereotactic body radiation therapy (SBRT) for early-stage lung cancer can be achieved with several methods: respiratory gating, body frame, or real-time target and motion tracking. Two target tracking methods are currently available with the CyberKnife® System: the first one, fiducial tracking, requires the use of radio-opaque markers implanted near or inside the tumor, while the other, Xsight® Lung Tracking System, (XLTS) is fiducial-free. With XLTS, targeting is synchronized directly with target motion, which occurs due to respiration. While the former method (fiducial tracking) is well documented, the clinical relevance of the latter (tracking without fiducials) has never been well described to this date. A study was performed at our department for each patient treated for lung cancer with CyberKnife using XLTS. Selection criteria were: primary or recurring T1 or T2 stage non-small-cell lung cancer (NSCLC) with 15–60 mm tumor size. Initial staging included CT-Scan and FDG-PET. Fifty-one patients not amenable to surgery were treated with XLTS. Median follow-up was 15 months (range, 5–30 months). Median tumor size was 24 mm (range, 15–60 mm). Median total dose was 60 Gy (36–60 Gy) in three fractions. Actuarial overall survival was 85.5% (95% CI = 74.5–96%) at 1 year and 79.4% (95% CI = 64–94.8%) at 2 years. Actuarial local control rate was 92% (95% CI = 84–99%) at one1 year and 86% (95% CI = 75–97%) at 2 years. Local control and overall survival rates were similar to previous reports that used fiducials for tumor tracking. Toxicity was lower than most studies since tumor tracking did not require fiducial implantion. This fiducial-free method for respiratory motion tracking is a valid option for the most fragile patients

  15. Application of Raman spectroscopy to identify microcalcifications and underlying breast lesions at stereotactic core needle biopsy

    OpenAIRE

    Barman, Ishan; Dingari, Narahara Chari; Saha, Anushree; McGee, Sasha; Galindo, Luis H.; Liu, Wendy; Plecha, Donna; Klein, Nina; Dasari, Ramachandra Rao; Fitzmaurice, Maryann

    2013-01-01

    Microcalcifications are a feature of diagnostic significance on a mammogram and a target for stereotactic breast needle biopsy. Here, we report development of a Raman spectroscopy technique to simultaneously identify microcalcification status and diagnose the underlying breast lesion, in real-time, during stereotactic core needle biopsy procedures. Raman spectra were obtained ex vivo from 146 tissue sites from fresh stereotactic breast needle biopsy tissue cores from 33 patients, including 50...

  16. Hypofractionated image-guided breath-hold SABR (Stereotactic Ablative Body Radiotherapy of liver metastases – clinical results

    Directory of Open Access Journals (Sweden)

    Boda-Heggemann Judit

    2012-06-01

    Full Text Available Abstract Purpose Stereotactic Ablative Body Radiotherapy (SABR is a non-invasive therapy option for inoperable liver oligometastases. Outcome and toxicity were retrospectively evaluated in a single-institution patient cohort who had undergone ultrasound-guided breath-hold SABR. Patients and methods 19 patients with liver metastases of various primary tumors consecutively treated with SABR (image-guidance with stereotactic ultrasound in combination with computer-controlled breath-hold were analysed regarding overall-survival (OS, progression-free-survival (PFS, progression pattern, local control (LC, acute and late toxicity. Results PTV (planning target volume-size was 108 ± 109cm3 (median 67.4 cm3. BED2 (Biologically effective dose in 2 Gy fraction was 83.3 ± 26.2 Gy (median 78 Gy. Median follow-up and median OS were 12 months. Actuarial 2-year-OS-rate was 31%. Median PFS was 4 months, actuarial 1-year-PFS-rate was 20%. Site of first progression was predominantly distant. Regression of irradiated lesions was observed in 84% (median time to detection of regression was 2 months. Actuarial 6-month-LC-rate was 92%, 1- and 2-years-LC-rate 57%, respectively. BED2 influenced LC. When a cut-off of BED2 = 78 Gy was used, the higher BED2 values resulted in improved local control with a statistical trend to significance (p = 0.0999. Larger PTV-sizes, inversely correlated with applied dose, resulted in lower local control, also with a trend to significance (p-value = 0.08 when a volume cut-off of 67 cm3 was used. No local relapse was observed at PTV-sizes 3 and BED2 > 78 Gy. No acute clinical toxicity > °2 was observed. Late toxicity was also ≤ °2 with the exception of one gastrointestinal bleeding-episode 1 year post-SABR. A statistically significant elevation in the acute phase was observed for alkaline-phosphatase; in the chronic phase for alkaline-phosphatase, bilirubine, cholinesterase and C

  17. Initial clinical experience with frameless optically guided stereotactic radiosurgery/radiotherapy in pediatric patients

    OpenAIRE

    Keshavarzi, Sassan; Meltzer, Hal; Ben-Haim, Sharona; Benjamin Newman, Charles; D Lawson, Joshua; Levy, Michael L.; Murphy, Kevin

    2009-01-01

    Objective The objective of this study is to report our initial experience treating pediatric patients with central nervous system tumors using a frameless, optically guided linear accelerator. Materials and methods Pediatric patients were selected for treatment after evaluation by a multidisciplinary neuro-oncology team including neurosurgery, neurology, pathology, oncology, and radiation oncology. Prior to treatment, all patients underwent treatment planning using magnetic resonance imaging ...

  18. Wind energy applications guide

    Energy Technology Data Exchange (ETDEWEB)

    anon.

    2001-01-01

    The brochure is an introduction to various wind power applications for locations with underdeveloped transmission systems, from remote water pumping to village electrification. It includes an introductory section on wind energy, including wind power basics and system components and then provides examples of applications, including water pumping, stand-alone systems for home and business, systems for community centers, schools, and health clinics, and examples in the industrial area. There is also a page of contacts, plus two specific example applications for a wind-diesel system for a remote station in Antarctica and one on wind-diesel village electrification in Russia.

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

    OpenAIRE

    Ren, Juan; Wang, Shuwen; Yan, Yanli; Xue, Chaofan; Tan, Li; Ma, Xiaowei

    2016-01-01

    Shu-wen Wang,1 Juan Ren,1 Yan-li Yan,2 Chao-fan Xue,2 Li Tan,2 Xiao-wei Ma2 1Department of Radiotherapy, First Affiliated Hospital of Xian Jiaotong University, 2Medical School of Xian Jiaotong University, Xi’an, Shaanxi, People’s Republic of China Abstract: The objective of this study was to compare the effects of image-guided hypofractionated radiotherapy and conventional fractionated radiotherapy on non-small-cell lung cancer (NSCLC). Fifty stage- and age-matched cases...

  20. Complete removal of colloid cyst via CT-guided stereotactic bioportal neuro endoscopy

    International Nuclear Information System (INIS)

    Four patients harbouring a colloid cyst of the 3rd ventricle were operated on endoscopically. With the 'classical' mono portal technique, through a precoronal burr hole only partial removal could be achieved in the first case. As the crucial point of the procedure is the safe dissection of the cyst from the thela chorioidea and from the internal cerebral veins, adequate control of the posterior rim of the foramen of Monro and the roof of the 3rd ventricle is mandatory. Accordingly in other three cases a CT-guided biportal endoscopic technique was applied, which permitted radical removal of the entire cyst with maximum safety. CT-guidance is essential for optimal planning after careful study of the individual anatomy. In this way the rigid scopes are moved exclusively along their own axes throughout the procedure, the resulting brain damage thereby being minimal. With regard to all circumstances of the procedure, the use of flexible endoscopes appears to be inappropriate and biportal endoscopy offers itself as the method of choice. (author)

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

    Energy Technology Data Exchange (ETDEWEB)

    Folkert, Michael R. [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Bilsky, Mark H. [Department of Neurosurgery, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Tom, Ashlyn K. [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Oh, Jung Hun [Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Alektiar, Kaled M. [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Laufer, Ilya [Department of Neurosurgery, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Tap, William D. [Department of Medical Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Yamada, Yoshiya, E-mail: yamadaj@mskcc.org [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States)

    2014-04-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Kirkpatrick, John P., E-mail: john.kirkpatrick@dm.duke.edu [Department of Radiation Oncology, Duke University, Durham, North Carolina (United States); Department of Surgery, Duke University, Durham, North Carolina (United States); Wang, Zhiheng [Department of Radiation Oncology, Duke University, Durham, North Carolina (United States); Sampson, John H. [Department of Radiation Oncology, Duke University, Durham, North Carolina (United States); Department of Surgery, Duke University, Durham, North Carolina (United States); McSherry, Frances; Herndon, James E. [Department of Biostatistics and Bioinformatics, Duke University, Durham, North Carolina (United States); Allen, Karen J.; Duffy, Eileen [Department of Radiation Oncology, Duke University, Durham, North Carolina (United States); Hoang, Jenny K. [Department of Radiology, Duke University, Durham, North Carolina (United States); Chang, Zheng; Yoo, David S.; Kelsey, Chris R.; Yin, Fang-Fang [Department of Radiation Oncology, Duke University, Durham, North Carolina (United States)

    2015-01-01

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

  3. Experience in intracranial stereotactic radiosurgery with a non-invasive and guided immobilization system optical; Experience en radiocirugia esterotaxica intracraneal con un sistema de inmovilizacion no invasivo guiado optico

    Energy Technology Data Exchange (ETDEWEB)

    Pellejero Pellejero, S.; Maneru Camara, F.; Lozares Cordero, S.; Otal Palacin, A.; Fuentemilla Urio, N.; Olasolo Alonso, J.; Miquelez Alonso, S.; Martin Albina, M. L.; Rubio Arroniz, A.

    2013-07-01

    At our Center we use an immobilization system non invasive, frameless type, in certain treatment of intracranial Stereotactic radiotherapy in an Linear Accelerator of Trilogy Electron Varian. We present the results obtained in the positioning of the patients with a system of guided optical infrared. (Author)

  4. Dosimetric characterization of a bi-directional micromultileaf collimator for stereotactic applications.

    Science.gov (United States)

    Bucciolini, M; Russo, S; Banci Buonamici, F; Pini, S; Silli, P

    2002-07-01

    A 6 MV photon beam from Linac SL75-5 has been collimated with a new micromultileaf device that is able to shape the field in the two orthogonal directions with four banks of leaves. This is the first clinical installation of the collimator and in this paper the dosimetric characterization of the system is reported. The dosimetric parameters required by the treatment planning system used for the dose calculation in the patient are: tissue maximum ratios, output factors, transmission and leakage of the leaves, penumbra values. Ionization chambers, silicon diode, radiographic films, and LiF thermoluminescent dosimeters have been employed for measurements of absolute dose and beam dosimetric data. Measurements with different dosimeters supply results in reasonable agreement among them and consistent with data available in literature for other models of micromultileaf collimator; that permits the use of the measured parameters for clinical applications. The discrepancies between results obtained with the different detectors (around 2%) for the analyzed parameters can be considered an indication of the accuracy that can be reached by current stereotactic dosimetry. PMID:12148726

  5. Dosimetric characterization of a bi-directional micromultileaf collimator for stereotactic applications.

    Science.gov (United States)

    Bucciolini, M; Russo, S; Banci Buonamici, F; Pini, S; Silli, P

    2002-07-01

    A 6 MV photon beam from Linac SL75-5 has been collimated with a new micromultileaf device that is able to shape the field in the two orthogonal directions with four banks of leaves. This is the first clinical installation of the collimator and in this paper the dosimetric characterization of the system is reported. The dosimetric parameters required by the treatment planning system used for the dose calculation in the patient are: tissue maximum ratios, output factors, transmission and leakage of the leaves, penumbra values. Ionization chambers, silicon diode, radiographic films, and LiF thermoluminescent dosimeters have been employed for measurements of absolute dose and beam dosimetric data. Measurements with different dosimeters supply results in reasonable agreement among them and consistent with data available in literature for other models of micromultileaf collimator; that permits the use of the measured parameters for clinical applications. The discrepancies between results obtained with the different detectors (around 2%) for the analyzed parameters can be considered an indication of the accuracy that can be reached by current stereotactic dosimetry.

  6. Dose-Guided Radiotherapy: Potential Benefit of Online Dose Recalculation for Stereotactic Lung Irradiation in Patients With Non-Small-Cell Lung Cancer

    International Nuclear Information System (INIS)

    Purpose: To determine whether dose-guided radiotherapy (i.e., online recalculation and evaluation of the actual dose distribution) can improve decision making for lung cancer patients treated with stereotactic body radiotherapy. Methods and Materials: For this study 108 cone-beam computed tomography (CBCT) scans of 10 non-small-cell lung cancer patients treated with stereotactic body radiotherapy were analyzed retrospectively. The treatment plans were recalculated on the CBCT scans. The V100% of the internal target volume (ITV) and Dmax of the organs at risk (OARs) were analyzed. Results from the recalculated data were compared with dose estimates for target and OARs by superposition of the originally planned dose distribution on CBCT geometry (i.e., the original dose distribution was assumed to be spatially invariant). Results: Before position correction was applied the V100% of the ITV was 100% in 65% of the cases when an ITV–PTV margin of 5 mm was used and 52% of the cases when a margin of 3 mm was used. After position correction, the difference of Dmax in the OARs with respect to the treatment plan was within 5% in the majority of the cases. When the dose was not recalculated but estimated assuming an invariant dose distribution, clinically relevant errors occurred in both the ITV and the OARs. Conclusion: Dose-guided radiotherapy can be used to determine the actual dose in OARs when the target has moved with respect to the OARs. When the workflow is optimized for speed, it can be used to prevent unnecessary position corrections. Estimating the dose by assuming an invariant dose instead of recalculation of the dose gives clinically relevant errors.

  7. Stereotactic radiosurgery

    Energy Technology Data Exchange (ETDEWEB)

    Leksell, L. (Karolinska Sjukhuset, Stockholm (Sweden))

    1983-09-01

    The development and scope of stereotactic radiosurgery is described. The technique, which combines well with the latest diagnostic methods, has already proved a safe and effective way of treating inaccessible cerebral lesions and in particular small arteriovenous malformations, acoustic neuroma and the solid component of craniopharyngioma, as well as playing an increasingly useful role in the therapy of pituitary adenoma.

  8. Development and clinical usefulness of stereotactic endoneurosurgical system for intracerebral hematoma

    International Nuclear Information System (INIS)

    Since computed tomography (CT)-guided stereotactic surgery is essentially blind surgery, it always involves the risk of injuring viable brain tissue and vessels. Thus, we have developed a new endoneurosurgical system for stereotactic brain surgery. This system consists of a neuroendoscope made of a Selfoc long rod-shaped deflective distribution lens 1.0 mm in diameter, a special ultrasonic aspirator for fragmentation and aspiration of hard blood clots, a micromanipulator and a specially designed stereotactic attachment device, so that they can be accurately inserted into the optimun position from any direction. We have applied this stereotactic endoneurosurgical system to 30 cases of intracerebral hematoma comprising 12 putaminal, 11 thalamic, 4 subcortical, 2 brain stem, 1 cerebellar hemorrhage. The mean age was 65 years old, 79% of patients were over 60 years old, mean hematoma volume was 22 ml, mean rate of removal was 85%, and there was no intraoperative or postoperative hemorrhage. During removal of an intracerebral hematoma, intraoperative bleeding was prevented by the direct observation of microvessels in the wall of the hematoma cavity. This system was developed to allow application of stereotactic techniques to endoscopic surgery. The stereotactic endoneurosurgery is considered to be less invasive, safer, and more accurate, as it can be applied to removal of intracerebral hematoma. (author)

  9. 微电极引导立体定向手术治疗帕金森病的研究%Management of Parkinson's Diseases with Microelectrode-guided Stereotactic Pallidotomy and Thalamotomy

    Institute of Scientific and Technical Information of China (English)

    崔高宇; 冯华; 王宪荣; 吴国材; 陈志

    2001-01-01

    Objective To study the methods and outcome of 71 patients with Parkinson's disease treated with microelectrode-guided stereotactic pallidotomy and thalamotomy. Method Pallidal and thalamal target sites are chosen by supervision of microelectrode recording technique in 71 patients with Parkinson's disease. The UPDRS motor score was used to evaluate the outcomes 12 weeks before and after operation Result After 12 months follow-up, tremor disappeared completely or nearly completely in 12 patients who underwent unilateral and l bilateral ventrolateral thalamotomy. Dramatic improvement of tremor, rigidity, bradykinesia were observed in 57 patients underwent posteroventral pallidotomy,including 6 underwent bilateral posteroventral pallidotomy. Intracerebral hemorrhage was observed in l patient. Conclusion Microelectrode-guided stereotactic pallidotomy and thalamotomy are effective in treatmenting Parkinson's disease, but with serious complications

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

    International Nuclear Information System (INIS)

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

  11. Feasibility of using cone-beam CT to verify and reposition the optically guided target localization of linear accelerator based stereotactic radiosurgery

    Energy Technology Data Exchange (ETDEWEB)

    Zhu Jingeng [Cancer Care Department, Provena Saint Joseph Medical Center, Joliet, Illinois 60435 (United States)

    2011-01-15

    Purpose: The optically guided target localization had been developed for linear accelerator based stereotactic radiosurgery (SRS). Unlike the traditional laser localization, the optical guided target localization utilizes a digital system to position patient. Although the system has been proven accurate and robust, it takes away the capability of physicist to directly double check the target position prior to irradiation. Any error from system calibration, data transformation, or head ring position maintenance will not be caught. The purpose of this work is to investigate the possibility of using cone-beam CT (CBCT) to double check the optically guided SRS target localization and reposition the patient. Methods: A SRS quality assurance (QA) phantom was used in the study. The phantom mounted with SRS head frame was scanned by computer tomography (CT) and planned according to the SRS radiation treatment planning process. A target isocenter is defined and transferred to the optically guided target localization system. The phantom was then transported to the linear accelerator room and localized at the initial position agreed by the optically guided target localization system and the CBCT system. Tests were conducted by moving/rotating the phantom to a set of preset offsets and taking CBCT images. Shifts detected by CBCT were compared with the preset offsets. Agreements between them were studied to see how well the CBCT was in discovering the optically guided target localization error. Results: Experiment results demonstrated good agreement between the CBCT detected phantom shift and the preset offset, when the offset is above 1 mm shift or 0.2 degree rotation. Offset less than 1 mm shift or 0.2 degree rotation was not detectable by CBCT. Conclusions: The study concludes that the CBCT is able to discover the optically guided target localization error due to the system calibration or had ring migration. It is a valuable second check tool for SRS target localization

  12. Application of Raman spectroscopy to identify microcalcifications and underlying breast lesions at stereotactic core needle biopsy.

    Science.gov (United States)

    Barman, Ishan; Dingari, Narahara Chari; Saha, Anushree; McGee, Sasha; Galindo, Luis H; Liu, Wendy; Plecha, Donna; Klein, Nina; Dasari, Ramachandra Rao; Fitzmaurice, Maryann

    2013-06-01

    Microcalcifications are a feature of diagnostic significance on a mammogram and a target for stereotactic breast needle biopsy. Here, we report development of a Raman spectroscopy technique to simultaneously identify microcalcification status and diagnose the underlying breast lesion, in real-time, during stereotactic core needle biopsy procedures. Raman spectra were obtained ex vivo from 146 tissue sites from fresh stereotactic breast needle biopsy tissue cores from 33 patients, including 50 normal tissue sites, 77 lesions with microcalcifications, and 19 lesions without microcalcifications, using a compact clinical system. The Raman spectra were modeled on the basis of the breast tissue components, and a support vector machine framework was used to develop a single-step diagnostic algorithm to distinguish normal tissue, fibrocystic change (FCC), fibroadenoma, and breast cancer, in the absence and presence of microcalcifications. This algorithm was subjected to leave-one-site-out cross-validation, yielding a positive predictive value, negative predictive value, sensitivity, and specificity of 100%, 95.6%, 62.5%, and 100% for diagnosis of breast cancer (with or without microcalcifications) and an overall accuracy of 82.2% for classification into specific categories of normal tissue, FCC, fibroadenoma, or breast cancer (with and without microcalcifications). Notably, the majority of breast cancers diagnosed are ductal carcinoma in situ (DCIS), the most common lesion associated with microcalcifications, which could not be diagnosed using previous Raman algorithm(s). Our study shows the potential of Raman spectroscopy to concomitantly detect microcalcifications and diagnose associated lesions, including DCIS, and thus provide real-time feedback to radiologists during such biopsy procedures, reducing nondiagnostic and false-negative biopsies. PMID:23729641

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

    International Nuclear Information System (INIS)

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

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

    Directory of Open Access Journals (Sweden)

    David Kaul

    2015-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Binkley, Michael S. [Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California (United States); Shrager, Joseph B. [Division of Thoracic Surgery, Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, California (United States); Stanford Cancer Institute, Stanford University School of Medicine, Stanford, California (United States); Leung, Ann N. [Department of Radiology, Stanford University School of Medicine, Stanford, California (United States); Popat, Rita [Department of Health Research and Policy, Stanford University School of Medicine, Stanford, California (United States); Trakul, Nicholas [Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California (United States); Department of Radiation Oncology, University of Southern California Keck School of Medicine, Los Angeles, California (United States); Atwood, Todd F.; Chaudhuri, Aadel [Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California (United States); Maxim, Peter G. [Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California (United States); Stanford Cancer Institute, Stanford University School of Medicine, Stanford, California (United States); Diehn, Maximilian, E-mail: Diehn@Stanford.edu [Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California (United States); Stanford Cancer Institute, Stanford University School of Medicine, Stanford, California (United States); Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, California (United States); Loo, Billy W., E-mail: BWLoo@Stanford.edu [Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California (United States); Stanford Cancer Institute, Stanford University School of Medicine, Stanford, California (United States)

    2014-09-01

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

  16. GNOME 3 application development beginner's guide

    CERN Document Server

    Anwari, Mohammad

    2013-01-01

    This book is a step-by-step guide with ready-to-run codes to guide you in developing applications with GNOME. If you have programming skill either in Linux or other operating systems and want to have GNOME 3 as one of your deployment targets, then this book is for you. This book is also for commercial software developers or an open source software hacker. The reader needs to be familiar with Vala and JavaScript before starting to develop Gtk+ and Clutter applications.

  17. Applications guide to pedestrian SNM monitors

    International Nuclear Information System (INIS)

    The applications guide introduces readers to the pedestrian special nuclear material (SNM) monitors that provide nuclear material control at DOE contractor facilities. It explains the principles of operation, the strong and weak points, and steps for calibration and maintenance of the monitors. Administrators and security specialists will find an overview of pedestrain monitor application and upkeep in Part 1 of the guide and a descriptive catalog of present-day monitors in Part 3. Technically oriented readers will be interested in the more detailed discussion of SNM monitoring physics and SNM monitor design principles found in Part 2. 18 refs., 33 figs., 9 tabs

  18. Applications guide to pedestrian SNM monitors

    Energy Technology Data Exchange (ETDEWEB)

    Fehlau, P.E.

    1986-02-01

    The applications guide introduces readers to the pedestrian special nuclear material (SNM) monitors that provide nuclear material control at DOE contractor facilities. It explains the principles of operation, the strong and weak points, and steps for calibration and maintenance of the monitors. Administrators and security specialists will find an overview of pedestrain monitor application and upkeep in Part 1 of the guide and a descriptive catalog of present-day monitors in Part 3. Technically oriented readers will be interested in the more detailed discussion of SNM monitoring physics and SNM monitor design principles found in Part 2. 18 refs., 33 figs., 9 tabs.

  19. A 3D optical head motion measurement system and its primary application in stereotactic radiosurgery

    International Nuclear Information System (INIS)

    Head motion is a significant source of therapy-effect degradation in stereotactic radiosurgery (SRS). In this study, a 3D optical head motion measurement system with a precision less than 0.1 mm has been developed by our group. During the clinical SRS treatment experiments, three dimensional (3D) positions of infrared light emission diode (ILED) markers on the head-chin, nose tip, forehead and ear were measured with a data sampling rate of once per second for 30 minutes, in frame and frameless sessions, respectively, by this system. The t-test and linear correlation analysis have been used, and the results indicate that the difference of head motion with moldable thermoplastic frame on and without frame was highly statistically significant (p<0.01), and the fixation of the moldable thermoplastic frame in X axial direction (defined in local treatment-couch coordinate system) needs to be reinforced to realize better fixation effect for high degree of treatment precision. It is also shown that the head motion was mainly due to the rotation about the occiput-couch contact point, however, the chin is the most easily movable area on the head. The result implies that in the newly developing frameless SRS treatment, the landmarkers should be attached to the relatively static areas such as forehead and ear. (author)

  20. Manual on panoramic gamma irradiators (categories 2 and 4). Incorporating: Applications guide, procedures guide, basics guide

    International Nuclear Information System (INIS)

    The document is the first revision of a previous one published in 1993 to provide guidance on the safe use and regulation of self-contained gamma irradiators (Co-60 or Cs-137 sources) in different fields of application. It includes three parts: Applications Guide, which describes the main applications of self-contained gamma irradiators, the type of equipment, including safety systems, operation and maintenance, and how to deal with incidents. Procedures Guide, which gives step by step instructions on how to carry out the practice. Basics Guide, which explains the fundamentals of radiation, the system of units, interaction of radiation with matter radiation detection, etc. The manual is aimed primarily at persons handling such radiation sources on a daily routine basis, as well as at the competent authorities for training of workers in radiation protection or for setting up local radiation protection rules

  1. Diagnosis of Central nervous system lymphoma by MRI-guided stereotactic biopsy.%MRI引导下立体定向活组织检查诊断中枢神经系统淋巴瘤

    Institute of Scientific and Technical Information of China (English)

    杨超; 刘金龙; 柯春龙; 叶小帆; 王凌雁

    2011-01-01

    目的:探讨MRI引导下立体定向活组织检查(活检)手术在中枢神经系统淋巴瘤诊断中的应用,提高中枢神经系统淋巴瘤的诊断水平.方法:对16例疑诊中枢神经系统淋巴瘤的患者行MRI引导下立体定向活检手术.安装Leksell立体定向头架,行MRI扫描,计算靶点取标本,所取标本送病理学检查.结果:16例患者手术成功率100%,经病理证实,均诊断为中枢神经系统淋巴瘤,其中15例为弥漫性大B细胞淋巴瘤,1例为Burkitt淋巴瘤.术后复查CT有4例出现血肿,1例患者于术后第4日出现迟发性出血、脑疝,行开颅手术后死亡.结论:立体定向活检术对于明确诊断中枢神经系统淋巴瘤,具有重要的应用价值.%Objective; To evaluate the accuracy and complications of MRI-guided frame-based stereotactic brain biopsy procedures in the diagnosis of Central nervous system CNS lymphoma. Methods; MRI-guided stereotactic brain biopsy was performed in 16 suspected patients with (CNS) lymphoma. Anatomical location, diagnostic accuracy, morbidity and mortality were analyzed. Results; A total of 16 stereotactic surgery procedures were successfully performed. All were pathologically proven CNS lymphoma, with 15 cases of diffuse large B-cell lymphoma and 1 case of Burkitt lymphoma. Diagnostic accuracy was 100% in this study. Hemorrhage was detected in 4 cases using postoperative CT scanning. One patient died of delayed intracranial hematoma. Conclusion; MRI-guided stereotactic brain biopsy is a reliable and safe method for the diagnosis of CNS lymphoma.

  2. Microsoft Application Virtualization Advanced Guide

    CERN Document Server

    Alvarez, Augusto

    2012-01-01

    A practical tutorial containing clear, step-by-step explanations of all the concepts required to understand the technology involved in virtualizing your application infrastructure. Each chapter uses real-world scenarios so that the readers can put into practice what they learn immediately and with the right guidance. Each topic is written defining a common need and developing the process to solve it using Microsoft App-V. This book is for system administrators or consultants who want to master and dominate App-V, and gain a deeper understanding of the technology in order to optimize App V impl

  3. Active and passive beam application design guide for global application

    CERN Document Server

    Rimmer, Julian

    2015-01-01

    The Active and Passive Beam Application Design Guide is the result of collaboration by worldwide experts to give system designers a current, authoritative guide on successfully applying active and passive beam technology. Active and Passive Beam Application Design Guide provide energy-efficient methods of cooling, heating, and ventilating indoor areas, especially spaces that require individual zone control and where internal moisture loads are moderate. The systems are simple to operate, with low maintenance requirements. This book is an essential resource for consulting engineers, architects, owners, and contractors who are involved in the design, operation, and installation of these systems. Building on REHVA’s Chilled Beam Application Guidebook, this new guide provides up-to-date tools and advice for designing, commissioning, and operating chilled-beam systems to achieve a determined indoor climate, and includes examples of active and passive beam calculations and selections. Dual units (SI and I-P) are...

  4. Manual on therapeutic uses of iodine-131. Incorporating: Applications guide, procedures guide, basics guide

    International Nuclear Information System (INIS)

    This publication is part of practical radiation safety manual series for different fields of application aimed primarily at persons handling radiation sources on a daily routine basis, which could at same time be used by the competent authorities, supporting their efforts in the radiation protection training of workers or medical assistance personnel or helping on-site management to set up local radiation protection rules. It is dedicated to therapeutic uses of Iodine-131: its application and procedures guides

  5. Manual on high energy teletherapy. Incorporating: Applications guide, procedures guide, basics guide

    International Nuclear Information System (INIS)

    This publication is part of practical radiation safety manual series for different fields of application aimed primarily at persons handling radiation sources on a daily routine basis, which could at same time be used by the competent authorities, supporting their efforts in the radiation protection training of workers or medical assistance personnel or helping on-site management to set up local radiation protection rules. It is dedicated to high energy radiotherapy: its application and procedures guides

  6. Apply Pesticides Correctly, A Guide for Commercial Applicators: Aerial Application.

    Science.gov (United States)

    Wamsley, Mary Ann, Ed.; Vermeire, Donna M., Ed.

    This guide contains basic information to meet specific standards for pesticide applicators. The text is concerned with the calibration of dry and liquid pesticide systems for aerial application. Additionally, dispersal equipment is discussed with considerations for environmental and safety factors. (CS)

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

    Science.gov (United States)

    Tsang, Maverick W K

    2016-07-01

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

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

    International Nuclear Information System (INIS)

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

  9. CRISPR guide RNA design for research applications.

    Science.gov (United States)

    Mohr, Stephanie E; Hu, Yanhui; Ewen-Campen, Benjamin; Housden, Benjamin E; Viswanatha, Raghuvir; Perrimon, Norbert

    2016-09-01

    The rapid rise of CRISPR as a technology for genome engineering and related research applications has created a need for algorithms and associated online tools that facilitate design of on-target and effective guide RNAs (gRNAs). Here, we review the state of the art in CRISPR gRNA design for research applications of the CRISPR-Cas9 system, including knockout, activation, and inhibition. Notably, achieving good gRNA design is not solely dependent on innovations in CRISPR technology. Good design and design tools also rely on availability of high-quality genome sequence and gene annotations, as well as on availability of accumulated data regarding off-targets and effectiveness metrics.

  10. Application Guide to Neutron Multiplicity Counting

    Energy Technology Data Exchange (ETDEWEB)

    D. G. Langner; J. E. Stewart; M. M. Pickrell; M. S. Krick; N. Ensslin; W. C. Harker

    1998-11-01

    This document is intended to serve as a comprehensive applications guide to passive neutron multiplicity counting, a new nondestructive assay (NDA) technique developed over the past ten years. The document describes the principles of multiplicity counter design, electronics, and mathematics. Existing counters in Department of Energy (DOE) facilities are surveyed, and their operating requirements and procedures and defined. Current applications to plutonium material types found in DOE facilities are described, and estimates of the expected assay precision and bias are given. Lastly, guidelines for multiplicity counter selection and procurement are summarized. The document also includes a detailed collection of references on passive neutron coincidence and multiplicity publications over the last ten to fifteen years.

  11. Dosimetric and Deformation Effects of Image-Guided Interventions during Stereotactic Body Radiation Therapy of the Prostate using an Endorectal Balloon

    CERN Document Server

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

    2013-01-01

    During Stereotactic Body Radiotherapy (SBRT) for the treatment of prostate cancer, an inflatable endorectal balloon (ERB) may be used to reduce motion of the target and reduce the dose to the posterior rectal wall. This work assessed the dosimetric impact of manual interventions on ERB position in patients receiving prostate SBRT and investigated the impact of ERB interventions on prostate shape. Daily kilovoltage (kV) cone-beam computed tomography (CBCT) imaging was performed to localize the PTV, and an automated fusion with the planning images yielded displacements required for PTV re-localization. When the ERB volume and/or position were judged to yield inaccurate repositioning, manual adjustment (ERB re-inflation and/or repositioning) was performed. Based on all 59 CBCT image sets acquired, a deformable registration algorithm was used to determine the dose received by, displacement of, and deformation of the prostate, bladder, and anterior rectal wall. This dose tracking methodology was applied to images ...

  12. Computer Concepts and Software Applications. Teacher's Guide.

    Science.gov (United States)

    Illinois State Board of Education, Springfield. Dept. of Adult, Vocational and Technical Education.

    This curriculum guide is one of five developed as part of the Illinois Plan for Business, Marketing, and Management Education for use in 9th and 10th grades. The curriculum guide includes teacher and student activities that can be implemented in many ways. Information on how to integrate the activity objectives of the Illinois Plan into the State…

  13. The Development of a Guide Device for Stereotactic Core-needle Biopsy of the Breast%一种乳腺立体定位穿刺导向架的研制

    Institute of Scientific and Technical Information of China (English)

    孔龙阳; 吴剑; 高鹏; 吴国辉; 李修往

    2013-01-01

    针对临床上乳腺穿刺手术中精确定位穿刺枪的需求,设计出一款能匹配于国产乳腺机的立体定位穿刺导向架,以帮助医生提高手术质量。该装置包括运动模块、位移测量模块及显示模块,可实现三个方向相互垂直的直线运动,能实时显示三方向的运动位移。实验结果表明,该装置能与国产乳腺机良好匹配,使用感觉良好,各个运动方向的定位精度和重复性均较好,通过观察显示值,操作者可以准确改变穿刺枪的空间位置。%To meet the need of accurate positioning for biopsy gun in the breast biopsy operation, a new stereotactic biopsy guide device have been developed to adapt to the domestic mammary machine, which can help physician to carry out biopsy operation more accurately and effectively. The guide device has the motion model, measurement model and display model and can realize linear motion and display real-time displacement values in X, Y and Z direction. The experimental results showed that the guide device could be wel fixed in the domestic mammary machine, and achieved good accuracy and repeatability in each direction. Depending on the displacement values, physician can change the space of biopsy gun accurately.

  14. A kinetic model of tumor growth and its radiation response with an application to Gamma Knife stereotactic radiosurgery

    CERN Document Server

    Watanabe, Yoichi; Leder, Kevin Z; Hui, Susanta K

    2015-01-01

    We developed a mathematical model to simulate the growth of tumor volume and its response to a single fraction of high dose irradiation. We made several key assumptions of the model. Tumor volume is composed of proliferating (or dividing) cancer cells and non-dividing (or dead) cells. Tumor growth rate (or tumor volume doubling time, Td) is proportional to the ratio of the volumes of tumor vasculature and the tumor. The vascular volume grows slower than the tumor by introducing the vascular growth retardation factor, theta. Upon irradiation the proliferating cells gradually die over a fixed time period after irradiation. Dead cells are cleared away with cell clearance time, Tcl. The model was applied to simulate pre-treatment growth and post-treatment radiation response of rat rhabdomyosarcoma tumor and metastatic brain tumors of five patients who were treated by Gamma Knife stereotactic radiosurgery (GKSRS). By selecting appropriate model parameters, we showed the temporal variation of the tumors for both th...

  15. Business Financial Applications. Curriculum Guide. Simulations. Test Bank.

    Science.gov (United States)

    Massey, Ray Nell; Patton, Jan

    This business financial applications document combines the curriculum guide, simulations, and the test bank for the 1-semester course. The guide provides students with an overview of the banking industry used for entry-level positions or advancement into an occupationally specific course. It begins with a course description, suggested scope and…

  16. Manual on high energy teletherapy. Incorporating: Applications guide, procedures guide, basics guide

    International Nuclear Information System (INIS)

    Apart from a basic guide to the principles of the production of ionizing radiation and to methods of radiation protection and dose measurements, this booklet contains information about radiation protection measures for high-energy teletherapy

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

    Science.gov (United States)

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

    2013-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Kemmerer, Eric [Department of Radiation Oncology, Temple University Hospital, Philadelphia, Pennsylvania (United States); Hernandez, Enrique; Ferriss, James S. [Department of Obstetrics and Gynecology, Temple University Hospital, Philadelphia, Pennsylvania (United States); Valakh, Vladimir; Miyamoto, Curtis; Li, Shidong [Department of Radiation Oncology, Temple University Hospital, Philadelphia, Pennsylvania (United States); Micaily, Bizhan, E-mail: bizhan.micaily@tuhs.temple.edu [Department of Radiation Oncology, Temple University Hospital, Philadelphia, Pennsylvania (United States)

    2013-01-01

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

  19. Application of modified dynamic conformal arc (MDCA) technique on liver stereotactic body radiation therapy (SBRT) planning following RTOG 0438 guideline

    Energy Technology Data Exchange (ETDEWEB)

    Shi, Chengyu, E-mail: shicy1974@yahoo.com; Chen, Yong; Fang, Deborah; Iannuzzi, Christopher

    2015-04-01

    Liver stereotactic body radiation therapy (SBRT) is a feasible treatment method for the nonoperable, patient with early-stage liver cancer. Treatment planning for the SBRT is very important and has to consider the simulation accuracy, planning time, treatment efficiency effects etc. The modified dynamic conformal arc (MDCA) technique is a 3-dimensional conformal arc planning method, which has been proposed for liver SBRT planning at our center. In this study, we compared the MDCA technique with the RapidArc technique in terms of planning target volume (PTV) coverage and sparing of organs at risk (OARs). The results show that the MDCA technique has comparable plan quality to RapidArc considering PTV coverage, hot spots, heterogeneity index, and effective liver volume. For the 5 PTVs studied among 4 patients, the MDCA plan, when compared with the RapidArc plan, showed 9% more hot spots, more heterogeneity effect, more sparing of OARs, and lower liver effective volume. The monitor unit (MU) number for the MDCA plan is much lower than for the RapidArc plans. The MDCA plan has the advantages of less planning time, no-collision treatment, and a lower MU number.

  20. Multi-institutional application of Failure Mode and Effects Analysis (FMEA) to CyberKnife Stereotactic Body Radiation Therapy (SBRT)

    International Nuclear Information System (INIS)

    A multidisciplinary and multi-institutional working group applied the Failure Mode and Effects Analysis (FMEA) approach to assess the risks for patients undergoing Stereotactic Body Radiation Therapy (SBRT) treatments for lesions located in spine and liver in two CyberKnife® Centres. The various sub-processes characterizing the SBRT treatment were identified to generate the process trees of both the treatment planning and delivery phases. This analysis drove to the identification and subsequent scoring of the potential failure modes, together with their causes and effects, using the risk probability number (RPN) scoring system. Novel solutions aimed to increase patient safety were accordingly considered. The process-tree characterising the SBRT treatment planning stage was composed with a total of 48 sub-processes. Similarly, 42 sub-processes were identified in the stage of delivery to liver tumours and 30 in the stage of delivery to spine lesions. All the sub-processes were judged to be potentially prone to one or more failure modes. Nineteen failures (i.e. 5 in treatment planning stage, 5 in the delivery to liver lesions and 9 in the delivery to spine lesions) were considered of high concern in view of the high RPN and/or severity index value. The analysis of the potential failures, their causes and effects allowed to improve the safety strategies already adopted in the clinical practice with additional measures for optimizing quality management workflow and increasing patient safety

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

    Energy Technology Data Exchange (ETDEWEB)

    Parsai, S; Dalhart, A; Chen, C; Parsai, E; Pearson, D; Sperling, N; Reddy, K [University of Toledo Medical Center, Toledo, OH (United States)

    2014-06-01

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

  2. IBM WebSphere Application Server 80 Administration Guide

    CERN Document Server

    Robinson, Steve

    2011-01-01

    IBM WebSphere Application Server 8.0 Administration Guide is a highly practical, example-driven tutorial. You will be introduced to WebSphere Application Server 8.0, and guided through configuration, deployment, and tuning for optimum performance. If you are an administrator who wants to get up and running with IBM WebSphere Application Server 8.0, then this book is not to be missed. Experience with WebSphere and Java would be an advantage, but is not essential.

  3. Manual on therapeutic uses of iodine-131. Incorporating: Applications guide, procedures guide, basics guide

    International Nuclear Information System (INIS)

    This booklet contains information about procedures to protect hospital staff and visitors and families of patients treated with iodine 131 from exposure to radiation from I-131. It also includes a basic guide to the principles of the production of ionizing radiation and to methods of radiation protection and dosimetry

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

    International Nuclear Information System (INIS)

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

  5. R statistical application development by example : beginner's guide

    CERN Document Server

    Tattar, Narayanachart Prabhanjan

    2013-01-01

    Full of screenshots and examples, this Beginner's Guide by Example will teach you practically everything you need to know about R statistical application development from scratch. You will begin learning the first concepts of statistics in R which is vital in this fast paced era and it is also a bargain as you do not need to do a preliminary course on the subject.

  6. Apply Pesticides Correctly, A Guide for Commercial Applicators: Seed Treatment.

    Science.gov (United States)

    Wamsley, Mary Ann, Ed.; Vermeire, Donna M., Ed.

    This guide contains basic information to meet specific standards for pesticide applicators. The text is concerned with the types of seeds that require chemical protection against pests. Methods of treatment and labeling requirements for such seeds as rye, wheat, soybeans, peas, and grass hybrids are discussed. Safety and environmental precautions…

  7. Software metrics a guide to planning, analysis, and application

    CERN Document Server

    Pandian, C Ravindranath

    2003-01-01

    Software Metrics: A Guide to Planning, Analysis, and Application simplifies software measurement and explains its value as a pragmatic tool for management. Ideas and techniques presented in this book are derived from best practices. The ideas are field-proven, down to earth, and straightforward, making this volume an invaluable resource for those striving for process improvement.

  8. Tomotherapy and stereotactic radiosurgery

    Science.gov (United States)

    Soisson, Emilie T.

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

  9. Use of FDG-PET to guide dose prescription heterogeneity in stereotactic body radiation therapy for lung cancers with volumetric modulated arc therapy: a feasibility study

    International Nuclear Information System (INIS)

    The aim of this study was to assess if FDG-PET could guide dose prescription heterogeneity and decrease arbitrary location of hotspots in SBRT. For three patients with stage I lung cancer, a CT-simulation and a FDG-PET were registered to define respectively the PTVCT and the biological target volume (BTV). Two plans involving volumetric modulated arc therapy (VMAT) and simultaneous integrated boost (SIB) were calculated. The first plan delivered 4 × 12 Gy within the PTVCT and the second plan, with SIB, 4 × 12 Gy and 13.8 Gy (115% of the prescribed dose) within the PTVCT and the BTV respectively. The Dmax-PTVCT had to be inferior to 60 Gy (125% of the prescribed dose). Plans were evaluated through the D95%, D99% and Dmax-PTVCT, the D2 cm, the R50% and R100% and the dice similarity coefficient (DSC) between the isodose 115% and BTV. DSC allows verifying the location of the 115% isodose (ideal value = 1). The mean PTVCT and BTV were 36.7 (±12.5) and 6.5 (±2.2) cm3 respectively. Both plans led to similar target coverage, same doses to the OARs and equivalent fall-off of the dose outside the PTVCT. On the other hand, the location of hotspots, evaluated through the DSC, was improved for the SIB plans with a mean DSC of 0.31 and 0.45 for the first and the second plans respectively. Use of PET to decrease arbitrary location of hotspots is feasible with VMAT and SIB for lung cancer

  10. Application of Fully Digital Mammography Stereotactic and Removal Tech-nology to the Nonpalpable Breast Lesion%全数字化乳腺X线立体定位及切除技术对触诊阴性乳腺病灶的应用

    Institute of Scientific and Technical Information of China (English)

    董文龙

    2015-01-01

    目的:探讨全数字化乳腺X线立体定位及切除技术对触诊阴性乳腺病灶的应用价值。方法对146例乳腺触诊阴性病灶行X线检查确定病灶位置,采用导丝立体定位乳腺病灶,根据定位导丝指引完整切除病灶及定位导丝,切除标本行X线检查,证实预定病灶已完整切除,标本做病理检查,确定病灶的病理类型。结果146例乳腺病灶中乳腺癌21例,占14.38%(21/146),癌前病变(非典型增生17例,导管内乳头状瘤病6例)共23例,占15.75%(23/146),良性病变102例,占(69.86%,102/146)。结论立体定位切除活检对触诊阴性乳腺病灶定位准确,可以早期发现乳腺癌及癌前病变,对提高乳腺癌的早期诊断率、提高乳腺癌的二级预防具有一定的临床应用价值。%Objective To investigate the application value of fully digital mammography stereotactic and removal technology to the nonpalpable breast lesion. Methods In 146 cases of the negative nonpalpable breast lesions,applying mammography to determine the focal position, and using located needles stereotactic positioning breast lesions, according to the guide of positioning located needles completely cut off the lesions and located needles, then do mammography examination, to confirm reservation lesions have been completely resected, specimen for pathological examination, determine the pathological types.Results In 146 cases of breast lesions ,21 cases of breast cancer, accounting for 14.38%(21/146), 8 cases of breast carcinoma in situ (38.09%, 8/21), 12 cases ofⅠperiod of breast cancer (57.14%, 12/21), 1 case ofIIperiod breast cancer (4.76%, 1/21), precancerous lesions (17 cases of atyp-ical hyperplasia , 6 cases of intraductal papilloma disease), a total of 23 cases, accounted for 15.75% (23/146), 102 cases of be-nign lesions (69.86%, 102/146). For breast cancer cases with breast-conserving surgery, Mammary gland resection alone and breast

  11. STOMP Subsurface Transport Over Multiple Phases: Application guide

    Energy Technology Data Exchange (ETDEWEB)

    Nichols, W.E.; Aimo, N.J.; Oostrom, M.; White, M.D.

    1997-09-01

    The U.S. Department of Energy (DOE), through the Office of Technology Development, has requested the demonstration of remediation technologies for the cleanup of volatile organic compounds and associated radionuclides within the soil and ground water at arid sites. This demonstration program, called the VOC-Arid Soils Integrated Demonstrated Program (Arid-ID), has been initially directed at a volume of unsaturated and saturated soil contaminated with carbon tetrachloride on the Hanford Site near Richland, Washington. A principal subtask of the Arid-ID program involves the development of an integrated engineering simulator for evaluating the effectiveness and efficiency of various remediation technologies. The engineering simulator`s intended users include scientists and engineers who are investigating soil physics phenomena associated with remediation technologies. Principal design goals for the engineering simulator include broad applicability, verified algorithms, quality assurance controls, and validated simulations against laboratory and field-scale experiments. An important goal for the simulator development subtask involves the ability to scale laboratory and field-scale experiments to full-scale remediation technologies, and to transfer acquired technology to other arid sites. The STOMP (Subsurface Transport Over Multiple Phases) simulator has been developed by the Pacific Northwest Laboratory for modeling remediation technologies. Information on the use, application, and theoretical basis of the STOMP simulator are documented in three companion guide guides. This document, the Application Guide, provides a suite of example applications of the STOMP simulator.

  12. Stereotactic radiotherapy for vestibular schwannoma

    DEFF Research Database (Denmark)

    Muzevic, Dario; Legcevic, Jelena; Splavski, Bruno;

    2014-01-01

    BACKGROUND: Vestibular schwannomas (acoustic neuromas) are common benign tumours that arise from the Schwann cells of the vestibular nerve. Management options include observation with neuroradiological follow-up, microsurgical resection and stereotactic radiotherapy. OBJECTIVES: To assess...

  13. 1997 update for the applications guide to vehicle SNM monitors

    International Nuclear Information System (INIS)

    Ten years have elapsed since the publication of the original applications guide to vehicle special nuclear material (SNM) monitors. During that interval, use of automatic vehicle monitors has become more commonplace, and formal procedures for monitor upkeep and evaluation have become available. New concepts for vehicle monitoring are being explored, as well. This update report reviews the basics of vehicle SNM monitoring, discusses what is new in vehicle SNM monitoring, and catalogs the vehicle SNM monitors that are commercial available

  14. Analog circuit design a tutorial guide to applications and solutions

    CERN Document Server

    Williams, Jim

    2011-01-01

    * Covers the fundamentals of linear/analog circuit and system design to guide engineers with their design challenges. * Based on the Application Notes of Linear Technology, the foremost designer of high performance analog products, readers will gain practical insights into design techniques and practice. * Broad range of topics, including power management tutorials, switching regulator design, linear regulator design, data conversion, signal conditioning, and high frequency/RF design. * Contributors include the leading lights in analog design, Robert Dobkin, Jim Willia

  15. Application for TJ-II Signals Visualization: User's Guide

    International Nuclear Information System (INIS)

    In this documents are described the functionalities of the application developed by the Data Acquisition Group for TJ-II signal visualization. There are two versions of the application, the On-line version, used for signal visualization during TJ-II operation, and the Off-line version, used for signal visualization without TJ-II operation. Both versions of the application consist in a graphical user interface developed for X/Motif, in which most of the actions can be done using the mouse buttons. The functionalities of both versions of the application are described in this user's guide, beginning at the application start-up and explaining in detail all the options that it provides and the actions that can be done with each graphic control. (Author) 8 refs

  16. Stability of percutaneously implanted markers for lung stereotactic radiotherapy

    OpenAIRE

    Persson, Gitte Bjørnsen Fredberg; Josipovic, Mirjana; Von Der Recke, Peter; Aznar, Marianne Camille; Munck af Rosenschöld, Per Martin; Korreman, Stine; Specht, Lena; Juhler-Nøttrup, Trine

    2013-01-01

    The purpose of this study was to evaluate the stability of complex markers implanted into lung tumors throughout a course of stereotactic body radiotherapy (SBRT). Fifteen patients referred for lung SBRT were prospectively included. Radio-opaque markers were implanted percutaneously, guided by computed tomography (CT). Deep inspiration breath-hold CT scans (BHCT) were acquired at planning and on three treatment days. The treatment days' BHCTs were registered to the planning BHCT. Intraobserve...

  17. International stereotactic radiosurgery society

    International Nuclear Information System (INIS)

    Stereotactic radiosurgery (SR) is a multi-disciplinary treatment strategy that has a growing impact on the current management of a wide variety of neurological disorders. SR is effective for many patients; it is associated with reduced hospital stay, reduced costs, rapid return to employment status, long term efficacy, and reduced morbidity. An institutional commitment to high level quality assurance reduces the likelihood of errors in patient selection, target determination, dose delivery, and follow-up. The principles and practice of SR must be included in contemporary training of neurological surgeons, radiation oncologists, and medical physicists. Although SR may represent an initially high start-up cost, our long-term analysis indicates that SR will continue to have a major impact on the cost and success of high technology health care delivery at major medical centers worldwide. (author)

  18. Stereotactic treatment. Definitions and literature overview

    International Nuclear Information System (INIS)

    The topics discussed include, among others, the following: Radiosurgery definitions; Stereotactic radiosurgery (SRS) and stereotactic radiotherapy (SRT); Available uncertainties in SRS; Gamma knife; Linac-based SRS; Components of a radiosurgery system; Stereotactic hardware (brain lab); m3 linac attachment; Radiosurgery - clinical procedure; Cancer management; Rationale for SRT; Role of radiosurgery in the management of intracranial tumors; Indications for stereotactic SRS/SRT; Physical components required for SRS/SRT; Stereotactic patient set-up; Stereotactic CT scan for SRS; Physical components required for SRT: Relocatable head frame (GTC); Patient immobilization; Treatment planning system; Basic requirements for SRS dosimetry (Linac based); Stereotactic set-up QA (Linac); Stereotactic frames and QA; Beam dose measurements; Dose evaluation tools; Phantoms. (P.A.)

  19. Multimodality Image Fusion-Guided Procedures: Technique, Accuracy, and Applications

    Energy Technology Data Exchange (ETDEWEB)

    Abi-Jaoudeh, Nadine, E-mail: naj@mail.nih.gov [National Institutes of Health, Radiology and Imaging Sciences (United States); Kruecker, Jochen, E-mail: jochen.kruecker@philips.com [Philips Research North America (United States); Kadoury, Samuel, E-mail: samuel.kadoury@polymtl.ca [Ecole Polytechnique de Montreal, Department of Computer and Software Engineering, Institute of Biomedical Engineering (Canada); Kobeiter, Hicham, E-mail: hicham.kobeiter@gmail.com [CHU Henri Mondor, UPEC, Departments of Radiology and d' imagrie medicale (France); Venkatesan, Aradhana M., E-mail: VenkatesanA@cc.nih.gov; Levy, Elliot, E-mail: levyeb@cc.nih.gov; Wood, Bradford J., E-mail: bwood@cc.nih.gov [National Institutes of Health, Radiology and Imaging Sciences (United States)

    2012-10-15

    Personalized therapies play an increasingly critical role in cancer care: Image guidance with multimodality image fusion facilitates the targeting of specific tissue for tissue characterization and plays a role in drug discovery and optimization of tailored therapies. Positron-emission tomography (PET), magnetic resonance imaging (MRI), and contrast-enhanced computed tomography (CT) may offer additional information not otherwise available to the operator during minimally invasive image-guided procedures, such as biopsy and ablation. With use of multimodality image fusion for image-guided interventions, navigation with advanced modalities does not require the physical presence of the PET, MRI, or CT imaging system. Several commercially available methods of image-fusion and device navigation are reviewed along with an explanation of common tracking hardware and software. An overview of current clinical applications for multimodality navigation is provided.

  20. Stereotactic body radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Lo, Simon S. [Univ. Hospitals Seidman Cancer Center, Cleveland, OH (United States). Dept. of Radiation Oncology; Case Western Reserve Univ., Cleveland, OH (United States). Case Comprehensive Cancer Center; Teh, Bin S. [The Methodist Hospital Cancer Center and Research Institute, Houston, TX (United States). Weill Cornell Medical College; Lu, Jiade J. [National Univ. of Singapore (Singapore). Dept. of Radiation Oncology; Schefter, Tracey E. (eds.) [Colorado Univ., Aurora, CO (United States). Dept. of Radiation Oncology

    2012-11-01

    Comprehensive an up-to-date account of the physical/technological, biological, and clinical aspects of SBRT. Examines in detail retrospective studies and prospective clinical trials for various organ sites from around the world. Written by world-renowned experts in SBRT from North America, Asia and Europe. Stereotactic body radiation therapy (SBRT) has emerged as an innovative treatment for various primary and metastatic cancers, and the past five years have witnessed a quantum leap in its use. This book provides a comprehensive and up-to-date account of the physical/technological, biological, and clinical aspects of SBRT. It will serve as a detailed resource for this rapidly developing treatment modality. The organ sites covered include lung, liver, spine, pancreas, prostate, adrenal, head and neck, and female reproductive tract. Retrospective studies and prospective clinical trials on SBRT for various organ sites from around the world are examined, and toxicities and normal tissue constraints are discussed. This book features unique insights from world-renowned experts in SBRT from North America, Asia, and Europe. It will be necessary reading for radiation oncologists, radiation oncology residents and fellows, medical physicists, medical physics residents, medical oncologists, surgical oncologists, and cancer scientists.

  1. Stereotactic Radiosurgery for Glioblastoma.

    Science.gov (United States)

    Redmond, Kristin J; Mehta, Minesh

    2015-01-01

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

  2. Mobile application development for Android operating system : case NepGuide Mobile

    OpenAIRE

    Poudel, Amrit

    2013-01-01

    ‘NepGuide Mobile’ is a mobile application developed for NepGuide Pvt. Ltd. NepGuide Pvt. Ltd. is a newly established service providing company in Nepal. NepGuide Pvt. Ltd. provides online business and telephone directory of companies in Nepal. The objective of this thesis was to develop a mobile application for android mobile devices for NepGuide Pvt. Ltd. This thesis aims to help Android app developer and anyone interested in database application to understand the basic fundamentals of mobil...

  3. Stereotactic radiation therapy and radiosurgery.

    Science.gov (United States)

    Ostertag, C B

    1994-01-01

    In all stereotactic irradiation procedures, a high dose is delivered to a relatively small target volume. Whether fractionated stereotactic radiotherapy is preferable (based on a therapeutic ratio) or a radiosurgical method (aiming at the precise and complete destruction of a tissue volume) depends on the definition and composition of the target. The methodologies can be grouped in closed-skull external focussed beam stereotactic radiosurgery/radiotherapy and in stereotactic implantation/injection of radiation sources. Although originally developed to treat functional disorders of the brain, stereotactic radiosurgery has been used most successfully for over 4 decades to treat cerebral arteriovenous malformations. Complete obliteration ranges from 30 to 50% after 1 year are reported. At 2 years the results range from 72 to 90%. Clearly the outcome is influenced by patient selection. In the treatment of acoustic neurinomas follow-up data of larger series of radiosurgery show that the treatment performed under local anesthesia on an outpatient basis becomes comparable with the best microsurgery data. Using multiple isocenters and MR localization tumor growth control is achieved in more than 90% of cases, with hearing preservation of approximately 50%. Pituitary tumors with Cushing's syndrome, acromegaly, Nelson's syndrome, prolactinomas and nonsecreting adenomas have been treated with various stereotactic irradiation methods. Further refinement of both localization techniques, dose distribution and beam manipulation will make radiosurgery an attractive modality because of its noninvasive character and low morbidity. Only a small subgroup of patients with low-grade gliomas are candidates for stereotactic localized irradiation treatment, namely those with circumscribed tumors with only limited spread of tumor cells into the periphery. For this subgroup, which usually comprises not more than 25% of all low-grade gliomas, the results from interstitial radiosurgery compete

  4. Raman spectroscopy: a real-time tool for identifying microcalcifications during stereotactic breast core needle biopsies

    OpenAIRE

    Saha, A; Barman, I.; Dingari, N. C.; McGee, S; Volynskaya, Z.; Galindo, L. H.; Liu, W.; Plecha, D.; Klein, N.; Dasari, R. R.; Fitzmaurice, M.

    2011-01-01

    Microcalcifications are an early mammographic sign of breast cancer and a target for stereotactic breast needle biopsy. We present here a Raman spectroscopic tool for detecting microcalcifications in breast tissue based on their chemical composition. We collected ex vivo Raman spectra from 159 tissue sites in fresh stereotactic breast needle biopsies from 33 patients, including 54 normal sites, 75 lesions with microcalcifications and 30 lesions without microcalcifications. Application of our ...

  5. Multimedia educational services in stereotactic radiotherapy.

    Science.gov (United States)

    Bazioglou, M; Theodorou, K; Kappas, C

    1999-01-01

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

  6. Medical applications of fast 3D cameras in real-time image-guided radiotherapy (IGRT) of cancer

    Science.gov (United States)

    Li, Shidong; Li, Tuotuo; Geng, Jason

    2013-03-01

    Dynamic volumetric medical imaging (4DMI) has reduced motion artifacts, increased early diagnosis of small mobile tumors, and improved target definition for treatment planning. High speed cameras for video, X-ray, or other forms of sequential imaging allow a live tracking of external or internal movement useful for real-time image-guided radiation therapy (IGRT). However, none of 4DMI can track real-time organ motion and no camera has correlated with 4DMI to show volumetric changes. With a brief review of various IGRT techniques, we propose a fast 3D camera for live-video stereovision, an automatic surface-motion identifier to classify body or respiratory motion, a mechanical model for synchronizing the external surface movement with the internal target displacement by combination use of the real-time stereovision and pre-treatment 4DMI, and dynamic multi-leaf collimation for adaptive aiming the moving target. Our preliminary results demonstrate that the technique is feasible and efficient in IGRT of mobile targets. A clinical trial has been initiated for validation of its spatial and temporal accuracies and dosimetric impact for intensity-modulated RT (IMRT), volumetric-modulated arc therapy (VMAT), and stereotactic body radiotherapy (SBRT) of any mobile tumors. The technique can be extended for surface-guided stereotactic needle insertion in biopsy of small lung nodules.

  7. Light-Guided Surface Engineering for Biomedical Applications

    Science.gov (United States)

    Jayagopal, Ashwath; Stone, Gregory P.; Haselton, Frederick R.

    2010-01-01

    Free radical species generated through fluorescence photobleaching have been reported to effectively couple a water-soluble species to surfaces containing electron-rich sites (1). In this report, we expand upon this strategy to control the patterned attachment of antibodies and peptides to surfaces for biosensing and tissue engineering applications. In the first application, we compare hydrophobic attachment and photobleaching methods to immobilize FITC-labeled anti-M13K07 bacteriophage antibodies to the SiO2 layer of a differential capacitive biosensor and to the polyester filament of a feedback-controlled filament array. On both surfaces, antibody attachment and function were superior to the previously employed hydrophobic attachment. Furthermore, a laser scanning confocal microscope could be used for automated, software-guided photoattachment chemistry. In a second application, the cell-adhesion peptide RGDS was site-specifically photocoupled to glass coated with fluorescein-conjugated poly(ethylene glycol). RGDS attachment and bioactivity were characterized by a fibroblast adhesion assay. Cell adhesion was limited to sites of RGDS photocoupling. These examples illustrate that fluorophore-based photopatterning can be achieved by both solution-phase fluorophores or surface-adhered fluorophores. The coupling preserves the bioactivity of the patterned species, is amenable to a variety of surfaces, and is readily accessible to laboratories with fluorescence imaging equipment. The flexibility offered by visible light patterning will likely have many useful applications in bioscreening and tissue engineering where the controlled placement of biomolecules and cells is critical, and should be considered as an alternative to chemical coupling methods. PMID:18314938

  8. Stereotactic CO2 laser therapy for hydrocephalus

    Science.gov (United States)

    Kozodoy-Pins, Rebecca L.; Harrington, James A.; Zazanis, George A.; Nosko, Michael G.; Lehman, Richard M.

    1994-05-01

    A new fiber-optic delivery system for CO2 radiation has been used to successfully treat non-communicating hydrocephalus. This system consists of a hollow sapphire waveguide employed in the lumen of a stereotactically-guided neuroendoscope. CO2 gas flows through the bore of the hollow waveguide, creating a path for the laser beam through the cerebrospinal fluid (CSF). This delivery system has the advantages of both visualization and guided CO2 laser radiation without the same 4.3 mm diameter scope. Several patients with hydrocephalus were treated with this new system. The laser was used to create a passage in the floor of the ventricle to allow the flow of CSF from the ventricles to the sub-arachnoid space. Initial postoperative results demonstrated a relief of the clinical symptoms. Long-term results will indicate if this type of therapy will be superior to the use of implanted silicone shunts. Since CO2 laser radiation at 10.6 micrometers is strongly absorbed by the water in tissue and CSF, damage to tissue surrounding the lesion with each laser pulse is limited. The accuracy and safety of this technique may prove it to be an advantageous therapy for obstructive hydrocephalus.

  9. Apply Pesticides Correctly, A Guide for Commercial Applicators: Forest Pest Control.

    Science.gov (United States)

    Wamsley, Mary Ann, Ed.; Vermeire, Donna M., Ed.

    This guide contains basic information to meet specific standards for pesticide applicators. Common forest pests and their control are discussed. Special attention is given to the effectiveness of different application techniques and potential human and environmental hazards. (CS)

  10. Stereotactic Radiosurgery for Gynecologic Cancer

    OpenAIRE

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

    2012-01-01

    Stereotactic body radiotherapy (SBRT) distinguishes itself by necessitating more rigid patient immobilization, accounting for respiratory motion, intricate treatment planning, on-board imaging, and reduced number of ablative radiation doses to cancer targets usually refractory to chemotherapy and conventional radiation. Steep SBRT radiation dose drop-off permits narrow 'pencil beam' treatment fields to be used for ablative radiation treatment condensed into 1 to 3 treatments. Treating physici...

  11. Stereotactic radiosurgery: comparing different technologies

    OpenAIRE

    Schwartz, M.

    1998-01-01

    Radiosurgery can be defined as 3-dimensional stereotactic irradiation of small intracranial targets by various radiation techniques. The goal is to deliver, with great accuracy, a large, single fraction dose to a small intracranial target, while minimizing the absorbed dose in the surrounding tissue. This article describes certain technical aspects of radiosurgery and compares the different methods of performing such treatment. The 2 most frequently used types of devices for radiosurgery are ...

  12. Stereotactic irradiation of functional disorders

    International Nuclear Information System (INIS)

    One initial use of stereotactic radiosurgery was for lesion in functional neurosurgical procedures. Increasingly, Gamma Knife radiosurgery is used to treat trigeminal neuralgia. Radiosurgery was performed sparingly for this indication until recently, when high resolution imaging of the trigeminal nerve provided excellent definition of the target. Maximum radiosurgical doses of 70 or 80 Gy were shown to provide significant pain relief, as a minimal access approach to trigeminal neuralgia (TN)

  13. Stereotactic radiosurgery of brain metastases.

    Science.gov (United States)

    Specht, Hanno M; Combs, Stephanie E

    2016-09-01

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

  14. Computationally Guided Design of Polymer Electrolytes for Battery Applications

    Science.gov (United States)

    Wang, Zhen-Gang; Webb, Michael; Savoie, Brett; Miller, Thomas

    We develop an efficient computational framework for guiding the design of polymer electrolytes for Li battery applications. Short-times molecular dynamics (MD) simulations are employed to identify key structural and dynamic features in the solvation and motion of Li ions, such as the structure of the solvation shells, the spatial distribution of solvation sites, and the polymer segmental mobility. Comparative studies on six polyester-based polymers and polyethylene oxide (PEO) yield good agreement with experimental data on the ion conductivities, and reveal significant differences in the ion diffusion mechanism between PEO and the polyesters. The molecular insights from the MD simulations are used to build a chemically specific coarse-grained model in the spirit of the dynamic bond percolation model of Druger, Ratner and Nitzan. We apply this coarse-grained model to characterize Li ion diffusion in several existing and yet-to-be synthesized polyethers that differ by oxygen content and backbone stiffness. Good agreement is obtained between the predictions of the coarse-grained model and long-timescale atomistic MD simulations, thus providing validation of the model. Our study predicts higher Li ion diffusivity in poly(trimethylene oxide-alt-ethylene oxide) than in PEO. These results demonstrate the potential of this computational framework for rapid screening of new polymer electrolytes based on ion diffusivity.

  15. Tubular Scaffold with Shape Recovery Effect for Cell Guide Applications

    Directory of Open Access Journals (Sweden)

    Kazi M. Zakir Hossain

    2015-07-01

    Full Text Available Tubular scaffolds with aligned polylactic acid (PLA fibres were fabricated for cell guide applications by immersing rolled PLA fibre mats into a polyvinyl acetate (PVAc solution to bind the mats. The PVAc solution was also mixed with up to 30 wt % β-tricalcium phosphate (β-TCP content. Cross-sectional images of the scaffold materials obtained via scanning electron microscopy (SEM revealed the aligned fibre morphology along with a significant number of voids in between the bundles of fibres. The addition of β-TCP into the scaffolds played an important role in increasing the void content from 17.1% to 25.3% for the 30 wt % β-TCP loading, which was measured via micro-CT (µCT analysis. Furthermore, µCT analyses revealed the distribution of aggregated β-TCP particles in between the various PLA fibre layers of the scaffold. The compressive modulus properties of the scaffolds increased from 66 MPa to 83 MPa and the compressive strength properties decreased from 67 MPa to 41 MPa for the 30 wt % β-TCP content scaffold. The scaffolds produced were observed to change into a soft and flexible form which demonstrated shape recovery properties after immersion in phosphate buffered saline (PBS media at 37 °C for 24 h. The cytocompatibility studies (using MG-63 human osteosarcoma cell line revealed preferential cell proliferation along the longitudinal direction of the fibres as compared to the control tissue culture plastic. The manufacturing process highlighted above reveals a simple process for inducing controlled cell alignment and varying porosity features within tubular scaffolds for potential tissue engineering applications.

  16. PHP|architect's guide to PHP security a step-by-step guide to writing secure and reliable PHP applications

    CERN Document Server

    Alshanetsky, Ilia

    2005-01-01

    With the number of security flaws and exploits discovered and released every day constantly on the rise, knowing how to write secure and reliable applications is become more and more important every day. Written by Ilia Alshanetsky, one of the foremost experts on PHP security in the world, php|architect's Guide to PHP Security focuses on providing you with all the tools and knowledge you need to both secure your existing applications and writing new systems with security in mind. This book gives you a step-by-step guide to each security-related topic, providing you with real-world examples of proper coding practices and their implementation in PHP in an accurate, concise and complete way. Provides techniques applicable to any version of PHP, including 4.x and 5.x Includes a step-by-step guide to securing your applications Includes a comprehensive coverage of security design Teaches you how to defend yourself from hackers Shows you how to distract hackers with a "tar pit" to help you fend off potential attacks...

  17. Transcerebellar stereotactic biopsy for brainstem lesions in children

    Directory of Open Access Journals (Sweden)

    Purav Patel

    2009-01-01

    Full Text Available Brain stem lesions are pathologically heterogeneous. Pre-operative radiological diagnoses prove to be wrong in 10 to 20% of cases. It is therefore imperative to have a tissue diagnosis for appropriate therapeutic measures. We report a series of 24 patients (14 males, ten females, age range: 6-17 years CT guided stereotactic biopsy for brain stem lesions approached via the suboccipital transcerebellar route in semi sitting position with principle used to violate only one pial plane with the biopsy probe not entering the ventral surface of the cerebellum. The inclusion and exclusion criteria with detailed material and method are discussed. Histological diagnosis was established in 23 patients (96% with no procedure-related mortality. Our results indicate that stereotaxic approach to brain-stem lesions provides a high yield of positive histological diagnoses with a low incidence of morbidity. Awake CT-guided stereotactic biopsy via the suboccipital transcerebellar route in a semi-sitting position is a safe, reliable, and effective method for brainstem lesions that can obtain adequate tissue for histological diagnosis, thus providing each patient with the best available treatment.

  18. Guided-wave acousto-optics interactions, devices, and applications

    CERN Document Server

    1990-01-01

    The field of integrated- or guided-wave optics has experienced significant and continuous growth since its inception in the late 1960s. There has been a considerable increase in research and development activity in this field worldwide and some significant advances in the realization of working in­ tegrated optic devices and modules have been made in recent years. In fact, there have already been some commercial manufacturing and technical ap­ plications of such devices and modules. The guided-wave-acoustooptics involving Bragg interactions between guided optical waves and surface acoustic waves is one of the areas of in­ tegrated-optics that has reached some degree of scientific and technological maturity. This topical volume is devoted to an in-depth treatment of this emerging branch of science and technology. Presented in this volume are concise treatments on bulk-wave acoustooptics, guided-wave optics, and surface acoustic waves, and detailed studies of guided-wave acoustooptic Bragg diffraction in thr...

  19. Stereotactic radiosurgery: a "targeted" therapy for cancer

    Institute of Scientific and Technical Information of China (English)

    Ming Zeng; Liang-Fu Han

    2012-01-01

    The developments of medicine always follow innovations in science and technology.In the past decade,such innovations have made cancer-related targeted therapies possible.In general,the term "targeted therapy" has been used in reference to cellular and molecular level oriented therapies.However,improvements in the delivery and planning of traditional radiation therapy have also provided cancer patients more options for "targeted" treatment,notably stereotactic radiosurgery (SRS) and stereotactic body radiotherapy (SBRT).In this review,the progress and controversies of SRS and SBRT are discussed to show the role of stereotactic radiation therapy in the ever evolving multidisciplinary care of cancer patients.

  20. Dosimetric verification and clinical evaluation of a new commercially available Monte Carlo-based dose algorithm for application in stereotactic body radiation therapy (SBRT) treatment planning

    Science.gov (United States)

    Fragoso, Margarida; Wen, Ning; Kumar, Sanath; Liu, Dezhi; Ryu, Samuel; Movsas, Benjamin; Munther, Ajlouni; Chetty, Indrin J.

    2010-08-01

    Modern cancer treatment techniques, such as intensity-modulated radiation therapy (IMRT) and stereotactic body radiation therapy (SBRT), have greatly increased the demand for more accurate treatment planning (structure definition, dose calculation, etc) and dose delivery. The ability to use fast and accurate Monte Carlo (MC)-based dose calculations within a commercial treatment planning system (TPS) in the clinical setting is now becoming more of a reality. This study describes the dosimetric verification and initial clinical evaluation of a new commercial MC-based photon beam dose calculation algorithm, within the iPlan v.4.1 TPS (BrainLAB AG, Feldkirchen, Germany). Experimental verification of the MC photon beam model was performed with film and ionization chambers in water phantoms and in heterogeneous solid-water slabs containing bone and lung-equivalent materials for a 6 MV photon beam from a Novalis (BrainLAB) linear accelerator (linac) with a micro-multileaf collimator (m3 MLC). The agreement between calculated and measured dose distributions in the water phantom verification tests was, on average, within 2%/1 mm (high dose/high gradient) and was within ±4%/2 mm in the heterogeneous slab geometries. Example treatment plans in the lung show significant differences between the MC and one-dimensional pencil beam (PB) algorithms within iPlan, especially for small lesions in the lung, where electronic disequilibrium effects are emphasized. Other user-specific features in the iPlan system, such as options to select dose to water or dose to medium, and the mean variance level, have been investigated. Timing results for typical lung treatment plans show the total computation time (including that for processing and I/O) to be less than 10 min for 1-2% mean variance (running on a single PC with 8 Intel Xeon X5355 CPUs, 2.66 GHz). Overall, the iPlan MC algorithm is demonstrated to be an accurate and efficient dose algorithm, incorporating robust tools for MC

  1. Ultrasonic wave-guide for high temperature sodium applications

    International Nuclear Information System (INIS)

    Liquid sodium is used as coolant in Fast Breeder Reactors. Viewing objects under sodium is helpful in the safe operation of Reactor. In-house developed sodium immersible Ultrasonic transducers are limited to temperatures of about 200 degC. As a consequence, the imaging device can only be inserted in to the Reactor during a shut down condition when temperature of sodium in 200 degC only. But in the case of Prototype Fast Breeder Reactor, during scanning the sub-assemblies at close quarters the transducer may experience a temperature of 270 degC, while the bulk sodium is at 200 degC. Therefore as an alternative to high temperature immersion transducers ultrasonic wave-guide technique can be employed. Towards this, a special type of wave-guide utilizing surface (lamb) waves is under development and water test results are reported here. (author)

  2. Guided Signal Reconstruction with Application to Image Magnification

    OpenAIRE

    Gadde, Akshay; Knyazev, Andrew; Tian, Dong; Mansour, Hassan

    2015-01-01

    We study the problem of reconstructing a signal from its projection on a subspace. The proposed signal reconstruction algorithms utilize a guiding subspace that represents desired properties of reconstructed signals. We show that optimal reconstructed signals belong to a convex bounded set, called the "reconstruction" set. We also develop iterative algorithms, based on conjugate gradient methods, to approximate optimal reconstructions with low memory and computational costs. The effectiveness...

  3. Guide for generic application of Reliability Centered Maintenance (RCM) recommendations

    International Nuclear Information System (INIS)

    Previously completed reliability centered maintenance (RCM) studies form the basis for developing or refining a preventive maintenance program. This report describes a generic methodology that will help utilities optimize nuclear plant maintenance programs using RCM techniques. This guide addresses the following areas: history of the generic methodology development process, and use of the generic methodology for conducting system-to-system and component-to-component evaluations. 2 refs., 2 figs., 5 tabs

  4. Guideline of stereotactic radiotherapy of body trunk

    International Nuclear Information System (INIS)

    The guideline is issued for safe and effective practice of the stereotactic radiotherapy of body trunk by giving appropriate methodologies and their theoretical backgrounds to radiological stuff concerned, such as doctors, technologists, physicists, quality assurance (QA)/quality control (QC) personnel, and nurses. The issue is motivated by the recent and expected increase of facilities conducting the therapy popularized from its approval by health insurance authorities in 2004, is based on the drafts by the Study Group for improving prognosis of the accurate 3-D radiotherapy organized in the MHLW and by Jap. 3-D Conformal External Beam Radiotherapy Group and, after edition by QA committee of Jap. Soc. Ther. Radiol. Oncol., is herein published by the Society. The guideline is composed mainly from 4 chapters of Introduction, Clinical practice, Physics and technology, and QA/QC of equipments and systems. The second chapter contains, concerning the therapy, its definition, contraindication, application to health insurance (applicable diseases and requirement), target setting, radiation dose and fractionation, risk organs (serial and parallel ones) and dose limits, and progress observation post therapy. The third chapter, its definition and methods, therapeutic planning, and actual performance, and the forth, the principle, essential concept, items particularly needed (dosimetry and mechanical/geometrical accuracy of equipments, equipments for therapy planning, and QA/QC of the system). The guideline is to be revised within 2-3 years hereafter. (R.T.)

  5. The Application of the Functional Equivalence in the Translation of Chi-nese Tourist Guide

    Institute of Scientific and Technical Information of China (English)

    吴娟

    2014-01-01

    In recent years, with the rapid growth of Chinese tourism, more and more foreigners come to China to travel. The translation of Chinese tourist guide has become an effective way to publicize China and promote the development of Chinese tourism.The thesis mainly analyzes the application of the functional equivalence in the translation of Chinese tourist guide from the reader’s reception and response, and suggests some different translation techniques such as conversion, recasting, analogy and creative translation to make the translation of Chinese tourist guide better accepted by the target language readers.

  6. Apply Pesticides Correctly, A Guide for Commercial Applicators: Food Processing Pest Control.

    Science.gov (United States)

    Wamsley, Mary Ann, Ed.; Vermeire, Donna M., Ed.

    This guide contains basic information to meet specific standards for pesticide applicators. Characteristics, life cycles and habits of pests such as roaches, beetles, flies, ants and rodents are discussed. Additionally, pest control measures, especially by application of aerosols, dusts, baits, fumigants or vapors, is presented. (CS)

  7. Apply Pesticides Correctly, A Guide for Commercial Applicators: Right-of-Way Pest Control.

    Science.gov (United States)

    Wamsley, Mary Ann, Ed.; Vermeire, Donna M., Ed.

    This guide contains basic information to meet specific standards for pesticide applicators. The text is concerned with the recognition of weeds and methods of their control in rights-of-way. Different types of application equipment both airborne and ground are discussed with precautions for the safe and effective use of herbicides. (CS)

  8. Raman spectroscopy: a real-time tool for identifying microcalcifications during stereotactic breast core needle biopsies

    Science.gov (United States)

    Saha, A.; Barman, I.; Dingari, N. C.; McGee, S.; Volynskaya, Z.; Galindo, L. H.; Liu, W.; Plecha, D.; Klein, N.; Dasari, R. R.; Fitzmaurice, M.

    2011-01-01

    Microcalcifications are an early mammographic sign of breast cancer and a target for stereotactic breast needle biopsy. We present here a Raman spectroscopic tool for detecting microcalcifications in breast tissue based on their chemical composition. We collected ex vivo Raman spectra from 159 tissue sites in fresh stereotactic breast needle biopsies from 33 patients, including 54 normal sites, 75 lesions with microcalcifications and 30 lesions without microcalcifications. Application of our Raman technique resulted in a positive predictive value of 97% for detecting microcalcifications. This study shows that Raman spectroscopy has the potential to detect microcalcifications during stereotactic breast core biopsies and provide real-time feedback to radiologists, thus reducing non-diagnostic and false negative biopsies. PMID:22025985

  9. Target identification for stereotactic thalamotomy using diffusion tractography.

    Directory of Open Access Journals (Sweden)

    Zsigmond Tamás Kincses

    Full Text Available BACKGROUND: Stereotactic targets for thalamotomy are usually derived from population-based coordinates. Individual anatomy is used only to scale the coordinates based on the location of some internal guide points. While on conventional MR imaging the thalamic nuclei are indistinguishable, recently it has become possible to identify individual thalamic nuclei using different connectivity profiles, as defined by MR diffusion tractography. METHODOLOGY AND PRINCIPAL FINDINGS: Here we investigated the inter-individual variation of the location of target nuclei for thalamotomy: the putative ventralis oralis posterior (Vop and the ventral intermedius (Vim nucleus as defined by probabilistic tractography. We showed that the mean inter-individual distance of the peak Vop location is 7.33 mm and 7.42 mm for Vim. The mean overlap between individual Vop nuclei was 40.2% and it was 31.8% for Vim nuclei. As a proof of concept, we also present a patient who underwent Vop thalamotomy for untreatable tremor caused by traumatic brain injury and another patient who underwent Vim thalamotomy for essential tremor. The probabilistic tractography indicated that the successful tremor control was achieved with lesions in the Vop and Vim respectively. CONCLUSIONS: Our data call attention to the need for a better appreciation of the individual anatomy when planning stereotactic functional neurosurgery.

  10. 立体定向放射消融治疗肝胰肿瘤的临床应用进展%Advance and clinical application of stereotactic ablative radiotherapy in liver and pancreatic cacinoma

    Institute of Scientific and Technical Information of China (English)

    王振宇; 张群; 文碧秀

    2013-01-01

    Stereotactic ablative radiotherapy (SABR) is a special type of radiation therapy to deliver a high dose of radiation to the extracranial tumor in one or a small number of fractions with a high degree of precision. The tumor target is destroyed by ionizing irradiation while minimizing the exposure of radiation to normal tissues. SABR has been applied to treat patients with medically inoperable primary hepatocellular carcinoma, non-small-cell lung cancer and so on with promising effect. This article has comprehensively reviewed the clinical application of SABR in liver and pancreatic cancer and the progress in radiophysics and radiobiology of SABR.%立体定向放射消融(SABR)是一种对肿瘤靶区采用单次或几次大剂量的精确照射,使肿瘤靶区形成放射性毁损,而靶区外正常组织受照剂量很小的治疗手段。目前该技术治疗不能手术的原发性肝细胞癌、早期非小细胞肺癌等取得了较好的疗效,并越来越多地被应用于腹部肿瘤临床。本文就立体定向放射消融在肝胰肿瘤的临床应用及其在放射物理生物学方面的进展做一综述。

  11. Automated guided vehicle systems a primer with practical applications

    CERN Document Server

    Ullrich, Günter

    2015-01-01

    This primer is directed at experts and practitioners in intralogistics who are concerned with optimizing material flows. The presentation is comprehensive covering both, practical and theoretical aspects with a moderate degree of specialization, using clear and concise language. Areas of operation as well as technical standards of all relevant components and functions are described. Recent developments in technology and in the markets are taken into account. The goal of this book is to further stronger use of automated guided transport systems and the enhancement of their future performance.

  12. Guided wave photonics fundamentals and applications with Matlab

    CERN Document Server

    Binh, Le Nguyen

    2012-01-01

    IntroductionHistorical Overview of Integrated Optics and PhotonicsWhy Analysis of Optical Guided-wave Devices?Principal ObjectivesChapters OverviewSingle Mode Planar Optical WaveguidesFormation of Planar Single Mode Waveguide ProblemsApproximate Analytical Methods of SolutionAPPENDIX A: Maxwell Equations in Dielectric MediaAPPENDIX B: Exact Analysis of Clad-linear Optical WaveguidesAPPENDIX C: Wentzel-Kramers-Brilluoin Method, Turning Points and Connection FormulaeAPPENDIX D: Design and Simulation of Planar Optical Waveguides3D Integrated Optical WaveguidesMarcatili's Method| Effective Index M

  13. Radioterapia estereotáctica Stereotactic radiation therapy

    Directory of Open Access Journals (Sweden)

    J.J. Aristu

    2009-01-01

    independent of the patient to achive a precise location of the lesion. Stereotactic radiotherapy generate highly conformal, precisely focused radiation beams to administer very high doses of radiation without increasing the radiation to healthy surrounding organs or structures. When the procedure is carried out in one treatment session the procedure is termed radiosurgery, and when the treatment is administered in several fractions, the radiation modality is termed stereotactic radiotherapy. Special systems of patient immobilization (guides or stereotactic frames are required together with radiotherapy devices capable of generating conformal beams (lineal accelerator, gammaknife, cyberknife, tomotherapy, cyclotrons. Modern stereotactic radiotherapy techniques employ intra-tumoural radio-opaque fiducials or CT image systems included in the irradiation device, which make possible a precise location of mobile lesions in each treatment session. Besides, technological advances permit breathing synchronized radiation (gating and tracking for maximum tightening of margins and excluding a greater volume of healthy tissue. Radiosurgery is mainly indicated in benign or malign cerebral lesions less than 3-4 centimetres (arteriovenous malformations, neurinomas, meningiomas, cerebral metastases and stereotactic radiotherapy is basically administered in tumours of extracraneal location that require high conformation and precision, such as inoperable early lung cancer and liver metastasis.

  14. The experience of stereotactic aspiration in treatment of brain abscesses

    OpenAIRE

    Zinkevych, Iaroslav; Kostiuk, Kostyantyn; Glavatskyi, Oleksandr; Bolіukh, Andrii; Malysheva, Tatyana; Tkachik, Irina; Tsymbaliuk, Vitaliy

    2015-01-01

    Purpose. To estimate efficiency of stereotactic aspiration of intracerebral abscesses in deep and functionally eloquent brain areas.Methods. 12 patients with brain abscesses who underwent stereotactic aspiration were included into the study. Stereotactic interventions were performed using CRW Radionics Stereotactic System with StereoFusion, StereoPlan (Radionics) and FraimLink (Medtronic) software for target definition. Postoperative follow-up was from 1 to 36 months, in average (14±3.6) mont...

  15. Stereotactic computer tomography with a modified Riechert-Mundinger device as the basis for integrated stereotactic neuroradiological investigations

    Energy Technology Data Exchange (ETDEWEB)

    Sturm, V.; Pastyr, O.; Schlegel, W.; Scharfenberg, H.; Zabel, H.J.; Netzeband, G.; Schabbert, S.; Berberich, W. (Heidelberg Univ. (Germany, F.R.))

    1983-01-01

    For stereotactic biopsy, intracavitary and interstitial irradiation of intracranial tumours, stereotactic CT investigations are of utmost importance. Targetpoints within a tumour as well as the tumour-outlines have to be transferred precisely from transverse and longitudinal CT sections to stereotactic X-ray images. For this purpose, the stereotactic apparatus of Riechert and Mundinger has been equipped with a fixation system of carbon fibre and a measuring phantoma of plexiglas with embedded steel wires allowing stereotactic CT scanning without artefacts. The stereotactic coordinates (x, y, z) of any target point can be taken directly from transverse CT images with high accuracy. The tumour outlines can be transferred to the stereotactic coordinate system from longitudinal CT reconstructions using special programmes. Precise transfer is possible if the CT investigations are performed stereotactically.

  16. Enterprise applications administration the definitive guide to implementation and operations

    CERN Document Server

    Faircloth, Jeremy

    2014-01-01

    Enterprise Applications Administration prepares you for the full breadth of work associated with administering large enterprise applications. This book provides essential information on tasks such as operating systems administration, network design, system architecture, project planning, working within a team, protecting the network, and how to keep applications up and running. The book effectively bridges the gap between what is taught in the technology-specific literature and the real world of enterprise application administrators.Provides a general understanding of all key knowledge areas n

  17. Guide to porting MPI applications to GPI-2

    OpenAIRE

    Machado, Rui; Rotaru, Tiberiu; Rahn, Mirko; Bartsch, Valeria

    2016-01-01

    This document provides simple guidelines on the process of porting an MPI application to GPI-2. Part I of this document introduces GPI-2, its main arguments and then takes the reader through a simple framework with distinct steps towards a GPI-2 application. Part II provides a simple example, a MPI code solving the Laplace equation on a three dimensional regular grid.

  18. Application of ''A Guide to Reactor Site Evaluation'' in Japan

    International Nuclear Information System (INIS)

    The Japan Atomic Energy Commission (JAEC) has issued ''A Guide to Reactor Site Evaluation'' to provide a provisional criterion for site selection. The basic idea of the guide is that even if a certain postulated accident occurred which released fission products, the public in the surrounding area should not suffer from radiation hazards. ''Major accident'' and ''hypothetical accident'' are defined as postulated accidents; the former is connected with a non-residential area and the latter with a low-population area and population centre distance. In a safety analysis such as this, the method of evaluation of meteorological conditions is as important as the assumption of an accident. Therefore the JAEC has issued ''Meteorological Guidance for Reactor Safety Analysis'', This document states that the meteorological conditions should be selected by the statistical processing of observed data, so that if other conditions are selected the results may not become more severe. Construction permits for three commercial power reactors have recently been granted after JAEC examined the safety of the reactors according to the two JAEC documents mentioned above. The data, derived from many conservative premises, seem to show that site selection for a light-water reactor is not a problematic matter in Japan as long as it concerns the safety estimated by accident analysis. On the other hand, however, waste disposal and its treatment may be a problem affecting the site selection of a reactor. The proximity of reactors to population centres seems to present a problem, owing to the fear of the Japanese of radiation hazards. (author)

  19. Application of the concepts of exclusion, exemption and clearance. Safety guide

    International Nuclear Information System (INIS)

    The objective of this Safety Guide is to provide guidance to national authorities, including regulatory bodies, and operating organizations on the application of the concepts of exclusion, exemption and clearance as established in the International Basic Safety Standards for Protection against Ionizing Radiation and for the Safety of Radiation Sources (BSS). The Safety Guide includes specific values of activity concentration for both radionuclides of natural origin and those of artificial origin that may be used for bulk amounts of material for the purpose of applying exclusion or exemption. It also elaborates on the possible application of these values to clearance

  20. Application of light scattering to coatings a user's guide

    CERN Document Server

    Diebold, Michael P

    2014-01-01

    The book begins with the fundamentals of light scattering, first by individual particles, then by small groups of particles, and finally by the trillions of particles present in a real-life paint film. From there, Dr. Diebold focuses on application of these fundamentals to paint formulation. The scope includes both theory and practice with an emphasis on application (from both performance and cost standpoints). The book gives a clear understanding of light scattering principles and application of these principles to paint formulation (with a focus on TiO2 - the strongest scattering material a

  1. A practical guide to testing wireless smartphone applications

    CERN Document Server

    Harty, Julian

    2009-01-01

    Testing applications for mobile phones is difficult, time-consuming, and hard to do effectively. Many people have limited their testing efforts to hands-on testing of an application on a few physical handsets, and they have to repeat the process every time a new version of the software is ready to test. They may miss many of the permutations of real-world use, and as a consequence their users are left with the unpleasant mess of a failing application on their phone.Test automation can help to increase the range and scope of testing, while reducing the overhead of manual testing of each version

  2. Stability of percutaneously implanted markers for lung stereotactic radiotherapy

    DEFF Research Database (Denmark)

    Persson, Gitte Bjørnsen Fredberg; Josipovic, Mirjana; Von Der Recke, Peter;

    2013-01-01

    The purpose of this study was to evaluate the stability of complex markers implanted into lung tumors throughout a course of stereotactic body radiotherapy (SBRT). Fifteen patients referred for lung SBRT were prospectively included. Radio-opaque markers were implanted percutaneously, guided by...... mm in one or more registrations throughout the SBRT course. This is the first study to evaluate stability of complex markers implanted percutaneously into lung tumors for image guidance in SBRT. We conclude that the observed stability of marker position within the tumor indicates that complex markers...... computed tomography (CT). Deep inspiration breath-hold CT scans (BHCT) were acquired at planning and on three treatment days. The treatment days' BHCTs were registered to the planning BHCT. Intraobserver uncertainty in both tumor and marker registration was determined. Deviations in the difference between...

  3. Variable speed pumping: A guide to successful applications - Executive summary

    Energy Technology Data Exchange (ETDEWEB)

    None, None

    2004-05-01

    This document is the result of a collaboration between the Hydraulic Institute, Europump, and the U.S. DOE Industrial Technologies Program, and describes the cost and energy savings potential of pumping applications with variable duty requirements.

  4. Apply Pesticides Correctly, A Guide for Commercial Applicators: Agricultural Pest Control -- Animal.

    Science.gov (United States)

    Wamsley, Mary Ann, Ed.; Vermeire, Donna M., Ed.

    This guide contains basic information to meet specific standards for pesticide applicators. The text is concerned with the common pests of agricultural animals such as flies, ticks, bots, lice and mites. Methods for controlling these pests and appropriate pesticides are discussed. (CS)

  5. Apply Pesticides Correctly, A Guide for Commercial Applicators: Aquatic Pest Control.

    Science.gov (United States)

    Wamsley, Mary Ann, Ed.; Vermeire, Donna M., Ed.

    This guide presents information needed to meet the requirements for pesticide applicator certification. The first part deals with recognition and control of aquatic pests such as aquatic weeds, fish and other vertebrates. Environmental concerns in aquatic pest control are discussed in the second section. (CS)

  6. Apply Pesticides Correctly, A Guide for Commercial Applicators: Ornamental and Turfgrass Pest Control.

    Science.gov (United States)

    Wamsley, Mary Ann, Ed.; Vermeire, Donna M., Ed.

    This guide contains basic information to meet specific standards for pesticide applicators. The text is concerned with recognition and control of ornamental and turfgrass pests such as leaf spot, scab, powdery mildew, galls, grubs and weeds. A section of the text is also devoted to environmental concerns to be considered when undertaking pest…

  7. Apply Pesticides Correctly, A Guide for Commercial Applicators: Public Health Pest Control.

    Science.gov (United States)

    Wamsley, Mary Ann, Ed.; Vermeire, Donna M., Ed.

    This guide contains basic information to meet specific standards for pesticide applicators. The text is concerned with recognition of pests and vectors such as lice, fleas, mosquitoes, flies and rodents. There is also discussion on methods of control without pesticides or in combination with pesticide treatment. Sections of the text are devoted to…

  8. Apply Pesticides Correctly, A Guide for Commercial Applicators: Industrial, Institutional, Structural and Health Related Pest Control.

    Science.gov (United States)

    Wamsley, Mary Ann, Ed.; Vermeire, Donna M., Ed.

    This guide contains basic information to meet the specific standards for pesticide applicators. The thrust of this document is the recognition and control of common pests. Included are those which directly affect man such as bees, roaches, mites, and mosquitoes; and those which destroy food products and wooden structures. Both mechanical and…

  9. Wind Atlas for South Africa (WASA) – Best practice guide for application of WASA

    DEFF Research Database (Denmark)

    Hansen, Jens Carsten; Mortensen, Niels Gylling; Cronin, Tom;

    The present report is a best practice guide for application of results from the Wind Atlas for South Africa (WASA). A general description of the methodological framework – the wind atlas methodology – is given, including validation results of the numerical wind atlas at 10 measurement sites...

  10. New applications of radio guided surgery in oncology

    Energy Technology Data Exchange (ETDEWEB)

    Bitencourt, Almir Galvao Vieira; Pinto, Paula Nicole Vieira; Martins, Eduardo Bruno Lobato; Chojniak, Rubens [Hospital A.C. Camargo, Sao Paulo, SP (Brazil). Dept. of Image], e-mail: almirgvb@yahoo.com.br; Lima, Eduardo Nobrega Pereira [Hospital A.C. Camargo, Sao Paulo, SP (Brazil). Nuclear Medicine

    2009-07-01

    Objective: To report oncological cases (excluding those related to breast cancer) for which radioguided surgery has been used in combination with the Radioguided Occult Lesion Localization technique. Introduction: Radioguided surgery enables a surgeon to identify lesions or tissues that have been preoperatively marked with radioactive substances. The Radioguided Occult Lesion Localization technique has been widely used to identify the sentinel lymph node and occult lesions in patients with breast cancer. However, few studies have reported the use of this technique for non-breast cancer pathologies. Methodology: In all cases, injection of Technetium-99m sulfur colloid was performed, directly inside or near by the suspicious lesion, guided by ultrasound or computed tomography, up to 36 hours prior to the surgical procedure. Intraoperative lesion detection was carried out using a gamma-probe. Results: We report five oncology cases in which preoperative markings of the lesions were carried out using the Radioguided Occult Lesion Localization technique. The patients presented with the following: recurrence of renal cell carcinoma, cervical recurrence of papillary carcinoma of the thyroid, recurrence of retroperitoneal sarcoma, lesions of the popliteal fossa, and recurrence of rhabdomyosarcoma of a thigh. In each case, the lesions that were marked preoperatively were ultimately successfully excised. Conclusions: Radioguided surgery has proven to be a safe and effective alternative for the management of oncology patients. The Radioguided Occult Lesion Localization technique can be useful in selected cases where suspect lesions may be difficult to identify intraoperatively, due to their dimensions or anatomical location. The procedure allows for more conservative excisions and reduces the surgery-related morbidity. (author)

  11. MR-guided pain therapy: principles and clinical applications

    International Nuclear Information System (INIS)

    X-ray fluoroscopy and computed tomography are frequently used to perform percutaneous interventions in pain therapy. The development of MR-compatible therapy needles now allows these interventions to be performed under MR imaging guidance. MR-guided interventions may be performed using most clinical MR scanners; however, systems with an open configuration are advantageous. Multiplanar pre- and intra-procedural MR imaging provides the interventionalist with essential information, such as evaluation of anatomy and pathology, as well as the planning of the procedure and monitoring of fluid distribution without the use of contrast agents. With the use of non-ionizing radiation, interventional MR imaging is especially suited for the treatment of children and young adults as well as for serial injection therapy. For spinal MR interventions, passive needle visualization is an easily achievable and reliable method. The resulting needle artifact is influenced by several factors such as the alloy of the needle, the strength of the static magnetic field, the sequence type, the spatial orientation of the therapy needle as well as the echo time and may further be optimized during the intervention by alteration of the last three factors. Fast acquisition techniques and image processing allow for continuous, near real-time MR imaging (so-called MR fluoroscopy) and interactive needle navigations, comparable to X-ray fluoroscopy and CT fluoroscopy. The purpose of this review is to illustrate and discuss general concepts of interventional MR imaging. A spectrum of interventional MR imaging procedures in spinal pain therapy is described and illustrated, including procedures such as lumbar facet joint injections, sacroiliac joint injections, lumbar spinal nerve root infiltrations and drug delivery to the lumbar sympathetic chain. (orig.)

  12. Illinois Pesticide Applicator Study Guide. A Training Manual for Private and Commercial Pesticide Applicators and Operators. Special Publication 39.

    Science.gov (United States)

    Bever, Wayne; And Others

    This study guide is designed to provide the necessary information to prepare for certification as a private or commercial pesticide applicator. In addition to providing basic information covering the various sections of the amended Federal Insecticide, Fungicide, and Rodenticide Act, it contains a glossary of common pesticide terms, a list of…

  13. Illumination of interior spaces by bended hollow light guides: Application of the theoretical light propagation method

    Energy Technology Data Exchange (ETDEWEB)

    Darula, Stanislav; Kocifaj, Miroslav; Kittler, Richard [ICA, Slovak Academy of Sciences, Bratislava (Slovakia); Kundracik, Frantisek [Department of Experimental Physics, FMPI, Comenius University, Bratislava (Slovakia)

    2010-12-15

    To ensure comfort and healthy conditions in interior spaces the thermal, acoustics and daylight factors of the environment have to be considered in the building design. Due to effective energy performance in buildings the new technology and applications also in daylight engineering are sought such as tubular light guides. These allow the transport of natural light into the building core reducing energy consumption. A lot of installations with various geometrical and optical properties can be applied in real buildings. The simplest set of tubular light guide consists of a transparent cupola, direct tube with high reflected inner surface and a ceiling cover or diffuser redistributing light into the interior. Such vertical tubular guide is often used on flat roofs. When the roof construction is inclined a bend in the light guide system has to be installed. In this case the cupola is set on the sloped roof which collects sunlight and skylight from the seen part of the sky hemisphere as well as that reflected from the ground and opposite facades. In comparison with the vertical tube some additional light losses and distortions of the propagated light have to be expected in bended tubular light guides. Recently the theoretical model of light propagation was already published and its applications are presented in this study solving illuminance distributions on the ceiling cover interface and further illuminance distribution on the working plane in the interior. (author)

  14. Imaging of Radiation Dose for Stereotactic Radiosurgery.

    Science.gov (United States)

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

    2015-01-01

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

  15. Computerized Tomography and its Applications: a Guided Tour

    OpenAIRE

    Roerdink, J.B.T.M.

    1992-01-01

    We present a review of the mathematical principles of computerized tomography. Topics treated include the role of the Radon transform and related transforms, inversion formulas, uniqueness, ill-posedness and stability, practical reconstruction algorithms, and various generalizations such as diffraction tomography. References to the most relevant literature are cited. Several applications are briefly discussed; in particular, we present a case study of a mathematical problem arising in cardiac...

  16. Evaluating humanoid embodied conversational agents in mobile guide applications

    OpenAIRE

    Doumanis, Ioannis

    2013-01-01

    Evolution in the area of mobile computing has been phenomenal in the last few years. The exploding increase in hardware power has enabled multimodal mobile interfaces to be developed. These interfaces differ from the traditional graphical user interface (GUI), in that they enable a more “natural” communication with mobile devices, through the use of multiple communication channels (e.g., multi-touch, speech recognition, etc.). As a result, a new generation of applications has emerged that pro...

  17. The Poor Man's Guide to Computer Networks and their Applications

    DEFF Research Database (Denmark)

    Sharp, Robin

    2003-01-01

    These notes for DTU course 02220, Concurrent Programming, give an introduction to computer networks, with focus on the modern Internet. Basic Internet protocols such as IP, TCP and UDP are presented, and two Internet application protocols, SMTP and HTTP, are described in some detail. Techniques f...... for network programming are described, with concrete examples in Java. Techniques considered include simple socket programming, RMI, Corba, and Web services with SOAP....

  18. A Guide to Using STITCHER for Overlapping Assembly PCR Applications.

    Science.gov (United States)

    O'Halloran, Damien M

    2017-01-01

    Overlapping PCR is commonly used in many molecular applications that include stitching PCR fragments together, generating fluorescent transcriptional and translational fusions, inserting mutations, making deletions, and PCR cloning. Overlapping PCR is also used for genotyping and in detection experiments using techniques such as loop-mediated isothermal amplification (LAMP). STITCHER is a web tool providing a central resource for researchers conducting all types of overlapping assembly PCR experiments with an intuitive interface for automated primer design that's fast, easy to use, and freely available online.

  19. A Guide to Using STITCHER for Overlapping Assembly PCR Applications.

    Science.gov (United States)

    O'Halloran, Damien M

    2017-01-01

    Overlapping PCR is commonly used in many molecular applications that include stitching PCR fragments together, generating fluorescent transcriptional and translational fusions, inserting mutations, making deletions, and PCR cloning. Overlapping PCR is also used for genotyping and in detection experiments using techniques such as loop-mediated isothermal amplification (LAMP). STITCHER is a web tool providing a central resource for researchers conducting all types of overlapping assembly PCR experiments with an intuitive interface for automated primer design that's fast, easy to use, and freely available online. PMID:27671928

  20. Stereotactic Irradiation of Lung Cancer

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    To investigate the best stereotactic irradiation (STI) technique in treatment of small lung tumors, using dose-volume statistics. Methods: Dose-volume histogram (DVH) of the study phantom consisting of CT using the software of FOCUS-3D planning system. The beam was a 6MV X-ray from a Varian 2300C. The analysis data of Dose-volume statistics was from the technique used for: (1) 2- 12 arcs; (2) 20° - 45° separation angle of arcs; (3) 80° - 160° of gantry rotation. Then we studied the difference of DVH with various irradiation techniques and the influence of target positions and field size by calculated to the distribution of dose from 20%- 90% of the six targets in the lung with 3×3 cm2, 4′ 4 cm2 and 5′ 5 cm2 field size. Results: The volume irradiated pulmonary tissue was the smallest using a six non-coplanar 120° arcs with 30° separation between arcs in the hypothetical set up, the non-coplanar SRI was superiority than conventional one's. The six targets were chosen in the right lung, the volume was the largest in geometric center and was decreased in hilus, bottom, anterior chest wall, lateral wall and apex of the lung in such an order. The DVH had significant change with an increasing field size. Conclusion: the irradiation damage of normal pulmonary tissue was the lowest using the six non-coplanar 120° arcs with a 30° separation between arcs by <5×5 cm2 field and the position of target was not a restricting factor.

  1. Guided self-assembly of magnetic beads for biomedical applications

    CERN Document Server

    Gusenbauer, Markus; Reichel, Franz; Exl, Lukas; Bance, Simon; Fischbacher, Johann; Özelt, Harald; Kovacs, Alexander; Brandl, Martin; Schrefl, Thomas

    2013-01-01

    Micromagnetic beads are widely used in biomedical applications for cell separation, drug delivery, and hypothermia cancer treatment. Here we propose to use self-organized magnetic bead structures which accumulate on fixed magnetic seeding points to isolate circulating tumor cells. The analysis of circulating tumor cells is an emerging tool for cancer biology research and clinical cancer management including the detection, diagnosis and monitoring of cancer. Microfluidic chips for isolating circulating tumor cells use either affinity, size or density capturing methods. We combine multiphysics simulation techniques to understand the microscopic behavior of magnetic beads interacting with Nickel accumulation points used in lab-on-chip technologies. Our proposed chip technology offers the possibility to combine affinity and size capturing with special antibody-coated bead arrangements using a magnetic gradient field created by Neodymium Iron Boron permanent magnets. The multiscale simulation environment combines ...

  2. Guided self-assembly of magnetic beads for biomedical applications

    Science.gov (United States)

    Gusenbauer, Markus; Nguyen, Ha; Reichel, Franz; Exl, Lukas; Bance, Simon; Fischbacher, Johann; Özelt, Harald; Kovacs, Alexander; Brandl, Martin; Schrefl, Thomas

    2014-02-01

    Micromagnetic beads are widely used in biomedical applications for cell separation, drug delivery, and hyperthermia cancer treatment. Here we propose to use self-organized magnetic bead structures which accumulate on fixed magnetic seeding points to isolate circulating tumor cells. The analysis of circulating tumor cells is an emerging tool for cancer biology research and clinical cancer management including the detection, diagnosis and monitoring of cancer. Microfluidic chips for isolating circulating tumor cells use either affinity, size or density capturing methods. We combine multiphysics simulation techniques to understand the microscopic behavior of magnetic beads interacting with soft magnetic accumulation points used in lab-on-chip technologies. Our proposed chip technology offers the possibility to combine affinity and size capturing with special antibody-coated bead arrangements using a magnetic gradient field created by Neodymium Iron Boron permanent magnets. The multiscale simulation environment combines magnetic field computation, fluid dynamics and discrete particle dynamics.

  3. Light-guide snapshot spectrometer for biomedical applications

    Science.gov (United States)

    Wang, Ye; Pawlowski, Michal E.; Tkaczyk, Tomasz S.

    2016-04-01

    We present a proof-of-principle prototype of a fiber-based snapshot spectrometer to provide high spatial and spectral sampling for biomedical application such as cell signaling or diagnostics. An image is collected by a custom fiber bundle and then divided into spatial groups with spaces in between for dispersion. The image is later scaled down by an image taper (to scale down the image size and allow smaller optical components), dispersed with a prism and captured by a CCD camera. An interpolation algorithm is used to locate each wavelength and reconstruct the image for each spectral channel. The fiber bundle is fabricated by aligning multi-mode bare fiber ribbons as matrix, gluing together in Teflon molds, laser cutting and polishing. We present preliminary finger occlusion results obtained with the spectrometer where the oxy- and deoxy-hemoglobin spectrum could be differentiated.

  4. Template Guided Live Wire and Its Application on Automatic Extraction of Tongue in Digital Image

    Institute of Scientific and Technical Information of China (English)

    ZHENG Yuan-jie; YANG Jie; ZHOU Yue

    2005-01-01

    In this paper, we propose a novel automatic object extraction algorithm, named the Template Guided Live Wire, based on the popularly used livewire techniques. We discuss in details the novel method's applications on tongue extraction in digital images. With the guides of a given template curve which approximates the tongue's shape, our method can finish the extraction of tongue without any human intervention. In the paper, we also discussed in details how the template guides the live wire, and why our method functions more effectively than other boundary based segmentation methods especially the snake algorithm. Experimental results on some tongue images areas well provided to show our method's better accuracy and robustness than the snake algorithm.

  5. 三维可视化图像引导立体定位脑干及松果体区病灶活检术的研究%The technical report of three-dimension visualized image-guided stereotactic biopsy for lesions in pineal region and brain stem

    Institute of Scientific and Technical Information of China (English)

    王亚明; 于新; 李志超; 惠瑞; 刘锐; 尹丰; 张雷鸣; 程岗; 张剑宁

    2015-01-01

    Objective To investigate the methodology,technical essential and significance of threedimension visualized image-guided stereotactic biopsy (SB) for lesions in pineal region and brain stem.Methods A total of 88 cases of lesions in pineal region and brain stem underwent image-guided SB in our department were retrospectively studied.Frame-based and CAS-2 type frameless SBs were performed in 57 and 31 cases respectively.Pre-biopsy three-dimension visualized image reconstruction was performed by SB planning software and the structure related to possible trajectory in each image slice was confirmed.The most suitable trajectory was selected accordingly.For lesions in pineal region,anterior-frontal trans-tentorium cerebella hiatus trajectory for avoiding tentorial margin was used.For lesions in mesencephalon,posteriorfrontal trans-lateral ventrical-thalamus trajectory via the vertical axis of brain stem was used.For pontal lesions,supra-occipital trans-pedunculus cerebellaris medius trajectory was used.Results Histological diagnosis was established in all 88 cases,which gave a high diagnostic yield (100%).Fifty-six lesions (64%) located in brain stem (middle brain and pons) and 32 (36%) in pineal region.In 56 brain stem lesions,there were 38 cases (68%) of glioma,3(5%) lymphoma,2(4%) neurodegenerative disease,6 (11%) multiple sclerosis and tumefactive demyelinating lesion,2 (4%) non-specific inflammation,2 (4%)brain infarct,2(4%) brain metastases,and 1 (2%) radiation necrosis.For lesions in pineal region,there were 18 cases (56%) of germ cell tumor,4(13%) glioma,9 (28%) pineal cell tumor,and 1 (3%) Wemicke encephalopathy.One case (1%) died of biopsy-related hemorrhage.The neurological deficits became severe because of hemorrhage in 5 cases,the medical treatment was adopted in 3 cases (3%)and drainage in 2 (2%).Conclusions Stereotactic biopsy for lesions in pineal region and brain stem was a safe and effective procedure that could help

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

    Directory of Open Access Journals (Sweden)

    Neffendorf JE

    2015-09-01

    Full Text Available James E Neffendorf, Timothy L Jackson Department of Ophthalmology, School of Medicine, King’s College London, London, United Kingdom Abstract: Neovascular age-related macular degeneration is a leading cause of blindness in the developed world. Currently, the treatment of choice is intravitreal injections of anti-VEGF medications. These require frequent dosing, up to monthly, and impose a substantial burden on patients and the health economy. Ionizing radiation was proposed as a possible treatment for age-related macular degeneration due to its anti-inflammatory and anti-fibrotic properties. Stereotactic radiotherapy is an outpatient-based radiotherapy platform that provides stereotactic application of low energy X-ray to the retina in three highly collimated beams that cross the inferior sclera to overlap at the macula. A randomized, double-masked, sham-controlled trial of 230 patients (INTREPID showed that a single dose of stereotactic radiotherapy significantly reduces the number of intravitreal anti-VEGF injections needed over 2 years. A larger randomized controlled trial (STAR is underway. Keywords: wet age-related macular degeneration, radiation therapy, stereotactic radiotherapy, vascular endothelial growth factor

  7. Mustafa environment description and users' guide with applications to CLIC

    CERN Document Server

    Guignard, Gilbert

    1998-01-01

    In the main linacs of future linear colliders, the control of the emittances and the stability of a train of bunches are critical. It was therefore important for the Compact Linear Collider study (CLIC) to have a tool allowing numerical investigations of these questions. An interactive environment called MUSTAFA (MUltibunch Simulation and Tracking Algorithm for Future Accelerators) has been created and different tools have been developed over the time according to the needs. Progressively, these code and interactive facilities evolved into two main features, their portability on PCs independent from the main frame computers and their analysis capability using animated graphics. All the codes have been written under the MS-DOS operating system. The main application MBTR has been written in FORTRAN, the animated graphics facility MOVIE and the so-called MBUNCH utility program in QUICKBASIC (MS V4.5). The MBUNCH code was created in order to manage in a user friendly set-up the other two mentioned as well as the ...

  8. A Framework for Research in Gamified Mobile Guide Applications using Embodied Conversational Agents (ECAs

    Directory of Open Access Journals (Sweden)

    Ioannis Doumanis

    2015-09-01

    Full Text Available Mobile Guides are mobile applications that provide players with local and location-based services (LBS, such as navigation assistance, where and when they need them most. Advances in mobile technologies in recent years have enabled the gamification of these applications, opening up new opportunities to transfer education and culture through game play. However, adding traditional game elements such as PBLs (points, badges, and leaderboards alone cannot ensure that the intended learning outcomes will be met, as the player’s cognitive resources are shared between the application and the surrounding environment. This distribution of resources prevents players from easily immersing themselves into the educational scenario. Adding artificial conversational characters (ECAs that simulate the social norms found in real-life human-to-human guide scenarios has the potential to address this problem and improve the player’s experience and learning of cultural narratives [1]. Although significant progress has been made towards creating game-like mobile guides with ECAs ([2], [3], there is still a lack of a unified framework that enables researchers and practitioners to investigate the potential effects of such applications to players and how to approach the concepts of player experience, cognitive accessibility and usability in this context. This paper presents a theoretically-well supported research framework consisted of four key components: differences in players, different features of the gamified task, aspects of how the ECA looks, sound or behaves and different mobile environments. Furthermore, it provides based on this framework a working definition of what player experience, cognitive accessibility and usability are in the context of game-like mobile guide applications. Finally, a synthesis of the results of six empirical studies conducted within this research framework is discussed and a series of design guidelines for the effective gamification

  9. Guide to cloud computing for business and technology managers from distributed computing to cloudware applications

    CERN Document Server

    Kale, Vivek

    2014-01-01

    Guide to Cloud Computing for Business and Technology Managers: From Distributed Computing to Cloudware Applications unravels the mystery of cloud computing and explains how it can transform the operating contexts of business enterprises. It provides a clear understanding of what cloud computing really means, what it can do, and when it is practical to use. Addressing the primary management and operation concerns of cloudware, including performance, measurement, monitoring, and security, this pragmatic book:Introduces the enterprise applications integration (EAI) solutions that were a first ste

  10. Stereotactic body radiotherapy for solitary spine metastasis

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sun Young [Dept. of Radiation Oncology, Sun Medical Center, Daejeon (Korea, Republic of); Chun, Mison [Dept. of Radiation Oncology, Ajou University School of Medicine, Suwon (Korea, Republic of); Lee, Mi Jo [Dept. of Radiation Oncology, Eulji Universtiy School of Medicine, Daejeon (Korea, Republic of)

    2013-12-15

    A clear consensus has not been established regarding the best treatment for solitary bone metastasis. Here, we reviewed the medical records of patients with a controlled primary malignancy who had only solitary spine metastasis without metastasis to the extraspinal bone or viscera and underwent treatment between April 2007 and December 2012 with stereotactic body radiosurgery using CyberKnife, with a total dose of 24 Gy in three to four fractions. During that time, there were only four cases. This was effective in each case, and all the four patients had no local failure and remained alive at a median follow-up of 68 months (range, 64 to 80 months). Although our experience is limited, this study suggests that stereotactic body radiotherapy could be a feasible, safe, effective, and noninvasive alternative treatment for solitary spine metastasis in patients who are medically inoperable or unsuitable for surgery.

  11. Stereotactic linac radiosurgery for arteriovenous malformations.

    OpenAIRE

    Kenny, B G; Hitchcock, E. R.; Kitchen, G.; Dalton, A E; Yates, D A; Chavda, S V

    1992-01-01

    Stereotactic linear accelerator (linac) radiosurgery has been in operation in the West Midlands since 1987, the first of its kind in the United Kingdom. Forty two patients with high-flow cerebral arteriovenous malformations have been treated, 26 of whom have been followed up. Angiography one year after treatment showed that five lesions were obliterated, 11 were reduced in size and/or flow rate and 10 were unchanged. Overall results show that nine out of 10 patients reviewed at 24 months had ...

  12. COL Application Content Guide for HTGRs: Revision to RG 1.206, Part 1 - Status Report

    Energy Technology Data Exchange (ETDEWEB)

    Wayne Moe

    2012-08-01

    A combined license (COL) application is required by the Nuclear Regulatory Commission (NRC) for all proposed nuclear plants. The information requirements for a COL application are set forth in 10 CFR 52.79, “Contents of Applications; Technical Information in Final Safety Analysis Report.” An applicant for a modular high temperature gas-cooled reactor (HTGR) must develop and submit for NRC review and approval a COL application which conforms to these requirements. The technical information necessary to allow NRC staff to evaluate a COL application and resolve all safety issues related to a proposed nuclear plant is detailed and comprehensive. To this, Regulatory Guide (RG) 1.206, “Combined License Applications for Nuclear Power Plants” (LWR Edition), was developed to assist light water reactor (LWR) applicants in incorporating and effectively formatting required information for COL application review (Ref. 1). However, the guidance prescribed in RG 1.206 presumes a LWR design proposal consistent with the systems and functions associated with large LWR power plants currently operating under NRC license.

  13. Early Site Permit Demonstration Program: Siting Guide, Site selection and evaluation criteria for an early site permit application. Revision 1

    Energy Technology Data Exchange (ETDEWEB)

    1993-03-24

    In August 1991, the Joint Contractors came to agreement with Sandia National Laboratories (SNL) and the Department of Energy (DOE) on a workscope for the cost-shared Early Site Permit Demonstration Program. One task within the scope was the development of a guide for site selection criteria and procedures. A generic Siting Guide his been prepared that is a roadmap and tool for applicants to use developing detailed siting plans for their specific region of the country. The guide presents three fundamental principles that, if used, ensure a high degree of success for an ESP applicant. First, the site selection process should take into consideration environmentally diverse site locations within a given region of interest. Second, the process should contain appropriate opportunities for input from the public. Third, the process should be applied so that it is clearly reasonable to an impartial observer, based on appropriately selected criteria, including criteria which demonstrate that the site can host an advanced light water reactor (ALWR). The Siting Guide provides for a systematic, comprehensive site selection process in which three basic types of criteria (exclusionary, avoidance, and suitability) are presented via a four-step procedure. It provides a check list of the criteria for each one of these steps. Criteria are applied qualitatively, as well as presented numerically, within the guide. The applicant should use the generic guide as an exhaustive checklist, customizing the guide to his individual situation.

  14. Early Site Permit Demonstration Program: Siting Guide, Site selection and evaluation criteria for an early site permit application

    International Nuclear Information System (INIS)

    In August 1991, the Joint Contractors came to agreement with Sandia National Laboratories (SNL) and the Department of Energy (DOE) on a workscope for the cost-shared Early Site Permit Demonstration Program. One task within the scope was the development of a guide for site selection criteria and procedures. A generic Siting Guide his been prepared that is a roadmap and tool for applicants to use developing detailed siting plans for their specific region of the country. The guide presents three fundamental principles that, if used, ensure a high degree of success for an ESP applicant. First, the site selection process should take into consideration environmentally diverse site locations within a given region of interest. Second, the process should contain appropriate opportunities for input from the public. Third, the process should be applied so that it is clearly reasonable to an impartial observer, based on appropriately selected criteria, including criteria which demonstrate that the site can host an advanced light water reactor (ALWR). The Siting Guide provides for a systematic, comprehensive site selection process in which three basic types of criteria (exclusionary, avoidance, and suitability) are presented via a four-step procedure. It provides a check list of the criteria for each one of these steps. Criteria are applied qualitatively, as well as presented numerically, within the guide. The applicant should use the generic guide as an exhaustive checklist, customizing the guide to his individual situation

  15. Detection-Guided Fast Affine Projection Channel Estimator for Speech Applications

    Directory of Open Access Journals (Sweden)

    Yan Wu Jennifer

    2007-04-01

    Full Text Available In various adaptive estimation applications, such as acoustic echo cancellation within teleconferencing systems, the input signal is a highly correlated speech. This, in general, leads to extremely slow convergence of the NLMS adaptive FIR estimator. As a result, for such applications, the affine projection algorithm (APA or the low-complexity version, the fast affine projection (FAP algorithm, is commonly employed instead of the NLMS algorithm. In such applications, the signal propagation channel may have a relatively low-dimensional impulse response structure, that is, the number m of active or significant taps within the (discrete-time modelled channel impulse response is much less than the overall tap length n of the channel impulse response. For such cases, we investigate the inclusion of an active-parameter detection-guided concept within the fast affine projection FIR channel estimator. Simulation results indicate that the proposed detection-guided fast affine projection channel estimator has improved convergence speed and has lead to better steady-state performance than the standard fast affine projection channel estimator, especially in the important case of highly correlated speech input signals.

  16. A Love Wave Reflective Delay Line with Polymer Guiding Layer for Wireless Sensor Application

    Directory of Open Access Journals (Sweden)

    Shitang He

    2008-12-01

    Full Text Available This paper presents an optimal design for a Love wave reflective delay line on 41o YX LiNbO3 with a polymer guiding layer for wireless sensor applications. A theoretical model was established to describe the Love wave propagation along the larger piezoelectric substrate with polymer waveguide, and the lossy mechanism from the viscoelastic waveguide was discussed, which results in the optimal guiding layer thickness. Coupling of modes (COM was used to determine the optimal design parameters of the reflective delay line structured by single phase unidirectional transducers (SPUDTs and shorted grating reflectors. Using the network analyzer, the fabricated Love wave reflective delay line was characterized, high signal noise ratio (S/N, sharp reflection peaks, and few spurious noise between the peaks were found, and the measured result agrees well with the simulated one. Also, the optimal guiding layer thickness of 1.5~1.8μm was extracted experimentally, and it is consistent with the theoretical analysis.

  17. Patient-specific Deformation Modelling via Elastography: Application to Image-guided Prostate Interventions.

    Science.gov (United States)

    Wang, Yi; Ni, Dong; Qin, Jing; Xu, Ming; Xie, Xiaoyan; Heng, Pheng-Ann

    2016-01-01

    Image-guided prostate interventions often require the registration of preoperative magnetic resonance (MR) images to real-time transrectal ultrasound (TRUS) images to provide high-quality guidance. One of the main challenges for registering MR images to TRUS images is how to estimate the TRUS-probe-induced prostate deformation that occurs during TRUS imaging. The combined statistical and biomechanical modeling approach shows promise for the adequate estimation of prostate deformation. However, the right setting of the biomechanical parameters is very crucial for realistic deformation modeling. We propose a patient-specific deformation model equipped with personalized biomechanical parameters obtained from shear wave elastography to reliably predict the prostate deformation during image-guided interventions. Using data acquired from a prostate phantom and twelve patients with suspected prostate cancer, we compared the prostate deformation model with and without patient-specific biomechanical parameters in terms of deformation estimation accuracy. The results show that the patient-specific deformation model possesses favorable model ability, and outperforms the model without patient-specific biomechanical parameters. The employment of the patient-specific biomechanical parameters obtained from elastography for deformation modeling shows promise for providing more precise deformation estimation in applications that use computer-assisted image-guided intervention systems. PMID:27272239

  18. Ultrasonographic-guided, percutaneous antegarde pyelography: technique and clinical application in the dog and cat

    International Nuclear Information System (INIS)

    Fluoroscopically guided, percutaneous antegrade pyelography in canine patients has been described previously in the veterinary literature. This report describes the technique with ultrasonographic guidance and its clinical application in the diagnosis of four cases (two dogs, two cats) of obstructive uropathy. The technique provided successful diagnosis of ureteral obstruction in all four cases. No complications were observed in three cases. In one feline case, ureteral obstruction with a blood clot occurred following the procedure; however, it could not be ascertained whether this event represented a complication of the technique

  19. SystemVerilog assertions and functional coverage guide to language, methodology and applications

    CERN Document Server

    Mehta, Ashok B

    2013-01-01

    This book provides a hands-on, application-oriented guide to the language and methodology of both SystemVerilog Assertions and SytemVerilog Functional Coverage.  Readers will benefit from the step-by-step approach to functional hardware verification, which will enable them to uncover hidden and hard to find bugs, point directly to the source of the bug, provide for a clean and easy way to model complex timing checks and objectively answer the question 'have we functionally verified everything'.  Written by a professional end-user of both SystemVerilog Assertions and SystemVerilog Functional Co

  20. Robust remote-pumping sodium laser for advanced LIDAR and guide star applications

    Science.gov (United States)

    Ernstberger, Bernhard; Enderlein, Martin; Friedenauer, Axel; Schwerdt, Robin; Wei, Daoping; Karpov, Vladimir; Leisching, Patrick; Clements, Wallace R. L.; Kaenders, Wilhelm G.

    2015-10-01

    The performance of large ground-based optical telescopes is limited due to wavefront distortions induced by atmospheric turbulence. Adaptive optics systems using natural guide stars with sufficient brightness provide a practical way for correcting the wavefront errors by means of deformable mirrors. Unfortunately, the sky coverage of bright stars is poor and therefore the concept of laser guide stars was invented, creating an artificial star by exciting resonance fluorescence from the mesospheric sodium layer about 90 km above the earth's surface. Until now, mainly dye lasers or sumfrequency mixing of solid state lasers were used to generate laser guide stars. However, these kinds of lasers require a stationary laser clean room for operation and are extremely demanding in maintenance. Under a development contract with the European Southern Observatory (ESO) and W. M. Keck Observatory (WMKO), TOPTICA Photonics AG and its partner MPB Communications have finalized the development of a next-generation sodium guide star laser system which is available now as a commercial off-the-shelf product. The laser is based on a narrow-band diode laser, Raman fiber amplifier (RFA) technology and resonant second-harmonic generation (SHG), thus highly reliable and simple to operate and maintain. It emits > 22 W of narrow-linewidth (≈ 5 MHz) continuous-wave radiation at sodium resonance and includes a re-pumping scheme for boosting sodium return flux. Due to the SHG resonator acting as spatial mode filter and polarizer, the output is diffraction-limited with RMS wavefront error space debris tracking as well as LIDAR applications.

  1. Biophysical characterization of a relativistic proton beam for image-guided radiosurgery

    International Nuclear Information System (INIS)

    We measured the physical and radiobiological characteristics of 1 GeV protons for possible applications in stereotactic radiosurgery (image-guided plateau-proton radiosurgery). A proton beam was accelerated at 1 GeV at the Brookhaven National Laboratory (Upton, NY) and a target in polymethyl methacrylate (PMMA) was used. Clonogenic survival was measured after exposures to 1-10 Gy in three mammalian cell lines. Measurements and simulations demonstrate that the lateral scattering of the beam is very small. The lateral dose profile was measured with or without the 20-cm plastic target, showing no significant differences up to 2 cm from the axis A large number of secondary swift protons are produced in the target and this leads to an increase of approximately 40% in the measured dose on the beam axis at 20 cm depth. The relative biological effectiveness at 10% survival level ranged between 1.0 and 1.2 on the beam axis, and was slightly higher off-axis. The very low lateral scattering of relativistic protons and the possibility of using online proton radiography during the treatment make them attractive for image-guided plateau (non-Bragg peak) stereotactic radiosurgery. (author)

  2. Stereotactic laser induced thermotherapy (LITT): a novel treatment for brain lesions regrowing after radiosurgery.

    Science.gov (United States)

    Torres-Reveron, Juan; Tomasiewicz, Hilarie C; Shetty, Anil; Amankulor, Nduka M; Chiang, Veronica L

    2013-07-01

    Since the inception of radiosurgery, the management of brain metastases has become a common problem for neurosurgeons. Although the use of stereotactic radiosurgery and/or whole brain radiation therapy serves to control the majority of disease burden, patients who survive longer than 6-8 months sometimes face the problem of symptomatic radiographically regrowing lesions with few treatment options. Here we investigate the feasibility of use of MRI-guided stereotactic laser induced thermotherapy (LITT) as a novel treatment option for these lesions. Six patients who had previously undergone gamma knife stereotactic radiosurgery for brain metastases were selected. All patients had an initial favorable response to radiosurgery but subsequently developed regrowth of at least one lesion associated with recurrent edema and progressive neurological symptoms requiring ongoing steroids for symptom control. All lesions were evaluated for craniotomy, but were deemed unresectable due to deep location or patient's comorbidities. Stereotactic biopsies were performed prior to the thermotherapy procedure in all cases. LITT was performed using the Visualase system and follow-up MRI imaging was used to determine treatment response. In all six patients biopsy results were negative for tumor and consistent with adverse radiation effects also known as radiation necrosis. Patients tolerated the procedure well and were discharged from the hospital within 48 h of the procedure. In 4/6 cases there was durable improvement of neurological symptoms until death. In all cases steroids were weaned off within 2 months. One patient died from systemic causes related to his cancer a month after the procedure. One patient had regrowth of the lesion 3 months after the procedure and required re-initiation of steroids and standard craniotomy for surgical resection. There were no complications directly related to the thermocoagulation procedure. Stereotactic laser induced thermotherapy is a feasible

  3. Stability of percutaneously implanted markers for lung stereotactic radiotherapy

    DEFF Research Database (Denmark)

    Persson, Gitte Bjørnsen Fredberg; Josipovic, Mirjana; Von Der Recke, Peter;

    2013-01-01

    The purpose of this study was to evaluate the stability of complex markers implanted into lung tumors throughout a course of stereotactic body radiotherapy (SBRT). Fifteen patients referred for lung SBRT were prospectively included. Radio-opaque markers were implanted percutaneously, guided by co...... can be used as surrogates for tumor position during a short course of SBRT as long as the uncertainties related to their position within the tumor are incorporated into the planning target volume....... by computed tomography (CT). Deep inspiration breath-hold CT scans (BHCT) were acquired at planning and on three treatment days. The treatment days' BHCTs were registered to the planning BHCT. Intraobserver uncertainty in both tumor and marker registration was determined. Deviations in the difference between...... on all days were significantly larger than for 3D marker registrations (p = 0.007). Overall median differences between tumor and marker position were 0.0 mm (range -2.9 to 2.6 mm) in LR, 0.0 mm (-1.8 to 1.5 mm) in AP, and -0.2 mm (-2.6 to 2.8 mm) in CC directions. Four patients had deviations exceeding 2...

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

    Science.gov (United States)

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

    2014-09-10

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

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

    International Nuclear Information System (INIS)

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

  6. Clinical accuracy of ExacTrac intracranial frameless stereotactic system

    Energy Technology Data Exchange (ETDEWEB)

    Ackerly, T.; Lancaster, C. M.; Geso, M.; Roxby, K. J. [William Buckland Radiotherapy Centre, Alfred Hospital, Melbourne 3004, Australia and School of Medical Sciences - RMIT University, Melbourne 3083 (Australia); William Buckland Radiotherapy Centre, Alfred Hospital, Melbourne 3004 (Australia); School of Medical Sciences - RMIT University, Melbourne 3083 (Australia); William Buckland Radiotherapy Centre, Alfred Hospital, Melbourne 3004 (Australia)

    2011-09-15

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

  7. Highly directional transurethral ultrasound applicators with rotational control for MRI-guided prostatic thermal therapy

    International Nuclear Information System (INIS)

    Transurethral ultrasound applicators with highly directional energy deposition and rotational control were investigated for precise treatment of benign prostatic hyperplasia (BPH) and adenocarcinoma of the prostate (CaP). Two types of catheter-based applicators were fabricated, using either sectored tubular (3.5 mm OD x 10 mm) or planar transducers (3.5 mm x 10 mm). They were constructed to be MRI compatible, minimally invasive and allow for manual rotation of the transducer array within a 10 mm cooling balloon. In vivo evaluations of the applicators were performed in canine prostates (n 3) using MRI guidance (0.5 T interventional magnet). MR temperature imaging (MRTI) utilizing the proton resonance frequency shift method was used to acquire multiple-slice temperature overlays in real time for monitoring and guiding the thermal treatments. Post-treatment T1-weighted contrast-enhanced imaging and triphenyl tetrazolium chloride stained tissue sections were used to define regions of tissue coagulation. Single sonications with the tubular applicator ) produced coagulated zones covering a wedge of the prostate extending from 1-2 mm outside the urethra to the outer boundary of the gland (16 mm radial coagulation). Single sonications with the planar applicator (15-20 W, 10 min, ∼8 MHz) generated thermal lesions of ∼30 extending to the prostate boundary. Multiple sequential sonications (sweeping) of a planar applicator (12 W with eight rotations of 30 each) demonstrated controllable coagulation of a 270 contiguous section of the prostate extending to the capsule boundary. The feasibility of using highly directional transurethral ultrasound applicators with rotational capabilities to selectively coagulate regions of the prostate while monitoring and controlling the treatments with MRTI was demonstrated in this study

  8. Highly directional transurethral ultrasound applicators with rotational control for MRI-guided prostatic thermal therapy

    Science.gov (United States)

    Ross, Anthony B.; Diederich, Chris J.; Nau, William H.; Gill, Harcharan; Bouley, Donna M.; Daniel, Bruce; Rieke, Viola; Butts, R. Kim; Sommer, Graham

    2004-01-01

    Transurethral ultrasound applicators with highly directional energy deposition and rotational control were investigated for precise treatment of benign prostatic hyperplasia (BPH) and adenocarcinoma of the prostate (CaP). Two types of catheter-based applicators were fabricated, using either 90° sectored tubular (3.5 mm OD × 10 mm) or planar transducers (3.5 mm × 10 mm). They were constructed to be MRI compatible, minimally invasive and allow for manual rotation of the transducer array within a 10 mm cooling balloon. In vivo evaluations of the applicators were performed in canine prostates (n = 3) using MRI guidance (0.5 T interventional magnet). MR temperature imaging (MRTI) utilizing the proton resonance frequency shift method was used to acquire multiple-slice temperature overlays in real time for monitoring and guiding the thermal treatments. Post-treatment T1-weighted contrast-enhanced imaging and triphenyl tetrazolium chloride stained tissue sections were used to define regions of tissue coagulation. Single sonications with the 90° tubular applicator (9-15 W, 12 min, 8 MHz) produced coagulated zones covering an 80° wedge of the prostate extending from 1-2 mm outside the urethra to the outer boundary of the gland (16 mm radial coagulation). Single sonications with the planar applicator (15-20 W, 10 min, ~8 MHz) generated thermal lesions of ~30° extending to the prostate boundary. Multiple sequential sonications (sweeping) of a planar applicator (12 W with eight rotations of 30° each) demonstrated controllable coagulation of a 270° contiguous section of the prostate extending to the capsule boundary. The feasibility of using highly directional transurethral ultrasound applicators with rotational capabilities to selectively coagulate regions of the prostate while monitoring and controlling the treatments with MRTI was demonstrated in this study.

  9. Highly directional transurethral ultrasound applicators with rotational control for MRI-guided prostatic thermal therapy

    Energy Technology Data Exchange (ETDEWEB)

    Ross, Anthony B [Thermal Therapy Research Group, UCSF Radiation Oncology, San Francisco, CA (United States); Diederich, Chris J [Thermal Therapy Research Group, UCSF Radiation Oncology, San Francisco, CA (United States); Nau, William H [Thermal Therapy Research Group, UCSF Radiation Oncology, San Francisco, CA (United States); Gill, Harcharan [Department of Urology, Stanford University, Stanford, CA (United States); Bouley, Donna M [Department of Comparative Medicine, Stanford University, Stanford, CA (United States); Daniel, Bruce [Department of Radiology, Stanford University, Stanford, CA (United States); Rieke, Viola [Department of Radiology, Stanford University, Stanford, CA (United States); Butts, R Kim [Department of Radiology, Stanford University, Stanford, CA (United States); Sommer, Graham [Department of Radiology, Stanford University, Stanford, CA (United States)

    2004-01-21

    Transurethral ultrasound applicators with highly directional energy deposition and rotational control were investigated for precise treatment of benign prostatic hyperplasia (BPH) and adenocarcinoma of the prostate (CaP). Two types of catheter-based applicators were fabricated, using either sectored tubular (3.5 mm OD x 10 mm) or planar transducers (3.5 mm x 10 mm). They were constructed to be MRI compatible, minimally invasive and allow for manual rotation of the transducer array within a 10 mm cooling balloon. In vivo evaluations of the applicators were performed in canine prostates (n 3) using MRI guidance (0.5 T interventional magnet). MR temperature imaging (MRTI) utilizing the proton resonance frequency shift method was used to acquire multiple-slice temperature overlays in real time for monitoring and guiding the thermal treatments. Post-treatment T1-weighted contrast-enhanced imaging and triphenyl tetrazolium chloride stained tissue sections were used to define regions of tissue coagulation. Single sonications with the tubular applicator ) produced coagulated zones covering a wedge of the prostate extending from 1-2 mm outside the urethra to the outer boundary of the gland (16 mm radial coagulation). Single sonications with the planar applicator (15-20 W, 10 min, {approx}8 MHz) generated thermal lesions of {approx}30 extending to the prostate boundary. Multiple sequential sonications (sweeping) of a planar applicator (12 W with eight rotations of 30 each) demonstrated controllable coagulation of a 270 contiguous section of the prostate extending to the capsule boundary. The feasibility of using highly directional transurethral ultrasound applicators with rotational capabilities to selectively coagulate regions of the prostate while monitoring and controlling the treatments with MRTI was demonstrated in this study.

  10. Metallic stent and stereotactic conformal radiotherapy for hilar cholangiocarcinoma

    International Nuclear Information System (INIS)

    Objective: To evaluate the effect of metallic stent combined with stereotactic conformal radiotherapy (SCRT) for hilar cholangiocarcinoma. Methods: Fifty-four patients with hilar cholangiocarcinoma were analyzed, including 31 treated with stent plus stereotactic conformal radiotherapy (combined group) and 23 with metallic stent alone (control group). Results: The mean survival time of combined group was 11.1 ± 4.6 months, compared with 5.1 ± 2.8 months of the control group, giving a significant difference between the two groups (P<0.01). Conclusion: The combination of metallic stent and stereotactic conformal radiotherapy is more effective than metallic stent alone for unresectable hilar cholangiocarcinoma. (authors)

  11. Pulmonary oligometastases: Metastasectomy or stereotactic ablative radiotherapy?

    International Nuclear Information System (INIS)

    Background and purpose: Stereotactic ablative radiotherapy (SABR; or stereotactic body radiotherapy, SBRT) emerges as treatment option for pulmonary oligometastatic disease (OMD), but there are no studies comparing SABR with pulmonary metastasectomy (PME). We analysed consecutive patients referred via a university-hospital based multidisciplinary team. Material and methods: Patients were offered PME as first choice and SABR in case they were considered to be less suitable surgical candidates. Overall survival was the primary endpoint. Secondary endpoints were progression-free-survival, local control of treated metastases, and freedom-from-failure of a local-only treatment strategy without systemic therapy. Results: From 2007 until 2010, 110 patients were treated and analysed (PME, n = 68; SABR, n = 42). Median follow-up time was 43 months (minimally, 25). Estimated overall survival rates at one, three, and five years were 87%, 62%, and 41% for PME, and 98%, 60%, and 49% for SABR, respectively (logrank-test, p = 0.43). Local control at two years was 94% for SABR and 90% for PME. Progression-free survival was 17% at three years, but 43% of the patients still had not failed a local-only treatment strategy. Conclusions: Although SABR was second choice after PME, survival after PME was not better than after SABR. Prospective comparative studies are clearly required to define the role of both, SABR and PME in OMD

  12. Experimental new automatic tools for robotic stereotactic neurosurgery: towards "no hands" procedure of leads implantation into a brain target.

    Science.gov (United States)

    Mazzone, P; Arena, P; Cantelli, L; Spampinato, G; Sposato, S; Cozzolino, S; Demarinis, P; Muscato, G

    2016-07-01

    The use of robotics in neurosurgery and, particularly, in stereotactic neurosurgery, is becoming more and more adopted because of the great advantages that it offers. Robotic manipulators easily allow to achieve great precision, reliability, and rapidity in the positioning of surgical instruments or devices in the brain. The aim of this work was to experimentally verify a fully automatic "no hands" surgical procedure. The integration of neuroimaging to data for planning the surgery, followed by application of new specific surgical tools, permitted the realization of a fully automated robotic implantation of leads in brain targets. An anthropomorphic commercial manipulator was utilized. In a preliminary phase, a software to plan surgery was developed, and the surgical tools were tested first during a simulation and then on a skull mock-up. In such a way, several tools were developed and tested, and the basis for an innovative surgical procedure arose. The final experimentation was carried out on anesthetized "large white" pigs. The determination of stereotactic parameters for the correct planning to reach the intended target was performed with the same technique currently employed in human stereotactic neurosurgery, and the robotic system revealed to be reliable and precise in reaching the target. The results of this work strengthen the possibility that a neurosurgeon may be substituted by a machine, and may represent the beginning of a new approach in the current clinical practice. Moreover, this possibility may have a great impact not only on stereotactic functional procedures but also on the entire domain of neurosurgery. PMID:27194228

  13. The clinical application of DSA and Xper-CT in guiding lung tumor radiofrequency ablation procedure

    International Nuclear Information System (INIS)

    Objective: To discuss the clinical application of DSA and Xper-CT in guiding lung tumor radiofrequency ablation (RFA). Methods: Navigated by DSA and Xper-CT images, RFA was performed in 21 patients with lung tumor. The tumors included peripheral lung cancer (n=3) and lung metastases from hepatocellular carcinoma (n=12) or from colorectal cancer (n=6). The lesions were located at left upper lobe (n=5), at left lower lobe (n=2), at right upper lobe (n=5), at right middle lobe (n=6) and at right lower lobe (n=4). One lesion was situated at the right thoracic wall and one lesion was situated at the left thoracic wall. Results: A total of 24 lesions were detected in the 21 patients. Of the 24 lesions, successful puncturing with single procedure was obtained in 22, with a success rate of 91.67%. Two lesions had the diameter less than one cm, and the treatment was accomplished after two times of puncturing. Conclusion: For the treatment of lung tumors, DSA and Xper-CT-guided radiofrequency ablation is clinically - safe and technically - simple with higher localizing accuracy. Therefore, this technique should be recommended in clinical practice. (authors)

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

    Science.gov (United States)

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

    2016-07-01

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

  15. A neurosurgery/stereotactic radiotherapy dedicated PACS for conformal radiotherapy

    International Nuclear Information System (INIS)

    To realise conformal cerebral stereotactic irradiations we use a Neurosurgery/stereotactic dedicated PACS between two distant hospitals. It connects the stereotactic neurosurgery planification imaging system NEUROAXIS (Sopelem-Sofretec/Ste Anne Hospital) with the dosimetric TPS ARTEMIS-3D/Dosigray (Tenon Hospital). NEUROAXIS is a computer aided stereotactic biopsies and stereo-electroencephalographies, used by surgeons in operating room. The system determines the precise location data for Talairach radiological equipment (X ray source at 5 meters from film) and the geometry of scanner and MRI stereotactical referentials. It provides a full set of features for lesion localization, geometrical computations, surgical planifications, picture archiving, stereotactic angiography, CT and MRI image processing and networking. It sends images through the French public digital network ISDN (NUMERIS/France Telecom : 2x64 Kbits/s) from Ste Anne to Tenon Hospital. Stereotactic angiographic and CT images are reformatted into the DOSIGRAY image processing environment where 3-D dose distributions, displays and DVHs are computed to determine the optimal treatment. ARTEMIS-3D/Dosigray is a TPS for stereotactic radiotherapy devised by the Tenon Hospital for clinical methodology and 3D dose calculations, optimization software development and the Dosigray company for multimodality imaging, (2D(3D)) computer graphics for dose and anatomical representation and data networking. Communication within the radiation oncology department is provided by local area ETHERNET network, linking heterogeneous systems (Vaxstations-3200; Decstation (5000(240))) by means of different protocols. The works in progress are to send back via the same network the 3-D dose matrix to Neurosurgery department NEUROAXIS system. Our PACS is used since six months to treat patients. It has permitted to improve the treatment quality in comparison with our first version TPS ARTEMIS-3D

  16. Cerebral control and survival after stereotactic radiotherapy of brain metastases

    International Nuclear Information System (INIS)

    This retrospective study, including 275 patients who underwent stereotactic radiotherapy due to brain metastases between 2003 and 2008, investigates influencing factors regarding cerebral control and survival, symptomatic effects and a potential benefit for patients older than 70 years. We were able to identify risk factors for remote brain failure which leads to a therapeutic recommendation. Furthermore we confirm a positive symptomatic effect and a benefit of stereotactic readiotherapy for patients over 70 years.

  17. Targeting tumour hypoxia to improve outcome of stereotactic radiotherapy

    DEFF Research Database (Denmark)

    Wittenborn, Thomas R; Horsman, Michael R

    2015-01-01

    BACKGROUND: Hypoxia is a characteristic feature of solid tumours that significantly reduces the efficacy of conventional radiation therapy. In this study we investigated the role of hypoxia in a stereotactic radiation schedule by using a variety of hypoxic modifiers in a preclinical tumour model...... OXi4503 and heat with the final 15 Gy had a significantly larger effect (TCD50 = 2 Gy). CONCLUSIONS: Clinically relevant modifiers of hypoxia effectively enhanced an equivalent stereotactic radiation treatment confirming the importance of hypoxia in such schedules....

  18. 76 FR 46330 - NUREG-1934, Nuclear Power Plant Fire Modeling Application Guide (NPP FIRE MAG); Second Draft...

    Science.gov (United States)

    2011-08-02

    ... COMMISSION NUREG-1934, Nuclear Power Plant Fire Modeling Application Guide (NPP FIRE MAG); Second Draft... for public comment a document entitled, NUREG-1934 (EPRI 1023259), ``Nuclear Power Plant Fire Modeling... pdr.resource@nrc.gov . NUREG-1934 (EPRI 1023259), ``Nuclear Power Plant Fire Modeling...

  19. [Stereotactic body radiation therapy for spinal metastases].

    Science.gov (United States)

    Pasquier, D; Martinage, G; Mirabel, X; Lacornerie, T; Makhloufi, S; Faivre, J-C; Thureau, S; Lartigau, É

    2016-10-01

    After the liver and lungs, bones are the third most common sites of cancer metastasis. Palliative radiotherapy for secondary bone tumours helps relieve pain, improve the quality of life and reduce the risk of fractures. Stereotactic body radiotherapy can deliver high radiation doses with very tight margins, which has significant advantages when treating tumours close to the spinal cord. Strict quality control is essential as dose gradient at the edge of the spinal cord is important. Optimal schedule is not defined. A range of dose-fractionation schedules have been used. Pain relief and local control are seen in over 80%. Toxicity rates are low, although vertebral fracture may occur. Ongoing prospective studies will help clarify its role in the management of oligometastatic patients. PMID:27614511

  20. Periodontal healing following guided tissue regeneration with citric acid and fibronectin application.

    Science.gov (United States)

    Caffesse, R G; Nasjleti, C E; Anderson, G B; Lopatin, D E; Smith, B A; Morrison, E C

    1991-01-01

    This study was undertaken to determine the effects of guided tissue regeneration (GTR) with and without citric acid conditioning and autologous fibronectin application. The study subjects were four female beagle dogs with spontaneous periodontitis. The dogs were given thorough root debridement and 4 weeks later, mucoperiosteal flaps were raised on both sides of the mandible involving the 2nd, 3rd, and 4th premolar and 1st molar teeth. After debridement, notches were placed on the roots at the level of supporting bone. Citric acid (pH 1) was topically applied for 3 minutes on the exposed root surfaces of one side (experimental). The roots were irrigated with normal saline solution. Both the root surfaces and the inner surface of the flap were then bathed in autologous fibronectin in saline. Following this, Gore-Tex periodontal material was adapted to the roots of each tooth and sutured. The contralateral side, serving as control, was treated by surgery and application of Gore-Tex periodontal material only. All membranes were removed 1 month after surgery, and the dogs sacrificed at 3 months. Both mesio-distal and bucco-lingual microscopic histological sections were evaluated by descriptive histology, and linear measurements and surface area determination of the furcal tissues were made. Periodontal healing following the use of GTR procedure resulted in an increase in connective tissue and alveolar bone regeneration. Adjunctive critic acid plus autologous fibronectin produced slightly better results, but these differences were not statistically significant for this sample. PMID:2002428

  1. SystemVerilog assertions and functional coverage guide to language, methodology and applications

    CERN Document Server

    Mehta, Ashok B

    2016-01-01

    This book provides a hands-on, application-oriented guide to the language and methodology of both SystemVerilog Assertions and SystemVerilog Functional Coverage. Readers will benefit from the step-by-step approach to functional hardware verification using SystemVerilog Assertions and Functional Coverage, which will enable them to uncover hidden and hard to find bugs, point directly to the source of the bug, provide for a clean and easy way to model complex timing checks and objectively answer the question ‘have we functionally verified everything’. Written by a professional end-user of ASIC/SoC/CPU and FPGA design and Verification, this book explains each concept with easy to understand examples, simulation logs and applications derived from real projects. Readers will be empowered to tackle the modeling of complex checkers for functional verification, thereby drastically reducing their time to design and debug. This updated second edition addresses the latest functional set released in IEEE-1800 (2012) L...

  2. Application of a diagnosis-based clinical decision guide in patients with neck pain

    Directory of Open Access Journals (Sweden)

    Murphy Donald R

    2011-08-01

    Full Text Available Abstract Background Neck pain (NP is a common cause of disability. Accurate and efficacious methods of diagnosis and treatment have been elusive. A diagnosis-based clinical decision guide (DBCDG; previously referred to as a diagnosis-based clinical decision rule has been proposed which attempts to provide the clinician with a systematic, evidence-based guide in applying the biopsychosocial model of care. The approach is based on three questions of diagnosis. The purpose of this study is to present the prevalence of findings using the DBCDG in consecutive patients with NP. Methods Demographic, diagnostic and baseline outcome measure data were gathered on a cohort of NP patients examined by one of three examiners trained in the application of the DBCDG. Results Data were gathered on 95 patients. Signs of visceral disease or potentially serious illness were found in 1%. Centralization signs were found in 27%, segmental pain provocation signs were found in 69% and radicular signs were found in 19%. Clinically relevant myofascial signs were found in 22%. Dynamic instability was found in 40%, oculomotor dysfunction in 11.6%, fear beliefs in 31.6%, central pain hypersensitivity in 4%, passive coping in 5% and depression in 2%. Conclusion The DBCDG can be applied in a busy private practice environment. Further studies are needed to investigate clinically relevant means to identify central pain hypersensitivity, oculomotor dysfunction, poor coping and depression, correlations and patterns among the diagnostic components of the DBCDG as well as inter-examiner reliability, validity and efficacy of treatment based on the DBCDG.

  3. A GUIDED SWAT MODEL APPLICATION ON SEDIMENT YIELD MODELING IN PANGANI RIVER BASIN: LESSONS LEARNT

    Directory of Open Access Journals (Sweden)

    Preksedis M. Ndomba

    2008-01-01

    Full Text Available The overall objective of this paper is to report on the lessons learnt from applying Soil and Water Assessment Tool (SWAT in a well guided sediment yield modelling study. The study area is the upstream of Pangani River Basin (PRB, the Nyumba Ya Mungu (NYM reservoir catchment, located in the North Eastern part of Tanzania. It should be noted that, previous modeling exercises in the region applied SWAT with preassumption that inter-rill or sheet erosion was the dominant erosion type. In contrast, in this study SWAT model application was guided by results of analysis of high temporal resolution of sediment flow data and hydro-meteorological data. The runoff component of the SWAT model was calibrated from six-years (i.e. 1977¿1982 of historical daily streamflow data. The sediment component of the model was calibrated using one-year (1977-1988 daily sediment loads estimated from one hydrological year sampling programme (between March and November, 2005 rating curve. A long-term period over 37 years (i.e. 1969-2005 simulation results of the SWAT model was validated to downstream NYM reservoir sediment accumulation information. The SWAT model captured 56 percent of the variance (CE and underestimated the observed daily sediment loads by 0.9 percent according to Total Mass Control (TMC performance indices during a normal wet hydrological year, i.e., between November 1, 1977 and October 31, 1978, as the calibration period. SWAT model predicted satisfactorily the long-term sediment catchment yield with a relative error of 2.6 percent. Also, the model has identified erosion sources spatially and has replicated some erosion processes as determined in other studies and field observations in the PRB. This result suggests that for catchments where sheet erosion is dominant SWAT model may substitute the sediment-rating curve. However, the SWAT model could not capture the dynamics of sediment load delivery in some seasons to the catchment outlet.

  4. A GUIDED SWAT MODEL APPLICATION ON SEDIMENT YIELD MODELING IN PANGANI RIVER BASIN: LESSONS LEARNT

    Directory of Open Access Journals (Sweden)

    Preksedis Marco Ndomba

    2008-12-01

    Full Text Available The overall objective of this paper is to report on the lessons learnt from applying Soil and Water Assessment Tool (SWAT in a well guided sediment yield modelling study. The study area is the upstream of Pangani River Basin (PRB, the Nyumba Ya Mungu (NYM reservoir catchment, located in the North Eastern part of Tanzania. It should be noted that, previous modeling exercises in the region applied SWAT with preassumption that inter-rill or sheet erosion was the dominant erosion type. In contrast, in this study SWAT model application was guided by results of analysis of high temporal resolution of sediment flow data and hydro-meteorological data. The runoff component of the SWAT model was calibrated from six-years (i.e. 1977–1982 of historical daily streamflow data. The sediment component of the model was calibrated using one-year (1977–1988 daily sediment loads estimated from one hydrological year sampling programme (between March and November, 2005 rating curve. A long-term period over 37 years (i.e. 1969–2005 simulation results of the SWAT model was validated to downstream NYM reservoir sediment accumulation information. The SWAT model captured 56 percent of the variance (CE and underestimated the observed daily sediment loads by 0.9 percent according to Total Mass Control (TMC performance indices during a normal wet hydrological year, i.e., between November 1, 1977 and October 31, 1978, as the calibration period. SWAT model predicted satisfactorily the long-term sediment catchment yield with a relative error of 2.6 percent. Also, the model has identified erosion sources spatially and has replicated some erosion processes as determined in other studies and field observations in the PRB. This result suggests that for catchments where sheet erosion is dominant SWAT model may substitute the sediment-rating curve. However, the SWAT model could not capture the dynamics of sediment load delivery in some seasons to the catchment outlet.

  5. Dosimetric evaluation of proton stereotactic radiosurgery

    Energy Technology Data Exchange (ETDEWEB)

    Min, Byung Jun; Shin, Dong Ho; Yoo, Seung Hoon; Jeong, Hojin; Lee, Se Byeong [Proton Therapy Center, National Cancer Center, Goyang (Korea, Republic of)

    2011-11-15

    Surgical excision, conventional external radiotherapy, and chemotherapy could prolong survival in patients with small intracranial tumors. However, surgical excision for meningiomas located in the region of the base of skull or re-resection is often difficult. Moreover, treatment is needed for patients with recurrent tumors or postoperative residual tumors. Conventional external radiotherapy is popular and has significantly increased for treating brain tumors. Stereotactic radiosurgery is an effective alternative treatment technique to microsurgical resection such as benign brain tumor or vestibular Schwannomas. In general, the dose to OAR of 3D conformal plan is lower than that of conformal arc and dynamic conformal arc plans. However, any of OARs was not reached to tolerance dose. Although mean dose of the healthy brain tissue for 3D conformal plan was slightly higher than that of arc plans, the doses of the healthy brain tissue at V10 and V20 were significantly low for dynamic conformal arc plan. The dosimetric differences were the greatest at lower doses. In contrast, 3D conformal plan was better spare at higher doses. In this study, a dosimetric evaluation of proton stereotactic radiosurgery for brain lesion tumors was using fixed and arc beams. A brass block fitted to the PTV structure was modeled for dynamic conformal collimator. Although all treatment plans offer a very good coverage of the PTV, we found that proton arc plans had significantly better conformity to the PTV than static 3D conformal plan. The V20 dose of normal brain for dynamic conformal arc therapy is dramatically reduced compare to those for other therapy techniques.

  6. Fractionated stereotactic radiotherapy in patients with acromegaly: an interim single-centre audit

    DEFF Research Database (Denmark)

    Roug, Anne Stidsholt; Rasmussen, Åse Krogh; Juhler, M;

    2010-01-01

    To evaluate the effect of fractionated stereotactic radiotherapy (FSRT) in acromegaly in a retrospective analysis.......To evaluate the effect of fractionated stereotactic radiotherapy (FSRT) in acromegaly in a retrospective analysis....

  7. Stereotactic radiosurgery for the treatment of brain metastases; results from a single institution experience.

    LENUS (Irish Health Repository)

    Burke, D

    2013-09-01

    Stereotactic radiosurgery is frequently used for the treatment of brain metastases. This study provides a retrospective evaluation of patients with secondary lesions of the brain treated with stereotactic radiosurgery (SRS) at our institution.

  8. Stereotactic Body Radiotherapy Reirradiation for Recurrent Epidural Spinal Metastases

    Energy Technology Data Exchange (ETDEWEB)

    Mahadevan, Anand, E-mail: amahadev@bidmc.harvard.edu [Department of Radiation Oncology, Beth Israel Deaconess Medical Center, Boston, Massachusetts and Harvard Medical School (Israel); Floyd, Scott [Department of Radiation Oncology, Beth Israel Deaconess Medical Center, Boston, Massachusetts and Harvard Medical School (Israel); Wong, Eric; Jeyapalan, Suriya [Department of Neuro-Oncology, Beth Israel Deaconess Medical Center, Boston, Massachusetts and Harvard Medical School (Israel); Groff, Michael; Kasper, Ekkehard [Department of Neurosurgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts and Harvard Medical School (Israel)

    2011-12-01

    Purpose: When patients show progression after conventional fractionated radiation for spine metastasis, further radiation and surgery may not be options. Stereotactic body radiotherapy (SBRT) has been successfully used in treatment of the spine and may be applicable in these cases. We report the use of SBRT for 60 consecutive patients (81 lesions) who had radiological progressive spine metastasis with epidural involvement after previous radiation for spine metastasis. Methods and Materials: SBRT was used with fiducial and vertebral anatomy-based targeting. The radiation dose was prescribed based on the extent of spinal canal involvement; the dose was 8 Gy Multiplication-Sign 3 = 24 Gy when the tumor did not touch the spinal cord and 5 to 6 Gy x 5 = 25 to 30 Gy when the tumor abutted the cord. The cord surface received up to the prescription dose with no hot spots in the cord. Results: The median overall survival was 11 months, and the median progression-free survival was 9 months. Overall, 93% of patients had stable or improved disease while 7% of patients showed disease progression; 65% of patients had pain relief. There was no significant toxicity other than fatigue. Conclusions: SBRT is feasible and appears to be an effective treatment modality for reirradiation after conventional palliative radiation fails for spine metastasis patients.

  9. Stereotactic radiosurgery for intracranial arteriovenous malformations: A review

    Directory of Open Access Journals (Sweden)

    Ranjith K Moorthy

    2015-01-01

    Full Text Available Stereotactic radiosurgery (SRS has proven to be an effective strategy in the management of intracranial arteriovenous malformations (AVMs in children and adults over the past three decades. Its application has resulted in lowering the morbidity and mortality associated with treatment of deep-seated AVMs. SRS has been used as a primary modality of therapy as well as in conjunction with embolization and microsurgery in the management of AVMs. The obliteration rate after SRS has been reported to range from 35% to 92%. Smaller AVMs receiving higher marginal doses have obliteration rates of 70% and more. The median follow-up reported in most series is approximately 36–40 months. The median time to obliteration has been reported to be approximately 24–36 months in most series. Radiation-induced neurological complications have been reported in less than 10% of patients, with a 1.5%–6% risk of developing a new permanent neurological deficit. The bleeding rate during the latency to obliteration has been reported to be approximately 5%. This review describes the experience reported in literature with respect to the indications, dosage, factors affecting obliteration rate of AVMs, and complications after SRS.

  10. Opportunities for Radiosensitization in the Stereotactic Body Radiation Therapy (SBRT) Era.

    Science.gov (United States)

    Moding, Everett J; Mowery, Yvonne M; Kirsch, David G

    2016-01-01

    Stereotactic body radiation therapy (SBRT) utilizing a small number of high-dose radiation therapy fractions continues to expand in clinical application. Although many approaches have been proposed to radiosensitize tumors with conventional fractionation, how these radiosensitizers will translate to SBRT remains largely unknown. Here, we review our current understanding of how SBRT eradicates tumors, including the potential contributions of endothelial cell death and immune system activation. In addition, we identify several new opportunities for radiosensitization generated by the move toward high dose per fraction radiation therapy. PMID:27441746

  11. Radiation necrosis masquerading as late tumor recurrence: 14 years after combined fractionated stereotactic radiosurgery and conventional radiation therapy

    OpenAIRE

    Brashears, James H; Vissage, Kristi; Jenrette, Joseph

    2015-01-01

    Radiation necrosis is a known sequela of delivering high doses of ionizing radiation to the central nervous system and may be confused with tumor recurrence. Although stereotactic radiation has found increasing application in managing central nervous system malignancies, the imaging appearance of benign tissue several years after such treatment has not been frequently documented in the medical literature. We present the imaging and pathologic features of brain tissue that received fractionate...

  12. Stereotactic localization and visualization of the subthalamic nucleus

    Institute of Scientific and Technical Information of China (English)

    SHEN Wei-gao; WANG Hai-yang; LIN Zhi-guo; SHEN Hong; CHEN Xiao-guang; FU Yi-li; GAO Wen-peng

    2009-01-01

    Background The subthalamic nucleus (STN) is widely recognized as one of the most important and commonly targeted nuclei in stereotactic and functional neurosurgery. The success of STN surgery depends on accuracy in target determination. Construction of a digitalized atlas of STN based on stereotactic MRI will play an instrumental role in the accuracy of anatomical localization. The aim of this study was to investigate the three-dimensional (3D) target location of STN in stereotactic space and construct a digitalized atlas of STN to accomplish the visualization of the STN on stereotactic MRI, thus providing clinical guidance on the precise anatomical localization of STN.Methods One hundred and twenty healthy people volunteered to be scanned by 1.5 Tesla MRI scanning with 1-mm-thick slice in the standard stereotactic space between 2005 and 2006. One adult male was selected for 3D reconstruction of STN. The precess of 3D reconstruction included identification, manual segmentation, extraction,conservation and reconstruction.Results There was a significant correlation between the coordinates and age (P <0.05). The volume of left STN was significantly larger than the right STN, and there was a significant negative correlation between volume and age (P <0.05).The surface of the STN nucleus after 3D reconstruction appeared smooth, natural and realistic. The morphological feature of STN on the individual brain could be visualized directly in 3D. The 3D reconstructed STN could be rotated,zoomed and displayed at any direction in the stereotactic space. The anteroposterior diameter of the STN nucleus was longer than the vertical and transverse diameters in 3D space. The 3D reconstruction of STN manifested typical structure of the "dual lens".Conclusions The visualization of individual brain atlas based on stereotactic MRI is feasible. However, software for automated segmentation, extraction and registration of MR images need to be further developed.

  13. Current concepts in stereotactic radiosurgery - a neurosurgical and radiooncological point of view

    OpenAIRE

    Vesper J; Bölke E; Wille C; Gerber PA; Matuschek C; Peiper M; Steiger HJ; Budach W; Lammering G

    2009-01-01

    Abstract Stereotactic radiosurgery is related to the history of "radiotherapy" and "stereotactic neurosurgery". The concepts for neurosurgeons and radiooncologists have been changed during the last decade and have also transformed neurosurgery. The gamma knife and the stereotactically modified linear accelerator (LINAC) are radiosurgical equipments to treat predetermined intracranial targets through the intact skull without damaging the surrounding normal brain tissue. These technical develop...

  14. Recommendations for implementing stereotactic radiotherapy in peripheral stage IA non-small cell lung cancer: report from the Quality Assurance Working Party of the randomised phase III ROSEL study

    International Nuclear Information System (INIS)

    A phase III multi-centre randomised trial (ROSEL) has been initiated to establish the role of stereotactic radiotherapy in patients with operable stage IA lung cancer. Due to rapid changes in radiotherapy technology and evolving techniques for image-guided delivery, guidelines had to be developed in order to ensure uniformity in implementation of stereotactic radiotherapy in this multi-centre study. A Quality Assurance Working Party was formed by radiation oncologists and clinical physicists from both academic as well as non-academic hospitals that had already implemented stereotactic radiotherapy for lung cancer. A literature survey was conducted and consensus meetings were held in which both the knowledge from the literature and clinical experience were pooled. In addition, a planning study was performed in 26 stage I patients, of which 22 were stage 1A, in order to develop and evaluate the planning guidelines. Plans were optimised according to parameters adopted from RTOG trials using both an algorithm with a simple homogeneity correction (Type A) and a more advanced algorithm (Type B). Dose conformity requirements were then formulated based on these results. Based on current literature and expert experience, guidelines were formulated for this phase III study of stereotactic radiotherapy versus surgery. These guidelines can serve to facilitate the design of future multi-centre clinical trials of stereotactic radiotherapy in other patient groups and aid a more uniform implementation of this technique outside clinical trials

  15. Application of the MCNPX-McStas interface for shielding calculations and guide design at ESS

    DEFF Research Database (Denmark)

    Klinkby, Esben Bryndt; Bergbäck Knudsen, Erik; Willendrup, Peter Kjær;

    2013-01-01

    Recently, an interface between the Monte Carlo code MCNPX and the neutron ray-tracing code MCNPX was developed[1]. Based on the expected neutronic performance and guide geometries relevant for the ESS, the combined MCNPX-McStas code is used to calculate dose rates along neutron beam guides. The g...

  16. Application of the MCNPX-McStas interface for shielding calculations and guide design at ESS

    DEFF Research Database (Denmark)

    Klinkby, Esben Bryndt; Bergbäck Knudsen, Erik; Willendrup, Peter Kjær;

    2014-01-01

    Recently, an interface between the Monte Carlo code MCNPX and the neutron ray-tracing code MCNPX was developed [1, 2]. Based on the expected neutronic performance and guide geometries relevant for the ESS, the combined MCNPX-McStas code is used to calculate dose rates along neutron beam guides. T...

  17. Diagnostic accuracy for different strategies of image-guided breast intervention in cases of nonpalpable breast lesions.

    NARCIS (Netherlands)

    Pijnappel, R.M.; Donk, M. van den; Holland, R.; Mali, W.P.Th.; Peterse, J.L.; Hendriks, J.H.C.L.; Peeters, P.H.

    2004-01-01

    To find out whether ultrasound-guided fine-needle aspiration (FNA) and ultrasound and stereotactic-guided large core needle biopsy (LCNB) are reliable alternatives to needle-localised open breast biopsy (NLBB) in daily practice, we performed a retrospective study and evaluated the validity of these

  18. Stereotactic Irradiation of GH-Secreting Pituitary Adenomas

    Directory of Open Access Journals (Sweden)

    G. Minniti

    2012-01-01

    Full Text Available Radiotherapy (RT is often employed in patients with acromegaly refractory to medical and/or surgical interventions in order to prevent tumour regrowth and normalize elevated GH and IGF-I levels. It achieves tumour control and hormone normalization up to 90% and 70% of patients at 10–15 years. Despite the excellent tumour control, conventional RT is associated with a potential risk of developing late toxicity, especially hypopituitarism, and its role in the management of patients with GH-secreting pituitary adenomas remains a matter of debate. Stereotactic techniques have been developed with the aim to deliver more localized irradiation and minimize the long-term consequences of treatment, while improving its efficacy. Stereotactic irradiation can be given in a single dose as stereotactic radiosurgery (SRS or in multiple doses as fractionated stereotactic radiotherapy (FSRT. We have reviewed the recent published literature on stereotactic techniques for GH-secreting pituitary tumors with the aim to define the efficacy and potential adverse effects of each of these techniques.

  19. Treatment accuracy of fractionated stereotactic radiotherapy

    International Nuclear Information System (INIS)

    Background and purpose: To assess the geometric accuracy of the delivery of fractionated stereotactic radiotherapy (FSRT) for brain tumours using the Gill-Thomas-Cosman (GTC) relocatable frame. Accuracy of treatment delivery was measured via portal images acquired with an amorphous silicon based electronic portal imager (EPI). Results were used to assess the existing verification process and to review the current margins used for the expansion of clinical target volume (CTV) to planning target volume (PTV). Patients and methods: Patients were immobilized in a GTC frame. Target volume definition was performed on localization CT and MRI scans and a CTV to PTV margin of 5 mm (based on initial experience) was introduced in 3D. A Brown-Roberts-Wells (BRW) fiducial system was used for stereotactic coordinate definition. The existing verification process consisted of an intercomparison of the coordinates of the isocentres and anatomy between the localization and verification CT scans. Treatment was delivered with 6 MV photons using four fixed non-coplanar conformal fields using a multi-leaf collimator. Portal imaging verification consisted of the acquisition of orthogonal images centred through the treatment isocentre. Digitally reconstructed radiographs (DRRs) created from the CT localization scans were used as reference images. Semi-automated matching software was used to quantify set up deviations (displacements and rotations) between reference and portal images. Results: One hundred and twenty six anterior and 123 lateral portal images were available for analysis for set up deviations. For displacements, the total errors in the cranial/caudal direction were shown to have the largest SD's of 1.2 mm, while systematic and random errors reached SD's of 1.0 and 0.7 mm, respectively, in the cranial/caudal direction. The corresponding data for rotational errors (the largest deviation was found in the sagittal plane) was 0.7 deg. SD (total error), 0.5 deg. (systematic) and 0

  20. Functional Neurosurgery in the Human Thalamus by Transcranial Magnetic Resonance Guided Focused Ultrasound

    Science.gov (United States)

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

    2009-04-01

    Potential applications of Transcranial Magnetic Resonance guided Focused Ultrasound (TcMRgFUS) include treatment of functional brain disorders, such as Parkinson's disease, dystonia and tremor, neurogenic pain and tinnitus, neuropsychiatric disorders and epilepsy. In this study we demonstrate the feasibility of non-invasive TcMRgFUS ablation of clinically well established targets in the human thalamus that are currently accessed stereotactically by interventional strategies based on the concept of the thalamocortical dysrhythmia (TCD). Thermal hotspots suitable for clinical intervention were created successfully in anatomical preparations of human ex-vivo heads under pseudo clinical conditions. The hotspots could be positioned at the target locations as needed and local energy deposition was sufficient to create tissue ablation. Numerical simulations based on these experimental data predict that the acoustic energy needed to create ablative lesions in-vivo will be within limits that can safely applied.

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

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Mi Sook; Kim, Won Woo; Park, In Hwan; Kim, Hee Jong; Lee, Eun Jin; Jung, Jae Hoon [Research Center for Radiotherapy, Korea Institute of Radiological and Medical Sciences, Seoul (Korea, Republic of); Cho, Lawrence Chin Soo; Song, Chang W. [Dept. of Radiation Oncology, University of Minnesota Medical School, Minneapolis (United States)

    2015-12-15

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

  2. The Application of AHP Model to Guide Decision Makers: A Case Study of E-banking Security

    OpenAIRE

    Syamsuddin, Irfan; Hwang, Junseok

    2010-01-01

    Changes in technology have resulted in new ways for bankers to deliver their services to costumers. Electronic banking systems in various forms are the evidence of such advancement. However, information security threats also evolving along this trend. This paper proposes the application of Analytic Hierarchy Process (AHP) methodology to guide decision makers in banking industries to deal with information security policy. The model is structured according aspects of information security policy...

  3. Preliminary Study of Stereotactic Radiotherapy for Lung Cancer

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    From March 1997 to November 1999, 45 patients with lung cancer were treated by astereotactic radiotherapy, with 15 cases treated by a stereotactic radiotherapy alone, and 30 cases by the external radiotherapy plus stereotactic radiotherapy. The clinical target volume was 1.89-187. 26 cm3 with the median being 18. 17 cm3. The doses of plan target volume (PTV) edge was 16-30 Gy/2-3 times and the doses of center was 120 % to 150 % of PTV edge doses. The overall response rate was 84.4 % (38/45), with 11 complete response (CR) and 27 partial response (PR). This study confirmed that the stereotactic radiotherapy is a safe and effective therapy for lung cancer. For those early-stage patients who can tolerate neither operation nor even conventional radiotherapy for various reasons, it can both achieve therapeutic purpose and improve quality of life.

  4. The Confluence of Stereotactic Ablative Radiotherapy and Tumor Immunology

    Directory of Open Access Journals (Sweden)

    Steven Eric Finkelstein

    2011-01-01

    Full Text Available Stereotactic radiation approaches are gaining more popularity for the treatment of intracranial as well as extracranial tumors in organs such as the liver and lung. Technology, rather than biology, is driving the rapid adoption of stereotactic body radiation therapy (SBRT, also known as stereotactic ablative radiotherapy (SABR, in the clinic due to advances in precise positioning and targeting. Dramatic improvements in tumor control have been demonstrated; however, our knowledge of normal tissue biology response mechanisms to large fraction sizes is lacking. Herein, we will discuss how SABR can induce cellular expression of MHC I, adhesion molecules, costimulatory molecules, heat shock proteins, inflammatory mediators, immunomodulatory cytokines, and death receptors to enhance antitumor immune responses.

  5. Comprehensive quality assurance for stereotactic radiosurgery treatments

    Energy Technology Data Exchange (ETDEWEB)

    Ramaseshan, R [Radiation Physics Department, Princess Margaret Hospital, University Health Network, 610 University Avenue, Toronto, ON, M5G 2M9 (Canada); Heydarian, M [Department of Radiation Oncology, University of Toronto, Toronto, ON, M5G 2M9 (Canada)

    2003-07-21

    We have used a commercially available high precision Lucy{sup TM} phantom to perform comprehensive quality assurance for stereotactic radiosurgery treatments. The quantitative evaluation of system uncertainties included imaging, planning and treatment delivery systems. The quality assurance tests showed that the well-defined targets were identified to within {+-}1 mm in all the imaging modalities. The pre-known target volumes were reproduced within 2 cm{sup 3} in both MR and CT. The planned target was delivered within 2% of the prescribed dose and to within 2 mm accuracy. The inaccuracy in the isocentre position at the Linac was less than 1.2 mm. The maximum error observed in the depth helmet was 0.5 mm and the overall uncertainty was within 0.23 mm. We have also established a quality assurance program based on the study and proposed the tolerance and the frequency of the tests required to be carried out. The tests were carried out using a Radionics planning system and delivered on a Varian Clinac 2100 linear accelerator machine. These tests also established a base line for future comparisons. (note)

  6. Fractionated Stereotactic Radiotherapy for Facial Nerve Schwannomas.

    Science.gov (United States)

    Shi, Wenyin; Jain, Varsha; Kim, Hyun; Champ, Colin; Jain, Gaurav; Farrell, Christopher; Andrews, David W; Judy, Kevin; Liu, Haisong; Artz, Gregory; Werner-Wasik, Maria; Evans, James J

    2016-02-01

    Purpose Data on the clinical course of irradiated facial nerve schwannomas (FNS) are lacking. We evaluated fractionated stereotactic radiotherapy (FSRT) for FNS. Methods Eight consecutive patients with FNS treated at our institution between 1998 and 2011 were included. Patients were treated with FSRT to a median dose of 50.4 Gy (range: 46.8-54 Gy) in 1.8 or 2.0 Gy fractions. We report the radiographic response, symptom control, and toxicity associated with FSRT for FNS. Results The median follow-up time was 43 months (range: 10-75 months). All patients presented with symptoms including pain, tinnitus, facial asymmetry, diplopia, and hearing loss. The median tumor volume was 1.57 cc. On the most recent follow-up imaging, five patients were noted to have stable tumor size; three patients had a net reduction in tumor volume. Additionally, six patients had improvement in clinical symptoms, one patient had stable clinical findings, and one patient had worsened House-Brackmann grade due to cystic degeneration. Conclusion FSRT treatment of FNS results in excellent control of growth and symptoms with a small rate of radiation toxicity. Given the importance of maintaining facial nerve function, FSRT could be considered as a primary management modality for enlarging or symptomatic FNS. PMID:26949592

  7. Application of a diagnosis-based clinical decision guide in patients with low back pain

    Directory of Open Access Journals (Sweden)

    Murphy Donald R

    2011-10-01

    Full Text Available Abstract Background Low back pain (LBP is common and costly. Development of accurate and efficacious methods of diagnosis and treatment has been identified as a research priority. A diagnosis-based clinical decision guide (DBCDG; previously referred to as a diagnosis-based clinical decision rule has been proposed which attempts to provide the clinician with a systematic, evidence-based means to apply the biopsychosocial model of care. The approach is based on three questions of diagnosis. The purpose of this study is to present the prevalence of findings using the DBCDG in consecutive patients with LBP. Methods Demographic, diagnostic and baseline outcome measure data were gathered on a cohort of LBP patients examined by one of three examiners trained in the application of the DBCDG. Results Data were gathered on 264 patients. Signs of visceral disease or potentially serious illness were found in 2.7%. Centralization signs were found in 41%, lumbar and sacroiliac segmental signs in 23% and 27%, respectively and radicular signs were found in 24%. Clinically relevant myofascial signs were diagnosed in 10%. Dynamic instability was diagnosed in 63%, fear beliefs in 40%, central pain hypersensitivity in 5%, passive coping in 3% and depression in 3%. Conclusion The DBCDG can be applied in a busy private practice environment. Further studies are needed to investigate clinically relevant means to identify central pain hypersensitivity, poor coping and depression, correlations and patterns among the diagnostic components of the DBCDG as well as inter-examiner reliability and efficacy of treatment based on the DBCDG.

  8. Application of endobronchial ultrasound-guided transbronchial needle aspiration in the diagnosis of mediastinal lesions

    Institute of Scientific and Technical Information of China (English)

    ZHAO Hui; LIU Jun; LI Jian-feng; JIANG Guan-chao; WANG Jun; ZHOU Zu-li; LI Yun; BU Liang; YANG Fan; SUI Xi-zhao; CHEN Ke-zhong; LI Xiao

    2011-01-01

    Background Mediastinal lesions are often difficult to diagnose in clinical practice because of the unique anatomical position of the mediastinum,which makes performance of biopsy difficult.The value of endobronchial ultrasound-guided transbronchial needle aspiration in the diagnosis of lung cancer and mediastinal lymph node staging has been widely accepted.However,few studies have been conducted on the value of endobronchial ultrasound-guided transbronchial needle aspiration in the diagnosis and differential diagnosis of mediastinal lesions.The current study was conducted to investigate the value of endobronchial ultrasound-guided transbronchial needle aspiration in the diagnosis and differential diagnosis of isolated mediastinal lesions without lung abnormalities.Methods We retrospectively analyzed the data of patients with isolated mediastinal lesions without lung abnormalities for whom endobronchial ultrasound-guided transbronchial needle aspiration examination was performed at the Department of Thoracic Surgery of Peking University People's Hospital,between September 2009 and December 2010.For patients who could not be diagnosed with endobronchial ultrasound-guided transbronchial needle aspiration,surgical biopsy or more than 6 months of clinical and imaging follow-up was carried out.Results Endobronchial ultrasound-guided transbronchial needle aspiration was performed for 60 patients with isolated mediastinal lesions.Correct diagnosis was made in 48 cases.Nineteen cases were malignant,and 29 were benign.The rate of correct diagnosis was 80%.The sensitivity,specificity,and accuracy of endobronchial ultrasound-guided transbronchial needle aspiration in distinguishing benign from malignant mediastinal lesions were 95%,100%,and 98%,respectively.The examination was tolerable for all patients.No associated complications were observed.Conclusion Endobronchial ultrasound-guided transbronchial needle aspiration is a safe and effective method of diagnosing

  9. Eargle's the microphone book from mono to stereo to surround : a guide to microphone design and application

    CERN Document Server

    Rayburn, Ray A

    2012-01-01

    Eargle's Microphone Book is the only guide you will ever need for the latest in microphone technology, application and technique. This new edition features more on microphone arrays and wireless microphones, new material on digital models; the latest developments in surround; expanded advice on studio set up, recording and mic selection. Ray A. Rayburn provides detailed analysis of the different types of microphones available and addresses their application through practical examples of actual recording sessions and studio operations. The book takes you into the stu

  10. Biological characteristics of HCC by ultrasound-guided aspiration biopsy and its clinical application

    Institute of Scientific and Technical Information of China (English)

    Li-Wu Lin; Xue-Ying Lin; Yi-Mi He; Shang-Da Gao; Xiao-Dong Lin

    2003-01-01

    AIM: To probe the pathological biological characteristics of hepatocellular carcinoma (HCC) by the ultrasound-guided aspiration biopsy and assess the clinical application value of this method.METHODS: The biopsy and DNA analysis by flow cytometry (FCM) were taken in 46 cases with HCC nodules, including 26 cases and 20 cases with nodules ≤3 cm and >3 cm in diameters respectively, and 12 cases with intrahepatic benign hyperplastic nodules. They were taken in 22 cases of 46cases with HCC before and after the therapy. Fine-needles and automatic histological incised biopsy needles were used.The fresh biopsy tissue was produced into the single cell suspension, which was sent for DNA detection and ratio analysis of cell period. The ratio of each DNA period of cell proliferation of each group was calculated and compared with each other. The DNA aneuploid (AN) and apoptosis cell peak were observed and their percentages were calculated.RESULTS: The ratios of S and G2/M periods of DNA, which reflect cell hyperproliferation, in the group with HCC tumors >3 cm in diameter were markedly higher than those of the group with HCC nodules ≤3 cm in diameter and the group with the benign hyperplastic nodules (P<0.01 except A:B of S period, P<0.05). The ratios of the middle group were also apparently higher than those of the latter group (P<0.01).The ratio of DNA AN of 46 cases with HCC nodules was 34.8 % (16/46). None of the cases with the intrahepatic hyperplastic nodules appeared AN. The DNA AN appeared more apparently with the growth of the tumors. The AN ratio of the group with tumors >3 cm in diameter was 55 %(11/20), markedly higher than that of the group with tumors ≤3 cm in diameter which was 19.2 % (5/26) (P<0.01). The FCM DNA analysis of 22 specimens of hepatic carcinoma tissue before therapy showed that the aneuploid peaks appeared in 5 cases (22.7 %). The ratio of G1 period rose after therapy while the S period and G2/M ratios fell (P<0.01).The

  11. Stereotactic Body Radiation Therapy in Spinal Metastases

    Energy Technology Data Exchange (ETDEWEB)

    Ahmed, Kamran A. [Mayo Medical School, College of Medicine, Mayo Clinic, Rochester, MN (United States); Stauder, Michael C.; Miller, Robert C.; Bauer, Heather J. [Department of Radiation Oncology, Mayo Clinic, Rochester, MN (United States); Rose, Peter S. [Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN (United States); Olivier, Kenneth R. [Department of Radiation Oncology, Mayo Clinic, Rochester, MN (United States); Brown, Paul D. [Department of Radiation Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States); Brinkmann, Debra H. [Department of Radiation Oncology, Mayo Clinic, Rochester, MN (United States); Laack, Nadia N., E-mail: laack.nadia@mayo.edu [Department of Radiation Oncology, Mayo Clinic, Rochester, MN (United States)

    2012-04-01

    Purpose: Based on reports of safety and efficacy, stereotactic body radiotherapy (SBRT) for treatment of malignant spinal tumors was initiated at our institution. We report prospective results of this population at Mayo Clinic. Materials and Methods: Between April 2008 and December 2010, 85 lesions in 66 patients were treated with SBRT for spinal metastases. Twenty-two lesions (25.8%) were treated for recurrence after prior radiotherapy (RT). The mean age of patients was 56.8 {+-} 13.4 years. Patients were treated to a median dose of 24 Gy (range, 10-40 Gy) in a median of three fractions (range, 1-5). Radiation was delivered with intensity-modulated radiotherapy (IMRT) and prescribed to cover 80% of the planning target volume (PTV) with organs at risk such as the spinal cord taking priority over PTV coverage. Results: Tumor sites included 48, 22, 12, and 3 in the thoracic, lumbar, cervical, and sacral spine, respectively. The mean actuarial survival at 12 months was 52.2%. A total of 7 patients had both local and marginal failure, 1 patient experienced marginal but not local failure, and 1 patient had local failure only. Actuarial local control at 1 year was 83.3% and 91.2% in patients with and without prior RT. The median dose delivered to patients who experienced local/marginal failure was 24 Gy (range, 18-30 Gy) in a median of three fractions (range, 1-5). No cases of Grade 4 toxicity were reported. In 1 of 2 patients experiencing Grade 3 toxicity, SBRT was given after previous radiation. Conclusion: The results indicate SBRT to be an effective measure to achieve local control in spinal metastases. Toxicity of treatment was rare, including those previously irradiated. Our results appear comparable to previous reports analyzing spine SBRT. Further research is needed to determine optimum dose and fractionation to further improve local control and prevent toxicity.

  12. Stereotactic Body Radiotherapy for Primary Hepatocellular Carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Andolino, David L., E-mail: dandolin@iupui.edu [Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, IN (United States); Johnson, Cynthia S. [Department of Biostatistics, Indiana University School of Medicine, Indianapolis, IN (United States); Maluccio, Mary [Department of Surgery, Indiana University School of Medicine, Indianapolis, IN (United States); Kwo, Paul [Department of Medicine, Indiana University School of Medicine, Indianapolis, IN (United States); Tector, A. Joseph [Department of Surgery, Indiana University School of Medicine, Indianapolis, IN (United States); Zook, Jennifer; Johnstone, Peter A.S.; Cardenes, Higinia R. [Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, IN (United States)

    2011-11-15

    Purpose: To evaluate the safety and efficacy of stereotactic body radiotherapy (SBRT) for the treatment of primary hepatocellular carcinoma (HCC). Methods and Materials: From 2005 to 2009, 60 patients with liver-confined HCC were treated with SBRT at the Indiana University Simon Cancer Center: 36 Child-Turcotte-Pugh (CTP) Class A and 24 CTP Class B. The median number of fractions, dose per fraction, and total dose, was 3, 14 Gy, and 44 Gy, respectively, for those with CTP Class A cirrhosis and 5, 8 Gy, and 40 Gy, respectively, for those with CTP Class B. Treatment was delivered via 6 to 12 beams and in nearly all cases was prescribed to the 80% isodose line. The records of all patients were reviewed, and treatment response was scored according to Response Evaluation Criteria in Solid Tumors v1.1. Toxicity was graded according to the Common Terminology Criteria for Adverse Events v4.0. Local control (LC), time to progression (TTP), progression-free survival (PFS), and overall survival (OS) were calculated according to the method of Kaplan and Meier. Results: The median follow-up time was 27 months, and the median tumor diameter was 3.2 cm. The 2-year LC, PFS, and OS were 90%, 48%, and 67%, respectively, with median TTP of 47.8 months. Subsequently, 23 patients underwent transplant, with a median time to transplant of 7 months. There were no {>=}Grade 3 nonhematologic toxicities. Thirteen percent of patients experienced an increase in hematologic/hepatic dysfunction greater than 1 grade, and 20% experienced progression in CTP class within 3 months of treatment. Conclusions: SBRT is a safe, effective, noninvasive option for patients with HCC {<=}6 cm. As such, SBRT should be considered when bridging to transplant or as definitive therapy for those ineligible for transplant.

  13. Evaluation of time, attendance of medical staff, and resources during stereotactic radiotherapy/radiosurgery. QUIRO-DEGRO trial

    International Nuclear Information System (INIS)

    department for the maintenance, protection and optimization of operational readiness for the application of intra- and extracranial stereotactic radiotherapy was determined methodically. (orig.)

  14. [FRACTIONATED STEREOTACTIC RADIOSURGERY: A GAME CHANGER FOR NEUROSURGERY].

    Science.gov (United States)

    Nissim, Ouzi; Spiegelmann, Roberto

    2016-05-01

    The article by Dr. Cohen-Inbar published in this issue of Harefuah is a timely review that brings to the general medical community the recent important developments in the field of radiosurgery--the evolution of multi-session radiosurgery [or "FSR", standing for Fractionated Stereotactic Radiation]. Radiosurgery and FSR continue to have a tremendous impact on modern neurosurgery. Sharing sub-millimetric accuracy in radiation delivery made possible by real-time-imaging positioning, frameless single and multisession radiosurgery have become two faces of a therapeutic technique with wide application in the field of intracranial pathology. Blending dose fractionation with delivery precision, FSR is a hybrid tool that can be implemented safely and effectively for practically any intra-cranial pathology without restrictions of volume or location. Dr. Cohen Inbar reviews the available data regarding doses, fractionation schemes, and results for the different pathologies in which FSR is being increasingly applied. FSR, as single-dose radiosurgery since the late 1980s, has changed the practice of neurosurgery. Radical microsorgical tumor removal at any cost in demanding intracranial locations has been replaced by upfront conservative volume-reduction surgery, leaving the more complicated part of those tumors to safer elimination by precise irradiation in single or multiple sessions. In Israel, further to the first unit operative since 1993 at the Sheba Medical Center, 3 new active LINAC based treatment sites have been added in recent years, with facilities either planned or under construction in the remaining major medical centers with neurosurgical and radiotherapy resources. They are evidence of the central role this modality has captured in the management of intracranial pathology. PMID:27526561

  15. Laser cutting technology which use the water jet guiding the laser beam. Application examination for the thick plate cutting

    International Nuclear Information System (INIS)

    Due to the increase of aged nuclear reactors, reduction of radioactive wastes is expected and cutting technology for thick structure would be necessary. Thermal cutting technology would be convenient for cutting thick materials, but generation of radioactive fume is one of the problems. A water jet-guided laser cutting is one of the suitable technologies for this application, because radioactive fume would be confined in the water and dose level won't be increased. However, this technology was developed for precision machining like dicing and slotting of silicon wafers, it is difficult to cut thick materials. In this study, cutting technology for thick material with a water jet-guided laser was discussed. Phenomenon during cutting thick stainless steel was observed by using high speed camera and optimum conditions for both water jet and laser cutting were derived. Finally, 50 mm thick stainless steel plate was successfully cut by using this technology. (author)

  16. Protein adsorption capability on polyurethane and modified-polyurethane membrane for periodontal guided tissue regeneration applications.

    Science.gov (United States)

    Sheikh, Zeeshan; Khan, Abdul Samad; Roohpour, Nima; Glogauer, Michael; Rehman, Ihtesham U

    2016-11-01

    Periodontal disease if left untreated can result in creation of defects within the alveolar ridge. Barrier membranes are frequently used with or without bone replacement graft materials for achieving periodontal guided tissue regeneration (GTR). Surface properties of barrier membranes play a vital role in their functionality and clinical success. In this study polyetherurethane (PEU) membranes were synthesized by using 4,4'-methylene-diphenyl diisocyanate (MDI), polytetramethylene oxide (PTMO) and 1,4-butane diol (BDO) as a chain extender via solution polymerization. Hydroxyl terminated polydimethylsiloxane (PDMS) due to having inherent surface orientation towards air was used for surface modification of PEU on one side of the membranes. This resulting membranes had one surface being PEU and the other being PDMS coated PEU. The prepared membranes were treated with solutions of bovine serum albumin (BSA) in de-ionized water at 37°C at a pH of 7.2. The surface protein adsorptive potential of PEU membranes was observed using Attenuated Total Reflectance Fourier Transform Infrared Spectroscopy (ATR-FTIR), Raman spectroscopy and Confocal Raman spectroscopy. The contact angle measurement, tensile strength and modulus of prepared membranes were also evaluated. PEU membrane (89.86±1.62°) exhibited less hydrophobic behavior than PEU-PDMS (105.87±3.16°). The ultimate tensile strength and elastic modulus of PEU (27±1MPa and 14±2MPa) and PEU-PDMS (8±1MPa and 26±1MPa) membranes was in required range. The spectral analysis revealed adsorption of BSA proteins on the surface of non PDMS coated PEU surface. The PDMS modified PEU membranes demonstrated a lack of BSA adsorption. The non PDMS coated side of the membrane which adsorbs proteins could potentially be used facing towards the defect attracting growth factors for periodontal tissue regeneration. Whereas, the PDMS coated side could serve as an occlusive barrier for preventing gingival epithelial cells from

  17. Protein adsorption capability on polyurethane and modified-polyurethane membrane for periodontal guided tissue regeneration applications.

    Science.gov (United States)

    Sheikh, Zeeshan; Khan, Abdul Samad; Roohpour, Nima; Glogauer, Michael; Rehman, Ihtesham U

    2016-11-01

    Periodontal disease if left untreated can result in creation of defects within the alveolar ridge. Barrier membranes are frequently used with or without bone replacement graft materials for achieving periodontal guided tissue regeneration (GTR). Surface properties of barrier membranes play a vital role in their functionality and clinical success. In this study polyetherurethane (PEU) membranes were synthesized by using 4,4'-methylene-diphenyl diisocyanate (MDI), polytetramethylene oxide (PTMO) and 1,4-butane diol (BDO) as a chain extender via solution polymerization. Hydroxyl terminated polydimethylsiloxane (PDMS) due to having inherent surface orientation towards air was used for surface modification of PEU on one side of the membranes. This resulting membranes had one surface being PEU and the other being PDMS coated PEU. The prepared membranes were treated with solutions of bovine serum albumin (BSA) in de-ionized water at 37°C at a pH of 7.2. The surface protein adsorptive potential of PEU membranes was observed using Attenuated Total Reflectance Fourier Transform Infrared Spectroscopy (ATR-FTIR), Raman spectroscopy and Confocal Raman spectroscopy. The contact angle measurement, tensile strength and modulus of prepared membranes were also evaluated. PEU membrane (89.86±1.62°) exhibited less hydrophobic behavior than PEU-PDMS (105.87±3.16°). The ultimate tensile strength and elastic modulus of PEU (27±1MPa and 14±2MPa) and PEU-PDMS (8±1MPa and 26±1MPa) membranes was in required range. The spectral analysis revealed adsorption of BSA proteins on the surface of non PDMS coated PEU surface. The PDMS modified PEU membranes demonstrated a lack of BSA adsorption. The non PDMS coated side of the membrane which adsorbs proteins could potentially be used facing towards the defect attracting growth factors for periodontal tissue regeneration. Whereas, the PDMS coated side could serve as an occlusive barrier for preventing gingival epithelial cells from

  18. Standard guide for mutual inductance bridge applications for wall thickness determinations in boiler tubing

    CERN Document Server

    American Society for Testing and Materials. Philadelphia

    2010-01-01

    1.1 This guide describes a procedure for obtaining relative wall thickness indications in ferromagnetic and non-ferromagnetic steels using the mutual inductance bridge method. The procedure is intended for use with instruments capable of inducing two substantially identical magnetic fields and noting the change in inductance resulting from differing amounts of steel. It is used to distinguish acceptable wall thickness conditions from those which could place tubular vessels or piping at risk of bursting under high temperature and pressure conditions. 1.2 This guide is intended to satisfy two general needs for users of industrial Mutual Inductance Bridge (MIB) equipment: (1) the need for a tutorial guide addressing the general principles of Mutual Inductance Bridges as they apply to industrial piping; and (2) the need for a consistent set of MIB performance parameter definitions, including how these performance parameters relate to MIB system specifications. Potential users and buyers, as well as experienced M...

  19. Transnasal stereotactic surgery of pituitary adenomas concomitant with acromegaly.

    Science.gov (United States)

    Metyolkina, L; Peresedov, V

    1995-01-01

    Since 1960 we have performed stereotactic transsphenoidal cryohypophysectomy in 70 patients with pituitary adenomas, 42 women and 28 men, aged 11-59 years. The dominant clinical syndrome was acromegaly in 50 patients, galactorrhea in 9, amenorrhea in 5, adiposogenital dystrophy in 4 and gigantism with mild endocrine symptomatology in 2 patients. In 67 patients the histological structure of the tumor was established by biopsy (50 patients with eosinophil adenoma, 10 with mixed-type adenoma, 4 with chromophobe adenoma and 3 with basophil adenoma). Somatotropic hormone, human growth hormone, prolactin, ACTH and 17-ketosteroid levels indicated active/inactive adenomas. In 42 cases the adenoma was only intrasellar, which was confirmed by contrast X-ray investigations, CT scanning, angiography and ophthalmological investigation. Transnasal stereotactic cryohypophysectomy was performed in all 70 cases using a stereotactic apparatus especially designed for operations on the pituitary. All patients (except 2) tolerated the operation well. No complications occurred. Vision deteriorated after operation in 1 patient. Thrombosis of the left middle cerebral artery developed in another patient. All the other patients noted improvement directly after operation - rapid diminution of signs of acromegaly and rapid restoration of normal values in hormonal tests. Six patients with continuing growth of the tumor underwent a second operation 1.5-6 years after the first operation. We conclude from our own clinical experience and information from the literature that transnasal stereotactic cryodestruction is highly effective and relatively safe in the management of pituitary adenoma. PMID:8916351

  20. Fractionated stereotactic radiotherapy of vestibular schwannomas accelerates hearing loss

    DEFF Research Database (Denmark)

    Rasmussen, Rune; Claesson, Magnus; Stangerup, Sven-Eric;

    2012-01-01

    To evaluate long-term tumor control and hearing preservation rates in patients with vestibular schwannoma treated with fractionated stereotactic radiotherapy (FSRT), comparing hearing preservation rates to an untreated control group. The relationship between radiation dose to the cochlea and hear...

  1. Optimization of Dose Distribution for the System of Linear Accelerator-Based Stereotactic Radiosurgery.

    Science.gov (United States)

    Suh, Tae-Suk

    The work suggested in this paper addresses a method for obtaining an optimal dose distribution for stereotactic radiosurgery. Since stereotactic radiosurgery utilizes multiple noncoplanar arcs and a three-dimensional dose evaluation technique, many beam parameters and complex optimization criteria are included in the dose optimization. Consequently, a lengthy computation time is required to optimize even the simplest case by a trial and error method. The basic approach presented here is to use both an analytical and an experimental optimization to minimize the dose to critical organs while maintaining a dose shaped to the target. The experimental approach is based on shaping the target volumes using multiple isocenters from dose experience, or on field shaping using a beam's eye view technique. The analytical approach is to adapt computer -aided design optimization to find optimum parameters automatically. Three-dimensional approximate dose models are developed to simulate the exact dose model using a spherical or cylindrical coordinate system. Optimum parameters are found much faster with the use of computer-aided design optimization techniques. The implementation of computer-aided design algorithms with the approximate dose model and the application of the algorithms to several cases are discussed. It is shown that the approximate dose model gives dose distributions similar to those of the exact dose model, which makes the approximate dose model an attractive alternative to the exact dose model, and much more efficient in terms of computer -aided design and visual optimization.

  2. Detecting MLC errors in stereotactic radiotherapy plans with a liquid filled ionization chamber array.

    Science.gov (United States)

    O'Connor, Patrick; Seshadri, Venkatakrisnan; Charles, Paul

    2016-03-01

    Quality assurance of stereotactic radiotherapy demands the use of equipment with the highest resolution and sensitivity available. This study examines the sensitivity of a commercially available liquid-filled ionization chamber array--the Octavius 1000 SRS (PTW, Frieburg, Germany) for detecting small (sub-millimetre) multi-leaf collimator (MLC) alignment errors in static square fields (side length 16-40 mm). Furthermore, the effectiveness of detecting small MLC errors in clinical stereotactic radiotherapy patient plans using the device was also evaluated. The commonly used gamma pass rate metric (of the measurements compared with treatment planning system generated results) was used. The gamma pass rates were then evaluated as a function of MLC position error (MLC error size 0.1-2.5 mm). The detector array exhibited a drop in pass rate between plans without error and those which had MLC errors induced. For example a drop in pass rate of 4.5% (gamma criteria 3%, 1 mm) was observed when a 0.8 mm error was introduced into a 16 mm square field. Furthermore the drop in pass rate increased as the MLC position error increased. This study showed that the Octavius 1000 SRS array could be a useful tool for applications requiring the detection of small geometric delivery uncertainties.

  3. Wireless Occupancy Sensors for Lighting Controls: An Applications Guide for Federal Facility Managers

    Energy Technology Data Exchange (ETDEWEB)

    None

    2016-03-15

    This guide provides federal facility managers with an overview of the energy savings potential of wireless lighting occupancy sensors for various room types, cost considerations, key steps to successful installation of wireless sensors, pros and cons of various technology options, light source considerations, and codes and standards.

  4. Application of multi-target stereotactic surgery in refractory psychosis and its analysis of 1-year follow-up%多靶点立体定向手术在难治性精神病的应用及随访分析

    Institute of Scientific and Technical Information of China (English)

    殷捷; 吴勤奋; 耿卫峰; 邹志浩; 郑玺; 王建江; 藏袆

    2013-01-01

    Objective To investigate the applications of multi-target stereotactic surgery in refractory psy-chosis and make an analysis of 1-year follow-up.Methods 49 patients with multi-target stereotactic sur-gery were selected and followed up in 6 months and one year after their surgery by Brief Psychiatric Rating Scale(BPRS),Positive and Negative Syndrome Rating Scale(PANSS)and the Wechsler Intelligence Scale (WISC)to evaluate.The criteria of 1990 National Cooperative Group of Psychosurgery were used to evalu-ate the treatment of clinical efficacy after six month′s follow-up.Results 4 7 cases were followed-up after 6 months,with the follow-up rate of 9 5 .9%;4 4 cases were followed up 1 year after surgery,with the success-ful follow-up rate of 8 9 .8%.The scores of PANSS and BPRS scale at 6 months follow-up and 1 year follow-up were lower than before,especially in the item of hostile suspicion and activity,with the difference statistically significant (P 0 .0 5 ).After the surgery,positive PAN-SS score scale and negative scale score were lower than before.Verbal IQ,performance IQ and full IQ scores showed no significant difference (P >0 .0 5 )in the pre-operation and 6 months and 1 year post-operation fol-low-up.4 9 patients with refractory psychiatric patients,including the cingulate gyrus damage targets+anterior limb amygdala,cingulate gyrus amygdala + anterior limb medial septal nucleus,cingulate gyrus+amygdala dorsomedial hypothalamic nucleus, cingulate gyrus+ caudate anterior limb Nucleation beam, have the efficiency of 8 8 .9%,7 7 .8%,9 0 .0%,8 3 .3% respectively.Conclusion As a better treatment for mental illness,stereotactic surgery can improve the positive and negative symptoms with no effect on intelligence. Joint targets are preferred for the choice of targets.%目的探讨多靶点立体定向手术在难治性精神病的应用。方法选择49例难治性精神病且接受多靶点立体定向手术治疗的患者,于手术后6、12个月对患者进行

  5. Electromagnetic ultrasonic guided waves

    CERN Document Server

    Huang, Songling; Li, Weibin; Wang, Qing

    2016-01-01

    This book introduces the fundamental theory of electromagnetic ultrasonic guided waves, together with its applications. It includes the dispersion characteristics and matching theory of guided waves; the mechanism of production and theoretical model of electromagnetic ultrasonic guided waves; the effect mechanism between guided waves and defects; the simulation method for the entire process of electromagnetic ultrasonic guided wave propagation; electromagnetic ultrasonic thickness measurement; pipeline axial guided wave defect detection; and electromagnetic ultrasonic guided wave detection of gas pipeline cracks. This theory and findings on applications draw on the author’s intensive research over the past eight years. The book can be used for nondestructive testing technology and as an engineering reference work. The specific implementation of the electromagnetic ultrasonic guided wave system presented here will also be of value for other nondestructive test developers.

  6. The Application of AHP Model to Guide Decision Makers: A Case Study of E-banking Security

    CERN Document Server

    Syamsuddin, Irfan; 10.1109/ICCIT.2009.251

    2010-01-01

    Changes in technology have resulted in new ways for bankers to deliver their services to costumers. Electronic banking systems in various forms are the evidence of such advancement. However, information security threats also evolving along this trend. This paper proposes the application of Analytic Hierarchy Process (AHP) methodology to guide decision makers in banking industries to deal with information security policy. The model is structured according aspects of information security policy in conjunction with information security elements. We found that cultural aspect is valued on the top priority among other security aspects, while confidentiality is considered as the most important factor in terms of information security elements.

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

    OpenAIRE

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

    2004-01-01

    International audience Synchrotron stereotactic radiotherapy (SSR) consists in loading the tumour with a high atomic number element (Z), and exposing it to monochromatic x-rays from a synchrotron source (50-100 keV), in stereotactic conditions. The dose distribution results from both the stereotactic monochromatic x-ray irradiation and the presence of the high Z element. The purpose of this preliminary study was to evaluate the two-dimensional dose distribution resulting solely from the ir...

  8. Linear accelerator-based stereotactic radiosurgery in 140 brain metastases from malignant melanoma

    OpenAIRE

    Hauswald, Henrik; Stenke, Alina; Debus, Jürgen; Combs, Stephanie E

    2015-01-01

    Background: To retrospectively access outcome and prognostic parameters of linear accelerator-based stereotactic radiosurgery in brain metastases from malignant melanoma. Methods: Between 1990 and 2011 140 brain metastases in 84 patients with malignant melanoma (median age 56 years) were treated with stereotactic radiosurgery. At initial stereotactic radiosurgery 48 % of patients showed extracerebral control. The median count of brain metastases in a single patient was 1, the median diamete...

  9. The treatment of a large acoustic tumor with fractionated stereotactic radiotherapy

    OpenAIRE

    McClelland, Shearwood; Gerbi, Bruce J.; Cho, Kwan H.; Hall, Walter A.

    2007-01-01

    The treatment of acoustic neuromas (AN) usually involves surgical excision or stereotactic radiosurgery. However, for large AN (mean diameter > 3 cm), stereotactic radiosurgery is rarely used, leaving patients with limited noninvasive treatment options. Recently, the use of fractionated stereotactic radiotherapy (FSRT) has been effective in treating small to medium-sized AN. We present a patient with a large AN treated with FSRT. The patient was a 43-year-old man presenting with imbalance, ti...

  10. Quality assurance in stereotactic radiosurgery/radiotherapy according to DIN 6875-1

    OpenAIRE

    Mack, A.; Mack, G.; Scheib, S.; Czempiel, H; Kreiner, H. J.; Lomax, N J; Gianolini, S.; Rieker, M.; Weltz, D.; Wolff, R.; Muacevic, A.; Wowra, B.; Böttcher, H. D.; Seifert, V

    2004-01-01

    The new DIN (' Deutsche Industrie- Norm') 6875- 1, which is currently being finalised, deals with quality assurance ( QA) criteria and tests methods for linear accelerator and Gamma Knife stereotactic radiosurgery/ radiotherapy including treatment planning, stereotactic frame and stereotactic imaging and a system test to check the whole chain of uncertainties. Our existing QA program, based on dedicated phantoms and test procedures, has been refined to fulfill the demands of this new DIN. The...

  11. Application of Guided Imagery to Facilitate the Transition of New Graduate Registered Nurses

    OpenAIRE

    Boehm, Laura B.; Tse, Alice M.

    2013-01-01

    Traditionally, the new graduate registered nurse (RN) transition has included a didactic and skills-based orientation accompanied by a period of preceptored practice. However, these methods do not ensure that new RNs are in a state of reduced anxiety to fully interact with their new environment. Transition to practice may cause anxiety, and the new graduate RN may perceive moderate to severe stress. One method of stress reduction is the use of guided imagery, which has shown strong potential ...

  12. Application of a Magnetostrictive Guided wave Technique to Monitor the Evolution of Defect Signals

    Energy Technology Data Exchange (ETDEWEB)

    Cheong, Yong-Moo; Oh, Se-Beom; Lee, Duck-Hyun [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2015-10-15

    An advantage of a magnetostrictive strip transducer for a long-range guided wave inspection is that wave patterns are clear and simple when compared to a conventional piezoelectric ultrasonic transducer. Therefore, if we can characterize the evolution of defect signals, it could be a promising tool for a structural health monitoring of pipes for a long period of time as well as an identification of flaw. Of course, when evaluating a signal during a realistic field examination, it should be careful because of some spurious signals or false indications, such as signals due to a directionality, multiple reflections, mode conversion, geometrical reflections etc. Therefore, the different frequency components of the guided waves will travel at different speeds and the shape of the received signal will changed as it propagates along the pipe. Once the magnetostrictive sensors are attached in the pipe permanently and the signal shape and phase can be compared to the signals before and after, we can monitor the evolution of the flow for the given period. We developed a program to subtract the guided wave signal. The program has a capability of adjusting the time scale and can minimize the noise level after subtraction. By applying the newly developed program, a notch with 2% of CSA can be detected with increased accuracy with noise reduction.

  13. Clinical Application of CT-guided Preoperative Pulmonary Nodule Localization Technique

    Directory of Open Access Journals (Sweden)

    Yiming NI

    2011-05-01

    Full Text Available Background and objective It’s difficult to localize the accurate position for some pulmonary nodules in video-assisted thoracoscopic surgery (VATS wedge resection. The aim of this study is to retrospectively analyze the clinical significance of CT-guided preoperative pulmonary nodule localization technique. Methods Between Jan 2010 and Apr 2011, 20 patients of the First Affiliated Hospital of Medical School of Zhejiang University underwent preoperative pulmonary nodule localization technique before performing VATS wedge resection of the pulmonary nodule. Diameter of the lesion ranges from 0.5 cm to 2 cm (average 9.8 cm±5.3 cm. It was evaluated with the success rate in localization technique, rate of localization related complications, and rate of transferring thoracotomy. Results Eighteen patients underwent successful CT-guided Hookwire localization, with the average time of 14.5 minutes. There was no serious complications. Conclusion CT-guided preoperative pulmonary nodule localization is a promising technique for small solitary pulmonary nodules. It could play an important role in accurate localization of small pulmonary nodules, and it is a safe technique with less postoperative complications.

  14. The clinical application of CT-guided percutaneous biopsy in the diagnosis of bone lesions

    International Nuclear Information System (INIS)

    Objective: To evaluate the clinical value of CT-guided percutaneous biopsy for bone lesions. Methods: Forty-Eight patients with different sited bone lesions had received the procedure of CT guided percutaneous biopsy from July 2003 to January 2005, including 34 cases only with complete clinical records. The procedure was carried out with patient lied on CT table and followed by localization scanning to demonstrate the best sites for puncture and biopsy route. 11-14 G bone puncture needle or 18 G trigger type biopsy needle was undertaken to penetrate into the lesion for obtaining specimens under local anesthesia and CT monitoring and in turn for fixation with 10% formalin to have pathologic examination. Results: The whole procedure finished within 20-40 minutes with adequate samples obtained for pathologic examination of all cases. Confirmed diagnosis was made in 30 cases with an accuracy of 91.2% and no correlative complications were found. Conclusions: The CT-guided percutaneous biopsy is safe and efficient for diagnosis of bone lesions, deserving to be extensively used. (authors)

  15. Breast tissue bulge and lesion visibility during stereotactic biopsy – A phantom study

    International Nuclear Information System (INIS)

    Background: During mammography guided stereotactic breast biopsy a bulge of tissue can form in the paddle needle biopsy aperture. This bulge has been estimated to have a height of up to 30% of the breast itself. During clinical biopsy we have noticed that lesions can appear to be less visible when tissue bulges are evident. This can make biopsy more difficult in some cases. Objectives: This experiment investigates how lesion visibility varies with breast bulge magnitude. Method: Using a phantom to represent breast and breast bulge, lesion visibility was assessed using a two alternative forced choice methodology. To mimic clinical conditions, imaging was performed on a full field digital mammography system with the biopsy paddle attached using an automatic exposure device. Organ dose (breast) was estimated. Results: As breast bulge increases lesion visibility decreases; organ dose increases as breast bulge magnitude increases. Conclusion: Consideration should be given to the impact of breast bulge magnitude and lesion visibility when performing image guided biopsy. Advances in knowledge: The authors found no similar studies and the results of this study demonstrate a potential clinical risk

  16. Extracranial doses during stereotactic radiosurgery and fractionated stereotactic radiotherapy measured with thermoluminescent dosimeter in vivo

    Energy Technology Data Exchange (ETDEWEB)

    Kim, I.H.; Lim, D.H.; Kim, S.; Hong, S.; Kim, B.K.; Kang, W-S.; Wu, H.G.; Ha, S.W.; Park, C.I. [Seoul National University College of Medicine, Department of Therapeutic Radiology (Korea)

    2000-05-01

    Recently the usage of 3-dimensional non-coplanar radiotherapy technique is increasing. We measured the extracranial dose and its distribution g the above medical procedures to estimate effect of exit doses of stereotactic radiosurgery (SRS) and fractionated stereotactic radiotherapy (FSRT) of the intracranial target lesions using a linac system developed in our hospital. Among over hundred patients who were treated with SRS or FSRT from 1995 to 1998, radiation dosimetry data of 15 cases with SRS and 20 cases with FSRT were analyzed. All patients were adults. Of SRS cases, 11 were male and 4 were female. Vascular malformation cases were 9, benign tumors were 3, and malignant tumors were 3. Of FSRT cases, males were 12 and females were 8. Primary malignant brain tumors were 5, benign tumors were 6, and metastatic brain tumors were 10. Doses were measured with lithium fluoride TLD chips (7.5% Li-6 and 92.5% Li-7; TLD-100, Harshaw/Filtrol, USA). The chips were attached patient's skin at the various extracranial locations during SRS or FSRT. For SRS, 14-25 Gy were delivered with 1-2 isocenters using 12-38 mm circular tertiary collimators with reference to 50-80% isodose line conforming at the periphery of the target lesions. For FSRT, 5-28 fractions were used to deliver 9-56 Gy to periphery with dose maximum of 10-66 Gy. Both procedures used 6 MV X-ray generated from Clinac-18 (Varian, USA). For SRS procedures, extracranial surface doses (relative doses) were 8.07{+-}4.27 Gy (0.31{+-}0.16% Mean{+-}S.D.) at the upper eyelids, 6.13{+-}4.32 Gy (0.24{+-}0.16%) at the submental jaw, 7.80{+-}5.44 Gy (0.33{+-}0.26%) at thyroid, 1.78{+-}0.64 Gy (0.07{+-}0.02%) at breast, 0.75{+-}0.38 Gy (0.03{+-}0.02%) at umbilicus, 0.40{+-}0.07 Gy (0.02{+-}0.01%) at perineum, and 0.46{+-}0.39 Gy (0.02{+-}0.01%) at scrotum. Thus the farther the distance from the brain, the less the dose to the location. In overall the doses were less than 0.3% and thus less detrimental. For FSRT procedures

  17. Extracranial doses during stereotactic radiosurgery and fractionated stereotactic radiotherapy measured with thermoluminescent dosimeter in vivo

    International Nuclear Information System (INIS)

    Recently the usage of 3-dimensional non-coplanar radiotherapy technique is increasing. We measured the extracranial dose and its distribution g the above medical procedures to estimate effect of exit doses of stereotactic radiosurgery (SRS) and fractionated stereotactic radiotherapy (FSRT) of the intracranial target lesions using a linac system developed in our hospital. Among over hundred patients who were treated with SRS or FSRT from 1995 to 1998, radiation dosimetry data of 15 cases with SRS and 20 cases with FSRT were analyzed. All patients were adults. Of SRS cases, 11 were male and 4 were female. Vascular malformation cases were 9, benign tumors were 3, and malignant tumors were 3. Of FSRT cases, males were 12 and females were 8. Primary malignant brain tumors were 5, benign tumors were 6, and metastatic brain tumors were 10. Doses were measured with lithium fluoride TLD chips (7.5% Li-6 and 92.5% Li-7; TLD-100, Harshaw/Filtrol, USA). The chips were attached patient's skin at the various extracranial locations during SRS or FSRT. For SRS, 14-25 Gy were delivered with 1-2 isocenters using 12-38 mm circular tertiary collimators with reference to 50-80% isodose line conforming at the periphery of the target lesions. For FSRT, 5-28 fractions were used to deliver 9-56 Gy to periphery with dose maximum of 10-66 Gy. Both procedures used 6 MV X-ray generated from Clinac-18 (Varian, USA). For SRS procedures, extracranial surface doses (relative doses) were 8.07±4.27 Gy (0.31±0.16% Mean±S.D.) at the upper eyelids, 6.13±4.32 Gy (0.24±0.16%) at the submental jaw, 7.80±5.44 Gy (0.33±0.26%) at thyroid, 1.78±0.64 Gy (0.07±0.02%) at breast, 0.75±0.38 Gy (0.03±0.02%) at umbilicus, 0.40±0.07 Gy (0.02±0.01%) at perineum, and 0.46±0.39 Gy (0.02±0.01%) at scrotum. Thus the farther the distance from the brain, the less the dose to the location. In overall the doses were less than 0.3% and thus less detrimental. For FSRT procedures, dose ranged 1.7 to 4.0 Gy in the

  18. MRI-only lesions: application of diffusion-weighted imaging obviates unnecessary MR-guided breast biopsies

    Energy Technology Data Exchange (ETDEWEB)

    Spick, Claudio; Pinker-Domenig, Katja; Helbich, Thomas H.; Baltzer, Pascal A. [Medical University of Vienna (AKH), General Hospital Vienna, Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Wien (Austria); Rudas, Margaretha [Medical University of Vienna (AKH), Clinical Institute of Pathology, Wien (Austria)

    2014-06-15

    To assess if the application of diffusion-weighted imaging (DWI) obviates unnecessary MR-guided biopsies in suspicious breast lesions visible only on contrast-enhanced MRI (CE-MRI). This institutional review board (IRB)-approved, retrospective, single-centre study included 101 patients (mean age, 49.5; SD 13.9 years) who underwent additional DWI at 1.5 T prior to MRI-guided biopsy of 104 lesions classified as suspicious for malignancy and visible on CE-MRI only. An experienced radiologist, blinded to histopathologic and follow-up results, measured apparent diffusion coefficient (ADC) values obtained from DWI. Diagnostic accuracy was investigated using receiver operating characteristics (ROC) analysis. Histopathology revealed 20 malignant and 84 benign lesions. Lesions were masses in 61 (15 malignant, 24.6 %) and non-masses in 43 cases (five malignant, 11.6 %). Mean ADC values were 1.53 ± 0.38 x 10{sup -3} mm{sup 2}/s in benign lesions and 1.06 ± 0.27 x 10{sup -3} mm{sup 2}/s in malignant lesions. ROC analysis revealed exclusively benign lesions if ADC values were greater than 1.58 x 10{sup -3} mm{sup 2}/s. As a consequence, 29 false-positive biopsies (34.5 %) could have been avoided without any false-negative findings. Both in mass and in non-mass lesions, rule-in and rule-out criteria were identified using flexible ADC thresholds based on ROC analysis. Additional application of DWI in breast lesions visible only on MRI can avoid false-positive, MR-guided biopsies. Thus, DWI should be an integral part of breast MRI protocols. (orig.)

  19. Stereotactic radiosurgery for primary trigeminal neuralgia: state of the evidence and recommendations for future reports

    OpenAIRE

    Lopez, B.; Hamlyn, P; Zakrzewska, J.

    2004-01-01

    Objective: To identify systematically all the studies reporting outcomes and complications of stereotactic radiosurgery for trigeminal neuralgia and to evaluate them against predefined quality criteria.

  20. The Environment for Application Software Integration and Execution (EASIE) version 1.0. Volume 4: System installation and maintenance guide

    Science.gov (United States)

    Randall, Donald P.; Jones, Kennie H.; Rowell, Lawrence F.

    1988-01-01

    The Environment for Application Software Integration and Execution (EASIE) provides both a methodology and a set of software utility programs to ease the task of coordinating engineering design and analysis codes. This document provides necessary information for installing the EASIE software on a host computer system. The target host is a DEX VAX running VMS version 4; host dependencies are noted when appropriate. Relevant directories and individual files are identified, and compile/load/execute sequences are specified. In the case of the data management utilities, database management system (DBMS) specific features are described in an effort to assist the maintenance programmer in converting to a new DBMS. The document also describes a sample EASIE program directory structure to guide the program implementer in establishing his/her application dependent environment.

  1. 大脑中央区脑囊虫病灶的立体定向手术治疗%Analysis of neurocysticercosis in the central region by stereotactic open surgery

    Institute of Scientific and Technical Information of China (English)

    夏成雨; 牛朝诗; 凌士营

    2011-01-01

    目的 探讨CT或MRI导向的立体定向手术切除中央区脑囊虫病灶的应用价值,总结手术治疗的经验.方法 采用Lesell-G型立体定向仪,在CT或MRI导向下对25例中央区脑囊虫病灶,通过环钻开颅和显微外科技术摘除病灶.结果 25例脑囊虫病灶均能精确定位后完全切除,全组无新的神经功能损伤出现.结论 CT或MRI导向下的立体定向手术治疗中央区脑囊虫病灶安全有效.%Objective To discuss the experience and value of CT/MRI guided stereotactic open surgery on the treatment of neurocysticercosis in the central region. Methods 25 patients with neurocysticercosis underwent resection of the lesions in the central region by CT/MRI guided Leksell-G type stereotactic system, through craniectomy by trepan and microsurgical skills. Results Total resection was performed in all 25 patients with lesions of neurocysticercosis in the cental region without new neurological deficit or mortality. Conclusion CT/MRI guided stereotactic open surgery is a safety and effective method for treatment of the lesions of neurocysticercosis in the central region.

  2. Cone-beam computed tomography in hypofractionated stereotactic radiotherapy for brain metastases

    Directory of Open Access Journals (Sweden)

    Ingrosso Gianluca

    2012-04-01

    Full Text Available Abstract Background To assess interfraction translational and rotational setup errors, in patients treated with image-guded hypofractionated stereotactic radiotherapy, immobilized by a thermoplastic mask and a bite-block and positioned using stereotactic coordinates. Methods 37 patients with 47 brain metastases were treated with hypofractionated stererotactic radiotherapy. All patients were immobilized with a combination of a thermoplastic mask and a bite-block fixed to a stereotactic frame support. Daily cone-beam CT scans were acquired for every patient before the treatment session and were matched online with planning CT images, for 3D image registration. The mean value and standard deviation of all translational (X, Y, Z and rotational errors (θx, θy, θz were calculated for the matching results of bone matching algorithm. Results A total of 194 CBCT scans were analyzed. Mean +/- standard deviation of translational errors (X, Y, Z were respectively 0.5 +/- 1.6 mm (range -5.7 and 5.9 mm in X; 0.4 +/- 2.7 mm (range -8.2 and 12.1 mm in Y; 0.4 +/- 1.9 mm (range -7.0 and 14 mm in Z; median and 90th percentile were respectively within 0.5 mm and 2.4 mm in X, 0.3 mm and 3.2 mm in Y, 0.3 mm and 2.2 mm in Z. Mean +/- standard deviation of rotational errors (θx, θy, θz were respectively 0.0 degrees+/- 1.3 degrees (θx (range -6.0 degrees and 3.1 degrees; -0.1 degrees +/- 1.1 degrees (θy (range -3.0 degrees and 2.4 degrees; -0.6 degrees +/- 1.4 degrees (θz (range -5.0 degrees and 3.3 degrees. Median and 90th percentile of rotational errors were respectively within 0.1 degrees and 1.4 degrees (θx, 0.0 degrees and 1.2 degrees (θy, 0.0 degrees and 0.9 degrees (θz. Mean +/- SD of 3D vector was 3.1 +/- 2.1 mm (range 0.3 and 14.9 mm; median and 90th percentile of 3D vector was within 2.7 mm and 5.1 mm. Conclusions Hypofractionated stereotactic radiotherapy have the significant limitation of uncertainty in interfraction repeatability of the patient

  3. A Smartphone Application for Landscape Plants: A Case Study and Guide to Developing a Decision-Making Application

    Science.gov (United States)

    Hansen, Gail; Purcell, Scott

    2012-01-01

    Smart phone applications are rapidly gaining popularity, and Extension programs are eager to use this teaching tool. But developing an application can be time intensive and costly. Students in environmental horticulture at the University of Florida teamed with the Florida-Friendly Landscaping™ program to develop an application with an extensive…

  4. The use of RapidArc volumetric-modulated arc therapy to deliver stereotactic radiosurgery and stereotactic body radiotherapy to intracranial and extracranial targets

    Energy Technology Data Exchange (ETDEWEB)

    Roa, Dante E., E-mail: droa@uci.edu [Department of Radiation Oncology, Chao Family Comprehensive Cancer Center, University of California, Irvine-Medical Center, Orange, CA (United States); Schiffner, Daniel C.; Zhang Juying; Dietrich, Salam N.; Kuo, Jeffrey V.; Wong, Jason; Ramsinghani, Nilam S.; Al-Ghazi, Muthana S.A.L. [Department of Radiation Oncology, Chao Family Comprehensive Cancer Center, University of California, Irvine-Medical Center, Orange, CA (United States)

    2012-10-01

    Twenty-three targets in 16 patients treated with stereotactic radiosurgery (SRS) or stereotactic body radiotherapy (SBRT) were analyzed in terms of dosimetric homogeneity, target conformity, organ-at-risk (OAR) sparing, monitor unit (MU) usage, and beam-on time per fraction using RapidArc volumetric-modulated arc therapy (VMAT) vs. multifield sliding-window intensity-modulated radiation therapy (IMRT). Patients underwent computed tomography simulation with site-specific immobilization. Magnetic resonance imaging fusion and optical tracking were incorporated as clinically indicated. Treatment planning was performed using Eclipse v8.6 to generate sliding-window IMRT and 1-arc and 2-arc RapidArc plans. Dosimetric parameters used for target analysis were RTOG conformity index (CI{sub RTOG}), homogeneity index (HI{sub RTOG}), inverse Paddick Conformity Index (PCI), D{sub mean} and D5-D95. OAR sparing was analyzed in terms of D{sub max} and D{sub mean}. Treatment delivery was evaluated based on measured beam-on times delivered on a Varian Trilogy linear accelerator and recorded MU values. Dosimetric conformity, homogeneity, and OAR sparing were comparable between IMRT, 1-arc RapidArc and 2-arc RapidArc plans. Mean beam-on times {+-} SD for IMRT and 1-arc and 2-arc treatments were 10.5 {+-} 7.3, 2.6 {+-} 1.6, and 3.0 {+-} 1.1 minutes, respectively. Mean MUs were 3041, 1774, and 1676 for IMRT, 1-, and 2-arc plans, respectively. Although dosimetric conformity, homogeneity, and OAR sparing were similar between these techniques, SRS and SBRT fractions treated with RapidArc were delivered with substantially less beam-on time and fewer MUs than IMRT. The rapid delivery of SRS and SBRT with RapidArc improved workflow on the linac with these otherwise time-consuming treatments and limited the potential for intrafraction organ and patient motion, which can cause significant dosimetric errors. These clinically important advantages make image-guided RapidArc useful in the delivery

  5. Clinical application of CT-guided 125I seed interstitial implantation for local recurrent rectal carcinoma

    International Nuclear Information System (INIS)

    The present study aimed to explore the safety profile and clinical efficacy of CT-guided radioactive seed implantation in treating local recurrent rectal carcinoma. CT-guided 125I seed implantation was carried out in 20 patients with locally recurrent rectal carcinoma. 14 of the 20 patient had prior adjuvant external-beam radiation therapy (EBRT). The treatment planning system (TPS) was used preoperatively to reconstruct three dimensional images of the tumor and to calculate the estimated seed number and distribution. The median matched peripheral dose (MPD) was 120 Gy (range, 100-160 Gy). Of the 20 patients, 12 were male, 8 were female, and ages ranged from 38 to 78, with a median age of 62. Duration of follow-up was 3-34 months. The response rate of pain relief was 85% (17/20). Repeat CT scan 2 months following the procedure revealed complete response (CR) of the tumor in 2 patients, partial response (PR) in 13 patients, stable disease (SD) in 3 patients, and progressive disease (PD) in 2 patients. 75% of patients had either CR or PR. Median survival time was 18.8 months (95% CI: 3.5-22.4 months). 1 and 2 year survival rates were 75% and 25%, respectively. 4 patients died of recurrent tumor; 4 patients died of distant metastases; 9 patients died of recurrent tumor and distant metastases. 3 patients survived after 2 year follow up. Two patients were found to have mild hematochezia, which was reversible with symptomatic management. CT-guided 125I seed implantation appeared to be a safe, useful and less complicated interventional treatment option for local recurrent rectal carcinoma

  6. Dosimetric comparison of linear accelerator-based stereotactic radiosurgery systems

    OpenAIRE

    Sharma S; Kumar Sudhir; Dagaonkar S; Bisht Geetika; Dayanand S; Devi Reena; Deshpande S; Chaudhary S; Bhatt B; Kannan S

    2007-01-01

    Stereotactic radiosurgery (SRS) is a special radiotherapy technique used to irradiate intracranial lesions by 3-D arrangements of narrow photon beams eliminating the needs of invasive surgery. Three different tertiary collimators, namely BrainLab and Radionics circular cones and BrainLab micro multileaf collimator (mMLC), are used for linear accelerator-based SRS systems (X-Knife). Output factor (St), tissue maximum ratio (TMR) and off axis ratio (OAR) of these three SRS systems were measured...

  7. Endovascular Therapy Followed by Stereotactic Radiosurgery for Cerebral Arteriovenous Malformations

    OpenAIRE

    Arai, Y.; Handa, Y.; Ishii, H; Ueda, Y.; Uno, H; Nakajima, T.; Hirose, S; Kubota, T.

    2006-01-01

    Pre-radiosurgical embolization was carried out using cyanoacrylate in seven of 13 patients with cerebral arteriovenous malformations (AVMs) treated by stereotactic radiosurgery (SRS) with a linear accelerator (LINAC). The aim of embolization before SRS was the reduction of AVM volume and/or the elimination of vascular structures bearing an increased risk of haemorrhage. Staged-volume SRS was also performed in two patients because of residual irregular shaped nidus of AVMs even after the embol...

  8. Linear accelerator based stereotactic radiosurgery for melanoma brain metastases

    OpenAIRE

    Bernard, Mark E.; Wegner, Rodney E; Katharine Reineman; Dwight E Heron; John Kirkwood; Burton, Steven A; Mintz, Arlan H.

    2012-01-01

    Purpose: Melanoma is one of the most common malignancies to metastasize to the brain. Many patients with this disease will succumb to central nervous system (CNS) disease, highlighting the importance of effective local treatment of brain metastases for both palliation and survival of the disease. Our objective was to evaluate the outcomes associated with stereotactic radiosurgery (SRS) in the treatment of melanoma brain metastases. Materials and Methods: We retrospectively reviewed 54 pa...

  9. Stereotactic body radiotherapy in lung cancer: an update

    Energy Technology Data Exchange (ETDEWEB)

    Abreu, Carlos Eduardo Cintra Vita; Ferreira, Paula Pratti Rodrigues; Moraes, Fabio Ynoe de; Neves Junior, Wellington Furtado Pimenta; Carvalho, Heloisa de Andrade, E-mail: heloisa.carvalho@hc.fm.usp.br [Hospital Sirio-Libanes, Sao Paulo, SP (Brazil). Departamento de Radioterapia; Gadia, Rafael [Hospital Sirio-Libanes, Brasilia, DF (Brazil). Departamento de Radioterapia; Universidade de Sao Paulo (USP), Sao Paulo, SP (Brazil). Departamento de Radiologia e Oncologia. Servico de Radioterapia

    2015-07-15

    For early-stage lung cancer, the treatment of choice is surgery. In patients who are not surgical candidates or are unwilling to undergo surgery, radiotherapy is the principal treatment option. Here, we review stereotactic body radiotherapy, a technique that has produced quite promising results in such patients and should be the treatment of choice, if available. We also present the major indications, technical aspects, results, and special situations related to the technique. (author)

  10. Stereotactic radiosurgery in hemangioblastoma: Experience over 14 years

    OpenAIRE

    Nishant Goyal; Deepak Agrawal; Raghav Singla; Shashank Sharad Kale; Manmohan Singh; Bhawani Shankar Sharma

    2016-01-01

    Background: Although gamma knife has been advocated for hemangioblastomas, it is not used widely by neurosurgeons. Objective: We review our experience over 14 years in an attempt to define the role of stereotactic radiosurgery (SRS) in the management of hemangioblastomas. Patients and Methods: A retrospective study was conducted on all patients of hemangioblastoma who underwent SRS at our institute over a period of 14 years (1998–2011). Gamma knife plans, clinical history, and radiology were ...

  11. Stereotactic radiosurgery: a “targeted” therapy for cancer

    OpenAIRE

    Liang-Fu Han; Ming Zeng

    2012-01-01

    The developments of medicine always follow innovations in science and technology. In the past decade, such innovations have made cancer-related targeted therapies possible. In general, the term "targeted therapy" has been used in reference to cellular and molecular level oriented therapies. However, improvements in the delivery and planning of traditional radiation therapy have also provided cancer patients more options for "targeted" treatment, notably stereotactic radiosurgery (SRS) and ste...

  12. Unique nucleotide sequence-guided assembly of repetitive DNA parts for synthetic biology applications

    Energy Technology Data Exchange (ETDEWEB)

    Torella, JP; Lienert, F; Boehm, CR; Chen, JH; Way, JC; Silver, PA

    2014-08-07

    Recombination-based DNA construction methods, such as Gibson assembly, have made it possible to easily and simultaneously assemble multiple DNA parts, and they hold promise for the development and optimization of metabolic pathways and functional genetic circuits. Over time, however, these pathways and circuits have become more complex, and the increasing need for standardization and insulation of genetic parts has resulted in sequence redundancies-for example, repeated terminator and insulator sequences-that complicate recombination-based assembly. We and others have recently developed DNA assembly methods, which we refer to collectively as unique nucleotide sequence (UNS)-guided assembly, in which individual DNA parts are flanked with UNSs to facilitate the ordered, recombination-based assembly of repetitive sequences. Here we present a detailed protocol for UNS-guided assembly that enables researchers to convert multiple DNA parts into sequenced, correctly assembled constructs, or into high-quality combinatorial libraries in only 2-3 d. If the DNA parts must be generated from scratch, an additional 2-5 d are necessary. This protocol requires no specialized equipment and can easily be implemented by a student with experience in basic cloning techniques.

  13. Digital imaging improves upright stereotactic core biopsy of mammographic microcalcifications

    Energy Technology Data Exchange (ETDEWEB)

    Whitlock, J.P.L.; Evans, A.J.; Burrell, H.C.; Pinder, S.E.; Ellis, I.O.; Blamey, R.W.; Wilson, A.R.M

    2000-05-01

    AIM: This comparative study was carried out to assess the effect of using digital images compared to conventional film-screen mammography on the accuracy of core biopsy of microcalcifications using upright stereotactic equipment. MATERIALS AND METHODS: The biopsy results from a consecutive series of 104 upright stereotactic 14-gauge core biopsies performed with conventional X-ray (Group A) were compared with 40 biopsies carried out using stereotaxis with digital imaging (Group B). In all cases specimen radiography was performed and analysed for the presence of calcifications. Pathological correlation was then carried out with needle and surgical histology. RESULTS: The use of digital add-on equipment increased the radiographic calcification retrieval rate from 55 to 85% (P < 0.005). The absolute sensitivity of core biopsy in pure ductal carcinoma in situ (DCIS) cases rose from 34 to 69% (P < 0.03), with the complete sensitivity increasing from 52 to 94% (P < 0.005). For DCIS with or without an invasive component the absolute sensitivity rose from 41 to 67% (P = 0.052), while the complete sensitivity was 59% before and 86% after the introduction of digital imaging (P < 0.04). CONCLUSION: Digital equipment improves the performance of upright stereotactic core biopsy of microcalcifications, giving a significantly increased success rate in accurately obtaining calcifications. This leads to an improvement in absolute and complete sensitivity of core biopsy when diagnosing DCIS. Whitlock, J.P.L. (2000)

  14. Linear-accelerator-based stereotactic irradiation for metastatic brain tumors

    Energy Technology Data Exchange (ETDEWEB)

    Takemoto, Mitsuhiro; Katsui, Kuniaki; Yoshida, Atsushi [Okayama Univ. (Japan). School of Medicine] [and others

    2003-05-01

    To assess the safety and availability of stereotactic radiotherapy (SRT) for metastatic brain tumors, we reviewed 54 consecutive cases with a total of 118 brain metastases treated with linear-accelerator-based stereotactic irradiation (STI). Nineteen patients with a total of 27 brain tumors that were larger than 3 cm or close to critical normal tissues were treated with SRT. The marginal dose of SRT was 15-21 Gy (median 21 Gy) in 3 fractions for 3 days. The median marginal dose of stereotactic radiosurgery (SRS) was 20 Gy. Effective rates of imaging studies were 72.7% and 94.4%, and those of clinical symptoms were 46.7% and 55.6% for SRT and SRS, respectively. One-year and two-year survival rates of SRT were 40.9% and 17.6%, respectively, and the median follow-up period was 6.4 months. The one-year survival rate of SRS was 32.7%, with a median follow-up of 4.6 months. Fourteen cases (7 cases each) had recurrent tumors at STI sites. Early complications were observed in one case of SRT and 8 cases of SRS, and late complications occurred in 3 cases of SRS. There were no significant differences among effective rates, survival rates, median follow-up times, recurrence rates, and complications between SRT and SRS. We concluded that SRT is a safe, effective therapy for large or eloquent area metastases. (author)

  15. DVHs evaluation in brain metastases stereotactic radiotherapy treatment plans

    International Nuclear Information System (INIS)

    Purpose: The aim of this work is to report a retrospective study of radiobiological indicators based on Dose-Volume Histograms analysis obtained by stereotactic radiotherapy treatments. Methods and materials: Fifty-five patients for a total of sixty-seven brain metastases with a mean target volume of 8.49 cc were treated by Dynamic Conformal Arc Therapy (DCAT) and Intensity-Modulated Stereotactic Radiotherapy (IMRST). The Delivered prescription dose was chosen on the basis of tumor size and location so as to ensure a 100% isodose coverage to the target volume. Results: The treatment plans reported a mean value of 10% and 2.19% for the inhomogeneity and conformal index, respectively. The F factor showed we overdosed sixty-three patients delivering an additional 7% dose more than calculated values. The radiobiological parameters: TCP and NTCP showed a complete tumor control limiting the organs at risk damage. Conclusion: One goal of stereotactic radiotherapy is to design a treatment plan in which the steep dose gradient achievable minimizes the amount of radiation delivered outside the tumor region. This technique allows to deliver a much larger dose to the target without exceeding the radiation-related tolerance of normal tissues and improving patients' quality of life

  16. Safety and Efficacy of Frameless Stereotactic Brain Biopsy Techniques

    Institute of Scientific and Technical Information of China (English)

    Qiu-jian Zhang; Wen-hao Wang; Xiang-pin Wei; Yi-gang Yu

    2013-01-01

    Objective To explore the safety and efficacy of frameless stereotactic brain biopsy.MethodsDiagnosticaccuracy was calculatedby comparing biopsy diagnosis with definitive pathology in 62 patients who underwent frameless stereotactic brain biopsy between January 2008 and December 2010in Xiamen University Southeast Hospital. Preoperative characteristics and histological diagnosis werereviewed and then information was analysed to identify factors associated with the biopsy not yielding a diagnosis and complications.ResultsDiagnostic yield was 93.5%. No differences were found between pathological diagnosis andfrozen pathological diagnosis. The most common lesions were astrocytic lesions, included 16 cases of low-grade glioma and 12 cases of malignant glioma.Remote hemorrhage, metastasis, and lymphoma werefollowing in incidence. Multiple brain lesions were found in 17 cases (27.4%). Eleven cases were frontal lesions (17.7%), 8 were frontotemporal (12.9%), 6 were frontoparietal (9.7%), and 5 each were temporal,parietal, and parietotemporal lesions (8.1%).Postoperative complications occurred in 21.0% of the patients after biopsies,including 10 haemorrhages (16.1%) and 3 temporary neurological deficits (1 epilepsy, 1headache, and 1 partial hemiparesis). No patient required operation for hematoma evacuation.Conclusion Frameless stereotactic biopsy is an effective and safetechnique for histologic diagnosis of brain lesions, particularly for multifocal and frontal lesions.

  17. Stereotactic Radiotherapy for Adrenal Gland Metastases: University of Florence Experience

    Energy Technology Data Exchange (ETDEWEB)

    Casamassima, Franco, E-mail: f.casamassima@dfc.unifi.it [Clinical Radiobiological Institute, University of Florence, Florence (Italy); Livi, Lorenzo [Department of Radiation-Oncology, University of Florence, Florence (Italy); Masciullo, Stefano; Menichelli, Claudia; Masi, Laura [Clinical Radiobiological Institute, University of Florence, Florence (Italy); Meattini, Icro [Department of Radiation-Oncology, University of Florence, Florence (Italy); Bonucci, Ivano [Clinical Radiobiological Institute, University of Florence, Florence (Italy); Agresti, Benedetta; Simontacchi, Gabriele [Department of Radiation-Oncology, University of Florence, Florence (Italy); Doro, Raffaela [Clinical Radiobiological Institute, University of Florence, Florence (Italy)

    2012-02-01

    Purpose: To evaluate a retrospective single-institution outcome after hypofractionated stereotactic body radiotherapy (SBRT) for adrenal metastases. Methods and Materials: Between February 2002 and December 2009, we treated 48 patients with SBRT for adrenal metastases. The median age of the patient population was 62.7 years (range, 43-77 years). In the majority of patients, the prescription dose was 36 Gy in 3 fractions (70% isodose, 17.14 Gy per fraction at the isocenter). Eight patients were treated with single-fraction stereotactic radiosurgery and forty patients with multi-fraction stereotactic radiotherapy. Results: Overall, the series of patients was followed up for a median of 16.2 months (range, 3-63 months). At the time of analysis, 20 patients were alive and 28 patients were dead. The 1- and 2-year actuarial overall survival rates were 39.7% and 14.5%, respectively. We recorded 48 distant failures and 2 local failures, with a median interval to local failure of 4.9 months. The actuarial 1-year disease control rate was 9%; the actuarial 1- and 2-year local control rate was 90%. Conclusion: Our retrospective study indicated that SBRT for the treatment of adrenal metastases represents a safe and effective option with a control rate of 90% at 2 years.

  18. Stereotactic radiosurgery for intracranial lesions using a linear accelerator

    Energy Technology Data Exchange (ETDEWEB)

    Shoji, Kazufusa [Mie Univ., Tsu (Japan). School of Medicine; Toyota, Shun; Seta, Hidetoshi [and others

    1996-09-01

    Experiences in 47 cases of stereotactic radiosurgery were reported. The surgery was carried out using stereotactic radiosurgery system of Fisher STP system (Leibinger Co.). The accelerator was Clinac 2100c (Varian Co., 10 mV X ray) or EXL-15 SP (Mitsubishi Co., 6 mV) equipped with collimator. CT and MRI imaging data were firstly transported to the working station to determine the target volume, target coordinates and radiation dose. Irradiation from 90deg to -90deg directions from isocenter of the linac was done within an error of 1 mm after the actual measurement of the target on the port film. The treatment was necessary for 6-8 hr and and irradiation was essentially complete for it. The dose was 20 Gy for metastatic brain tumors (31 patients), 14-16 Gy for acoustic neuroma (1) and 16 Gy for arteriovenous malformation (1). The local control rate of the brain tumors was as high as 90%. The complication was cerebral necrosis (1 case) and exacerbation of neurological symptoms (1), which exhibited remission with steroid treatment. Thus stereotactic radiosurgery with linac made it possible to treat intracranial lesions without invasion effectively and safely. (K.H.)

  19. Immune Modulation and Stereotactic Radiation: Improving Local and Abscopal Responses

    Directory of Open Access Journals (Sweden)

    Jing Zeng

    2013-01-01

    Full Text Available New and innovative treatment strategies for cancer patients in the fields of immunotherapy and radiotherapy are rapidly developing in parallel. Among the most promising preclinical treatment approaches is combining immunotherapy with radiotherapy where early data suggest synergistic effects in several tumor model systems. These studies demonstrate that radiation combined with immunotherapy can result in superior efficacy for local tumor control. More alluring is the emergence of data suggesting an equally profound systemic response also known as “abscopal” effects with the combination of radiation and certain immunotherapies. Studies addressing optimal radiation dose, fractionation, and modality to be used in combination with immunotherapy still require further exploration. However, recent anecdotal clinical reports combining stereotactic or hypofractionated radiation regimens with immunotherapy have resulted in dramatic sustained clinical responses, both local and abscopal. Technologic advances in clinical radiation therapy has made it possible to deliver hypofractionated regimens anywhere in the body using stereotactic radiation techniques, facilitating further clinical investigations. Thus, stereotactic radiation in combination with immunotherapy agents represents an exciting and potentially fruitful new space for improving cancer therapeutic responses.

  20. Application of mobile digital communications in law enforcement, an introductory planning guide

    Science.gov (United States)

    Sohn, R. L.; Abraham, J. E.; Leflang, W. G.; Kennedy, R. D.; Wilson, J. H.; Gurfield, R. M.

    1975-01-01

    A set of planning guidelines for the application of digital communications techniques to law enforcement use is presented. Some essential characteristics of digital techniques and their applications are outlined, as are some principles of system analysis, evaluation, and planning. Requirements analysis, system concept design, implementation planning, and performance and cost modeling are described and demonstrated with respect to this application problem. Information on law enforcement digital communications systems and equipment and a list of vendor sources are given in appendices.

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

    Science.gov (United States)

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

    2014-09-01

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

  2. Fractionated stereotactic radiotherapy for skull base tumors: analysis of treatment accuracy using a stereotactic mask fixation system

    Directory of Open Access Journals (Sweden)

    Montagnoli Roberto

    2010-01-01

    Full Text Available Abstract Background To assess the accuracy of fractionated stereotactic radiotherapy (FSRT using a stereotactic mask fixation system. Patients and Methods Sixteen patients treated with FSRT were involved in the study. A commercial stereotactic mask fixation system (BrainLAB AG was used for patient immobilization. Serial CT scans obtained before and during FSRT were used to assess the accuracy of patient immobilization by comparing the isocenter position. Daily portal imaging were acquired to establish day to day patient position variation. Displacement errors along the different directions were calculated as combination of systematic and random errors. Results The mean isocenter displacements based on localization and verification CT imaging were 0.1 mm (SD 0.3 mm in the lateral direction, 0.1 mm (SD 0.4 mm in the anteroposterior, and 0.3 mm (SD 0.4 mm in craniocaudal direction. The mean 3D displacement was 0.5 mm (SD 0.4 mm, being maximum 1.4 mm. No significant differences were found during the treatment (P = 0.4. The overall isocenter displacement as calculated by 456 anterior and lateral portal images were 0.3 mm (SD 0.9 mm in the mediolateral direction, -0.2 mm (SD 1 mm in the anteroposterior direction, and 0.2 mm (SD 1.1 mm in the craniocaudal direction. The largest displacement of 2.7 mm was seen in the cranio-caudal direction, with 95% of displacements Conclusions The results indicate that the setup error of the presented mask system evaluated by CT verification scans and portal imaging are minimal. Reproducibility of the isocenter position is in the best range of positioning reproducibility reported for other stereotactic systems.

  3. Application of 2-D Position Sensitive Detector in Spatial Straightness Measurement of Guide Rails

    Institute of Scientific and Technical Information of China (English)

    GUO Lifeng; ZHANG Guoxiong; GONG Qiang; ZHENG Qi

    2005-01-01

    A laser collimating system based on 2-D position sensitive detector (PSD) is presented in this paper. The working principle of PSD is depicted in detail. A calibration device was developed to check the nonlinearity errors of PSD and a multilayer feedforward neural network based on error back-propagation algorithm was used to compensate errors. With the aid of computer-based data acquisition system, an automatic dynamic measuring process was realized. A series of experiments, including comparison tests with laser interferometer, were done to evaluate the performance of the measuring system. The experimental results show that the spatial straightness errors of guide rails can be measured with high accuracy. The maximum differences between the device and laser interferometer are 0.027 mm in Y direction, and 0.053 mm in X direction in the measuring distance of 6 m.

  4. Self-regulation theory: applications to medical education: AMEE Guide No. 58.

    Science.gov (United States)

    Sandars, John; Cleary, Timothy J

    2011-01-01

    Self-regulation theory, as applied to medical education, describes the cyclical control of academic and clinical performance through several key processes that include goal-directed behaviour, use of specific strategies to attain goals, and the adaptation and modification to behaviours or strategies to optimise learning and performance. Extensive research across a variety of non-medical disciplines has highlighted differences in key self-regulation processes between high- and low-achieving learners and performers. Structured identification of key self-regulation processes can be used to develop specific remediation approaches that can improve performance in academic and complex psycho-motor skills. General teaching approaches that are guided by a self-regulation perspective can also enhance academic performance. Self-regulation theory offers an exciting potential for improving academic and clinical performance in medical education. PMID:22022899

  5. AGV技术发展综述%Automatic Guided Vehicles System & Its Application

    Institute of Scientific and Technical Information of China (English)

    张正义

    2005-01-01

    @@ 定义 自动导引车系统AGVS(Automatic GuidedVehicles System)是指由自动导引车AGV和地面导引系统组成的、进行物料搬运作业的光机电信息技术一体化的系统.原美国物流协会对AGV的定义是:装备有电磁或光学等自动导引装置,能够沿规定的导引路径行驶,具有安全保护以及各种移载功能的运输车辆.

  6. Spatially varying Riemannian elasticity regularization: Application to thoracic CT registration in image-guided radiotherapy

    DEFF Research Database (Denmark)

    Bjerre, Troels; Hansen, Mads Fogtmann; Aznar, M.;

    2012-01-01

    For deformable registration of computed tomography (CT) scans in image guided radiation therapy (IGRT) we apply Riemannian elasticity regularization. We explore the use of spatially varying elasticity parameters to encourage bone rigidity and local tissue volume change only in the gross tumor...... volume (GTV) and the lungs. We evaluate the method on the point-validated 4DCT breathing thorax POPI-model and demonstrate its use and properties in registration of pre- and post-chemo CT scans for contour propagation in a Hodgkin lymphoma (HL) case showing significant tumor shrinkage. For the POPI......-model we achieved a total mean target registration error (TRE) of 0.92 ± 0.49 mm. Using spatially varying regularization for the HL case, deformation was limited to the GTV and lungs....

  7. Impact of lubrication on the tribological behaviour of PTFE composites for guide rings application

    Indian Academy of Sciences (India)

    M TRABELSI; M KHARRAT; M DAMMAK

    2016-09-01

    In this study, the friction and wear behaviours of polytetrafluoroethylene (PTFE)-based composites were comparatively evaluated under dry sliding and oil-lubricated conditions. Two PTFE composites filled with bronze and bronze $+$ molybdenum disulfide (MoS$_2$) were considered. These composites were used as guide rings for hydraulic actuating cylinder. Friction and wear tests of the composite specimens sliding against high chromium steel ball were conducted using reciprocating linear tribometer. The wear mechanisms of the composites under the two different sliding conditions were analysed and discussed based on scanning electron microscopic (SEM) examinationsof the worn surface and optical micrographs of the steel counterface. Under the oil-lubricated condition, the friction and wear behaviours of the composites were considerably improved if compared to that under the dry sliding. The oil adsorbed layer limited the transfer of the composite to the steel counterface and avoided the oxidation of the MoS$_2$ during the sliding test.

  8. Totally Accessible MRI A User's Guide to Principles, Technology, and Applications

    CERN Document Server

    Lipton, Michael L

    2008-01-01

    This is a practical guide that offers a lucid introduction to the principles of MRI physics. The author, recognized in the imaging community for his exceptional teaching methods and lectures, has written an easy to understand text. Each chapter explains the "why" and "how" behind MRI physics. Readers will understand how altering MRI parameters will have many different consequences for image quality and the speed in which images are generated. Practical topics, selected for their value to clinical practice, include progressive changes in key MRI parameters, imaging time, and signal to noise ratio. A wealth of high quality illustrations, complemented by concise text, enables readers to gain a thorough understanding of the subject without requiring prior in-depth knowledge

  9. Developing experimental protocols for chronic irradiation studies: the application of a good practice guide framework

    International Nuclear Information System (INIS)

    The EC-funded FASSET (Framework for Assessment of Environmental Impact) project collated information on the transfer, dosimetry, and effects of ionising radiation on wildlife. A major output from the project is the FASSET Radiation Effects Database (FRED). A review of the information contained within FRED highlighted that information on the effects of low-dose, chronic exposure was, at best, fragmentary. However, these data are required to define the dose effect relationships needed to underpin the assessment tools that are being developed. To address this requirement, a series of four Good Practice Guides (GPGs) has been produced as part of a protocol development framework. This framework aims to harmonise experimental approaches, with a view to ensuring that all necessary data on appropriate endpoints are collected, so that dose effect relationships can be determined. The GPGs cover test species selection, endpoint selection, radiation exposure and experimental design considerations. A key is used to guide researchers through the GPGs and the decisions made are recorded on an output pro-forma. The completed pro-forma forms the basis of the experimental protocol. The pro-forma also indicates the information that should be included when presenting the results of the experiment. Standardising approaches ensures that results are comparable between experiments and that they are suitable for determining dose effect relationships. This protocol development framework has been adopted by the UK Environment Agency as a document upon which future Agency-funded experimental work on the effects of chronic, low-level exposure to ionising radiation will be based. It is hoped that the framework will gain acceptance in the wider scientific community and facilitate addressing the knowledge gaps that have been identified in order that successful protection of non-human biota can be demonstrated. (author)

  10. Improved immobilization and verification of fractionated stereotactic radiotherapy

    International Nuclear Information System (INIS)

    Accepted radiobiological principles predict improved results in terms of late effects, when treatment is fractionated. With the advent of reliable relocatable stereotactic frames, fractionated stereotactic radiotherapy is becoming a standard tool in the treatment of brain malignancies. At the Ottawa Regional Cancer Centre we have developed a system for the delivery of fractionated stereotactic radiotherapy with the following unique features: 1) Very accurate, stable, reproducible, non-invasive BRW-compatible relocatable stereotactic frame, based on a custom made Cobalt-Chrome bite block with circumferential clasps that lock into the undercuts of the teeth. This design results in precise repositioning and virtually eliminates translational and rotational head motion. 2) Positional verification which consists of the following: a) CT verification: Following treatment planning the calculated Cartesian coordinates of the target centre are marked on the localizer frame with 0.5mm Pb shot. A CT slice is then obtained through the plane defined by the lead shots to verify the centre of the target volume. The lines connecting the opposed lead shots should intersect at the calculated isocentre. b) Check film: Patient setup is verified using 3 mm Pb shot placed on the patient's skin at each of the lateral laser crosses as well as the anterior laser cross. AP and lateral double exposure check films are then taken. The projected distances between the Pb shot at the isocentre (centre of the circular field) and the other Pb shot on the patient skin is measured and compared to the corresponding distances on the treatment plan and on the verification CT. c) PPMS: Our optically based Patient Position Monitoring system (PPM) is used to measure setup and treatment error. Measurements of patient and frame position are made in 3D with a resolution of better than 0.2 mm and accuracy of better than 0.4 mm. PPM is used to assist and verify setup and to record treatment position every 5

  11. Stereotactic vacuum-assisted biopsy of microcalcifications using an upright add-on type stereotactic mammography unit

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sung Hun; Lee, Jae Hee; Song, Byoung Joo; Jung, Sang Seol [The Catholic Univeristy of Korea, Seoul (Korea, Republic of)

    2007-09-15

    This study examined the yield of mammographically detected calcifications following a stereotactic vacuum-assisted biopsy (SVAB) using an upright add-on type stereotactic device. Ninety-two women underwent a SVAB between April 2002 and December 2005, and 90 calcifications obtained by the SVAB were evaluated retrospectively. The calcification retrieval rate was examined. The false negative and underestimation rates were determined by comparing the biopsy results with the results from surgery and follow-up mammography. The calcification retrieval rate was 97.8% (90/92). The histopathology of the 90 lesions was benign for 66 (73.3%), borderline for 3 (3.3%) and malignant for 21 (23.3%). A total of 22 malignancies were confirmed surgically. SVAB had a false negative rate of 4.5% (1/22). The underestimation rate of a surgically excised atypical ductal hyperplasia (ADH) and of ductal carcinoma in situ (DCIS) was 50% (1/2) and 10% (2/20), respectively. The use of SVAB with an upright add-on type stereotactic device is an efficient biopsy method for mammographically detected microcalcifications, with low false negative and high calcification retrieval rates.

  12. Environmental Guide Value (VGE) and specific reference values (QS) for uranium. Synthesis and elements for application to French fresh waters

    International Nuclear Information System (INIS)

    This report proposes a synthesis of works performed to determine criteria of protection of continental aquatic ecosystems with respect to uranium. These works resulted in the determination of an environmental guide value (VGE) for the assessment of the ecological and chemical condition of waters. Other specific reference values have been determined to be used in risk assessment: average annual concentration, maximum admissible concentration. After a recall of the methodology adopted for the determination of VGE in the case of uranium, the report discusses the specific reference values in the case of uranium for different organisms, for predators, for the protection of human health against a risk of exposure by consumption of fished products or drinkable water. The determination of VGE and its application are reported, and its consistency with the criterion of radiation protection of the environment applied to water and sediments is discussed. The determination of specific reference values is then discussed

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

    Energy Technology Data Exchange (ETDEWEB)

    Cusumano, Davide, E-mail: davide.cusumano@unimi.it [School of Medical Physics, University of Milan, Milan (Italy); Fumagalli, Maria L. [Health Department, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan (Italy); Marchetti, Marcello; Fariselli, Laura [Department of Neurosurgery, Radiotherapy Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan (Italy); De Martin, Elena [Health Department, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan (Italy)

    2015-10-01

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

  14. Guides d'ondes infrarouges pour applications en télécommunications, capteurs chimiques et biochimiques

    Science.gov (United States)

    Smektala, F.; Bureau, B.; Adam, J. L.; Lucas, J.

    2002-06-01

    Les énergies de phonons élevés des verres à base de silice limitent leurs applications dans l'infrarouge. Il devient donc incontournable de créer des verres à plus faible énergie de phonons pour développer une optique passive guidée opérationnelle dans l'IR moyen et pour réaliser de nouveaux guide d'ondes optiques activés par des lanthanides pouvant jouer le rôle soit d'amplificateurs optiques soit de fibres lasers. Les compositions de verres stables répondant à ces critères sont exceptionnelles et appartiennent aux familles chimiques des fluorures et des chalcogénures. Les verres de fluorures, convenablement dopés par des terres rares, ont permis la réalisation d'amplificateurs optiques opérant dans la fenêtre télecom de la silice (1.3 μm avec le praséodyme, 1.45 μm avec le thulium et 1.55 μm avec l'erbium. Les verres de chalcogénures permettent la réalisation de fibres opérationnelles jusqu'à 12 μm mais seulement pour des applications courtes distances telles que le transport d'énergie moyenne, la radiométrie à l'ambiante et la spectrométrie IR déportée par fibre optique de molécules chimiques ou de tissus biologiques.

  15. Development and application of stent-based image guided navigation system for oral and maxillofacial surgery

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Woo Jin; Kim, Dae Seung [Interdisciplinary Program in Radiation Applied Life Science, Dental Research Institute and BK21, College of Medicine, Seoul National University, Seoul (Korea, Republic of); Yi, Won Jin; Lee, Sam Sun; Choi, Soon Chul; Heo, Min Suk; Huh, Kyung Hoe; Kim, Myung Jin; Lee, Jee Ho [Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, Seoul (Korea, Republic of)

    2009-09-15

    The purpose of this study was to develop a stent-based image guided surgery system and to apply it to oral and maxillofacial surgeries for anatomically complex sites. We devised a patient-specific stent for patient-to-image registration and navigation. Three dimensional positions of the reference probe and the tool probe were tracked by an optical camera system and the relative position of the handpiece drill tip to the reference probe was monitored continuously on the monitor of a PC. Using 8 landmarks for measuring accuracy, the spatial discrepancy between CT image coordinate and physical coordinate was calculated for testing the normality. The accuracy over 8 anatomical landmarks showed an overall mean of 0.56 {+-} 0.16 mm. The developed system was applied to a surgery for a vertical alveolar bone augmentation in right mandibular posterior area and possible interior alveolar nerve injury case of an impacted third molar. The developed system provided continuous monitoring of invisible anatomical structures during operation and 3D information for operation sites. The clinical challenge showed sufficient accuracy and availability of anatomically complex operation sites. The developed system showed sufficient accuracy and availability in oral and maxillofacial surgeries for anatomically complex sites.

  16. Optimal structure of particles-based superparamagnetic microrobots: application to MRI guided targeted drug therapy

    International Nuclear Information System (INIS)

    This paper presents an optimal design strategy for therapeutic magnetic micro carriers (TMMC) guided in real time by a magnetic resonance imaging (MRI) system. As aggregates of TMMCs must be formed to carry the most amount of drug and magnetic actuation capability, different clustering agglomerations could be arranged. Nevertheless, its difficult to predict the hydrodynamic behavior of any arbitrary-shaped object due to the nonlinear hydrodynamic effects. Indeed, the drag effect is related not only to the properties of the bolus but also to its interaction with the fluid viscosity, the free-stream velocity and the container geometry. In this work, we propose a mathematical framework to optimize the TMMC aggregates to improve the steering efficiency in experimental endovascular conditions. The proposed analysis is carried out on various sizes and geometries of microcarrier: spherical, ellipsoid-like, and chain-like of microsphere structures. We analyze the magnetophoretic behavior of such designs to exhibit the optimal configuration. Based on the optimal design of the boluses, experimental investigations were carried out in mm-sized fluidic artery phantoms to demonstrate the steerability of the magnetic bolus using a proof-of-concept setup. The experiments demonstrate the steerability of the magnetic bolus under different velocity, shear-stress, and trajectory constraints with a laminar viscous fluidic environment. Preliminary experiments with a MRI system confirm the feasibility of the steering of these TMMCs in hepatic artery microchannel phantom

  17. Guide d'application de la réglementation incendie

    CERN Document Server

    2012-01-01

    Vous trouverez dans ce guide, de nombreux schémas et tableaux de synthèses, associés aux recommandations et alertes de l'auteur qui permettent d'aborder la problématique de la sécurité incendie étape par étape en identifiant clairement les dispositions à mettre en œuvre selon le type de construction. Pour chaque type de locaux, les principes de sécurité, le classement des bâtiments, les dispositions constructives, le désenfumage, les règles d'aménagement, les installations techniques ainsi que les moyens de secours sont décrits et commentés. Des cas spécifiques, tels que les logements-foyers, les parcs de stationnement ou les grandes cuisines (ERP) sont abordés. Pour les ERP, les dispositions de sécurité sont développées en tenant compte des spécificités des 15 types d'établissements les plus courants. Cette édition prend en compte les dernières évolutions réglementaires intégrées et/ou des précisions sur certains points : - installations de détecteurs de fumée dans les hab...

  18. Application of Intraoperative Ultrasonography for Guiding Microneurosurgical Resection of Small Subcortical Lesions

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Jia; Duan, Yun You; Liu, Xi; Wang, Yu; Gao, Guo Dong; Qin, Huai Zhou; Wang, Liang [Tangdu Hospital of the Fourth Military Medicine University, Xi an (China)

    2011-10-15

    We wanted to evaluate the clinical value of intraoperative ultrasonography for real-time guidance when performing microneurosurgical resection of small subcortical lesions. Fifty-two patients with small subcortical lesions were involved in this study. The pathological diagnoses were cavernous hemangioma in 25 cases, cerebral glioma in eight cases, abscess in eight cases, small inflammatory lesion in five cases, brain parasite infection in four cases and the presence of an intracranial foreign body in two cases. An ultrasonic probe was sterilized and lightly placed on the surface of the brain during the operation. The location, extent, characteristics and adjacent tissue of the lesion were observed by high frequency ultrasonography during the operation. All the lesions were located in the cortex and their mean size was 1.3 {+-} 0.2 cm. Intraoperative ultrasonography accurately located all the small subcortical lesions, and so the neurosurgeon could provide appropriate treatment. Different lesion pathologies presented with different ultrasonic appearances. Cavernous hemangioma exhibited irregular shapes with distinct margins and it was mildly hyperechoic or hyperechoic. The majority of the cerebral gliomas displayed irregular shapes with indistinct margins, and they often showed cystic and solid mixed echoes. Postoperative imaging identified that the lesions had completely disappeared, and the original symptoms of all the patients were significantly alleviated. Intraoperative ultrasonography can help accurately locate small subcortical lesions and it is helpful for selecting the proper approach and guiding thorough resection of these lesions.

  19. Optimal structure of particles-based superparamagnetic microrobots: application to MRI guided targeted drug therapy

    Energy Technology Data Exchange (ETDEWEB)

    Mellal, Lyès [INSA Centre Val de Loire, Université d’Orléans, PRISME EA 4229 (France); Belharet, Karim [Hautes Études d’Ingénieur campus Centre, PRISME EA 4229 (France); Folio, David; Ferreira, Antoine, E-mail: antoine.ferreira@insa-cvl.fr, E-mail: antoine.ferreira@ensi-bourges.fr [INSA Centre Val de Loire, Université d’Orléans, PRISME EA 4229 (France)

    2015-02-15

    This paper presents an optimal design strategy for therapeutic magnetic micro carriers (TMMC) guided in real time by a magnetic resonance imaging (MRI) system. As aggregates of TMMCs must be formed to carry the most amount of drug and magnetic actuation capability, different clustering agglomerations could be arranged. Nevertheless, its difficult to predict the hydrodynamic behavior of any arbitrary-shaped object due to the nonlinear hydrodynamic effects. Indeed, the drag effect is related not only to the properties of the bolus but also to its interaction with the fluid viscosity, the free-stream velocity and the container geometry. In this work, we propose a mathematical framework to optimize the TMMC aggregates to improve the steering efficiency in experimental endovascular conditions. The proposed analysis is carried out on various sizes and geometries of microcarrier: spherical, ellipsoid-like, and chain-like of microsphere structures. We analyze the magnetophoretic behavior of such designs to exhibit the optimal configuration. Based on the optimal design of the boluses, experimental investigations were carried out in mm-sized fluidic artery phantoms to demonstrate the steerability of the magnetic bolus using a proof-of-concept setup. The experiments demonstrate the steerability of the magnetic bolus under different velocity, shear-stress, and trajectory constraints with a laminar viscous fluidic environment. Preliminary experiments with a MRI system confirm the feasibility of the steering of these TMMCs in hepatic artery microchannel phantom.

  20. Fully automated image-guided needle insertion: application to small animal biopsies.

    Science.gov (United States)

    Ayadi, A; Bour, G; Aprahamian, M; Bayle, B; Graebling, P; Gangloff, J; Soler, L; Egly, J M; Marescaux, J

    2007-01-01

    The study of biological process evolution in small animals requires time-consuming and expansive analyses of a large population of animals. Serial analyses of the same animal is potentially a great alternative. However non-invasive procedures must be set up, to retrieve valuable tissue samples from precisely defined areas in living animals. Taking advantage of the high resolution level of in vivo molecular imaging, we defined a procedure to perform image-guided needle insertion and automated biopsy using a micro CT-scan, a robot and a vision system. Workspace limitations in the scanner require the animal to be removed and laid in front of the robot. A vision system composed of a grid projector and a camera is used to register the designed animal-bed with to respect to the robot and to calibrate automatically the needle position and orientation. Automated biopsy is then synchronised with respiration and performed with a pneumatic translation device, at high velocity, to minimize organ deformation. We have experimentally tested our biopsy system with different needles.

  1. Method for MRI-guided conformal thermal therapy of prostate with planar transurethral ultrasound heating applicators

    Energy Technology Data Exchange (ETDEWEB)

    Chopra, Rajiv [Sunnybrook and Women' s College Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario, M4N 3M5 (Canada); Burtnyk, Mathieu [Sunnybrook and Women' s College Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario, M4N 3M5 (Canada); Haider, Masoom A [University Health Network, Princess Margaret Hospital, 610 University Avenue, Toronto, Ontario, M5G 2M9 (Canada); Bronskill, Michael J [Sunnybrook and Women' s College Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario, M4N 3M5 (Canada)

    2005-11-07

    A method for conformal prostate thermal therapy using transurethral ultrasound heating applicators incorporating planar transducers is described. The capability to shape heating patterns to the geometry of the prostate gland from a single element in a multi-element heating applicator was evaluated using Bioheat transfer modelling. Eleven prostate geometries were obtained from patients who underwent MR imaging of the prostate gland prior to radical prostatectomy. Results indicate that ultrasound heating applicators incorporating multi-frequency planar transducers (4 x 20 mm, f 4.7 MHz, 9.7 MHz) are capable of shaping thermal damage patterns to the geometry of individual prostates. A temperature feedback control algorithm has been developed to control the frequency, rotation rate and applied power level from transurethral heating applicators based on measurements of the boundary temperature during heating. The discrepancy between the thermal damage boundary and the target boundary was less than 5 mm, and the transition distance between coagulation and normal tissue was less than 1 cm. Treatment times for large prostate volumes were less than 50 min, and perfusion did not have significant impact on the control algorithm. Rectal cooling will play an important role in reducing undesired heating near the rectal wall. Experimental validation of the simulations in a tissue-mimicking gel phantom demonstrated good agreement between the predicted and generated patterns of thermal damage.

  2. Maven The Definitive Guide

    CERN Document Server

    Company, Sonatype

    2009-01-01

    Written by Maven creator Jason Van Zyl and his team at Sonatype, Maven: The Definitive Guide clearly explains how this popular tool can bring order to your software development projects. The first part of the book demonstrates Maven's capabilities through the development of several sample applications from ideation to deployment, and the second part offers a complete reference guide. Concise and to the point, this is the only guide you need to manage your project.

  3. Clinical outcome and dosimetric parameters of chemo-radiation including MRI guided adaptive brachytherapy with tandem-ovoid applicators for cervical cancer patients: A single institution experience.

    NARCIS (Netherlands)

    Nomden, C.N.; Leeuw, A.A. de; Roesink, J.M.; Tersteeg, R.J.; Moerland, M.A.; Witteveen, P.O.; Schreuder, H.W.B.; Dorst, E.B. van; Jurgenliemk-Schulz, I.M.

    2013-01-01

    PURPOSE: To evaluate dosimetric parameters and clinical outcome for cervical cancer patients treated with chemo-radiation and MR-image guided adaptive brachytherapy (MR-IGABT) using tandem-ovoid applicators for intracavitary or combined intracavitary/interstitial approaches. METHOD: This retrospecti

  4. Computation and Optimization of Dose Distributions for Rotational Stereotactic Radiosurgery

    Science.gov (United States)

    Fox, Timothy Harold

    1994-01-01

    The stereotactic radiosurgery technique presented in this work is the patient rotator method which rotates the patient in a sitting position with a stereotactic head frame attached to the skull while collimated non-coplanar radiation beams from a 6 MV medical linear accelerator are delivered to the target point. The hypothesis of this dissertation is that accurate, three-dimensional dose distributions can be computed and optimized for the patient rotator method used in stereotactic radiosurgery. This dissertation presents research results in three areas related to computing and optimizing dose distributions for the patient rotator method. A three-dimensional dose model was developed to calculate the dose at any point in the cerebral cortex using a circular and adjustable collimator system and the geometry of the radiation beam with respect to the target point. The computed dose distributions compared to experimental measurements had an average maximum deviation of <0.7 mm for the relative isodose distributions greater than 50%. A system was developed to qualitatively and quantitatively visualize the computed dose distributions with patient anatomy. A registration method was presented for transforming each dataset to a common reference system. A method for computing the intersections of anatomical contour's boundaries was developed to calculate dose-volume information. The system efficiently and accurately reduced the large computed, volumetric sets of dose data, medical images, and anatomical contours to manageable images and graphs. A computer-aided optimization method was developed for rigorously selecting beam angles and weights for minimizing the dose to normal tissue. Linear programming was applied as the optimization method. The computed optimal beam angles and weights for a defined objective function and dose constraints exhibited a superior dose distribution compared to a standard plan. The developed dose model, qualitative and quantitative visualization

  5. Stereotactic radiotherapy of primary liver cancer and hepatic metastases

    Energy Technology Data Exchange (ETDEWEB)

    Wulf, Joern; Guckenberger, Matthias; Haedinger, Ulrich; Oppitz, Ulrich; Mueller, Gerd; Baier, Kurt; Flentje, Michael [Univ. of Wuerzburg (Germany). Dept. of Radiotherapy

    2006-09-15

    The purpose was to evaluate the clinical results of stereotactic radiotherapy in primary liver tumors and hepatic metastases. Five patients with primary liver cancer and 39 patients with 51 hepatic metastases were treated by stereotactic radiotherapy since 1997. Twenty-eight targets were treated in a 'low-dose'-group with 3x10 Gy (n=27) or 4x7 Gy (n=1) prescribed to the PTV-encl. 65%-isodose. In a 'high-dose'-group patients were treated with 3x12 - 12.5 Gy (n=19; same dose prescription) or 1x26 Gy/PTV-enclosing 80%-isodose (n=9). Median follow-up was 15 months (2-48 months) for primary liver cancer and 15 months (2-85 months) for hepatic metastases. While all primary liver cancers were controlled, nine local failures (3-19 months) of 51 metastases were observed resulting in an actuarial local control rate of 92% after 12 months and 66% after 24 months and later. A borderline significant correlation between dose and local control was observed (p=0.077): the actuarial local control rate after 12 and 24?months was 86% and 58% in the low-dose-group versus 100% and 82% in the high-dose-group. In multivariate analysis high versus low-dose was the only significant factor predicting local control (p=0.0089). Overall survival after 1 and 2 years was 72% and 32% for all patients and was impaired due to systemic progression of disease. No severe acute or late toxicity exceeding RTOG/EORTC-score 2 were observed. Stereotactic irradiation of primary liver cancer and hepatic metastases offers a locally effective treatment without significant complications in patients, who are not amenable for surgery. Patient selection is important, because those with low risk for systemic progression are more likely to benefit from this approach.

  6. Stereotactic radiotherapy of primary liver cancer and hepatic metastases

    International Nuclear Information System (INIS)

    The purpose was to evaluate the clinical results of stereotactic radiotherapy in primary liver tumors and hepatic metastases. Five patients with primary liver cancer and 39 patients with 51 hepatic metastases were treated by stereotactic radiotherapy since 1997. Twenty-eight targets were treated in a 'low-dose'-group with 3x10 Gy (n=27) or 4x7 Gy (n=1) prescribed to the PTV-encl. 65%-isodose. In a 'high-dose'-group patients were treated with 3x12 - 12.5 Gy (n=19; same dose prescription) or 1x26 Gy/PTV-enclosing 80%-isodose (n=9). Median follow-up was 15 months (2-48 months) for primary liver cancer and 15 months (2-85 months) for hepatic metastases. While all primary liver cancers were controlled, nine local failures (3-19 months) of 51 metastases were observed resulting in an actuarial local control rate of 92% after 12 months and 66% after 24 months and later. A borderline significant correlation between dose and local control was observed (p=0.077): the actuarial local control rate after 12 and 24?months was 86% and 58% in the low-dose-group versus 100% and 82% in the high-dose-group. In multivariate analysis high versus low-dose was the only significant factor predicting local control (p=0.0089). Overall survival after 1 and 2 years was 72% and 32% for all patients and was impaired due to systemic progression of disease. No severe acute or late toxicity exceeding RTOG/EORTC-score 2 were observed. Stereotactic irradiation of primary liver cancer and hepatic metastases offers a locally effective treatment without significant complications in patients, who are not amenable for surgery. Patient selection is important, because those with low risk for systemic progression are more likely to benefit from this approach

  7. Stereotactic radiosurgery for trigeminal neuralgia: outcomes and complications.

    Science.gov (United States)

    Loescher, Alison R; Radatz, Matthias; Kemeny, Andras; Rowe, Jeremy

    2012-02-01

    Stereotactic radiosurgery is one of a number of recognised treatments for the management of trigeminal neuralgia refractory to drug therapy. The reported success of stereotactic radiosurgery in managing patients with trigeminal neuralgia varies in different units from 22 to 75%. This paper reports the outcomes of patients with trigeminal neuralgia who were treated at the National Centre for Stereotactic Radiosurgery in Sheffield, UK. The study reports the outcome of 72 patients treated consecutively between October 2004 and May 2008. Data were collected prospectively by a postal questionnaire sent to patients at 6, 12 and 24 months after treatment. The median age was 65.6 years (39 males: 33 females). Fourteen patients had secondary trigeminal neuralgia (eight multiple sclerosis). Fifteen of the patients included in the study were receiving a second treatment (an initial treatment having improved their pain significantly for at least 6 months). All radiosurgical procedures were performed using a single 4 mm collimator isocenter covering the region of the dorsal root entry zone with a maximal radiation dose of 80 Gy. The percentage of patients defined as having an excellent outcome (pain free without medication) was 39% after 6 months, 36% after 12 months and 64% after 24 months. The percentage of patients who reported being very satisfied with treatment was 71% after 6 months, 57% after 12 months and 53% after 24 months. Half the patients with secondary trigeminal neuralgia were pain free without medication after treatment, and 60% of patients who underwent a second treatment were pain free. A new trigeminal sensory deficit was reported by 31% of patients after radiosurgical treatment.

  8. Guide to Evaluating Usability, Accessibility and Communicability in Web Applications with User Intervention

    Directory of Open Access Journals (Sweden)

    Asnier Góngora R.

    2013-12-01

    Full Text Available The article is associated with the creation of a usability lab where various types of tests performed using static and dynamic tools for evaluating the characteristics of usability, accessibility and Communicability by indicators in the software testing process with the user's presence. It also addresses the current situation in Cuba on the issue of evidence of these characteristics and the impact it could bring to the development teams. In addition, an analysis of the result of applying a tool (check list to multiple Web applications on tests conducted at the National Center for Software Quality Cuba (CALISOFT. We also present a set of best practices that support the development of web applications to suit the user.

  9. LENS repair and modification of metal NW components:materials and applications guide.

    Energy Technology Data Exchange (ETDEWEB)

    Smugeresky, John E. (Sandia National Laboratories, Livermore, CA); Gill, David Dennis; Oberhaus, Jason (BWXT Y-12); Adams, Thad (Savannah River National Laboratory); VanCamp, Chad (Kansas City Plant)

    2006-11-01

    Laser Engineered Net Shaping{trademark} (LENS{reg_sign}) is a unique, layer additive, metal manufacturing technique that offers the ability to create fully dense metal features and components directly from a computer solid model. LENS offers opportunities to repair and modify components by adding features to existing geometry, refilling holes, repairing weld lips, and many other potential applications. The material deposited has good mechanical properties with strengths typically slightly higher that wrought material due to grain refinement from a quickly cooling weld pool. The result is a material with properties similar to cold worked material, but without the loss in ductility traditionally seen with such treatments. Furthermore, 304L LENS material exhibits good corrosion resistance and hydrogen compatibility. This report gives a background of the LENS process including materials analysis addressing the requirements of a number of different applications. Suggestions are given to aid both the product engineer and the process engineer in the successful utilization of LENS for their applications. The results of testing on interface strength, machinability, weldability, corrosion resistance, geometric effects, heat treatment, and repair strategy testing are all included. Finally, the qualification of the LENS process is briefly discussed to give the user confidence in selecting LENS as the process of choice for high rigor applications. The testing showed LENS components to have capability in repair/modification applications requiring complex castings (W80-3 D-Bottle bracket), thin wall parts requiring metal to be rebuilt onto the part (W87 Firing Set Housing and Y-12 Test Rings), the filling of counterbores for use in reservoir reclamation welding (SRNL hydrogen compatibility study) and the repair of surface defects on pressure vessels (SRNL gas bottle repair). The material is machinable, as testing has shown that LENS deposited material machines similar to that of

  10. Operational modal analysis of civil engineering structures an introduction and guide for applications

    CERN Document Server

    Rainieri, Carlo

    2014-01-01

    This book covers all aspects of operational modal analysis for civil engineering, from theoretical background to applications, including measurement hardware, software development, and data processing. In particular, this book provides an extensive description and discussion of OMA methods, their classification and relationship, and advantages and drawbacks. The authors cover both the well-established theoretical background of OMA methods and the most recent developments in the field, providing detailed examples to help the reader better understand the concepts and potentialities of the technique. Additional material is provided (data, software) to help practitioners and students become familiar with OMA. Covering a range of different aspects of OMA, always with the application in mind, the practical perspective adopted in this book makes it ideal for a wide range of readers from researchers to field engineers; graduate and undergraduate students; and technicians interested in structural dynamics, system iden...

  11. Leveraging software architectures to guide and verify the development of sense/compute/control applications

    DEFF Research Database (Denmark)

    Cassou, Damien; Balland, Emilie; Consel, Charles;

    2011-01-01

    A software architecture describes the structure of a computing system by specifying software components and their interactions. Mapping a software architecture to an implementation is a well known challenge. A key element of this mapping is the architecture’s description of the data and control-f...... verifications. We instantiate our approach in an architecture description language for Sense/Compute/Control applications, and describe associated compilation and verification strategies....

  12. PiroPinus: a spreadsheet application to guide prescribed burning operations in maritime pine forest

    OpenAIRE

    Fernandes, Paulo; Loureiro, Carlos; Botelho, Hermínio

    2011-01-01

    The efficient, sustainable and safe use of prescribed burning is based on quantitative application guidelines. PiroPinus was conceived for operational support to line-ignited, hazard-reduction burning in maritime pine (Pinus pinaster) forest, but can be used as a modelling tool for surface fire behaviour in general. PiroPinus rests on a sound empirical foundation and links the fire environment (fuel, weather, terrain), fire behaviour characteristics, and fire effects on fuels and trees. PiroP...

  13. Application of real-time single camera SLAM technology for image-guided targeting in neurosurgery

    Science.gov (United States)

    Chang, Yau-Zen; Hou, Jung-Fu; Tsao, Yi Hsiang; Lee, Shih-Tseng

    2012-10-01

    In this paper, we propose an application of augmented reality technology for targeting tumors or anatomical structures inside the skull. The application is a combination of the technologies of MonoSLAM (Single Camera Simultaneous Localization and Mapping) and computer graphics. A stereo vision system is developed to construct geometric data of human face for registration with CT images. Reliability and accuracy of the application is enhanced by the use of fiduciary markers fixed to the skull. The MonoSLAM keeps track of the current location of the camera with respect to an augmented reality (AR) marker using the extended Kalman filter. The fiduciary markers provide reference when the AR marker is invisible to the camera. Relationship between the markers on the face and the augmented reality marker is obtained by a registration procedure by the stereo vision system and is updated on-line. A commercially available Android based tablet PC equipped with a 320×240 front-facing camera was used for implementation. The system is able to provide a live view of the patient overlaid by the solid models of tumors or anatomical structures, as well as the missing part of the tool inside the skull.

  14. Curative effect of stereotactic body radiotherapy on hepatic hilar carcinoma

    OpenAIRE

    DANG, YA-ZHENG; HUANG, SHI-GAO; LU, WAN-LING; WU, FA-WEI; Wang, Qian-Yun

    2014-01-01

    This study was conducted to investigate the effect of stereotactic body radiotherapy (SBRT) on hepatic hilar tumors. Between October, 2006 and October, 2012, we analyzed 63 unresectable hepatic hilar tumors that were treated by SBRT at the Department of Radiation Oncology, 323 Hospital of the People’s Liberation Army, Xi’an, China. The patients received a total radiation dose of 45 Gy (range, 44–48 Gy) with a dose fractionation of 3–6 Gy/fx, administered for a total of 9–12 times, 2–5 times/w...

  15. Novalis Stereotactic Radiosurgery for Spinal Dural Arteriovenous Fistula

    Science.gov (United States)

    Sung, Kyoung-Su; Song, Young-Jin

    2016-01-01

    The spinal dural arteriovenous fistula (SDAVF) is rare, presenting with progressive, insidious symptoms, and inducing spinal cord ischemia and myelopathy, resulting in severe neurological deficits. If physicians have accurate and enough information about vascular anatomy and hemodynamics, they achieve the good results though the surgery or endovascular embolization. However, when selective spinal angiography is unsuccessful due to neurological deficits, surgery and endovascular embolization might be failed because of inadequate information. We describe a patient with a history of vasospasm during spinal angiography, who was successfully treated by spinal stereotactic radiosurgery using Novalis system. PMID:27446527

  16. JBoss ESB Beginner's Guide

    CERN Document Server

    DiMaggio, Len; Magesh, Kumar

    2012-01-01

    Part of Packt's Beginner's Guide series, each chapter contains practical examples with step-by-step instructions and plenty of screenshots to guide you through the implementation of JBoss ESB. This book is intended for Java programmers although you don't need previous experience with middleware such as application servers or ESBs.

  17. Stereotactic Hypofractionated Irradiation for Metastatic, Inoperable, and Recurrent Malignancies: A Modern Necessity, rather than a Luxury

    Directory of Open Access Journals (Sweden)

    Sridhar P. Susheela

    2014-01-01

    Full Text Available Stereotactic-irradiation combines highly conformal delivery of radiation to selected volumes at large doses per fraction, with the treatment completed typically within one to five fractions. The radiobiological equivalence of doses delivered by stereotactic-irradiation (often beyond 80–100 Gy is much higher in comparison to the doses achievable by conventional fractionation. At the high fraction sizes used in stereotactic-irradiation, evidence suggests the role of various radiobiological mechanisms of actions, which are not traditionally relatable with conventional radiotherapy. In spite of the accumulating evidence in favour of the efficacy of stereotactic irradiation in terms of improving local control and at times attaining increments in survival, the clinical adoption of the technique remains dismal. This review provides a brief description of the available evidence describing the benefits of stereotactic-irradiation for the management of patients with oligometastases, unresectable malignancies and for disease recurrence after prior radiotherapy. Given the growing body of evidence illustrating the efficacy of stereotactic irradiation among patients with conditions which were previously often regarded as untreatable, it is likely that the widespread adoption of stereotactic irradiation may achieve cure in a few patients, while in the remainder providing prospects of long term local control. This could be a step in the direction of converting incurable malignancies into chronic controllable diseases.

  18. Climate risk screening tools and their application: A guide to the guidance

    Energy Technology Data Exchange (ETDEWEB)

    Traerup, S.; Olhoff, A.

    2011-07-01

    Climate risk screening is an integral part of efforts to ascertain current and future vulnerabilities and risks related to climate change. It is a prerequisite for identifying and designing adaptation measures, and an important element in the process of integrating, or mainstreaming, climate change adaptation into development project, planning and policy processes. There is an increasing demand and attention among national stakeholders in developing countries to take into account potential implications of climate variability and change for planning and prioritizing of development strategies and activities. Subsequently, there is a need for user friendly guidance on climate risk screening tools and their potentials for application that targets developing country stakeholders. This need is amplified by the sheer volume of climate change mainstreaming guidance documents and risk screening and assessment tools available and currently under development. Against this background, this paper sets out to provide potential users in developing countries, including project and programme developers and managers, with an informational entry point to climate risk screening tools. The emphasis in this report is on providing: 1) An overview of available climate risk screening and assessment tools along with indications of the tools available and relevant for specific purposes and contexts (Section 3). 2) Examples of application of climate risk screening and assessment tools along with links to further information (Section 4). Before turning to the respective sections on available climate risk screening tools and examples of their application, a delimitation of the tools included in this paper is included in Section 2. This section also provides a brief overview of how climate screening and related tools fit into decision making steps at various planning and decision making levels in conjunction with an outline of overall considerations to make when choosing a tool. The paper is

  19. Recommendation of the working group commissioned by the French nuclear safety authority on stereotactic radiation therapy

    International Nuclear Information System (INIS)

    Purpose. - At the request of the French nuclear safety authority (Autorite de Surete Nucleaire, ASN) a working party of multidisciplinary experts was initiated to elaborate a report regarding propositions for the clinical practice of stereotactic radiation therapy and the related medical physics. Material and methods. - Several stereotactic radiation therapy experts were audited by the working party, especially neurosurgeons and neuro-radiologists, as well as radiation oncologists, medical physicists and radiation technologists. An international survey was conducted looking at legal requirements and guidelines concerning stereotactic radiation therapy. A national survey was conducted in France among 29 departments performing stereotactic radiation therapy. The working party report was submitted for advice to the permanent group of medical experts of ASN. Results. - Among the 13 countries who responded, very few have legal documents. Some of them are stating that stereotactic radiation therapy must be performed in a radiotherapy department and only by well-trained professionals. Guidelines describing the role of each participant have been published in the USA. In France, stereotactic radiation therapy is performed with dedicated machines or adapted linear accelerators. In 2009, within the 29 departments, 4247 patients were treated with stereotactic radiation therapy representing 4% of the patients treated with external beam radiation therapy. Intracranial lesions were: 3383 and extracranial: 864. The working party of multidisciplinary experts made 7 recommendations. The first one saying that stereotactic radiation therapy must be considered as a radiotherapy. The permanent group of medical experts is asking to modify the 'decret du 19 mars 2007' regarding 'radiosurgery'. Conclusion. - The medical benefit of stereotactic radiation therapy is well admitted and it is an increasingly used technique. This work through practical guidelines and legal propositions intends

  20. Image-guided intracranial cannula placement for awake in vivo microdialysis in nonhuman primates

    Science.gov (United States)

    Chen, Antong; Bone, Ashleigh; Hines, Catherine D. G.; Dogdas, Belma; Montgomery, Tamara O.; Michener, Maria; Winkelmann, Christopher T.; Ghafurian, Soheil; Lubbers, Laura S.; Renger, John; Bagchi, Ansuman; Uslaner, Jason M.; Johnson, Colena; Zariwala, Hatim A.

    2016-03-01

    Intracranial microdialysis is used for sampling neurochemicals and large peptides along with their metabolites from the interstitial fluid (ISF) of the brain. The ability to perform this in nonhuman primates (NHP) e.g., rhesus could improve the prediction of pharmacokinetic (PK) and pharmacodynamics (PD) action of drugs in human. However, microdialysis in rhesus brains is not as routinely performed as in rodents. One challenge is that the precise intracranial probe placement in NHP brains is difficult due to the richness of the anatomical structure and the variability of the size and shape of brains across animals. Also, a repeatable and reproducible ISF sampling from the same animal is highly desirable when combined with cognitive behaviors or other longitudinal study end points. Toward that end, we have developed a semi-automatic flexible neurosurgical method employing MR and CT imaging to (a) derive coordinates for permanent guide cannula placement in mid-brain structures and (b) fabricate a customized recording chamber to implant above the skull for enclosing and safeguarding access to the cannula for repeated experiments. In order to place the intracranial guide cannula in each subject, the entry points in the skull and the depth in the brain were derived using co-registered images acquired from MR and CT scans. The anterior/posterior (A/P) and medial-lateral (M/L) rotation in the pose of the animal was corrected in the 3D image to appropriately represent the pose used in the stereotactic frame. An array of implanted fiducial markers was used to transform stereotactic coordinates to the images. The recording chamber was custom fabricated using computer-aided design (CAD), such that it would fit the contours of the individual skull with minimum error. The chamber also helped in guiding the cannula through the entry points down a trajectory into the depth of the brain. We have validated our method in four animals and our results indicate average placement error

  1. Verification of dose volume histograms in stereotactic radiosurgery and radiotherapy using polymer gel and MRI

    Science.gov (United States)

    Šemnická, Jitka; Novotný, Josef, Jr.; Spěváček, Václav; Garčic, Jirí; Steiner, Martin; Judas, Libor

    2006-12-01

    In this work we focus on dose volume histograms (DVHs) measurement in stereotactic radiosurgery (SR) performed with the Leksell gamma knife (ELEKTA Instrument AB, Stockholm, Sweden) and stereotactic radiotherapy (SRT) performed with linear accelerator 6 MV Varian Clinac 2100 C/D (Varian Medical Systems, Palo Alto, USA) in conjunction with BrainLAB stereotactic system (BrainLAB, Germany) using modified BANG gel and magnetic resonance imaging (MRI). The aim of the experiments was to investigate a method for acquiring entire dose volume information from irradiated gel dosimeter and calculate DVHs.

  2. Sensitivity analysis and application guides for integrated building energy and CFD simulation

    Energy Technology Data Exchange (ETDEWEB)

    Zhiqiang John Zhai [Colorado Univ., Boulder, CO (United States). Dept. of Civil, Environmental, and Architectural Engineering; Qingyan Yan Chen [Purdue Univ., West Lafayette, IN (United States). School of Mechanical Engineering

    2006-09-15

    Building energy simulation (ES) and computational fluid dynamics (CFD) programs provide complementary information essential to evaluating building thermal performance. Integration of the two programs eliminates many model assumptions in separate applications and thus improves the quality of simulation results. This paper discusses the potential building and environmental characteristics that may affect the necessity and effectiveness of applying an ES-CFD coupling simulation. These characteristics and the solution accuracy requirement determine whether a coupled simulation is needed for a specific building and which coupling method can provide the best solution with the compromise of both accuracy and efficiency. The study conducts a sensitivity analysis of the coupling simulation to the potential influential factors, based on which general suggestions on appropriate usage of the coupling simulation are provided. (author)

  3. Sensitivity analysis and application guides for integrated building energy and CFD simulation

    Energy Technology Data Exchange (ETDEWEB)

    Zhai, Z.J. [Department of Civil, Environmental and Architectural Engineering, University of Colorado at Boulder, Boulder, CO (United States); Chen, Q.Y. [School of Mechanical Engineering, Purdue University, West Lafayette, IN (United States)

    2006-07-01

    Building energy simulation (ES) and computational fluid dynamics (CFD) programs provide complementary information essential to evaluating building thermal performance. Integration of the two programs eliminates many model assumptions in separate applications and thus improves the quality of simulation results. This paper discusses the potential building and environmental characteristics that may affect the necessity and effectiveness of applying an ES-CFD coupling simulation. These characteristics and the solution accuracy requirement determine whether a coupled simulation is needed for a specific building and which coupling method can provide the best solution with the compromise of both accuracy and efficiency. The study conducts a sensitivity analysis of the coupling simulation to the potential influential factors, based on which general suggestions on appropriate usage of the coupling simulation are provided. (author)

  4. Reconfigurable MRI-guided robotic surgical manipulator: prostate brachytherapy and neurosurgery applications.

    Science.gov (United States)

    Su, Hao; Iordachita, Iulian I; Yan, Xiaoan; Cole, Gregory A; Fischer, Gregory S

    2011-01-01

    This paper describes a modular design approach for robotic surgical manipulator under magnetic resonance imaging (MRI) guidance. The proposed manipulator provides 2 degree of freedom (DOF) Cartesian motion and 2-DOF pitch and yaw motion. Primarily built up with dielectric materials, it utilizes parallel mechanism and is compact in size to fit into the limited space of close-bore MRI scanner. It is ideal for needle based surgical procedures which usually require positioning and orientation control for accurate imaging plane alignment. Specifically, this mechanism is easily reconfigurable to over constrained manipulator structure which provides 2-DOF Cartesian motion by simple structure modification. This modular manipulator integrated with different end-effector modules is investigated for prostate brachytherapy and neurosurgery applications as preliminary evaluation. PMID:22254754

  5. Application Guide for AFINCH (Analysis of Flows in Networks of Channels) Described by NHDPlus

    Science.gov (United States)

    Holtschlag, David J.

    2009-01-01

    AFINCH (Analysis of Flows in Networks of CHannels) is a computer application that can be used to generate a time series of monthly flows at stream segments (flowlines) and water yields for catchments defined in the National Hydrography Dataset Plus (NHDPlus) value-added attribute system. AFINCH provides a basis for integrating monthly flow data from streamgages, water-use data, monthly climatic data, and land-cover characteristics to estimate natural monthly water yields from catchments by user-defined regression equations. Images of monthly water yields for active streamgages are generated in AFINCH and provide a basis for detecting anomalies in water yields, which may be associated with undocumented flow diversions or augmentations. Water yields are multiplied by the drainage areas of the corresponding catchments to estimate monthly flows. Flows from catchments are accumulated downstream through the streamflow network described by the stream segments. For stream segments where streamgages are active, ratios of measured to accumulated flows are computed. These ratios are applied to upstream water yields to proportionally adjust estimated flows to match measured flows. Flow is conserved through the NHDPlus network. A time series of monthly flows can be generated for stream segments that average about 1-mile long, or monthly water yields from catchments that average about 1 square mile. Estimated monthly flows can be displayed within AFINCH, examined for nonstationarity, and tested for monotonic trends. Monthly flows also can be used to estimate flow-duration characteristics at stream segments. AFINCH generates output files of monthly flows and water yields that are compatible with ArcMap, a geographical information system analysis and display environment. Chloropleth maps of monthly water yield and flow can be generated and analyzed within ArcMap by joining NHDPlus data structures with AFINCH output. Matlab code for the AFINCH application is presented.

  6. Quality assurance for stereotactic radiosurgery using linear accelerator

    International Nuclear Information System (INIS)

    Stereotactic radiosurgery using a linear accelerator requires two quality assurance items; positional accuracy of irradiation and its prescribed dose. Authors have evaluated these two items in the QA program. To evaluate the positional accuracy of irradiation, the alignment of a laser pointer was measured at a isocenter using a target point simulator. The positional accuracy of the gantry and couch rotations of the linear accelerator was evaluated by the 'star shot' method. As to the dose measurement, tissue maximum ratio, off axis ratio, and relative output factor were determined using a diamond detector. Since a laser pointer is susceptible to small vibrations, it should always be checked. The results indicated that the positional accuracy of the gantry and couch rotations must be maintained within 1.0 mm for 360 degrees. As to the dose measurement, TMR, OAR, and ROF should be measured regularly by a small-sized detector with a high sensitivity and low-energy dependance such as a diamond detector. Stereotactic radiosurgery using a linear accelerator requires a QA program. Among other maintenance items in this QA program, the positional accuracy of gantry and couch rotation should be maintained within 1.0 mm for 360 degrees. (author)

  7. Stereotactic radiosurgery for acoustic neuroma: a Canadian perspective

    Energy Technology Data Exchange (ETDEWEB)

    Ross, I.B. [Univ. of Manitoba, Section of Neurosurgery, Winnipeg, MB (Canada); Tator, C.H. [Univ. of Toronto, Div. of Neurosurgery, Toronto, Ontario (Canada)

    1998-11-01

    Stereotactically delivered radiation is now an accepted treatment for patients with acoustic neuroma. In some cases, patient preference may be the reason for its selection, while in others neurosurgeons may select it for patients who are elderly or have significant risk factors for conventional surgery. The majority of patients with acoustic neuroma treatment with stereotactic radiosurgery have been treated with the Gamma Knife, with follow ups of over 25 years in some instances. Other radiosurgical modalities utilizing the linear accelerator have been developed and appear promising, but there is no long-term: follow up. Canada does not possess a Gamma Knife facility, and its government-funded hospital and medical insurance agencies have made it difficult for patients to obtain reimbursement for Gamma Knife treatments in other countries. We review the literature to date on the various forms of radiation treatment for acoustic neuroma and discuss the current issues facing physicians and patients in Canada who wish to obtain their treatment of choice. (author)

  8. Clinical commissioning of Laitinen Stereoadapter for fractionated stereotactic radiotherapy.

    Science.gov (United States)

    Weidlich, G A; Gebert, J A; Fuery, J J

    1998-01-01

    The Laitinen Stereoadapter 5000 from Sandstroem Trade and Technology was acceptance tested and commissioned for clinical use in a Fractionated Stereotactic Radiotherapy Program at our facility. The frame was implemented to function as a localization device for target delineation rather than as an immobilization device. The frame is of non-invasive nature utilizing ear plugs and a nasion bridge adapter as the connecting points with the patient's head. The reproducibility of the head frame position with respect to external skull reference points was tested. CT and MRI imaging studies were performed on a patient phantom with the stereoadapter in place. The target was delineated and target coordinates were calculated for two implanted targets. The phantom was positioned according to the target coordinates on a Siemens MXE Linear Accelerator by aid of the target positioning lasers. Radiographic port film images were taken with the circular fields typically used in stereotactic radiosurgery. A complete treatment isodose plan was performed and dosimetric accuracy was tested by positioning a small volume ionization chamber at the center of the target volume in the head phantom. The results of these tests were found to be clinically acceptable. PMID:9863732

  9. Optimization of a hybrid electric power system design for large commercial buildings: An application design guide

    Science.gov (United States)

    Lee, Keun

    Renewable energy in different forms has been used in various applications for survival since the beginning of human existence. However, there is a new dire need to reevaluate and recalibrate the overall energy issue both nationally and globally. This includes, but is not limited to, the finite availability of fossil fuel, energy sustainability with an increasing demand, escalating energy costs, environmental impact such as global warming and green-house gases, to name a few. This dissertation is primarily focused and related to the production and usage of electricity from non-hydro renewable sources. Among non-hydro renewable energy sources, electricity generation from wind and solar energy are the fastest-growing technologies in the United States and in the world. However, due to the intermittent nature of such renewable sources, energy storage devices are required to maintain proper operation of the grid system and in order to increase reliability. A hybrid system, as the name suggests, is a combination of different forms of non-renewable and renewable energy generation, with or without storage devices. Hybrid systems, when applied properly, are able to improve reliability and enhance stability, reduce emissions and noise pollution, provide continuous power, increase operation life, reduce cost, and efficiently use all available energy. In the United States (U.S.), buildings consume approximately 40% of the total primary energy and 74% of the total electricity. Therefore, reduction of energy consumption and improved energy efficiency in U.S. buildings will play a vital role in the overall energy picture. Electrical energy usage for any such building varies widely depending on age (construction technique), electricity and natural gas usage, appearance, location and climate. In this research, a hybrid system including non-renewable and renewable energy generation with storage devices specifically for building applications, is studied in detail. This research deals

  10. 打油诗在导游词创作中的研究与应用%Research and Application of Doggerel on the Tour Guide Word Creation

    Institute of Scientific and Technical Information of China (English)

    周晓梅

    2014-01-01

    The tour guide speech is useful in helping people establish a correct view of appreciating beauty knowledge. Using literature collection method and case study method,this paper discusses the four principles of tour guide speech creation,which could be summarized into "correctly and clearly,vivid,popular". The objectives of the wide application of doggerel have two aspects. On one hand,the tourists in the tourism have pleasure in the process;on the other hand,it is able to cultivate the sense of humor of guides. If tour guides can use in the creation,it will make the tour guide speech better.%导游词是导游员引导人们观景赏美的重要路径。导游员在创作导游词时适当应用打油诗,会令其导游词锦上添花。运用文献收集法、案例研究法阐述了导游词及导游词创作的四个基本原则,论述打油诗在导游词创作中的广泛应用,希望能够为众多的导游员在编创导游词过程中起到抛砖引玉的作用。

  11. Disorder Prediction Methods, Their Applicability to Different Protein Targets and Their Usefulness for Guiding Experimental Studies

    Directory of Open Access Journals (Sweden)

    Jennifer D. Atkins

    2015-08-01

    Full Text Available The role and function of a given protein is dependent on its structure. In recent years, however, numerous studies have highlighted the importance of unstructured, or disordered regions in governing a protein’s function. Disordered proteins have been found to play important roles in pivotal cellular functions, such as DNA binding and signalling cascades. Studying proteins with extended disordered regions is often problematic as they can be challenging to express, purify and crystallise. This means that interpretable experimental data on protein disorder is hard to generate. As a result, predictive computational tools have been developed with the aim of predicting the level and location of disorder within a protein. Currently, over 60 prediction servers exist, utilizing different methods for classifying disorder and different training sets. Here we review several good performing, publicly available prediction methods, comparing their application and discussing how disorder prediction servers can be used to aid the experimental solution of protein structure. The use of disorder prediction methods allows us to adopt a more targeted approach to experimental studies by accurately identifying the boundaries of ordered protein domains so that they may be investigated separately, thereby increasing the likelihood of their successful experimental solution.

  12. Magnetic resonance imaging-guided interstitial application of laser aided by fiber optic temperature sensing

    Science.gov (United States)

    Farahani, Keyvan; Shellock, Frank G.; Lufkin, Robert B.; Castro, Dan J.

    1992-04-01

    In order to further understand signal variations observed on magnetic resonance imaging scans of interstitial laser heating, a commercial multichannel fluoroptic thermometer, equipped with fiber optic sensors, was employed in conjunction with the laser/MRI phototherapy system. Three calibrated fiber optic sensors of the thermometer were used to measure temperature changes in ex-vivo sheep's brain at various distances directly across from the beam of a Nd:YAG laser emitted from a bare fiber. Laser was operated at 5 W for 220 sec. Temperature was measured every 10 seconds and MR images were acquired during and after laser irradiation until temperature in all probes returned to the equilibrium level of prelaser irradiation. Image contrast analysis of the heated region showed that MRI signal variations, during heating and cooling periods, correlated well with the changes in temperature. It is concluded that direct thermometry of MRI-monitored laser application will aid in understanding the effects of high focal heating on the MRI signal.

  13. In vitro bioactivity assessment of composite membrane containing antimicrobial lauric acid for guided bone regeneration in dental application

    Science.gov (United States)

    Suleiman, Muhammad Jabir; Kalitheertha, Jamuna Thevi; Sabri, Siti Noorzidah

    2015-07-01

    The manuscript reflect research work in fabrication of a triple layered composite membrane and to perform an in vitro bioactivity evaluation on composite membrane containing antimicrobial lauric acid. Poly(lactic-co-glycolic acid) (PLGA) matrix was incorporated with various amounts of nanoapatite (NAp) and lauric acid (LA) to form a triple-layered composite membrane. This membrane was prepared using a single step fabrication technique comprising of solvent casting, thermally induced phase separation and solvent leaching processes. Apatite mineralization was detected on the composite membranes within 30 days of exposure to simulated body fluid (SBF) and showed increased apatite formation at 30-60wt% of NAp content in the PLGA matrix on layer 3 (L3), that has the highest amount of NAp compared with layer 1 (L1) and layer 2 (L2) of the membrane. However, apatite mineralization was not detected on pure PLGA membrane. In addition, incorporation of LA on L1 and L2 has no influence on apatite mineral formation as none detected on these surfaces. The presence of NAp determines the formation of apatite crystals on the composite membrane. These membranes with triple layered design and bioactive properties showed potential use for guided bone regeneration purposes in dental application.

  14. Improved drug delivery properties of PVDF membranes functionalized with beta-cyclodextrin--application to guided tissue regeneration in periodontology.

    Science.gov (United States)

    Boschin, F; Blanchemain, N; Bria, M; Delcourt-Debruyne, E; Morcellet, M; Hildebrand, H F; Martel, B

    2006-10-01

    The purpose of this study was to develop a membrane for guided tissue regeneration applicable in periodontology that could release antimicrobial agent during the healing period. Our strategy consisted to graft beta-cyclodextrin (beta-CD), a molecule that is known to form inclusion complexes with a large variety of drugs, onto PVDF membranes. Grafting occurred by using citric acid that provoked a crosslinking reaction of beta-CD, and the resulting polymer was imprisoned into the porous structure of the PVDF membrane. The reaction produced a weight increase of the membrane, the range of which depended on the temperature and on the time of curing applied in the process. The biological behavior of the membranes evaluated by proliferation and vitality tests showed good proliferation and improved activity of L132 epithelial cells on the raw and on the grafted membranes. Doxycyclin (DOX) and chlorhexidine (CHX) were used as antimicrobial agents. Their inclusion into the beta-CD cavity in aqueous solutions was confirmed by NMR spectroscopy. After the impregnation of the membranes with DOX and CHX, their release was studied in vitro in batch type experiments and measured by UV spectrophotometry. Low amounts of DOX and CHX were delivered from the raw membranes within the first few hours of tests. Grafted membranes, however, delivered DOX and CHX in larger quantities within 24 h and 10 days respectively. PMID:16758457

  15. Applicability of the Calgary-Cambridge Guide to Dog and Cat Owners for Teaching Veterinary Clinical Communications.

    Science.gov (United States)

    Englar, Ryane E; Williams, Melanie; Weingand, Kurt

    2016-01-01

    Effective communication in health care benefits patients. Medical and veterinary schools not only have a responsibility to teach communication skills, the American Veterinary Medical Association (AVMA) Council on Education (COE) requires that communication be taught in all accredited colleges of veterinary medicine. However, the best strategy for designing a communications curriculum is unclear. The Calgary-Cambridge Guide (CCG) is one of many models developed in human medicine as an evidence-based approach to structuring the clinical consultation through 71 communication skills. The model has been revised by Radford et al. (2006) for use in veterinary curricula; however, the best approach for veterinary educators to teach communication remains to be determined. This qualitative study investigated if one adaptation of the CCG currently taught at Midwestern University College of Veterinary Medicine (MWU CVM) fulfills client expectations of what constitutes clinically effective communication. Two focus groups (cat owners and dog owners) were conducted with a total of 13 participants to identify common themes in veterinary communication. Participants compared communication skills they valued to those taught by MWU CVM. The results indicated that while the CCG skills that MWU CVM adopted are applicable to cat and dog owners, they are not comprehensive. Participants expressed the need to expand the skillset to include compassionate transparency and unconditional positive regard. Participants also expressed different communication needs that were attributed to the species of companion animal owned.

  16. Railo 3 Beginner's Guide

    CERN Document Server

    Drew, Mark

    2011-01-01

    Part of Packt's Beginner's Guide series, this book uses practical examples and screenshots to steadily guide the reader through setting up and using Railo. If you want to develop your own dynamic web applications using CFML, then this book is for you. No prior experience with Railo or CFML is required, although you will be expected to have some web application development experience and knowledge of HTML.

  17. PrimeFaces beginner's guide

    CERN Document Server

    Reddy, K Siva Prasad

    2013-01-01

    A guide for beginner's with step-by-step instructions and an easy-to-follow approach.PrimeFaces Beginners Guide is a simple and effective guide for beginners, wanting to learn and implement PrimeFaces in their JSF-based applications. Some basic JSF and jQuery skills are required before you start working through the book.

  18. Stereotactic body radiotherapy for liver tumors. Principles and practical guidelines of the DEGRO Working Group on Stereotactic Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Sterzing, Florian [Deutsches Krebsforschungszentrum (DKFZ), Klinische Kooperationseinheit Strahlentherapie, Heidelberg (Germany); Radiologische Universitaetsklinik, Abteilung fuer Radioonkologie und Strahlentherapie, Heidelberg (Germany); Brunner, Thomas B. [Universitaetsklinikum Freiburg, Klinik fuer Strahlenheilkunde, Radiologische Klinik, Freiburg (Germany); Ernst, Iris; Greve, Burkhard [Universitaetsklinikum Muenster, Klinik fuer Strahlentherapie - Radioonkologie, Muenster (Germany); Baus, Wolfgang W. [Universitaetsklinikum Koeln, Klinik und Poliklinik fuer Strahlentherapie, Koeln (Germany); Herfarth, Klaus [Radiologische Universitaetsklinik, Abteilung fuer Radioonkologie und Strahlentherapie, Heidelberg (Germany); Guckenberger, Matthias [UniversitaetsSpital Zuerich, Klinik fuer Radio-Onkologie, Zuerich (Switzerland)

    2014-10-15

    This report of the Working Group on Stereotactic Radiotherapy of the German Society of Radiation Oncology (DEGRO) aims to provide a practical guideline for safe and effective stereotactic body radiotherapy (SBRT) of liver tumors. The literature on the clinical evidence of SBRT for both primary liver tumors and liver metastases was reviewed and analyzed focusing on both physical requirements and special biological characteristics. Recommendations were developed for patient selection, imaging, planning, treatment delivery, motion management, dose reporting, and follow-up. Radiation dose constraints to critical organs at risk are provided. SBRT is a well-established treatment option for primary and secondary liver tumors associated with low morbidity. (orig.) [German] Die Arbeitsgruppe Stereotaxie der Deutschen Gesellschaft fuer Radioonkologie (DEGRO) legt hier eine Empfehlung zur sicheren und effektiven Durchfuehrung der SBRT von Lebertumoren vor. Eine Literaturrecherche zur Untersuchung der Evidenz der SBRT sowohl fuer primaere Lebertumore als auch fuer Lebermetastasen wurde durchgefuehrt. Auf dieser Basis werden Empfehlungen fuer technisch-physikalische Voraussetzungen wie auch fuer die taegliche Praxis der Leber-SBRT gegeben. Weiterhin werden radiobiologische Besonderheiten dieses Verfahrens dargestellt. Praktische Vorgaben werden fuer Patientenselektion, Bildgebung, Planung, Applikation, Bewegungsmanagement, Dosisdokumentation und Follow-up gegeben. Dosisempfehlungen fuer die kritischen Risikoorgane werden dargestellt. Die SBRT stellt eine etablierte Behandlungsmethode fuer primaere und sekundaere Lebertumore dar und ist mit niedriger Morbiditaet assoziiert. (orig.)

  19. Clinical experience of stereotactic biopsy for the brain lesions%立体定向脑内病灶活检的临床意义

    Institute of Scientific and Technical Information of China (English)

    田增民; 王亚明; 于新; 赵全军; 惠瑞; 刘锐; 李志超

    2010-01-01

    目的 探讨先进图像引导立体定向脑组织活检术方法 ,明确其在神经系统疾病诊断中的意义.方法 回顾性分析1987年12月至2009年1月立体定向脑内病灶活检的1187例病历资料,其中男性694例(58.5%),女性493例(41.5%);年龄1~85岁(平均39.7岁).CT(含正电子发射断层扫描)引导活检607例,MRI(含氢质子磁共振波谱成像)引导活检580例;采用常规框架立体定向活检手术726例,采用无框架立体定向机器人活检手术461例(含定向引导神经内镜活检).早期450例立体定向手术定位,采用CT或MRI图像测量靶点坐标方法 ,不能立体显示穿刺途径;后期737例立体定向手术定位,采用计算机三维重建病灶方法 ,能够立体显示穿刺路径.结果 活检明确组织病理学诊断1156例(活检阳性诊断率97.4%).本组中983例(82.8%)获得肿瘤学病理诊断,主要包括神经胶质瘤、转移性肿瘤、原发性淋巴瘤、生殖细胞瘤等;173例(14.6%)为非肿瘤性病变,其中包括多发硬化和瘤样脱髓鞘病变、神经变性疾病、炎性病变、寄生虫病等.活检穿刺手术并发少量血肿(10ml)需要外科处理(置管引流或开颅血肿清除)9例(0.8%);活检出血导致死亡3例(0.3%).本组无颅内感染病例.结论 先进影像技术引导的立体定向脑组织活检术是一种微侵袭、可靠的脑内疾病确定诊断手段.生化成像、功能成像技术的发展,为立体定向引导的活检技术赋予了崭新的内容.%Objectives To investigate the methodology of diversified advanced image-guided stereotactic biopsy for the brain lesions, and its diagnostic significance and experience in nervous system diseases. Methods Retrospectively reviewed 1187 cases of brain lesions underwent image-guided stereotactic biopsy from December 1987 to January 2009. There were 694 male (58.5% )and 493 female (41.5%)patients, aged from 1 to 85 years (average 39.7 years). There were 607 cases in CT-guided

  20. MO-B-18C-01: Proton Therapy II: Proton Stereotactic Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Winey, B; Daartz, J [Massachusetts General Hospital, Boston, MA (United States)

    2014-06-15

    Proton stereotactic radiotherapy shares fundamental principles with general proton therapy physics, specifically range uncertainties and broad beam measurement techniques. Significant differences emerge when treating with smaller field sizes that suffer lateral disequilibrium and when fractions are reduced. This session will explore the history and scope of proton stereotactic radiotherapy in clinical practice. Uncertainties and treatment planning methods specific to stereotactic treatments will be discussed. The session will include an overview of the physical properties of small proton fields and resulting needs for accurate measurements and modeling of dose distributions for radiosurgery treatment planning. Learning Objectives: Understand the clinical rationale for proton radiosurgery. Understand the similarities and differences from general proton therapy. Understand the similarities and differences from photon stereotactic radiosurgery. Understand the basic physics and clinical physics methods for measuring and commissioning a radiosurgery program.

  1. Stereotactic radiotherapy and radiosurgery in pediatric patients: analysis of indications and outcome

    DEFF Research Database (Denmark)

    Mirza, Bilal; Mønsted, Anne; Jensen, Josephine Harding;

    2010-01-01

    We describe indications, outcomes, and risk profiles of fractionated stereotactic radiotherapy (SRT) and single fraction "radiosurgery" (SRS) in pediatric patients compared to the adult population and evaluate the causal role of SRS and SRT in inducing new neurological complications....

  2. The clinical outcome of intracranial hemangioblastomas treated with linac-based stereotactic radiosurgery and radiotherapy

    OpenAIRE

    Puataweepong, Putipun; Dhanachai, Mantana; Hansasuta, Ake; Dangprasert, Somjai; Sitathanee, Chomporn; Puddhikarant, Parmon; Jiarpinitnun, Chuleeporn; Ruangkanchanasetr, Rawee; Dechsupa, Patchareporn; Pairat, Kumutinee

    2014-01-01

    Recent publications have reported stereotactic radiosurgery as an effective and safe treatment for intracranial hemangioblastomas. However, because of the low incidence of these particular tumors, reports on large patient number studies have not yet been available. The objective of this study was to analyze the clinical results of 14 patients with 56 intracranial hemangioblastomas treated with linear accelerator (linac)-based stereotactic radiosurgery (SRS) and radiotherapy (SRT) in the same ...

  3. Stereotactic radiosurgery for arteriovenous malformations noninvasive; Radiocirugia estereotaxica no invasiva para malformaciones arteriovenosas

    Energy Technology Data Exchange (ETDEWEB)

    Rodriguez Romero, R.; Castro Tejero, P.; Sanchez Rubio, P.; Nunez Martin, L.; Medrano, J. C.

    2011-07-01

    Historically, stereotactic radiosurgery has been associated with invasive fixation systems-location guarantee that sub-millimeter accuracy to deliver high radiation doses to small volumes. The development of noninvasive stereotactic systems (no frame) allow for greater patient comfort without compromising accuracy. System availability BrainLAB for frame less cranial arteriovenous malformations (AVM) is relatively recent. It discusses the preliminary results of the positioning accuracy of AVM patients treated with the frame less system.

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

    OpenAIRE

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

    2008-01-01

    Anatomical knowledge of the structures to be targeted and of the circuitry involved is crucial in stereotactic functional neurosurgery. The present study was undertaken in the context of surgical treatment of motor disorders such as essential tremor (ET) and Parkinson’s disease (PD) to precisely determine the course and three-dimensional stereotactic localisation of the cerebellothalamic and pallidothalamic tracts in the human brain. The course of the fibre tracts to the thalamus was traced i...

  5. MR findings of stereotactic radiofrequency VIM-Thalamotomy

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Joo Hyun; Hwang, Hee Young; Lee, Un; Kim, Hyung Sik; Lee, Young Seok [Chung-Ang Gil General Hospital, Inchon (Korea, Republic of); Kim, Sang Jun [Dankook University Hospital, Seoul (Korea, Republic of)

    1994-09-15

    To evaluate the role of the MRI after the stereotactic radiofrequency ventralis intermedius nucleus(VIM) thalamotomy for the treatment of tremor. 156 cases of the postthalamotomy MR findings were analyzed retrospectively. The sagittal T1 weighted image(WI), axial and coronal Proton and T2WI were obtained by using 0.38 T(Resonex Sunnyvale, U. S. A) machine . The interval between thalamotomy and MR examination was from 3 days to 2 months. The MR characteristics and complications related to thalamotomy were reviewed. In 16 cases, a follow-up MR was done 3 to 13 months after the initial MR study. We also reviewed the follow-up MR findings. The mean size of the thalamus lesion was 16 mm. The thalamus lesions were noted as a single layer in 23 cases and as layers of different signal intensity in 100 cases; (2 layers in 84 cases, and 3 or more layers in 16 cases). In 74 cases of the 84 cases with 2 layers, the inner layers was isointense with gray matter on T1WI, hypointense on T2WI, and the outer layer was hypointense on T1WI, hypointense on T2WI. There were extrathalamic lesions that were related to mistargetting of stereotactic radiofrequency. The locations of the extrathalamic lesions were the posterior limb of the interal capsule(119 case), the posterior limb of the internal capsule and the midbrain(39 cases), the posterior limb of the internal capsule and the basal ganglia(11 cases), and the midbraine(9 cases). In 5 cases of the mistargetting, double radiofrequency lesions were visualized because of the repeated coaqulation. The other complications were intracerebral hemorrhage(2 cases), subdural hemorrhage(2 cases), epidural hemorrhage(1 case), and intraventricular hemorrhage(1 case). On the follow up MR studies(16 cases), 2 cases showed the hemosiderin deposition in periphery of the lesion. The MRI was useful for the evaluation of the thalamic lesions and complications after the stereotactic radiofrequency VIM-thalamotomy for the treatment of tumor.

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

    Science.gov (United States)

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

    2012-06-01

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

  7. Creative arts therapies in psychiatry : A clinical application of the Bonny method of guided imagery and music and creative arts groups

    OpenAIRE

    Körlin, Dag

    2005-01-01

    The Creative Arts Therapies (CATs) are characterized by imagery in altered states of consciousness, artistic expression (art, music, dance, drama) and metaphoric expression (as in poetry). The CATs implemented in this thesis consist of The Bonny Method of Guided Imagery and Music (BMGIM), and the Spektrum Creative arts group program. Spektrum is a four-week treatment program, where group applications of BMGIM and Art therapy are combined with psychodynamic verbal group and o...

  8. Six-dimensional correction of intra-fractional prostate motion with CyberKnife stereotactic body radiation therapy

    Directory of Open Access Journals (Sweden)

    Sean eCollins

    2011-12-01

    Full Text Available AbstractLarge fraction radiation therapy offers a shorter course of treatment and radiobiological advantages for prostate cancer treatment. The CyberKnife is an attractive technology for delivering large fraction doses based on the ability to deliver highly conformal radiation therapy to moving targets. In addition to intra-fractional translational motion (left-right, superior-inferior and anterior-posterior, prostate rotation (pitch, roll and yaw can increase geographical miss risk. We describe our experience with six-dimensional (6D intrafraction prostate motion correction using CyberKnife stereotactic body radiation therapy (SBRT. Eighty-eight patients were treated by SBRT alone or with supplemental external radiation therapy. Trans-perineal placement of four gold fiducials within the prostate accommodated X-ray guided prostate localization and beam adjustment. Fiducial separation and non-overlapping positioning permitted the orthogonal imaging required for 6D tracking. Fiducial placement accuracy was assessed using the CyberKnife fiducial extraction algorithm. Acute toxicities were assessed using Common Toxicity Criteria (CTC v3. There were no Grade 3, or higher, complications and acute morbidity was minimal. Ninety-eight percent of patients completed treatment employing 6D prostate motion tracking with intrafractional beam correction. Suboptimal fiducial placement limited treatment to 3D tracking in 2 patients. Our experience may guide others in performing 6D correction of prostate motion with CyberKnife SBRT.

  9. Application for TJ-II Signals Visualization: User's Guide; Aplicacion para la Visualizacion de Senales de TJ-II: Guia del Usuario

    Energy Technology Data Exchange (ETDEWEB)

    Sanchez, E.; Portas, A. B.; Vega, J. [Ciemat, Madrid (Spain)

    2000-07-01

    In this documents are described the functionalities of the application developed by the Data Acquisition Group for TJ-II signal visualization. There are two versions of the application, the On-line version, used for signal visualization during TJ-II operation, and the Off-line version, used for signal visualization without TJ-II operation. Both versions of the application consist in a graphical user interface developed for X/Motif, in which most of the actions can be done using the mouse buttons. The functionalities of both versions of the application are described in this user's guide, beginning at the application start-up and explaining in detail all the options that it provides and the actions that can be done with each graphic control. (Author) 8 refs.

  10. Ultrasound-Guided Pulsed Radiofrequency Application via the Pterygopalatine Fossa: A Practical Approach to Treat Refractory Trigeminal Neuralgia.

    Science.gov (United States)

    Nader, Antoun; Bendok, Bernard R; Prine, Jeremy J; Kendall, Mark C

    2015-01-01

    Although pharmacological therapy is the primary treatment modality for trigeminal neuralgia associated pain, ineffective analgesia and dose limiting side effects often prompt patients to seek alternative pharmacological solutions such as interventional nerve blockade. Blockade of the Gasserian ganglion or its branches is an effective analgesic procedure for trigeminal neuralgia, traditionally performed using fluoroscopy or CT imaging. Ultrasonography allows point of care and real time visualization of needle placement within the surrounding anatomical structures. The use of ultrasonography with pulsed radiofrequency therapy for trigeminal neuralgia has not been reported. Our case is a 66-year-old male suffering from trigeminal neuralgia for 4 years that was refractory to pharmacologic therapy. Neurological examination was normal with no sensory deficit. Imaging showed no vascular compression or mass involving the trigeminal nerve. A diagnostic ultrasound-guided trigeminal nerve block via the pterygopalatine fossa with 4 mL of bupivacaine 0.25% and 4 mg dexamethasone provided immediate pain relief (100%) with sustained analgesia >50% at 2 weeks. Pain relief was not sustained at one month, with return to pretreatment symptoms. A series of injections were performed with similar intermittent analgesic effectiveness. The decision was made that the patient was a suitable candidate for pulsed radiofrequency application in the pterygopalatine fossa. We successfully used an alternative approach through the pterygopalatine fossa to treat trigeminal neuralgia using ultrasound guidance in an office setting. Our case demonstrates the utility of ultrasound-guidance pulsed radiofrequency treatment in the pterygopalatine fossa as a potential alternative to other percutaneous techniques for patients with medical refractory trigeminal neuralgia.

  11. The benefits of paired-agent imaging in molecular-guided surgery: an update on methods and applications (Conference Presentation)

    Science.gov (United States)

    Tichauer, Kenneth M.

    2016-03-01

    One of the major complications with conventional imaging-agent-based molecular imaging, particularly for cancer imaging, is variability in agent delivery and nonspecific retention in biological tissue. Such factors can account to "swamp" the signal arising from specifically bound imaging agent, which is presumably indicative of the concentration of targeted biomolecule. In the 1950s, Pressman et al. proposed a method of accounting for these delivery and retention effects by normalizing targeted antibody retention to the retention of a co-administered "untargeted"/control imaging agent [1]. Our group resurrected the approach within the last 5 years, finding ways to utilize this so-called "paired-agent" imaging approach to directly quantify biomolecule concentration in tissue (in vitro, ex vivo, and in vivo) [2]. These novel paired-agent imaging approaches capable of quantifying biomolecule concentration provide enormous potential for being adapted to and optimizing molecular-guided surgery, which has a principle goal of identifying distinct biological tissues (tumor, nerves, etc…) based on their distinct molecular environment. This presentation will cover the principles and nuances of paired-agent imaging, as well as the current status of the field and future applications. [1] D. Pressman, E. D. Day, and M. Blau, "The use of paired labeling in the determination of tumor-localizing antibodies," Cancer Res, 17(9), 845-50 (1957). [2] K. M. Tichauer, Y. Wang, B. W. Pogue et al., "Quantitative in vivo cell-surface receptor imaging in oncology: kinetic modeling and paired-agent principles from nuclear medicine and optical imaging," Phys Med Biol, 60(14), R239-69 (2015).

  12. Clinical application of CT and CT-guided percutaneous transthoracic needle biopsy in patients with indeterminate pulmonary nodules

    Energy Technology Data Exchange (ETDEWEB)

    Cardoso, Luciana Vargas; Souza Júnior, Arthur Soares, E-mail: fabianonatividade@terra.com.br [Rio Preto-Ultra-X Radiological Diagnosis Institute, São José do Rio Preto, SP (Brazil)

    2014-07-15

    Objective: To investigate the clinical application of CT and CT-guided percutaneous transthoracic needle biopsy (CT-PTNB) in patients with indeterminate pulmonary nodules (IPNs). Methods: We retrospectively studied 113 patients with PNs undergoing CT and CT-PTNB. Variables such as gender, age at diagnosis, smoking status, CT findings, and CT-PTNB techniques were analyzed. Data analysis was performed with the Student's t-test for independent samples the chi-square test, and normal approximation test for comparison of two proportions. Results: Of the 113 patients studied, 68 (60.2%) were male and 78 (69%) were smokers. The diameter of malignant lesions ranged from 2.6 cm to 10.0 cm. Most of the IPNs (85%) were located in the peripheral region. The biopsied IPNs were found to be malignant in 88 patients (77.8%) and benign in 25 (22.2%). Adenocarcinoma was the most common malignant tumor, affecting older patients. The IPN diameter was significantly greater in patients with malignant PNs than in those with benign IPNs (p < 0.001). Having regular contour correlated significantly with an IPN being benign (p = 0.022), whereas spiculated IPNs and bosselated IPNs were more often malignant (in 50.7% and 28.7%, respectively). Homogeneous attenuation and necrosis were more common in patients with malignant lesions (51.9% and 26.9%, respectively). Conclusions: In our sample, CT and CT-PTNB were useful in distinguishing between malignant and benign IPNs. Advanced age and smoking were significantly associated with malignancy. Certain CT findings related to IPNs (larger diameter, spiculated borders, homogeneous attenuation, and necrosis) were associated with malignancy. (author)

  13. Image-guided therapies in the treatment of hepatocellularcarcinoma: A multidisciplinary perspective

    Institute of Scientific and Technical Information of China (English)

    Jonathon Willatt; Kevin K Hannawa; Julie A Ruma; Timothy L Frankel; Dawn Owen; Pranab M Barman

    2015-01-01

    A multidisciplinary approach to the treatment ofpatients with unresectable hepatocellular carcinoma(HCC) has led to improvements in screening, detection,and treatments. Interventional techniques includethermal ablation, transarterial chemoembolization, andradioembolization whilst stereotactic body radiationtherapy also uses imaging to target the radiation. Bothsurvival rates and cure rates have improved markedlysince the introduction of these techniques. This reviewarticle describes the image guided techniques used forthe treatment of HCC.

  14. Stereotactic radiosurgery dosimetry using thermoluminescent dosimeters and radiochromic films

    Science.gov (United States)

    Ávila-Rodríguez, Miguel A.; Rodríguez-Villafuerte, Mercedes; Perches, Rodolfo Díaz

    2000-10-01

    In this work we present a protocol to measure absorbed dose distributions in stereotactic radiosurgery treatments with a linear accelerator (Linac) using thermoluminescent dosimeters (TLD) and radiochromic dye films. A Linac Philips SL-15 (6 MV X-rays), a ZD2 stereoactic system for localizing the target via computed tomography (CT), and Leibinger radiosurgery accessories will be used. A versatile spherical acrylic phantom of 16 cm diameter to measure the dose distributions has been designed. The phantom is composed of two hemispheres. On one flat side of the hemispheres an array of Harshaw/Bicron TLD-100 or a sheet of GafChromic MD-55 film will be placed. The phantom will be irradiated in three different orientations to obtain spatial dose distributions in the coronal, sagital and transverse planes. The experimental measurement will be compared with the results provided by a commercial treatment-planning system.

  15. Gastrointestinal Toxicities With Combined Antiangiogenic and Stereotactic Body Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Pollom, Erqi L.; Deng, Lei [Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California (United States); Pai, Reetesh K. [Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (United States); Brown, J. Martin; Giaccia, Amato; Loo, Billy W.; Shultz, David B.; Le, Quynh Thu; Koong, Albert C. [Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California (United States); Chang, Daniel T., E-mail: dtchang@stanford.edu [Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California (United States)

    2015-07-01

    Combining the latest targeted biologic agents with the most advanced radiation technologies has been an exciting development in the treatment of cancer patients. Stereotactic body radiation therapy (SBRT) is an ablative radiation approach that has become established for the treatment of a variety of malignancies, and it has been increasingly used in combination with biologic agents, including those targeting angiogenesis-specific pathways. Multiple reports have emerged describing unanticipated toxicities arising from the combination of SBRT and angiogenesis-targeting agents, particularly of late luminal gastrointestinal toxicities. In this review, we summarize the literature describing these toxicities, explore the biological mechanism of action of toxicity with the combined use of antiangiogenic therapies, and discuss areas of future research, so that this combination of treatment modalities can continue to be used in broader clinical contexts.

  16. Complications from Stereotactic Body Radiotherapy for Lung Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Kylie H. [School of Medicine, Case Western Reserve University, Cleveland, OH 44106 (United States); Okoye, Christian C.; Patel, Ravi B. [Department of Radiation Oncology, University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH 44106 (United States); Siva, Shankar [Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, East Melbourne, Victoria 3002 (Australia); Biswas, Tithi; Ellis, Rodney J.; Yao, Min; Machtay, Mitchell; Lo, Simon S., E-mail: Simon.Lo@uhhospitals.org [Department of Radiation Oncology, University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH 44106 (United States)

    2015-06-15

    Stereotactic body radiotherapy (SBRT) has become a standard treatment option for early stage, node negative non-small cell lung cancer (NSCLC) in patients who are either medically inoperable or refuse surgical resection. SBRT has high local control rates and a favorable toxicity profile relative to other surgical and non-surgical approaches. Given the excellent tumor control rates and increasing utilization of SBRT, recent efforts have focused on limiting toxicity while expanding treatment to increasingly complex patients. We review toxicities from SBRT for lung cancer, including central airway, esophageal, vascular (e.g., aorta), lung parenchyma (e.g., radiation pneumonitis), and chest wall toxicities, as well as radiation-induced neuropathies (e.g., brachial plexus, vagus nerve and recurrent laryngeal nerve). We summarize patient-related, tumor-related, dosimetric characteristics of these toxicities, review published dose constraints, and propose strategies to reduce such complications.

  17. Complications from Stereotactic Body Radiotherapy for Lung Cancer

    International Nuclear Information System (INIS)

    Stereotactic body radiotherapy (SBRT) has become a standard treatment option for early stage, node negative non-small cell lung cancer (NSCLC) in patients who are either medically inoperable or refuse surgical resection. SBRT has high local control rates and a favorable toxicity profile relative to other surgical and non-surgical approaches. Given the excellent tumor control rates and increasing utilization of SBRT, recent efforts have focused on limiting toxicity while expanding treatment to increasingly complex patients. We review toxicities from SBRT for lung cancer, including central airway, esophageal, vascular (e.g., aorta), lung parenchyma (e.g., radiation pneumonitis), and chest wall toxicities, as well as radiation-induced neuropathies (e.g., brachial plexus, vagus nerve and recurrent laryngeal nerve). We summarize patient-related, tumor-related, dosimetric characteristics of these toxicities, review published dose constraints, and propose strategies to reduce such complications

  18. The use of stereotactic radiosurgery in the management of meningiomas.

    Science.gov (United States)

    Malik, Irfan; Rowe, J G; Walton, L; Radatz, M W R; Kemeny, A A

    2005-02-01

    This is a systematic review of a consecutive series of 309 meningiomas treated with gamma knife stereotactic radiosurgery between 1994 and 2000. There was an extreme selection bias towards lesions unfavourable for surgery, determined by the patients referred for treatment: 70% of tumours involved the skull base, 47% specifically the cavernous sinus: 15% of patients had multiple meningiomatosis or type 2 neurofibromatosis. Tumour histology was the main determinant of growth control (p < 0.001), the 5-year actuarial control rates being 87% for typical meningiomas, 49% for atypical tumours and 0% for malignant lesions. Complications from radiosurgery were rare, occurring in 3% of tumours, and were most frequently trigeminal and eye movement disturbances treating cavernous sinus meningiomas. Given the problems inherent in managing these tumours, radiosurgery is a valuable strategy and adjuvant treatment for these meningiomas.

  19. Dose volume analysis in brachytherapy and stereotactic radiosurgery

    CERN Document Server

    Tozer-Loft, S M

    2000-01-01

    compared with a range of figures of merit which express different aspects of the quality of each dose distributions. The results are analysed in an attempt to answer the question: What are the important features of the dose distribution (conformality, uniformity, etc) which show a definite relationship with the outcome of the treatment? Initial results show positively that, when Gamma Knife radiosurgery is used to treat acoustic neuroma, some measures of conformality seem to have a surprising, but significant association with outcome. A brief introduction to three branches of radiotherapy is given: interstitial brachytherapy, external beam megavoltage radiotherapy, and stereotactic radiosurgery. The current interest in issues around conformity, uniformity and optimisation is explained in the light of technical developments in these fields. A novel method of displaying dose-volume information, which mathematically suppresses the inverse-square law, as first suggested by L.L. Anderson for use in brachytherapy i...

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  2. Stereotactic radiotherapy in the liver hilum. Basis for future studies

    Energy Technology Data Exchange (ETDEWEB)

    Zamboglou, C.; Messmer, M.B.; Momm, F. [Univ. Hospital Freiburg (Germany). Dept. of Radiation Oncology; Becker, G. [Univ. Hospital Freiburg (Germany). Dept. of Gastroenterology and Hepatology

    2012-01-15

    A basis for future trials with stereotactic body radiotherapy (SBRT) for tumors of the liver hilum should be established. Thus, dosage concepts, planning processes, and dose constraints as well as technical innovations are summarized in this contribution. Methods On the background of our own data, the current literature was reviewed. The use of SBRT in the most common tumors of the liver hilum (pancreatic cancer and Klatskin tumors) was investigated. Dose constraints were calculated in 2 Gy standard fractionation doses. Results A total of 8 pilot or phase I/II studies about SBRT in the liver hilum were identified. In recent years, the SBRT technique has developed very quickly from classical stereotactic body frame radiotherapy to IGRT techniques including gating and tracking systems. In the studies using classical body frame technique, patients experienced considerable toxicities (duodenal ulcer/perforation) as compared to tolerable side effects in IGRT studies (<10% grade 3 and 4 toxicities). Dose constraints for duodenum, liver, kidneys, colon, and spinal cord were derived from the investigated studies. Survival and local tumor control data are very heterogeneous: median survival in these patients with locally advanced pancreatic or Klatskin tumors ranges between 5 and 32 months. Excellent local tumor control rates of about 80% over 24 months were achieved using SBRT. Conclusion Despite a few negative results, SBRT seems to be a promising technique in the treatment of tumors of the liver hilum. Highest precision in diagnostics, positioning, and irradiation as well as strict dose constraints should be applied to keep target volumes as small as possible and side effects tolerable. (orig.)

  3. Dose volume analysis in brachytherapy and stereotactic radiosurgery

    Energy Technology Data Exchange (ETDEWEB)

    Tozer-Loft, S.M

    2000-12-01

    A brief introduction to three branches of radiotherapy is given: interstitial brachytherapy, external beam megavoltage radiotherapy, and stereotactic radiosurgery. The current interest in issues around conformity, uniformity and optimisation is explained in the light of technical developments in these fields. A novel method of displaying dose-volume information, which mathematically suppresses the inverse-square law, as first suggested by L.L. Anderson for use in brachytherapy is explained in detail, and some improvements proposed. These 'natural' histograms are extended to show the effects of real point sources which do not exactly follow the inverse-square law, and to demonstrate the in-target dose-volume distribution, previously unpublished. The histograms are used as a way of mathematically analysing the properties of theoretical mono-energetic radionuclides, and for demonstrating the dosimetric properties of a potential new brachytherapy source (Ytterbium-169). A new modification of the Anderson formalism is then described for producing Anderson Inverse-Square Shifted (AISS) histograms for the Gamma Knife, which are shown to be useful for demonstrating the quality of stereotactic radiosurgery dose distributions. A study is performed analysing the results of Gamma Knife treatments on 44 patients suffering from a benign brain tumour (acoustic neuroma). Follow-up data is used to estimate the volume shrinkage or growth of each tumour, and this measure of outcome is compared with a range of figures of merit which express different aspects of the quality of each dose distributions. The results are analysed in an attempt to answer the question: What are the important features of the dose distribution (conformality, uniformity, etc) which show a definite relationship with the outcome of the treatment? Initial results show positively that, when Gamma Knife radiosurgery is used to treat acoustic neuroma, some measures of conformality seem to have a surprising

  4. Hazard screening application guide

    International Nuclear Information System (INIS)

    The basic purpose of hazard screening is to group precesses, facilities, and proposed modifications according to the magnitude of their hazards so as to determine the need for and extent of follow on safety analysis. A hazard is defined as a material, energy source, or operation that has the potential to cause injury or illness in human beings. The purpose of this document is to give guidance and provide standard methods for performing hazard screening. Hazard screening is applied to new and existing facilities and processes as well as to proposed modifications to existing facilities and processes. The hazard screening process evaluates an identified hazards in terms of the effects on people, both on-site and off-site. The process uses bounding analyses with no credit given for mitigation of an accident with the exception of certain containers meeting DOT specifications. The process is restricted to human safety issues only. Environmental effects are addressed by the environmental program. Interfaces with environmental organizations will be established in order to share information

  5. [18F]Choline PET/CT and stereotactic body radiotherapy on treatment decision making of oligometastatic prostate cancer patients: preliminary results

    International Nuclear Information System (INIS)

    A new entity of patients with recurrent prostate cancer limited to a small number of active metastatic lesions is having growing interest: the oligometastatic patients. Patients with oligometastatic disease could eventually be managed by treating all the active lesions with local therapy, i.e. either surgery or ablative stereotactic body radiotherapy. This study aims to assess the impact of [18F]Choline ([18F]FMCH) PET/CT and the use stereotactic body radiotherapy (SBRT) in patients (pts) with oligometastatic prostate cancer (PCa). Twenty-nine pts with oligometastatic PCa (≤3 synchronous active lesions detected with [18F]FMCHPET/CT) were treated with repeated salvage SBRT until disease progression (development of > three active synchronous metastases). Primary endpoint was systemic therapy-free survival measured from the baseline [18F]FMCHPET/CT. A total of 45 lesions were treated with SBRT. After a median follow-up of 11.5 months (range 3–40 months), 20 pts were still in the study and did not receive any systemic therapy. Nine pts started systemic therapy, and the median time of the primary endpoint was 39.7 months (CI 12.20–62.14 months). No grade 3 or 4 toxicity was recorded. Repeated salvage [18F]FMCHPET/CT-guided SBRT is well tolerated and could defer the beginning of systemic therapy in selected patients with oligometastatic PCa

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

    Energy Technology Data Exchange (ETDEWEB)

    Lu Xingqi, E-mail: xlu@bidmc.harvard.edu [Department of Radiation Oncology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (United States); Mahadevan, Anand; Mathiowitz, George [Department of Radiation Oncology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (United States); Lin, Pei-Jan P. [Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (United States); Thomas, Ajith; Kasper, Ekkehard M. [Department of Neurosurgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (United States); Floyd, Scott R.; Holupka, Edward; La Rosa, Salvatore; Wang, Frank; Stevenson, Mary Ann [Department of Radiation Oncology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (United States)

    2012-09-01

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

  7. Hematological Toxicity After Robotic Stereotactic Body Radiosurgery for Treatment of Metastatic Gynecologic Malignancies

    Energy Technology Data Exchange (ETDEWEB)

    Kunos, Charles A., E-mail: charles.kunos@UHhospitals.org [Department of Radiation Oncology, University Hospitals Case Medical Center and Case Western Reserve University School of Medicine, Cleveland, Ohio (United States); Debernardo, Robert [Department of Obstetrics and Gynecology, University Hospitals Case Medical Center and Case Western Reserve University School of Medicine, Cleveland, Ohio (United States); Radivoyevitch, Tomas [Department of Epidemiology and Biostatistics, University Hospitals Case Medical Center and Case Western Reserve University School of Medicine, Cleveland, Ohio (United States); Fabien, Jeffrey; Dobbins, Donald C.; Zhang Yuxia; Brindle, James [Department of Radiation Oncology, University Hospitals Case Medical Center and Case Western Reserve University School of Medicine, Cleveland, Ohio (United States)

    2012-09-01

    Purpose: To evaluate hematological toxicity after robotic stereotactic body radiosurgery (SBRT) for treatment of women with metastatic abdominopelvic gynecologic malignancies. Methods and Materials: A total of 61 women with stage IV gynecologic malignancies treated with abdominopelvic SBRT were analyzed after ablative radiation (2400 cGy/3 divided consecutive daily doses) delivered by a robotic-armed Cyberknife SBRT system. Abdominopelvic bone marrow was identified using computed tomography-guided contouring. Fatigue and hematologic toxicities were graded by retrospective assignment of common toxicity criteria for adverse events (version 4.0). Bone marrow volume receiving 1000 cGy (V10) was tested for association with post-therapy (median 32 days [25%-75% quartile, 28-45 days]) white- or red-cell counts, hemoglobin levels, and platelet counts as marrow toxicity surrogates. Results: In all, 61 women undergoing abdominopelvic SBRT had a median bone marrow V10 of 2% (25%-75% quartile: 0%-8%). Fifty-seven (93%) of 61 women had received at least 1 pre-SBRT marrow-taxing chemotherapy regimen for metastatic disease. Bone marrow V10 did not associate with hematological adverse events. In all, 15 grade 2 (25%) and 2 grade 3 (3%) fatigue symptoms were self-reported among the 61 women within the first 10 days post-therapy, with fatigue resolved spontaneously in all 17 women by 30 days post-therapy. Neutropenia was not observed. Three (5%) women had a grade 1 drop in hemoglobin level to <10.0 g/dL. Single grade 1, 2, and 3 thrombocytopenias were documented in 3 women. Conclusions: Abdominopelvic SBRT provided ablative radiation dose to cancer targets without increased bone marrow toxicity. Abdominopelvic SBRT for metastatic gynecologic malignancies warrants further study.

  8. [The use of twist drill craniostomy in stereotactic surgery for brain tumors].

    Science.gov (United States)

    Matsumoto, K; Tomita, S; Nakagawa, M; Adachi, H; Tada, E; Maeda, Y; Furuta, T; Ohmoto, T

    1995-12-01

    A twist drill craniostomy is a rapid and relatively simple technique for perforating the skull in order to gain access to the epidural and subdural spaces and the brain. Fifty-eight patients underwent 173 twist drill craniostomies in the stereotactic procedures for the diagnosis and the treatment of brain tumors (brain tumor biopsy, implanting radioactive sources and placement of the catheters for navigation surgery) from September, 1992, through to May, 1995, at our institute. The technique was compared with standard burr hole craniostomy used in 42 patients with brain tumor. In the twist drill craniostomy, the scalp was penetrated directly by hand twist drill (2.7 mm in diameter) and scalp bleeding was able to be be controlled by injecting local anesthetic with epinephrine subcutaneously. The safety stop on the drill was set in advance based on the expected thickness of the skull at its penetration point to provide control of penetration depth as it passed through the skull hole and dura. A hole in the skull was made as the drill was advanced until a change in resistance indicated that the inner table of the skull had been penetrated and the dura lacerated. The cannula with stylet was then inserted through the guide tube to assure the penetration of the skull and dura. As the cannula penetrated the dura, a loss of resistance was noted as it proceeded through the dura toward the pial surface, The time needed in this procedure was less than 3 minutes. Associated with this procedure, there were no complications such as bleeding, or infection in 173 twist drill craniostomies in the 58 patients. Our experience with this procedure proved it to be simple, efficient, safe and superior to conventional burr hole craniostomy. PMID:8927216

  9. Rapid fabrication of custom patient biopsy guides.

    Science.gov (United States)

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

    2009-01-01

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

  10. Clinical application on CT guiding interventional radiology technology%CT导引介人技术的临床应用

    Institute of Scientific and Technical Information of China (English)

    何建华; 彭述文; 米霞

    2011-01-01

    Objective The Computer Tomography (CT) guiding interventional radiology technology already became an extremely adequate technology in the large-scale general hospital, which was brought in since 2008-2009 in our hospital, and it has carried out dozens of cases, we improved it into a new kind of technology suitable for our hospital after summing up and studying it. This technology should be extended for popular use among the primary hospitals. Methods TOSHIBA Activion 16 screw CT scanner was used with the puncture needle Cook19G.After skin lung puncture biopsy 12 cases, after skin kidney puncture 25 cases, after skin liver puncture 7 cases. Results Among 12 cases of lung puncture biopsy, 9 cases are periphery the lung cancer, 2 cases are the pulmonary tuberculoses, 1 cases is pneumonia change in sexuality. 32 cases livers, the kidney puncture biopsy is a cyst, after extracts the pouch fluid to involve the hardened treatment, biggest cyst 11 cm, smallest cyst approximately 6cm, the short-term reexamination cyst obviously reduces approximately, after half year of reexaminations, the cyst disappeared basically or completely. No serious complication occurred. Conclusion The CT guiding interventional radiology technology belongs to the interventional radiology technology category, its application scope is broad, involving the whole body various systems, becoming one of the important methods of clinical diagnosis and treatment domain with characteristics of high security, minimally invasive surgery and less complication, etc. It' s worth to be extended popularly in primary hospitals.%目的 归纳、总结并不断改进我院CT导引介入技术,形成适应本院的一种新技术.方法 使用TOSHIBA Activion 16螺旋CT扫描机.穿刺针为Cook19G.经皮肺穿刺活检12例,经皮肾穿刺25例,经皮肝穿刺7例.结果 12例肺穿刺活检,9例为周围型肺癌,2例为肺结核,1例为肺炎性变.32例肝、肾穿刺活检为囊肿,抽取囊液后介入

  11. Stereotactic radiosurgery versus stereotactic radiotherapy for patients with vestibular schwannoma: a Leksell Gamma Knife Society 2000 debate.

    Science.gov (United States)

    Linskey, Mark E

    2013-12-01

    By definition, the term "radiosurgery" refers to the delivery of a therapeutic radiation dose in a single fraction, not simply the use of stereotaxy. Multiple-fraction delivery is better termed "stereotactic radiotherapy." There are compelling radiobiological principles supporting the biological superiority of single-fraction radiation for achieving an optimal therapeutic response for the slowly proliferating, late-responding, tissue of a schwannoma. It is axiomatic that complication avoidance requires precise three-dimensional conformality between treatment and tumor volumes. This degree of conformality can only be achieved through complex multiisocenter planning. Alternative radiosurgery devices are generally limited to delivering one to four isocenters in a single treatment session. Although they can reproduce dose plans similar in conformality to early gamma knife dose plans by using a similar number of isocenters, they cannot reproduce the conformality of modern gamma knife plans based on magnetic resonance image--targeted localization and five to 30 isocenters. A disturbing trend is developing in which institutions without nongamma knife radiosurgery (GKS) centers are championing and/or shifting to hypofractionated stereotactic radiotherapy for vestibular schwannomas. This trend appears to be driven by a desire to reduce complication rates to compete with modern GKS results by using complex multiisocenter planning. Aggressive advertising and marketing from some of these centers even paradoxically suggests biological superiority of hypofractionation approaches over single-dose radiosurgery for vestibular schwannomas. At the same time these centers continue to use the term radiosurgery to describe their hypofractionated radiotherapy approach in an apparent effort to benefit from a GKS "halo effect." It must be reemphasized that as neurosurgeons our primary duty is to achieve permanent tumor control for our patients and not to eliminate complications at the

  12. 3D quantitative assessment of response to fractionated stereotactic radiotherapy and single-session stereotactic radiosurgery of vestibular schwannoma

    Energy Technology Data Exchange (ETDEWEB)

    Schneider, T. [The Johns Hopkins Hospital School of Medicine, Russell H. Morgan Department of Radiology and Radiological Sciences, Division of Neuroradiology, Baltimore, MD (United States); University Medical Center Hamburg-Eppendorf, Department of Diagnostic and Interventional Neuroradiology, Hamburg (Germany); Chapiro, J. [The Johns Hopkins Hospital School of Medicine, Russell H. Morgan Department of Radiology and Radiological Sciences, Division of Interventional Radiology, Baltimore, MD (United States); Lin, M. [Philips Research North America, Ultrasound Imaging and Interventions (UII), Briarcliff Manor, NY (United States); Geschwind, J.F. [The Johns Hopkins Hospital School of Medicine, Russell H. Morgan Department of Radiology and Radiological Sciences, Division of Interventional Radiology, Baltimore, MD (United States); Yale University School of Medicine, Department of Radiology and Imaging Science, New Haven, CT (United States); Kleinberg, L. [The Johns Hopkins University School of Medicine, Department of Radiation Oncology and Molecular Radiation Sciences, Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD (United States); Rigamonti, D.; Jusue-Torres, I.; Marciscano, A.E. [The Johns Hopkins University School of Medicine, Department of Neurological Surgery, Baltimore, MD (United States); Yousem, D.M. [The Johns Hopkins Hospital School of Medicine, Russell H. Morgan Department of Radiology and Radiological Sciences, Division of Neuroradiology, Baltimore, MD (United States)

    2016-03-15

    To determine clinical outcome of patients with vestibular schwannoma (VS) after treatment with fractionated stereotactic radiotherapy (FSRT) and single-session stereotactic radiosurgery (SRS) by using 3D quantitative response assessment on MRI. This retrospective analysis included 162 patients who underwent radiation therapy for sporadic VS. Measurements on T1-weighted contrast-enhanced MRI (in 2-year post-therapy intervals: 0-2, 2-4, 4-6, 6-8, 8-10, 10-12 years) were taken for total tumour volume (TTV) and enhancing tumour volume (ETV) based on a semi-automated technique. Patients were considered non-responders (NRs) if they required subsequent microsurgical resection or developed radiological progression and tumour-related symptoms. Median follow-up was 4.1 years (range: 0.4-12.0). TTV and ETV decreased for both the FSRT and SRS groups. However, only the FSRT group achieved significant tumour shrinkage (p < 0.015 for TTV, p < 0.005 for ETV over time). The 11 NRs showed proportionally greater TTV (median TTV pre-treatment: 0.61 cm{sup 3}, 8-10 years after: 1.77 cm{sup 3}) and ETV despite radiation therapy compared to responders (median TTV pre-treatment: 1.06 cm{sup 3}; 10-12 years after: 0.81 cm{sup 3}; p = 0.001). 3D quantification of VS showed a significant decrease in TTV and ETV on FSRT-treated patients only. NR had significantly greater TTV and ETV over time. (orig.)

  13. Stereotactic radiotherapy for early stage non-small cell lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Ricardi, Umberto; Badellino, Serena; Filippi, Andrea Riccardo [Dept. of Oncology, Radiation Oncology, University of Torino, Torino (Italy)

    2015-06-15

    Stereotactic body radiotherapy (SBRT) represents a consolidated treatment option for patients with medically inoperable early stage non-small cell lung cancer (NSCLC). The clinical evidence accumulated in the past decade supports its use as an alternative to surgery with comparable survival outcomes. Due to its limited toxicity, SBRT is also applicable to elderly patients with very poor baseline pulmonary function or other severe comorbidities. Recent comparative studies in operable patients raised the issue of the possible use of SBRT also for this subgroup, with quite promising results that still should be fully confirmed by prospective trials with long-term follow-up. Aim of this review is to summarize and discuss the major studies conducted over the years on SBRT and to provide data on the efficacy and toxicity of this radiotherapy technique for stage I NSCLC. Technical aspects and quality of life related issues are also discussed, with the goal to provide information on the current role and limitations of SBRT in clinical practice.

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

    Science.gov (United States)

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

    1998-06-01

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

  15. Image-guided breast biopsy: state-of-the-art

    Energy Technology Data Exchange (ETDEWEB)

    O' Flynn, E.A.M., E-mail: lizoflynn@doctors.org.u [South East London Breast Screening Programme and National Breast Screening Training Centre, Kings College Hospital NHS Foundation Trust, London SE5 9RS (United Kingdom); Wilson, A.R.M.; Michell, M.J. [South East London Breast Screening Programme and National Breast Screening Training Centre, Kings College Hospital NHS Foundation Trust, London SE5 9RS (United Kingdom)

    2010-04-15

    Percutaneous image-guided breast biopsy is widely practised to evaluate predominantly non-palpable breast lesions. There has been steady development in percutaneous biopsy techniques. Fine-needle aspiration cytology was the original method of sampling, followed in the early 1990s by large core needle biopsy. The accuracy of both has been improved by ultrasound and stereotactic guidance. Larger bore vacuum-assisted biopsy devices became available in the late 1990s and are now commonplace in most breast units. We review the different types of breast biopsy devices currently available together with various localization techniques used, focusing on their advantages, limitations and current controversial clinical management issues.

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

    Science.gov (United States)

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

    1998-06-01

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

  17. Image-guided breast biopsy: state-of-the-art.

    Science.gov (United States)

    O'Flynn, E A M; Wilson, A R M; Michell, M J

    2010-04-01

    Percutaneous image-guided breast biopsy is widely practised to evaluate predominantly non-palpable breast lesions. There has been steady development in percutaneous biopsy techniques. Fine-needle aspiration cytology was the original method of sampling, followed in the early 1990s by large core needle biopsy. The accuracy of both has been improved by ultrasound and stereotactic guidance. Larger bore vacuum-assisted biopsy devices became available in the late 1990s and are now commonplace in most breast units. We review the different types of breast biopsy devices currently available together with various localization techniques used, focusing on their advantages, limitations and current controversial clinical management issues. PMID:20338392

  18. Image-guided breast biopsy: state-of-the-art

    International Nuclear Information System (INIS)

    Percutaneous image-guided breast biopsy is widely practised to evaluate predominantly non-palpable breast lesions. There has been steady development in percutaneous biopsy techniques. Fine-needle aspiration cytology was the original method of sampling, followed in the early 1990s by large core needle biopsy. The accuracy of both has been improved by ultrasound and stereotactic guidance. Larger bore vacuum-assisted biopsy devices became available in the late 1990s and are now commonplace in most breast units. We review the different types of breast biopsy devices currently available together with various localization techniques used, focusing on their advantages, limitations and current controversial clinical management issues.

  19. VOLTTRON: User Guide

    Energy Technology Data Exchange (ETDEWEB)

    Lutes, Robert G.; Katipamula, Srinivas; Akyol, Bora A.; Tenney, Nathan D.; Haack, Jereme N.; Monson, Kyle E.; Carpenter, Brandon J.

    2014-04-24

    This document is a user guide for the deployment of the Transactional Network platform and agent/application development within the VOLTTRON. The intent of this user guide is to provide a description of the functionality of the Transactional Network Platform. This document describes how to deploy the platform, including installation, use, guidance, and limitations. It also describes how additional features can be added to enhance its current functionality.

  20. Extracranial image-guided stereotactic; Stereotaxie extracranienne guidee par l'image

    Energy Technology Data Exchange (ETDEWEB)

    Ailleres, N.; Fenoglietto, P.; Boisselier, P.; Santoro, L.; Idri, K.; Simeon, S.; Azria, D.; Dubois, J.B. [CRLCC, Val d' Aurelle-Paul-Lamarque, Dept. de Radiotherapie Oncologique, 34 - Montpellier (France)

    2009-10-15

    The use of three-dimensional imaging board associated to dynamic computed tomography allows to reduce the patients positioning margins and to make sure that the target stays in the planned treatment volume (P.T.V.) during the different sessions. (N.C.)

  1. 精密模具中粘接型导套的应用%Application of the Bonding-Typed Guide Bushes in Precision Dies

    Institute of Scientific and Technical Information of China (English)

    吴水勇

    2001-01-01

    模具加工过程中,固定导套通常采用的工艺是通过过盈配合将导套压入导套固定板的方法,即压入法。但此方法用于精密模具 (如电机定转子叠铆模 )则有一定的弊端,用胶水粘接导套的方法可适用于精密模具。%In the processing of dies, the technological process usually adopted for matching the guide bushes is the overfilling method, namely the pressing- in method. But it is not suit for precision dies, such as the folding and riveting die for the stators and rotators of motors. For precision dies, the method of bonding the guide bushes with glue is applicable.

  2. Multiscale registration of medical images based on edge preserving scale space with application in image-guided radiation therapy

    International Nuclear Information System (INIS)

    Mutual information (MI) is a well-accepted similarity measure for image registration in medical systems. However, MI-based registration faces the challenges of high computational complexity and a high likelihood of being trapped into local optima due to an absence of spatial information. In order to solve these problems, multi-scale frameworks can be used to accelerate registration and improve robustness. Traditional Gaussian pyramid representation is one such technique but it suffers from contour diffusion at coarse levels which may lead to unsatisfactory registration results. In this work, a new multi-scale registration framework called edge preserving multiscale registration (EPMR) was proposed based upon an edge preserving total variation L1 norm (TV-L1) scale space representation. TV-L1 scale space is constructed by selecting edges and contours of images according to their size rather than the intensity values of the image features. This ensures more meaningful spatial information with an EPMR framework for MI-based registration. Furthermore, we design an optimal estimation of the TV-L1 parameter in the EPMR framework by training and minimizing the transformation offset between the registered pairs for automated registration in medical systems. We validated our EPMR method on both simulated mono- and multi-modal medical datasets with ground truth and clinical studies from a combined positron emission tomography/computed tomography (PET/CT) scanner. We compared our registration framework with other traditional registration approaches. Our experimental results demonstrated that our method outperformed other methods in terms of the accuracy and robustness for medical images. EPMR can always achieve a small offset value, which is closer to the ground truth both for mono-modality and multi-modality, and the speed can be increased 5–8% for mono-modality and 10–14% for multi-modality registration under the same condition. Furthermore, clinical application by

  3. Standard guide for application of radiation monitors to the control and physical security of special nuclear material

    CERN Document Server

    American Society for Testing and Materials. Philadelphia

    1999-01-01

    1.1 This guide briefly describes the state-of-the-art of radiation monitors for detecting special nuclear material (SNM) (see 3.1.11) in order to establish the context in which to write performance standards for the monitors. This guide extracts information from technical documentation to provide information for selecting, calibrating, testing, and operating such radiation monitors when they are used for the control and protection of SNM. This guide offers an unobtrusive means of searching pedestrians, packages, and motor vehicles for concealed SNM as one part of a nuclear material control or security plan for nuclear materials. The radiation monitors can provide an efficient, sensitive, and reliable means of detecting the theft of small quantities of SNM while maintaining a low likelihood of nuisance alarms. 1.2 Dependable operation of SNM radiation monitors rests on selecting appropriate monitors for the task, operating them in a hospitable environment, and conducting an effective program to test, calibrat...

  4. Application of a topical vapocoolant spray decreases pain at the site of initial intradermal anaesthetic injection during ultrasound-guided breast needle biopsy

    International Nuclear Information System (INIS)

    Aim: To assess whether the application of a topical vapocoolant spray immediately prior to initial intradermal anaesthetic injection during ultrasound-guided breast biopsy decreases pain at the site of the initial injection. Materials and methods: In this institutional review board-approved, Health Insurance Portability and Accountability Act (HIPAA)-compliant study, 50 women aged 49.1 ± 1.6 years (mean ± standard error) were recruited and provided written informed consent. Participants served as their own controls and were blinded as to whether a topical vapocoolant spray or a placebo was used immediately prior to the initial local anaesthetic injection at two separate biopsy sites. With the exception of the application of vapocoolant or placebo, the entire ultrasound-guided procedure was performed according to a routine protocol. Participants recorded pain at initial injection site on a visual analogue scale. General linear mixed models for repeated measures analysis of variance and a 0.05 significance level were used. Results: Application of topical vapocoolant spray was shown to significantly decrease pain at the site of initial intradermal anaesthetic injection as compared to placebo (p<0.001). Treatment effect was independent of age of the subject, race/ethnicity, operator, type of biopsy device, and histopathology result. No complications from vapocoolant spray use were reported. Conclusion: Application of a topical vapocoolant spray immediately prior to initial intradermal anaesthetic injection during ultrasound-guided breast biopsy significantly decreases pain at the site of the initial injection and could contribute to improve the patient's overall procedural experience. -- Highlights: •Topical vapocoolant spray decreased pain at site of initial anesthetic injection (

  5. Current External Beam Radiation Therapy Quality Assurance Guidance: Does It Meet the Challenges of Emerging Image-Guided Technologies?

    International Nuclear Information System (INIS)

    The traditional prescriptive quality assurance (QA) programs that attempt to ensure the safety and reliability of traditional external beam radiation therapy are limited in their applicability to such advanced radiation therapy techniques as three-dimensional conformal radiation therapy, intensity-modulated radiation therapy, inverse treatment planning, stereotactic radiosurgery/radiotherapy, and image-guided radiation therapy. The conventional QA paradigm, illustrated by the American Association of Physicists in Medicine Radiation Therapy Committee Task Group 40 (TG-40) report, consists of developing a consensus menu of tests and device performance specifications from a generic process model that is assumed to apply to all clinical applications of the device. The complexity, variation in practice patterns, and level of automation of high-technology radiotherapy renders this 'one-size-fits-all' prescriptive QA paradigm ineffective or cost prohibitive if the high-probability error pathways of all possible clinical applications of the device are to be covered. The current approaches to developing comprehensive prescriptive QA protocols can be prohibitively time consuming and cost ineffective and may sometimes fail to adequately safeguard patients. It therefore is important to evaluate more formal error mitigation and process analysis methods of industrial engineering to more optimally focus available QA resources on process components that have a significant likelihood of compromising patient safety or treatment outcomes

  6. CompTIA A+ Complete Deluxe Study Guide, Exams 220-701/220-702 Essentials/Practical Application

    CERN Document Server

    Docter, Quentin; Skandier, Toby

    2009-01-01

    An arsenal of study aids for anyone preparing to take the CompTIA A+ certification exams. The CompTIA A+ certification is the industry standard in terms of measuring a technician's hardware and software knowledge. As the most popular entry-level certification, it is particularly popular among individuals switching from another career to computers. This Deluxe Edition of the bestselling CompTIA A+ Study Guide features bonus practice exams, flashcards, and more than an hour of instructional video of key hands-on tasks. Covering all exam objectives, study guide focuses on the new best practices a

  7. Toxic risk of stereotactic body radiotherapy and concurrent helical tomotherapy followed by erlotinib for non-small-cell lung cancer treatment - case report

    International Nuclear Information System (INIS)

    Stereotactic body radiation therapy (SBRT) applied by helical tomotherapy (HT) is feasible for lung cancer in clinical. Using SBRT concurrently with erlotinib for non-small cell lung cancer (NSCLC) is not reported previously. A 77-year-old man with stage III NSCLC, received erlotinib 150 mg/day, combined with image-guided SBRT via HT. A total tumor dose of 54 Gy/9 fractions was delivered to the tumor bed. The tumor responded dramatically and the combined regimen was well tolerated. After concurrent erlotinib-SBRT, erlotinib was continued as maintenance therapy. The patient developed dyspnea three months after the combined therapy and radiation pneumonitis with interstitial lung disease was suspected. Combination SBRT, HT, and erlotinib therapy provided effective anti-tumor results. Nonetheless, the potential risks of enhanced adverse effects between radiation and erlotinib should be monitored closely, especially when SBRT is part of the regimen

  8. Current concepts in stereotactic radiosurgery - a neurosurgical and radiooncological point of view

    Directory of Open Access Journals (Sweden)

    Vesper J

    2009-03-01

    Full Text Available Abstract Stereotactic radiosurgery is related to the history of "radiotherapy" and "stereotactic neurosurgery". The concepts for neurosurgeons and radiooncologists have been changed during the last decade and have also transformed neurosurgery. The gamma knife and the stereotactically modified linear accelerator (LINAC are radiosurgical equipments to treat predetermined intracranial targets through the intact skull without damaging the surrounding normal brain tissue. These technical developments allow a more precise intracranial lesion control and offer even more conformal dose plans for irregularly shaped lesions. Histological determination by stereotactic biopsy remains the basis for any otherwise undefined intracranial lesion. As a minimal approach, it allows functional preservation, low risk and high sensitivity. Long-term results have been published for various indications. The impact of radiosurgery is presented for the management of gliomas, metastases, brain stem lesions, benign tumours and vascular malformations and selected functional disorders such as trigeminal neuralgia. In AVM's it can be performed as part of a multimodality strategy including resection or endovascular embolisation. Finally, the technological advances in radiation oncology as well as stereotactic neurosurgery have led to significant improvements in radiosurgical treatment opportunities. Novel indications are currently under investigation. The combination of both, the neurosurgical and the radiooncological expertise, will help to minimize the risk for the patient while achieving a greater treatment success.

  9. Clinical and pathological changes in cerebral arteriovenous malformations after stereotactic radiosurgery failure

    Institute of Scientific and Technical Information of China (English)

    LIU Wei-ming; YE Xun; ZHAO Yuan-li; WANG Shuo; ZHAO Ji-zong

    2008-01-01

    Background Stereotactic radiosurgery is an alternative to resection of intracraniaI cerebral arteriovenous malformations (AVMs),while it will failin some cases.This study aimed to evaluate the changes after stereotactic radiosurgery for AVMs.Methods Nineteen cases with cerebral AVMs had failure after stereotactic radiosurgery therapy.The symptoms and angiography were assessed.All patients underwent microsurgery.Pathologic examination was performed for all cases and electron microscopic examination was carried out in 6 patients.Reaults Seven cases had hemorrhage from 12 to 98 months after stereotactic radiosurgery,5 had headache.4 had refractory encephalon edema,2 had epilepsy as a new symptom and 1 had a pressure cyst 5 years after radiosurgery.Angiography in 18 cases,8-98 months after radiation therapy,demonstrated no significant changes in 5 cases.slight reduction in 9,near complete obliteration in 1 and complete obliteration in 3.An abnormal vessel was found on pathologic examination in 17 cases,even one case had obliterated in angiography.Electron microscopy examination showed vessel wall weakness,but the vessels remained open and blood circulated.One case died because of a moribund state before surgery.The other 18 cases had no new neurological deficiencies,seizure control and no hemorrhage occurred after microsurgery at an average follow-up of 3 years.Conclusion Stereotactic radiotherapy for AVMs should have a long period follow-up.If serious complications occur,microsurgery can be performed as salvage treatment.

  10. Drug intercalation in layered double hydroxide clay: Application in the development of a nanocomposite film for guided tissue regeneration

    DEFF Research Database (Denmark)

    Chakraborti, M.; Jackson, J.K.; Plackett, David;

    2011-01-01

    It has been proposed that localized and controlled delivery of alendronate and tetracycline to periodontal pocket fluids via guided tissue regeneration (GTR) membranes may be a valuable adjunctive treatment for advanced periodontitis. The objectives of this work were to develop a co...

  11. Overcoming the Glassy-Eyed Nod: An Application of Process-Oriented Guided Inquiry Learning Techniques in Information Technology

    Science.gov (United States)

    Myers, Trina; Monypenny, Richard; Trevathan, Jarrod

    2012-01-01

    Two significant problems faced by universities are to ensure sustainability and to produce quality graduates. Four aspects of these problems are to improve engagement, to foster interaction, develop required skills and to effectively gauge the level of attention and comprehension within lectures and large tutorials. Process-Oriented Guided Inquiry…

  12. Treatment of Five or More Brain Metastases With Stereotactic Radiosurgery

    Energy Technology Data Exchange (ETDEWEB)

    Hunter, Grant K.; Suh, John H.; Reuther, Alwyn M. [Department of Radiation Oncology, Cleveland Clinic, Cleveland, OH (United States); Vogelbaum, Michael A.; Barnett, Gene H.; Angelov, Lilyana; Weil, Robert J. [Department of Neurosurgery, Cleveland Clinic, Cleveland, OH (United States); Neyman, Gennady [Department of Radiation Oncology, Cleveland Clinic, Cleveland, OH (United States); Chao, Samuel T., E-mail: chaos@ccf.org [Department of Radiation Oncology, Cleveland Clinic, Cleveland, OH (United States)

    2012-08-01

    Purpose: To examine the outcomes of patients with five or more brain metastases treated in a single session with stereotactic radiosurgery (SRS). Methods and Materials: Sixty-four patients with brain metastases treated with SRS to five or more lesions in a single session were reviewed. Primary disease type, number of lesions, Karnofsky performance score (KPS) at SRS, and status of primary and systemic disease at SRS were included. Patients were treated using dosing as defined by Radiation Therapy Oncology Group Protocol 90-05, with adjustments for critical structures. We defined prior whole-brain radiotherapy (WBRT) as WBRT completed >1 month before SRS and concurrent WBRT as WBRT completed within 1 month before or after SRS. Kaplan-Meier estimates and Cox proportional hazard regression were used to determine which patient and treatment factors predicted overall survival (OS). Results: The median OS after SRS was 7.5 months. The median KPS was 80 (range, 60-100). A KPS of {>=}80 significantly influenced OS (median OS, 4.8 months for KPS {<=}70 vs. 8.8 months for KPS {>=}80, p = 0.0097). The number of lesions treated did not significantly influence OS (median OS, 6.6 months for eight or fewer lesions vs. 9.9 months for more than eight, p = nonsignificant). Primary site histology did not significantly influence median OS. On multivariate Cox modeling, KPS and prior WBRT significantly predicted for OS. Whole-brain radiotherapy before SRS compared with concurrent WBRT significantly influenced survival, with a risk ratio of 0.423 (95% confidence interval 0.191-0.936, p = 0.0338). No significant differences were observed when no WBRT was compared with concurrent WBRT or when the no WBRT group was compared with prior WBRT. A KPS of {<=}70 predicted for poorer outcomes, with a risk ratio of 2.164 (95% confidence interval 1.157-4.049, p = 0.0157). Conclusions: Stereotactic radiosurgery to five or more brain lesions is an effective treatment option for patients with

  13. Characteristics of a novel treatment system for linear accelerator-based stereotactic radiosurgery.

    Science.gov (United States)

    Wen, Ning; Li, Haisen; Song, Kwang; Chin-Snyder, Karen; Qin, Yujiao; Kim, Jinkoo; Bellon, Maria; Gulam, Misbah; Gardner, Stephen; Doemer, Anthony; Devpura, Suneetha; Gordon, James; Chetty, Indrin; Siddiqui, Farzan; Ajlouni, Munther; Pompa, Robert; Hammoud, Zane; Simoff, Michael; Kalkanis, Steven; Movsas, Benjamin; Siddiqui, M Salim

    2015-01-01

    The purpose of this study is to characterize the dosimetric properties and accuracy of a novel treatment platform (Edge radiosurgery system) for localizing and treating patients with frameless, image-guided stereotactic radiosurgery (SRS) and stereotactic body radiotherapy (SBRT). Initial measurements of various components of the system, such as a comprehensive assessment of the dosimetric properties of the flattening filter-free (FFF) beams for both high definition (HD120) MLC and conical cone-based treatment, positioning accuracy and beam attenuation of a six degree of freedom (6DoF) couch, treatment head leakage test, and integrated end-to-end accuracy tests, have been performed. The end-to-end test of the system was performed by CT imaging a phantom and registering hidden targets on the treatment couch to determine the localization accuracy of the optical surface monitoring system (OSMS), cone-beam CT (CBCT), and MV imaging systems, as well as the radiation isocenter targeting accuracy. The deviations between the percent depth-dose curves acquired on the new linac-based system (Edge), and the previously published machine with FFF beams (TrueBeam) beyond D(max) were within 1.0% for both energies. The maximum deviation of output factors between the Edge and TrueBeam was 1.6%. The optimized dosimetric leaf gap values, which were fitted using Eclipse dose calculations and measurements based on representative spine radiosurgery plans, were 0.700 mm and 1.000 mm, respectively. For the conical cones, 6X FFF has sharper penumbra ranging from 1.2-1.8 mm (80%-20%) and 1.9-3.8 mm (90%-10%) relative to 10X FFF, which has 1.2-2.2mm and 2.3-5.1mm, respectively. The relative attenuation measurements of the couch for PA, PA (rails-in), oblique, oblique (rails-out), oblique (rails-in) were: -2.0%, -2.5%, -15.6%, -2.5%, -5.0% for 6X FFF and -1.4%, -1.5%, -12.2%, -2.5%, -5.0% for 10X FFF, respectively, with a slight decrease in attenuation versus field size. The systematic

  14. An image-intensive ePR for image-guided minimally invasive spine surgery applications including real-time intra-operative image acquisition, archival, and display

    Science.gov (United States)

    Documet, Jorge R.; Le, Anh; Liu, Brent; Huang, H. K.; Chiu, John

    2009-02-01

    Recent developments in medical imaging informatics have improved clinical workflow in Radiology enterprise but gaps remain in the clinical workflow from diagnosis to surgical treatment through post-operative follow-up. One solution to bridge this gap is the development of an electronic patient record (ePR) that integrates key imaging and informatics data during the pre, intra, and post-operative phases of clinical workflow. We present an ePR system based on standards and tailored to the clinical application for image-guided minimally invasive spinal surgery (MISS). The ePR system has been implemented in a clinical environment for a half-year.

  15. Producing and managing dynamic style guides

    OpenAIRE

    2007-01-01

    In this thesis, I investigate the style guide processes in Telenor, a Norwegian mobile operator that is one of the largest in the world. The ‘style guide problem’ is well known, and it is difficult to handle guidelines, principles, and conventions in any organization. Most people agree that style guides are important to ensure consistency and quality in applications and various content utilizing style guides. No dedicated tool exists to produce and manage style guides in Telenor, but there...

  16. Optically-guided frameless linac-based radiosurgery for brain metastases: clinical experience

    OpenAIRE

    Nath, Sameer K; Lawson, Joshua D.; Wang, Jia-Zhu; Simpson, Daniel R.; Newman, C. Benjamin; Alksne, John F.; Mundt, Arno J.; Murphy, Kevin T.

    2009-01-01

    The purpose of this study was to describe our clinical experience using optically-guided linear accelerator (linac)-based frameless stereotactic radiosurgery (SRS) for the treatment of brain metastases. Sixty-five patients (204 lesions) were treated between 2005 and 2008 with frameless SRS using an optically-guided bite-block system. Patients had a median of 2 lesions (range, 1–13). Prescription dose ranged from 14 to 22 Gy (median, 18 Gy) and was given in a single fraction. Clinical and radi...

  17. Low-grade astrocytomas: treatment with unconventionally fractionated external beam stereotactic radiation therapy

    International Nuclear Information System (INIS)

    Fourteen patients with nonoperable low-grade astrocytomas were treated with unconventionally fractionated stereotactic radiation therapy. The target volume was defined with computed tomography (CT) performed under stereotactic conditions. The treatment was carried out with a technique producing multiple noncoplanar arc irradiation, with the center of the target volume placed at the isocenter of the linear accelerator. A total dose of 16-50 Gy was administered in either one fraction or two fractions 8 days apart. The concentration of dose within the target volume allowed reduction of dose absorbed by adjacent critical structures of the intact brain. Patients were followed up for 11-48 months. Twelve of 14 patients had a partial or complete response to treatment, as demonstrated by CT. Stereotactic radiation therapy appears to be effective in the control of small radioresistant cerebral neoplasms, without damaging surrounding healthy tissues

  18. Low-grade astrocytomas: treatment with unconventionally fractionated external beam stereotactic radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Pozza, F.; Colombo, F.; Chierego, G.; Avanzo, R.C.; Marchetti, C.; Benedetti, A.; Casentini, L.; Danieli, D.

    1989-05-01

    Fourteen patients with nonoperable low-grade astrocytomas were treated with unconventionally fractionated stereotactic radiation therapy. The target volume was defined with computed tomography (CT) performed under stereotactic conditions. The treatment was carried out with a technique producing multiple noncoplanar arc irradiation, with the center of the target volume placed at the isocenter of the linear accelerator. A total dose of 16-50 Gy was administered in either one fraction or two fractions 8 days apart. The concentration of dose within the target volume allowed reduction of dose absorbed by adjacent critical structures of the intact brain. Patients were followed up for 11-48 months. Twelve of 14 patients had a partial or complete response to treatment, as demonstrated by CT. Stereotactic radiation therapy appears to be effective in the control of small radioresistant cerebral neoplasms, without damaging surrounding healthy tissues.

  19. Volume growth rate of acoustic neuromas on MRI post-stereotactic radiosurgery

    Energy Technology Data Exchange (ETDEWEB)

    To, S.Y.; Lufkin, R.B.; Rand, R.; Robinson, J.D.; Hanafee, W.

    1990-01-01

    Of the approximately 160 acoustic neuroma patients treated with stereotactic radiosurgery in the world up to 1987, 8 patients at UCLA Medical Center have had two or more magnetic resonance scans at least one year apart available for study (all 8 patients were treated with stereotactic radiosurgery for acoustic neuromas by the Department of Neurosurgery at the Karolinska Hospital, Stockholm, Sweden). The followup time after radiosurgery ranged from 4 to 8 years. The volume doubling rate post-stereotactic radiosurgery was calculated to be slow (763 to 888 days) in two patients, virtually arrested in five patients (doubling times larger than 2500 days) and negative (-563 days) in one patient indicating a shrinking tumor. Due to the limited sample size no radiological finding or clinical data correlated with the volume doubling times. A control patient that had no treatment for her tumor had a doubling time of 217 days for comparison.

  20. Stereotactic fractionated radiotherapy in patients with optic nerve sheath meningioma

    International Nuclear Information System (INIS)

    Purpose: To evaluate the effectiveness of stereotactic fractionated radiotherapy (SFRT) in the treatment of optic nerve sheath meningioma (ONSM). Methods and Materials: Between 1994 and 2000, a total of 39 patients with either primary (n=15) or secondary (n=24) ONSM were treated with SFRT and received a median total tumor dose of 54 Gy using 1.8 Gy/fraction. Results: The radiographic response to SFRT was documented in all patients as stable disease (no change) except for 1 patient with a partial response. After a median follow-up of 35.5 months, all patients with ONSM were alive without recurrence. The visual fields and visual acuity were improved in 6 of 15 and 1 of 16 examined eyes in patients with primary ONSM, respectively, and in 6 of 24 and 7 of 26 examined eyes in patients with secondary ONSM, respectively. Stable visual fields and visual acuity was observed in 8 of 14 and 15 of 16 patients with primary ONSM, respectively, and in 17 of 24 and 19 of 26 patients with secondary ONSM, respectively. Except for reversible alopecia and erythema, no other SFRT-related toxicity was observed. Conclusion: SFRT represents a very effective and low-toxic treatment modality for ONSM. Despite a median follow-up of 3 years, this series of primary ONSM holds promise for future studies. It adds substantial evidence that SFRT may definitely become a standard treatment approach in selected cases of ONSM

  1. NOTE: Comprehensive quality assurance for stereotactic radiosurgery treatments

    Science.gov (United States)

    Ramaseshan, R.; Heydarian, M.

    2003-07-01

    We have used a commercially available high precision LucyTM phantom to perform comprehensive quality assurance for stereotactic radiosurgery treatments. The quantitative evaluation of system uncertainties included imaging, planning and treatment delivery systems. The quality assurance tests showed that the well-defined targets were identified to within +/-1 mm in all the imaging modalities. The pre-known target volumes were reproduced within 2 cm3 in both MR and CT. The planned target was delivered within 2% of the prescribed dose and to within 2 mm accuracy. The inaccuracy in the isocentre position at the Linac was less than 1.2 mm. The maximum error observed in the depth helmet was 0.5 mm and the overall uncertainty was within 0.23 mm. We have also established a quality assurance program based on the study and proposed the tolerance and the frequency of the tests required to be carried out. The tests were carried out using a Radionics planning system and delivered on a Varian Clinac 2100 linear accelerator machine. These tests also established a base line for future comparisons.

  2. Hypofractionated stereotactic radiotherapy for brain metastases larger than three centimeters

    International Nuclear Information System (INIS)

    To evaluate the efficacy and outcomes of hypofractionated stereotactic radiotherapy (HSRT) for brain metastases > 3 cm. From March 2003 to October 2009, 40 patients with brain metastases larger than 3 cm were treated by HSRT. HSRT was applied in 29 patients for primary treatment and in 11 patients for rescue. Single brain metastasis was detected in 21 patients. Whole brain radiotherapy was incorporated into HSRT in 10 patients for primary treatment. HSRT boosts were applied in 23 patients. The diameters of the brain metastases ranged from 3.1 to 5.5 cm (median, 4.1 cm). The median prescribed dose (not including HSRT boosts) was 40 Gy (range, 20-53 Gy) with a median of 10 fractions (range, 4-15 fractions) to the 90% isodose line. The median dose of the boost was 20 Gy (range, 10-35 Gy) in 4 fractions (range, 2-10 fractions). The median overall survival time was 15 months. The overall survival and local control rate at 12 months was 55.3% and 94.2%, respectively. Four patients experienced local progression of large brain metastases. Nine patients died of intracranial disease progression. One patient died of radiation necrosis with brain edema. HSRT was a safe and effective treatment for patients with brain metastases ranged from 3.1 to 5.5 cm. Dose escalation of HSRT boost may improve local control with an acceptable toxicity

  3. Automated fiducial marker planning for thoracic stereotactic body radiation therapy

    Science.gov (United States)

    Gibbs, Jason D.; Rai, Lav; Wibowo, Henky; Tsalyuk, Serge; Anderson, Eric D.

    2012-02-01

    Stereotactic body-radiation therapy (SBRT) has gained acceptance in treating lung cancer. Localization of a thoracic lesion is challenging as tumors can move significantly with breathing. Some SBRT systems compensate for tumor motion with the intrafraction tracking of targets by two stereo fluoroscopy cameras. However, many lung tumors lack a fluoroscopic signature and cannot be directly tracked. Small radiopaque fiducial markers, acting as fluoroscopically visible surrogates, are instead implanted nearby. The spacing and configuration of the fiducial markers is important to the success of the therapy as SBRT systems impose constraints on the geometry of a fiducial-marker constellation. It is difficult even for experienced physicians mentally assess the validity of a constellation a priori. To address this challenge, we present the first automated planning system for bronchoscopic fiducial-marker placement. Fiducial-marker planning is posed as a constrained combinatoric optimization problem. Constraints include requiring access from a navigable airway, having sufficient separation in the fluoroscopic imaging planes to resolve each individual marker, and avoidance of major blood vessels. Automated fiducial-marker planning takes approximately fifteen seconds, fitting within the clinical workflow. The resulting locations are integrated into a virtual bronchoscopic planning system, which provides guidance to each location during the implantation procedure. To date, we have retrospectively planned over 50 targets for treatment, and have implanted markers according to the automated plan in one patient who then underwent SBRT treatment. To our knowledge, this approach is the first to address automated bronchoscopic fiducialmarker planning for SBRT.

  4. Toxicity after reirradiation of pulmonary tumours with stereotactic body radiotherapy

    International Nuclear Information System (INIS)

    Purpose: To assess toxicity and feasibility of reirradiation with stereotactic body radiotherapy (SBRT) after prior lung SBRT for primary lung cancer or lung metastases. Patients and materials: Twenty-nine patients reirradiated with SBRT on 32 lung lesions (11 central, 21 peripheral) were retrospectively reviewed. Median follow-up time was 12 months (range 1–97). The primary endpoint was toxicity, secondary endpoints were local control and overall survival time. Toxicity was scored according to the NCI-CTCAE version 3. Results: Grade 3–4 toxicity was scored 14 times in eight patients. Three patients died because of massive bleeding (grade 5). Larger clinical target volumes (CTV) and central tumour localization were associated with more severe toxicity. There was no correlation between mean lung dose (MLD) and lung toxicity. Local control at 5 months after reirradiation was 52%, as assessed by CT-scan (n = 12) or X-thorax (n = 3). A larger CTV was associated with poorer local control. Kaplan–Meier estimated 1- and 2-year survival rates were 59% and 43%, respectively. Conclusions: Reirradiation with SBRT is feasible although increased risk of toxicity was reported in centrally located tumours. Further research is warranted for more accurate selection of patients suitable for reirradiation with SBRT.

  5. Stereotactic gamma radiosurgery of pineal and related tumors

    Energy Technology Data Exchange (ETDEWEB)

    Kobayashi, Tatsuya; Mori, Yoshimasa; Yamada, Yasushi; Kida, Yoshihisa [Komaki City Hospital, Aichi (Japan). Gamma Knife Center

    2001-06-01

    The role of gamma radiosurgery as an additional therapy after conventional treatments for pineal and related tumors was studied in 30 out of 33 cases with a mean follow-up of 23.3 months. Overall results showed that complete response (CR) was obtained in 8 cases (26.7%) and response rate was 73.3%. However, enlargement of the tumors was noted in 8 cases, of which 7 (23.3%) died of tumor progression (PG). Germinomas and pineocytomas showed higher response and control rates of 100%, and no tumor enlargement or death occurred after gamma knife treatment. In germinoma with STGC (syncytiotrophoblastic giant cell) which has been thought to have intermediate prognosis, two cases showed partial response (PR), but another died from progression of the disease. Malignant germ cell tumors and pineoblastomas showed unfavorable response and prognosis; the response and progression rates were 50%. However, complete response was obtained in 3 cases (25%) after gamma radiosurgery. Gamma knife was the initial treatment in three cases without pathological diagnosis in which one obtained CR and two showed partial response (PR). Stereotactic gamma radiosurgery is expected to be an effective and novel treatment for pineal and related tumors not only as an adjuvant, but also as an initial therapy. (author)

  6. Stereotactic radiosurgery in hemangioblastoma: Experience over 14 years

    Directory of Open Access Journals (Sweden)

    Nishant Goyal

    2016-01-01

    Full Text Available Background: Although gamma knife has been advocated for hemangioblastomas, it is not used widely by neurosurgeons. Objective: We review our experience over 14 years in an attempt to define the role of stereotactic radiosurgery (SRS in the management of hemangioblastomas. Patients and Methods: A retrospective study was conducted on all patients of hemangioblastoma who underwent SRS at our institute over a period of 14 years (1998–2011. Gamma knife plans, clinical history, and radiology were reviewed for all patients. Results: A total of 2767 patients underwent gamma knife during the study period. Of these, 10 (0.36% patients were treated for 24 hemangioblastomas. Eight patients (80% had von Hippel-Lindau disease while two had sporadic hemangioblastomas. The median peripheral dose (50% isodose delivered to the tumors was 29.9 Gy. Clinical and radiological follow-up data were available for eight patients. Of these, two were re-operated for persisting cerebellar symptoms. The remaining six patients were recurrence-free at a mean follow-up of 48 months (range 19–108 months. One patient had an increase in cyst volume along with a decrease in the size of the mural nodule. Conclusions: SRS should be the first option for asymptomatic hemangioblastomas. Despite the obvious advantages, gamma knife is not widely used as an option for hemangioblastomas.

  7. Fractionated stereotactic radiotherapy in the treatment of pituitary adenomas

    Energy Technology Data Exchange (ETDEWEB)

    Kopp, C.; Theodorou, M.; Poullos, N.; Astner, S.T.; Geinitz, H.; Molls, M. [Technische Univ. Muenchen, Klinikum rechts der Isar (Germany). Klinik und Poliklinik fuer Strahlentherapie und Radiologische Onkologie; Stalla, G.K. [Max-Planck-Institut fuer Psychiatrie, Muenchen (Germany). Klinische Neuroendokrinologie; Meyer, B. [Technische Univ. Muenchen, Klinikum rechts der Isar (Germany). Neurochirurgische Klinik und Poliklinik; Nieder, C. [Nordland Hospital, Bodoe (Norway). Dept. of Oncology and Palliative Medicine; Tromsoe Univ. (Norway). Inst. of Clinical Medicine; Grosu, A.L [Freiburg Univ. (Germany). Klinik fuer Strahlenheilkunde

    2013-11-15

    Purpose: The purpose of this work was to evaluate tumor control and side effects associated with fractionated stereotactic radiotherapy (FSRT) in the management of residual or recurrent pituitary adenomas. Patients and methods: We report on 37 consecutive patients with pituitary adenomas treated with FSRT at our department. All patients had previously undergone surgery. Twenty-nine patients had nonfunctioning, 8 had hormone-producing adenoma. The mean total dose delivered by a linear accelerator was 49.4 Gy (range 45-52.2 Gy), 5 x 1.8 Gy weekly. The mean PTV was 22.8 ccm (range 2.0-78.3 ccm). Evaluation included serial imaging tests, endocrinologic and ophthalmologic examination. Results: Tumor control was 91.9 % for a median follow-up time of 57 months (range 2-111 months). Before FSRT partial hypopituitarism was present in 41 % of patients, while 35 % had anterior panhypopituitarism. After FSRT pituitary function remained normal in 22 %, 43 % had partial pituitary dysfunction, and 35 % had anterior panhypopituitarism. Visual acuity was stable in 76 % of patients, improved in 19 %, and deteriorated in 5 %. Visual fields remained stable in 35 patients (95 %), improved in one and worsened in 1 patient (2.7 %). Conclusion: FSRT is an effective and safe treatment for recurrent or residual pituitary adenoma. Good local tumor control and preservation of adjacent structures can be reached, even for large tumors. (orig.)

  8. Stereotactic Ablative Radiotherapy for Oligometastatic Disease in Liver

    Directory of Open Access Journals (Sweden)

    Myungsoo Kim

    2014-01-01

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

  9. Stereotactic Radiosurgery for Acoustic Neuromas: What Happens Long Term?

    Energy Technology Data Exchange (ETDEWEB)

    Roos, Daniel E., E-mail: daniel.roos@health.sa.gov.au [Department of Radiation Oncology, Royal Adelaide Hospital, Adelaide, South Australia (Australia); University of Adelaide School of Medicine, Adelaide, South Australia (Australia); Potter, Andrew E. [Department of Radiation Oncology, Royal Adelaide Hospital, Adelaide, South Australia (Australia); Brophy, Brian P. [Department of Neurosurgery, Royal Adelaide Hospital, Adelaide, South Australia (Australia); University of Adelaide School of Medicine, Adelaide, South Australia (Australia)

    2012-03-15

    Purpose: To determine the clinical outcomes for acoustic neuroma treated with low-dose linear accelerator stereotactic radiosurgery (SRS) >10 years earlier at the Royal Adelaide Hospital using data collected prospectively at a dedicated SRS clinic. Methods and Materials: Between November 1993 and December 2000, 51 patients underwent SRS for acoustic neuroma. For the 44 patients with primary SRS for sporadic (unilateral) lesions, the median age was 63 years, the median of the maximal tumor diameter was 21 mm (range, 11-34), and the marginal dose was 14 Gy for the first 4 patients and 12 Gy for the other 40. Results: The crude tumor control rate was 97.7% (1 patient required salvage surgery for progression at 9.75 years). Only 8 (29%) of 28 patients ultimately retained useful hearing (interaural pure tone average {<=}50 dB). Also, although the Kaplan-Meier estimated rate of hearing preservation at 5 years was 57% (95% confidence interval, 38-74%), this decreased to 24% (95% confidence interval, 11-44%) at 10 years. New or worsened V and VII cranial neuropathy occurred in 11% and 2% of patients, respectively; all cases were transient. No case of radiation oncogenesis developed. Conclusions: The long-term follow-up data of low-dose (12-14 Gy) linear accelerator SRS for acoustic neuroma have confirmed excellent tumor control and acceptable cranial neuropathy rates but a continual decrease in hearing preservation out to {>=}10 years.

  10. Stereotactic radiosurgery (SRS) for brain metastases: a systematic review

    International Nuclear Information System (INIS)

    In many patients with brain metastases, the primary therapeutic aim is symptom palliation and maintenance of neurologic function, but in a subgroup, long-term survival is possible. Local control in the brain, and absent or controlled extracranial sites of disease are prerequisites for favorable survival. Stereotactic radiosurgery (SRS) is a focal, highly precise treatment option with a long track record. Its clinical development and implementation by several pioneering institutions eventually rendered possible cooperative group randomized trials. A systematic review of those studies and other landmark studies was undertaken. Most clinicians are aware of the potential benefits of SRS such as a short treatment time, a high probability of treated-lesion control and, when adhering to typical dose/volume recommendations, a low normal tissue complication probability. However, SRS as sole first-line treatment carries a risk of failure in non-treated brain regions, which has resulted in controversy around when to add whole-brain radiotherapy (WBRT). SRS might also be prescribed as salvage treatment in patients relapsing despite previous SRS and/or WBRT. An optimal balance between intracranial control and side effects requires continued research efforts

  11. Effect of spine hardware on small spinal stereotactic radiosurgery dosimetry

    International Nuclear Information System (INIS)

    Monte Carlo (MC) modeling of a 6 MV photon beam was used to study the dose perturbation from a titanium rod 5 mm in diameter in various small fields range from 2 × 2 to 5 × 5 cm2. The results showed that the rod increased the dose to water by ∼6% at the water–rod interface because of electron backscattering and decreased the dose by ∼7% in the shadow of the rod because of photon attenuation. The Pinnacle3 treatment planning system calculations matched the MC results at the depths more than 1 cm past the rod when the correct titanium density of 4.5 g cm−3 was used, but significantly underestimated the backscattering dose at the water–rod interface. A CT–density table with a top density of 1.82 g cm−3 (cortical bone) is a practical way to reduce the dosimetric error from the artifacts by preventing high density assignment to them, but can underestimates the attenuation by the titanium rod by 6%. However, when multi-beam with intensity modulation is used in actual patient spinal stereotactic radiosurgery treatment, the dosimetric effect of assigning 4.5 instead of 1.82 g cm−3 to titanium implants is complicated. It ranged from minimal effect to 2% dose difference affecting 15% target volume in the study. When hardware is in the beam path, density override to the titanium hardware is recommended. (paper)

  12. Fractionated stereotactic radiotherapy in the treatment of pituitary adenomas

    International Nuclear Information System (INIS)

    Purpose: The purpose of this work was to evaluate tumor control and side effects associated with fractionated stereotactic radiotherapy (FSRT) in the management of residual or recurrent pituitary adenomas. Patients and methods: We report on 37 consecutive patients with pituitary adenomas treated with FSRT at our department. All patients had previously undergone surgery. Twenty-nine patients had nonfunctioning, 8 had hormone-producing adenoma. The mean total dose delivered by a linear accelerator was 49.4 Gy (range 45-52.2 Gy), 5 x 1.8 Gy weekly. The mean PTV was 22.8 ccm (range 2.0-78.3 ccm). Evaluation included serial imaging tests, endocrinologic and ophthalmologic examination. Results: Tumor control was 91.9 % for a median follow-up time of 57 months (range 2-111 months). Before FSRT partial hypopituitarism was present in 41 % of patients, while 35 % had anterior panhypopituitarism. After FSRT pituitary function remained normal in 22 %, 43 % had partial pituitary dysfunction, and 35 % had anterior panhypopituitarism. Visual acuity was stable in 76 % of patients, improved in 19 %, and deteriorated in 5 %. Visual fields remained stable in 35 patients (95 %), improved in one and worsened in 1 patient (2.7 %). Conclusion: FSRT is an effective and safe treatment for recurrent or residual pituitary adenoma. Good local tumor control and preservation of adjacent structures can be reached, even for large tumors. (orig.)

  13. Ablative stereotactic surgery improves manual performance time in Parkinson's disease.

    Science.gov (United States)

    Balás, I; Llumiguano, C; Dóczi, T P

    2006-05-01

    The objective of this study was to determine the influence of stereotactic ablative surgical interventions on the time required for the performance of manual tasks (i.e. performance time) in patients with Parkinson's disease (PD). We studied 28 patients after pallidotomy and pallido-thalamotomy who were evaluated at four time: before the operation, and 2 days, 3 and 6 months postoperatively. The speed of performance of handwriting and drawing were assessed by means of a chronometer using certain parts of an international standard scale (modified by Fahn). The patients were also assessed according to the Unified Parkinson's Disease Rating Scale (UPDRS) part III. The patients were divided into two groups. Those in group A had relief of all main Parkinsonian symptoms after pallidotomy including tremor. The patients in group B had no relief of tremor straight after pallidotomy. For them the pallidotomy was completed with thalamotomy in the same sitting, which had resulted in cessation of tremor. The time of performance of the manual tasks diminished significantly in all cases in both groups (Student's t-test: phandwriting and drawing in both groups, but pallido-thalamotomy was accompanied with complications. PMID:16549384

  14. Guided labworks

    DEFF Research Database (Denmark)

    Jacobsen, Lærke Bang

    For the last 40 years physics education research has shown poor learning outcomes of guided labs. Still this is found to be a very used teaching method in the upper secodary schools. This study explains the teacher's choice of guided labs throught the concept of redesign as obstacle dislodgement...

  15. Effect of Oral Administration of Acetaminophen and Topical Application of EMLA on Pain during Transrectal Ultrasound-Guided Prostate Biopsy

    OpenAIRE

    Kim, Seol; Yoon, Byung Il; Kim, Su Jin; Cho, Hyuk Jin; Kim, Hyo Sin; Hong, Sung Hoo; Lee, Ji Youl; Hwang, Tae-Kon; Kim, Sae Woong

    2011-01-01

    Purpose Transrectal ultrasound-guided prostate biopsy is the procedure of choice for diagnosing prostate cancer. We compared with pain-relieving effect of acetaminophen, a known drug for enhancing the pain-relieving effect of tramadol, and eutectic mixture of local anesthetics (EMLA), a local anesthetic agent, with that of the conventional periprostatic nerve block method. Materials and Methods This was a prospective, randomized, single-blinded study. A total of 430 patients were randomly ass...

  16. HBR guides

    CERN Document Server

    Duarte, Nancy; Dillon, Karen

    2015-01-01

    Master your most pressing professional challenges with this seven-volume set that collects the smartest best practices from leading experts all in one place. "HBR Guide to Better Business Writing" and "HBR Guide to Persuasive Presentations" help you perfect your communication skills; "HBR Guide to Managing Up and Across" and "HBR Guide to Office Politics" show you how to build the best professional relationships; "HBR Guide to Finance Basics for Managers" is the one book you'll ever need to teach you about the numbers; "HBR Guide to Project Management" addresses tough questions such as how to manage stakeholder expectations and how to manage uncertainty in a complex project; and "HBR Guide to Getting the Right Work Done" goes beyond basic productivity tips to teach you how to prioritize and focus on your work. This specially priced set of the most popular books in the series makes a perfect gift for aspiring leaders looking for trusted advice. Arm yourself with the advice you need to succeed on the job, from ...

  17. Prospective Longitudinal Assessment of Quality of Life for Liver Cancer Patients Treated With Stereotactic Body Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Klein, Jonathan, E-mail: jonathan.klein@rmp.uhn.on.ca [Department of Radiation Oncology, University of Toronto, Toronto, Ontario (Canada); Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Ontario (Canada); Dawson, Laura A. [Department of Radiation Oncology, University of Toronto, Toronto, Ontario (Canada); Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Ontario (Canada); Jiang, Haiyan [Department of Biostatistics, Princess Margaret Cancer Centre, Toronto, Ontario (Canada); Kim, John; Dinniwell, Rob; Brierley, James; Wong, Rebecca [Department of Radiation Oncology, University of Toronto, Toronto, Ontario (Canada); Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Ontario (Canada); Lockwood, Gina [Department of Biostatistics, Princess Margaret Cancer Centre, Toronto, Ontario (Canada); Ringash, Jolie [Department of Radiation Oncology, University of Toronto, Toronto, Ontario (Canada); Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Ontario (Canada)

    2015-09-01

    Purpose: To evaluate quality of life (QoL), an important outcome owing to poor long-term survival, after stereotactic body radiation therapy (SBRT) to the liver. Methods and Materials: Patients (n=222) with hepatocellular carcinoma (HCC), liver metastases, or intrahepatic cholangiocarcinoma and Child-Pugh A liver function received 24-60 Gy of 6-fraction image-guided SBRT. Prospective QoL assessment was completed with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 (QLQ-C30) and/or Functional Assessment of Cancer Therapy-Hepatobiliary (FACT-Hep, version 4) questionnaires at baseline and 1, 3, 6, and 12 months after treatment. Ten HCC patients with Child-Pugh B liver function were also treated. Results: The QLQ-C30 was available for 205 patients, and 196 completed the FACT-Hep. No difference in baseline QoL (P=.17) or overall survival (P=.088) was seen between the HCC, liver metastases, and intrahepatic cholangiocarcinoma patients. Appetite loss and fatigue measured by the QLQ-C30 clinically and statistically worsened by 1 month after treatment but recovered by 3 months. At 3 and 12 months after treatment, respectively, the FACT-Hep score had improved relative to baseline in 13%/19%, worsened in 36%/27%, and remained stable in 51%/54%. Using the QLQ-C30 Global Health score, QoL improved in 16%/23%, worsened in 34%/39%, and remained stable in 50%/38% at 3 and 12 months, respectively. Median survival was 17.0 months (95% confidence interval [CI] 12.3-19.8 months). Higher baseline scores on both FACT-Hep and QLQ-C30 Global Health were associated with improved survival. Hazard ratios for death, per 10-unit decrease in QoL, were 0.90 (95% CI 0.83-0.98; P=.001) and 0.88 (95% CI 0.82-0.95; P=.001), respectively. Tumor size was inversely correlated with survival. Conclusions: Liver SBRT temporarily worsens appetite and fatigue, but not overall QoL. Stereotactic body radiation therapy is well tolerated and warrants

  18. SU-E-J-247: Time Evolution of Radiation-Induced Lung Injury After Stereotactic Proton Therapy

    International Nuclear Information System (INIS)

    Purpose: Quantitative metrics to assess patient-specific radiation-induced lung injury have the potential to guide individualization of therapy and be early indicators of recurrence. Here we investigate computed tomography (CT) density changes in normal lung after stereotactic Proton Therapy. Methods: Participants in a phase-I clinical trial for stereotactic body radiation therapy (SBRT) with protons are analyzed on a rolling basis. The dataset includes 9 patients with 34 CT images to date. Follow-up images are registered to the planning CT using deformable image registration and the change in CT density is correlated to the dose to examine the time-evolution of Hounsfield Unit (HU) changes after large doses of proton radiation. Results: The lung density observed on the follow-up images increases significantly with dose for all dose levels above 5 Gy(RBE) (p<0.001) for 8/9 patients. The change per unit dose [HU/Gy] varies significantly among the patients, from 0.1 (for the one patient without significant correlation) to 5.7 ΔHU/Gy(RBE). The current population average of ΔHU/Gy(RBE) is 2.1, i.e. a 1 Gy(RBE) increase in dose leads on average to a 2.1 HU increase in CT density. The slope of the dose-response curve is constant for all timepoints investigated (from 3–24+ months). Additionally a pronounced non-linearity in the dose response curve is noted for long follow-up times (>18 months). Conclusion: CT density changes have a robust correlation with proton dose, quantitatively similar to photon dose, and may allow estimation of a patient’s intrinsic radiosensitivity after proton therapy. The stability of the correlation with time however diverges from what is known about CT response after photon irradiation. This could have important implications for clinical decision-making during proton therapy for lung cancer, especially for scheduling of follow-up CT/PET imaging and diagnosis of recurrence

  19. SU-E-J-247: Time Evolution of Radiation-Induced Lung Injury After Stereotactic Proton Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Grassberger, C; Sharp, G; Fintelmann, F; Paganetti, H; Willers, H [Massachusetts General Hospital, Boston, MA (United States)

    2015-06-15

    Purpose: Quantitative metrics to assess patient-specific radiation-induced lung injury have the potential to guide individualization of therapy and be early indicators of recurrence. Here we investigate computed tomography (CT) density changes in normal lung after stereotactic Proton Therapy. Methods: Participants in a phase-I clinical trial for stereotactic body radiation therapy (SBRT) with protons are analyzed on a rolling basis. The dataset includes 9 patients with 34 CT images to date. Follow-up images are registered to the planning CT using deformable image registration and the change in CT density is correlated to the dose to examine the time-evolution of Hounsfield Unit (HU) changes after large doses of proton radiation. Results: The lung density observed on the follow-up images increases significantly with dose for all dose levels above 5 Gy(RBE) (p<0.001) for 8/9 patients. The change per unit dose [HU/Gy] varies significantly among the patients, from 0.1 (for the one patient without significant correlation) to 5.7 ΔHU/Gy(RBE). The current population average of ΔHU/Gy(RBE) is 2.1, i.e. a 1 Gy(RBE) increase in dose leads on average to a 2.1 HU increase in CT density. The slope of the dose-response curve is constant for all timepoints investigated (from 3–24+ months). Additionally a pronounced non-linearity in the dose response curve is noted for long follow-up times (>18 months). Conclusion: CT density changes have a robust correlation with proton dose, quantitatively similar to photon dose, and may allow estimation of a patient’s intrinsic radiosensitivity after proton therapy. The stability of the correlation with time however diverges from what is known about CT response after photon irradiation. This could have important implications for clinical decision-making during proton therapy for lung cancer, especially for scheduling of follow-up CT/PET imaging and diagnosis of recurrence.

  20. Prospective Longitudinal Assessment of Quality of Life for Liver Cancer Patients Treated With Stereotactic Body Radiation Therapy

    International Nuclear Information System (INIS)

    Purpose: To evaluate quality of life (QoL), an important outcome owing to poor long-term survival, after stereotactic body radiation therapy (SBRT) to the liver. Methods and Materials: Patients (n=222) with hepatocellular carcinoma (HCC), liver metastases, or intrahepatic cholangiocarcinoma and Child-Pugh A liver function received 24-60 Gy of 6-fraction image-guided SBRT. Prospective QoL assessment was completed with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 (QLQ-C30) and/or Functional Assessment of Cancer Therapy-Hepatobiliary (FACT-Hep, version 4) questionnaires at baseline and 1, 3, 6, and 12 months after treatment. Ten HCC patients with Child-Pugh B liver function were also treated. Results: The QLQ-C30 was available for 205 patients, and 196 completed the FACT-Hep. No difference in baseline QoL (P=.17) or overall survival (P=.088) was seen between the HCC, liver metastases, and intrahepatic cholangiocarcinoma patients. Appetite loss and fatigue measured by the QLQ-C30 clinically and statistically worsened by 1 month after treatment but recovered by 3 months. At 3 and 12 months after treatment, respectively, the FACT-Hep score had improved relative to baseline in 13%/19%, worsened in 36%/27%, and remained stable in 51%/54%. Using the QLQ-C30 Global Health score, QoL improved in 16%/23%, worsened in 34%/39%, and remained stable in 50%/38% at 3 and 12 months, respectively. Median survival was 17.0 months (95% confidence interval [CI] 12.3-19.8 months). Higher baseline scores on both FACT-Hep and QLQ-C30 Global Health were associated with improved survival. Hazard ratios for death, per 10-unit decrease in QoL, were 0.90 (95% CI 0.83-0.98; P=.001) and 0.88 (95% CI 0.82-0.95; P=.001), respectively. Tumor size was inversely correlated with survival. Conclusions: Liver SBRT temporarily worsens appetite and fatigue, but not overall QoL. Stereotactic body radiation therapy is well tolerated and warrants

  1. Evaluation of volume change in rectum and bladder during application of image-guided radiotherapy for prostate carcinoma

    Science.gov (United States)

    Luna, J. A.; Rojas, J. I.

    2016-07-01

    All prostate cancer patients from Centro Médico Radioterapia Siglo XXI receive Volumetric Modulated Arc Therapy (VMAT). This therapy uses image-guided radiotherapy (IGRT) with the Cone Beam Computed Tomography (CBCT). This study compares the planned dose in the reference CT image against the delivered dose recalculate in the CBCT image. The purpose of this study is to evaluate the anatomic changes and related dosimetric effect based on weekly CBCT directly for patients with prostate cancer undergoing volumetric modulated arc therapy (VMAT) treatment. The collected data were analyzed using one-way ANOVA.

  2. The application of Guided Ion Beam Tandem Mass Spectrometer; Bond dissociation energies of bare and ligated copper group cluster anions

    International Nuclear Information System (INIS)

    Threshold energies, fragmentation patterns, and integral cross sections for the reactions of collision induced dissociations of bare and ligated copper group cluster anions are determined using a Guided Ion Beam Tandem Mass Spectrometer (GIB-MS). The bond breaking patterns for the copper cluster anions show dramatic even/odd tendencies, e.g., all copper group anions generate as the predominant reaction product, Carbon monoxide is weakly bound to copper group cluster anions. Cohesive energies of the bare copper and silver cluster anions are determined and exhibit a good correspondence with estimate cohesive energies by the model of Miedema.

  3. Impact of IMRT and leaf width on stereotactic body radiotherapy of liver and lung lesions

    International Nuclear Information System (INIS)

    Purpose: The present study explored the impact of intensity-modulated radiotherapy (IMRT) on stereotactic body RT (SBRT) of liver and lung lesions. Additionally, because target dose conformity can be affected by the leaf width of a multileaf collimator (MLC), especially for small targets and stereotactic applications, the use of a micro-MLC on 'uniform intensity' conformal and intensity-modulated SBRT was evaluated. Methods and Materials: The present study included 10 patients treated previously with SBRT in our institution (seven lung and three liver lesions). All patients were treated with 3 x 12 Gy prescribed to the 65% isodose level. The actual MLC-based conformal treatment plan served as the standard for additional comparison. In total, seven alternative treatment plans were made for each patient: a standard (actual) plan and an IMRT plan, both calculated with Helax TMS (Nucletron) using a pencil beam model; and a recalculated standard and a recalculated IMRT plan on Helax TMS using a point dose kernel approach. These four treatment plans were based on a standard MLC with 1-cm leaf width. Additionally, the following micro-MLC (central leaf width 3 mm)-based treatment plans were calculated with the BrainSCAN (BrainLAB) system: standard, IMRT, and dynamic arc treatments. For each treatment plan, various target parameters (conformity, coverage, mean, maximal, and minimal target dose, equivalent uniform doses, and dose-volume histogram), as well as organs at risk parameters (3 Gy and 6 Gy volume, mean dose, dose-volume histogram) were evaluated. Finally, treatment efficiency was estimated from monitor units and the number of segments for IMRT solutions. Results: For both treatment planning systems, no significant difference could be observed in terms of target conformity between the standard and IMRT dose distributions. All dose distributions obtained with the micro-MLC showed significantly better conformity values compared with the standard and IMRT plans using a

  4. A two dimensional silicon detectors array for quality assurance in stereotactic radiotherapy: MagicPlate-512

    International Nuclear Information System (INIS)

    Purpose: Silicon diode arrays are commonly implemented in radiation therapy quality assurance applications as they have a number of advantages including: real time operation (compared to the film) and high spatial resolution, large dynamic range and small size (compared to ionizing chambers). Most diode arrays have detector pitch that is too coarse for routine use in small field applications. The goal of this work is to characterize the two-dimensional monolithic silicon diode array named “MagicPlate-512” (MP512) designed for QA in stereotactic body radiation therapy (SBRT) and stereotactic radio surgery (SRS). Methods: MP512 is a silicon monolithic detector manufactured on ap-type substrate. An array contains of 512 pixels with size 0.5 × 0.5 mm2 and pitch 2 mm with an overall dimension of 52 × 52 mm2. The MP512 monolithic detector is wire bonded on a printed circuit board 0.5 mm thick and covered by a thin layer of raisin to preserve the silicon detector from moisture and chemical contamination and to protect the bonding wires. Characterization of the silicon monolithic diode array response was performed, and included pixels response uniformity, dose linearity, percent depth dose, output factor, and beam profiling for beam sizes relevant to SBRT and SRS and depth dose response in comparison with ionization chamber. Results: MP512 shows a good dose linearity (R2 = 0.998) and repeatability within 0.2%. The measured depth dose response for field size of 10 × 10 cm2 agreed to within 1.3%, when compared to a CC13 ionization chamber for depths in PMMA up to 30 cm. The output factor of a 6 MV Varian 2100EX medical linac beam measured by MP512 at the isocenter agrees to within 2% when compared to PTW diamond, Scanditronix point EDD-2 diode and MOSkin detectors for field sizes down to 1 × 1 cm2. An over response of 4% was observed for square beam size smaller than 1 cm when compared to EBT3 films, while the beam profiles (FWHM) of MP512 match to within 2% the data

  5. Hyperfractionated stereotactic reirradiation for recurrent head and neck cancer

    Energy Technology Data Exchange (ETDEWEB)

    Cvek, Jakub; Knybel, Lukas; Skacelikova, Eva; Otahal, Bretislav; Molenda, Lukas; Feltl, David [University Hospital Ostrava, Department of Oncology, Ostrava (Czech Republic); Stransky, Jiri; Res, Oldrich [University Hospital Ostrava, Department of Maxilofacial Surgery, Ostrava (Czech Republic); Matousek, Petr; Zelenik, Karol [University Hospital Ostrava, Department of Otolaryngology, Ostrava (Czech Republic)

    2016-01-15

    The goal of this work was to evaluate the efficacy and toxicity of hyperfractionated stereotactic reirradiation (re-RT) as a treatment for inoperable, recurrent, or second primary head and neck squamous cell cancer (HNSCC) that is not suitable for systemic treatment. Forty patients with recurrent or second primary HNSCC were included in this study. The patients had a median gross tumor volume of 76 ml (range 14-193 ml) and a previous radiotherapy dose greater than 60 Gy. Treatment was designed to cover 95 % of the planning target volume (PTV, defined as gross tumor volume [GTV] + 3 mm to account for microscopic spreading, with no additional set-up margin) with the prescribed dose (48 Gy in 16 fractions b.i.d.). Treatment was administered twice daily with a minimum 6 h gap. Uninvolved lymph nodes were not irradiated. Treatment was completed as planned for all patients (with median duration of 11 days, range 9-14 days). Acute toxicity was evaluated using the RTOG/EORTC scale. A 37 % incidence of grade 3 mucositis was observed, with recovery time of ≤ 4 weeks for all of these patients. Acute skin toxicity was never observed to be higher than grade 2. Late toxicity was also evaluated according to the RTOG/EORTC scale. Mandible radionecrosis was seen in 4 cases (10 %); however, neither carotid blowout syndrome nor other grade 4 late toxicity occurred. One-year overall survival (OS) and local progression-free survival (L-PFS) were found to be 33 and 44 %, respectively. Performance status and GTV proved to be significant prognostic factors regarding local control and survival. Hyperfractionated stereotactic re-RT is a reasonable treatment option for patients with recurrent/second primary HNSCC who were previously exposed to high-dose irradiation and who are not candidates for systemic treatment or hypofractionation. (orig.) [German] Ziel der Studie war es, die Effektivitaet und Toxizitaet der hyperfraktionierten akzelerierten stereotaktischen Wiederbestrahlung (re

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

    Energy Technology Data Exchange (ETDEWEB)

    Moussazadeh, Nelson [Division of Neurological Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Department of Neurological Surgery, Weill Cornell Medical College, New York Presbyterian Hospital, New York, New York (United States); Lis, Eric [Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Katsoulakis, Evangelia [Department of Radiation Oncology, New York Methodist Hospital, Brooklyn, New York (United States); Kahn, Sweena; Svoboda, Marek; DiStefano, Natalie M.; McLaughlin, Lily [Division of Neurological Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Bilsky, Mark H. [Division of Neurological Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Department of Neurological Surgery, Weill Cornell Medical College, New York Presbyterian Hospital, New York, New York (United States); Yamada, Yoshiya [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Laufer, Ilya, E-mail: lauferi@mskcc.org [Division of Neurological Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Department of Neurological Surgery, Weill Cornell Medical College, New York Presbyterian Hospital, New York, New York (United States)

    2015-10-01

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

  7. SU-E-J-165: Dosimetric Impact of Liver Rotations in Stereotactic Body Radiation Therapy

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    Pinnaduwage, D; Paulsson, A; Sudhyadhom, A; Chen, J; Chang, A; Anwar, M; Gottschalk, A; Yom, S S.; Descovich, M [University of California San Francisco, San Francisco, CA (United States)

    2015-06-15

    Purpose: Often in liver stereotactic body radiotherapy a single fiducial is implanted near the tumor for image-guided treatment delivery. In such cases, rotational corrections are calculated based on the spine. This study quantifies rotational differences between the spine and liver, and investigates the corresponding dosimetric impact. Methods: Seven patients with 3 intrahepatic fiducials and 4DCT scans were identified. The planning CT was separately co-registered with 4 phases of the 4DCT (0%, 50%, 100% inhale and 50% exhale) by 1) rigid registration of the spine, and 2) point-based registration of the 3 fiducials. Rotation vectors were calculated for each registration. Translational differences in fiducial positions between the 2 registrations methods were investigated. Dosimetric impact due to liver rotations and deformations was assessed using critical structures delineated on the 4DCT phases. For dose comparisons, a single fiducial was translationally aligned following spine alignment to represent what is typically done in the clinic. Results: On average, differences between spine and liver rotations during the 0%, 50%, 100% inhale, and 50% exhale phases were 3.23°, 3.27°, 2.26° and 3.11° (pitch), 3.00°, 2.24°, 3.12° and 1.73° (roll), and 1.57°, 1.98°, 2.09° and 1.36° (yaw), respectively. The maximum difference in rotations was 12°, with differences of >3° seen in 14/28 (pitch), 10/28 (roll), and 6/28 (yaw) cases. Average fiducial displacements of 2.73 (craniocaudal), 1.04 (lateral) and 1.82 mm (vertical) were seen. Evaluating percent dose differences for 5 patients at the peaks of the respiratory cycle, the maximum dose to the duodenum, stomach, bowel and esophagus differed on average by 11.4%, 5.3%, 11.2% and 49.1% between the 2 registration methods. Conclusion: Lack of accounting for liver rotation during treatment might Result in clinically significant dose differences to critical structures. Both rotational and translational deviations

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

    International Nuclear Information System (INIS)

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

  9. Organizing pneumonia after stereotactic ablative radiotherapy of the lung

    International Nuclear Information System (INIS)

    Organizing pneumonia (OP), so called bronchiolitis obliterans organizing pneumonia after postoperative irradiation for breast cancer has been often reported. There is little information about OP after other radiation modalities. This cohort study investigated the clinical features and risk factors of OP after stereotactic ablative radiotherapy of the lung (SABR). Patients undergoing SABR between 2004 and 2010 in two institutions were investigated. Blood test and chest computed tomography were performed at intervals of 1 to 3 months after SABR. The criteria for diagnosing OP were: 1) mixture of patchy and ground-glass opacity, 2) general and/or respiratory symptoms lasting for at least 2 weeks, 3) radiographic lesion in the lung volume receiving < 0.5 Gy, and 4) no evidence of a specific cause. Among 189 patients (164 with stage I lung cancer and 25 with single lung metastasis) analyzed, nine developed OP. The incidence at 2 years was 5.2% (95% confidence interval; 2.6-9.3%). Dyspnea were observed in all patients. Four had fever. These symptoms and pulmonary infiltration rapidly improved after corticosteroid therapy. Eight patients had presented with symptomatic radiation pneumonitis (RP) around the tumor 2 to 7 months before OP. The prior RP history was strongly associated with OP (hazard ratio 61.7; p = 0.0028) in multivariate analysis. This is the first report on OP after SABR. The incidence appeared to be relatively high. The symptoms were sometimes severe, but corticosteroid therapy was effective. When patients after SABR present with unusual pneumonia, OP should be considered as a differential diagnosis, especially in patients with prior symptomatic RP

  10. Dosimetric comparison of linear accelerator-based stereotactic radiosurgery systems

    Directory of Open Access Journals (Sweden)

    Sharma S

    2007-01-01

    Full Text Available Stereotactic radiosurgery (SRS is a special radiotherapy technique used to irradiate intracranial lesions by 3-D arrangements of narrow photon beams eliminating the needs of invasive surgery. Three different tertiary collimators, namely BrainLab and Radionics circular cones and BrainLab micro multileaf collimator (mMLC, are used for linear accelerator-based SRS systems (X-Knife. Output factor (St, tissue maximum ratio (TMR and off axis ratio (OAR of these three SRS systems were measured using CC01 (Scanditronix/ Welhofer and Pinpoint (PTW cylindrical and Markus plane parallel ionization chambers as well as TLD and radiochromic film. Measurement results of CC01 and Pinpoint chambers were very close to each other which indicate that further reduction in volume and physical dimensions of cylindrical ionization chamber is not necessary for SRS/SRT dosimetry. Output factors of BrainLab and Radionics SRS cones were very close to each other while output factors of equivalent diameter mMLC field were different from SRS circular cones. TMR of the three SRS systems compared were very close to one another. OAR of Radionics cone and BrainLab mMLC were very close to each other, within 2%. However, OARs of BrainLab cone were found comparable to OARs of Radionics cone and BrainLab mMLC within maximum variation of 4%. In addition, user-measured similar data of other three mMLC X-Knives were compared with the mMLC X-Knife data measured in this work and found comparable. The concept of switching over to mMLC-based SRS/SRT is thus validated from dosimetric characteristics as well.

  11. Linear accelerator based stereotactic radiosurgery for melanoma brain metastases

    Directory of Open Access Journals (Sweden)

    Mark E Bernard

    2012-01-01

    Full Text Available Purpose: Melanoma is one of the most common malignancies to metastasize to the brain. Many patients with this disease will succumb to central nervous system (CNS disease, highlighting the importance of effective local treatment of brain metastases for both palliation and survival of the disease. Our objective was to evaluate the outcomes associated with stereotactic radiosurgery (SRS in the treatment of melanoma brain metastases. Materials and Methods: We retrospectively reviewed 54 patients with a total of 103 tumors treated with SRS. Twenty patients had prior surgical resection and nine patients underwent prior whole brain radiation therapy (WBRT. 71% of patients had active extracranial disease at the time of SRS. Median number of tumors treated with SRS was 1(range: 1-6 with median radiosurgery tumor volume 2.1 cm 3 (range: 0.05-59.7 cm 3 . The median dose delivered to the 80% isodose line was 24 Gy in a single fraction. Results: The median follow-up from SRS was five months (range:1-30 months. Sixty-five percent of patients had a follow-up MRI available for review. Actuarial local control at six months and 12 months was 87 and 68%, respectively. Eighty-one percent of patients developed new distant brain metastases at a median time of two months. The six-month and 12-month actuarial overall survival rates were 50 and 25%, respectively. The only significant predictor of overall survival was surgical resection prior to SRS. Post-SRS bleeding occurred in 18% of patients and at a median interval of 1.5 months. There was only one episode of radiation necrosis with no other treatment-related toxicity. Conclusion: SRS for brain metastases from melanoma is safe and achieves acceptable local control.

  12. Stereotactic body radiation therapy for centrally located lung lesions

    Energy Technology Data Exchange (ETDEWEB)

    Joyner, Melissa [Univ. of Texas Health Science Center at San Antonio (United States). Dept. of Radiation Oncology; Salter, Bill J. [The Univ. of Utah, Salt Lake City, Utah (United States). Dept. of Radiation Oncology; Papanikolaou, Niko [Cancer Therapy and Research Center, San Antonio, Texas (United States); Fuss, Martin [Oregon Health and Science Univ., Portland (United States). Dept. of Radiation Medicine

    2006-09-15

    Presentation of outcomes of patients treated by stereotactic body radiation therapy (SBRT) for lung lesions located within or touching a 2 cm zone around major airways. Serial tomotherapeutic SBRT has been planned and delivered at our institution since August 2001. Of 108 patients treated for primary and secondary lung tumors, nine harbored tumors (8 metastases, 1 recurrent NSCLC) located in close proximity to carina, right and left main bronchi, right and left upper lobe bronchi, intermedius, right middle lobe, lingular, or right and left lower lobe bronchi. SBRT was delivered to total doses of 36 Gy in 3 fractions (n=8) or 6 fractions (n=1), using a serial tomotherapy system (Nomos Peacock). We assessed local tumor control, clinical toxicity, normal tissue imaging changes, and overall survival. Median tumor volume was 26 cm{sup 3} (range 1.7 to 135 cm{sup 3}). Tumor locations were hilar (n=3), and parenchymal in six cases. Hilar lesions accounted for the three largest tumor volumes in the series. During a median follow-up of 10.6 months (range 2.5 to 41.5 months), all lesions treated were locally controlled as confirmed by CT or CT/PET imaging. Parenchymal imaging changes included focal lung fibrosis and major airway wall thickening. One occurrence of major airway occlusion (right lower lobe bronchus) was observed. This event was diagnosed by chest x-ray at 36 months, following treatment of the second largest hilar lesion in the present series. Based on the outcomes observed in this small sample series, SBRT for centrally located lung lesions appears feasible, was associated with low incidence of toxicities, and provided sustained local tumor control. However, long-term survival may be associated with major airway injury. As long-term follow-up in larger numbers of patients is lacking at this time, exclusion of patients with centrally located lesions may be considered when patients are treated in curative intent.

  13. Stereotactic Body Radiation Therapy in Recurrent Hepatocellular Carcinoma

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    Huang, Wen-Yen [Department of Radiation Oncology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (China); Jen, Yee-Min, E-mail: yeeminjen@yahoo.com.tw [Department of Radiation Oncology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (China); Lee, Meei-Shyuan [School of Public Health, National Defense Medical Center, Taipei, Taiwan (China); Chang, Li-Ping [Department of Radiation Oncology, Cardinal Tien Hospital, Taipei, Taiwan (China); Chen, Chang-Ming [Department of Radiation Oncology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (China); Ko, Kai-Hsiung [Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (China); Lin, Kuen-Tze; Lin, Jang-Chun; Chao, Hsing-Lung; Lin, Chun-Shu; Su, Yu-Fu; Fan, Chao-Yueh; Chang, Yao-Wen [Department of Radiation Oncology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (China)

    2012-10-01

    Purpose: To examine the safety and efficacy of Cyberknife stereotactic body radiation therapy (SBRT) and its effect on survival in patients of recurrent hepatocellular carcinoma (HCC). Methods and Materials: This was a matched-pair study. From January 2008 to December 2009, 36 patients with 42 lesions of unresectable recurrent HCC were treated with SBRT. The median prescribed dose was 37 Gy (range, 25 to 48 Gy) in 4-5 fractions over 4-5 consecutive working days. Another 138 patients in the historical control group given other or no treatments were selected for matched analyses. Results: The median follow-up time was 14 months for all patients and 20 months for those alive. The 1- and 2-year in-field failure-free rates were 87.6% and 75.1%, respectively. Out-field intrahepatic recurrence was the main cause of failure. The 2-year overall survival (OS) rate was 64.0%, and median time to progression was 8.0 months. In the multivariable analysis of all 174 patients, SBRT (yes vs. no), tumor size ({<=}4 cm vs. >4 cm), recurrent stage (stage IIIB/IV vs. I) and Child-Pugh classification (A vs. B/C) were independent prognostic factors for OS. Matched-pair analysis revealed that patients undergoing SBRT had better OS (2-year OS of 72.6% vs. 42.1%, respectively, p = 0.013). Acute toxicities were mild and tolerable. Conclusion: SBRT is a safe and efficacious modality and appears to be well-tolerated at the dose fractionation we have used, and its use correlates with improved survival in this cohort of patients with recurrent unresectable HCC. Out-field recurrence is the major cause of failure. Further studies of combinations of SBRT and systemic therapies may be reasonable.

  14. Radiation pneumonitis after stereotactic radiation therapy for lung cancer

    Institute of Scientific and Technical Information of China (English)

    Hideomi; Yamashita; Wataru; Takahashi; Akihiro; Haga; Keiichi; Nakagawa

    2014-01-01

    Stereotactic body radiation therapy(SBRT)has a locacontrol rate of 95%at 2 years for non-small cell lungcancer(NSCLC)and should improve the prognosis oinoperable patients,elderly patients,and patients withsignificant comorbidities who have early-stage NSCLCThe safety of SBRT is being confirmed in internationalmulti-institutional PhaseⅡtrials for peripheral lungcancer in both inoperable and operable patients,bureports so far have found that SBRT is a safe and effective treatment for early-stage NSCLC and early metastatic lung cancer.Radiation pneumonitis(RP)is oneof the most common toxicities of SBRT.Although mospost-treatment RP is Grade 1 or 2 and either asymptomatic or manageable,a few cases are severe,symptomatic,and there is a risk for mortality.The reportedrates of symptomatic RP after SBRT range from 9%to28%.Being able to predict the risk of RP after SBRT isextremely useful in treatment planning.A dose-effecrelationship has been demonstrated,but suggesteddose-volume factors like mean lung dose,lung V20and/or lung V2.5 differed among the reports.We foundthat patients who present with an interstitial pneumo-nitis shadow on computed tomography scan and high levels of serum Krebs von den Lungen-6 and surfactant protein D have a high rate of severe radiation pneumo-nitis after SBRT.At our institution,lung cancer patients with these risk factors have not received SBRT since 2006,and our rate of severe RP after SBRT has de-creased significantly since then.

  15. A preplanning method for stereotactic radiosurgery to improve treatment workflow.

    Science.gov (United States)

    Ahn, Kang-Hyun; Ozturk, Naim; Smith, Brett; Slavin, Konstantin V; Koshy, Matthew; Aydogan, Bulent

    2016-01-01

    Frame-based stereotactic radiosurgery (SRS) requires fixation of an invasive head ring to ensure accurate targeting. Minimizing waiting time with a fixed head ring is important for patient comfort and satisfaction. We report a practical preplanning solution for the Brainlab iPlan treatment planning system that reduces waiting time by expediting the planning process on treatment day. A water-filled anthropomorphic head phantom was used to acquire a surrogate CT image set for preplanning and fused with patient's MRI, which was obtained before the day of treatment. Once an acceptable preplan was obtained, it was saved as a plan template and the phantom image set was removed from the Brainlab database to prevent any confusion and mix-up of image sets. On the treatment day, the patient's CT and MRI were fused, and the customized beam settings of the preplan template were then applied and optimized. Up to 10-fold of reduction in treatment plan time was demonstrated by bench testing with multiple planners and a variety of cases. Loading the plan template and fine-tuning the preconfigured beam settings took only a small fraction of the preplan time to restore the conformity and dose falloff comparable to those of the preplan. For instance, preplan time was 2 hr for a two-isocenter case, whereas, it took less than 20 min for a less experienced planner to plan it on the day of treat-ment using the preplan method. The SRS preplanning technique implemented in this study for the Brainlab iPlan treatment planning system offers an opportunity to explore possible beam configurations thoroughly, optimize planning parameters, resolve gantry angle clearance issues, and communicate and address challenges with physicians before the treatment day. Preplanning has been proven to improve plan quality and to improve efficiency in our clinic, especially for multiple-isocenter and dosimetrically challenging cases. PMID:27167274

  16. Proton Stereotactic Radiosurgery for the Treatment of Benign Meningiomas

    International Nuclear Information System (INIS)

    Purpose: Given the excellent prognosis for patients with benign meningiomas, treatment strategies to minimize late effects are important. One strategy is proton radiation therapy (RT), which allows less integral dose to normal tissue and greater homogeneity than photon RT. Here, we report the first series of proton stereotactic radiosurgery (SRS) used for the treatment of meningiomas. Methods and Materials: We identified 50 patients with 51 histologically proven or image- defined, presumed-benign meningiomas treated at our institution between 1996 and 2007. Tumors of <4 cm in diameter and located ≥2 mm from the optic apparatus were eligible for treatment. Indications included primary treatment (n = 32), residual tumor following surgery (n = 8), and recurrent tumor following surgery (n = 10). The median dose delivered was 13 Gray radiobiologic equivalent (Gy[RBE]) (range, 10.0-15.5 Gy[RBE]) prescribed to the 90% isodose line. Results: Median follow-up was 32 months (range, 6-133 months). Magnetic resonance imaging at the most recent follow-up or time of progression revealed 33 meningiomas with stable sizes, 13 meningiomas with decreased size, and 5 meningiomas with increased size. The 3-year actuarial tumor control rate was 94% (95% confidence interval, 77%-98%). Symptoms were improved in 47% (16/ 34) of patients, unchanged in 44% (15/34) of patients, and worse in 9% (3/34) of patients. The rate of potential permanent adverse effects after SRS was 5.9% (3/51 patients). Conclusions: Proton SRS is an effective therapy for small benign meningiomas, with a potentially lower rate of long-term treatment-related morbidity. Longer follow-up is needed to assess durability of tumor control and late effects.

  17. Fractionated Stereotactic Radiotherapy of Vestibular Schwannomas Accelerates Hearing Loss

    Energy Technology Data Exchange (ETDEWEB)

    Rasmussen, Rune, E-mail: rune333@gmail.com [Department of Neurosurgery, Rigshospitalet, Copenhagen (Denmark); Claesson, Magnus [Department of Neurosurgery, Rigshospitalet, Copenhagen (Denmark); Stangerup, Sven-Eric [Ear, Nose, and Throat Department, Rigshospitalet, Copenhagen (Denmark); Roed, Henrik [Department of Radiation Oncology, Rigshospitalet, Copenhagen (Denmark); Christensen, Ib Jarle [Finsen Laboratory, Rigshospitalet, Copenhagen (Denmark); Caye-Thomasen, Per [Ear, Nose, and Throat Department, Rigshospitalet, Copenhagen (Denmark); Juhler, Marianne [Department of Neurosurgery, Rigshospitalet, Copenhagen (Denmark)

    2012-08-01

    Objective: To evaluate long-term tumor control and hearing preservation rates in patients with vestibular schwannoma treated with fractionated stereotactic radiotherapy (FSRT), comparing hearing preservation rates to an untreated control group. The relationship between radiation dose to the cochlea and hearing preservation was also investigated. Methods and Materials: Forty-two patients receiving FSRT between 1997 and 2008 with a minimum follow-up of 2 years were included. All patients received 54 Gy in 27-30 fractions during 5.5-6.0 weeks. Clinical and audiometry data were collected prospectively. From a 'wait-and-scan' group, 409 patients were selected as control subjects, matched by initial audiometric parameters. Radiation dose to the cochlea was measured using the original treatment plan and then related to changes in acoustic parameters. Results: Actuarial 2-, 4-, and 10-year tumor control rates were 100%, 91.5%, and 85.0%, respectively. Twenty-one patients had serviceable hearing before FSRT, 8 of whom (38%) retained serviceable hearing at 2 years after FSRT. No patients retained serviceable hearing after 10 years. At 2 years, hearing preservation rates in the control group were 1.8 times higher compared with the group receiving FSRT (P=.007). Radiation dose to the cochlea was significantly correlated to deterioration of the speech reception threshold (P=.03) but not to discrimination loss. Conclusion: FSRT accelerates the naturally occurring hearing loss in patients with vestibular schwannoma. Our findings, using fractionation of radiotherapy, parallel results using single-dose radiation. The radiation dose to the cochlea is correlated to hearing loss measured as the speech reception threshold.

  18. Fractionated stereotactic conformal radiotherapy for large benign skull base meningiomas

    International Nuclear Information System (INIS)

    to assess the safety and efficacy of fractionated stereotactic radiotherapy (FSRT) for large skull base meningiomas. Fifty-two patients with large skull base meningiomas aged 34-74 years (median age 56 years) were treated with FSRT between June 2004 and August 2009. All patients received FSRT for residual or progressive meningiomas more than 4 centimeters in greatest dimension. The median GTV was 35.4 cm3 (range 24.1-94.9 cm3), and the median PTV was 47.6 cm3 (range 33.5-142.7 cm3). Treatment volumes were achieved with 5-8 noncoplanar beams shaped using a micromultileaf collimator (MLC). Treatment was delivered in 30 daily fractions over 6 weeks to a total dose of 50 Gy using 6 MV photons. Outcome was assessed prospectively. At a median follow-up of 42 months (range 9-72 months) the 3-year and 5-year progression-free survival (PFS) rates were 96% and 93%, respectively, and survival was 100%. Three patients required further debulking surgery for progressive disease. Hypopituitarism was the most commonly reported late complication, with a new hormone pituitary deficit occurring in 10 (19%) of patients. Clinically significant late neurological toxicity was observed in 3 (5.5%) patients consisting of worsening of pre-existing cranial deficits. FSRT as a high-precision technique of localized RT is suitable for the treatment of large skull base meningiomas. The local control is comparable to that reported following conventional external beam RT. Longer follow-up is required to assess long term efficacy and toxicity, particularly in terms of potential reduction of treatment-related late toxicity

  19. The use of spine stereotactic radiosurgery for oligometastatic disease.

    Science.gov (United States)

    Ho, Jennifer C; Tang, Chad; Deegan, Brian J; Allen, Pamela K; Jonasch, Eric; Amini, Behrang; Wang, Xin A; Li, Jing; Tatsui, Claudio E; Rhines, Laurence D; Brown, Paul D; Ghia, Amol J

    2016-08-01

    OBJECTIVE The authors investigated the outcomes following spine stereotactic radiosurgery (SSRS) for patients with oligometastatic disease of the spine. METHODS The study was a secondary analysis of 38 of 209 patients enrolled in 2 separate institutional Phase I/II prospective protocols and treated with SSRS between 2002 and 2011. Of these 38 patients, 33 (87%) were treated for a solitary spine metastasis, with no other history of metastatic disease. SSRS was prescribed to 24 Gy in 1 fraction (8%), 18 Gy in 1 fraction (18%), 16 Gy in 1 fraction (11%), 27 Gy in 3 fractions (53%), 30 Gy in 5 fractions (8%), or 20 Gy in 5 fractions (3%). Seventeen patients (45%) received prior conventional external beam radiation therapy. RESULTS The median overall survival (OS) was 75.7 months, and the 2- and 5-year OS rates were 84% and 60%, respectively. In multivariate analysis, patients who had prior spine surgery and a better Karnofsky Performance Scale score had an improved OS (HR 0.16, 95% CI 0.05-0.52, p < 0.01, and HR 0.33, 95% CI 0.13%-0.84%, p = 0.02, respectively), and those who had undergone prior radiation therapy had a worse OS (HR 3.6, 95% CI 1.2%-10%, p = 0.02). The 1-, 2-, and 5-year local progression-free survival rates were 85%, 82%, and 78%, respectively. The median time to systemic therapy modification was 41 months. Two patients (5%) experienced late Grade 3-4 toxicity. CONCLUSIONS Patients with oligometastatic disease of the spine treated with SSRS can experience long-term survival and a long time before needing a modification in systemic therapy. In addition, SSRS leads to excellent local control and minimal late toxicity. PMID:27035507

  20. Stereotactic Radiosurgery for Recurrent or Unresectable Pilocytic Astrocytoma

    Energy Technology Data Exchange (ETDEWEB)

    Hallemeier, Christopher L. [Department of Radiation Oncology, Mayo Clinic, Rochester, MN (United States); Pollock, Bruce E. [Department of Radiation Oncology, Mayo Clinic, Rochester, MN (United States); Department of Neurological Surgery, Mayo Clinic, Rochester, MN (United States); Schomberg, Paula J. [Department of Radiation Oncology, Mayo Clinic, Rochester, MN (United States); Link, Michael J. [Department of Neurological Surgery, Mayo Clinic, Rochester, MN (United States); Brown, Paul D. [Department of Radiation Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States); Stafford, Scott L., E-mail: Stafford.scott@mayo.edu [Department of Radiation Oncology, Mayo Clinic, Rochester, MN (United States)

    2012-05-01

    Purpose: To report the outcomes in patients with recurrent or unresectable pilocytic astrocytoma (PA) treated with Gamma Knife stereotactic radiosurgery (SRS). Methods and Materials: Retrospective review of 18 patients (20 lesions) with biopsy-confirmed PA having SRS at our institution from 1992 through 2005. Results: The median patient age at SRS was 23 years (range, 4-56). Thirteen patients (72%) had undergone one or more previous surgical resections, and 10 (56%) had previously received external-beam radiation therapy (EBRT). The median SRS treatment volume was 9.1 cm{sup 3} (range, 0.7-26.7). The median tumor margin dose was 15 Gy (range, 12-20). The median follow-up was 8.0 years (range, 0.5-15). Overall survival at 1, 5, and 10 years after SRS was 94%, 71%, and 71%, respectively. Tumor progression (local solid progression, n = 4; local solid progression + distant, n = 1; distant, n = 2; cyst development/progression, n = 4) was noted in 11 patients (61%). Progression-free survival at 1, 5, and 10 years was 65%, 41%, and 17%, respectively. Prior EBRT was associated with inferior overall survival (5-year risk, 100% vs. 50%, p = 0.03) and progression-free survival (5-year risk, 71% vs. 20%, p = 0.008). Nine of 11 patients with tumor-related symptoms improved after SRS. Symptomatic edema after SRS occurred in 8 patients (44%), which resolved with short-term corticosteroid therapy in the majority of those without early disease progression. Conclusions: SRS has low permanent radiation-related morbidity and durable local tumor control, making it a meaningful treatment option for patients with recurrent or unresectable PA in whom surgery and/or EBRT has failed.

  1. Small Bowel Dose Tolerance for Stereotactic Body Radiation Therapy.

    Science.gov (United States)

    LaCouture, Tamara A; Xue, Jinyu; Subedi, Gopal; Xu, Qianyi; Lee, Justin T; Kubicek, Gregory; Asbell, Sucha O

    2016-04-01

    Inconsistencies permeate the literature regarding small bowel dose tolerance limits for stereotactic body radiation therapy (SBRT) treatments. In this review, we organized these diverse published limits with MD Anderson at Cooper data into a unified framework, constructing the dose-volume histogram (DVH) Risk Map, demonstrating low-risk and high-risk SBRT dose tolerance limits for small bowel. Statistical models of clinical data from 2 institutions were used to assess the safety spectrum of doses used in the exposure of the gastrointestinal tract in SBRT; 30% of the analyzed cases had vascular endothelial growth factor inhibitors (VEGFI) or other biological agents within 2 years before or after SBRT. For every dose tolerance limit in the DVH Risk Map, the probit dose-response model was used to estimate the risk level from our clinical data. Using the current literature, 21Gy to 5cc of small bowel in 3 fractions has low toxicity and is reasonably safe, with 6.5% estimated risk of grade 3 or higher complications, per Common Terminology Criteria for Adverse Events version 4.0. In the same fractionation for the same volume, if lower risk is required, 16.2Gy has an estimated risk of only 2.5%. Other volumes and fractionations are also reviewed; for all analyzed high-risk small bowel limits, the risk is 8.2% or less, and the low-risk limits have 4% or lower estimated risk. The results support current clinical practice, with some possibility for dose escalation. PMID:27000513

  2. Organizing pneumonia after stereotactic ablative radiotherapy of the lung

    Directory of Open Access Journals (Sweden)

    Murai Taro

    2012-08-01

    Full Text Available Abstract Background Organizing pneumonia (OP, so called bronchiolitis obliterans organizing pneumonia after postoperative irradiation for breast cancer has been often reported. There is little information about OP after other radiation modalities. This cohort study investigated the clinical features and risk factors of OP after stereotactic ablative radiotherapy of the lung (SABR. Methods Patients undergoing SABR between 2004 and 2010 in two institutions were investigated. Blood test and chest computed tomography were performed at intervals of 1 to 3 months after SABR. The criteria for diagnosing OP were: 1 mixture of patchy and ground-glass opacity, 2 general and/or respiratory symptoms lasting for at least 2 weeks, 3 radiographic lesion in the lung volume receiving  Results Among 189 patients (164 with stage I lung cancer and 25 with single lung metastasis analyzed, nine developed OP. The incidence at 2 years was 5.2% (95% confidence interval; 2.6-9.3%. Dyspnea were observed in all patients. Four had fever. These symptoms and pulmonary infiltration rapidly improved after corticosteroid therapy. Eight patients had presented with symptomatic radiation pneumonitis (RP around the tumor 2 to 7 months before OP. The prior RP history was strongly associated with OP (hazard ratio 61.7; p = 0.0028 in multivariate analysis. Conclusions This is the first report on OP after SABR. The incidence appeared to be relatively high. The symptoms were sometimes severe, but corticosteroid therapy was effective. When patients after SABR present with unusual pneumonia, OP should be considered as a differential diagnosis, especially in patients with prior symptomatic RP.

  3. Neuropathological changes following experimental stereotactic irradiation. Progressive injuries of oligodendrocytes

    International Nuclear Information System (INIS)

    This report describes the results of neuropathological examinations in 14 rabbit brains after 100 Gy of linear stereotactic irradiation. The tissue around the area of radiation necrosis was subjected to special examination. Fourteen rabbits were given a single dose of 100 Gy by a linear accelerator with a use of the 10 mm collimator. Animals were sacrificed serially after irradiation. Brains were removed and formalin treated paraffin sections were made. All sections were stained by H and E, GFAP and TUNEL (TdT-mediated dUTP-biotin nick end labeling method) stain. Pathological changes of vessels and neural tissue around the area of necrosis were examined. Three months after irradiation, TUNEL-positive oligodendrocytes were seen scattered in the white matter or the radiated field, and after 6 months, these changes extended around the radiating field, but vessels and neurons appeared to be intact. Two years after irradiation, massive necrosis had occurred in the radiated area. Thickness and fibrinoid degeneration of the vessel walls were evident in the area around the necrosis. These vessel changes were recognized in the zone of the 40 Gy radiated region. TUNEL-positive oligodendrocytes were also observed around the necrosis, and were scattered in the white matter and corpus callosum over the region of vascular changes. These findings suggested the following: In the later period after irradiation, oligodendrocytes in the peripheral zone of necrosis are damaged by ischemia and edema, which are caused by vascular changes. TUNEL-positive oligodendrocytes which exsisted in the white matter and corpus callosum distal to the radiated area may exhibit development of serial damage of oligodendrocytes in those regions. (author)

  4. Radiographer-performed stereotactic needle core biopsy: Making a difference

    International Nuclear Information System (INIS)

    This case study describes a qualitative investigation of the experiences of 14 experienced mammography radiographers who successfully undertook a formal programme of education and training in stereotactic needle core biopsy (SNCB) of the breast. They now routinely perform SNCB within symptomatic and screening breast services in a variety of NHS hospitals across the country. All 14 radiographers completed a semi-structured postal questionnaire approximately six months after the end of the course. A tentative theory derived from the data suggests that the professional challenge associated with radiographer-performed SNCB builds personal confidence and effects positive change. Three main categories emerging from the data - challenge, confidence and change are underpinned by two main themes - educational, professional and service drivers that promote the realisation of goals and vision; and personal, peer and external motivation sustained by respect, recognition and reward. SNCB role extension as explored in this study is having a positive and transformational impact on patient users of breast diagnostic clinical services and on the professional health carers providing them. The key drivers for this as identified in the study are a formal educational experience, professional role extension opportunities and the NHS modernisation process. The participants experienced positive change as individuals and as professional breast cancer multidisciplinary team members. Academic and financial rewards, respect and recognition from colleagues across professional disciplines and from patients, were key motivators that sustained the process. This study indicates that radiographer-performed SNCB can help deliver the NHS Plan and the NHS Cancer Plan and in doing so has the potential to improve the working lives of health care professionals and ultimately to improve the quality of care for patients

  5. Fractionated Stereotactic Radiotherapy in Patients With Optic Nerve Sheath Meningioma

    Energy Technology Data Exchange (ETDEWEB)

    Paulsen, Frank, E-mail: frank.paulsen@med.uni-tuebingen.de [Department of Radiation Oncology, University of Tuebingen, Tuebingen (Germany); Doerr, Stefan [Department of Radiation Oncology, University of Tuebingen, Tuebingen (Germany); Wilhelm, Helmut [Department of Ophthalmology, University of Tuebingen, Tuebingen (Germany); Becker, Gerd [Department of Radiation Oncology, Klinik am Eichert, Goeppingen (Germany); Bamberg, Michael [Department of Radiation Oncology, University of Tuebingen, Tuebingen (Germany); Classen, Johannes [Department of Radiation Oncology, St. Vincentius-Kliniken, Karlsruhe (Germany)

    2012-02-01

    Purpose: To evaluate the effectiveness of fractionated stereotactic radiotherapy (SFRT) in the treatment of optic nerve sheath meningioma (ONSM). Methods and Materials: Between 1993 and 2005, 109 patients (113 eyes) with primary (n = 37) or secondary (n = 76) ONSM were treated according to a prospective protocol with SFRT to a median dose of 54 Gy. All patients underwent radiographic, ophthalmologic, and endocrine analysis before and after SFRT. Radiographic response, visual control, and late side effects were endpoints of the analysis. Results: Median time to last clinical, radiographic, and ophthalmologic follow up was 30.2 months (n = 113), 42.7 months (n = 108), and 53.7 months (n = 91), respectively. Regression of the tumor was observed in 5 eyes and progression in 4 eyes, whereas 104 remained stable. Visual acuity improved in 12, deteriorated in 11, and remained stable in 68 eyes. Mean visual field defects reduced from 33.6% (n = 90) to 17.8% (n = 56) in ipsilateral and from 10% (n = 94) to 6.7% (n = 62) in contralateral eyes. Ocular motility improved in 23, remained stable in 65, and deteriorated in 3 eyes. Radiographic tumor control was 100% at 3 years and 98% at 5 years. Visual acuity was preserved in 94.8% after 3 years and in 90.9% after 5 years. Endocrine function was normal in 90.8% after 3 years and in 81.3% after 5 years. Conclusions: SFRT represents a highly effective treatment for ONSM. Interdisciplinary counseling of the patients is recommended. Because of the high rate of preservation of visual acuity we consider SFRT the standard approach for the treatment of ONSM. Prolonged observation is warranted to more accurately assess late visual impairment. Moderate de-escalation of the radiation dose might improve the preservation of visual acuity and pituitary gland function.

  6. SU-E-J-04: Integration of Interstitial High Intensity Therapeutic Ultrasound Applicators On a Clinical MRI-Guided High Intensity Focused Ultrasound Treatment Planning Software Platform

    Energy Technology Data Exchange (ETDEWEB)

    Ellens, N [Johns Hopkins University, Baltimore, Maryland (United States); Partanen, A [Philips Healthcare, Andover, Massachusetts (United States); Ghoshal, G; Burdette, E [Acoustic MedSystems Inc., Savoy, IL (United States); Farahani, K [National Cancer Institute, Bethesda, MD (United States)

    2015-06-15

    Purpose: Interstitial high intensity therapeutic ultrasound (HITU) applicators can be used to ablate tissue percutaneously, allowing for minimally-invasive treatment without ionizing radiation [1,2]. The purpose of this study was to evaluate the feasibility and usability of combining multielement interstitial HITU applicators with a clinical magnetic resonance imaging (MRI)-guided focused ultrasound software platform. Methods: The Sonalleve software platform (Philips Healthcare, Vantaa, Finland) combines anatomical MRI for target selection and multi-planar MRI thermometry to provide real-time temperature information. The MRI-compatible interstitial US applicators (Acoustic MedSystems, Savoy, IL, USA) had 1–4 cylindrical US elements, each 1 cm long with either 180° or 360° of active surface. Each applicator (4 Fr diameter, enclosed within a 13 Fr flexible catheter) was inserted into a tissue-mimicking agar-silica phantom. Degassed water was circulated around the transducers for cooling and coupling. Based on the location of the applicator, a virtual transducer overlay was added to the software to assist targeting and to allow automatic thermometry slice placement. The phantom was sonicated at 7 MHz for 5 minutes with 6–8 W of acoustic power for each element. MR thermometry data were collected during and after sonication. Results: Preliminary testing indicated that the applicator location could be identified in the planning images and the transducer locations predicted within 1 mm accuracy using the overlay. Ablation zones (thermal dose ≥ 240 CEM43) for 2 active, adjacent US elements ranged from 18 mm × 24 mm (width × length) to 25 mm × 25 mm for the 6 W and 8 W sonications, respectively. Conclusion: The combination of interstitial HITU applicators and this software platform holds promise for novel approaches in minimally-invasive MRI-guided therapy, especially when bony structures or air-filled cavities may preclude extracorporeal HIFU.[1] Diederich et al

  7. SU-E-J-04: Integration of Interstitial High Intensity Therapeutic Ultrasound Applicators On a Clinical MRI-Guided High Intensity Focused Ultrasound Treatment Planning Software Platform

    International Nuclear Information System (INIS)

    Purpose: Interstitial high intensity therapeutic ultrasound (HITU) applicators can be used to ablate tissue percutaneously, allowing for minimally-invasive treatment without ionizing radiation [1,2]. The purpose of this study was to evaluate the feasibility and usability of combining multielement interstitial HITU applicators with a clinical magnetic resonance imaging (MRI)-guided focused ultrasound software platform. Methods: The Sonalleve software platform (Philips Healthcare, Vantaa, Finland) combines anatomical MRI for target selection and multi-planar MRI thermometry to provide real-time temperature information. The MRI-compatible interstitial US applicators (Acoustic MedSystems, Savoy, IL, USA) had 1–4 cylindrical US elements, each 1 cm long with either 180° or 360° of active surface. Each applicator (4 Fr diameter, enclosed within a 13 Fr flexible catheter) was inserted into a tissue-mimicking agar-silica phantom. Degassed water was circulated around the transducers for cooling and coupling. Based on the location of the applicator, a virtual transducer overlay was added to the software to assist targeting and to allow automatic thermometry slice placement. The phantom was sonicated at 7 MHz for 5 minutes with 6–8 W of acoustic power for each element. MR thermometry data were collected during and after sonication. Results: Preliminary testing indicated that the applicator location could be identified in the planning images and the transducer locations predicted within 1 mm accuracy using the overlay. Ablation zones (thermal dose ≥ 240 CEM43) for 2 active, adjacent US elements ranged from 18 mm × 24 mm (width × length) to 25 mm × 25 mm for the 6 W and 8 W sonications, respectively. Conclusion: The combination of interstitial HITU applicators and this software platform holds promise for novel approaches in minimally-invasive MRI-guided therapy, especially when bony structures or air-filled cavities may preclude extracorporeal HIFU.[1] Diederich et al

  8. Medication Guide

    Science.gov (United States)

    ... Size Small Text Medium Text Large Text Contrast Dark on Light Light on Dark Donate Search Menu Donate What is Glaucoma? Care ... Low Vision Resources Medication Guide Resources on the Web » See All Articles Help the Cause Glaucoma affects ...

  9. XMPP The Definitive Guide

    CERN Document Server

    Saint-Andre, Peter; Smith, Kevin

    2009-01-01

    This practical book provides everything you need to know about the Extensible Messaging and Presence Protocol (XMPP) -- the open technology for real-time communication used in instant messaging, Voice over IP, real-time collaboration, social networking, microblogging, lightweight middleware, cloud computing, and more. XMPP: The Definitive Guide walks you through the thought processes and design decisions involved in building a complete XMPP-enabled application, and adding real-time interfaces to existing applications.

  10. Feasibility of proton transmission-beam stereotactic ablative radiotherapy versus photon stereotactic ablative radiotherapy for lung tumors: a dosimetric and feasibility study.

    Directory of Open Access Journals (Sweden)

    Benjamin Mou

    Full Text Available Stereotactic ablative radiotherapy is being increasingly adopted in the treatment of lung tumors. The use of proton beam therapy can further reduce dose to normal structures. However, uncertainty exists in proton-based treatment plans, including range uncertainties, large sensitivity to position uncertainty, and calculation of dose deposition in heterogeneous areas. This study investigated the feasibility of proton transmission beams, i.e. without the Bragg peak, to treat lung tumors with stereotactic ablative radiotherapy. We compared three representative treatment plans using proton transmission beams versus conformal static-gantry photon beams. It was found that proton treatment plans using transmission beams passing through the patient were feasible and demonstrated lower dose to normal structures and markedly reduced treatment times than photon plans. This is the first study to demonstrate the feasibility of proton-based stereotactic ablative radiotherapy planning for lung tumors using proton transmission beams alone. Further research using this novel approach for proton-based planning is warranted.

  11. qooxdoo Beginner's Guide

    CERN Document Server

    Raffi, Mohamed

    2011-01-01

    This is a Packt beginner's guide. The unique style of the book is to set the requirements for an application, Team Twitter, in the first chapter and apply the concepts in the application as you learn in the following chapters. When you complete this book, you would have developed a complete application. Although the scope of this book is only on the Qooxdoo framework, which is a client side framework, we have explained how to set up one of the RPC servers and demonstrated the end to end application in the Team Twitter. This book is intended for the client side developers who design and develop

  12. Virtualization A Manager's Guide

    CERN Document Server

    Kusnetzky, Dan

    2011-01-01

    What exactly is virtualization? As this concise book explains, virtualization is a smorgasbord of technologies that offer organizations many advantages, whether you're managing extremely large stores of rapidly changing data, scaling out an application, or harnessing huge amounts of computational power. With this guide, you get an overview of the five main types of virtualization technology, along with information on security, management, and modern use cases. Topics include: Access virtualization-Allows access to any application from any deviceApplication virtualization-Enables applications

  13. Phase-II study on stereotactic radiotherapy of locally advanced pancreatic carcinoma

    DEFF Research Database (Denmark)

    Høyer, Morten; Roed, Henrik; Sengeløv, Lisa;

    2005-01-01

    BACKGROUND AND PURPOSE: The majority of patients with pancreatic cancer have advanced disease at the time of diagnosis and are not amenable for surgery. Stereotactic radiotherapy (SRT) may be an alternative treatment for patients with locally advanced disease. The effect of SRT was investigated...

  14. Optimizing dose prescription in stereotactic body radiotherapy for lung tumours using Monte Carlo dose calculation

    NARCIS (Netherlands)

    Widder, Joachim; Hollander, Miranda; Ubbels, Jan F.; Bolt, Rene A.; Langendijk, Johannes A.

    2010-01-01

    Purpose: To define a method of dose prescription employing Monte Carlo (MC) dose calculation in stereotactic body radiotherapy (SBRT) for lung tumours aiming at a dose as low as possible outside of the PTV. Methods and materials: Six typical T1 lung tumours - three small, three large - were construc

  15. Clinical efficacy of stereotactic ablative radiotherapy for lung metastases arising from colorectal cancer

    International Nuclear Information System (INIS)

    Limited data describe the prognosis after stereotactic ablative radiotherapy for lung metastases arising from colorectal cancer. Thus, we evaluated treatment outcomes of stereotactic ablative radiotherapy for those patients. The study involved patients received stereotactic ablative radiotherapy for one to three lung metastases arising from colorectal cancer at a single institution. A total dose of 40–60 Gy (median, 48 Gy) in three or four fractions was prescribed. A total of 79 metastatic lung lesions from 50 patients who underwent curative resection for their primary colorectal cancer or salvage treatment at a recurrent site were included. The one- and three-year local control rates were 88.7 % and 70.6 %, respectively. The three-year overall survival and progression-free survival rates were 64.0 % and 24.0 %, respectively. Patients with tumor volume ≤1.5 mL had a significantly better overall survival rate than those with tumor volume >1.5 mL (68.0 % vs. 60.0 % at three-year, p = 0.02). Local control was associated with a trend towards better survival (p = 0.06). No pulmonary complications greater than grade 2 were observed. Stereotactic ablative radiotherapy is a competitive treatment modality for the management of lung metastases arising from colorectal cancer

  16. Patterns of recurrence and survival after surgery or stereotactic radiotherapy for early stage NSCLC

    NARCIS (Netherlands)

    van den Berg, Liseth L.; Klinkenberg, Theo J.; Groen, Harry J. M.; Widder, Joachim

    2015-01-01

    Introduction: Surgery is the standard treatment for early stage non-small-cell lung cancer (NSCLC). For medically inoperable patients, stereotactic ablative radiotherapy (SABR) has emerged as widely used standard treatment. The aim of this study was to analyze survival and patterns of tumor recurren

  17. Visual outcome after fractionated stereotactic radiation therapy of benign anterior skull base tumors

    DEFF Research Database (Denmark)

    Astradsson, Arnar; Wiencke, Anne Katrine; Munck af Rosenschold, Per;

    2014-01-01

    To determine visual outcome including the occurrence of radiation induced optic neuropathy (RION) as well as tumor control after fractionated stereotactic radiation therapy (FSRT) of benign anterior skull base meningiomas or pituitary adenomas. Thirty-nine patients treated with FSRT for anterior ...

  18. Regulatory Facility Guide for Tennessee

    Energy Technology Data Exchange (ETDEWEB)

    Anderson, S.S.; Bock, R.E.; Francis, M.W.; Gove, R.M.; Johnson, P.E.; Kovac, F.M.; Mynatt, J.O. [Oak Ridge National Lab., TN (United States); Rymer, A.C. [Transportation Consulting Services, Knoxville, TN (United States)

    1994-02-28

    This guide provides detailed compilations of international, federal, and state transportation related regulations applicable to shipments originating at or destined to Tennessee facilities. Information on preferred routes is also given.

  19. The RSSearch™ Registry: patterns of care and outcomes research on patients treated with stereotactic radiosurgery and stereotactic body radiotherapy

    International Nuclear Information System (INIS)

    The RSSearch™ Registry is a multi-institutional, observational, ongoing registry established to standardize data collection from patients treated with stereotactic radiosurgery (SRS) and/or stereotactic body radiotherapy (SBRT). This report describes the design, patient demographics, lesion characteristics, and SRS/SBRT treatment patterns in RSSearch™. Illustrative patient-related outcomes are also presented for two common treatment sites – brain metastases and liver metastases. Thirty-nine US centers participated in RSSearch™. Patients screened for SRS/SBRT were eligible to be enrolled. Descriptive analyses were performed to assess patient characteristics, physician treatment practices, and clinical outcomes. Kaplan-Meier analysis was used to determine overall survival (OS), local progression-free (LPFS), and distant disease-free survival (DDFS). From January, 2008 – January, 2013, 11,457 patients were enrolled. The median age was 67 years (range 7–100 years); 51% male and 49% female. Forty-six percent had no prior treatment, 22% had received chemotherapy, 19% radiation therapy and 17% surgery. There were 11,820 lesions from 65 treatment locations; 54% extracranial and 46% intracranial. The most common treatment locations were brain/cranial nerve/spinal cord, lung, prostate and liver. Metastatic lesions accounted for the majority of cases (41.6%), followed by primary malignant (32.9%), benign (10.9%), recurrent (9.4%), and functional diseases (4.3%). SRS/SBRT was used with a curative intent in 39.8% and palliative care in 44.8% of cases. The median dose for all lesions was 30 Gy (range < 1 – 96.7 Gy) delivered in a median number of 3 fractions. The median dose for lesions in the brain/cranial nerve/spinal cord, lung, liver, pancreas and prostate was 24, 54, 45, 29 and 36.25 Gy, respectively. In a subset analysis of 799 patients with 952 brain metastases, median OS was 8 months. For patients with a Karnofsky performance score (KPS) > 70, OS was 11

  20. Stereotactic radiotherapy localization verification based on digitally reconstructed radiographs and portal image matching

    International Nuclear Information System (INIS)

    Purpose: To improve the accuracy of fractionated stereotactic radiotherapy by providing reference digitally reconstructed radiographs (DRRs) and image matching tools for on-line setup verification. Materials and Methods: Sixteen patients received stereotactic radiotherapy for brain metastases between June 1995 and March 1996. A subset (5) of these patients were treated prior to the availability of reference DRRs. For comparison with treatments where DRRs were used, these treatments were retrospectively analyzed to provide a reference distribution of the error of repeat fixation. One to 3 isocenters were treated with stereotactic cone sizes ranging from 16-34mm, and the number of arcs ranged from two transverse to five standard. Total doses ranged from 5 to 54 Gy in 3 to 30 fractions. For the procedure, patients are first fitted with a non-invasive thermoplastic head mask. The BRW ring is fixed to the mask with carbon fiber pins. The patients are scanned (contrast enhanced CT: 2mm thickness, 2mm index) with head ring and the BRW localizer in place. Standard stereotactic isocenter(s) are selected and treatment doses are calculated. The BRW isocenter coordinates are converted to CT coordinates, and both AP and lateral DRR reference images are generated from the CT data set. The isocenter and collimator outline are displayed on the DRRs. The DRRs are digitally transferred into a portal imaging data base. During treatment setup for each fraction, double exposures of the AP and lateral setup fields are imaged to visualize anatomical landmarks. These images are imported into the portal imaging database. Based on reference image - portal image matching, patient setup is adjusted before patient treatment, and another portal image set is taken from which final errors are determined in the AP, lateral and vertical directions. Results: The mean residual patient localization error and standard deviation for setup with DRRs and without DRRs are shown below. Mean setup errors are

  1. Laser-guided direct writing for three-dimensional tissue engineering: Analysis and application of radiation forces

    Science.gov (United States)

    Nahmias, Yaakov Koby

    Tissue Engineering aims for the creation of functional tissues or organs using a combination of biomaterials and living cells. Artificial tissues can be implanted in patients to restore tissue function that was lost due to trauma, disease, or genetic disorder. Tissue equivalents may also be used to screen the effects of drugs and toxins, reducing the use of animals in research. One of the principle limitations to the size of engineered tissue is oxygen and nutrient transport. Lacking their own vascular bed, cells embedded in the engineered tissue will consume all available oxygen within hours while out branching blood vessels will take days to vascularize the implanted tissue. Establishing capillaries within the tissue prior to implantation can potentially eliminate this limitation. One approach to establishing capillaries within the tissue is to directly write endothelial cells with micrometer accuracy as it is being built. The patterned endothelial cells will then self-assemble into vascular structures within the engineering tissue. The cell patterning technique known as laser-guided direct writing can confine multiple cells in a laser beam and deposit them as a steady stream on any non-absorbing surface with micrometer scale accuracy. By applying the generalized Lorenz-Mie theory for light scattering on laser-guided direct writing we were able to accurately predict the behavior of with various cells and particles in the focused laser. In addition, two dimensionless parameters were identified for general radiation-force based system design. Using laser-guided direct writing we were able to direct the assembly of endothelial vascular structures with micrometer accuracy in two and three dimensions. The patterned vascular structures provided the backbone for subsequent in vitro liver morphogenesis. Our studies show that hepatocytes migrate toward and adhere to endothelial vascular structures in response to endothelial-secreted hepatocyte growth factor (HGF). Our

  2. Stereotactic Irradiation of the Postoperative Resection Cavity for Brain Metastasis: A Frameless Linear Accelerator-Based Case Series and Review of the Technique

    International Nuclear Information System (INIS)

    Purpose: Whole-brain radiation therapy (WBRT) is the standard of care after resection of a brain metastasis. However, concern regarding possible neurocognitive effects and the lack of survival benefit with this approach has led to the use of stereotactic radiosurgery (SRS) to the resection cavity in place of WBRT. We report our initial experience using an image-guided linear accelerator-based frameless stereotactic system and review the technical issues in applying this technique. Methods and Materials: We retrospectively reviewed the setup accuracy, treatment outcome, and patterns of failure of the first 18 consecutive cases treated at Brigham and Women’s Hospital. The target volume was the resection cavity without a margin excluding the surgical track. Results: The median number of brain metastases per patient was 1 (range, 1–3). The median planning target volume was 3.49 mL. The median prescribed dose was 18 Gy (range, 15–18 Gy) with normalization ranging from 68% to 85%. In all cases, 99% of the planning target volume was covered by the prescribed dose. The median conformity index was 1.6 (range, 1.41–1.92). The SRS was delivered with submillimeter accuracy. At a median follow-up of 12.7 months, local control was achieved in 16/18 cavities treated. True local recurrence occurred in 2 patients. No marginal failures occurred. Distant recurrence occurred in 6/17 patients. Median time to any failure was 7.4 months. No Grade 3 or higher toxicity was recorded. A long interval between initial cancer diagnosis and the development of brain metastasis was the only factor that trended toward a significant association with the absence of recurrence (local or distant) (log-rank p = 0.097). Conclusions: Frameless stereotactic irradiation of the resection cavity after surgery for a brain metastasis is a safe and accurate technique that offers durable local control and defers the use of WBRT in select patients. This technique should be tested in larger prospective

  3. Stereotactic Irradiation of the Postoperative Resection Cavity for Brain Metastasis: A Frameless Linear Accelerator-Based Case Series and Review of the Technique

    Energy Technology Data Exchange (ETDEWEB)

    Kelly, Paul J., E-mail: pkelly@lroc.harvard.edu [Department of Radiation Oncology, Dana-Farber/Brigham and Women' s Cancer Center, Boston, MA (United States); Lin Yijie Brittany; Yu, Alvin Y. [Harvard Medical School, Boston, MA (United States); Alexander, Brian M.; Hacker, Fred; Marcus, Karen J.; Weiss, Stephanie E. [Department of Radiation Oncology, Dana-Farber/Brigham and Women' s Cancer Center, Boston, MA (United States)

    2012-01-01

    Purpose: Whole-brain radiation therapy (WBRT) is the standard of care after resection of a brain metastasis. However, concern regarding possible neurocognitive effects and the lack of survival benefit with this approach has led to the use of stereotactic radiosurgery (SRS) to the resection cavity in place of WBRT. We report our initial experience using an image-guided linear accelerator-based frameless stereotactic system and review the technical issues in applying this technique. Methods and Materials: We retrospectively reviewed the setup accuracy, treatment outcome, and patterns of failure of the first 18 consecutive cases treated at Brigham and Women's Hospital. The target volume was the resection cavity without a margin excluding the surgical track. Results: The median number of brain metastases per patient was 1 (range, 1-3). The median planning target volume was 3.49 mL. The median prescribed dose was 18 Gy (range, 15-18 Gy) with normalization ranging from 68% to 85%. In all cases, 99% of the planning target volume was covered by the prescribed dose. The median conformity index was 1.6 (range, 1.41-1.92). The SRS was delivered with submillimeter accuracy. At a median follow-up of 12.7 months, local control was achieved in 16/18 cavities treated. True local recurrence occurred in 2 patients. No marginal failures occurred. Distant recurrence occurred in 6/17 patients. Median time to any failure was 7.4 months. No Grade 3 or higher toxicity was recorded. A long interval between initial cancer diagnosis and the development of brain metastasis was the only factor that trended toward a significant association with the absence of recurrence (local or distant) (log-rank p = 0.097). Conclusions: Frameless stereotactic irradiation of the resection cavity after surgery for a brain metastasis is a safe and accurate technique that offers durable local control and defers the use of WBRT in select patients. This technique should be tested in larger prospective studies.

  4. Analytical modeling of contact acoustic nonlinearity of guided waves and its application to evaluating severity of fatigue damage

    Science.gov (United States)

    Wang, Kai; Su, Zhongqing

    2016-04-01

    Targeting quantitative estimate of fatigue damage, a dedicated analytical model was developed based on the modal decomposition method and the variational principle. The model well interprets the contact acoustic nonlinearity induced by a "breathing" crack in a two-dimensional scenario, and the nonlinear characteristics of guided ultrasonic waves (GUWs) (e.g., reflection, transmission, mode conversion and high-order generation) when GUWs traversing the crack. Based on the model, a second-order reflection index was defined. Using the index, a fatigue damage evaluation framework was established, showing demonstrated capacity of estimating the severity of fatigue damage in a quantitative manner. The approach, in principle, does not entail a benchmarking process against baseline signals pre-acquired from pristine counterparts. The results obtained using the analytical modeling were compared with those from finite element simulation, showing good coincidence. Limitations of the model were also discussed.

  5. Application of GIS in Campus Guiding System%GIS在校园导航中的应用

    Institute of Scientific and Technical Information of China (English)

    肖林颖; 乔江河

    2016-01-01

    为了给学校新生和校园来访者提供更便捷的服务,结合GIS技术研究和设计了C/S模式的山西农业大学校园导航系统。该系统包含地图查询、校园导航,校园环境预览和校园简介四个功能模块,并提供与现有系统集成的接口。该系统操作简便,成本小便于管理和升级,具有较强实用性。这方便了社会各界人士更好的了解百年名校,将学校的信息及时准确地提供给来访者,同时也加强了数字化校园建设,为学校日后建立科学、智能、网络一体化的综合校园管理体系奠定了基础。%In order to provide more convenient service for the new students and visitors, the Shanxi Agricultural University campus guiding system based on GIS and c/s mode was designed. The system had four functional modules, including map consulting, campus guiding, environment previewing and campus introduction, and provided an interface for exiting system integration. Due to the low cost, simple operation and easy management, it had strong practicability and offered ready service for people to know the great school. At the same time, it laid a foundation for the construction of scientific, intelligent, networked comprehensive campus management system.

  6. Air-guiding Photonic Bandgap Fibers

    DEFF Research Database (Denmark)

    Hansen, Theis Peter

    2005-01-01

    Photonic bandgap fibers that guide light in an air core have attracted much interest since their first demonstration in 1999. The prospect of low-loss guiding of light in air has importance for a multitude of applications, such as data transmission, gas sensors, dispersion compensation and guiding...

  7. Grammar-Guided Writing for AAC Users

    Science.gov (United States)

    Hunnicutt, Sheri; Magnuson, Tina

    2007-01-01

    A method of grammar-guided writing has been devised to guide graphic sign users through the construction of text messages for use in e-mail and other applications with a remote receiver. The purpose is to promote morphologically and syntactically correct sentences. The available grammatical structures in grammar-guided writing are the highest…

  8. Application of guided bone regeneration technique in dental implantation%骨引导再生技术在牙种植中的应用

    Institute of Scientific and Technical Information of China (English)

    仲维剑; 马国武; 张晓燕

    2009-01-01

    骨引导再生技术是目前在牙种植外科中常用的一种增加牙槽骨骨量的重要手段.该技术通过在骨缺损处放置屏障膜,维持膜下稳定的空间,阻止结缔组织长入,促进骨组织优先生长.近年来,各种屏障膜和各类骨移植材料不断涌现,此项技术的临床应用范围也在不断拓展.文章对膜材料的种类和特性以及该项技术在牙种植中的应用现状进行了综述.%Guided bone regeneration technique (GBR) is regarded as one of the most important methods to increase the bone amount of alveolar ridge, which is often recommended to be applied in the dental implantation surgery. Barrier membrane is utilized in GBR technique to cover the bone defect and create a secluded space, which prevents the connective tissue from growing into the space and facilitates the growth priority of bone tissue. In recent years, along with the emerging of different kinds of barrier membranes and bone grafting materials, the scope of clinical application of this technology is continuously expanded. This article reviews the classification and property of the membranes and the application situation of guided bone regeneration technology in the field of dental implantation.

  9. Renewable energy for professional applications: a guide to implementing off-grid power supplies in the UK

    Energy Technology Data Exchange (ETDEWEB)

    Paish, O.; Oldach, R.

    2002-09-01

    These guidelines are intended to help those considering renewable energy systems to supply power to off-grid applications without access to the UK mains electricity network. The guidelines consider: examples of renewable energy systems used applications with a low power demand in the UK; renewable energy technologies relevant to off-grid applications (solar photovoltaics, wind generators, micro-hydro turbines and hybrid systems); nine steps for project implementation; defining and optimising the load application; estimating energy resources when using solar energy, wind power and hydro power; general rules of thumb when choosing a power source; system components such as batteries, inverters, support structure and civil works; basic system sizing calculations; developing a specification and contacting suppliers; checking equipment, installation and commissioning; legal and other non-technical issues; operating issues such as maintenance and safety; and selected case studies from the UK.

  10. Dysuria Following Stereotactic Body Radiation Therapy for Prostate Cancer

    Directory of Open Access Journals (Sweden)

    Einsley-Marie eJanowski

    2015-07-01

    Full Text Available Background: Dysuria following prostate radiation therapy is a common toxicity that adversely affects patients’ quality of life and may be difficult to manage. Methods: 204 patients treated with stereotactic body radiation therapy (SBRT from 2007 to 2010 for localized prostate carcinoma with a minimum follow up of three years were included in this retrospective review of prospectively collected data. All patients were treated to 35-36.25Gy in 5 fractions delivered with robotic SBRT with real time fiducial tracking. Dysuria and other lower urinary tract symptoms were assessed via Question 4b (Pain or burning on urination of the Expanded Prostate Index Composite (EPIC-26 and the American Urological Association (AUA Symptom Score at baseline and at routine follow up. Results: 204 patients (82 low-, 105 intermediate-, and 17 high risk according to the D’Amico classification at a median age of 69 years (range 48-91 received SBRT for their localized prostate cancer with a median follow up of 47 months. Bother associated with dysuria significantly increased from a baseline of 12% to a maximum of 43% at one month (p<0.0001. There were two distinct peaks of moderate to severe dysuria bother at 1 month and at 6-12 months, with 9% of patients experiencing a late transient dysuria flare. While a low level of dysuria was seen through the first two years of follow-up, it returned to below baseline by two years (p=0.91. The median baseline AUA score of 7.5 significantly increased to 11 at 1 month (p<0.0001 and returned to 7 at 3 months (p= 0.54. Patients with dysuria had a statistically higher AUA score at baseline and at all follow-ups up to 30 months. Dysuria significantly correlated with dose and AUA score on multivariate analysis. Frequency and strain significantly correlated with dysuria on stepwise multivariate analysis.Conclusions: The rate and severity of dysuria following SBRT is comparable to patients treated with other radiation modalities.

  11. Pulmonary Function Testing After Stereotactic Body Radiotherapy to the Lung

    Energy Technology Data Exchange (ETDEWEB)

    Bishawi, Muath [Division of Cardiothoracic Surgery, Stony Brook University Medical Center, Stony Brook, NY (United States); Kim, Bong [Division of Radiology, Stony Brook University Medical Center, Stony Brook, NY (United States); Moore, William H. [Division of Radiation Oncology, Stony Brook University, Stony Brook, NY (United States); Bilfinger, Thomas V., E-mail: Thomas.bilfinger@stonybrook.edu [Division of Cardiothoracic Surgery, Stony Brook University Medical Center, Stony Brook, NY (United States)

    2012-01-01

    Purpose: Surgical resection remains the standard of care for operable early-stage non-small-cell lung cancer (NSCLC). However, some patients are not fit for surgery because of comorbidites such as chronic obstructive pulmonary disease (COPD) and other medical conditions. We aimed to evaluate pulmonary function and tumor volume before and after stereotactic body radiotherapy (SBRT) for patients with and without COPD in early-stage lung cancer. Methods and Materials: A review of prospectively collected data of Stage I and II lung cancers, all treated with SBRT, was performed. The total SBRT treatment was 60 Gy administered in three 20 Gy fractions. The patients were analyzed based on their COPD status, using their pretreatment pulmonary function test cutoffs as established by the American Thoracic Society guidelines (forced expiratory volume [FEV]% {<=}50% predicted, FEV%/forced vital capacity [FVC]% {<=}70%). Changes in tumor volume were also assessed by computed tomography. Results: Of a total of 30 patients with Stage I and II lung cancer, there were 7 patients in the COPD group (4 men, 3 women), and 23 in t he No-COPD group (9 men, 14 women). At a mean follow-up time of 4 months, for the COPD and No-COPD patients, pretreatment and posttreatment FEV% was similar: 39 {+-} 5 vs. 40 {+-} 9 (p = 0.4) and 77 {+-} 0.5 vs. 73 {+-} 24 (p = 0.9), respectively. The diffusing capacity of the lungs for carbon monoxide (DL{sub CO}) did significantly increase for the No-COPD group after SBRT treatment: 60 {+-} 24 vs. 69 {+-} 22 (p = 0.022); however, DL{sub CO} was unchanged for the COPD group: 49 {+-} 13 vs. 50 {+-} 14 (p = 0.8). Although pretreatment tumor volume was comparable for both groups, tumor volume significantly shrank in the No-COPD group from 19 {+-} 24 to 9 {+-} 16 (p < 0.001), and there was a trend in the COPD patients from 12 {+-} 9 to 6 {+-} 5 (p = 0.06). Conclusion: SBRT did not seem to have an effect on FEV{sub 1} and FVC, but it shrank tumor volume and

  12. Reirradiation Human Spinal Cord Tolerance for Stereotactic Body Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Sahgal, Arjun, E-mail: Arjun.sahgal@rmp.uhn.on.ca [Department of Radiation Oncology, Sunnybrook Health Sciences Centre, Princess Margaret Hospital, University of Toronto, Toronto (Canada); Ma, Lijun [Department of Radiation Oncology, University of California San Francisco, San Francisco, CA (United States); Weinberg, Vivian [University of California San Francisco Helen Diller Family Comprehensive Cancer Center Biostatistics Core, San Francisco, CA (United States); Gibbs, Iris C. [Department of Radiation Oncology, Stanford University, Stanford, CA (United States); Chao, Sam [Departments of Radiation Oncology and Neurosurgery, Cleveland Clinic, Cleveland, OH (United States); Chang, Ung-Kyu [Department of Neurosurgery, Korea Institute of Radiation and Medical Science, Seoul (Korea, Republic of); Werner-Wasik, Maria [Department of Radiation Oncology, Thomas Jefferson University Hospital, Philadelphia, PA (United States); Angelov, Liliyanna [Departments of Radiation Oncology and Neurosurgery, Cleveland Clinic, Cleveland, OH (United States); Chang, Eric L. [Department of Radiation Oncology, M.D. Anderson Cancer Center, University of Texas, Houston, TX (United States); Sohn, Moon-Jun [Department of Neurosurgery, Inje University, Seoul (Korea, Republic of); Soltys, Scott G. [Department of Radiation Oncology, Stanford University, Stanford, CA (United States); Letourneau, Daniel [Department of Radiation Oncology, Princess Margaret Hospital, University of Toronto, Toronto (Canada); Ryu, Sam [Department of Radiation Oncology, Henry Ford Hospital, Detroit, MI (United States); Gerszten, Peter C. [Departments of Neurological Surgery and Radiation Oncology, University of Pittsburgh Medical Center, Pittsburgh, PA (United States); Fowler, Jack [Departments of Human Oncology and Medical Physics, University of Wisconsin, WI (United States); Wong, C. Shun [Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto (Canada); and others

    2012-01-01

    Purpose: We reviewed the treatment for patients with spine metastases who initially received conventional external beam radiation (EBRT) and were reirradiated with 1-5 fractions of stereotactic body radiotherapy (SBRT) who did or did not subsequently develop radiation myelopathy (RM). Methods and Materials: Spinal cord dose-volume histograms (DVHs) for 5 RM patients (5 spinal segments) and 14 no-RM patients (16 spine segments) were based on thecal sac contours at retreatment. Dose to a point within the thecal sac that receives the maximum dose (P{sub max}), and doses to 0.1-, 1.0-, and 2.0-cc volumes within the thecal sac were reviewed. The biologically effective doses (BED) using {alpha}/{beta} = 2 Gy for late spinal cord toxicity were calculated and normalized to a 2-Gy equivalent dose (nBED = Gy{sub 2/2}). Results: The initial conventional radiotherapy nBED ranged from {approx}30 to 50 Gy{sub 2/2} (median {approx}40 Gy{sub 2/2}). The SBRT reirradiation thecal sac mean P{sub max} nBED in the no-RM group was 20.0 Gy{sub 2/2} (95% confidence interval [CI], 10.8-29.2), which was significantly lower than the corresponding 67.4 Gy{sub 2/2} (95% CI, 51.0-83.9) in the RM group. The mean total P{sub max} nBED in the no-RM group was 62.3 Gy{sub 2/2} (95% CI, 50.3-74.3), which was significantly lower than the corresponding 105.8 Gy{sub 2/2} (95% CI, 84.3-127.4) in the RM group. The fraction of the total P{sub max} nBED accounted for by the SBRT P{sub max} nBED for the RM patients ranged from 0.54 to 0.78 and that for the no-RM patients ranged from 0.04 to 0.53. Conclusions: SBRT given at least 5 months after conventional palliative radiotherapy with a reirradiation thecal sac P{sub max} nBED of 20-25 Gy{sub 2/2} appears to be safe provided the total P{sub max} nBED does not exceed approximately 70 Gy{sub 2/2}, and the SBRT thecal sac P{sub max} nBED comprises no more than approximately 50% of the total nBED.

  13. Reirradiation Human Spinal Cord Tolerance for Stereotactic Body Radiotherapy

    International Nuclear Information System (INIS)

    Purpose: We reviewed the treatment for patients with spine metastases who initially received conventional external beam radiation (EBRT) and were reirradiated with 1–5 fractions of stereotactic body radiotherapy (SBRT) who did or did not subsequently develop radiation myelopathy (RM). Methods and Materials: Spinal cord dose–volume histograms (DVHs) for 5 RM patients (5 spinal segments) and 14 no-RM patients (16 spine segments) were based on thecal sac contours at retreatment. Dose to a point within the thecal sac that receives the maximum dose (Pmax), and doses to 0.1-, 1.0-, and 2.0-cc volumes within the thecal sac were reviewed. The biologically effective doses (BED) using α/β = 2 Gy for late spinal cord toxicity were calculated and normalized to a 2-Gy equivalent dose (nBED = Gy2/2). Results: The initial conventional radiotherapy nBED ranged from ∼30 to 50 Gy2/2 (median ∼40 Gy2/2). The SBRT reirradiation thecal sac mean Pmax nBED in the no-RM group was 20.0 Gy2/2 (95% confidence interval [CI], 10.8–29.2), which was significantly lower than the corresponding 67.4 Gy2/2 (95% CI, 51.0–83.9) in the RM group. The mean total Pmax nBED in the no-RM group was 62.3 Gy2/2 (95% CI, 50.3–74.3), which was significantly lower than the corresponding 105.8 Gy2/2 (95% CI, 84.3–127.4) in the RM group. The fraction of the total Pmax nBED accounted for by the SBRT Pmax nBED for the RM patients ranged from 0.54 to 0.78 and that for the no-RM patients ranged from 0.04 to 0.53. Conclusions: SBRT given at least 5 months after conventional palliative radiotherapy with a reirradiation thecal sac Pmax nBED of 20–25 Gy2/2 appears to be safe provided the total Pmax nBED does not exceed approximately 70 Gy2/2, and the SBRT thecal sac Pmax nBED comprises no more than approximately 50% of the total nBED.

  14. Pulmonary Function Testing After Stereotactic Body Radiotherapy to the Lung

    International Nuclear Information System (INIS)

    Purpose: Surgical resection remains the standard of care for operable early-stage non–small-cell lung cancer (NSCLC). However, some patients are not fit for surgery because of comorbidites such as chronic obstructive pulmonary disease (COPD) and other medical conditions. We aimed to evaluate pulmonary function and tumor volume before and after stereotactic body radiotherapy (SBRT) for patients with and without COPD in early-stage lung cancer. Methods and Materials: A review of prospectively collected data of Stage I and II lung cancers, all treated with SBRT, was performed. The total SBRT treatment was 60 Gy administered in three 20 Gy fractions. The patients were analyzed based on their COPD status, using their pretreatment pulmonary function test cutoffs as established by the American Thoracic Society guidelines (forced expiratory volume [FEV]% ≤50% predicted, FEV%/forced vital capacity [FVC]% ≤70%). Changes in tumor volume were also assessed by computed tomography. Results: Of a total of 30 patients with Stage I and II lung cancer, there were 7 patients in the COPD group (4 men, 3 women), and 23 in t he No-COPD group (9 men, 14 women). At a mean follow-up time of 4 months, for the COPD and No-COPD patients, pretreatment and posttreatment FEV% was similar: 39 ± 5 vs. 40 ± 9 (p = 0.4) and 77 ± 0.5 vs. 73 ± 24 (p = 0.9), respectively. The diffusing capacity of the lungs for carbon monoxide (DLCO) did significantly increase for the No-COPD group after SBRT treatment: 60 ± 24 vs. 69 ± 22 (p = 0.022); however, DLCO was unchanged for the COPD group: 49 ± 13 vs. 50 ± 14 (p = 0.8). Although pretreatment tumor volume was comparable for both groups, tumor volume significantly shrank in the No-COPD group from 19 ± 24 to 9 ± 16 (p 1 and FVC, but it shrank tumor volume and improved DLCO for patients without COPD.

  15. Adaptive Stereotactic Body Radiation Therapy Planning for Lung Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Qin, Yujiao [Medical Physics Graduate Program, Duke University, Durham, North Carolina (United States); Zhang, Fan [Occupational and Environmental Safety Office, Duke University Medical Center, Durham, North Carolina (United States); Yoo, David S.; Kelsey, Chris R. [Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States); Yin, Fang-Fang [Medical Physics Graduate Program, Duke University, Durham, North Carolina (United States); Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States); Cai, Jing, E-mail: jing.cai@duke.edu [Medical Physics Graduate Program, Duke University, Durham, North Carolina (United States); Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States)

    2013-09-01

    Purpose: To investigate the dosimetric effects of adaptive planning on lung stereotactic body radiation therapy (SBRT). Methods and Materials: Forty of 66 consecutive lung SBRT patients were selected for a retrospective adaptive planning study. CBCT images acquired at each fraction were used for treatment planning. Adaptive plans were created using the same planning parameters as the original CT-based plan, with the goal to achieve comparable comformality index (CI). For each patient, 2 cumulative plans, nonadaptive plan (P{sub NON}) and adaptive plan (P{sub ADP}), were generated and compared for the following organs-at-risks (OARs): cord, esophagus, chest wall, and the lungs. Dosimetric comparison was performed between P{sub NON} and P{sub ADP} for all 40 patients. Correlations were evaluated between changes in dosimetric metrics induced by adaptive planning and potential impacting factors, including tumor-to-OAR distances (d{sub T-OAR}), initial internal target volume (ITV{sub 1}), ITV change (ΔITV), and effective ITV diameter change (Δd{sub ITV}). Results: 34 (85%) patients showed ITV decrease and 6 (15%) patients showed ITV increase throughout the course of lung SBRT. Percentage ITV change ranged from −59.6% to 13.0%, with a mean (±SD) of −21.0% (±21.4%). On average of all patients, P{sub ADP} resulted in significantly (P=0 to .045) lower values for all dosimetric metrics. Δd{sub ITV}/d{sub T-OAR} was found to correlate with changes in dose to 5 cc (ΔD5cc) of esophagus (r=0.61) and dose to 30 cc (ΔD30cc) of chest wall (r=0.81). Stronger correlations between Δd{sub ITV}/d{sub T-OAR} and ΔD30cc of chest wall were discovered for peripheral (r=0.81) and central (r=0.84) tumors, respectively. Conclusions: Dosimetric effects of adaptive lung SBRT planning depend upon target volume changes and tumor-to-OAR distances. Adaptive lung SBRT can potentially reduce dose to adjacent OARs if patients present large tumor volume shrinkage during the treatment.

  16. Local radiotherapeutic management of ependymomas with fractionated stereotactic radiotherapy (FSRT

    Directory of Open Access Journals (Sweden)

    Combs Stephanie E

    2006-09-01

    Full Text Available Abstract Background To assess the role of Fractionated Stereotactic Radiotherapy (FSRT in the management of ependymomas. Methods From January 1992 to July 2003, FSRT was performed in 19 patients with histologically confirmed ependymomas. The median age was 15 years, 5 patients were younger than 4 years of age. Twelve patients received FSRT as primary postoperative radiotherapy after surgical resection. In 6 patients irradiation of the posterior fossa was performed with a local boost to the tumor bed, and in 4 patients the tumor bed only was irradiated. In 7 patients FSRT was performed as re-irradiation for tumor progression. This patient group was analyzed separately. A median dose of 54 Gy was prescribed in a median fractionation of 5 × 1.8 Gy per week for primary RT using 6 MeV photons with a linear accelerator. For FSRT as re-irradiation, a median dose of 36 Gy was applied. All recurrent tumors were localized within the former RT-field. Results The 5- and 10-year overall survival rates were 77% and 64%, respectively. Patients treated with FSRT for primary irradiation showed an overall survival of 100% and 78% at 3 and 5 years after irradiation of the posterior fossa with a boost to the tumor bed, and a survival rate of 100% at 5 years with RT of the tumor bed only. After re-irradiation with FSRT, survival rates of 83% and 50% at 3-and 5 years, respectively, were obtained. Progression-free survival rates after primary RT as compared to re-irradiation were 64% and 60% at 5 years, respectively. FSRT was well tolerated by all patients and could be completed without interruptions due to side effects. No severe treatment related toxicity > CTC grade 2 for patients treated with FSRT could be observed. Conclusion The present analysis shows that FSRT is well tolerated and highly effective in the management of ependymal tumors. The rate of recurrences, especially at the field border, is not increased as compared to conventional radiotherapy consisting

  17. Innovative Power-Augmentation-Guide-Vane Design of Wind-Solar Hybrid Renewable Energy Harvester for Urban High Rise Application

    Science.gov (United States)

    Tong, Chong Wen; Zainon, M. Z.; Chew, Poh Sin; Kui, Soo Chun; Keong, Wee Seng; Chen, Pan Kok

    2010-06-01

    To generate greater quantities of energy from wind, the most efficient solution would be by increasing the wind speed. Also, due to the decreasing number of economic wind energy sites, there are plans to place wind turbines closer to populated areas. To site wind turbines out from rural areas, the current problems of wind turbines need to be resolved, especially visual impact, poor starting behaviour in low wind speeds, noise and danger caused by blade failure. In this paper, a patented wind-solar hybrid renewable energy harvester is introduced. It is a compact system that integrates and optimizes several green elements and can be built on the top (or between upper levels) of high rise buildings or structures. This system can be used in remote and urban areas, particularly at locations where the wind speed is lower and more turbulent. It overcomes the inferior aspect on the low wind speed by guiding and increasing the speed of the high altitude free-stream wind through fixed or yaw-able power-augmentation-guide-vane (PAGV) before entering the wind turbine (straight-bladed vertical axis wind turbine, VAWT in this project) at center portion. PAGV is a new and innovative design where its appearance or outer design can be blended into the building architecture without negative visual impact. From the studies, it is shown that the wind speed increment in the PAGV can be produced according to the Bernoulli's principle. Computational fluid dynamics (CFD) simulation is used to optimize the geometry of the PAGV and the simulation results demonstrated the technical possibility of this innovative concept. The PAGV replaces the free air-stream from wind by multiple channels of speed-increased and directional-controlled air-stream. With the PAGV, this lift-type VAWT can be self-started and its size can be reduced for a given power output. The design is also safer since the VAWT is enclosed by the PAGV. By integrating the PAGV with the VAWT (the diameter and height of PAGV are 2

  18. CT perfusion imaging as an early biomarker of differential response to stereotactic radiosurgery in C6 rat gliomas.

    Directory of Open Access Journals (Sweden)

    Timothy Pok Chi Yeung

    Full Text Available BACKGROUND: The therapeutic efficacy of stereotactic radiosurgery for glioblastoma is not well understood, and there needs to be an effective biomarker to identify patients who might benefit from this treatment. This study investigated the efficacy of computed tomography (CT perfusion imaging as an early imaging biomarker of response to stereotactic radiosurgery in a malignant rat glioma model. METHODS: Rats with orthotopic C6 glioma tumors received either mock irradiation (controls, N = 8 or stereotactic radiosurgery (N = 25, 12 Gy in one fraction delivered by Helical Tomotherapy. Twelve irradiated animals were sacrificed four days after stereotactic radiosurgery to assess acute CT perfusion and histological changes, and 13 irradiated animals were used to study survival. Irradiated animals with survival >15 days were designated as responders while those with survival ≤15 days were non-responders. Longitudinal CT perfusion imaging was performed at baseline and regularly for eight weeks post-baseline. RESULTS: Early signs of radiation-induced injury were observed on histology. There was an overall survival benefit following stereotactic radiosurgery when compared to the controls (log-rank P<0.04. Responders to stereotactic radiosurgery showed lower relative blood volume (rBV, and permeability-surface area (PS product on day 7 post-stereotactic radiosurgery when compared to controls and non-responders (P<0.05. rBV and PS on day 7 showed correlations with overall survival (P<0.05, and were predictive of survival with 92% accuracy. CONCLUSIONS: Response to stereotactic radiosurgery was heterogeneous, and early selection of responders and non-responders was possible using CT perfusion imaging. Validation of CT perfusion indices for response assessment is necessary before clinical implementation.

  19. Quality inspection guided laser processing of irregular shape objects by stereo vision measurement: application in badminton shuttle manufacturing

    Science.gov (United States)

    Qi, Li; Wang, Shun; Zhang, Yixin; Sun, Yingying; Zhang, Xuping

    2015-11-01

    The quality inspection process is usually carried out after first processing of the raw materials such as cutting and milling. This is because the parts of the materials to be used are unidentified until they have been trimmed. If the quality of the material is assessed before the laser process, then the energy and efforts wasted on defected materials can be saved. We proposed a new production scheme that can achieve quantitative quality inspection prior to primitive laser cutting by means of three-dimensional (3-D) vision measurement. First, the 3-D model of the object is reconstructed by the stereo cameras, from which the spatial cutting path is derived. Second, collaborating with another rear camera, the 3-D cutting path is reprojected to both the frontal and rear views of the object and thus generates the regions-of-interest (ROIs) for surface defect analysis. An accurate visual guided laser process and reprojection-based ROI segmentation are enabled by a global-optimization-based trinocular calibration method. The prototype system was built and tested with the processing of raw duck feathers for high-quality badminton shuttle manufacture. Incorporating with a two-dimensional wavelet-decomposition-based defect analysis algorithm, both the geometrical and appearance features of the raw feathers are quantified before they are cut into small patches, which result in fully automatic feather cutting and sorting.

  20. Potential applications of image-guided radiotherapy for brain metastases and glioblastoma to improve patient quality of life

    Directory of Open Access Journals (Sweden)

    Nam Phong Nguyen

    2013-11-01

    Full Text Available Treatment of glioblastoma multiforme (GBM and brain metastasis remains a challenge because of the poor survival and the potential for brain damage following radiation. Despite concurrent chemotherapy and radiation dose escalation, local recurrence remains the predominant pattern of failure in GBM most likely secondary to repopulation of cancer stem cells. Even though radiotherapy is highly effective for local control of radio-resistant tumors such as melanoma and renal cell cancer, systemic disease progression is the cause of death in most patients with brain metastasis. Preservation of quality of life of cancer survivors is the main issue for patients with brain metastasis. Image-guided radiotherapy (IGRT by virtue of precise radiation dose delivery may reduce treatment time of patients with GBM without excessive toxicity and potentially improve neurocognitive function with preservation of local control in patients with brain metastasis. Future prospective trials for primary brain tumors or brain metastasis should include IGRT to assess its efficacy to improve patient quality of life.

  1. Effect of a light guide plate with lenticular-arrayed surface on optical output for backlight and illumination application

    Science.gov (United States)

    Teng, Tun-Chien; Tseng, Li-Wei

    2013-09-01

    In this paper, we investigated the optical output characteristic of the light guide plate (LGP) with microstructures engraved by a CO2 laser, which is for edge-lit backlight of liquid crystal display or illumination. Especially, the laser-engraving method is suitable for the slim large-sized LGP used in LED TV backlight, and the engraved microstructure has polished surface to contribute to better optical efficiency. For seeking higher optical efficiency, we adopted a LGP with lenticular-arrayed surface (LAS LGP) as the experimental substrate. In order to investigate the effect of the lenticular-arrayed surface on optical output characteristic for the different kinds of the engraved microstructures, we used the laser to directly engrave the flat surface (opposite to the lenticular-arrayed surface) of the LAS LGP with different kinds of microstructures as experimental samples; each sample has one kind of the engraved microstructures on its flat surface. Similarly, we also engraved the same kinds of the microstructures on the flat LGP as a controlled group for comparison. The cross-section profiles of the engraved microstructures on both LAS LGP and flat LGP were measured by a laser confocal microscope. All the samples were further measured for spatial and angular luminance by the BM7 and Conoscope, respectively. In addition, both the experimental data and simulation results were demonstrated and compared to each other in this paper.

  2. Carbon fibre and nitinol needles for MRI-guided interventions: First in vitro and in vivo application

    Energy Technology Data Exchange (ETDEWEB)

    Thomas, Christoph, E-mail: Christoph.thomas@med.uni-tuebingen.de [Department of Diagnostic and Interventional Radiology, University of Tuebingen, Hoppe-Seyler-Strasse 3, 72076 Tuebingen (Germany); Wojtczyk, Hanne [Section of Experimental Radiology, University of Tuebingen, Hoppe-Seyler-Strasse 3, 72076 Tuebingen (Germany); Rempp, Hansjoerg; Clasen, Stephan; Horger, Marius [Department of Diagnostic and Interventional Radiology, University of Tuebingen, Hoppe-Seyler-Strasse 3, 72076 Tuebingen (Germany); Lassberg, Christoph von [Department of Sports Medicine, University of Tuebingen, Silcherstrasse 5, 72076 Tuebingen (Germany); Fritz, Jan [Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Baltimore, MD 21287 (United States); Claussen, Claus D. [Department of Diagnostic and Interventional Radiology, University of Tuebingen, Hoppe-Seyler-Strasse 3, 72076 Tuebingen (Germany); Pereira, Philippe L. [Department of Radiology, Minimally Invasive Therapies and Nuclearmedicine, SLK-Kliniken Heilbronn GmbH, Am Gesundbrunnen 20-26, 74078 Heilbronn (Germany)

    2011-09-15

    Objective: To assess the artefact properties of a MR-compatible carbon fibre needle with a nitinol mandrin in vitro and to report first clinical experiences. Materials and methods: In vitro, the carbon fibre/nitinol needle was imaged at different angles against the main magnetic field (1.5 T open bore magnet). A gradient echo MR fluoroscopy sequence (GRE: TR 9.3 ms, TE 3.12 ms, bandwidth 200 Hz/pixel, flip-angle 12{sup o}) and a fast turbo spin echo sequence (FSE: TR 412 ms, TE 9.7 ms, bandwidth 200 Hz/pixel, flip-angle 150{sup o}) were used. Artefact width, needle intensity contrast and needle tip location errors were assessed. In vivo, lumbar periradicular corticosteroid injections and one sclerotherapy were performed with carbon fibre needles (10 procedures) and with titanium alloy needles (2 procedures). The artefact sizes and contrasts were measured. Results: In vitro, artefact diameters of the carbon fibre needle ranged from 3.3 to 4.6 mm, contrasts from 0.11 to 0.52, with larger artefact contrasts and widths with the GRE sequence. Needle tip location errors of -2.1 to -2.8 mm were observed. Decreasing angles to the main field lead to smaller artefacts. In vivo, the carbon fibre/nitinol needle produced smaller artefacts (mean width FSE/GRE: 2.8 mm/4.6 mm) with lower contrast (0.30-0.42) than the titanium alloy needle (mean width FSE/GRE: 4.1 mm/7.5 mm, contrast 0.60-0.73). Conclusions: The carbon fibre/nitinol needle is useful for performing MR-guided interventions at 1.5 T, producing more subtle artefacts than a titanium alloy needle, but with an incomplete depiction and thus inaccurate localization of the needle tip.

  3. Politics and application guide of urgency measures and administrative sanctions of the CNSNS; Politica y guia de aplicacion de medidas de apremio y sanciones administrativas de la CNSNS

    Energy Technology Data Exchange (ETDEWEB)

    Espinosa V, J.M.; Cruz R, L.A.; EsquiveI T, J.L.; Nunez C, A. [CNSNS, 03020 Mexico D.F. (Mexico)]. e-mail: jmespinosa@cnsns.gob.mx

    2007-07-01

    In use of their attributions, granted by the Regulation Law of the 27 Constitutional Article in Nuclear Matter, the National Commission of Nuclear Safety and Safeguards (CNSNS) it has taken charge to the authors the Politics' s elaboration and Guide of Application of Urgency measures and Administrative Sanctions (PGAMASA) with the double objective of discouraging the licensees, contractors and employees of incurring in nonfulfillment or violations to the regulator mark and of encouraging them to be attentive to the prompt identification and the immediate and appropriate correction of the violations and nonfulfillment. The present article presents the legal mark that confers the CNSNS the attributions to implant a PGAMASA and it exposes the more important elements that conform it. The urgency measures and administrative sanctions are defined, the approaches to determine the level of graveness of a violation or nonfulfillment and it is related the application process of urgency measures and administrative sanctions are presented. Like this among the urgency measures they stand out figures like the Notifications of Violation and the Regulatory Orders by their versatility and use potentiality. The PGAMASA has a basically dissuasive character and its last purpose it is to strengthen the actions that the CNSNS carries out in the fulfillment of its functions to maintain the safety standards in the operation of the nuclear facilities. (Author)

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

    International Nuclear Information System (INIS)

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

  5. Application of ultrasonic guided waves to the characterization of texture in metal sheets of cubic and hexagonal crystallites

    Energy Technology Data Exchange (ETDEWEB)

    Li, Yan.

    1990-10-08

    Ultrasonic techniques have recently been applied to the texture characterization in polycrystalline aggregates of hexagonal crystals. The basis of this application lies in the relations between the elastic constants {bar C}{sub ij} of the aggregates, which can be inferred from ultrasonic wave velocity measurements, and the orientation distribution coefficients. This communication present such relations for aggregates which possess orthotopic material symmetry and hexagonal crystal symmetry for Voigt, Reuss, and Hill averaging methods in a unified and concise representation.

  6. Surface Attachment of Gold Nanoparticles Guided by Block Copolymer Micellar Films and Its Application in Silicon Etching

    OpenAIRE

    Mingjie Wei; Yong Wang

    2015-01-01

    Patterning metallic nanoparticles on substrate surfaces is important in a number of applications. However, it remains challenging to fabricate such patterned nanoparticles with easily controlled structural parameters, including particle sizes and densities, from simple methods. We report on a new route to directly pattern pre-formed gold nanoparticles with different diameters on block copolymer micellar monolayers coated on silicon substrates. Due to the synergetic effect of complexation and ...

  7. Hydrogen Technologies Safety Guide

    Energy Technology Data Exchange (ETDEWEB)

    Rivkin, C. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Burgess, R. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Buttner, W. [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2015-01-01

    The purpose of this guide is to provide basic background information on hydrogen technologies. It is intended to provide project developers, code officials, and other interested parties the background information to be able to put hydrogen safety in context. For example, code officials reviewing permit applications for hydrogen projects will get an understanding of the industrial history of hydrogen, basic safety concerns, and safety requirements.

  8. Guide to Using Sierra

    Energy Technology Data Exchange (ETDEWEB)

    Shaw, Ryan Phillip [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Agelastos, Anthony Michael [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Miller, Joel D. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2015-03-01

    Sierra is an engineering mechanics simulation code suite supporting the Nation's Nuclear Weapons mission as well as other customers. It has explicit ties to Sandia National Labs' workfow, including geometry and meshing, design and optimization, and visualization. Dis- tinguishing strengths include "application aware" development, scalability, SQA and V&V, multiple scales, and multi-physics coupling. This document is intended to help new and existing users of Sierra as a user manual and troubleshooting guide.

  9. Potency preservation following stereotactic body radiation therapy for prostate cancer

    International Nuclear Information System (INIS)

    Erectile dysfunction after prostate radiation therapy remains an ongoing challenge and critical quality of life issue. Given the higher dose of radiation per fraction using stereotactic body radiation therapy (SBRT) there is concern that post-SBRT impotency would be higher than conventional radiation therapy approaches. This study sought to evaluate potency preservation and sexual function following SBRT for prostate cancer. Between February 2008 and March 2011, 216 men with clinically localized prostate cancer were treated definitively with SBRT monotherapy at Georgetown University Hospital. Potency was defined as the ability to have an erection firm enough for intercourse with or without sexual aids while sexual activity was defined as the ability to have an erection firm enough for masturbation and foreplay. Patients who received androgen deprivation therapy (ADT) were excluded from this study. Ninety-seven hormone-naïve men were identified as being potent at the initiation of therapy and were included in this review. All patients were treated to 35–36.25 Gy in 5 fractions delivered with the CyberKnife Radiosurgical System (Accuray). Prostate specific antigen (PSA) and total testosterone levels were obtained pre-treatment, every 3 months for the first year and every 6 months for the subsequent year. Sexual function was assessed with the Sexual Health Inventory for Men (SHIM), the Expanded Prostate Index Composite (EPIC)-26 and Utilization of Sexual Medication/Device questionnaires at baseline and all follow-up visits. Ninety-seven men (43 low-, 50 intermediate- and 4 high-risk) at a median age of 68 years (range, 48–82 years) received SBRT. The median pre-treatment PSA was 5.9 ng/ml and the minimum follow-up was 24 months. The median pre-treatment total serum testosterone level was 11.4 nmol/L (range, 4.4-27.9 nmol/L). The median baseline SHIM was 22 and 36% of patients utilized sexual aids prior to treatment. Although potency rates declined following

  10. Tracker-on-C for cone-beam CT-guided surgery: evaluation of geometric accuracy and clinical applications

    Science.gov (United States)

    Reaungamornrat, S.; Otake, Y.; Uneri, A.; Schafer, S.; Mirota, D. J.; Nithiananthan, S.; Stayman, J. W.; Khanna, A. J.; Reh, D. D.; Gallia, G. L.; Taylor, R. H.; Siewerdsen, J. H.

    2012-02-01

    -arm CBCT with realtime tracking and demonstrated utility in a spectrum of image-guided interventions (e.g., spine surgery) benefiting from improved accuracy, enhanced visualization, and reduced radiation exposure.

  11. The Limits of Judicial Activism:Research on Application of Guiding Cases in Procuratorial Work%司法能动下的限度--论指导性案例在检察工作中的适用

    Institute of Scientific and Technical Information of China (English)

    马文; 范艳利

    2015-01-01

    基于对司法能动主义的争议和我国检察案例指导工作的特点,在适用指导性案例时应遵从一定的限制性规则:适用的前提是穷尽制定法;适用案件范围要遵循《最高人民检察院关于案例指导工作的规定》;在程序上由主办检察官提出适用,查明案例时应当区分必要事实和非必要事实,在正式的法律文书中应当标明所适用的具体指导性案例,并健全检察机关司法文书公开制度。%Because of the controversy of the judicial activism and the features of guiding cases in procuratorial work,the application of guiding cases should be restricted to comply with certain rules.The premise is having no statue law and the application scope should follow “provisions of Supreme People’s Procuratorate on guiding cases”.Procedural requirements are as follows:whether the guiding cases should be applied is determined by the procurators directing cases;the necessary facts and non essential facts should be distinguished when finding out the guiding cases;the specific applicable guiding cases should be marked in the formal legal documents.At the same time,the legal document public system of procuratorial organ should be improved.

  12. Facial demyelinating neuropathy caused by previous stereotactic irradiation to a vestibular schwannoma

    Energy Technology Data Exchange (ETDEWEB)

    Taniguchi, Makoto; Kurita, Hiroki; Sasaki, Tomio [Tokyo Univ. (Japan). Faculty of Medicine

    1997-12-01

    This is a report of a vestibular schwannoma patient who received surgical treatment 8 months after stereotactic gamma knife irradiation. The previous irradiation caused facial demyelinating neuropathy of the facial nerve, and it made the identification and preservation of the nerve during subsequent microsurgery difficult. In the affected nerve segments, stimulation even to the exposed facial nerve evoked only attenuated response or no responses in electromyography. As a result, the flattened facial nerve located behind the tumor was indistinguishable. In order to prevent damage of the facial nerve, subcapsular tumor removal had to be performed at the demyelinated segments. This sequela of stereotactic irradiation should be considered when the irradiation is planned as a primary treatment modality of a vestibular schwannoma, in particular in young patients who will eventually receive another surgery afterwards. (author)

  13. Hypofractionated Stereotactic Radiosurgery in a Large Bilateral Thalamic and Basal Ganglia Arteriovenous Malformation

    Directory of Open Access Journals (Sweden)

    Janet Lee

    2013-01-01

    Full Text Available Purpose. Arteriovenous malformations (AVMs in the basal ganglia and thalamus have a more aggressive natural history with a higher morbidity and mortality than AVMs in other locations. Optimal treatment—complete obliteration without new neurological deficits—is often challenging. We present a patient with a large bilateral basal ganglia and thalamic AVM successfully treated with hypofractionated stereotactic radiosurgery (HFSRS with intensity modulated radiotherapy (IMRT. Methods. The patient was treated with hypofractionated stereotactic radiosurgery to 30 Gy at margin in 5 fractions of 9 static fields with a minimultileaf collimator and intensity modulated radiotherapy. Results. At 10 months following treatment, digital subtraction angiography showed complete obliteration of the AVM. Conclusions. Large bilateral thalamic and basal ganglia AVMs can be successfully treated with complete obliteration by HFSRS with IMRT with relatively limited toxicity. Appropriate caution is recommended.

  14. Radiation bronchitis in lung cancer patient treated with stereotactic radiation therapy

    International Nuclear Information System (INIS)

    We report a case of chronic radiation bronchitis that developed in a patient with lung cancer treated with fractionated stereotactic radiation therapy. A 73-year-old woman with a medically inoperable T1N0M0 adenocarcinoma of the lung was treated with stereotactic radiation therapy. By using eight non-coplanar ports, 50 Gy/5 fractions was delivered in two weeks. At four weeks, a partial response was obtained with no acute adverse reaction. She developed severe cough at six months. Fiberoptic bronchoscopy revealed thick circumferentially coated bronchial mucosa in close proximity to the tumor site. At 12 months, follow-up study confirmed marked stenotic change in the B6 segmental bronchus without tumor progression. (author)

  15. The use of single fraction Leksell stereotactic radiosurgery in the treatment of uveal melanoma

    Energy Technology Data Exchange (ETDEWEB)

    Rennie, I. [Univ. of Sheffield, Dept. of Ophthalmology and Orthoptics (United Kingdom); Forster, D.; Kemeny, A. [Royal Hallamshire Hospital, Dept. of Neurosurgery (United Kingdom); Walton, L. [Royal Hallamshire Hospital, Dept. of Medical Physics (United Kingdom); Kunkler, I. [Weston Park Hospital, Dept. of Radiotherapy, Sheffield (United Kingdom)

    1996-11-01

    Fourteen patients with posterior uveal melanomas were treated using single fraction stereotactic radiosurgery. In each case a dose of 70 Gy was administered to the periphery of the tumour. Regression of the tumour has been observed in 13 patients, whilst the lesion has remained unchanged in one patient. The visual acuity has deteriorated in all 14 patients. Significant radiation induced adverse reactions were noted in 13 patients and include; retinopathy, optic neuropathy, rubeosis iridis, and secondary glaucoma. Two patients have required enucleation because of intractable rubeotic glaucoma. One patient has died from proven metastases. Although stereotactic radiosurgery appears to be a practical and effective method of treating uveal melanomas, its usefulness is limited by a high incidence of radiation induced adverse reactions. Further works is required to refine the current treatment protocol and establish an optimal prescription dose. (au) 30 refs.

  16. The use of single fraction Leksell stereotactic radiosurgery in the treatment of uveal melanoma

    International Nuclear Information System (INIS)

    Fourteen patients with posterior uveal melanomas were treated using single fraction stereotactic radiosurgery. In each case a dose of 70 Gy was administered to the periphery of the tumour. Regression of the tumour has been observed in 13 patients, whilst the lesion has remained unchanged in one patient. The visual acuity has deteriorated in all 14 patients. Significant radiation induced adverse reactions were noted in 13 patients and include; retinopathy, optic neuropathy, rubeosis iridis, and secondary glaucoma. Two patients have required enucleation because of intractable rubeotic glaucoma. One patient has died from proven metastases. Although stereotactic radiosurgery appears to be a practical and effective method of treating uveal melanomas, its usefulness is limited by a high incidence of radiation induced adverse reactions. Further works is required to refine the current treatment protocol and establish an optimal prescription dose. (au) 30 refs

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

    Science.gov (United States)

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

    2016-03-01

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

  18. Single versus multiple session stereotactic body radiotherapy for spinal metastasis: the risk-benefit ratio.

    Science.gov (United States)

    Redmond, Kristin J; Sahgal, Arjun; Foote, Matthew; Knisely, Jonathan; Gerszten, Peter C; Chao, Samuel T; Suh, John H; Sloan, Andrew E; Chang, Eric L; Machtay, Mitchell; Lo, Simon S

    2015-01-01

    Spine stereotactic body radiation therapy represents an important advancement in the management of spinal metastases that allows precise delivery of ablative doses of radiation therapy with excellent local control. Although the technique is being increasingly used in clinical practice, the optimal fractionation schedule remains uncertain. In this perspective paper, we review radiobiologic principles that support the use of multiple- versus single-fraction spine stereotactic body radiation therapy schedules and clinical data supporting the multiple-fraction approach. Specifically, we suggest that there may be a local control benefit of fractionation, while helping to limit the risk of toxicities such as vertebral body fracture, pain flare and radiation myelopathy. We conclude with future directions and the need for future study on this important topic.

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

    Science.gov (United States)

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

    2015-01-01

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

  20. Automating the Analysis of Spatial Grids A Practical Guide to Data Mining Geospatial Images for Human & Environmental Applications

    CERN Document Server

    Lakshmanan, Valliappa

    2012-01-01

    The ability to create automated algorithms to process gridded spatial data is increasingly important as remotely sensed datasets increase in volume and frequency. Whether in business, social science, ecology, meteorology or urban planning, the ability to create automated applications to analyze and detect patterns in geospatial data is increasingly important. This book provides students with a foundation in topics of digital image processing and data mining as applied to geospatial datasets. The aim is for readers to be able to devise and implement automated techniques to extract information from spatial grids such as radar, satellite or high-resolution survey imagery.